Two Catholic health care groups are urging the public to resist a measure to advance assisted suicide.
The National Association of Catholic Nurses (NACN), with the support of the Catholic Medical Association (CMA), are urging the public to submit comments in opposition to a proposed position statement of the American Nurses Association (ANA) that recommends nurses directly or indirectly assist patients seeking "aid in dying" (AID).
The ANA's proposed position statement, "The Nurse's Role When a Patient Requests Aid in Dying," seeks "to provide nurses with ethical guidance in response to a patient's request for aid in dying (AID)" by offering guidelines for "understanding nurses' ethical obligations and responsibilities amidst social and legislative shifts which make this option legal in an increasing number of U.S. jurisdictions."
Responding to this purpose statement, the NACN's downloadable line-by-line response to the ANA's proposal notes, "To refer to the decriminalization of assisting another person to kill themselves, which is what 'aid in dying' does, as a mere 'legislative shift' minimizes the dramatic reversal of long-standing law and ethics."
The NACN's response adds, "This suggests that the ANA either underestimates the importance of this fundamental change it is proposing for nursing and society or the ANA is playing it down in the hope to more easily gain acceptance of it, both of which are dangerous and wrong."
AID is currently legal in six states (California, Colorado, Hawaii, Montana, Oregon, Vermont and Washington) and the federal District of Columbia, while lawmakers are considering it in 21 other states this year/session.
The ANA's proposed position statement distinguishes between "aid in dying" and "euthanasia" based on the technical definitions of the terms as well as current legislation:
Laws that allow aid in dying permit the adult patient with terminal illness and capacity for medical decision making to self-administer oral or enteral medication to end suffering when certain criteria are met. Euthanasia, which is not legal in the United States, occurs when someone other than the patient administers medication in any form, with the intention to hasten the patient's death.
The proposal then states that euthanasia violates public trust and is inconsistent with the core commitments of the nursing profession, but does not extend those notions to AID.
The NACN's response finds this distinction somewhat spurious since there is no moral difference between euthanasia and AID:
Whether the nurse finds a physician who writes the lethal prescription, picks up the lethal drug at the pharmacy, or hands the cup of lethal drug to the patient for him to drink (AID) or whether the nurse holds that same cup to the patient's mouth so that he ingests it (euthanasia), the nurse is responsible for the death of the patient, either as an accomplice (AID) or as an agent (euthanasia).
Though the ANA proposal has a section on conscientious-based refusals and acknowledges a nurse's prerogative to conscientiously object, the document also states, "Nurses unable to provide care on moral grounds should ensure the ongoing care of the patient by identifying nurse colleagues willing to do so."
The NACN's response explains that allowing for non-participation based on conscientious objection while suggesting nurses have a duty to participate by referring patients is illogical.
"To say that it is morally permissible for a nurse to serve as an accomplice to killing but not as the killer is logically inconsistent and not supported by law or ethics," states the response.
On March 25, the Aid in Dying for the Terminally Ill Act (A1504/S1072) passed the New Jersey Assembly and Senate and currently awaits the signature of Gov. Phil Murphy, meaning New Jersey is poised to become the eighth jurisdiction to legalize AID, also known as "physician-assisted suicide."
Church Militant discussed the ANA's proposal with Judy Dauer, a Catholic registered nurse who works in the intensive care unit at Robert Wood Johnson University Hospital in Somerset, New Jersey.
"As a nurse, my obligation is to help a patient at any cost," she said. "Referring a patient to a nurse who would ask a doctor to prescribe lethal medication is more or less the same as asking the doctor myself."
"I would not want to have that on my conscience," she added.
Catholic moral teaching on AID and euthanasia is straightforward: "Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator."
Based on this teaching, Dr. Marie Hilliard, co-chair of the CMA's Ethics Committee, is able to state, "AID is not care and is the ultimate abandonment of a patient. Forcing the nurse to facilitate AID makes the nurse complicit in such abandonment."
The NACN and CMA are urging the public to submit comments to voice opposition to ANA's position proposal by leaving public comments at the ANA website, which is accepting comments until April 8.