Physician Assisted Suicide

[Happiness]

Funny had this same converstion with a nurse yesterday. First of all I agree that everyone has the right to end their own life and if it came down to it, I have always said the day I become a burden (as in a terminal illness not the old mom living in the basement to my family is day I want to leave this place. It is a personal choice and should be respected as that. As a person living in BC I have seen alot of this on the news.

This woman has all of her facalties and is at this time able to make this decision. She has seen what her life has instore for her and she wants to avoid that pain not only for herself but her family. Watching some one die is the most horrible thing on earth, we all know that.

I dont like the term Dr. Assisted myself, if someone wants to do this in a legal manner they should be the one to push the button and no one else. (yes I know that not all terminally ill people can but you get the idea) There are going to be times when someone has to make a decision on these things because the loved one may be unable to do so. In these cases they should have a process where the Drs and the courts make the decision and not the family members. And it should always be case to case.

http://www.health.go.../endoflife.html to be honest we already have a way to die with dignity in BC. If I go to a call and I am handed a piece of paper that states this person does not want any life saving things done I dont do it. There is obviously criteria for this but what is stopping someone from signing this and then taking their own life. Abosulitly nothing.

I get what your saying Wendy and please know I totally respect your opinion on the topic as I think this is not something you can't sit on the fence about its a yes or no agreement. I do have one question for you. As I read in your post you stated that it is acceptable to take those life saving measures away from someone and it made me think of http://www.nndb.com/.../435/000026357/. Terri was in a state of veggitation for 15 years and being kept alive with a feeding tube. They took it out and in 13 days she died basically from starvation. Now to me the family and Drs knew what the end result was going to be and if there was some sort of legislation to help her along to that end result it would not have taken 13 days to die. Yes I know there is alot of contriversy in this particular case but to me the ending of her life this way was cruel.

So if you have read my last post about being a part of saving my friends life, I have to say today I wish we didn't. That sounds kind of fucked up but now we have found out not only did he have a major heart attack but he also had a major stroke. They finally did a CAT scan on his brain and found out this is probably why he is not waking up. He is breathing on his own and his heart is pumping but his brain is screwed. This buddy of mine was a very vibrant man with a the most beautiful smile ever. He was a troller, siener and crab fisherman for his entire life. He went to the beach everyday with his family and taught them the way of land. I never once saw this man angry, or sad ever and I know that he does not want to be in the state that he is in, as Im sure none of us would be. Unless he has another stroke or heart attack he could be in that state for years, or if someone decides to take his feeding tube out and lets him die cruely. If something was in place today there could be an option for him to die peacefully and with dignity. Sometimes its very heart breaking to save the ones you love.

Edited June 21, 2012 by Happiness

[Just Plain Ruff]

Guys, I have made my wishes clear to my loved ones, they know that I wish not to live the way we have been discussing.

I actually have the means to end it all in my medicine chest since I'm a diabetic. We all know what that medication is. Give me enough insulin before I go to bed and I'm not waking up. Is that the way I want to go, I don't know but it would be MY choice and not anyone elses.

I don't understand all the hullaballoo surrounding if I'm in end stage cancer, where there is nothing else that any medical cure can do, no hope for remission, no hope that I'm going to come out of it and I am going to die. If I'm on boatloads of pain meds why can't I decide when and how I go out?

Why should I have to ask anyone if I can end my life? I should not have to go in front of any panel to ask them "can I end my life?"

I'm sorry but I find the correlation between the suffering of our pets and the suffering of our family members very relevant. I don't see the difference in end stage disease. The animals suffer just as humans do, they feel pain just as we do. We take them to the vet to ease their suffering, we take our family members to the doctors to ease our family members suffering. We take our animals to the vet to end the suffering but we can't end our family members suffering. All because we are supposedly human. Let's prolong the suffering to our family members all because its wrong to end the life of a fellow human to end their suffering. Why is it wrong to end a humans suffering but not an animals?

Give me 5 syringes of 300 units of insulin to end my suffering for my end stage cancer. Let me go in my sleep. I think that will do it. That's my personal euthansia kit.

[BillKaneEMT]

Guys, I have made my wishes clear to my loved ones, they know that I wish not to live the way we have been discussing.

