Thread: Choosing a candidate for voluntary euthanasia Board: Oblivion / Ship of Fools.


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Posted by Curiosity killed ... (# 11770) on :
 
Archbishop George Carey just can't resist the limelight and making things difficult for the CofE, can he?

This time he has come out in support of the right to die legislation against the CofE stance, just before it is debated in General Synod - CofE daily digest

quote:
the former Archbishop reveals that he is to back legislation tabled by Labour peer Lord Falconer that will seek to legalise assisted dying for the terminally ill in England and Wales.
This one has already had a few posts on the TICTH and I agree with deano (falls over in surprise, it's the second or third time recently) that it deserves it's own Hell thread.

How about Carey just volunteers for his suggestion first so we can see how it goes?
 
Posted by Curiosity killed ... (# 11770) on :
 
Copying over the posts from the TICTH thread:

Originally posted by Alex Cockell:
quote:
TICTH George Carey - for following the Nazi playbook on "assisted suicide" or Mercy Killing.

It's basically Action T4 being replayed.

http://en.wikipedia.org/wiki/Action_T4

Carey went public today - http://www.telegraph.co.uk/news/religion/10963195/Lord-Carey-I-support-assisted-dying.html

Does he want to look ME in the face and tell me that as an autistic man that I am less than human? because I am disabled? Does he view Mr Nicklinson as less of a human? Because that is the logical outcome.

quote:
Although officially started in September 1939, Action T4 might have been initiated with a sort of trial balloon.[24] In late 1938, Adolf Hitler instructed his personal physician Karl Brandt to evaluate a family's petition for the "mercy killing" of their blind, physically and developmentally disabled infant boy. The boy was eventually killed in July 1939.[25] Hitler instructed Brandt to proceed in the same manner in similar cases.[26] The Reich Committee for the Scientific Registering of Hereditary and Congenital Illnesses was established on 18 August 1939, three weeks after the killing of the mentioned boy. It was to prepare and proceed with the registration of ill children or newborns identified as defective. Secret killing of infants began in 1939 and increased after the war started. By 1941, more than 5,000 children had been killed.[27]

Hitler was in favour of killing those whom he judged to be "unworthy of life". In a 1939 conference with health minister Leonardo Conti and the head of the Reich Chancellery, Hans Lammers, a few months before the euthanasia decree, Hitler gave as examples of "life unworthy of life:" severely mentally ill people who he believed could only be bedded on sawdust or sand because they "perpetually dirtied themselves", or who "put their own excrement into their mouths, eating it and so on".
When did we become a fascist country?
originally posted by Albertus
quote:
Might of course cause a few 'liberal' supporters of the proposals to rethink their position. Hope so, anyway.
Originally posted by deano:
quote:
TICTH Twats who conflate comments like the following with nazi forced killing...

quote:
"I would have paraded all the usual concerns about the risks of “slippery slopes” and “state-sponsored euthanasia”.
"But those arguments which persuaded me in the past seem to lack power and authority when confronted with the experiences of those approaching a painful death.”
And who do it in a thread where debate is forbidden instead of having the balls to create a separate thread in purgatory where their arguments could have been dissected fully and completely.
Originally posted by Arethosemyfeet:
quote:
Now look what you've done, Alex, you've made me agree we deano.

Fuck. [Mad]
Originally posted by Spike:
quote:
quote:
Originally posted by Alex Cockell:
Does he want to look ME in the face and tell me that as an autistic man that I am less than human? because I am disabled? Does he view Mr Nicklinson as less of a human? Because that is the logical outcome.
I'm sure he would quite happily look you in the face, because what you are accusing him of is NOT what he is advocating. OK, so Carey is a dick of the first order and I've always thought so, but even more so since he became a rentagob for the Daily Mail, but although I disagree with his stance, your reaction is hysterical to say the least.

 
Posted by Gildas (# 525) on :
 
I am not an unqualified admirer of Lord Carey and, as it happens, I disagree with him on this issue. That said, it is something of an overstatement, to put it politely, to compare his comments to the Nazi Euthanasia programme.

When he was editor of the Telegraph Max Hastings* used to forbid his writers to compare anything to the Third Reich. I think that is a very good rule of thumb.

(*Rather ironically Sir Max was known to readers of Private Eye as 'Hitler').
 
Posted by Doublethink (# 1984) on :
 
I think it is harmful to others, to ask them to kill you. And therefore, it is morally suspect. But I have yet to see this issue seriously addressed in discussions about euthanesia.
 
Posted by anne (# 73) on :
 
quote:
Originally posted by Doublethink:
I think it is harmful to others, to ask them to kill you. And therefore, it is morally suspect. But I have yet to see this issue seriously addressed in discussions about euthanesia.
This is a significant factor in my objection to both euthanasia and to judicial killing. I don't think that society should place the burden on a person of expecting them to kill another human being, whether they are willing or not.

anne
 
Posted by Gildas (# 525) on :
 
Just to mix it up Obersteppenfuhrer Desmond Von Tutu comes out in favour of assisted dying in the Grauniad.

Has someone got an attic they can put Alex up in, for the duration?
 
Posted by Spawn (# 4867) on :
 
quote:
Originally posted by Curiosity killed ...:
How about Carey just volunteers for his suggestion first so we can see how it goes?
Did you just say what I think you said? Would you like to say it again?
 
Posted by Oscar the Grouch (# 1916) on :
 
The issue of assisted dying is a deeply complex one and also highly emotive in all directions.

I welcome Carey & Tutu's interventions, although I find it amusing that we can talk about them in the same breath. I think that the C of E should have a long hard look at this.

But what I find especially intriguing is that Carey uses the kind of arguments that are often used by those arguing in favour of SSM - and the kinds of arguments that Carey and others would dismiss out of hand if the subject WAS SSM.

I agree completely that personal experience of people who are suffering will make us think long and hard about the rights and wrongs of something like assisted dying. Will Carey now be doing the same sort of exercise with SSM and homosexuality in general? If not, why not?
 
Posted by Curiosity killed ... (# 11770) on :
 
Tutu is saying good death and not unnecessarily prolonging life, which is somewhat different to Carey's stance.

And Spawn, I don't actually wish anyone dead, but I really do wish that Lord Carey was silenced. That he would stop writing columns on how the CofE should be run. His term as ABC was two terms ago now, twelve years since, and throughout that time his pontifications have continued to poison the chalice that subsequent ABCs have inherited.
 
Posted by Spike (# 36) on :
 
quote:
Originally posted by Curiosity killed ...:
Archbishop George Carey just can't resist the limelight and making things difficult for the CofE, can he?
I don't think he's making things difficult. Most of us regard him as the mad old uncle who comes out with randomly odd comments but who is largely ignored.
 
Posted by Lyda*Rose (# 4544) on :
 
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Lyda*Rose:
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?
This is precisely my problem with voluntary euthanasia -- the possibility or likelihood that a dying person be talked into getting out of the way by unscrupulous relatives.
 
Posted by Sioni Sais (# 5713) on :
 
quote:
Originally posted by mousethief:
quote:
Originally posted by Lyda*Rose:
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?
This is precisely my problem with voluntary euthanasia -- the possibility or likelihood that a dying person be talked into getting out of the way by unscrupulous relatives.
I'm concerned that those who aren't related will try to influence "dying persons" too, and amongst 'those' I include non-personal entities.
 
Posted by Ariston (# 10894) on :
 
quote:
Originally posted by mousethief:
quote:
Originally posted by Lyda*Rose:
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?
This is precisely my problem with voluntary euthanasia -- the possibility or likelihood that a dying person be talked into getting out of the way by unscrupulous relatives.
Anyone who would automatically trust next of kin to always make the right decision for their relatives on principle needs to read a certain Hell thread.
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Sioni Sais:
I'm concerned that those who aren't related will try to influence "dying persons" too, and amongst 'those' I include non-personal entities.
Insurance companies are people, my friend.
 
Posted by Curiosity killed ... (# 11770) on :
 
There was this story too - an article showing how the number of deaths from assisted dying has escalated in the Netherlands and
quote:
former supporter of the Dutch Euthanasia laws and member of the Euthanasia Review Committee in The Netherlands, Professor Theo Boer tells Britain that he was wrong.
The problem with all these arguments is where do you draw the line? The "Thou shalt not kill; but needst not strive officiously to keep alive" argument sounds reasonable, but what is striving officiously to keep alive and what is giving up too early? And who decides? The patient? The family? The medical team? The finance board at the local hospital?

Is it striving officiously to keep alive a Down's Syndrome child of 3 with pneumonia? Is it striving officiously to keep a mother alive for three or four years with repeated hospital visits and daily treatments so her son has a few more years to grow up before she dies?
 
Posted by Curiosity killed ... (# 11770) on :
 
quote:
Originally posted by Spike:
I don't think he's making things difficult. Most of us regard him as the mad old uncle who comes out with randomly odd comments but who is largely ignored.
The press coverage today has certainly not ignored it. Every BBC news led on this story and the splits between the Archbishops and the Church of England and all the papers have picked up on it.
 
Posted by RuthW (# 13) on :
 
quote:
Originally posted by Curiosity killed ...:
The problem with all these arguments is where do you draw the line?
Uh, well, yeah. It's the whole problem with arguments on both sides. The problem with arguments for assisted suicide is that we could end up drawing the line too close to ending life, and the problem with arguments against it is that we could end up drawing the line too close to prolonging suffering.

I submit that the problem is that we're trying to draw lines not in the sand but in muddy water. Some might want every last possible moment of life. Others may feel that their suffering is so great that life isn't worth living. These two groups might be in very similar positions from a medical standpoint. And we're trying to write laws that tell people what they can and cannot do in extremely difficult situations. Wherever we draw this line, some people are going to end up on a side of it they don't want to be on.

So is there a way to do this without drawing a line? Without making a one-size-fits-all law?
 
Posted by Sioni Sais (# 5713) on :
 
quote:
Originally posted by RuthW:


.. is there a way to do this without drawing a line? Without making a one-size-fits-all law?
In Britain and America we have judges to make case-by-case decisions. They aren't perfect but I prefer them to legislation put together by politicians who may be swayed by lobbyists for goodness knows what.
 
Posted by Alex Cockell (# 7487) on :
 
quote:
Originally posted by Sioni Sais:
quote:
Originally posted by RuthW:


.. is there a way to do this without drawing a line? Without making a one-size-fits-all law?
In Britain and America we have judges to make case-by-case decisions. They aren't perfect but I prefer them to legislation put together by politicians who may be swayed by lobbyists for goodness knows what.
What was kinda my point. Just that if the line was moved on irrational or emotional bases... you have the risk of seeing people as "useless eaters". And if I factor int he attitudes of people like IDS and Esther McVey...
 
Posted by MarsmanTJ (# 8689) on :
 
I find this one tough. A relative of mine was dying of cancer. He was in agonising, debilitating pain, and had between 1-2 weeks of agony left. Or, alternatively, the Doctors offered enough morphine to deaden his pain, giving him 12-24 hours to live, but pain free and relatively with it. It wasn't a difficult decision. But technically that was illegally assisting suicide. All I know is, the family had an amazing last few hours vs the previous week of him being unable to talk through the pain. This is a hugely complex issue, and I can't help but feel that there are very rare occasions where it can be fully justified to give someone a lethal combination of pain-killers, just so their last few hours are pain-free.
 
Posted by Arabella Purity Winterbottom (# 3434) on :
 
I've had the same experience, with my granddad. He was able to die without pain, after saying goodbye to us individually. We all knew what the doctor was doing, including Granddad, and not one of us had a problem.

Mind you, he was very clearly right at the end of his life, and it would have been a matter of 2-3 days difference. But it was a dignified death as opposed to an agonising one.
 
Posted by Welease Woderwick (# 10424) on :
 
It was similar with my mum when the Dr prescribed Brompton's Mixture as and when required. This may well have shortened her life by a day or two but ensured that she was comfortable during the transition. The Dr instructed my dad and I to administer it as and when, which we did. I have no problem with my conscience on this - we gave her 5mls whenever she started exhibiting pain symptoms, she was already semi-comatose and the cancer wasn't going to go away.

I am very wary of the idea of NHS bureaucrats, or local equivalent, getting hold of any such rights, legislation, etc. particularly when or where healthcare is a commercial commodity.
[Codefix.]

