Do-Not-Resuscitate Orders in Suicide Attempts

"More people in the general population die from suicide than homicide in North America. There are almost 11 suicide deaths each year for every 100,000 people living in the United States, and for every suicide, there are between 8 and 25 attempts" (Brent 4203). Based on this research, the great effect of suicide is displayed. According to dictionary.com, suicide can be defined as "the intentional taking of one's own life." Suicide is a major issue for all people, but it most obviously affects those ranging from ten to twenty-four. People need to understand the tremendous ramifications caused from suicide everyday; when people take their lives, others lose their loved ones. Suicide, one of the leading causes of death of numerous people each day, has reached a crisis point for adolescents and young adults, and it needs to be prevented.

The rate of suicide, the act or an instance of taking one's own life voluntarily and intentionally, increases each year. “More adolescents die each year from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease, combined” (Preventing Teen Suicide, 2016, p.2). These facts show suicide is a serious problem among teens. Last year, teen suicide became the second leading cause of death in the United States confirming the significant increase in teen suicides.

The United States takes the eleventh spot in the top fifteen causes of death because of suicide. For our youth suicide is the third leading cause of death. In today’s society suicide in our youth is becoming a huge issue. Recently, youth suicide in Delaware has been a concerning topic. With the many suicides that have been taking place; we ask ourselves why is this happening to Delaware’s youth? It’s quite sad reading of all the lives taken at such young ages. It’s still questionable on the real reasons why so much of our youth want to cut their life short. There are numbers of things on why possibly our youth would want to commit suicide. There is one reason that has been proven to be the head cause and that is mental illness. A mental illness refers to a wide range of mental health conditions and disorders that affect your mood, thinking and behavior. Examples of mental illness includes depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. (Staff, 2012) Some other causes may be bullying, drug and alcohol abuse and physical and sexual abuse. Youth that die by suicide believes that suicide is the only option at that moment; however Delaware has several resources available to prevent youth suicide.

One of the largest arguments made about physician assisted suicide is it is morally wrong. Supporters of the right-to-die movement, argue that just as courts have found that there is a constitutional right to refuse medical treatment, there is a similar right to ask for medical assistance in dying. When patients reach a point where illness, pain, suffering, and lack of freedom have essentially destroyed their quality of life, supporters contend, they should have the ability to end their lives legally and in a dignified manner. The government, supporters argue, has no right to interfere in this choice (" The Right to Die" ). Assisted suicide proponents argue that it is like abortion, it is a choice issue because doctors have enough knowledge to know when a patient is close to dying. Accredited

There is at least 113 suicides each day or 1 every 13 minutes. Suicide among males is the seventh leading cause of death and the fourteenth leading cause in females. Most suicides are with a firearm and are carried out with a “ Saturday night special”. (Dilaura,Cynthia DiLaura) “More than 90 percent of suicide attempts with a gun are fatal. “ (Brady Campaign) There are a number of reasons why suicide occurs. Stress is the number one cause among our youth, bullies, peer pressure, depression, and abuse. 41,100 people committed suicide in the United States in 2013. Our young teens today does not take time to look deeper into there problem and to seek out a better solution. They are looking for a quick fix but not realizing once the trigger is pulled the result is final with no turning back. Most people who has attempted suicide is more likely to try a second attempt and most have an underlying mental illness. There is many warming that someone may be in a suicide crisis. We most learn how to see things through their eyes. No matter what one is facing in life or the difficult that lie ahead of them Nothing is worth taken your own

One argument is that every person should be free enough to make their own medical decisions. However, in the case of physician assisted suicide, a patient’s decision is influential on medical professionals, family, friends, and other patients (Boehnlein, 1999). Also, there may be an unconscious influence by people in the patient’s lives (Boehnlein, 1999). The patient might even be depressed, and therefore, cannot be fully competent of making this type of decision (Boehnlein, 1999). If a person is depressed, they are in a different state of mind. They may be feeling helpless, and PAS seems to be the only way out. In the end, it is the physician’s decision. One can see how this puts a lot of pressure on the physician. Physicians are humans too, which means they make mistakes. If a patient is being assessed by a psychiatrist, the psychiatrist must decide if the patient actually wants to end their life, or if it is a cry for help (Boehnlein, 1999). Also, it is the psychiatrist’s duty to assess risk factors for suicide because, “Not only is this standard ethical psychiatric practice, but we can be sued if we do not take appropriate steps to screen for, or prevent, suicide” (Boehnlein, 1999, p. 11). The burden on physicians and psychiatrist is very heavy and such a decision is something that has to be very carefully made. Every aspect has to be looked

Medical care in America is estimated to cost $2.7 trillion each year with roughly 30 percent of that cost attributed to ineffective or redundant care, approximately $800 billion (America's Health Insurance Plans, 2014; FOX, 2010). Within this section $44.6 billion is attributed to suicide treatment and medical cost (Center for Disease Control and Prevention, 2015). The CDD further estimates that with approximately 40,000 people dying of suicide annually suicide contributes to the 10th leading cause of death for Americans, narrowly being outstrode by kidney disease and influenza yet still achieving a higher overall medical cost than the ninth and eighth ranked causes of death (Keren, Zaoutis, Saddlemire, Luan, & Coffin, 2006;Webberley, 2015).

