Thank you for your article, "Assisted Suicide: Unraveling a Complex Issue" (April 2005). As a home care nurse, I'm caring for a ventilator-dependent patient with end-stage amyotrophic lateral sclerosis. Last month, she clearly told her primary care provider that she wanted to be taken off the ventilator and allowed to die with dignity at home on a chosen day. She was awake, alert, oriented, and not under the influence of any mind-altering medications. The gentle, loving conversations I witnessed put her in control of where, when, and how her life will end. With the support of her family, she'll die on her chosen day.

This situation has raised many questions for her nurses. Although we all understand our patient's decision, we still struggle with the legal, ethical, and moral issues of supporting her. I've brought her plans to the attention of my supervisors and my state board of nursing, but have gotten no reply. So I'm grateful for your article, which answered many of our questions.

NAME WITHHELD BY REQUEST

One good thing that may have come from the Terri Schiavo situation is that now we can talk about end-of-life issues. All life will end. It's not optional. The drama is in how we go about it.

I worked as a hospice nurse for 14 months, and it was the most inspirational and fulfilling experience in my 36-year nursing career. I personally could never knowingly hasten a death, and I don't know how I would respond if someone asked me to "help end the suffering." I can, however, respect a person's wishes not to prolong the dying process with tube feedings, mechanical ventilation, and other futile measures when there's no quality of life as defined by that person. And if a person tells me that she wants to exist in a condition such as Terri Schiavo's, I can respect that too.

As medicine advances, the choices will become more numerous and confusing. Each situation must be decided on unique and individual merits. Just because we can do something, doesn't mean we should. The dialogue must go on and on. There will never be one answer for everyone.

GAIL BATSON, RN, BSN

Natchitoches, La.

The word dignity is defined by Webster's as "being worthy of esteem or honor." I see nothing worthy of esteem or honor in taking a human life, either one's own or someone else's. The state of Oregon's so-called "Death With Dignity Act" is a clever, disgraceful euphemism.

I believe humans possess a soul, unlike animals and plants. No person has the right to determine when a life on this earth is over. This right belongs only to God. There's nothing dignified about anyone usurping this authority.

I agree with the American Nurses Association's position that "offering patients assistance in dying isn't compatible with a nurse's role."

FANNIE KAPP, LPN

Millville, Pa.

Assisted suicide is legal only in Oregon, and nurses in other states shouldn't be participating in it. It's imperative that nurses be familiar with their state's laws and guidelines about end-of-life issues and to support patients and families in a nonjudgmental way.

Cultural, ethical, and religious beliefs affect each person differently, and nurses must look deep within themselves and sort out how they feel about assisted suicide. Nurses should prepare themselves before they take care of a patient in this type of situation.

Assisted death is very controversial, and it's the responsibility of each person to make her end-of-life wishes known. An advance directive is a good way to do this.

LAUREL ALMQUIST, RN

Mashpee, Mass.

I have no issue with true end-of-life (EOL) care. But assisted suicide isn't care, it's the elimination of those who need care. True EOL care includes aggressive pain control, counseling, and spiritual support, not a cost-saving bolus of potassium chloride.

SARAH W. NORDHOLM, LPN

West Palm Beach, Fla.

Assisted suicide isn't complex, it's wrong!! We should be caring for people, not taking it into our own hands to get rid of them. If they need emotional or financial help, we should provide it, not kill them. Oregon was wrong to legalize assisted suicide. This law is not life, liberty, and the pursuit of happiness. It encourages murder.

DONNA M. HAGAN GILDEMEISTER, RN

Burnsville, Minn.

Assisted suicide is a topic of great interest to me as a disabled man. If you look at the statistics in your article about why people want to die, they're reasons I deal with daily, such as losing independence, not enjoying life, and loss of dignity. I have all those reasons to die too. But I have found a reason to live by growing intellectually, emotionally, and spiritually from my disability. A disabled life is still worth living.

RICH SALAZAR

DeKalb, Ill.

I'm in favor of assisted suicide. If a patient's fully informed, conscious of what his decision entails, and meets a set of requirements proving his mental health and capacity, his wishes and rights should be respected. In a country such as this, based on liberty, what right does anyone have to force his personal views onto another person? After all, living in America is supposed to guarantee that our rights are respected.

GRETE PELEPKO, NURSING STUDENT

Lebanon, Pa.

Individual liberty isn't the freedom to make any choice possible; rather, it's the freedom to do right.

The axiom that the end doesn't justify the means applies very well to this issue. The seemingly beneficent end of relieving suffering isn't justified by the means-setting aside the sanctity of human life, the morality of preserving life, and the spiritual value of human suffering.

ROSE U. BAKER, RN, CS, MSN

Akron, Ohio

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