[ 13. July 2014, 06:07: Message edited by: Ariston ]
 
Posted by North East Quine (# 13049) on :
 
My grandmother, too, though I'm sure her life was shortened by only a matter of hours, perhaps a day or two at most.

I knew what was happening, once they started the morphine, but I don't know whether the rest of the family knew or not. We've never discussed it. But once everyone who was going to come to say their goodbyes had arrived, the morphine was upped and Gran's distress ebbed away.

I think I'd arrived about 36 hours before the morphine was increased, and there was no doubt in my mind that my frail grandmother had no hope of recovery.

But this sort of "managed death" already happens. People have a reasonable expectation that they will not be left in agony when there are drugs to manage pain, even if a side effect of those drugs is to hasten the end.

The proposals go beyond that; to pre-empting anticipated pain, not just managing existing pain.

ETA - Gran didn't know what was happening; she would not have had the capacity to consent to the morphine being increased; had ceased to have that capacity several months earlier.

[ 13. July 2014, 06:09: Message edited by: North East Quine ]
 
Posted by Karl: Liberal Backslider (# 76) on :
 
quote:
Originally posted by Spike:
quote:
Originally posted by Curiosity killed ...:
Archbishop George Carey just can't resist the limelight and making things difficult for the CofE, can he?
I don't think he's making things difficult. Most of us regard him as the mad old uncle who comes out with randomly odd comments but who is largely ignored.
And on this occasion might be, and the uncharitable might use the phrase "stopped clock", right.

Which puts me in mind of the unusual experience I had the other day of feeling some sympathy for Leon Brittan (yes, really!) - not acting on a child abuse dossier provided by Geoffrey Dickens is not entirely unlike not acting on a dossier about lizard illuminati infiltration of the royal family provided by David Icke.

But I digress.

[ 13. July 2014, 07:20: Message edited by: Karl: Liberal Backslider ]
 
Posted by Doublethink (# 1984) on :
 
[langet]Re Leon Brittan, plus they are saying he didn't act - whilst also saying he passed it to officials (deals with conflict of interest / allegations of making political capital) who passed the allegations on to the police. How is that an inappropriate response ? Now its possible the police then dropped it like a stone, but that is a rather different issue. [/tangent]
 
Posted by orfeo (# 13878) on :
 
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.
 
Posted by Gee D (# 13815) on :
 
quote:
Originally posted by Sioni Sais:
In Britain and America we have judges to make case-by-case decisions. They aren't perfect but I prefer them to legislation put together by politicians who may be swayed by lobbyists for goodness knows what.

And here as well. On a similar thread a few months ago, I gave a link to a decision of a NSW Supreme Ct judge on an application by a hospital for a declaration that they would be justified in following the wishes of a patient to turn off his life support systems. He had been severely injured in his teens and survived for a dozen years or so. His condition was deteriorating and it was apparent that his expectancy was only about another year, over which time his condition would deteriorate even more. He did not want euthanasia*, but simply to turn off the various machines, in the hope that he would die on his 28th birthday. The judge considered large amounts of evidence and concluded that the hospital would indeed be justified in having the systems turned off. AIUI, his family were the ones who attended to that step and he died peacefully some 10 hours later, on his birthday as he had wished.

* He expressed his distaste for the idea that someone would have had to give him a fatal injection, his thoughts being along the lines set out by another poster above.
 
Posted by Schroedinger's cat (# 64) on :
 
I am steadfastly opposed to euthanasia, for all of the reasons above. Having said that, I do understand the desire to an extent - I would have liked to relieve my dad of his suffering for his last few days. But I am glad that I didn't/couldn't.

Carey has simply made a point that he has changed his mind. And yes, he knew exactly when to announce this, ahead of the synod debate, but it is more significant that he has changed his mind, I think. The CofE is actually not that important.

We do need to have a discussion about it. But I am not sure how we can in a climate where the only "discussions" are people shouting arguments to prove their points. If the government is serious about managing end-of-life care, the first thing to do is pay for the hospices, and help them to support the dying.
 
Posted by Curiosity killed ... (# 11770) on :
 
quote:
Originally posted by orfeo:
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.
Yep - no-one else was going to start a thread and I was still running a temperature, so shoot me.

[ 13. July 2014, 09:40: Message edited by: Curiosity killed ... ]
 
Posted by Curiosity killed ... (# 11770) on :
 
The problem is that we are likely to get a wholesale change in the law with all the attendant dangers to deal with those hard cases like the locked in cases. And even in these cases (pdf):
quote:
Healthy individuals and medical professionals sometimes assume that the quality of life of an LIS patient is so poor that it is not worth living. On the contrary, chronic LIS patients typically self-report meaningful quality of life and their demand for euthanasia is surprisingly infrequent. Biased clinicians might provide less aggressive medical treatment and influence the family in inappropriate ways.
This proposed law will allow so many consequences for so many other people that it is dangerous.

We do need a debate about how to support a good death, which is what the Liverpool Plan was attempting to achieve but the implementation was flawed. The link is to the report into the Liverpool Plan and suggested way forward from the Marie Curie Cancer Care charity.
 
Posted by Schroedinger's cat (# 64) on :
 
quote:
Originally posted by Curiosity killed ...:
quote:
Originally posted by orfeo:
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.
Yep - no-one else was going to start a thread and I was still running a temperature, so shoot me.
Actually, I can think of a few actual candidates. Not all of them politicians.
 
Posted by Penny S (# 14768) on :
 
My mother had brain cancer. A symptom was that any skin contact was agony. She was conscious but could not speak. The hospital suggested morphine (actually diamorphine which I later discovered was heroin) and when asked to indicate via blinking, she made it very clear she wanted it. It took them three days to clear the prescription. And she then had a bad reaction to it with a vile fluid leaking from her mouth. She was not peaceful, not able to communicate at all.

I had a look at the powered driver pump for the drug, but I could not work out how to increase the dose. I was prepared to go to jail for it.

Eventually a senior nurse took my father and I aside and explained that what was happening was an unusual and unpredictable side effect of the stuff and they were very sorry about it, and, curiously, while they were tidying the bed while we were out of the room, she left.

The spokesman who went on TV to counter Carey's opinions went on about the dignity of life to its end.

Even though this is a place where bad language is permissible, I can't bring myself to respond to that man. In his post, as bishop, he MUST have been at bedsides like my mother's, and it is utter gall to use the word dignity of that agony.

[ 13. July 2014, 11:51: Message edited by: Penny S ]
 
Posted by Curiosity killed ... (# 11770) on :
 
Nobody is against a good death. And the gradual increase of morphine to ease pain is well known to shorten life but make the death less painful. As is removal of life support when that is all that is keeping someone alive.

What this bill is suggesting is that people ask to be killed, as is already happening in the Netherlands. And people involved in the Dutch decision are pointing out that they are not comfortable with the results following the increase in assisted suicides - it looks like an exponential graph - linked above. There are all the risks that someone could be pressurised into being killed and people are seen as expendable.
 
Posted by Penny S (# 14768) on :
 
One of the things that I heard countering Carey which was a matter of serious concern was the linking of the issue with elder abuse, and the pointing out that the number of people wanting to have assisted suicide was much smaller than the number of reported cases of elder abuse. (And then I found myself watching an episode of New Tricks which touched on the theme.) That is a serious worry. There would need to be very strong defences against the possibility of pressures from outside, and those would cost public money.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by anne:
quote:
Originally posted by Doublethink:
I think it is harmful to others, to ask them to kill you. And therefore, it is morally suspect. But I have yet to see this issue seriously addressed in discussions about euthanesia.
This is a significant factor in my objection to both euthanasia and to judicial killing. I don't think that society should place the burden on a person of expecting them to kill another human being, whether they are willing or not.

anne
For me, giving doctors permission to kill their patients is crossing a line that I am deeply unhappy about. As said above, administering pain relief knowing that, as a side effect, it will shorten life, is seems to be a whole different ball game from administering a drug that has no purpose other than to kill the patient.
 
Posted by Pigwidgeon (# 10192) on :
 
I'm surprised no one has mentioned Sarah Palin's warning about Obama's Death Panels.
 
Posted by Ariston (# 10894) on :
 
quote:
Originally posted by Curiosity killed ...:
quote:
Originally posted by orfeo:
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.
Yep - no-one else was going to start a thread and I was still running a temperature, so shoot me.
You mean nobody else had started a thread, so, as Mistress of the Universe, Manager of Wayward Shipmates, Self-Appointed Boss of Everybody, Queen Junior Host Extraordinaire, you decided to butt in and dictate the starting terms?
 
Posted by Schroedinger's cat (# 64) on :
 
quote:
Originally posted by Curiosity killed ...:
Nobody is against a good death. And the gradual increase of morphine to ease pain is well known to shorten life but make the death less painful. As is removal of life support when that is all that is keeping someone alive.
Increasing pain killers to the point where a person is no longer in pain I am all for, even if it reduces their life expectancy from months to weeks. I am less sure if it is liable to take years off their life - that is a more difficult decision.

But there is a huge conceptual leap from "making their last days/weeks comfortable" to "deciding when to deliberately and explicitly end their life".

I did know of someone who went to have an induced birth, because the husband had to plan time to attend around his work. While I was disconcerted by this, it did make sense (and it was just about the right time). My worry is that a similar approach would be taken to dying: "can we just finish him off this weekend, so I can get back to work on Monday". It sounds callous, but (in possibly different words) would happen.

Death is always unpleasant. I actually think we need to deal with it a whole lot more, not comoditise it as something we can package up and organise.
 
Posted by Pyx_e (# 57) on :
 
3 points, mostly already made.

In 20 years of ministry I have never known anyone suffer terribly. The morphine thing is just true.

I know this is the age we live in but the venality of some adult/children of elder folk astonishes me. I have heard them complain that being in a nursing home is "wasting" their inheritance. I have often heard conversations which would take only the lightest straw to reach, "it's best we let them go now, they have no quality of life."

Lastly thousands of people die at their own hands every year. Assisted suicide is a misnomer. If I was that desperate to go I would simply refuse food and water and be expected to be helped to be pain free.

It is the mark of a decadent culture that so many are so afraid and unfamiliar with dying and death that they attempt to make that some hallmark moment too. It is a mess, so is life . It is not the living or dying that matters it is how we live and die. Pray God with hope and a sense of adventure. Not mewling as our kids pump us full of shit so they can go to the Maldives or their inheritance to get over the trauma.

Ghouls.

Pyx_e
 
Posted by Sioni Sais (# 5713) on :
 
One for the Quotes file there Pxy_e.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Pyx_e:
Lastly thousands of people die at their own hands every year. Assisted suicide is a misnomer. If I was that desperate to go I would simply refuse food and water and be expected to be helped to be pain free.
It worked for Tony Nicklinson.
 
Posted by Adeodatus (# 4992) on :
 
Concerning people with diseases such as most kinds of cancer, the argument is, as others have already said, a shoal of red herrings. Proper medical and nursing care make "assisted dying" all but unnecessary. (Here, a word about whether pain killing drugs can shorten life: yes, they can, sometimes. But the ethical principle of double effect is well established in both theology and medicine, which means that this, too, is irrelevant to the argument.)

The "difficult cases", which strain any instinctive opposition to this idea, are conditions like locked-in syndrome, in which the person seems to outsiders to be suspended in a limbo between life and death. I've no direct experience of any such cases, but they sound terrifying, and I simply don't know what side I'd be on if confronted with one.

Aside from the more commonly cited arguments, however, two other less commonly heard arguments continue to worry me. First, as I think I've said here before, if I have a right to ask a doctor to hasten my death, then somewhere, a doctor has the obligation to do so. My argument here is that the expression "right to die" is virtually meaningless. (One might as well say that Newton's apple, once it detached itself from the tree, had a "right to hit the ground".) What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.

Secondly, a major problem with this particular proposed legislation is the supposed "protection" built in by its requiring the agreement of two doctors. I'd just like to ask, have you ever tried to get two doctors to disagree? It's virtually impossible to get one doctor openly to contradict another. And if you need another illustration, just look at that other piece of legislation that was supposed to have exactly the same limiting factor: the Abortion Act of 1967. Here, too, it was said that the numbers involved would always be small because two doctors would have to agree to the procedure.

And how did that turn out?
 
