Should Physician-Assisted Suicide be legal throughout the US?

In My Humble Opinion
61

Who loved “Saving Private Ryan ?”

Remember at one of The Most Tense scenes in the movie, Tom Hanks’ character broke the tension by coming clean about what his profession was back in the States (2m36s):

I’m going to take a shot at a Captain John Miller (Hanks’ character) moment:

My paternal grandfather was a pharmacist in a major US metropolitan area. Then, as now, pharmacist was a highly-regarded profession. My grandparents were high-profile society types, also very active in their temple.

My grandmother – his wife – apparently got more than a little too close to the temple’s cantor and told my grandfather that she wanted a divorce. This was in the late-1950’s.

My grandfather killed himself, thereby detonating a proverbial bomb in the lives of his surviving wife and teenaged sons, one of whom eventually (all too quickly) became the father of my siblings and me.

It was a classic ‘permanent solution to a temporary problem’ from which nobody ever really recovered. It sent ripples down over the next generations.

Fast forward five or six decades.

I’m sick.

I’m in my late-50’s. A few years back, I had a rare adverse reaction to a drug prescribed for nerve pain. I cheated death over the next few months, but … then …

I started having heart palpitations, ridiculous exercise intolerance, debilitating fatigue, and other symptoms that were diagnosed by numerous cardiologists as “just atrial fibrillation.” But I wasn’t so sure.

So I did the research that I could, learned how to intepret the test data that we had, and decided that it was something worse. I wasn’t initially sure what.

It took several years of arguing with doctors before I self-referred to three of the most famous teaching hospitals in the country. Multiple heart biopsies proved that what I had was a restrictive cardiomyopathy called Non-Tropical Eosinophilic Endomyocardial Fibrosis.

It’s a known, if rare, consequence of DRESS Syndrome – the rare adverse drug reaction that I had experienced. Rare ^ 2 (rare squared).

There are no treatments. I do not qualify for a transplant (the drug regimen is intense, and I came to this place by an inexplicable, severe drug reaction).

Five year mortality rate is 80%. I’m in year eight and not doing well. It’s a low output form of heart failure. My proverbial batteries should put out 12 volts. Instead, they put out about four, and they won’t hold a charge. Think of your cell phone that will only hold a 10% charge. You don’t get much utility out of it, but even the few calls you can make are garbled and keep dropping out.

All systems are affected. The reduced cerebral blood flow also causes cognitive dysfunction and radically increases the risk of dementia.

It isn’t good.

I’m acutely aware of the collateral damage that suicide wreaks on families. I’m also aware of what a slow, degenerative, terminal disease looks like.

So this one is on my radar screen. I’m looking at options.

Like so many things … it’s just not simple, and so much depends on where you sit in an equation like this one. In a way, I’m lucky. I have a family that doesn’t think that my suffering should have to extend in perpetuity in order to minimize theirs.

To those whose lives were touched by suicide, you have my utmost sympathies. To those who have faced down an ugly terminal illness, and have had to consider the choice, you also have my utmost sympathies.

62

Your entire argument is based on logical fallacies.

Not doing X bc we did so poorly in the past. Logical fallacy

Not doing X because A,B,C may or may not happen. Logical fallacy

Not doing X unless I can be guaranteed Y will NEVER happen. Logical fallacy. (There is no such thing as a perfect system)

What you have to ask yourself is: Do we have a right to bodily autonomy?

Do you think the system will do a greater good to society than harm?

63

I have closed the poll. Thanks to everyone who voted. Mods, you can either close this thread or move it to GD if you want the discussion to continue.

There was no hidden agenda. I just wanted to see how people would vote on the question. I’m not saying that this message board is a representative sampling of people in the US, but I didn’t totally expect the response I got either.

64

It’s not a logical fallacy to look at mistakes made in the past and take steps to NOT repeat them. Look at the past mistakes in order to do things better going forward.

I have never said “outlaw forever PAS” in this thread. I have been saying IF society decides to allow it then put really strong safeguards in place. It would even be helpful if people state what safeguards there are, or will be, rather than just repeating their fears of dying in agony.

Tell me how you’d make the system as perfect as possible. Yes, there will be edge cases, outliers, and the occasional tragedy. What do you propose to minimize all of those?

Do you believe in an unlimited right? Does your bodily autonomy allow you to demand a replacement kidney from someone else in order to preserve your own life, as a very hypothetical example?

My right to bodily autonomy ends when my actions to preserve it start to harm others, or when I start demanding that others participate in a form of killing they find repugnant.

Yes, I think PAS is a greater harm than good. I’ve been very clear about that.

But if society votes to have it I really do want to know what safeguards there are, I’d like some history on how well safeguards currently in place have functioned.

You’re asking me to live in a society that allows consensual killing of human beings, human being who may be in an extremely vulnerable or helpless state. I want to know what guarantees will be in place so that I, who do not want to participate in this killing, do not have to worry about being subjected to mercy killing to which I do not consent. Again - I am not saying YOU can’t participate if that’s what you want. I am asking about how robust the opt-out will be.

