Assisted suicide is a deliberate act or omission, undertaken with the intention of helping someone to end their life. Such an act is not within the remit of health professionals, and is illegal in Australia.

Palliative care is aimed at supporting people at the end of their life. This may include for example, withholding or withdrawing futile treatment, which is not considered to be euthanasia or assisted suicide. Care of terminally ill patients that is lawful, never involves an intention to end a patient’s life.

Nurses working in palliative care are sometimes asked by patients to help them to ‘end it all’. This is called assisted suicide (or Euthanasia if they ask you to do it for them). These requests can be made when someone is depressed or emotionally distressed. Sometimes they may feel that they are a burden. Sometimes things are said in the heat of the moment, such as when in pain or short of breath, and other times things have been thought about carefully, such as deciding something is intolerable. 

If someone is talking of taking their own life, whether or not they are asking for help to do it, this situation needs to be addressed urgently. Sitting down and listening to their concerns and fears can help find out how they have come to make this request. Talking to others within the health care team whenever possible, provides a multidisciplinary approach to a situation that shouldn’t rest with one practitioner.

Resources

• End of Life / Palliative Education Resource Centre (EPERC) Fast Facts
  • Evaluating requests for hastened death
  • Responding to a request for hastening death
• The Southern Cross Bioethics Institute website provides access to information on bioethical legislation in Australia, much of which is relevant to palliative care. It can be different in each State and Territory, such as the Consent to Medical Treatment and Palliative Care Act 1995 (SA) and the Medical Treatment Act 1994 (ACT).
• The Australian Medical Association has information on the role of the medical Practitioner in end-of-life care (2007)
• The truth about dying explores some end of life ethical concepts around dying in the ABC's Unleashed radio show.
• The International Association of Hospice and Palliative care IAHPC Manual of Palliative Care 2nd Edition has a section on Ethical Issues. 
• The Center for Bioethics, University of Minnesota (US) has a document: End of Life Care: An Ethical Overview 
• A National Ageing Research Institute (vic) presentation on Information on the Medical Treatment Act and Guardianship and Administration Act in end-of-life decision making

Position Statements

• The Royal College of Nursing Australia has a position statement on voluntary euthanasia and assisted suicide (Reviewed 2006)
• The Australian Nurses Federation has a position statement on voluntary euthanasia and assisted suicide. 
• Palliative Care Australia has a position statement on voluntary euthanasia and physician assisted suicide.
• The Australian Psychological Society has a position paper on Psychological perspectives on euthanasia and the terminally ill (Updated 2008)
• NSW Health has produced Guidelines for end-of-life care and decision-making

Related CareSearch pages

Nurses Hub
Euthanasia
Communication
Advanced Care Planning
Working with Families
Symptom Management

GP Pages
Communication

For Patients and Families
Communication

CareSearch Review Collection
Desire for Hastened Death

Free Full Text Article

Oncology Nursing Society. Nurses' responsibility to patients requesting assistance in hastening death. Oncol Nurs Forum. 2007 Jul;34(4):763-4.

References

• Schwarz JK. Responding to persistent requests for assistance in dying: a phenomenological inquiry. Int J Palliat Nurs. 2004 May;10(5):225-35; discussion 235.
• Bilsen JJ, Vander Stichele RH, Mortier F, Deliens L. Involvement of nurses in physician-assisted dying. J Adv Nurs. 2004 Sep;47(6):583-91.
• King P, Jordan-Welch M. Nurse-assisted suicide: not an answer in end-of-life care. Issues Ment Health Nurs. 2003 Jan-Feb;24(1):45-57. No Abstract Available.
• Schwarz JK. Understanding and responding to patients' requests for assistance in dying. J Nurs Scholarsh. 2003;35(4):377-84. 
• Matzo ML, Schwarz JK. In their own words: oncology nurses respond to patient requests for assisted suicide and euthanasia. Appl Nurs Res. 2001 May;14(2):64-71. 

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This page was created on 27 August 2010
Last updated 27 August 2010*