Posted by Boogie (# 13538) on :
 
quote:
Originally posted by Pyx_e:
If I was that desperate to go I would simply refuse food and water and be expected to be helped to be pain free.
It takes about a week to die after giving up fluids. It's not an unpleasant death if people are around to keep you comfortable.

What I hate is when fluids are pumped into people when it's very clear they are dying - then they drown in their own fluids, a horrible and frightening death.
 
Posted by Anselmina (# 3032) on :
 
quote:
Originally posted by anne:
quote:
Originally posted by Doublethink:
I think it is harmful to others, to ask them to kill you. And therefore, it is morally suspect. But I have yet to see this issue seriously addressed in discussions about euthanesia.
This is a significant factor in my objection to both euthanasia and to judicial killing. I don't think that society should place the burden on a person of expecting them to kill another human being, whether they are willing or not.

anne
This is one of the things I would worry about, too. If I had a relative who wanted my collusion - albeit legally with the appropriate medical assistance - to put an end to his life, do I have the right to say 'no'? Who helps me to deal with the guilt if I say 'no' and they die horribly? Or the guilt if I say 'yes' and therefore their death is on my hands? Or if I wanted someone I loved to help me kill myself, in which ways have I provided for the psychological effects upon them of this action, for the rest of their life? After all, I won't be around to reassure them at 3 o'clock in the morning if they're torturing themselves wondering if they did the right thing.

In fact, what is the morality, at all, behind the idea that non-medical relatives and friends, immersed in the emotional and upsetting environment of a suffering and dying loved one is a fit person to collaborate in the decision-making surrounding the euthanasia of that loved one?

Also, what would qualify as an appropriate medical condition for such euthanasia? Physical suffering only? Why not mental? Life-limiting conditions? Or life-long conditions, eg, severe, debilitating untreatable chronic illness or disability?

On the other hand.... there must be situations where allowing particular persons to slip quietly out of the smoke-filled room (as Aurelius puts it) is the natural and humane thing to do.
 
Posted by Moo (# 107) on :
 
quote:
Originally posted by Adeodatus
What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.
I agree completely. I wonder about the effect on those who are willing to comply with such a demand.

Moo
 
Posted by Gwai (# 11076) on :
 
quote:
Originally posted by Moo:
quote:
Originally posted by Adeodatus
What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.
I agree completely. I wonder about the effect on those who are willing to comply with such a demand.

Moo
I think it makes a big difference who the people are. I have one relative who I know who could make such a request of me (if she were ill etc, which thank gGod she is not!) and not cause me significant guilt. I would be terribly upset to lose her, but she has always lived her life needing control. I doubt she'll ever make such a request of me because I suspect she will instead find a way to say goodbye and then quietly die alone without anyone to see her do anything so messy and uncomfortable. Knowing that, knowing her as well as I do, if she did need someone to make sure she could get enough morphine to go, or to make the doctors stop feeding her by tube or whatever, yeah I'd do it. And I wouldn't feel bad. It would be letting her live her own life, and I know she won't ask if she has any other options. That's essential.
 
Posted by Byron (# 15532) on :
 
All the practical concerns skirt the central issue: the sanctity of life.

Put it this way: if sufficient safeguards can be devised, would you still believe that assisted suicide and euthanasia are wrong? If so, do you believe that your opinion should be imposed on others against their will? If so, why?
 
Posted by Spawn (# 4867) on :
 
quote:
Originally posted by Adeodatus:
What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.
Pretty much agree with everything Adeodatus says and in fact I have severe reservations about assisted dying, but Adeodatus' reaction is to euthanasia not to a terminally ill person requesting medication to hasten their own end.
 
Posted by Byron (# 15532) on :
 
Putting my own cards on the table, I support both, as I believe that people ought to control their own lives, so much as possible. I'd have no problem with physicians having a conscience opt-out.
 
Posted by Penny S (# 14768) on :
 
Pyx_e
quote:
In 20 years of ministry I have never known anyone suffer terribly. The morphine thing is just true.
I'm glad you have been spared that. Morphine does not always work. I thought it would. I thought my mother would be able to go gently. It didn't. She couldn't. And she was afraid.

You only need to see one black swan to know it is not true that all swans are white.

Though maybe you might not take the reports of others that they exist. But my mother's suffering was as true as that I saw a black swan off Gravesend two weeks ago.
 
Posted by Lamb Chopped (# 5528) on :
 
Some people (me, as I know already) morphine just doesn't work for them. Seriously. It's like getting a shot of water. It does zip zap zero. (And no, I am not a drug abuser. It's an oddity of the metabolism, and occurs in a small percentage of the population. Unfortunately, a great many medical people are not as well informed as the one who explained this to me.)

If you or a loved one is getting no relief from morphine, do whatever the hell you have to do to get them to switch to another drug. It's real. And you don't have to suffer.
 
Posted by Pyx_e (# 57) on :
 
quote:
Originally posted by Penny S:
Pyx_e
quote:
In 20 years of ministry I have never known anyone suffer terribly. The morphine thing is just true.
I'm glad you have been spared that. Morphine does not always work. I thought it would. I thought my mother would be able to go gently. It didn't. She couldn't. And she was afraid.

You only need to see one black swan to know it is not true that all swans are white.

Though maybe you might not take the reports of others that they exist. But my mother's suffering was as true as that I saw a black swan off Gravesend two weeks ago.
I acknowledged it can be messy, I am sorry your mum struggled.

The worst was my friend who had motor neuron disease. I could not have born what he did and yet even when he could no longer speak he could make me laugh, and did. The last two weeks were fucking awful, his whole life including these two weeks were a inspirational testament to his spirit.

The last brief season must not be separated from all that went before, it is not a different person who we treat differently but the same one we always loved, who needs to know we love them still.

Pyx_e.
 
Posted by Lamb Chopped (# 5528) on :
 
Oops. Adding: I don't think Pyx_e meant to say that morphine in particular works for all people. But there are other drugs, and doctors should try them as needed.
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by Pyx_e:
The last brief season must not be separated from all that went before, it is not a different person who we treat differently but the same one we always loved, who needs to know we love them still.
Bur I would want my family to show they love me still by helping me to die quickly if I get to the stage when I can't take any more.
 
Posted by Doublethink (# 1984) on :
 
Even if you wound those you love in the process ?
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by Doublethink:
Even if you wound those you love in the process ?
The death of a loved one is a wound, anyway, isn't it? I wanted to offer my father a quick death - but didn't - however, after I'd reached the point of wanting to make the offer, he was lucky enough to get a bed in hospice shortly after, and died peacefully. But what if he hadn't been lucky? He'd got to the stage when our GP - who was a good bloke - was saying he could do no more.

Having said that, I had the most extraordinary experience when my Dad actually died. And perhaps part of the message there was that he'd gone when the time was right. So I don't know.

And then again, this: childbirth is natural, but we control it as far as possible, control the pain, and sometimes seek to hasten the process. Why not do that with death?
 
Posted by Niminypiminy (# 15489) on :
 
Agree with much that has been said. And also: so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Niminypiminy:
Agree with much that has been said. And also: so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.
This is why I didn't post any personal experiences: they can be spun any which way.

For me, no, assisted suicide and euthanasia aren't for the benefit of the relatives, but respecting the autonomy of the person suffering.

There are issues around coercion, but they apply equally to things already legal, like withdrawing treatment, and DNR notices. The real issue is whether the state ought to override a person's will for religious reasons, even if neither the patient, nor their caregivers, share those beliefs.
 
Posted by Doublethink (# 1984) on :
 
I would state that you can argue the harm done by asking others to kill is a significant harm, without recourse to religious faith.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Doublethink:
I would state that you can argue the harm done by asking others to kill is a significant harm, without recourse to religious faith.
Harm to whom?

The person who's asked to be helped to die? Questionable if it spares them further suffering, but in any case, it's their choice to take the risk.

Or their caregivers? If it does cause harm (presumably psychological trauma), is it worse than other traumas caused by treating patients? Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.
 
Posted by Doublethink (# 1984) on :
 
"freely" ? There are huge emotional pressures in such a situation. That is half the problem.
 
Posted by Niminypiminy (# 15489) on :
 
quote:
Originally posted by Byron

Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.
But those who would be most likely to be doing the killing, that is, doctors, are not in favour of assisted dying. Palliative care specialists least of all. It's one thing to say 'something should be done' and another to say 'I will do it'. And what about those who freely do chose to do the killing? What if they like it?
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Doublethink:
"freely" ? There are huge emotional pressures in such a situation. That is half the problem.
There's equally grave emotional pressures in signing a DNR notice, or deciding to withdraw treatment, or in making the call to switch off life support. In no other area of medicine is emotional pressure used as reason to deny a patient a choice over their treatment.

Right now, a patient can demand that all treatment cease. Caregivers are forced to let them die, and ease their passing if need be. Should patients be denied this right?

If not, how is assisted suicide radically different, either ethically, or psychologically?
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Niminypiminy:
quote:
Originally posted by Byron

Even if it is, so long as no one's forced to kill or assist in killing, they've freely accepted the consequences.
But those who would be most likely to be doing the killing, that is, doctors, are not in favour of assisted dying. Palliative care specialists least of all. It's one thing to say 'something should be done' and another to say 'I will do it'. And what about those who freely do chose to do the killing? What if they like it?
As I said, for any medical professional, taking part in euthanasia ought to be voluntary. Doctors are divided on the issue. Since they practise medicine for the benefit of their patients, the views of opponents shouldn't be controlling.

If they "like it," they're obviously grossly unsuited to the practise of medicine! They could equally "like" a patient dying in surgery, which would not be reason to cease surgery.

These arguments don't have the highest view of caregivers, do they?
 
Posted by Doublethink (# 1984) on :
 
Well, firstly, if there is enough emotional pressure you could argue they lack capacity under the MCA.

There is a big difference between doing something to someone, and not carrying out a specific treatment

In my experience, suicide has a damaging effect on those close to the deceased. An an effect that can be damaging to them years later. One of the things that raises your own risk of suicide, for example, is having known someone who took their own life.

[ 13. July 2014, 21:46: Message edited by: Doublethink ]
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Doublethink:
Well, firstly, if there is enough emotional pressure you could argue they lack capacity under the MCA.

There is a big difference between doing something to someone, and not carrying out a specific treatment

In my experience, suicide has a damaging effect on those close to the deceased. An an effect that can be damaging to them years later. One of the things that raises your own risk of suicide, for example, is having known someone who took their own life.
Does that include assisted suicide? There's a world of difference between a gravely ill relative choosing to end their suffering, and walking in on a loved one who's taken their own life. Many prefer to call it assisted dying to make precisely that distinction. By contrast, what's the data on relatives distressed by watching a loved one forced to suffer an agonizing death against their will?

What is the substantive difference between a doctor turning off a machine because the patient wants them to, and handing the patient the means to end their life? If anything, the first could be more traumatic, as the patient has foreclosed the possibility of recovery.

If someone lacks capacity under mental health laws, it's not specific to this issue.
 
Posted by Niminypiminy (# 15489) on :
 
quote:
Originally posted by Byron:

These arguments don't have the highest view of caregivers, do they?
I think Andrew Brown has it about right when he says "In general, the people most worried by the prospect of liberalising the law on assisted suicide are the professionals, whether doctors or clergy, who take a low view of human nature, having seen too much of it."
 
Posted by no prophet (# 15560) on :
 
The CBC did an extensive series on this, and revisited again recently. How Will We Die, Euthanasia and the Politics of Death. I listened to this twice, and read it several times.

Worthy of understanding:

quote:
Dr. Balfour Mount, the father of palliative care [who is also a cancer patient himself], said on our program last week doctors get very little training in end of life issues....
I think it is totally irresponsible to talk of mercy-killing, euthanasia, assisted suicide etc unless you also reference end of life care and proper medical access to it. No one ever discusses palliative sedation which does not involve actively killing the patient.

I also expect there is a economic argument, that emptying the hospital bed and disposing of the dead body is cheaper than the alternatives. I would also ask about the access to proper palliative pain management, in addition to palliative care at all.
 
Posted by Leorning Cniht (# 17564) on :
 
quote:
Originally posted by Byron:
The real issue is whether the state ought to override a person's will for religious reasons, even if neither the patient, nor their caregivers, share those beliefs.
You assume that the reasons to oppose voluntary euthanasia are all religious ones. That's not the case.

