As a member of the American Academy of Nursing's Bioethics Expert Panel, I thank AJN for presenting various perspectives on a contentious and ethically sensitive topic ("Assisted Suicide/Aid in Dying: What Is the Nurse's Role?," May). It is likely that clinical nurses and NPs will receive requests from patients and families asking for help in dying, especially when there is a sense of prolonged suffering-physical, psychological, economic, spiritual, or a combination of these.

Nurses are the eyes and ears at the bedside. Each nurse will have to decide what to do when faced with an ethically challenging situation that may foster uncertainty, disagreement, and conflict. As we see from the authors' viewpoints, there is an ethical tension associated with navigating requests for assistance in ending one's life while protecting the moral and professional integrity of those who are being asked.

Providing an open and transparent dialogue that presents both the benefits and the challenges of a particular ethical issue helps the profession address thorny questions regarding the everyday ethical challenges of nursing practice. Nursing's voice is critical to patients; it is no less significant to a society struggling with the morality of assisted suicide/aid in dying. Nurses must be part of the dialogue that affects the broader citizenry. Let us not be afraid to tackle the hard ethical issues that come before us as a profession-Ann Hamric and her colleagues have provided us with a unique opportunity to do just that.

Connie M. Ulrich, PhD, RN

Lillian S. Brunner Chair

Professor of Bioethics and Nursing

University of Pennsylvania Schools of Nursing and Medicine, Philadelphia