I actually have the means to end it all in my medicine chest since I'm a diabetic. We all know what that medication is. Give me enough insulin before I go to bed and I'm not waking up. Is that the way I want to go, I don't know but it would be MY choice and not anyone elses.

I don't understand all the hullaballoo surrounding if I'm in end stage cancer, where there is nothing else that any medical cure can do, no hope for remission, no hope that I'm going to come out of it and I am going to die. If I'm on boatloads of pain meds why can't I decide when and how I go out?

Why should I have to ask anyone if I can end my life? I should not have to go in front of any panel to ask them "can I end my life?"

I'm sorry but I find the correlation between the suffering of our pets and the suffering of our family members very relevant. I don't see the difference in end stage disease. The animals suffer just as humans do, they feel pain just as we do. We take them to the vet to ease their suffering, we take our family members to the doctors to ease our family members suffering. We take our animals to the vet to end the suffering but we can't end our family members suffering. All because we are supposedly human. Let's prolong the suffering to our family members all because its wrong to end the life of a fellow human to end their suffering. Why is it wrong to end a humans suffering but not an animals?

Give me 5 syringes of 300 units of insulin to end my suffering for my end stage cancer. Let me go in my sleep. I think that will do it. That's my personal euthansia kit.

Hey Cap, I don't have any firsthand experience with insulin overdose but from what I read here http://www.diabeticconnect.com/discussions/11449-insulin-overdose-suicide it seems to be a fairly unpleasant way to go and surprisingly unreliable to boot. As for me, I have no idea what I would choose in that sort of situation but it will certainly be something as painless and reliable as I can manage. Admittedly, the people referred to in that link may not have used the amount you mentioned but even so.

[Asysin2leads]

Wendy, i can understand your viewpoint, but here is mine. When it comes to someone who is terminally ill, it is NOT ethical to allow them to succumb to malnutrition or dehydration or even suffocation in the case of a ventilator when there are other options available. It is not ethical to put any living thing in unnecessary pain or discomfort if the ability to alleviate that pain is available.

I understand your reservations regarding 'slippery slope' when it comes to assisted suicide, but I can tell you that after the Nuremberg trials after World War II and the extent of the Nazis practices of euthanizing social undesirables, there very, very strict rules and laws in place governing that sort of thing. Do not buy into the Sarah Palin 'death panels' concept, you can easily institute a program that provides for end-of-life care without the fear of the afflicted being removed from the gene pool.

Your belief in the sanctity of human life is not misplaced, I happen to agree with you. But even more important than the mere presence or absence of life is the quality of life.

[Mateo_1387]

I am a proponent for euthanasia, that is for consenting and of sound mind adults.

The truth is that no law or government really has the power to stop someone from ending their life. There are multiple ways to do it. A physician does not have to be the one to perform the procedure. There is an exception to the rule, those that do not have the physical ability and means to complete such an act. Why not let a physician perform the act, in a humane manner, to ease suffering?

I do agree that it is ethical to control pain, alleviate suffering, and through those measures perhaps shorten the span of a life that otherwise might have gone on for longer. For example, I have no problem in the administration of benzodiazepines and narcotic pain relievers in hospice care, where you know full well that said administration will shorten the person's life.

I also agree that it is ethical to remove the artificial prolongation of life via medical interventions such as feeding tubes, artificial ventilation, intra-aortic balloon pumps, etc. Especially when the individual in question has created advanced directives indicating their preference with regard to this sort of care. Yes, you are removing an intervention that is directly supporting the individual's life... but you are not intentionally administering something to end that life. There is a very discrete ethical difference here.

What is this very discrete ethical difference? Is there really one?

This is one of my favorite essays I read while taking an Ethics class. It is called Active and Passive Euthanasia. It is written by James Rachels.

http://www2.sunysuffolk.edu/pecorip/scccweb/etexts/deathanddying_text/Active%20and%20Passive%20Euthanasia.pdf

[Arctickat]

Assisted-suicide ruling to be appealed by Ottawa

The federal government will appeal last month's ruling by the British Columbia Supreme Court that partially struck down Canada's ban on assisted suicide, Justice Minister Rob Nicholson says.