Whilst there certainly are religious reasons that people can give to oppose this, many of the arguments given (about slippery slopes etc., for example) are completely secular.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Curiosity killed ...:
quote:
Originally posted by orfeo:
You realise the thread title is pretty much a contradiction in terms...

Anyway, carry on.
Yep - no-one else was going to start a thread and I was still running a temperature, so shoot me.
I'm going to be charitable and assume that wasn't you demonstrating how to volunteer. Besides, I don't have a gun and even if I did my aim from THAT distance isn't sufficient.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Byron:
All the practical concerns skirt the central issue: the sanctity of life.
You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.
 
Posted by ExclamationMark (# 14715) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by Niminypiminy:
As I said, for any medical professional, taking part in euthanasia ought to be voluntary.
That's is how involvement with abortion was treated under the 1967 Act. It's rather different now .... who's to say that if Assisted Suicide or Voluntary Euthanasia was legalised, that the same wouldn't happen?

The safeguards may be there now but will change later.

[edited: busted UBB code]

[ 14. July 2014, 07:06: Message edited by: Sioni Sais ]
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by Niminypiminy:
...so many of the opinions in favour of assisted dying come down to "I had to watch someone suffering" -- it's not the suffering of the person that is really objectionable, it's being made to witness it.

In other words, assisted dying is a tidying-away measure, a means by which the living are protected from having to see and witness and bear other people's suffering.
Ahhh... Fundamental Attribution Errors - where would Hell be without them?

Incidentally "I had to watch someone suffer" is an experience, not an opinion. The opinion may be developed after reflection on experience, certainly, whereas your opinions are ... what, exactly? Utterly objective? Or second-hand and derivative?

If people were as utterly selfish as you suggest, then watching someone else suffer would not be a problem. You wouldn't need to tidy them away, because you could just walk.
 
Posted by Boogie (# 13538) on :
 
quote:
Originally posted by orfeo:
You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.
And what does sanctity of life mean anyway?
 
Posted by orfeo (# 13878) on :
 
^That too, Boogie. Because once upon a time it meant that suicide was a sin. I'm not at all sure what meaning Byron is giving it.
 
Posted by Matt Black (# 2210) on :
 
quote:
Originally posted by mousethief:
quote:
Originally posted by Lyda*Rose:
I worry about people who are terminal asking for death because they want to make it easier on their families. And even worse, unscrupulous family members who nudge a person toward choosing their death for the nudger's own well-being, and dare we say it, material ends in terms of legacy. This is similar to my opinion about capital punishment: what if it is gotten wrong? What if the dying miss out on important moments because of an attitude that if one is dying one might as well just get it over with?
This is precisely my problem with voluntary euthanasia -- the possibility or likelihood that a dying person be talked into getting out of the way by unscrupulous relatives.
There are also cases (and I know, I know, the plural of 'anecdote' is not 'data') of seriously/ terminally ill/ disabled people wanting to die when also suffering from severe depression who, when the depression is treated more or less successfully have said that they are very grateful that assisted suicide wasn't legal.

In addition, I think this kind of proposed legislation is very dangerous in the context in the UK at least of the recent horror stories of severe abuse of the elderly in care homes; there is therefore already a culture of abuse of the vulnerable and this kind of law should at the very least not be considered unless and until that culture has been eliminated.
 
Posted by seekingsister (# 17707) on :
 
Beyond the moral and ethical issues (of which there are many), why would a pharmaceutical company invest in research for better palliative care or pain management, when governments are passing assisted suicide laws?

And even if they did, why would the NHS or an insurance company prefer to pay for the more expensive treatment (palliative care) when a cheaper alternative (assisted suicide) is now available?

What is being presented as a "choice" may not be much of one in practice.
 
Posted by Karl: Liberal Backslider (# 76) on :
 
quote:
Originally posted by seekingsister:
Beyond the moral and ethical issues (of which there are many), why would a pharmaceutical company invest in research for better palliative care or pain management, when governments are passing assisted suicide laws?
Because some people want them and therefore there'll be a market for them?

quote:
And even if they did, why would the NHS or an insurance company prefer to pay for the more expensive treatment (palliative care) when a cheaper alternative (assisted suicide) is now available?
Because they're not the sociopaths you seem to think they are?
 
Posted by Pyx_e (# 57) on :
 
Matt Black wrote
quote:
I think this kind of proposed legislation is very dangerous in the context in the UK at least of the recent horror stories of severe abuse of the elderly in care homes; there is therefore already a culture of abuse of the vulnerable and this kind of law should at the very least not be considered unless and until that culture has been eliminated.
Amen brother. Only to add that the whole care system abuse thing is in my opinion only exaggerated and mirrored in family care situations. We keep saying "oh those horrible strangers not looking after us" while the vast majority of cruelty, abuse and emotional manipulation goes one behind the closed doors in our streets. To suggest that opening the doors to AS will do anything but cull the weak is IMHO daft.

This is not Sparta!

Pyx_e

p.s. if Lord Carey had spent a little less time sitting on his grey polyester covered arse in the House of Lord's and a little more time in his local hospice I suspect he would not be spouting this dangerous bollocks. And if we were to need any further example of how power corrupts I need look no further than him. And he ought to be careful his kids aren't putting labels on the telly and the best Wedgewood!

edit is/if ffs

[ 14. July 2014, 10:10: Message edited by: Pyx_e ]
 
Posted by seekingsister (# 17707) on :
 
quote:
Originally posted by Karl: Liberal Backslider:
Because some people want them and therefore there'll be a market for them?
"Some people" isn't enough to spend hundreds of millions of dollars on R&D. The drugs needed for assisted suicide already exist. Anyone who can do math can guess what a profit-oriented company might choose.

quote:
Originally posted by Karl: Liberal Backslider:
Because they're not the sociopaths you seem to think they are?
I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.
 
Posted by Adeodatus (# 4992) on :
 
quote:
Originally posted by Spawn:
quote:
Originally posted by Adeodatus:
What we're really talking about is "my" right to demand that "you" kill me - and I don't believe I have such a right.
Pretty much agree with everything Adeodatus says and in fact I have severe reservations about assisted dying, but Adeodatus' reaction is to euthanasia not to a terminally ill person requesting medication to hasten their own end.
Well, yes, I suppose so - but if this Bill becomes law, the courts will soon fill up with cases arguing over when that line is crossed.

Oddly enough, it's precisely because of this that the Bill fails to help the people whose cases, to me, seem most clear cut. The request to die has to be consciously made, and then the fatal drug has to be self-administered: that would seem to rule out those who are extensively paralysed or unable to communicate.

There is currently a "conscience clause" in the Falconer Bill, but there isn't one in the parallel Bill currently before the Scottish Parliament: physicians and pharmacists in Scotland would have no opt-out. It's probably worth noting, too, that "conscience clauses" have come increasingly under attack in recent years, so the English one may not survive its passage through Parliament.

Niminypiminy, it's true that the professionals who would be involved tend to be opposed to assisted dying, but I fundamentally disagree with Andrew Brown that it's because we have a "low view of human nature". I think it's because we see death daily, and know just how much can be done to give high quality care to the dying and those close to them.

(It's odd: in all the polls I've seen asking the question on assisted dying, I've never seen one that asked the opinions of the terminally ill. It's a truism in healthcare that the sick, who judge on their experience, have very different opinions from the well, who rely on their imagination.)
 
Posted by Anselmina (# 3032) on :
 
quote:
Originally posted by Byron:
Putting my own cards on the table, I support both, as I believe that people ought to control their own lives, so much as possible. I'd have no problem with physicians having a conscience opt-out.
On the face of it - in a black and white world - that would appaer to be a practical solution. But what would happen in that case would be what happens - to an extent - in the clergy world of, say, remarriage of divorced people. Those who opt out, because of conscience become those nasty moral judgemental medics who aren't willing to engage with the messiness of pain and death; just as clergy who choose not to re-marry divorcees get labelled as those not wanting to get involved in the sticky end of failed relationships. In other words, their freedom of choice simply becomes a focus of abuse, and a big stick with which to beat them for exercising their 'free' choice. Legislative history strongly suggests that such situations are rarely allowed to rest until the 'right' of one party MUST trump the 'right' of the other party.

Again, I do think the effect of pressure on the role of the loved ones, next of kin - whatever - is being somewhat underestimated here. Moral pressures within families to act against one's own conscience arise all the time, whether it's as banal as going with a choice of decor you abhor because you share the house with a parent, or taking up a job you don't care for because that's the family expectation. If it's hard resisting a loved-one's pressuring to conform to ordinary lifestyle decisions, imagine the impossibility of a situation such as signing up to a loved one's assisted euthanasia, on the premise of it as a 'free choice'?

It is one thing to discreetly - and on a day-by-day decision-making basis - work alongside medical professionals and with the wishes of the dying person, to respond to what is happening. It's quite another to find that the cold hand of the law is being leveraged against one's own inclination to plan and execute a path of deliberate death. I'm sure there would be a lot of intent with legislators and medical professionals to put in safeguards, permissions - perhaps even pastoral provision. But, personally, I would have little confidence in the comprehensive efficacy of such law-making for all parties - especially for the vulnerable, the dissenting, or the ambivalent.
 
Posted by Liopleurodon (# 4836) on :
 
quote:
Originally posted by seekingsister:
I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.
It's cheaper to let people die of cancer than it is to give them chemo. It's certainly cheaper to let a heart attack finish someone off than it is to do heart surgery. And yet the NHS does do chemo and heart surgery. Yes it has to do a cost benefit analysis to decide which treatments it will fund. But the fact remains that it's a massive leap to assume that the NHS will start bumping people off rather than giving them pain relief and nursing in their last days.

I'm hearing on this thread that:
a) Doctors don't want to kill people, even when those people are terminally ill and suffering and are actively stating that they want to die
and that
b) Doctors will kill everyone who's a bit vulnerable, even if they don't want to die, if we give them a foot in the door - however carefully we try to regulate.

While I can see that it's possible that all doctors fall into one group or the other, it doesn't seem very likely.

Yeah, I'm pro legalised voluntary euthanasia. Because I think that people have the right to check out when their suffering becomes unbearable. Not because I don't want to see them suffer, but because they don't want to suffer.
 
Posted by seekingsister (# 17707) on :
 
quote:
Originally posted by Liopleurodon:
It's cheaper to let people die of cancer than it is to give them chemo. It's certainly cheaper to let a heart attack finish someone off than it is to do heart surgery. And yet the NHS does do chemo and heart surgery. Yes it has to do a cost benefit analysis to decide which treatments it will fund. But the fact remains that it's a massive leap to assume that the NHS will start bumping people off rather than giving them pain relief and nursing in their last days.
I'm not saying they are going to murder people - chill with the hyperbole. I'm saying they will be suggesting it to people, and that the suggestion could be tainted by a financial bottom line.

I had an operation on the NHS and beforehand I got a second opinion from a US doctor on a visit home. The US doctor said the surgery was a necessity for my long-term health, even though I had made clear I would be having any operation in the UK (so no additional income for that particular doctor). The NHS specialist had previously told me it was optional. Had I gone with the NHS view I would be in big trouble as the results from the tissue removed came up as a borderline malignancy. A few more years and it would have been full-blown cancer.

I would not trust that same hospital to tell me the truth about whether my loved one should have palliative care vs. an early exit.

[ 14. July 2014, 12:17: Message edited by: seekingsister ]
 
Posted by Erroneous Monk (# 10858) on :
 
At the same time that Tony Nicklinson was campaigning for the right to require someone to end his life, Tony Scott committed suicide. For every expression of public support I read for Tony N's right to die, I read a public expression of sadness for the waste of Tony S's life.

Is the life of a physically disabled person worth so much less in modern terms that that of a not-yet-physically-disabled person?

[Frown]
 
Posted by The Great Gumby (# 10989) on :
 
quote:
Originally posted by Pyx_e:
I know this is the age we live in but the venality of some adult/children of elder folk astonishes me. I have heard them complain that being in a nursing home is "wasting" their inheritance. I have often heard conversations which would take only the lightest straw to reach, "it's best we let them go now, they have no quality of life."
Only the lightest straw? I don't doubt it. Because something along these lines is often pretty much how it is.

