Ah, I think I see a disconnect between my position and the position you state.
While stopping a suicide has a side-benefit to me that I don’t experience the pain of losing someone I care about (which can be pretty intense), that is NOT my primary motivation. I want to stop a suicide in hopes of making that person’s life better FOR THEM.
I’ve never heard of someone who, upon being given a terminal diagnosis, goes “YIPPEE! I now have an excuse to kill myself!” What people want is to stop hurting. I think that is true of the mentally ill as well. If those people who, as you put it, are being tortured by their brains could undergo a treatment with tolerable side effects or none and eliminate that mental torture/depression/illness I think they’d want to live - don’t you? (And if you don’t, please explain why not.)
Unfortunately, we don’t have such a magic bullet. We do have some treatments that help some people achieve a less painful state, and I think they should be tried. But, because I know we can’t fix everything, that is why I can tolerate the notion that in some cases death might be the lesser of two evils.
I don’t enjoy torturing people, but I think everyone is owed a chance to have what’s wrong with them treated if at all possible so they have a chance at a better life.
Yeah, I know - I was on a train that someone used for suicide. I even recounted it upthread.
Given the number of times I have heard exactly that sort of thing happening I dont’ think everyone who commits suicide is thinking of that - which is one reason it’s a selfish act. It’s not right to cause unnecessary trauma to other people when there are alternatives.
No.
I really do not think we want to get into the business of doctors killing patients.
Assisted suicide where the means to end one’s life are made available? I’m not at all happy about the notion but I can see a niche for it. Sure, have the docs prescribe a certain dose and set it on a table next to the patient’s bedside for the patient to take. Doctors injecting patients or forcing pills down their throats or whatever, that is killing them (which is what euthansia is - killing someone), no I can’t condone or accept that.
Do you not see the same difference I do?
Geez, took less than one page to go from “let’s allow suicide” to “let’s kill people”. There’s a slippery slope for you.
What idealistic nonsense. Would you give them money to sue those who have ruined their lives and ignored their so-called “inalienable” rights? Would you give them accommodation?
Of course not. These endless platitudes just make it more reasonable to want out of this madhouse.
What, you don’t believe altruism exists, especially between family members? Of course I want my friends and family to be happy in life, you want that for the people you care about.
If my sister was sick with the flu and I went and made her soup and gave her something for the aches and headache and fever would you assume I was doing it for selfish reasons or because I wanted her to feel better? Why the assumption that if a person is mentally ill I wouldn’t want then to get better? Would you expect to abandon someone *physically *ill? Why do you expect me to abandon someone *mentally *ill?
I don’t get this “money to sue those who have ruined their lives” - do you assume the reason for mental illness is always external? My sister’s life wasn’t “ruined” by anyone - she earned her Master’s degree, she was fully employed most of her adult life, she lived comfortably, paid her own bills, had enough for some luxuries. No one “ruined” her life, there was no one to blame, no one to sue. That’s sort of the curse of depression caused by brain chemical imbalance - it comes from within, not without.
I don’t doubt some people are dealt a shitty hand in life and treated badly, but that doesn’t apply to everyone. What I don’t get is this assumption that everyone else is out to “get” the depressed person, or only wants to profit from their misery.
If my sister had needed a place to live sure, I would take her in. I would have fed her, bought her clothes, taken care of her to the extent I was able to do so. Why the assumption that I would not? I’ve helped relatives off and on through my life. Why do you find that so unbelievable?
I don’t think you’ve spent much time at all around people who are dying.
I dare say that very few of them are enjoying any benefits of life during their last days.
Quite a few people who are in their last days of life are barely conscious, may not be able to talk, and can’t even move. They have no doubt already had made their impact on others, whatever that’s supposed to mean.
Any way you slice it, the decision is for them and their doctors, not for you or me or anyone else, to make.
Please see my posts numberef 53, 54, and 60.
This simplistic analysis is grossly incorrect for two reasons. One, it seems to assume that someone is out to kill the terminally ill, and that right-to-die laws somehow grant this unnamed third party that right. Nothing could be further from the truth, as the purpose of such laws is to ensure the right of self-determination, and to request assisted euthanasia in very specific and extreme cases where such help may be imperative.
