Yeah. Again, I can see why they put that restriction in; but I don’t like it. One problem with it is dementia – if one doesn’t want to spend potentially years slowly dying of an incurable disease that can leave you in a state of confusion and fear but unable to enjoy anything you love, that restriction means the only possible way out of it is to manage to kill yourself without assistance – and to do so while you may still have considerable good time left, as well as before you can be sure in what fashion the dementia will take you.
Requiring in addition that you be found competent by the time the approval comes through and things are set up, even if you were found competent when you made the request, only increases the incentive to act sooner than one might otherwise feel necessary.
Another problem with it is that some people have intractable pain and/or other highly unpleasant progressive illnesses that will also take years to kill them, and they’re required to wait (even, in most places, for hospice care) until a doctor will give them a six-months diagnosis.
And a third is of course the difficulty in providing that sort of diagnosis. In some cases it may be fairly clear; but in a lot of cases it isn’t. Many people who can’t get such a diagnosis do die in less than six months, many people who do get such a diagnosis live significantly longer.
Obviously the NZ law is a baby step into the water. They’re not tackling the hard or borderline cases. They’re tackling the easy bright-line cases.
As the first step on a long journey that’s a decent beginning. Lots of constituencies doubtless freaked out about even these baby steps. It will take time to habituate them to the sky not falling from these changes.
Lather rinse repeat.
Sociopolitical progress has a speed limit set by the most backwards 20%, not the most forward 20%. Insanely annoying this is, but pretending it was otherwise just produces revanchist disasters 20 years later.
Not that it would be an immediate on/off switch decision, I’ve made it clear to my family where medical care will end for me. After many, many years of hard drinking, my liver is shot, and I don’t intend to even get on the waiting list for a transplant. I watched a friend have a pretty crappy quality of life after a liver transplant. If it gets to that point, I hope it goes quickly, so my wife and daughter don’t have to take care of me. MAID is an option for me in Oregon, and I think doctors should be able to pinpoint within the window how much time I’d have. That’s assuming I haven’t lost what little mind I have left, but we do have advanced directives that will (hopefully) cover that. I guess one upside to it is that, other than the wife & daughter, no one would miss me enough to make a fuss about it.
Yeah; that’s pretty much why I said I can see why they put those restrictions in. Let’s hope things do proceed.
By the nature of the issue there are always going to be hard cases. Some oversight, and some restrictions, are necessary. Figuring exactly which is a difficult matter.
Another approach would be to identify an age at which you wish to limit the care you receive, as Ezekiel Emanuel has written. Not sure his is a perfect solution - and I’m not sure exactly how it deals with dementia, but it reflects a mindset I respect.
I can’t believe that people want to drag their children into ending them out of fear of, ‘being a burden.’ Honestly have you ever put an animal down, made the heartbreaking DECISION to turn off the machine on a loved one? That is a burden that will haunt them the rest of their lives, no matter how happy you are with the arrangement. And you have to add in the very high mental price of evermore carrying an untold thing. Because they’re not going to be able to tell anyone.
The burden of caregiving has an end date, the burden of knowing you offed your parent will be forever, I think.
My friend thinks he’s got it figured, when he’s crossed over into ‘not knowing’ most things, and a world of frustration, he wants his BP meds stopped, he wants to eat chips and fries with salt, and drink some beer. His reasoning is, it’s his decision, they are only complying with his refusal of his meds etc. So they don’t feel complicit, don’t need to make any decisions. He really likes that it brings back the randomness of it just being unexpectedly being ‘time’. It certainly sounds better than anything slow and withering, but not without its own risks perhaps.
Yes, they ‘ought to’. Could you speak of it, with friends, do you think? How’s that go? What is the offspring supposed to say or feel, when someone inevitably remarks, “Damn, how could you do that? Even knowing they wanted it, I could never…blah, blah, blah?”, I doubt very much, they will ever speak it. And I feel that makes the weight all the harder to carry/live with.
I’m arguing the hardship of caregiving has an end date. Deciding to end a parent is a much bigger burden, every day, and for the rest of your life. How could it be other wise?
My mother died a medically-assisted death. She was mentally competent to make the request and then follow through at the end, but she couldn’t physically do much of anything; she was completely reliant on her kids to jump through all the hoops on her behalf. It was up to her children to make doctor appointments, transport her to them, sign documents, go to multiple pharmacies to get the prescriptions filled (not every pharmacy is willing to fill a prescription for a fatal dose of Seconal), plan a family gathering, and dissolve the Seconal in water, and then hold the bottle with a straw in it so she could drink it.
We didn’t “turn off the machine”, but I don’t think what we did was meaningfully different. None of us feels any “burden” for having helped her die the way that she wanted. Quite the contrary, if she had begged for a merciful release from life and we had all steadfastly refused, I think we would have been very much haunted by that.
That’s probably the case for assisting a parent with their death in places where it’s illegal, as it could put the kids at risk of prosecution. But where medically-assisted death is legal, people can and do choose to talk about their role in the death of a loved one, although they might be selective about who they tell.
If you’re arguing that fear of being a burden on one’s children isn’t a legit reason to want to die, well, you’re certainly entitled to burden your children as much as they’re willing to bear, but other people feel differently. As far as I know, in places where medically-assisted death is legal, they don’t ask why you want to die. In Colorado for example, you are eligible for medical aid in dying if you are:
an adult
terminally ill
given a prognosis of six months or less to live
mentally capable of making your own healthcare decisions.