At the end of last year, my elderly grandmother was diagnosed with a particularly nasty form of cancer. We knew that her time was short. We were all prepared. She managed the pain with morphine, increasing the doses every time it stopped doing the job and reaching a pretty staggering dose by the end, but even then it wasn't really doing the job. I last saw her on the afternoon she died, at home as she'd wanted, although she was barely recognisable and may not even have recognised me. Because of the nature of her disease, she'd been able to make plans about how she wanted to die. She was DNR, and not to be taken to hospital - just a quiet slip away under the morphine blanket.

That afternoon, as a family we had a lot of conversations which could be interpreted in this way as taking just the lightest straw to get to whatever you want to put into other people's mouths, because we knew she was going fast and in serious pain, and we could see that every breath was a battle against her entire body. It was agony when she died, and the loss still hurts months later, but it was also a relief. And don't you fucking dare to tell me that this makes us anything but a loving family. She Rests In Peace now, and yes, having seen her at the end, in severe pain even through the morphine, that matters to me hugely. We didn't want to lose her, but we're so glad that her suffering's over.

There are some important practical and ethical concerns about assisted dying, but there's also a huge amount of sanctimonious bullshit flying around. Pumping her full of morphine (by the end, this was done by Macmillan nurses as she was unable to swallow tablets or even communicate clearly) shortened her life compared to other possible treatments, but it was what she wanted and it was the right thing to do. Anything else would have been wanton cruelty, and any attempt to define this as not somehow assisting her to die is pure sophistry. But this is rightly legal and accepted even by people who have an attack of the vapours at the mere suggestion of other means to the same end.

And my grandmother was lucky in one sense - she had the right sort of disease, one in which there's time to formulate an end of life plan and there's a societal acceptance of simply easing the pain at a cost to lifespan. What if she'd felt far greater mental torture from being suddenly paralysed after a stroke? She'd just have to live with it, for years on end, even if she'd rather be dead, because we are a Civilised Society and we know better than her.

We never thought of helping her to die in the way most people here are meaning it, but the final sedative she was given did the job as effectively as anything, as we all knew it would. And we wouldn't consider any alternative means when we knew how fast she was going, but if she'd been in that level of pain for days, weeks, months - how long is she expected to suffer for our legislative convenience?

It's a massively complicated issue, with many associated dangers and pitfalls. It would be nice if the conversation could be free from slippery slopes, Godwins, excluded middles and demonisation of anyone who ever held or expressed (conversations which would take only the lightest straw to reach) a view you disagree with, especially if they aren't present to defend themselves.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by orfeo:
You didn't get to decide when to start your life, which raises significant philosophical problems with the notion that 'sanctity of life' means you get to decide when to end it.
quote:
Originally posted by Boogie:
And what does sanctity of life mean anyway?
quote:
Originally posted by orfeo:
^That too, Boogie. Because once upon a time it meant that suicide was a sin. I'm not at all sure what meaning Byron is giving it.
The usual one. Much opposition to assisted suicide and euthanasia is motivated by a belief in the sanctity of life, but it's often not expressed in those terms.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Liopleurodon:
Yeah, I'm pro legalised voluntary euthanasia. Because I think that people have the right to check out when their suffering becomes unbearable. Not because I don't want to see them suffer, but because they don't want to suffer.
I agree that people have the right to check out when their suffering becomes unbearable but I do not see that that necessarily entails the right to demand that somebody else kill them.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Niminypiminy:
I think Andrew Brown has it about right when he says "In general, the people most worried by the prospect of liberalising the law on assisted suicide are the professionals, whether doctors or clergy, who take a low view of human nature, having seen too much of it."
Andrew Brown is an entertaining journo, but he's never met the fallacy he wouldn't spend the night with, so in finest irony, I'm not that worried by what he has to say.

Yes, healthcare professionals are human and therefore flawed. This applies to everything they do. What makes assisted suicide a special case?
quote:
Originally posted by Anselmina:
quote:
Originally posted by Byron:
Putting my own cards on the table, I support both, as I believe that people ought to control their own lives, so much as possible. I'd have no problem with physicians having a conscience opt-out.
On the face of it - in a black and white world - that would appaer to be a practical solution. But what would happen in that case would be what happens - to an extent - in the clergy world of, say, remarriage of divorced people. Those who opt out, because of conscience become those nasty moral judgemental medics who aren't willing to engage with the messiness of pain and death; just as clergy who choose not to re-marry divorcees get labelled as those not wanting to get involved in the sticky end of failed relationships. In other words, their freedom of choice simply becomes a focus of abuse, and a big stick with which to beat them for exercising their 'free' choice. Legislative history strongly suggests that such situations are rarely allowed to rest until the 'right' of one party MUST trump the 'right' of the other party.
Should abortion be recriminalized then? If not, pressure on a person who wants to exercise their conscience isn't grounds to ban something.
quote:
Again, I do think the effect of pressure on the role of the loved ones, next of kin - whatever - is being somewhat underestimated here. Moral pressures within families to act against one's own conscience arise all the time, whether it's as banal as going with a choice of decor you abhor because you share the house with a parent, or taking up a job you don't care for because that's the family expectation. If it's hard resisting a loved-one's pressuring to conform to ordinary lifestyle decisions, imagine the impossibility of a situation such as signing up to a loved one's assisted euthanasia, on the premise of it as a 'free choice'?

It is one thing to discreetly - and on a day-by-day decision-making basis - work alongside medical professionals and with the wishes of the dying person, to respond to what is happening. It's quite another to find that the cold hand of the law is being leveraged against one's own inclination to plan and execute a path of deliberate death. I'm sure there would be a lot of intent with legislators and medical professionals to put in safeguards, permissions - perhaps even pastoral provision. But, personally, I would have little confidence in the comprehensive efficacy of such law-making for all parties - especially for the vulnerable, the dissenting, or the ambivalent.
With coercion, what separates assisted suicide from the withdrawal of treatment, or a DNR notice? These issues exist across the field of medicine, but they seem to get raised selectively, as inverted special pleading against euthanasia.

If murderous relatives are a dime a dozen, shouldn't we ban any home deaths, just to be sure they're not offing their loved ones with a pillow or a vial of morphine?

Of course there should be safeguards against coercion, but in no other area of medicine is its risk used as reason to deny treatment.
 
Posted by Doublethink (# 1984) on :
 
quote:
Originally posted by seekingsister:
quote:
Originally posted by Karl: Liberal Backslider:
Because some people want them and therefore there'll be a market for them?
"Some people" isn't enough to spend hundreds of millions of dollars on R&D. The drugs needed for assisted suicide already exist. Anyone who can do math can guess what a profit-oriented company might choose.

quote:
Originally posted by Karl: Liberal Backslider:
Because they're not the sociopaths you seem to think they are?
I'm not accusing anyone of being a sociopath. There are drugs available in the global market that are more effective than those available on the NHS, but the NHS does not provide them due to cost. I personally am in such a situation. They are making a rational choice, but it affects my life and health for the worse.

To think the same organization would not compare the cost of a new pain management/palliative care therapy vs. that of euthanasia is idealistic at best.
They already do, they work out how much they will pay for a Quality Adjusted Life Year - it is partly derived from large surveys of people asking how they would feel about living with such and such a limitation.

I note the article opines:

quote:
However, the weight assigned to a particular condition can vary greatly, depending on the population being surveyed. Those who do not suffer from the affliction in question will, on average, overestimate the detrimental effect on quality of life, compared to those who are afflicted.

 
Posted by seekingsister (# 17707) on :
 
quote:
Originally posted by Byron:
The usual one. Much opposition to assisted suicide and euthanasia is motivated by a belief in the sanctity of life, but it's often not expressed in those terms.
Or it's motivated by the fear of potential for abuse and slippery slope. One glances to Belgium and the Netherlands and sees how interest groups have lobbied for the inclusion of the non-terminal, the depressed, and children. Where one of the leading doctors who campaigned for the law, now deeply regrets its introduction.

The Daily Beast

One glances at Oregon where someone was told by the state-run health insurance plan to go for suicide instead of chemo.

quote:
Richardson also interviews uninsured prostate cancer patient Randy Stroup, who was denied further health care by Oregon's insurance program after an initial operation was unsuccessful. In a notorious case that gained nationwide attention, the state offered him the Death With Dignity option instead of further surgery. Although the agency ultimately reversed its ruling and approved chemotherapy, Stroup succumbed, bringing further attention to the inadequacies of healthcare coverage for the uninsured.
Reuters

The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.
 
Posted by HCH (# 14313) on :
 
Perhaps this is a tangent: I have heard of criminals sentenced to life in prison who stated that they would prefer the death penalty. (Timothy McVeigh was one such.)
 
Posted by no prophet (# 15560) on :
 
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.
 
Posted by quetzalcoatl (# 16740) on :
 
Knowing when to breathe is also important.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by seekingsister:
[...] Or it's motivated by the fear of potential for abuse and slippery slope. [...]
I'm not arguing that abuse isn't a valid concern. (The "slippery slope" is a fallacy.) Why single-out euthanasia?

Your example from Netherlands is a specific issue, the ability of mentally ill patients to give consent. This issue extends beyond euthanasia, and would apply equally to a withdrawal of treatment. It's not an argument against euthanasia per se, but against a specific model of euthanasia. Don't allow people with depression and no other medical issue to be euthanized, and that problem goes.

The Oregon case is an egregious abuse, that says far more about insurance than it does assisted suicide. The callous accountants could equally have told him to withdraw from treatment and allow nature to take its course.

In both cases, specific issues are inflated to argue against an entire sphere of medicine. Unless this happens across the board, it suggests that abuses are being used as a pretext for something else, even if you're unaware of it. (It may not be sufficiently hellish to say I've done exactly the same thing myself, but I have, and often. We're all subject to unconscious motives and confirmation biases.)
quote:
The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.
Of course I'm concerned about abuses. I just try to ensure my concerns are proportionate.
 
Posted by no prophet (# 15560) on :
 
quote:
Originally posted by quetzalcoatl:
Knowing when to breathe is also important.
The point I think it that we have an illusion of control, even when we assert we are and feel we are, we aren't. Life is somewhat easier, and what I've observed of death and people dying is that it's better to understand you're not in control of either.
 
Posted by quetzalcoatl (# 16740) on :
 
quote:
Originally posted by no prophet:
quote:
Originally posted by quetzalcoatl:
Knowing when to breathe is also important.
The point I think it that we have an illusion of control, even when we assert we are and feel we are, we aren't. Life is somewhat easier, and what I've observed of death and people dying is that it's better to understand you're not in control of either.
Yes, I was being sarcastic. One thing I have learned through working as a therapist, is that when people resist some difficult process, such as mourning, they usually feel awful; if they surrender to it, they often feel awful, but they get through it, and it is over.
 
Posted by Gwai (# 11076) on :
 
quote:
Originally posted by seekingsister:
The pro-euthanasia argument seems to come down to two points:

- I don't want to suffer if I get sick or disabled
- I don't want to watch a loved one suffer if they get sick or disabled (or I've watched it and it was horrible so I don't want to watch it again)

It's all about personal choice and experience. No concern for those who will be victimized by this law - and there will be victims, they've already had them in the other places where this is legal.
Can you promise that there won't be victims if assisted suicide becomes/stays illegal? For instance, that no one will die horribly in pain feeling that they've had the right to die as they wish stolen from them? That argument only works if you can show that there will be clearly more victims one way than the other.
 
Posted by Gwai (# 11076) on :
 
quote:
Originally posted by no prophet:
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.
You aren't the only one who can take an argument to silly extremes. If control is not important, does that mean you'd be okay if the government told everyone who to marry, when to have kids, if they needed to divorce, and where to work?
 
Posted by quetzalcoatl (# 16740) on :
 
quote:
Originally posted by Gwai:
quote:
Originally posted by no prophet:
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.
You aren't the only one who can take an argument to silly extremes. If control is not important, does that mean you'd be okay if the government told everyone who to marry, when to have kids, if they needed to divorce, and where to work?
But you can turn that argument round. Do we control who we are attracted to, or want to marry?
 
Posted by Doublethink (# 1984) on :
 
No one can remove your right to die. You will die.

What is being asked for, is the legal infracstructure to ask someone to kill you without fear they will be prosecuted if they comply.

