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Euthanasia or Physician assisted suicide describes an active ending of a life that would not otherwise end at that point in time.

Withdrawing treatment describes the removal of a therapy that is actively prolonging life. Withdrawing this therapy does not cause death. The underlying disease process causes the death.

There is a large ethical divide between the two actions. And this is where community discussion comes into play.

Bioethics stems from the principles of beneficence, non maleficence, justice and autonomy.
Euthanasia can be argued to fail the test of beneficence and non maleficence.
Withdrawal of treatment in a terminal patient, and not prolonging the dying process, has no similar ethical issue.

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Originally posted by Carex:
The Oregon Death with Dignity Act has been in effect for 16 years. The details may be different, but part of the Oregon law requires the state to keep records and statistics, which may be useful to get a sense of who makes use of it and why. Roughly 2/3 of the people who have received prescriptions have used them over the years, and the overall death rate due to such prescriptions is about 0.2% of the total death rate in the state. That web site also has a list of the articles published on the DWDA in professional journals (mostly the Journal of Clinical Ethics and the New England Journal of Medicine), which may provide additional information not collected by the state, including one on people who chose not to make use if it.

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That sounds very humane

I think spiritually we're supposed to stay here for our allotted time. But there is no definition of how that should happen, and preventing death by legal means - rather than personal means - is a blunt instrument that probably does a lot of damage. Who knows whether someone would come through and lead a fulfilling life for another 20 years, or would die in parts and need to go home but not be allowed? There is no way to know. I have treated in my practuce people who were walking talking and apparently normal, but who felt like they were dead (no not zombies ). I guess there are a lot of ways to die, an dthere is a right tome and a wrong time - I just don't undertstand all the ins and outs of it.

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"Iti sapis potanda tinone" Lycophron

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Honest Ron Bacardi: Le Roc - I wouldn't challenge your assertion that most Dutch people are comfortable with the current situation in the Netherlands. But public comfort is just one thing, and is manipulable, not least by group-think.

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Originally posted by que sais-je:
So isn't relieving suffering sometimes an adequate reason to accept death? Is it never right to die for others?

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Originally posted by Byron:
If your argument's the risk of coercion, that counts, but only if it's consistent. Allowing patients to withdraw from care presents just as great a risk as euthanasia. If you're against one, you should be against another.

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Originally posted by JoannaP:
I strongly believe that everyone has the right to kill themselves if they feel that their life is intolerable but nobody has the right to an easy, pain free death or to ask anyone to actively help them.

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Originally posted by Byron:
There needs to be a much clearer line between policy and theology on this.

Regardless of whether you personally disagree with assisted suicide and euthanasia, law needs a rational and secular basis.

If your argument's the risk of coercion, that counts, but only if it's consistent. Allowing patients to withdraw from care presents just as great a risk as euthanasia. If you're against one, you should be against another.

If you're not, then what is "coercion" but a figleaf for imposing theology on those who don't share it?

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Just some thoughts.

For me palliative care is about attempting to alleviate suffering and restore relationship.
Terminal illness disrupt relationship. With the environment, with family and with spirituality. Palliative care at its heart attempts to restore relationship as best it can.

It helps you live longer and live well. And when it comes time to dying, it helps you die well. It supports the patient and their families and friends. It offers hope.

Palliative care offers hope.

The hope is in
Not having to make this journey alone.
Being heard and having symptoms addressed as best able.
Being valued.
Having your personhood recognised and developing a therapeutic relationship.

Palliative care is about hope, restoration of relationship and reducing suffering. The main argument I would mount against voluntary euthanasia, Is that I do not see hope, relationship or restoration in it.

One of the important things palliative care offers is that no matter how much you suffer, no matter how hard it gets, no matter how messy the dying is, you do not have to do it alone. Suffering is at its heart a lonely process. And developing relationship reduces suffering.

There have been times, in the messiest deaths, where my care has simply been to sit, hold the hand and participate in the journey. These are the times when I feel most powerless (and most valuable). These are the patients i remember the most. Their stories. Their families.

Palliative care is a privilege to deliver. It is not perfect. There are always things that can be done better. Life is messy. Death is messy. Relationships are messy. And that is ok.

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Originally posted by Gee D:
Earlier this year, there was a sad decision by a State Supreme Court judge here, one that I know caused him a lot of anguish and stress. A young man had been very seriously injured in a car accident about a decade beforehand. He had been bed-ridden since, with the usual sorts of problems that go with that. He had had several illnesses, and these were becoming more frequent and more severe. He depended upon a life support system. Despite all this, he was normally sentient and conscious. He was also quite intelligent and there had been little lowering of this in his accident. He knew that his life span had been substantially reduced by his injuries and the increasing frequency of his illnesses was evidence both that the life span had been reduced more than originally thought, and that the end was near. He wanted to die if possible on his 28th birthday, or as close as possible to it and asked that his life support be turned off. What do you think?

The hospital sought a declaration from the court that they would be justified in complying with his wishes. He was named as defendant and indicated his consent. Despite the consent, the court was presented with a large amount of medical evidence, including report separately prepared by a couple of psychiatrists that they concluded that the man's decision was considered and reached without any family or other pressure. The judge made the declaration sought. A week or so later the life support was turned off, only palliative care was given and the man in fact had his wish. What do you think? To me, this is very different to any sort of euthanasia or supported suicide.

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Originally posted by Uncle Pete:
Right-to-die advocates are the thin edge of the wedge as the question evolves from age and terminal illness to the " need-to-die because they are not perfect or cramp the lifestyle of the "carer"."

And it will. Have we learnt nothing from the the eugenics movement? Just today a US Senator avocades the sterilization of all poor women before they are allowed on Medicaid. What is next?