Second, your simplistic analysis overlooks the most critically important situation that has led enlightened courts like this one to strike down bans on assisted euthanasia, namely the fact that such bans are discriminatory, unconstitutional, and unimaginably cruel when they are applied to people whose terminal illness is so far gone that they are too sick to be able to take their own lives. Indeed one of the driving factors that lent that case great urgency was the patient’s fear that the disease she was suffering from would reduce her to just such a condition, where she would be left in a state of intolerable suffering and not have the means to end her own life or even the means to ask for help. I cannot imagine a more horrible way to die, and to wish this on anyone in the name of some uninformed and sanctimonious philosophizing is completely unconscionable.
If I have a chance of surviving, no matter how bad the world has gotten or how dangerous it becomes, I’ll take it.
I’m not sure what the question is. Are you saying the slave ought to have killed herself? She would’ve been freed eventually. Would it be better for her to destroy herself than to live long enough to be liberated?
I have no objection to hospice care or taking people who are brain-dead off of life support and allowing their bodies to die. Braindeath is irreversible; the individual is gone at that point, and all that’s left is a piece of meat.
If right to life is something that’s inalienable, then even if you choose to end it the justice system is duty-bound to uphold and protect your right to continue living.
First, you have no evidence whatsoever that “Nobody desires to not exist.”
Second, the claim that one who chooses suicide must simply be executing the best rational option to “terrible pain and misery” is also unsupported, even if it is often the case.
I am not generally inclined to debate what “human rights” are. I see no such construct provided by a universe generally unaware that humans exist at all. LOL
From a public policy perspective, I support an absolute legal right for an individual to determine whether or not they wish to end their life at any given moment. Should assistance to suicide be sought, it seems to me that a requirement of licensure/certification etc for those who assist is a reasonable public policy.
Since most of the (surviving ) suicidal patients I’ve taken care of change their minds about killing themselves, it also seems to me that public policy should unilaterally enforce a bit of a waiting period and an option for counselling for individuals with suicidal intent.
I don’t find arguments of what is “rational” compelling with respect to suicide. In general, the Meaning of Life is enough of an uncertainty that “rational” becomes an arbitrary definition created within any given belief paradigm not typically supported by evidence.
We humans could come up with a lovely Manifesto of How to Behave Rationally and Therefore Bring Meaning to Life. The following day Big Comet might wipe out civilization. At some level the universe does not support “rational.”
As I understand it, the same document that says the right to life is inalienable says the right to liberty is also inalienable. And yet the justice system had no problem when my father (who was drafted) and I (who chose to join up) served in the military: all of a sudden there were folks barking orders about where to go and what to do, and what to wear while doing it, and whether to drop and give them twenty at any given point, and everything from haircut minutiae to the finer points of being absent without leave, plus the question of quitting (where the answer is ‘no’).
So — what happened, there? Did it, somehow, get alienated?
You think I am such an uncaring human being that I don’t want people in general to be healthy and well? You act like I have some personal animosity towards everyone. Yes, I’d rather see a random stranger get better and have a better life. If someone is mentally ill I’d rather see them find a treatment that helps them. The biggest problem, of course, being that our ability to treat mental illness isn’t very good in many cases. Even so, I don’t see that as a reason to give up on people and just let them die without even trying to help them.
And, as I have said and as people with your attitude keep ignoring - at a certain point, yes, treatment is futile. But since I don’t advocate automatically killing off folks with something like terminal cancer I can’t advocate that for the mentally ill, either.
That’s silly. The first amendment guarantees an inalienable right to free speech, but if you choose to shut the fuck up the government isn’t duty-bound to prod you into giving your opinion - or vote. Nor does the second amendment mean the government should force you to own or shoot guns.
Rights are not duties. That’s why the words are different, see ?
Absolutely. Treatment and care and help should be (and is) the obvious first resort. That’s not the point where pro-euthanasia people enter the equation however. It’s when that fails and continues to fail that we ask “so, what now ?”. It’s, paradoxically, why some people with mental illnesses (myself included) are afraid to seek treatment in the first place : because if that doesn’t work, then that’s it. We’re stuck with the torture. Whereas if you don’t try, you can live with the torture AND the hope that there’s something out there that could end it.
Don’t think about it too hard :).
