What nurses profess: the Elizabeth Bouvia case

The prospect of nurses' cooperation in a patient's suicide raises the question, What do nurses profess? Confronted with the case of Elizabeth Bouvia, who in 1983 entered a California hospital intending to starve to death, a "nurse technician" would simply follow the physician-prescribed course of treatment, professing only a machinelike proficiency. A "nurse therapist," however, would work to become the patient's advocate, not judging but empathizing with the patient. Although supporters of Ms. Bouvia's position might appeal to this country's tradition of individual liberty and autonomy, the freedom of others also must be considered. As a community of professionals, nurses are bound by a set of ethics--beliefs that would be violated if they were forced to comply with her plan. And, as members of the civic community, nurses are responsible for protecting lives and fostering health and general welfare. A ruling in Ms. Bouvia's favor would have opened the doors for society to renege on its commitment to the handicapped and the gravely ill. The Bouvia case challenges nurses and all of society to reflect on what they believe in. What they profess must be more than mere tolerance of each other, more than technical proficiency, and more than a therapeutic understanding of patient needs. They must profess the sacred good of life and health.