Kaveri Roy, author of “Medical Aid in Dying: What Every Nurse Needs to Know”

·25 min·2 clips

Liz describes how they had to lie and use family excuses to get medical notes, fearing suicide reports would block their path to aid in dying.

This episode features an interview with Dr. Kaveri Roy, author of an AJN article on medical aid in dying, and Liz S., the spouse of a patient who sought this option. Host Sean Kennedy, Editor-in-Chief of AJN, guides a discussion on the clinical, legal, and personal dimensions of the topic. Dr. Roy is a hospice and palliative care nurse and professor, while Liz shares her family's firsthand experience. Liz explains her husband, a physician diagnosed with Alzheimer's, was determined to avoid his father's disease trajectory. Medical aid in dying is legal in only 10 U.S. states and D.C., but laws exclude conditions like Alzheimer's due to unclear prognoses and cognitive impairment. The family researched options and found Switzerland's Dignitas organization, which accepts non-citizens, initiating a complex, months-long application. They faced significant hurdles in obtaining full medical records without disclosing their intent, as suicidality is a reportable condition in the U.S. Liz describes using "deception" and "prevaricating" to secure notes, fearing a depression diagnosis would invalidate her husband's decision. A psychiatrist's note mentioning her husband's wish to "go to sleep" was flagged as depression, requiring an additional evaluation to satisfy Swiss authorities. Dr. Roy clarifies that medical aid in dying involves a patient self-administering medication, whereas euthanasia is illegal in the U.S. She notes that even where legal, the act is often stigmatized as "suicide" or "giving up." Liz reveals they received no support from their U.S. healthcare network, feeling compelled to conceal their plans from nurses and doctors. Dr. Roy highlights a lack of knowledge among nurses, referencing new supportive policies from the ANA and the Hospice and Palliative Care Nurses Association. She points out a disconnect, as public support for medical aid in dying outpaces that of many healthcare professionals. The process in Switzerland required two meetings with an assigned physician to confirm cognitive capacity and consent, with nurses present at the final gathering to reaffirm the decision. The tone is educational and deeply personal, blending a clinical interview with an emotional narrative. The style is conversational and respectful, focusing on factual hurdles and ethical complexities. This episode is essential for nurses, healthcare professionals, and anyone interested in end-of-life care ethics and patient autonomy. Listeners seeking clear legal guidance or debate might find it less applicable, as it centers on a specific, poignant story and systemic barriers.

As heard by us

A careful look at how law, autonomy, and comfort shape end-of-life care.

The episode treats medical aid in dying as a clinical, legal, and family matter rather than a slogan. Sean Kennedy speaks with Dr. Kaveri Roy and a family member about one patient’s search for a peaceful death, and the discussion quickly meets the limits of U.S. law.

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Why you'd press play

You need a nurse-focused look at medical aid in dying.

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