But given that question ISTM that if a person is depressed (in the clinical, chemical sense of the word) and that depression simply does not lift be it with chemicals, cognitive therapy etc… ; then if that person just wants to give up, then they should be allowed to. It’s not an easy decision, it’s not something that should be happily or giddily applied. But some people *are *broken beyond repair - by life, by family, by disease, by age, by isolation or by DNA, it doesn’t really matter. It’s not my place to deny them a way out should they seek one.
Well, not everybody does think about it, no. Not everybody is self-aware, self-critical. I know that for myself, whenever I seriously contemplated suicide, the one thing that held me back was “it’s going to wreck my mother & grandmother”. Which is kind of fucked up, when you think about it :o.
I can see that. But the line is fuzzy, too. Doctors unplug comatose people from machines that keep them alive every day - isn’t that killing them ? Now, you jump from forcing pills down somebody’s throat and that’s where I go “woaaah, hold yer horses pilgrim”.
But if someone has discussed it with their doctor and agreed to it (and is deemed capable of making that decision), then I don’t see a problem with the doctor inducing a morphine overdose to a sedated patient, if the patient isn’t able to do it themselves for one reason or another or simply prefers it that way. Of course there’s a very important issue with consent and meaningful consent that has to be addressed before that point.
But if the patient is OK with it and the doctor is OK with it, and they both ran down alternative options first then… what’s the problem ? What’s the meaningful distinction ?
If that’s your rather bizarre phrasing of “Kimstu, that whole paragraph is just, like, your opinion”, then sure, I’m not disputing that at all. Pretty much everything we’re arguing about in this thread is a matter of opinion.
Nowhere did I claim that everyone who chooses suicide is simply executing the best rational option to irremediable terrible pain and misery. I was just stating my conviction that if a person is suffering irremediable terrible pain and misery (and I was mostly thinking of the examples of terminally ill elderly patients discussed in the thread), then there is nothing irrational or wrong about their choosing death as an alternative.
“Human rights” are a human philosophical and legal construct. There is no need for this construct to be “provided by a universe” or by any other super-human entity in order to exist or to be debated or negotiated by humans. You personally don’t have to debate it if you don’t want to, of course.
This is why I think your proposed “absolute legal right” to suicide and your fuzzy notion of a legally imposed “bit of a waiting period” and “option for counselling” seems useless/counterproductive. Since we don’t really know how to determine indisputably whether choosing death is “rational” for any particular person at any particular time, I think we are better off restricting legal support for suicide/voluntary euthanasia to situations where somebody’s going to die soon anyway and is enduring significant physical suffering and incapacity.
If a physically able-bodied and mentally competent person is truly convinced that they need to end their life, they’ll generally be able to do so without society’s active support in the form of declaring an “absolute right” to suicide and providing professional assistance (with or without some kind of “bit of a waiting period”). Since, as you note, most people in that category who unsuccessfully attempt suicide end up changing their minds about wanting to die, we as a society should probably not be giving such would-be suicides any legal encouragement or help to make their attempts more successful.
Good for you, but no one cares because YOUR choice is not the subject of debate.
If you want to take your chances and live with whatever hardship life throws at you, that is YOUR choice. The question is whether OTHER PEOPLE have the right to make a different choice.
People keep saying this but you keep ignoring it: A right is not the same as an obligation. A right means you MAY CHOOSE to do something. And obligation means you MUST CHOOSE to do something.
Eg. I have the right to own a gun, but this does not mean I * have to * own a gun.
I have the right to life, but this does not mean I have to live.
If you are the kind of person who lives in wonderful circumstances and you think you can live with any hardship, that’s great but also completely irrelevant. We are not talking about what you want. We are talking about what other people may want, and since you are not them and your circumstances are not the same, your desires mean fuck-all. You don’t get to tell someone else how to live their life (or even whether to live their life) because we are not your property and no one gave you the right to force your wishes into another human being.
I have stated before that, under those circumstances, suicide is something I might tolerate as an option. Something that my critics either don’t notice or like to ignore. And, yet again, I state that where I draw the line on that issue is likely in a different place from a lot of other people. I don’t think that is something that can be determined in six months or a year, or with one or two treatments. There is also the problem of access - a serious problem for the mentally ill in this country (and other places) is difficulty in accessing treatment, which just complicates the matter.
I agree, the line isn’t as sharp as some would like it.
