I had a new experience at work yesterday. For those who don't know, I am a home health nurse. I was called out to see a patient who had fallen in the night and had refused to go to the ER even though he complained of pain in his hip after the fall.
Well, the fall was the least of his problems. He was very depressed due to advanced stages of his illnesses. He couldn't sleep, he was in diapers, he had a hard time breathing (due to the fluid build up in his lungs from the heart disease), and had frequent chest pain. I see people like this daily but this one was different. His body had different reactions to medications and there weren't many that he was responsive to. When he took pain meds to relieve his arthritis pain, then it made his breathing slow down to the point that he was gasping. If he didn't take pain medications then his pain was almost unbearable and he couldn't sleep. When he didn't sleep it made his already weakened heart work harder. Any sleeping pill he has taken up to this point actually caused insomnia. I could go on, but you get the picture.
Then he tells me that he has decided to kill himself. His wife and sister are standing there and become upset. He asked his sister to go get the gun that he had and , I kid you not, she went and got the damn thing!!! I started talking to him, and thankfully his sister came to her senses and took the loaded gun out of the house. I told him that I had to send him to the hospital at this point for being a danger to himself, at which point he said that he was not ever going to get any better (he is right) and he didn't want to go on like this, that he couldn't take the torture of his life any more. Why should he continue to live.

And I couldn't think of any reason.

If it had been me I would want to do the same thing. But as a professional, I had to intervene and start the wheels moving to prolong his already miserable life. I, by law, had to prolong this man's suffering.
Naturally I wouldn't have permitted him to blow himself away in front of his family. That way out is cowardly, leaving remains like that for his family to have to deal with.

My dilemma is that I know that I had to abide by the law and all the rules of my license, but I don't think I helped this man any. I could not give him any comfort, and actually have prolonged his suffering.

What are your thoughts and feelings if this had been you.

That's why I'm not a nurse or doctor... best policy to live without worries (I know this sounds stupid and even mean) is to not see in the first place this kind of cases.

This is quite a difficult situation, one that many of my colleagues also encounter. Not I though, yet. However I do have a client who would want to die, but she is not as far gone physically as this client of yours is.

I have suggested things to people, in the past, outside of my job. Things that are hard to decide on whether or not one should tell. Most of the time people already know all the things they can do with medication. Part of me however thinks: if a person is really willing to give up, the body would correspond and act on it.

I don't have anything to prove this statement, save for myself when I was so depressed my body took care of the healthy part and made it sick, dropping 30kg in a month's time. If he -really- doesn't want to live anymore, I think he would have insisted on the gun, regardless.

You are in between a person's wishes, the law, the rules that your employer puts on you, and the family members. I'd say all you could suggest is to tell the client to pick a less messy way, to think of the relatives who have to do the clean up. Usually they either snap out of it, or they act accordingly in due time.

It's a tough situation. Good luck!

that's awful. i feel for both of you!
if i were in his shoes, i think i would feel exactly the same as your patient.
i wouldn't want to have no quality of life either.
you both must be frustrated.

what are the laws where you live? can his doctors do something other than prolong his misery? and how does his family feel?; have you ever had a chance to talk about him to his family privately?

Wouldn't an intentionally accidental overdose be a good way do go? No pain, no mess, no way to prove it was intentional (maybe he forgot that he had already taken a dose).

But yeah, I can see where that situation would be impossible for everyone. If euthanasia were legal here, it wouldn't be such a dilemma. At least not for me. I beleive terminally ill patients should be able to end their lives in a dignified manner.

Just my 2 cents