Influencing Healthcare Policy: The Role of Nurses

The purpose of this paper is to discuss the legislative process and the manner in which the nursing profession can influence this process. Too often, nurses underestimate their potential to shape public policy regarding healthcare. Nurses can, and do, possess the necessary experience and skill to influence lawmakers, but do not always exercise this ability. This paper will explore the means by which nurses can impact the formation, implementation, and revision of healthcare policies in this country.
Legislative Process
The legislative process begins when someone drafts a bill for consideration by Congress. A sponsor is needed to present the bill to Congress, and the sponsor must be a member of Congress (Congress.org) The bill is considered

by the committee, and the committee can either act on the bill or choose to ignore it. Sometimes, a subcommittee is appointed to explore the bill in greater depth and make changes to the bill. Testimony is given, either in person, or by written statements. The committee’s function is that of a gatekeeper in determining the merit of the many proposed bills (Abood). If the full committee decides to publish the bill, it is placed on the House or Senate calendar for debate. If the bill again passes, it is sent to the other chamber for agreement. If both the House and the Senate approve the bill, it is sent to the President. The President can sign the bill into law, do nothing with the bill for ten days and allow it to automically become law, or veto it. Congress has the power to override the President’s veto (Congress.org)
Analysis of Political Issues
Physician-assisted suicide is an issue that faces physicians and nurses today. Currently, five states allow physician-assisted suicide, including California, Vermont, Oregon, Washington, and Montana (NYTimes). Proponents of physician-assisted suicide often cite the desire to reduce pain and suffering in terminally ill patients, as well as quality of life issues. Financial hardhip, on both the patient and the healthcare system, is a consideration. Some believe that doctors and nurses are obligated to fulfill a patient’s wish for death in order to protect the patient’s autonomy.
Those opposed to physician-assisted suicide argue that it serves to confuse physician-assisted suicide with palliative care, making it a medically and ethically acceptable solution to those with terminal illnesses. (Boudreau & Somerville, 2013). Non-maleficence requires that actions of medical personnel not inflict harm on their patients. Assisting a patient in committing suicide does not respect the sanctity of life that is held by many.
This Student’s Opinion
Perhaps the most emotional argument in favor of physician-assisted suicide is relief of patient pain.

Some consider it to be on the same continuum as palliative care, but palliative care seeks to neither postpone nor hasten the end of life in terminal patients. Aggressive pain management can eliminate or minimize patient suffering. A tremendous discrepancy can exist as to what constitutes “quality of life.” The quality of life that so many argue in favor of is not always measurable and should not apply to human beings. People are becoming comfortable with the idea that life must have a certain quality to be worth living. A life which would be considered unbearable to some can be considered a wrongful life, often discriminating against disabled persons. Suicide is not reversible. Patients cannot change their minds if conditions change. Illness or disability is not convenient for families or physicians, and certainly not for the patient, but arguing in favor of assisted suicide ignores the patient’s real fears of abandonment, pain, rejection, loneliness, and loss of value. If we allow the quality-of-life argument to permeate all levels of medicine and ethics, we ignore the sanctity of life. Even if one rejects the idea that life is a God-given gift, the intrinsic value of every life can still be argued. With the appropriate euphemisms, any killing can be justified, but this slippery slope, this sliding scale of who lives and who dies, puts all of us in the crosshairs of euthanasia, not just the elderly, the infirm, or the

handicapped.