Santa Rosa, Calif.
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Physician-assisted suicide: A matter of choice
I was dismayed to read all the negative feedback, including the famous phrase “I cancelled my subscription,” regarding “Physician-Assisted Suicide: A Nurse's Perspective” (March, 2014).∗ No nurse has to participate if he or she has moral objections. No physician has to offer the advice and prescriptions if he or she objects. Physicians don't advertise PAS, but patients do seek it.
I treasure the miracle of life, but I've also seen enough patients in my 45 years in nursing to know there are certain diagnoses and diseases that I don't want to experience if I have any choice in the matter. Most of our patients don't fear death, but they do fear how long and how unpleasant the process may be for them and their loved ones. Yes, pain, dyspnea, nausea, constipation, and pressure ulcers can all be addressed, but I wouldn't want an extended period of helplessness, dependency, and other declines that often accompany the dying process. I'd choose to shorten that process with medications, and I've discussed that with my daughters, two of whom are nurses as well.
It's not necessarily our place to suggest this option to patients with life-ending diseases, but it's also not our place to tell them they're wrong. It's a personal decision.
Don't stop yearly appointments
This is in response to “Screening Mammography: Study Calls For ‘Urgent’ Policy Reassessment” (Clinical Rounds, April, 2014).∗ This nurse is going to continue to recommend annual screening mammograms to friends, family, and patients. Why? Because I'm currently recovering from surgery for ductal carcinoma in situ with an invasive component, which was found on a screening mammogram. It was too small to be palpated and wasn't detectable on ultrasound. To me, it makes no sense to wait until a lesion is big enough to be palpated to begin treatment, which could potentially be more involved at that stage. I understand that for a large percentage of women, the annual mammogram is unnecessary, but when you're one of the women who benefits from the yearly appointment, it does make a difference.
I hope this study (and others like it) won't lead insurance companies to refuse to pay for annual mammograms.
—Sherrill Dunning-Riley, BSN, RN, CDE, CEN
Santa Rosa, Calif.
—Susan Merryfield, RN, CCRN