In answer - if someone is brain dead and machines are keeping their body going then they are already dead. Disconnecting the machines doesn’t kill them, because the dead are already dead and you can’t kill them twice.
If someone is only being kept alive because of machines then removing the machines is not what kills them, it is the disease process or injury that required the machines that kills them. That’s different than someone who would continue living without machinery being killed, at least in my mind.
If someone is terminally ill and more and more drugs are given to alleviate their pain that’s not killing the patient even if the side effects from the medication hasten death, because those drugs aren’t being given with the intention to kill, they’re being given with the intention to relieve pain.
If someone is given drugs to specifically end their life that is murder - except in very, very limited circumstances. Rather like hacking someone open to get to their heart is considered attempted murder - except in very limited circumstances. And I’ll point out that heart surgery can still kill you, but in that case the intent was not to kill and very different from someone trying to murder you, even if in both cases your thoracic cavity is opened up.
Intent can be important in ethical issues. Normally, killing yourself is considered suicide and frowned on, but in the classic case of a soldier throwing himself on a hand grenade to protect others the guy is still dead, but he didn’t do that because he wanted to die himself, he did it to save the lives of other people. At which point it becomes heroic self-sacrifice rather than cowardly suicide. He’s still dead, but how it’s viewed is affected by intent and context.
I think if, given a hypothetical situation where suicide is being considered as an option, if you’re physically capable of taking the fatal dose yourself you should do so. Doctors don’t normally put pills on a patient’s tongue, they hand the patient the pills. If you can do it yourself you should do it yourself. If you care so little about killing yourself you can’t be arsed to pick up the pills yourself I question your sincerity. By actually performing the deed you prevent later questions about you being murdered by someone else, killed against your will. This protects the medical people around you, who should not be punished for your actions.
Which leaves us with the the problem of a patient that wants suicide but is unable to perform the action.
For starters, there is a LONG history of doctors swearing to not cause harm. About 2500 years worth, dating back to Hippocrates and his famous oath which was developed in the context of the ancient world where suicide was much more socially tolerated than in later times. Granted how well observed that oath has been over time has been spotty, and there are definitely folks who pretty much broke it then stomped it into the ground (looking at you, Dr. Mengele) , but for a vast number of physicians it’s a real, guiding moral principal. It’s why lethal injection executions in the US are done by medically untrained people - just can’t get docs to get involved in such things.
There are some doctors willing to do this, of course - but someone like Dr. Kevorkian always struck me as a tad eager to kill. And he did, eventually, go to prison for 2nd degree murder.
But let’s say we have a supremely ethical and moral doctor willing to help out in this circumstance. He or she is going to be extremely careful to secure true consent from the patient beforehand.
How are you going to do that?
Well, ideally, said patient has carefully delineated his/her wishes while still of sound mind, and reiterated it prior to becoming completely incapacitated. In the real world, not a lot of healthy people sit down and write something like “In the event I am incapacitated by Lou Gehrig’s disease please end my suffering with a fatal dose of morphine” or “in the event I turn up with end-stage rabies please don’t attempt the Milwaukee protocol, just put me down because I deserve at least as much mercy as Old Yeller”. It would be nice if more people did this (including myself - I’ve been meaning to do it, but like most, I keep finding more interesting things to do than contemplate my eventual death) but they don’t.
But let’s say we have a patient who has actually done this - carefully and thoroughly documented their wishes in end-of-life matters.
Here’s the thing, though - even when people really don’t want a lingering death they don’t, normally, get something like a terminal cancer diagnosis then walk out the door of the doctor’s office and put a bullet through their head. There’s stuff like putting affairs in order, finishing a couple bucket list items, and saying goodbye to people. So timing factors into this - even when death is rapidly approaching most people don’t want to go immediately to the very end.
So… it becomes a matter of when. Everyone has different tolerances for what they will put up with. I’ve spoken to people who say that if they were in pain every day they’d want to die. On the other hand, I was married to a man who experienced pain nearly every day of his life and he did NOT want to die. There are some people who would find being a quadriplegic intolerable. There are others who adjust and want to continue living. So the “when” is very subjective. Determining subjective criteria requires being able to communicate with the person.
We had a poster here for several years that went by the name of “blinky” who had locked-in syndrome. He did state that he wanted to continue living despite severe limitations. Any system in place has to advocate as strongly for the continue care and life of someone like blinky as for the ending of someone who finds that state completely intolerable and wants to self-terminate.
