Physician Assisted Suicide

[Arctickat]

There is something unique about human life that makes it different.

More Valuable? Some would argue.

Yes, we put our animals down out of compassion... but an animal is not a human being.

Yet the animal has no choice in the matter. How are we to know the animal doesn't want to fight for survival? Humans have the understanding to make a choice, my dog, does not.

The sentience that comes with being human, and in my opinion, the existence of the soul,

My dog is a soulless creature? I won't see him in heaven if I go there? What about doggie heaven? Seriously, there are those who believe their pets will be in the afterlife. For such to occur, isn't a soul a prerequisite?

makes suicide (whether assisted via a physician or not) an act that I feel to be very wrong.

But should everyone be forced to conform to what you believe in?

I also would caution that there is another group of individuals who feel that euthanizing non-functional human beings is appropriate, and that is a very difficult and pitfall-ridden path to be walking along. Human life is invaluable. It is precious.

The same could be said for a certain group who tried to force the entire population of Europe to conform to their system of beliefs.

While I empathize with those suffering from chronic, debilitating, progressive diseases, I do not feel that opting to intentionally end your life is an appropriate intervention, nor should it be sanctioned by the medical community. I know many disagree with me on this, but this is something I am very firmly convicted of.

I respect your conviction, all I ask is that you also respect mine.

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.

So, it's okay to make them into drug addicts, but not to allow them to die with dignity?

Edited June 20, 2012 by Arctickat

[Kiwiology]

If we put down our dog because it is in pain or is otherwise suffering from some terminal illness or greatly reduced HRQOL and our goal is a quick, dignified death and end to suffering/pain etc should we not allow the same in humans?

I've strung myself up twice to go for the big swing, didn't exactly work real well but y'know, as long as the person agrees to it shouldn't they have the choice?

[Eydawn]

More Valuable? Some would argue.

Yes, but we're not in a "should we all be vegan?" debate here. I do know that for me, sentience tips the value scale. If I can rescue only one life in a burning house, and one is a sentient human being and the other is a cat, the cat's on his own...

Yet the animal has no choice in the matter. How are we to know the animal doesn't want to fight for survival? Humans have the understanding to make a choice, my dog, does not.

We don't know, unfortunately. Once dogs learn to speak, they can be afforded the right of self advocacy. We are guardians of the animals we choose to live with; we must make decisions that we feel are in their best interest. And, it is interesting to me that you assume that the dog might fight for SURVIVAL, when the issue at hand is individuals fighting AGAINST survival (under very specific circumstances).

My dog is a soulless creature? I won't see him in heaven if I go there? What about doggie heaven? Seriously, there are those who believe their pets will be in the afterlife. For such to occur, isn't a soul a prerequisite?

Ack... you got me there. I did not mean to imply that dogs have no soul (I am one who very firmly believes that our dogs wait for us... after all, isn't Heaven all the best of existence? And dogs surely qualify there...) and therefore that point is null to the argument.

I can't argue the value of the dog soul vs the human soul, as we even poorly understand the existence of a soul at all ourselves... it was my religious thinking pulling into the argument some, but not fully fleshing out. If you'd like to have a religious debate, we'll start another thread (as I have a very specific religious component to my conviction, but realize that not everyone shares that common ground and have no desire to step on more toes.)

But should everyone be forced to conform to what you believe in?

But should I be forced to accept legislation that I find morally repugnant without expressing the contrary viewpoint? Currently, society sees murder as illegal and abhorrent. (In general). If we were to suddenly find legislation justifying murder, wouldn't you see people argue against it? In this instance, I think suicide, assisted or not, is very wrong. Therefore, I find its sanction incorrect, and choose to argue against it. Take another example... late term abortions. I may not be carrying a baby, nor choose to abort that baby (we're talking past the age of viability here), so it does not affect me personally, and yet I find such abortions (for the sake of birth control alone) to be morally and ethically incorrect.