On what basis does one assert this is a right ?
 
Posted by Gwai (# 11076) on :
 
quote:
Originally posted by quetzalcoatl:
quote:
Originally posted by Gwai:
quote:
Originally posted by no prophet:
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.
You aren't the only one who can take an argument to silly extremes. If control is not important, does that mean you'd be okay if the government told everyone who to marry, when to have kids, if they needed to divorce, and where to work?
But you can turn that argument round. Do we control who we are attracted to, or want to marry?
As much as we can we do. Haven't we all tried to forget someone, and most of us can say that whether it was fast or slow we have indeed gotten over said person. I would say that it is human to try to assert control, even babies do it. One can't always, but I think we should be careful about where we do deny people the right to control their lives. Such a denial is sometimes a necessity--presumably none of us did force anyone to date or marry us--but I think that we as society should be very careful about when we absolutely must take over other people's lives, particularly at emotionally sensitive moments.

Doublethink, maybe if I reworded your question, it would be easier to see why I, at least, answer it the way I do: Do we have the right to ask that we* should not be prosecuted if we obey the last wishes of our nearest and dearest?

*Just to be ultra-clear, no one has made such a request of me.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Byron:
This issue [the ability of mentally ill patients to give consent] extends beyond euthanasia, and would apply equally to a withdrawal of treatment. It's not an argument against euthanasia per se, but against a specific model of euthanasia. Don't allow people with depression and no other medical issue to be euthanized, and that problem goes.
Not quite:

quote:
Originally posted by Matt Black:
There are also cases (and I know, I know, the plural of 'anecdote' is not 'data') of seriously/ terminally ill/ disabled people wanting to die when also suffering from severe depression who, when the depression is treated more or less successfully have said that they are very grateful that assisted suicide wasn't legal.

 
Posted by Byron (# 15532) on :
 
JoannaP, d'you think that comorbid depressed people should be denied the right to withdraw from treatment?

If not, then you presumably believe there exist safeguards that offer sufficient protection. Extend them to assisted suicide and euthanasia.
 
Posted by Lietuvos Sv. Kazimieras (# 11274) on :
 
To the extent that this thread relates to Lord Carey, let me just say I wish that the routine granting of life peerages to former ABCs would cease; also that Lord Carey would take a lesson in the virtues of silence from Pope Emeritus Benedict.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Byron:
JoannaP, d'you think that comorbid depressed people should be denied the right to withdraw from treatment?

If not, then you presumably believe there exist safeguards that offer sufficient protection. Extend them to assisted suicide and euthanasia.
Byron, Thank you. That is an interesting question and I confess I do not have an answer for it - it is not something I have thought about before. My gut instinct is to say "Yes, they should be denied the right" but I am not sure that I am happy with that.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Gwai:
Doublethink, maybe if I reworded your question, it would be easier to see why I, at least, answer it the way I do: Do we have the right to ask that we* should not be prosecuted if we obey the last wishes of our nearest and dearest?

*Just to be ultra-clear, no one has made such a request of me.
Gwai, bearing in mind that it is very hard to predict how one would actually behave in extreme circumstances, my answer to your question is No. I think that, if I sincerely believed that the best thing I could do for MrP was to hold a pillow over his face, I should have the courage of my convictions and be prepared to argue that case before a dozen of my peers (given that juries tend not to find mercy-killers guilty). I am not sure that I want to live in a society where I could kill my husband with no questions asked.

I do, however, feel that this is a bit of a distraction; the legislation being discussed in the House of Lords would, as I understand it, permit doctors to kill their patients without fear of prosecution and IMHO that is very different from the nearest and dearest doing the deed.
 
Posted by no prophet (# 15560) on :
 
quote:
Originally posted by quetzalcoatl:
quote:
Originally posted by Gwai:
quote:
Originally posted by no prophet:
It is said upthread that the idea of being in control one's own life is important. Really? Of one's conception too I suppose, navigating on'e sperm half to the egg half of yourself. And one's birth, by deciding when to go through the tunnel to the light.
You aren't the only one who can take an argument to silly extremes. If control is not important, does that mean you'd be okay if the government told everyone who to marry, when to have kids, if they needed to divorce, and where to work?
But you can turn that argument round. Do we control who we are attracted to, or want to marry?
If I have you right, you may have me backwards. We control to a degree who we marry or attracted to. I find on the first I was at the mercy of my hard-coded neuro-perceptive apparatus and my schema of what was good and attractive which I understand from Freud and Jared Diamond (book: The Third Chimpanzee) are derived from models formed in my very young years; thank God my socialization and chance allowed me to fall in with the right person. On the second, I was at the mercy of at least 50% of the right person. Who may have me backwards or forwards, as long as I remember that I am wrong.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Byron:
Yes, healthcare professionals are human and therefore flawed. This applies to everything they do. What makes assisted suicide a special case?
The consequences of the mistake.

Which is the same reason, incidentally, why I'm against capital punishment. There are some situations where saying "oops" - even saying "oops" while paying a large amount of money - just doesn't cut it.

And yes, I'm well aware that other forms of mistake by a health professional might cost someone their life. But I emphasise might. If the very goal of a procedure is to end life it becomes a guarantee. It's no longer a question about the competence of the health professional to carry out the procedure, it's a question about the very decision to carry out the procedure in the first place. That's fundamentally different.

[ 15. July 2014, 02:29: Message edited by: orfeo ]
 
Posted by seekingsister (# 17707) on :
 
quote:
Originally posted by Byron:
Why single-out euthanasia?
Because it is a life or death issue - literally. The only other argument for "slippery slope" that's in the same ballpark is abortion, and frankly we've seen no evidence anywhere that people are killing their infants because they've been desensitized by abortion. We have, however, seen in Belgium and Netherland, a slip (I know you don't like that term, but that's the best one to use here) in the original intent of euthanasia laws to include people who are not terminally ill, who have mental health issues, and who are minors.


quote:
Originally posted by Byron:
The Oregon case is an egregious abuse, that says far more about insurance than it does assisted suicide.
Randy Stroup was on Medicaid, which is a government-funded health care plan. He was not on private insurance.

[ 15. July 2014, 07:53: Message edited by: seekingsister ]
 
Posted by LeRoc (# 3216) on :
 
quote:
seekingsister: We have, however, seen in Belgium and Netherland, a slip (I know you don't like that term, but that's the best one to use here) in the original intent of euthanasia laws to include people who are not terminally ill, who have mental health issues, and who are minors.
I'm from the Netherlands. I'm in favour of the possibility of euthanasia for the terminally ill (and I'd include some forms of mental illness in that). I'm very worried though about the current trend that wants to allow (usually elderly) people to demand assisted dying because they don't want to live anymore (what is usually called Drion's pill).

The discussions are polluted by proponents using the term 'euthanasia' (which I'd like to reserve for the terminally ill) and even stupid things like "but they have the right to die!" People already have the right to die. Half a liter of arsenicum will do the trick, I'd add some whisky for the taste. But what I don't agree with is that they demand a government-sanctioned structure to assist them with that.
 
Posted by orfeo (# 13878) on :
 
^ This rather brings to mind the chief Australian advocate for voluntary euthanasia, Dr Philip Nitschke.

When he first started advocating, it was very much with a focus on the terminally ill and on people in great suffering.

But over time it expanded, and some of the greatest heat he's received has been over cases of death where the person was clearly not terminally ill. The case I most remember is one several years ago where he tried to HIDE the fact that the woman who ended her life was not terminally ill. She had had serious illness in the past (cancer I think), but at the time of her death she had been given a clean bill of health. Nitschke (and the woman herself, in recorded interviews) focused on her miserable past history, and stayed silent about the facts at the time of death. Others uncovered the truth. It seems pretty clear that Nitschke didn't want the public to know that the woman wasn't dying, because he knew how it would affect the public's sympathy for his cause.

Most recently, he is under investigation because of his association with a depressed man who decided to end his own life. I made reference to this case in TICTH. Relevant article (which I linked to in TICTH) is here.

[ 16. July 2014, 03:06: Message edited by: orfeo ]
 
Posted by Persephone Hazard (# 4648) on :
 
Death is undignified. I have now watched someone die, those last few weeks and days when the end is inevitable and all you can do is wait: there is no dignity or beauty to it, just long hours and biological vileness. Watching the person you love most in all the world as they fade and fade and eventually reach a full stop is almost unbearably awful, and there aren't even any dramatics to it; it's flat and dull and grey and at the time it seems endless.

I want a chance to go on my own terms. I want to know that I don't have to be seen like that - no dignity, no agency, no options, no control, just a slack jaw and a catheter. I won't do it. I won't. I fucking refuse.
 
Posted by seekingsister (# 17707) on :
 
quote:
Originally posted by Persephone Hazard:
I want a chance to go on my own terms. I want to know that I don't have to be seen like that - no dignity, no agency, no options, no control, just a slack jaw and a catheter. I won't do it. I won't. I fucking refuse.
Again - sorry for your loss. I liked your dad.

But you do have the right to go on your own terms - you just don't have the right to have a doctor legally prescribe you the means to do it.

I've sadly known two people who have committed suicide. It's not very hard to do, even for a sick person.
 
Posted by LeRoc (# 3216) on :
 
I agree with seekingsister. Persephone Hazard has every right to go on her own terms. What she doesn't have is the right to demand government-sanctioned assistence in this.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by orfeo:
quote:
Originally posted by Byron:
What makes assisted suicide a special case?
The consequences of the mistake. [...]
Identical to the consequences of terminating life support. If someone can only breathe with a ventilator, if you turn it off, they won't survive.

D'you believe patients should lose this right? If not, what else, besides consequences, separates the right to withdraw treatment from assisted suicide?
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by seekingsister:
[...] Randy Stroup was on Medicaid, which is a government-funded health care plan. He was not on private insurance.
I've covered consequences immediately above, but as far as Medicaid goes, it's a type of insurance, albeit a public one. The same pressures of cost are factored in, especially if it's contracting outside hospitals for treatment.
 
Posted by Doublethink (# 1984) on :
 
Just out of interest, what about unassisted suicide ?

We spend millions of pounds trying to prevent it, we detain people against their will to prevent such acts, we measure the performance of parts of our health service on their ability to reduce the occurrence, we hold formal internal, external and legal enquiries into what we could have done differently if it occurs etc etc

Why the sudden volt-face when it comes to *assisting* suicide ?

[ 16. July 2014, 18:32: Message edited by: Doublethink ]
 
Posted by LeRoc (# 3216) on :
 
quote:
Doublethink: Just out of interest, what about unassisted suicide ?

We spend millions of pounds trying to prevent it, we detain people against their will to prevent such acts, we measure the performance of parts of our health service on their ability to reduce the occurrence, we hold formal internal, external and legal enquiries into what we could have done differently if it occurs etc etc

Why the sudden volt-face when it comes to *assisting* suicide ?
Because assisting suicide is the opposite of unassisted suicide.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Doublethink:
Just out of interest, what about unassisted suicide ?

We spend millions of pounds trying to prevent it, we detain people against their will to prevent such acts, we measure the performance of parts of our health service on their ability to reduce the occurrence, we hold formal internal, external and legal enquiries into what we could have done differently if it occurs etc etc

Why the sudden volt-face when it comes to *assisting* suicide ?
We do that because, when people commit suicide in the shadows, all cases are lumped together. With assisted suicide, we'd could start making a distinction between different motives.

The phrase "commit suicide" is itself a holdover from the days when suicide was a crime. The current legal position is utterly inconsistent. Nowhere else is it a crime to assist someone with an act that is, in itself, legal.

If legal sanction deters and protects, where are the calls to recriminalize suicide?
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by Doublethink:
We spend millions of pounds trying to prevent it, we detain people against their will to prevent such acts, we measure the performance of parts of our health service on their ability to reduce the occurrence, we hold formal internal, external and legal enquiries into what we could have done differently if it occurs etc etc

Why the sudden volt-face when it comes to *assisting* suicide ?
I hope we strive to avoid all unnecessarily premature deaths, whether self-inflicted or not, because the issue in such cases is one of when people die - how many years longer they might have lived. It's not just about the person who dies, it's about those who love them, who have also been deprived.