So - there has to be a real, sincere effort to attempt to communicate with an incapacitated person. There has to be a real, sincere effort to consider things from their viewpoint and not the reactions of others who might find their situation intolerable (or, conversely, tolerable) even if the patient does not. Because people change their minds. Thoughts of suicide are actually common and considered normal in certain circumstances - such as breaking your neck and winding up paralyzed - but most people, once past the initial injury and trauma, and with proper rehabilitation and support, actually find they want to continue living after all. People put up with devastating cancer surgeries and treatment because they want to live a little longer for whatever reason (Roger Ebert lived the last 11 years of his life with no lower jaw, no ability to speak, and no ability to eat - yet continued to work and make public appearances, as an example).
Thus, even if there are clear written advance directives I think there still has to be an attempt to communicate with the patient and ask if they still feel the same way, if they’re changed their minds, if they are actually at the point they feel there is no point to continued life. This can be very challenging at times (see poster blinky and locked in syndrome) but I think it must be a requirement.
For cases where things aren’t absolutely clear I would also insist on an ethics committee of some sort.
Only after every attempt has been made to communicate with someone completely disabled, and there is sufficient reassurance that this is not spur of the moment or due to a temporary situation but a long-term, sincere belief, that I could contemplate a doctor deliberately killing a patient. There has to be openness, transparency, and a lot of safeguards.
And - absolutely - if society is going to legalize such a thing then the doctor (or other medical person, because this could be done by a nurse or physician’s assistant or the like) also needs legal protection because they shouldn’t have to fear angry relatives or unrelated groups coming at them with lawsuits.
This is not something that any medical person should be compelled to participate in - a lot of people have moral objections to this sort of thing. Which means you have to vet the people who are doing to eliminate the kooks and criminals who might get their jollies from killing people.
And yes, that’s a lot to read, but I am really, really concerned with making sure, if we’re going to allow this, that it is the PATIENT’S decision and no one else’s.
Finally, there may be circumstances where long time periods are not possible. As an example, someone who receives 100% severe burn coverage. We can’t save someone like that with modern medicine. They are going to die. There’s no skin left to regrow and recover their body. We don’t have a viable skin substitute. Without a skin you’re going to die. I could see presenting such a patient with three options: 1) we try to treat you and keep you conscious/alive for a time (someone might take that option in order to contact loved ones one last time, perhaps, or maybe they’re smapti and believe it is the right thing to do based on personal beliefs), 2) we drug you into a medical coma but don’t otherwise intervene, letting nature take its course but you won’t feel pain/suffer in the meanwhile, or 3) we can give you a mercy kill (which we’ll probably call “euthanasia” because that sounds more medical and we can bill by the syllable). Unfortunately, that’s a case where deliberate and careful thought isn’t possible, but on the other hand, there likely isn’t time for the patient to change their mind, either.
The thing is, “right to die” really has become “duty to die” in the past. There really are cases of medical people killing people without the patient’s consent. In the 20th Century disabled people really were murdered without being asked how they felt about the situation. There is historical evidence that this really can turn into a slippery slope into a very ugly situation. Thus, based on actual history, I am very reluctant to condone this sort of thing and, if society does choose this option, I very very much want extremely stringent safeguards on the whole process, with a lot of review and re-examination.
I think we just violently agree on a lot of things Let’s review :
The importance of making sure it’s what the patient wants rather than the doctor, or the state for that matter : yes, absolutely. And it’s an obviously difficult line to draw or thread since it’s the state ultimately drawing it. There are very obvious ethical and, as you note, historical pitfalls. It’s all the more pregnant a debate in the US that y’all have sold your collective souls to the capitalist devil and turned healthcare into a for-profit industry. No quibble from me there. There absolutely be robust safeguards, checks, balances, the works in place. However…
… you think ethics committees would help there. I tend to disagree. I hate committees. I distrusts group decisions - they inevitably gravitate towards compromises, ass-covering and the least-objectionable but most-unethical (or uncaring) solutions. Virtuous people are shut down, vile consensus rules. As a friend/mentor/artist/ideal of mine says, “there’s no such thing as an evil system, there’s only a sum of individual cowardices”. As such, I really don’t believe a pannel of doctors to produce better or more virtuous results than one truly caring practitioner.