The same could be said for a certain group who tried to force the entire population of Europe to conform to their system of beliefs.

I am not quite sure if we are on the same page? Because if you are referring to the Nazi euthanasia and sterilization movements, you're bolstering MY point... What were you trying to say (as I'm sure I've got it wrong, lol!)

I respect your conviction, all I ask is that you also respect mine.

I do respect yours, though I disagree with it; however, as it comes to policy-making and laws, we must each advocate for that which we find most correct, no?

So, it's okay to make them into drug addicts, but not to allow them to die with dignity?

Ok, you MUST know you're off in the ditch here. We're talking end stage hospice care for those who are suffering. I could shoot back with "So you think it's bad to give pain relief, but you're OK with killing them?" and it would sound equally as ridiculous. I believe you can die with dignity without hastening that end intentionally, and treading onto ethically shaky ground. The benefits of using benzos and narcs for those heading for those pearly gates far outweigh the downsides, and we all KNOW that giving pain control like that shortens the body's coping and hastens, to some extent, death... but it would be inhumane and cruel to withhold that kind of pain control.

Wendy

CO EMT-B

RN-ADN Student

[rock_shoes]

Wendy, can you explain the value in allowing someone to continue suffering with a terminal illness once they have passed the point of being able to retain any semblance of the all important quality of life? We all know that for a select group of terminally ill patients there comes a point where it simply isn't possible to retain any quality of life.

Consider the ALS patient who has deteriorated to the point they can no longer control there own respiration; imprisoned within their own body and now unable to even breath for themselves. It's acceptable to put them through the terror of simply shutting of the ventilator but it isn't acceptable to ease their death through pharmacological means at a time of their choosing? Terminally ill patient's deserve the right to leave life on their own terms. Taking that away amounts to barbarism.

I probably have a different outlook than many when it comes to these "controversial" issues. Pro-choice, pro-death penalty, pro-assisted suicide for the terminally ill. I'm not ashamed of my position and I am open to intelligent debate.

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[thrutheashes]

This is a touchy subject no matter which way you look at it. I am for the most part in agreement with the decision that was made. However I don't feel it should be yielded as a broad brush stroke and applied to every single person. I believe that this needs to be looked at on a case by case basis, or the risk for abuse becomes high. If people are trapped in failing bodies, better they should be able to end it on their own terms, and properly.The alternative is some will attempt on their own. We all know how some suicide attempts end up. They end up alive, angry, bitter, and with more problems than they initially had due to live, kidney, etc damage. And that is a further cost to themselves emotionally,physically, and to the health care system.

People should be counseled on their choice, and help offered. If in the end they chose to end it, on their terms, because of some malicious disease, I see no reason why they should not be allowed, and to have someone assist them to get it "right".

And before anyone says anything, I have personally felt the bite of suicide. My first wife attempted suicide a number of times before finally succeding in the fall of 2004. I know how touchy this subject can be.

The biggest question to come out of the debate for pro/con assisted suicde is this, what is in the best interest of our patients? I know if I was severely ill with little to no chance of recovery I would reach for the shot gun and do it myself, while I could.

Sorry about the rambling.

[scubanurse]

I strongly believe that passive or active euthanasia should be up to the individual. Wendy...you support passive euthenasia, removal of life sustaining equipment and treatments, but not active? I 100% believe and support your opinion but I disagree and fail to understand your stance.

I don't see how one could oppose letting someone take control of their own life. If someone of sound mind and judgement requests euthenasia twice at least two weeks apart...or some other set standard, then why not?

I believe every individual is free to determine their lives and taking away the option to choose how they die infringes on their rights as an autonomous individual.

