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Euthanasia, Assisted Suicide, and Aid in Dying Date

Euthanasia, Assisted Suicide, and Aid in Dying Date: April 24, 2013

Status: Revised, Combined Position Statement

Originated by: ANA Center for Ethics and Human Rights

Adopted by: ANA Board of Directors

Purpose: Historically, nurses have played a key role in caring for patients at end-of-life across

healthcare settings. Nurses provide expert care throughout life’s continuum and at end-of-life in

managing the bio-psychosocial and spiritual needs of patients and families both independently and in

collaboration with other members of the interprofessional healthcare team. While resources do exist to

educate and support nurses in this role, there are limited resources to assist nurses in understanding and

responding to patient and family questions related to euthanasia and assisted suicide.

The purpose of this position statement is to provide information that will describe the nurse’s ethical

obligations in responding to requests for euthanasia and assisted suicide, define these terms, support

the application of palliative care nursing guidelines in clinical practice, and identify recommendations for

nursing practice, education, administration, and research.

Statement of ANA Position: The American Nurses Association (ANA) prohibits nurses’ participation

in assisted suicide and euthanasia because these acts are in direct violation of Code of Ethics for Nurses

with Interpretive Statements (ANA, 2001; herein referred to as The Code), the ethical traditions and goals

of the profession, and its covenant with society. Nurses have an obligation to provide humane,

comprehensive, and compassionate care that respects the rights of patients but upholds the standards

of the profession in the presence of chronic, debilitating illness and at end-of-life.

History/previous position statements: ANA adopted position statements on Euthanasia and

Assisted Suicide originated by the Task Force on the Nurse’s Role in End-of-Life Decisions, Center for

Ethics and Human Rights on December 8, 1994.

Supersedes: Position Statements: Assisted Suicide (12/08/94); Active Euthanasia (12/08/94).

ANA Position Statement (04/24/13) Page 2 Euthanasia, Assisted Suicide, and Aid in Dying

Supportive Materials

ANA’s Foundational Documents

Code of Ethics for Nurses with Interpretive Statements

Provision 1, Interpretive Statement 1.3 of The Code (2001) speaks to the nurse’s commitment to the

inherent:

“… worth, dignity and rights of all human beings irrespective of the nature of the

health problem. The worth of the person is not affected by death, disability,

functional status, or proximity to death. This respect extends to all who require

the services of the nurse for the promotion of health, the prevention of illness, the

restoration of health, the alleviation of suffering, and the provision of supportive

care to those who are dying” (p. 12).

In a succeeding paragraph, the statement goes on to say that:

“… nursing care is directed toward meeting the comprehensive needs of patients

and their families across the continuum of care. This is particularly vital in the care

of patients and families at the end-of-life to prevent and relieve the cascade of

symptoms and suffering that are commonly associated with dying…Nurses may

not act with the sole intent of ending a patient’s life even though such action may

be motivated by compassion, respect for patient autonomy and quality of life

considerations” (p. 12).

Nursing’s Social Policy Statement: The Essence of the Profession

In the section entitled, “Knowledge Base for Nursing Practice” of this document, it states that “Nurses are

concerned with human experiences and responses across the life span. Nurses partner with individuals,

families, communities, and populations to address issues such as….physical, emotional, and spiritual

comfort, discomfort, and pain…emotions related to the experience of birth, growth and development,

health, illness, disease, and death….decision-making and the ability to make choices” (2010b, pp.13-14). In

its discussion of the Code of Ethics for Nurses, the section entitled, “Standards of Professional Nursing

Practice”, Social Policy Statement clearly states that “although the Code of Ethics for Nurses is intended to

be a living document for nurses, and health care is becoming more complex, the basic tenets found within

this particular code of ethics remains unchanged” (2010b, p. 24).

Nursing: Scope and Standards of Practice, 2nd Edition

Standard 7, under the heading “Standards of Professional Performance,” reiterates the moral obligation of

the nurse to practice ethically and to provide care “in a manner that preserves and protects healthcare

consumer autonomy, dignity, rights, values, and beliefs” and “assists healthcare consumers in self

determination and informed decision-making” (2010a, p. 47).

ANA Position Statement (04/24/13) Page 3 Euthanasia, Assisted Suicide, and Aid in Dying

Other Supporting Material

Palliative and hospice care provide individualized, comprehensive, holistic care to meet patient and family

needs predicated on goals of care from the time of diagnosis, through death, and into the bereavement

period. The following excerpt from this document emphasizes the role of palliative nursing care in the

nurse’s recognition and relief of symptoms within his or her professional boundaries and in a manner

consistent with safe, competent, ethical nursing practice:

“…Palliative care recognizes dying as part of the normal process of living and

focuses on maintaining the quality of remaining life. Palliative care affirms life

and neither hastens nor postpones death. Palliative care exists in the hope

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