That being said, obviously (and it’s the same quandary as democracy itself), it’s pretty hard to otherwise ascertain that the person making the ultimate decision is going to be an Enlightened Despot, I’m sorry, I meant a truly caring doctor.
You mention people who get their jollies killing people, and that’s certainly a concern, given the “Angel of Death” archetype, which I have to admit is fascinating to me. The pop-culture image of them is of people who do get a kick out of playing god and deciding who gets to live or die, I think the issue is a lot more complex and interesting and, if I could start again a million miles away [del]I would keep myself, I would find away[/del]I’d study psychology and criminology and interview as many of them as I could to really grok what makes these people tick ; because I believe they manage to warp a toxic compulsion to kill people into making themselves believe they truely care about other people, which is fascinating. But I digress, the point is : yes, you would have to find a way to screen that kind of fucked up out. That being said, how many euthanasia doctors would a given population need, when all is said and done ? They would surely be known, public quantities under a lot of scrutiny ; even moreso that a significant percentage of the population stringently disagrees with the whole notion and would be actively digging up the smallest motes of dirt on their activities or character, no ? I mean, I’m not well read on or really familiar with Dr. Kevorkian’s personality or personal ethics, but that’s what happened to him, isn’t it ?
Also, and this is important, we have to keep in mind that ultimately only the individual is capable of making that decision for themselves. Imagine a quadruple amputee (no arms, no legs) or even just a double (no arms) - certainly there are workarounds that can be found. Feelings of loss of ability can be turned around, and so on and so forth. There are plenty of feel good stories about people with such disabilities that wound up doing great things and being happy. But some other people won’t find it in them to do that. Not because they’re “weak” (fuck that word, for real), not because they failed, just because… well, it wasn’t in them. And that’s OK. There’s a very real tendency in our society to demonize or shame people who just can’t make their circumstances work. Losers ! But in reality, it’s not our place to judge, and furthermore we cannot possibly quantify the subjective level of pain/suffering/hopelesness/despair another person is feeling. One person will bounce back from a lover leaving them, another will be crushed by it for the rest of their lives. Some bend, some break. But the point is that in the end, pain is pain. It doesn’t matter if someone else bore the same pain more gracefully. It doesn’t matter that you maybe felt that same pain and were OK in the end. It doesn’t even matter that the cause of said pain is trivial and exaggerated and all in that person’s mind - they’re still feeling that fucking pain ! It’s real to them. And they don’t have your perspective or anyone else’s - only theirs, only right now. And that’s something that really should be indoctrinated into people throughout our society, because I shit you not, an ex- of mine had a fucking shrink tell her to “just man up” ; and another who had anorexia had her shrink tell her to stop being such a baby and eat. I’m still floored when I think about it - a trained medical professional trying to shame a teenage girl out of a disease notoriously *caused *by shame…
I feel I’ve lost myself somewhere along that argument. Ahem.
Anyway, yeah, I agree (?) ( )
Yeah, it’s not that we disagree in general, but I suspect we disagree a great deal in details.
As for ethics committees - I see their role more as oversight and seeking second opinions. Much like having a doctor involved in a case do a neurological examination to confirm or rule out brain death after a first doctor has made that determination. They have a role in the US in marginal/grey area/experimental cases in trying to guarantee that patient consent is real, that there is no coercion, and so forth.
As for Dr. Kevorkian - he had some valid points but he really did seem too comfortable with death and there were significant questions about just how consenting some of his patients/victims actually were. Quite a few pushed the button on the suicide machine he made themselves. I’m not overly troubled by those cases, as it was the dying person who made the decision. What does bother me were later instances where it was VERY questionable if the person was capable of giving consent. I was an administrative case manager for long term disability benefits for one of his victims and, while US law forbids me from commenting much on the case that was one instance where, having seen medical records and documentation for the person concerned, I can’t fathom how the person could have possibly given consent for the “procedure”. After that, I really had to ask if Kevorkian just liked killing people and had found a way to justify to himself and possibly others.
) suicidal patients I’ve taken care of change their minds about killing themselves, it also seems to me that public policy should unilaterally enforce a bit of a waiting period and an option for counselling for individuals with suicidal intent.
Let’s review :