65

What safeguards should we put in place to prevent abortion providers from pulling in kids off the street and killing them?

66

That’s considered murder and we have laws against it with extreme penalties.

It’s also ignoring that the purpose of abortion is not to kill children for shits and grins, it’s to end a pregnancy.

I don’t expect PAS doctors to go to a mall and randomly assassinate people.

Here’s the thing - no one in this country (US) is ever supposed to be forced to have an abortion, or to participate in one. Don’t want an abortion, don’t approve of them? Don’t have one and don’t perform them. But outside of extremely rare edge cases (someone comatose in a nursing home being raped, for example) all abortions involve human beings capable of making an informed decision at the time of the abortion.

Are you going to limit PAS solely to people of sound mind who are conscious and rational at the time of their proposed death? What safeguards will be in place to make sure there is no coercion and their minds are functional? Or will you allow the killing, at the behest of next-of-kin, of someone in a coma?

Why the resistance to answering these questions? Surely there are currently examples of safeguards in areas where this is allowed. I’ve given my cites, how about some cites about those.

67

I’m sleepy and need to go to bed. But I do want to address this: This is a downright disingenuous retort. You know damn well that’s not what I meant. Geez!

68

OK, try this:

If, hypothetically, one has a right to kill oneself I don’t agree that that right extends to involving anyone else in killing yourself. Your right to control over your life and body does not extend to demanding others help you kill yourself.

Now, maybe we can argue about where to draw the line. Is prescribing a lethal dose of drugs you can pick up in a little bottle and keep at your bedside and swallow when you choose to do so beyond the pale or not? Can you demand a doctor inject you with a lethal cocktail or is that too far? Or is that acceptable to you?

69

This example has ABSOLUTELY NOTHING to do with physician-assisted SUICIDE. Your examples are noting more that “I oppose “A” because “E” could lead to “F”, “G” and “H”!” without showing us how you got from “A” to “E” in the first place.

70

No one is demanding, bringing up or even hinting at the right to force doctors to do jack shit.

71

But what if the Nazis force abortions on lesser types? By your argument, we must ban abortions now just in case. Before you said what about those who would suffer? So, if a rapist would feel bad about the woman he raped aborting his child, she shouldn’t be allowed to? Do you favor the requirement that men have to sign off on all abortions? Your argument says that you should.
Our friend just killed herself through PAS. (She was in California.) She had a degenerative disease that meant she was losing control of her body, but her thought processes were unaffected. She made the decision herself. Her children and even her friends were aware of her decision. You would have condemned her to a life trapped inside a useless body, which is the worst torture I can imagine. Just because Nazis. (I’m Jewish too, so don’t pull that crap on me.) That’s despicable.
Not to mention that if legal and regulated PAS is more likely to prevent abuses where a physician and patent together decide that the dying patient be given the right pills and instructions without any oversight. How’s that for a more believable slippery slope?

72

Because they have nothing to do with the topic of this thread.

73

It is possible that PAS could lead to a non-zero number of people going down that path who wouldn’t have done so otherwise.
I stress the possible there, and that could be reduced via panels and independent assessments.
I don’t think any restrictions could guarantee that it will not happen. There are no perfect solutions but that’s no reason to let that be the enemy of the good.

What is certain, is that right now there are millions of people in extreme agony who have no quality of life, no hope of recovery and only the promise of physical pain, degradation and mental anguish from now until the end of their life.
They are denied the opportunity of an easier way out by a means and at a time of their choosing. Knowing they had that option would ease their mental suffering immensely even if they didn’t avail themselves of it. I know absolutely it would do that for me.

The balancing of a potential issue in the future vs the eradication of a definite ethical obscenity right here and now is a calculation I’m happy to make.

Pretty much every poll I’ve ever seem on this suggests that the vast, vast majority of people see the logic in this, that they want that option for themselves and their loved ones.

74

Something just occurred to me. For all this talk of a slippery slope between PAS (which I support) and state-sponsored murder (which I do not support), how many of the state-sponsored murder laws actually originated as genuine PAS laws and nothing more? Any?

My sense is that the eugenics movement in the US started straight up as a eugenics movement. Ditto with Nazi Germany. Same with their state-sponsored murder of the disabled or disfavored minorities and ethnic groups. None of these laws, to my knowledge, began as “Here is someone who wants to die, has asked us to kill him, and we should respect his wish.” As I understand it, they all began as something sinister, either on their face or in the clearly understood legislative intent (by which I mean, even where a literal reading of the laws at issue might have led one to imagine, at first glance, that it was a strictly voluntary program, anyone who had half a brain and was paying attention knew the intent from the outset was always to enact a state-sponsored program of eugenics and murder of the disabled), amounting to “People who are a burden on society, who might taint the gene pool, or who are otherwise leading lives we the state deem are ‘not worth living’ should not be allowed to live. If they agree with that assessment, cool, we’ll try and make it easy for them. If not, too freaking bad for them.”

