End-of-Life Issues...Death Row Style
Yesterday, I heard a very interesting piece on Here and Now, a daily news show produced at WBUR in Boston. I admit it...I am addicted to NPR.
The piece coincided with yesterday's publication of an article in the New England Journal of Medicine about doctors participating in executions. Dr. Atul Gawande presented his argument against health care providers' participation in lethal injections. I abhor the death penalty. Beside the fact that it seems to be completely useless as either a punishment or a deterrent, I believe it violates the Golden Rule, is inhumane and cannot be retracted in the presence of exonerating evidence. You can't exactly say, "Whoops! We were wrong...let us make it up to you," once someone is six feet under in the prison cemetary.
Imagine my surprise when I heard the dissenting opinion of Dr. Carlo Musso, a prison physician in Georgia who is a former ED physician. (If you prefer to listen to Dr. Musso's interview, please follow this link.) I've worked in Emergency Nursing for nearly five years now and have come to have a great respect for most of the physicians with whom I've worked. Dr. Musso considers caring for a patient prior to and during executions an issue of end-of-life care. This intrigues me, largely because of his background in Emergency Medicine. I believe he's right. You know...it doesn't get any more clearly end-of-life than when one has a predetermined date for ones demise.
I care for people at the end of their lives. It comes to me in the form of the 40-something who has overdosed on one substance or another, the 89 year-old whose family must make the decision to discontinue life support, the young trauma victim. It's come to me recently in the form of my father. Some of my most gratifying moments in nursing came early in my career, when I worked in Gyn/Gyn-Onc.
(Aside: Please take note of the following non-discrimination policy on the nursing employment opportunities page from Cooper University Hospital's website...
"It is the policy of Cooper University Hospitalnot to discriminate on the basis of race, creed, color, national origin, nationality, ancestry, age, sex, marital status, familial status, affectional or sexual orientation, atypical heredity cellular or blood trait, liability for military service, or mental or physical handicap."
... I am the reason the term, "affectional or sexual orientation" in now included in Cooper's non-discrimination language. During the negotiations for our local's first contract with The Cooper Health System, in the fall of 2000, I fought tooth-and-nail to have that language added to Cooper's policy. I didn't win at that time...they opted for more benign terminology about compliance with all relevant local, state and federal non-discrimination laws. I was very happy and proud, when I hopped on over to Cooper's site for a citation for this post, to see my exact language in their current policy. It's nice to see ones legacy continue.)
Back on track now...we were talking about end-of-life care. I miss developing a relationship with the women on my Gyn/Gyn-Onc floor who would ultimately pass away in my care. I got to know their families. I got to know my patient's desires and was instrumental in seeing they had what they wanted, as much as was in my power, at the end of their lives. The woman, with metastatic ovarian cancer in her abdomen, so extensive that she could neither eat nor drink, had a naso-gastric tube in place - through her nose into her stomach - because she had no room for anything else in there due to the size of the tumor. All she wanted was to drink...a Coke. Why not? I arranged that. She had a fizzy, fountain Coca-Cola with ice. I made sure of it. She died within hours of that, with her family at her bedside. She died on my shift. Her family hugged me when they left, in the early hours of the morning. Her name was Pat and this was 20 years ago. Pat was 43 years old.
Why do my patients deserve more than the men or women in prison who are at the end of their lives? Shouldn't death row inmates also receive care that is compassionate? Why shouldn't they get their fondest, simple wishes granted before they die? Why shouldn't they have their IV put in by someone who cares about them, not a detached, anonymous executioner? Are they any less important than Pat?
It's an interesting perspective.
The piece coincided with yesterday's publication of an article in the New England Journal of Medicine about doctors participating in executions. Dr. Atul Gawande presented his argument against health care providers' participation in lethal injections. I abhor the death penalty. Beside the fact that it seems to be completely useless as either a punishment or a deterrent, I believe it violates the Golden Rule, is inhumane and cannot be retracted in the presence of exonerating evidence. You can't exactly say, "Whoops! We were wrong...let us make it up to you," once someone is six feet under in the prison cemetary.
Imagine my surprise when I heard the dissenting opinion of Dr. Carlo Musso, a prison physician in Georgia who is a former ED physician. (If you prefer to listen to Dr. Musso's interview, please follow this link.) I've worked in Emergency Nursing for nearly five years now and have come to have a great respect for most of the physicians with whom I've worked. Dr. Musso considers caring for a patient prior to and during executions an issue of end-of-life care. This intrigues me, largely because of his background in Emergency Medicine. I believe he's right. You know...it doesn't get any more clearly end-of-life than when one has a predetermined date for ones demise.
I care for people at the end of their lives. It comes to me in the form of the 40-something who has overdosed on one substance or another, the 89 year-old whose family must make the decision to discontinue life support, the young trauma victim. It's come to me recently in the form of my father. Some of my most gratifying moments in nursing came early in my career, when I worked in Gyn/Gyn-Onc.
(Aside: Please take note of the following non-discrimination policy on the nursing employment opportunities page from Cooper University Hospital's website...
"It is the policy of Cooper University Hospitalnot to discriminate on the basis of race, creed, color, national origin, nationality, ancestry, age, sex, marital status, familial status, affectional or sexual orientation, atypical heredity cellular or blood trait, liability for military service, or mental or physical handicap."
... I am the reason the term, "affectional or sexual orientation" in now included in Cooper's non-discrimination language. During the negotiations for our local's first contract with The Cooper Health System, in the fall of 2000, I fought tooth-and-nail to have that language added to Cooper's policy. I didn't win at that time...they opted for more benign terminology about compliance with all relevant local, state and federal non-discrimination laws. I was very happy and proud, when I hopped on over to Cooper's site for a citation for this post, to see my exact language in their current policy. It's nice to see ones legacy continue.)
Back on track now...we were talking about end-of-life care. I miss developing a relationship with the women on my Gyn/Gyn-Onc floor who would ultimately pass away in my care. I got to know their families. I got to know my patient's desires and was instrumental in seeing they had what they wanted, as much as was in my power, at the end of their lives. The woman, with metastatic ovarian cancer in her abdomen, so extensive that she could neither eat nor drink, had a naso-gastric tube in place - through her nose into her stomach - because she had no room for anything else in there due to the size of the tumor. All she wanted was to drink...a Coke. Why not? I arranged that. She had a fizzy, fountain Coca-Cola with ice. I made sure of it. She died within hours of that, with her family at her bedside. She died on my shift. Her family hugged me when they left, in the early hours of the morning. Her name was Pat and this was 20 years ago. Pat was 43 years old.
Why do my patients deserve more than the men or women in prison who are at the end of their lives? Shouldn't death row inmates also receive care that is compassionate? Why shouldn't they get their fondest, simple wishes granted before they die? Why shouldn't they have their IV put in by someone who cares about them, not a detached, anonymous executioner? Are they any less important than Pat?
It's an interesting perspective.
posted by Cheryl at
3/24/2006 03:17:00 PM
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