Edited June 21, 2012 by Kate_826

[BillKaneEMT]

I'm kind of on the fence about this one. My personal code is something along the lines of "do what you like as long as you don't hurt anyone else". The problem I foresee with the assisted suicide issue is the competence factor. Is the patient truly competent to make the decision? In many, perhaps most cases they will be. What happens when the patient is not though? What happens when an elderly patient is cajoled, guilted, or tricked into requesting assisted suicide by their greedy offspring? This is a tough issue. I think both sides of this discussion have raised valid points, I would probably lean toward the "pro" side of this debate myself but only if there were some way of preventing worthless pieces of shit from murdering the elderly for personal gain. If anyone thinks it wouldn't come to that I must respectfully disagree based on my own observations in our local nursing homes.

So to clarify: I'd say yes, but with severe restrictions regarding competence of the patient, education pertaining to the patient's available choices, and extremely draconian penalties for violating those restrictions. Basically I'd prefer a system in which any violations of those rules change it from assisted suicide to murder. Because it will be.

Please don't misunderstand. I'm very open to letting people make their own decisions. Whether I approve or not isn't really relevant. I don't want people telling me what to do so I try to afford the same courtesy to others. I smoke. I'm aware of the danger of smoking and I do it anyway. I'm FAR from perfect. Hell, I'm far from good sometimes. So yes, let people choose by all means. But I don't smoke if I'm around non smokers. Because then my choice hurts them which is unacceptable. I know of at least 2 cases in local homes in which, if assisted suicide were made legal, family members would attempt to browbeat their suggestible elderly relatives into taking it. You wouldn't believe some of the things I've overheard said to patients by "loved ones". Or perhaps you would. In any case, I could accept this if the rules governing it ensured that NO patient, EVER, would be tricked, intimidated, or harassed into losing their life for the enrichment or convenience of someone else.

edit: Just as an fyi- reporting suspected elder abuse is both necessary and easy. You can do it anonymously if you like. Every state does it differently, as far as I know

Indiana is the only state in which the Adult Protective Services program is a criminal justice function. Laws to protect those who are unable to protect themselves vary by state but most seem to include some variation on the following: (taken from IN.gov)

Abuse:

Any touching (battery) of a person in a rude and insolent manner. Verbally abusing an individual is also a punishable offense.

Neglect:

The intentional withholding of essential care or service. Abandonment of an individual is also considered neglect.

Exploitation:

The intentional misuse of a person's property, person or services for financial gain.

Not trying to be preachy but seriously, if you're suspicious report it. They don't go off half cocked, they investigate. If you're wrong, oh well. If you're right you prevent physical/emotional pain and suffering and it costs you nothing. I'm not a violent man but physical or emotional abuse of people who can't defend themselves sets me off like nothing else.

Edited June 21, 2012 by BillKaneEMT

[island emt]

There is no afterlife except to feed the worms and micro-organisms and enrich the soil.

When your dead it's the end.

Live life to the fullest and when you are no longer able to enjoy it or control it due to debilitating disease ::::: pull the pin!

[scubanurse]

What happens when the patient is not though? What happens when an elderly patient is cajoled, guilted, or tricked into requesting assisted suicide by their greedy offspring?

I think doctors should be allowed to use their own judgement for the most part on this. Just as "greedy offspring" with a power of attorney can not just come in and stop live saving efforts or end life sustaining medical care if the physicians believe there is no reason to. A POA does have the right to make medical decisions but if the medical staff believe the patient is not brain dead or has a good chance of survival, I believe they can fight for their patients rights. Correct me if I am wrong though.

[DwayneEMTP]

Wendy, what is the difference between helping someone to die more quickly with compassionate care, as you mentioned with pain management, and helping them to die instantly with compassionate care? Isn't it only the time frame that's different?

Why is one person qualified to choose to die in a more quickly, lingering and painfully, and in most cases humiliating fashion, but another person unqualified to choose to choose to skip those steps and choose quick, and likely more dignified death?

Don't we, nearly every day in medicine, call people that choose ill health, pain, and humiliation mentally ill and hold them for treatment against their will? Why is this same person suddenly healthy if they are terminally ill?

What if a person's pain isn't manageable?