Suicide rate is a grow problem in the United States according to the American foundation for suicide prevention more than 41,149 suicides were reported in 2013. The highest rate of suicides is committed by adults between age 45-64 and this is especially true amongst the elderly. Older adults are inflected with a terminal disease, loneness and depression and because of this they are committing suicide at a higher rate. Suicide amongst the men is steadily higher than women, in 2013, 77.9% were male and 22.1% were female. Men success rate for suicide is much higher, because their attempt is more lethal, for example, men are more than likely to shot themselves, whereas women are more likely to use poisons to end their life. Suicide Rate committed race/ethnicity was higher among Whites 14.2%, American Indians and Alaska Natives 11.7%, Asians and Pacific Islanders 5.8%, Blacks 5.4% and Hispanics 5.7%. According to the mean method used to commit suicide is a firearm, then suffocation and poisoning. The main cause of suicide is due to mental health condition and depression is at the foremost leading factor.

Hundreds of thousands of people die due to suicide every year. This number is estimated to double by 2020 should the current trend continue. The primary cause of these suicides is mental disorders and harmful use of alcohol - which in itself is a result of mental health related conditions. The World Health Organization reports indicate that 20% of the world 's children and adolescents suffer from one or more mental disorders and according to the Kim foundation, 57.7 million people in the US suffer from a mental health disorder.

Imagine the situation of being terminally ill, with the only option available in life, is to lay in an hospital bed all day, receiving medication just to stay awake or get sleep. Waking up to hear news from the nurse about when the next surgery is, what medications to receive, not being able to interact with loved ones, or even go to the bathroom. Having no capability to do anything with a positive mindset, but understanding that time is coming to an end soon. Well, this is a just a small amount of situations that terminally ill patients go through during a daily basis. With all this pressure on an individual, there is nothing to do but become emotional; therefore, being so emotional to the point it results

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.

Walking down the cold, dimly lit hallways of one of the largest military hospitals in the United States listening to the coughing, moaning and sometimes crying coming out of the terminally ill patients rooms. I have watched many patients that I have personally cared for suffer a great deal during my time as a paramedic. During that span I have wondered and questioned why someone of their own free will not choose to end their own suffering. Working in this environment gave me some insight as to what others felt about the subject. One quote that has always stood out to me is “People want the right to die at a time of their own choosing. Too many families have watched helplessly as a relative dies slowly, longing for death”. (Toynbee) Some Doctors and nurses are totally against the idea while others support it. Let’s look into some of the reasons why assisted suicide should be a right for everyone.

Assisted suicide brings out some of the deepest feelings amongst human beings. It is a hard decision that nobody wishes to take, and is the power over life and death. Is killing a terminally ill patient justifiable? Who determines the worth of one’s life? God or human? The answer to this question varies, as there are many points of view to this controversial issue. Thus, assisted suicide is a form of suicide, which involves a person other than the person taking his or her own life. And during which the other person assists in direct or indirect physical means in giving effect to the suicide or, in the event of a statutory definition, in a manner as set out in that statute.

Suicide is a main source of death around the world and ranks among the three main causes of death among young adults aged between 15-45 years. Indeed, a response to this continuous worldwide issue, the World Health Organization called for the prevention of suicide (WHO, 2015). Several studies have evaluated some of the contributing factors, however, the connection between suicide and the evaluated factors is conclusively positive or negative.

Suicide is currently the 10th leading cause of death in the United States (Suicide and Self-Inflicted Injury, 2017). On average, 121 Americans complete suicide each day (CDC Fatal Injuries Report 2015, 2015). The American people are living longer with advances to medical care and technology, yet suicide rates continue to rise. According to the CDC, suicide rates have increased by 24% from the year 1999 to 2014 (Curtain, Warner & Hedegaard, 2016). Consequently, the suicide epidemic continues to grow with no clear path to prevention. This literature review was conducted using the Robert Morris University Library online databases. Databases accessed include PubMed…………., from the years 2000 to 2017. Overall, most the articles obtained are