The ruling declared that the Criminal Code section targeting anyone who "aids or abets a person to commit suicide" should not apply to physicians in cases where terminally ill patients request to die

http://www.cbc.ca/news/politics/story/2012/07/13/pol-cp-federal-appeal-assisted-suicide.html

[DwayneEMTP]

Wendy, what is the difference between removing a life saving intervention or applying a life ending measure?

The end result is exactly the same with the exception that those removing a life saving intervention are often doing so to then allow the patient to slowly suffocate in their own bodily fluids, while those administering are allowing a peaceful and more (in my opinion) dignified passing.

I've lost many that I've loved and been with them during the last days and moments of their lives as well as many patients in the same situation and I've never, if you leave God out of it with all of his 'gifts of suffering' seen any dignity nor benefit to end of life suffering...

[281mustang]

It is ridiculous that Physician assisted suicide is illegal. Obviously it needs limitations, but if a pt with ALS, late stage cancer, etc. decides after careful deliberation that they would rather die with dignity it is not the government's job to jump in and say "lolnope, we say that you painfully will rot away in a hospital bed so that's how it's going to play out. The right to make decisions regarding your personal life belongs soley to your government, not you"

Disgusting.

Edited July 16, 2012 by 281mustang

[Quakefire]

Wendy, what is the difference between removing a life saving intervention or applying a life ending measure?

The end result is exactly the same with the exception that those removing a life saving intervention are often doing so to then allow the patient to slowly suffocate in their own bodily fluids, while those administering are allowing a peaceful and more (in my opinion) dignified passing.

I've lost many that I've loved and been with them during the last days and moments of their lives as well as many patients in the same situation and I've never, if you leave God out of it with all of his 'gifts of suffering' seen any dignity nor benefit to end of life suffering...

I have to agree, the only argument that I can see for removing interventions like ventilators, IV fluids/nutrition, feeding tubes and the like is to allow a "natural death" allowing nature to take its course. Unfortunately with that thought I see the administration of pain killers or other medications to be against this desire to leave everything up to nature.

If you are allowing advanced interventions to artificially prolong life, I feel the opposite should be true as well, an advanced intervention to end suffering

[DFIB]

For some reason this subject is painful to think about and I am not sure where I will go with my ideas at this point. In a weird kind of way I see merit in both arguments and agree somewhat with both philosophies.

First I have to say that at least for me, animals do not rank in the same class as humans and bring a degree of imperfection to the argument by diluting the idea of the sanctity of human life. I say this is I affectionately pet my dog. I don't despise animals but only consider them valuable in the measure that they provide pleasure and well being to humans.

That said, I am writting without having read the article so that my thoughts are not mired by a single argument but to approach the subject generally speaking.

I think one of the difficulties of physician assisted suicide is deciding who gets to go and who still has the chance to live. ie; How much pain would a person have to be in? What would our litmus test be? What would the threshold for living and dying become?

This argument is terrifying in the sense that these societal evolutions never cease to progress. It would begin with a patient decision and progress into a family decision and then the Dr. or hospital board calling the shots. The ultimate loss of freedom would be the Government deciding through mandated health insurance who lives or dies. This aspect of the issue scares the crap out of me. Oddly enough the very thing which we would initially perceived as the ultimate expression of freedom would very possibly turned into the ultimate loss of liberty.

Broad legislation would not be an answer as each case would have to be considered individually. I agree with cbare's original comment only to the point that we can ascertain that the Dr. is an ethical person and not a psycho out to kill people.

The dichotomous nature of the assisted suicide line of action and the balance between ethics and humanity are the basis of our conundrum.

Even so it is very clear to me that there are situations that are immensely worse than death.

From a Hippocratic point of view we would have to redefine death as the not being the ultimate harm in order to "do no harm" defining the loss of quality of life as the ultimate harm and death as a cure or solution. The more I write the more I realize that I am not intelligent enough to come up with an answer.

From spiritual point of view I have a different perspective. God decides the time of each of our deaths not to imply the this does not involve free will. So the conundrum continues.

I think I would have to love someone very much to agree to help them die.

Edited July 17, 2012 by DFIB