“Quality of life” is the very abstract term that gets tossed about in discussions like this, but it means different things for different people, as this thread shows. A lot of folks think it’s about pain, but it might also mean an inability to do the things you used enjoy, or feeling a loss of dignity because you can no longer go to the bathroom without assistance. And for some folks, the knowledge that they are consuming a large portion of their children’s time and money is a thing that causes them a lot of anguish. I imagine it doesn’t feel good knowing that your kids can’t take their kids to Disneyworld because they can’t leave you unattended (or because they’re spending their travel money to help pay your assisted-living bill).
Nobody said any such thing to me. And most of my friends know that I agreed not to have my mother given artificial feeding (and, for that matter, which of my cats were euthanized at the vet.) Yes, I’ve talked to some of them about it. And I’ve had people talk to me about having made their own similar choices. Why wouldn’t we talk about it?
I don’t want to even imagine the burden that would be on me, for the rest of my life, if I’d decided to ignore my mother’s twenty years of instructions and had told the medical facility to put tubes into her against her will.
Yes. That’s what it felt like. Along with grief, of course. She was ready to go. I wasn’t ready for her to go; but she was ready, and she wanted to. And there was nothing about her life that was going to get better.
ETA: You know what? We’re all going to die. Each and every one of us; and every one who we love. There is no magic thing you or anyone can do to change that.
What some of us may be lucky enough to have is some choice in how we die.
There is a big difference between ending the life of a parent out of convenience and out of love for that parent, by stopping pain and misery. I’m not there yet, but I’m old enough to be able to imagine a situation where I’d want my kids to end my misery. I’d rather be able to do it myself, but I’d want my kids to do it if that were impossible.
This was the side effect of ovarian cancer that killed my mother. She lost voluntary muscle control. It was awful. We decided on a DNR on her when her quality of life was just gone and have never regretted it. I have, however, wanted to punch out people who have told me that we had “no right to play God and let her die”. Fuck them. Fuck them all.
Forcing her body to stay live is “playing God”. If you want to bring that guy in the sky into the argument, He gave her that cancer and is expecting her to die of it, and anything you do to prevent that is counteracting His wishes.
I’ve actually stated explicitly in my medical directive that basically “if my mind is gone, do everything to keep me comfortable, do NOT do anything to prolong my life”. Stuff like routine mammograms / colonocopies (you all KNOW that’s on my mind, LOL). Keep me comfortable even if doing so extends my life OR shortens it. And things like pacemakers may be disabled in that case, also.
If I’m physically disabled but mentally OK, I may well make the decision to turn off the machines that are keeping me going. I actually documented THAT in the medical directive as well, basically to show that such a decision was well thought out in advance.
A more lingering illness: that’s tougher. Something progressively disabling like Huntington’s (not in the family) or ALS (IS in the family but I think I’ve already outlived my grandfather), I guess I’d like to keep going as long as the care was not TOO burdensome on the family, and my mind was alert enough to find some joy. If I required machines to keep me breathing, nope nope nope. Of course if the disease progresses far enough, I likely would not be physically ABLE to comply with medically-assisted-suicide laws. Which I think is a problem with how those laws are written: you’re faced with either doing the deed when there’s still some change at some enjoyment of life, or waiting too long and being trapped (as Voyager noted).
We’ve been “fortunate” with our parents (3 of the 4 now deceased): my father had prostate cancer, and while there was some pain in his last few months, it was really only intolerable for a few weeks, and he passed peacefully at home. My mother’s lung cancer made her last year unpleasant but not intolerable; her final decline was quite fast. My father-in-law was in gradually declining health for a year or so, but still relatively active; HIS final illness (a series of strokes) hit him suddenly and swiftly and he was gone within a week.
Yeah. That’s the argument I used on somebody who was complaining, in general terms and not in respect to any particular person, about people disconnecting or refusing life-extending equipment. He’d said that maybe God would make a miracle and the patient would recover, if they were just kept alive long enough. I said that if God could make that miracle then God could make it whether the equipment was hooked up or not, and wasn’t that equipment just attempting to thwart God’s will that the patient die?
In the final years of my dad’s life he had a medical directive which said that if he was not cognitively able to participate in healthcare decisions, then health care providers were instructed not to provide life-extending care, just comfort care. His cognition didn’t decline to that point until maybe the final few months, but it was smart to have that in place well ahead of time.
A few year before the end, he was suffering from angina, for which the recommended treatment was the installation of stents. The joke we all shared at the time was that this effectively eliminated his pain, with the unfortunate side effect of prolonging his life.
Seven years ago(?) I was having unstable angina attacks and actually had one or more small heart attacks. I had some diagnostics done and was about to have a catheterization procedure to (hopefully) place a stent.
The cardiologist explained that if my coronary artery disease was severe, then a stent would not work and I’d need to go straight into bypass surgery. I had already decided that I wasn’t going to have any major invasive surgery, and I told him that. He explained that I could die as a result of my decision. I asked if he could perform the bypass without postoperative pain and he said no. I told him I’d rather not experience any avoidable pain in what remained of my life. The stent worked.
That would have to depend on what God’s will is. The people most likely, at least around here, to try that sort of argument would most likely say that God specifically told us to eat, in Genesis and most likely elsewhere.
However, I haven’t heard any of them argue that it’s God’s will that we all be physically immortal; at least, not since that business with the apple.