When someone is staring death in the face then it becomes instead a question of how to die. It's about whether we have the right to choose to die swiftly and painlessly. What are the loved ones being deprived of then? The right to watch you dying in pain? The right to watch you fighting for that last breath every inch of the way?

It's been suggested here (not by you, DT) that it's those supporting euthanasia are selfish. I think you could equally well and equally pointlessly, argue that it's the other way round.
 
Posted by Doublethink (# 1984) on :
 

There seem to be four things non-currently terminally ill people are worried about; pain, incontinence, cognitive deterioration, and physical restriction.

If you live to old age it is extremely likely all these things will happen to you, years before you die.

So what threshold are you looking for ?
 
Posted by Doublethink (# 1984) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by Doublethink:
Just out of interest, what about unassisted suicide ?

We spend millions of pounds trying to prevent it, we detain people against their will to prevent such acts, we measure the performance of parts of our health service on their ability to reduce the occurrence, we hold formal internal, external and legal enquiries into what we could have done differently if it occurs etc etc

Why the sudden volt-face when it comes to *assisting* suicide ?
We do that because, when people commit suicide in the shadows, all cases are lumped together. With assisted suicide, we'd could start making a distinction between different motives.

The phrase "commit suicide" is itself a holdover from the days when suicide was a crime. The current legal position is utterly inconsistent. Nowhere else is it a crime to assist someone with an act that is, in itself, legal.

If legal sanction deters and protects, where are the calls to recriminalize suicide?
I think, basically, it is not illegal because it is obviously pointless to treat it as a crime. It is generally an act that occurs in a state of mind unlikely to be deterred by - or if the attempt is unsuccessful - improved by punishment. It is usually held that someone who kills themselves does so "whilst the balance of their mind is disturbed" and therefore had impaired capacity and responsibility.

You can disapprove of and discourage drug addiction, without believing that criminalisation is the best way to deal with addicts - you'd probably still think it was wrong to go sell vulnerable people crack.

Likewise I think it is possible to have a coherent legal / societal view that an activity you wish to reduce should itself not be illegal, whilst encouraging it should be.

Suicide and homicide are different, and what people are asking for, is the ability to ask others to commit homicide.
 
Posted by Curiosity killed ... (# 11770) on :
 
It's currently being debated on the Moral Maze on BBC Radio 4.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Doublethink:
I think, basically, it is not illegal because it is obviously pointless to treat it as a crime. It is generally an act that occurs in a state of mind unlikely to be deterred by - or if the attempt is unsuccessful - improved by punishment. It is usually held that someone who kills themselves does so "whilst the balance of their mind is disturbed" and therefore had impaired capacity and responsibility.
If suicide is inherently wrong, criminalization doesn't hinge on deterrence. Most attempted suicides wouldn't meet the criminal burden for pleading insanity, so that's not, in itself, grounds to legalize it.

Suicide was criminalized on the understanding that our lives belong not to us, but to God. It was viewed as self-murder. The "sanctity of life" argument deployed against euthanasia and assisted suicide comes from the same place.

If we can reassess the law against one aspect of suicide, it creates a precedent to use against another.
quote:
You can disapprove of and discourage drug addiction, without believing that criminalisation is the best way to deal with addicts - you'd probably still think it was wrong to go sell vulnerable people crack.

Likewise I think it is possible to have a coherent legal / societal view that an activity you wish to reduce should itself not be illegal, whilst encouraging it should be.
I'm no fan of drug prohibition, either, for similar reasons.
quote:
Suicide and homicide are different, and what people are asking for, is the ability to ask others to commit homicide.
Only in cases of euthanasia. The English bill would only apply to assisted suicide.

Not that I stress the difference. Instead, I look at what other kinds of homicide are justifiable. Take self-defense: it happens in the heat of the moment, and mistakes are inevitable. If a person reasonably believes that deadly force is justified, they get a walk, even if they've killed an innocent person by mistake. Assisted suicide, with multiple tiers of review, is far less prone to error.

If we can allow one, why not another?
 
Posted by Doublethink (# 1984) on :
 
Well, ultimately - on a pragmatic level - my biggest fear, other than the absolutely massive safeguarding issues, is an expansion of eugenics and a failure to try to give effective treatment for depression for those people with life limiting illnesses or significant physical / communication disabilities.
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by orfeo:
quote:
Originally posted by Byron:
What makes assisted suicide a special case?
The consequences of the mistake. [...]
Identical to the consequences of terminating life support. If someone can only breathe with a ventilator, if you turn it off, they won't survive.
But what if the medics are wrong in their assessment?
I know of a case where the ventilator was switched off and the man continued berating unaided. A month later, he was walking around the park.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by orfeo:
quote:
Originally posted by Byron:
What makes assisted suicide a special case?
The consequences of the mistake. [...]
Identical to the consequences of terminating life support. If someone can only breathe with a ventilator, if you turn it off, they won't survive.

D'you believe patients should lose this right? If not, what else, besides consequences, separates the right to withdraw treatment from assisted suicide?
Making decisions about treatment is a well-established right.

Suicide is not 'treatment'.
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by orfeo:
Suicide is not 'treatment'.
Actually, you can come a point when the dose of morphine or whatever necessary to relieve pain is fatal. And I believe that technically - legally technically - that's ok (perhaps partly because people in extreme pain can absorb doses that would floor a carthorse?) But not all doctors will go to that point - so, if you can't get into a hospice, you're stuffed.

And morphine doesn't really touch bone pain, as my mother knew to her cost. There is at least one anti-depressant which can also be used as pain relief (it does something to the nerves), but people using it can still reach the point where they want to die. Are we in a (proper use) Catch-22 here?
If you're terminally ill and in pain and you want to die, then you must be depressed (no wonder) so you aren't competent to make that decision. If you don't want to die, then you're not depressed, so you would be competent to make such a decision - except, that as soon as you decide that now is the time to go, then you are self-evidently depressed ....
 
Posted by Matt Black (# 2210) on :
 
Yes, the principle of double-effect is well-established as I think others have pointed out. But that's not what this week's Lords debate is about.
 
Posted by QLib (# 43) on :
 
quote:
Originally posted by Matt Black:
Yes, the principle of double-effect is well-established as I think others have pointed out. But that's not what this week's Lords debate is about.
I wasn't discussing the debate in the Lords; I was discussing the proposition that suicide is not treatment.

Normally, it isn't, of course. But sometimes a moral decision involves choosing the lesser of two evils. There are certain medical circumstances in which I might choose to die. There are certain highly exceptional medical circumstances when I might prefer to die but be unable to do anything about it. In such a case, I believe, a doctor (or other person) who helped me to die would be giving me the treatment I needed to relieve my suffering. Although I recognise the very real difficulties and worries, I would like the right to such treatment to be enshrined in law.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by QLib:
quote:
Originally posted by orfeo:
Suicide is not 'treatment'.
Actually, you can come a point when the dose of morphine or whatever necessary to relieve pain is fatal.
And treatment that has death as a side-effect is not 'suicide'.

This is all pretty well-established stuff. It's about intention. Treatment is aimed at making someone better. Suicide is aimed at the exact opposite: of making someone as much worse in medical terms as it's possible to be. Whether someone might think that themselves or another person is, in some moral sense, better off dead isn't to the point.

That treatment might not in fact make someone better in a particular case is not to the point. Sometimes treatments don't work. Sometimes treatments have side effects. That doesn't mean that the side effect becomes the goal of treatment. It is in fact still thoroughly illegal to administer morphine to someone for the purpose of killing them. A recent fictional legal TV show here in Australia went into that very point, with a character giving his sick wife 3 doses of morphine in quick succession, inconsistent with a goal of pain relief.

[ 17. July 2014, 12:50: Message edited by: orfeo ]
 
Posted by leo (# 1458) on :
 
quote:
Originally posted by Curiosity killed ...:
It's currently being debated on the Moral Maze on BBC Radio 4.
Troible is that they have that dreadful womasn Melanie Phillips who does knee jerk Daily Mail arguments and looks down her nose at anyone who is more clever than her - which is a lot of people.

Giles Fraser spoke more sense.

I think that Carey should be put out to grass though, for once, I sympathised with what he said.

Trouble is that it is all much more complicated, which is what Fraser said and what Bp. Richard Harries wrote in last week's Church Times.
 
Posted by Boogie (# 13538) on :
 
Sir Chris Woodhead, the former chief inspector of schools, wants to be able to kill himself simply and with dignity when he feels the time is right. He has Motor neurone disease and supports the dignity in dying campaign. He says 'I don’t want to be told how I can die’.

I agree with him in this article. If I had his condition I think I'd feel just the same.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by JoannaP:
But what if the medics are wrong in their assessment?
I know of a case where the ventilator was switched off and the man continued berating unaided. A month later, he was walking around the park.
OK, rephrase as "extremely likely to die." I'm sure you'll agree that this isn't exactly common.

Withdrawing treatment at the request of the patient isn't dual effect: it's intentionally killing them, at their request. Doctors can also withdraw treatment without the patient's consent if they consider it hopeless. They do it on a nightly basis in ER.

If treatment were, as orfeo claims, about making people better, we wouldn't have palliative care. Treatment isn't cure. It's often about alleviating suffering. The good death is exactly that.
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Byron:
Withdrawing treatment at the request of the patient isn't dual effect: it's intentionally killing them, at their request.
No. Their condition kills them. Is allowed to kill them. Is no longer artificially kept from killing them. It is, in fact, dual effect. If without a certain treatment, especially a constant and ongoing treatment like feeding tubes, IVs, forced breathing, a patient would die, then withholding that ongoing treatment isn't killing the patient. It's allowing the patient to be killed by their disease. The difference is immense.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Byron:
If treatment were, as orfeo claims, about making people better, we wouldn't have palliative care.
What rot.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by mousethief:
No. Their condition kills them. Is allowed to kill them. Is no longer artificially kept from killing them. It is, in fact, dual effect. If without a certain treatment, especially a constant and ongoing treatment like feeding tubes, IVs, forced breathing, a patient would die, then withholding that ongoing treatment isn't killing the patient. It's allowing the patient to be killed by their disease. The difference is immense.
A caregiver who ends life support without justification is, depending on their intent, guilty either of murder or manslaughter, as culpability attaches with their intervening act. If it didn't, you could cut a climber's rope, and blame gravity for the sidewalk pizza; a suspended climber is, after all, being kept alive artificially. All that matters is whether death is a foreseeable consequence of an action.

This is moral hairsplitting, without bearing on issues like coercion.
 
Posted by Soror Magna (# 9881) on :
 
quote:
Originally posted by JoannaP:
... I think that, if I sincerely believed that the best thing I could do for MrP was to hold a pillow over his face, I should have the courage of my convictions and be prepared to argue that case before a dozen of my peers (given that juries tend not to find mercy-killers guilty). I am not sure that I want to live in a society where I could kill my husband with no questions asked. ...
Given that the end result for MrP (hypothetically and impersonally speaking, of course) is the same, I don't quite understand the distinction. There's also a middle ground of justifying the act to one's peers *before* doing it i.e. in between no questions asked and hoping to be acquitted afterwards. Could you unpack this a bit? Thanks!
 
Posted by JoannaP (# 4493) on :
 
quote:
Originally posted by Soror Magna:
quote:
Originally posted by JoannaP:
... I think that, if I sincerely believed that the best thing I could do for MrP was to hold a pillow over his face, I should have the courage of my convictions and be prepared to argue that case before a dozen of my peers (given that juries tend not to find mercy-killers guilty). I am not sure that I want to live in a society where I could kill my husband with no questions asked. ...
Given that the end result for MrP (hypothetically and impersonally speaking, of course) is the same, I don't quite understand the distinction. There's also a middle ground of justifying the act to one's peers *before* doing it i.e. in between no questions asked and hoping to be acquitted afterwards. Could you unpack this a bit? Thanks!
The distinction is more to do with me and my putative relations with society than with MrP; obviously anything that happens to me after his death is not going to make a difference to him.

I apologise if I was not clear; "a dozen of my peers" refers to a jury and our legal system does not have a mechanism for somebody to be tried before committing the crime. If I discussed it beforehand, then I would risk making other people criminals as accessories to murder.
 