Frankly, the whole right-to-die people scare the crap out of me.

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Originally posted by Adeodatus:
I think I've said this before here, but to me the expression "right to die" is a nonsensical euphemism. Once life is begun, death is inevitable. You might as well say that if I knock my coffee cup off the desk, it has a "right to hit the floor".

This is not about a right to die. It is about a right to ask someone else either to help you take your own life, or to kill you. And if I have that as a right, then someone is obliged to do it. I don't believe I have the right to put anyone under that obligation.

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Originally posted by Byron:

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Originally posted by Adeodatus:
I think I've said this before here, but to me the expression "right to die" is a nonsensical euphemism. Once life is begun, death is inevitable. You might as well say that if I knock my coffee cup off the desk, it has a "right to hit the floor".

This is not about a right to die. It is about a right to ask someone else either to help you take your own life, or to kill you. And if I have that as a right, then someone is obliged to do it. I don't believe I have the right to put anyone under that obligation.

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Any assisted suicide/euthanasia law ought to have a conscience clause, on practical grounds if no other. So theoretically, if every caregiver in country refused to participate, there'd be no right to die.

Somehow, I don't see this situation arising, do you?

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Originally posted by Uncle Pete:
Right-to-die advocates are the thin edge of the wedge as the question evolves from age and terminal illness to the " need-to-die because they are not perfect or cramp the lifestyle of the "carer"."

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Originally posted by Uncle Pete:
Any person has the right to withdraw from or refuse treatment. No one has the right to impose on other people to assist them to die.

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Originally posted by Byron:
Uncle Pete, that case is horrific, but what bearing does it have on assisted dying? It just illustrates the abuses possible under the law as it stands. If someone's willing to commit murder, involving physicians isn't likely to increase the risk, is it?

Patdys, I did consider the repetition, but this is a different thread in a (relatively ) unhellish forum. I agree there's little purpose in us two going through it again.

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No, Robert Latimer made an explicit appeal to the jury in his case that his actions were a 'mercy-killing". His crime was clearly First-Degree Murder (that is, premeditated) under the Criminal Code of Canada, but the jury in an fit of soft-nullification found him guilty of Second-Degree Murder.

Mr. Latimer was a murderer who made a fatuous excuse about "mercy-killing" to a jury and the jury bought it. And that scared the crap out of me because it lessened the protection of the law for people like Pete and myself who have disabilities and who may become dependent.

And Robert Latimer can rot in hell.

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NDP Federal Convention Ottawa 2018: A random assortment of Prots and Trots.

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Originally posted by Uncle Pete:
Thank you for that post, 3M Matt.

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3M Matt: There is no physical symptom, pain, vomiting, nausea, etc, that we cannot successfully erase with palliative care, provided you're willing to accept that we may very well shorten your life in the process, and will have to withdraw active treatments.

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Originally posted by 3M Matt:
[...] There is no physical symptom, pain, vomiting, nausea, etc, that we cannot successfully erase with palliative care, provided you're willing to accept that we may very well shorten your life in the process, and will have to withdraw active treatments.

We do not ever need euthanasia or assisted dying for those things. [...]

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Originally posted by Pearl B4 Swine
This subject has been in the back of my mind for a long time. Sometimes it bubbles to the surface, as it did this morning when I read about this suicide .
I seem to remember that in the past, suicide was considered illegal, although what penalty could or would be brought against the person who died is a mystery.

We have no say in being brought, living, into the world, but we do have the power and ability to cause our own deaths. I think there's a vast difference between a person suddenly, and with no prior knowledge of her/his family, committing suicide, and the well-planned exit from life, with the cooperation and "permission" if you will, of family, associates, etc.

Please let me know how you stand on this issue, and what the legal and maybe the theological implications are.

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Originally posted by LeRoc
There is a lot of discussion about this in the Netherlands, where elderly people who are in principle healthy demand the 'right to die'.

There is a lot of confusion about this, and I feel that some of it is deliberate. For example, the 'right to die' when people are not in the mood to continue living is confused with euthanasia for people who have certain diseases. Also, the 'right to die' is a misnomer. Everyone will die, and you can easily choose a moment for this if you want.

Where I draw the line is where people demand government assistance in their suicide.

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Gwai: Pasted over from another thread:

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Originally posted by Byron:
The line between physical and mental suffering is equally thin. A patient wracked with bone cancer, with a tolerance for opiates that'd awe a junkie, or a patient with a degenerative condition left immobile, incontinent, and with no quality of life, is suffering. The best judge of their quality of life is them.

At heart, like abortion, euthanasia is a religious debate the law ought to stay out of.

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Originally posted by Stercus Tauri:
That's a fairly good description of my mother. She also has inoperable cataracts, so she can't read and can barely see our photos any more, but she has a sharp mind and an astonishing memory, until the hallucinations roll out, anyway. She seems happy most of the time, and she has never, to my knowledge, suggested that she's had enough. I doubt I could do what she is doing, and from my present perspective, would want to find a way to shorten the wait if I were in the same condition. Her view and mine of her quality of life are quite different. She enjoys the nursing home and the regular visits, and asks for nothing more, or less. If she wanted to die, I think she would, quite easily and with very little help. But she doesn't.

When my father died of cancer he could probably have been kept alive for several more hours or even days with massive medical intervention. He was allowed to slip away in his sleep. That was a dignified death for him and all his family.

It's hard to engage in what is for most of us, a theoretical discussion, without sounding pompous and doctrinaire, but I do believe that applying the principle of 'do no harm' means alleviating incurable and unbearable suffering. So far, my ancient mother is bearing it.

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