Is my understanding of history incorrect? Do we have examples of laws that began as a sincere effort to give greater agency to the terminally ill and suffering, to allow them to choose the time of death and to make it painless according to their wishes, and then morphed into something more sinister, as the first step in a clear progression from sincere/genuine PAS to state-sponsored murder?

75

If I’m reading the thread correctly, virtually everyone believes that PAS with adequate safeguards should be not only allowed but actively encouraged to become legal everywhere. It turned out to be not controversial at all.

76

I could not find any reference to PAS in pre-Nazi Germany. I’d very much doubt it was legal due to the large Catholic population in the South, not that the Lutheran population would be any more for it.
I did notice in the search results that German courts overturned the ban on PAS, but didn’t investigate further.

77

You have a strange and selfish view of what autonomy means.

To minimize the risk to your autonomy in some hypothetical scenario where an unscrupulous person is trying to harm you, you seem to think everyone else should forego their autonomy. You might as well advocate the banning of painkillers, since a surreptitious overdose would be the preferred method for this hypothetical assassin. If everyone else has to forego the benefit of painkillers - that’s a price I’m sure you’re willing to make everyone pay for your peace of mind.

My right to PAS is analogous to my right to use painkillers when I’m in pain. Neither of these things are directly harming you. It may be true that they make it easier for a hypothetical bad actor to harm you - but then it is the bad actor who is harming you, not me. I have no burden to sacrifice my autonomy until I can prove to you that all risk from third party bad actors is eliminated. Safeguards to protect against bad actors is just something we all need to figure out.

78

These (and the examples in your previous post) are ridiculous straw man examples that have absolutely nothing to do with the topic of medically assisted suicide. No one has suggested that it should be OK to kill a child because he or she has autism. Examples from the distant past of crazily misguided ideas of eugenics, or outright genocide during the Nazi regime, equally have nothing to do with the topic. You are basically trying to say, “if we allow medically assisted suicide, all these terrible things that have nothing to do with medically assisted suicide will happen!”. It makes no sense.

Medical Assistance in Dying has been in force in Canada since 2016 and had its provisions updated earlier this year. If it had been in force at the time that Robert Latimer chose to kill his severely disabled daughter – one of your scare-story examples – it would have made no difference whatsoever as she did not meet many of the eligibility criteria, including being over 18 and having the ability to give informed consent and the clear absence of any coercion. Even though the enlightened ideas that eventually led to the enactment of Medical Assistance in Dying were already in the formative stages at the time Latimer was charged, he was treated in a manner that many found surprisingly harsh, include a lengthy jail term and denial of parole multiple times, and his sentencing was upheld by the Supreme Court of Canada. One of the arguments made against leniency, despite the fact that he acted out of compassion, was that any lesser penalty for killing someone with disabilities would implicitly devalue the lives of the disabled.

So in summary, we don’t need to consider physician-assisted suicide as some debatable hypothetical; it’s been in force in Canada for half a decade. There are also no legal restrictions on abortion whatsoever, although medical ethics plays a role when it comes to late-term abortions. Yet despite these legal positions that religious nutters would regard as godless and life-devaluing, Canadian values are strongly pro-life in providing universal health care, assistance for child care, assistance for the disabled and for the needy, and abolishment of the death penalty so long ago that no one even remembers it. IOW, physician-assisted suicide, properly regulated, is one of the pillars of life-affirming enlightenment, not a horrible slippery slope to some imaginary dystopia.

79

Options that are not cost-effective are already denied to patients, even in places where PAS is not legal; that’s nothing new. Why is it more irksome if the patient is offered choice between a quick painless death instead of a lingering, painful one?

The movie How To Die in Oregon presented the cases of of several PAS recipients in that state. It also covered the case of a man (Randy Stroup) who was denied state-sponsored treatment for his prostate cancer because his odds of survival were considered too low - in other words, the treatment was deemed to not be cost-effective (i.e. there needs to be a >5% chance of survival beyond 5 years). They did, however, offer to cover the cost of palliative and hospice care, up to and including PAS. After Stroup made a very public fuss about it, the state relented and covered the cost of his chemo. To no one’s surprise, the treatment was ineffective and he died in much less than five years.

Given that resources are finite, and there absolutely will be cases where treatments are reasonably denied by insurers because they are not cost-effective, how does the availability of PAS make things worse? Would Stroup’s situation have been somehow improved if PAS were not presented as a covered option?

80

Who is for PAS without any safeguards?

In my state, the physician assistance is writing a prescription for pills. The patient has to meet certain criteria (terminal within 6 months, not depressed, not coerced, etc.) has to ask more than once, and has to have approval from more than one doctor. And then, when they have the pills, they get to decide if and when to take them. No one is killing someone against their will. It’s still suicide.