Posted by Patdys (# 9397) on :
 
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.
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Byron:
This is moral hairsplitting, without bearing on issues like coercion.
Bullshit. There is no comparison between a rope holding up a climber, and an artificial life support system. Climbers aren't deathly ill, for one thing. They are not being kept alive against their bodies trying to shut down by medical means that didn't exist 100 years ago, and without which they would currently be dead. A climber is not a patient in a hospital. Climbing is not a medical condition. This is a fucking stupid analogy.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by mousethief:
[...] A climber is not a patient in a hospital. [...]
Not until they're decorating the sidewalk, at least. [Razz]

You dumped a ton of moral weight on a person being kept alive artificially: I chose an analogy to highlight the absurdity of the distinction. Snarky, and valid, unless a person being "deathly ill" has some ethical significance. If so, what is it?
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by mousethief:
[...] A climber is not a patient in a hospital. [...]
Not until they're decorating the sidewalk, at least. [Razz]

You dumped a ton of moral weight on a person being kept alive artificially: I chose an analogy to highlight the absurdity of the distinction. Snarky, and valid, unless a person being "deathly ill" has some ethical significance. If so, what is it?
Snarky and invalid. The ethical significance of keeping someone alive artificially is that they WOULD BE DEAD without the intervention. We are interfering with death. If that has no ethical significance to you, I confess I have no idea what you might think does.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by mousethief:
[...] The ethical significance of keeping someone alive artificially is that they WOULD BE DEAD without the intervention. [...]
Your point hasn't become stronger, merely taller.

Since you've no time for our unfortunate rappeler, we've established that the difference between euthanasia and withdrawing treatment doesn't hinge on a person being kept alive artificially. So what does it hinge on?
 
Posted by mousethief (# 953) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by mousethief:
[...] The ethical significance of keeping someone alive artificially is that they WOULD BE DEAD without the intervention. [...]
Your point hasn't become stronger, merely taller.

Since you've no time for our unfortunate rappeler, we've established that the difference between euthanasia and withdrawing treatment doesn't hinge on a person being kept alive artificially. So what does it hinge on?
You clearly aren't interested in this conversation but only in making silly points. Have at it then.
 
Posted by Gee D (# 13815) on :
 
Originally posted by Byron:
Not until they're decorating the sidewalk, at least. [Razz]


Remember the cartoon series in Mad? A pavement artist draws an elaborate picture frame, then takes the lift (elevator) to the 59th floor, jumps and lands in the middle of the frame he had drawn. The title of the series : Self Portrait.

[ 22. July 2014, 08:29: Message edited by: Gee D ]
 
Posted by Patdys (# 9397) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by mousethief:
[...] The ethical significance of keeping someone alive artificially is that they WOULD BE DEAD without the intervention. [...]
Your point hasn't become stronger, merely taller.

Since you've no time for our unfortunate rappeler, we've established that the difference between euthanasia and withdrawing treatment doesn't hinge on a person being kept alive artificially. So what does it hinge on?
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.

Part of the issue is confusing living well and dying well. They are separate stages of life, both treated with palliative care.
 
Posted by Byron (# 15532) on :
 
Gee D, would be a slam-dunk for the Turner Prize!

quote:
Originally posted by Patdys:
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.

Part of the issue is confusing living well and dying well. They are separate stages of life, both treated with palliative care.
What is the ethical distinctiveness of life being actively prolonged?

Withdrawing treatment raises all the same practical concerns (coercion, depression) leveled against assisted suicide and euthanasia. So the difference is already abstracted.

As intent (to cause death with consent) and the consequences (the morgue) are identical, it's further narrowed to strict deontologists. On what grounds is the ethical rule decided, and why ought society bind itself to it?

Unless an answer can be found, we're left swinging with the climber.
 
Posted by Patdys (# 9397) on :
 
The difference is in the phase of life.
Withdrawal is utilised in the 'dying' phase. It is utilised to reduce suffering induced by protracted dying in a terminal patient.
Euthanasia makes no distinction between living and dying phases of life.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Patdys:
The difference is in the phase of life.
Withdrawal is utilised in the 'dying' phase. It is utilised to reduce suffering induced by protracted dying in a terminal patient.
Euthanasia makes no distinction between living and dying phases of life.
A person can order treatment withdrawn at any time, for any reason, even if they had every chance of recovery.

In most jurisdictions, a person can't have themselves euthanized at any time, even if they've only hours to live, and are in unbearable pain.

So "phase of life" fails even on its own terms.
 
Posted by orfeo (# 13878) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by Patdys:
The difference is in the phase of life.
Withdrawal is utilised in the 'dying' phase. It is utilised to reduce suffering induced by protracted dying in a terminal patient.
Euthanasia makes no distinction between living and dying phases of life.
A person can order treatment withdrawn at any time, for any reason, even if they had every chance of recovery.

In most jurisdictions, a person can't have themselves euthanized at any time, even if they've only hours to live, and are in unbearable pain.

So "phase of life" fails even on its own terms.
But you are free to off yourself anytime you like, Byron.

Why exactly should other people be co-opted into that? Especially people who have gone into a profession whose aim is improve people's health?

This isn't about your right to die. This is about your right to get other people to make decisions. Bloody great big decisions.
 
Posted by Patdys (# 9397) on :
 
I am not sure of the point you are making. It seems to have changed. I am happy to discuss but I am not sure what we are discussing anymore?
 
Posted by leftfieldlover (# 13467) on :
 
My sister in law died in February this year after been told she was terminally ill with widespread cancer last November. Fortunately she was in a hospice to begin with and was kept pain-free and comfortable. However, she was keen to return home and arrangements were made. After just a few days, and in great pain she was taken to a Nursing Home [the hospice had no spare beds] where she spent a week or so in agony as the doctors tried to sort out her pain regime. They did not succeed and she told my husband that she would love just a little something to finish her off. Eventually she was moved back to the hospice where her pain relief was sorted out and pain free at last she mercifully died in her sleep. There are two points here. One, when she was so near to death and in great pain, why could not the Nursing Home ease her suffering for good? Second, hospices are wonderful institutions, but there aren't enough of them. Either money could be put into building more, or money could be provided for better end of life care in hospitals and nursing homes.
 
Posted by Patdys (# 9397) on :
 
I would certainly agree that euthanasia can only be opposed ethically in the setting of adequate access to palliative care. I am concerned about the closure of hospice beds as although nursing homes can deliver good palliative care, some patients have symptom burdens beyond their capabilities. I personally would argue for better palliative care services.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by orfeo:
But you are free to off yourself anytime you like, Byron.

Why exactly should other people be co-opted into that? Especially people who have gone into a profession whose aim is improve people's health?

This isn't about your right to die. This is about your right to get other people to make decisions. Bloody great big decisions.
No one would be "co-opted." The English bill would allow physicians to refuse on grounds of conscience. Participation would be voluntary.

Besides, even accepting your claims arguendo, medical professionals choose to enter a profession in which they make life and death choices on a daily basis. Some of the more odious arguments against assisted suicide demand that individuals suffer for the greater good. If a patient with bone cancer can be expected to die in agony, a doctor's conscientious scruples would be mild by comparison. This is another one that fails even on its own terms. (Terms I disagree with. No one should be forced to participate in a mercy killing.)

The only people being "co-opted" are those who wish to be helped to die, and those caregivers who are willing and able to relieve their suffering. They're forced to act against their conscience ... why, exactly? This thread's been unable to serve up a single substantive and consistent reason.
 
Posted by Curiosity killed ... (# 11770) on :
 
Nobody is saying that those who want to die can't choose to do that. Tony Nicklinson, the man with locked in syndrome who campaigned for the right to be killed, refused food and died of pneumonia a week after he lost his last case. He had every right to choose to die, and did eventually do that. What we are saying is that the person choosing to die cannot insist someone else helps them.

The 1967 Abortion Bill was intended for abortion to be a rare occurrence which allowed for the outlying cases. It contains a conscience clause for GPs and other medical professionals. But what actually happened is that abortion clinics were set up and there are 200,000 odd abortions a year in the UK. So there's a huge lack of trust in opt out clauses working in practice.

[ 24. July 2014, 07:48: Message edited by: Curiosity killed ... ]
 
Posted by Patdys (# 9397) on :
 
quote:
Originally posted by Byron:
quote:
Originally posted by orfeo:
But you are free to off yourself anytime you like, Byron.

Why exactly should other people be co-opted into that? Especially people who have gone into a profession whose aim is improve people's health?

This isn't about your right to die. This is about your right to get other people to make decisions. Bloody great big decisions.
No one would be "co-opted." The English bill would allow physicians to refuse on grounds of conscience. Participation would be voluntary.

Besides, even accepting your claims arguendo, medical professionals choose to enter a profession in which they make life and death choices on a daily basis. Some of the more odious arguments against assisted suicide demand that individuals suffer for the greater good. If a patient with bone cancer can be expected to die in agony, a doctor's conscientious scruples would be mild by comparison. This is another one that fails even on its own terms. (Terms I disagree with. No one should be forced to participate in a mercy killing.)

The only people being "co-opted" are those who wish to be helped to die, and those caregivers who are willing and able to relieve their suffering. They're forced to act against their conscience ... why, exactly? This thread's been unable to serve up a single substantive and consistent reason.
OK.

1) If palliative care services are available, then suffering should be able to be alleviated (It is not perfect).
2) Suffering is independent of pain or other symptoms. Pain can lead to suffering as can feeling like a burden on your family. This is really important. Symptoms do not equal suffering.
3) Euthanasia can induce suffering in its own right.
4) Good palliative care responds to the needs of the patient, their family/friends and wider society, including the treatment teams.
5) Physicians make life and death decisions daily according to the bioethical principles of
---1) beneficence do good for your patient
---2) non maleficence do no harm to your patient
---3) Justice, allocation of resources
---4)Autonomy- patient choice ( and physician choice)
You are ranking autonomy as supreme and it is not.
I would also advocate that euthanasia should be carried out by a technician rather than a doctor if implemented as the loss of trust would be terrible. How can you trust that the doctor would act in your best interest?

I have also worked out that we are approaching the issue from different ends- my view is that of a health professional rather than a patient (I think this is where some of my confusion was stemming from).

Nobody has the right to say autonomy is paramount. There are wider issues, including society mores etc. But, there must be scope to deliver comprehensive palliative care.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Patdys:
[...] You are ranking autonomy as supreme and it is not. [...]
Not the case, as the judgment of physicians is involved throughout: in addition to the diagnosis that triggers the request for euthanasia, they assess whether the patient's competent to give consent, and if so, prescribe the drugs. If autonomy were absolute, I recommend the patient be left alone with a revolver and a bottle of whiskey. I don't. (Well, a good Scotch, perhaps.)

For what reason are you raising the suffering euthanasia can cause? Many treatments cause immense suffering (chemotherapy, amputation, etc). It's just one factor to consider. If a patient is in continuous, unbearable pain, then it's a lesser evil.

Medicine is full of trade-offs. "Do no harm" is not used as grounds to avoid sometimes devastating surgery, since the alternative is worse. If a person is hours from death, and helped on their way, the harm done is a lot less than, say, cutting the arms and the legs off a baby with meningitis.

Assisted suicide and euthanasia are fully consistent with the four principles of biomedical ethics.

[ 24. July 2014, 10:53: Message edited by: Byron ]
 
Posted by Patdys (# 9397) on :
 
You are merely using a physician as a revolver and a bottle of whiskey.

To address the pain issue, palliative sedation is occasionally utilised. It is a team decision and discussion and involves a lot of soul searching.

I'd rather my doctor thought and cared rather than was simply a means to an end. There is always something that can be done to assist with suffering. Euthanasia lack the creativity , the compassion and the care of good medicine. And it can rob the family patient and community. And it can dehumanise the treating team.
This is why I cannot support it.

In my opinion, your argument is valid only in areas where palliative care cannot be provided.
 
Posted by Byron (# 15532) on :
 
quote:
Originally posted by Patdys:
[...] Euthanasia lack the creativity, the compassion and the care of good medicine. [...]
Creativity?! Medicine's an applied science, not performance art.

As for care and compassion, they've been covered in detail. If caregivers feel euthanasia is in the best interests of the patient, and patients agree, there needs to be compelling reasons for banning it by force of law.

Doctors expressing their muse just don't cut it.
 
Posted by Patdys (# 9397) on :
 
Medicine is both art and science. If you have time and interest, look up the WHO definition of palliative care. For now, I am done here.
 


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