Author Information
To obtain copies of HPNA Position Statements, contact the national office at: Penn Center West One, Suite 229, Pittsburgh, PA 15276; phone: (412) 787-9301; fax: (412) 787-9305; Web: http://www.HPNA.org.
In HPNA's role as the lead organization in end-of-life and palliative nursing care, the Board of Directors will sometimes adopt a position statement on an issue of importance to the membership. Such statements can be written in support of or in opposition to a specific position. There also is the option of deciding not to take a position but rather to acknowledge both the pros and cons of the issue. A position statement is intended to represent the position of the Association's membership on the issue. Once adopted by the Board, the position becomes the official statement that Directors and National Office staff use when asked to comment on the issue.
In the coming year, the Board of Directors will be assessing the need for additional position statements on key issues related to end-of-life and palliative care. We welcome your feedback on key issues that the Board should address through a position statement. Please e-mail your feedback to me at [email protected] or call me at 207-780-4404.
The Association's existing position statements are available on our Web site at http://www.hpna.org. Below is HPNA's 2001 position statement on the legalization of assisted suicide, which was originally adopted in 1994. This statement serves to exemplify the need to periodically revisit previously adopted position statements to assure that they truly reflect the voice of the membership.
HPNA POSITION STATEMENT: LEGALIZATION OF ASSISTED SUICIDE
Background
In 1992, hospice nurses returned a Hospice Nurses Association (HNA) survey on assisted suicide and active euthanasia. Of the respondents, 76% expressed a desire that HNA develop a position statement on assisted suicide. In 1994, the HNA Board of Directors adopted a position opposing the legalization of euthanasia and assisted suicide. The 1994 position was unique in that it supported open discussion and continued dialogue on these controversial issues.
In 2001, the Hospice and Palliative Care Nurses Association (HPNA) Board of Directors elected to revisit the position statement given the enactment of Oregon's Death With Dignity Act and the fact that numerous other states had, or were facing, legislative attempts to legalize physician-assisted suicide. Faber-Langendoen and Karlawish pose the question, "Should assisted suicide be only physician- assisted suicide?"1(p482) These authors further assert, "Assisted suicide requires physician involvement, but physicians' limited competence in performing the full range of tasks, the competencies of other professions, and the possibility that other professions could expand their authority in this area, suggest that physician- assisted suicide is a far too narrow construct of the task."1(p482) Recognizing the importance of this issue for palliative care and hospice nurses, the Board felt it was essential to reevaluate the 1994 position statement.
Position Statement
The Hospice and Palliative Nurses Association is committed to compassionate care of persons at the end of life. It is the position of the HPNA Board of Directors to:
* Oppose the legalization of assisted suicide.
* Affirm the value of end-of-life care, which includes aggressive and comprehensive symptom management.
* Affirm that "nurses must be vigilant advocates for humane and ethical care for the alleviation of suffering and for the non-abandonment of patients."2
* Support public policy that ensures access to hospice and palliative care for persons facing the end of life.
* Direct those nurses practicing in state(s) where assisted suicide is legal, that "the nurse may choose to continue to provide care or may withdraw from the situation after transferring responsibility for care to a nursing colleague."3(p442)
Definition of Terms: Assisted Suicide
The American Nurses Association defines assisted suicide as follows:
Suicide is traditionally understood as the act of taking one's own life. Participation in assisted suicide entails making a means of suicide (eg, providing pills or a weapon) available to a patient with knowledge of the patient's intention. The patient who is physically capable of suicide, subsequently acts to end his or her own life. Assisted suicide is distinguished from active euthanasia. In assisted suicide, someone makes the means of death available, but does not act as the direct agent of death.2
Schwarz defines assisted suicide as follows:
Assisted suicide is the provision of the means to end life, for example, a prescription for a lethal amount of drug, the lethal drug itself, or other measures, to an adult who is capable of ending life, with knowledge of that person's intentions.4(p368)
Approved by the HPNA Board of Directors June 3, 2001.
References