Nurses live with death every day. It becomes routine, but routine doesn't mean our hearts hurt any less when a patient passes, or that we feel any less joy when one heals. We get emotionally exhausted. We tire of suffering. Sometimes we wish it would end sooner. Sometimes we wish we could end it ourselves.
Euthanasia is intentionally ending a life by administering lethal medication. Animals are "put to sleep" at the vet to end needless suffering, and we call that humane. Society praises a peaceful end to an animal's suffering but condemns the same act for a human being. Those with a religious background often call it murder, and by legal definition murder is the intentional ending of life, sometimes with statutory weight added for malice aforethought, premeditation, or a death that occurs during another serious crime.
I once cared for a patient with end-stage cancer. He was under hospice care on a morphine drip, and he still suffered. His family suffered. For three weeks he fought for breath and struggled with pain the morphine couldn't reach. More than once I questioned the rightness of letting him suffer like that, and the immorality of bringing an inevitable end much sooner. Nurses are supposed to show mercy. My heart hurt.
But what about murder? If you hold to common law, intentionally ending a human life with malice aforethought and premeditation is murder. What if you argue that euthanasia carries no malice, only mercy? No person without legally vested authority gets to be judge, jury, and executioner over another. For those who practice religion, only God holds the authority to take a human life, and in specific cases He vests that authority in governments. In the Christian tradition, God permits suffering and uses it for His purposes, and mere mortals are in no position to question Him.
We take an oath to do no harm. We're also called to be merciful and compassionate. So is the euthanasia of a dying person an act of unspeakable harm, or unspeakable mercy?
Frequently Asked Questions
What is the difference between euthanasia and medical aid in dying? Euthanasia is a clinician directly administering a lethal medication to end a patient's life. Medical aid in dying (MAID) is different: a terminally ill, mentally capable adult self-administers medication that a physician prescribed for that purpose. The ANA treats the two as separate practices.
Is euthanasia legal in the United States? No. Euthanasia is illegal in every U.S. state. Medical aid in dying is a separate practice that is legal in a small number of states and Washington, D.C., each with strict eligibility rules around terminal diagnosis, mental capacity, and self-administration.
Can a nurse take part in euthanasia or assisted suicide? Under the ANA Code of Ethics for Nurses, nurses may not act with the sole intent of ending a patient's life, so administering euthanasia or aid-in-dying medication conflicts with the Code. Nurses can still provide aggressive pain and symptom relief, even when that care is intended to ease suffering rather than hasten death.
What should a nurse do when a patient asks to die? The ANA's 2019 position statement asks nurses to respond with compassion, explore the reasons behind the request, make sure pain and symptoms are well managed, involve the care team, and never abandon the patient.
Does the ANA take a position on this? Yes. The ANA prohibits nurse participation in administering lethal medication, but its 2019 statement urges nurses to stay objective and present rather than judgmental when patients explore their end-of-life options.
What is palliative care's role here? The ANA encourages nurses to focus on palliative care and pain management as the ethical response to suffering, advocating for better access to quality end-of-life care that protects patient dignity.