Physician Assisted Suicide

[emtannie]

I had always considered myself on the side of those who oppose physician-assisted suicide, until I cared for my father when he was in end stage cancer. I wouldn't wish what he went through on my worst enemy, and if he could have moved to take his own life, he would have. The pain he endured was horrible. The stress it put on my mother, and my sisters and brother, were horrible. He hated every second that he stayed alive the last few days. It was all I could do, to not fill him full of every med I had at my disposal, to put him into a deep sleep that would allow his escape from his pain-filled life.

He was very adamant that he did not want any life-saving interventions but it was unfortunate that he was not allowed to make the decision to end his life how he chose once the pain and suffering became unbearable.

Some of the posts here express concern about ending one's life like this becoming a casual event, that patients and doctors will make this decision like they decide whether they want an extra shot of cream in their coffee. It has to be the decision of the person who is ill, not the family, not the doctor. I don't believe that it will ever be a casual event, or that we have to worry about doctors using it as a regular form of treatment.

With proper education, most people are smart enough to make their own decisions. We try to educate our patients on the treatment options that they have. Why can we not do the same in this situation? People with debilitating diseases are generally informed about the progression of their disease, the signs and symptoms that will appear, and the deterioration of their quality of life. With that information, why do we not allow them to make the decision that will allow them to escape that pain and suffering in the way they see fit?

My personal opinion is that by withdrawing treatments eg feeding tubes or medications, and then allowing the person to starve, or allow a slow organ failure, and accepting that as a more appropriate treatment than the person deciding to have a quick, less painful death through some other means, is merely a way of splitting hairs to distance ourselves from the negative connotation of "suicide." By allowing the slower, more painful, less dignified death, we can comfort ourselves that the person "died naturally" rather than "suicide." But who did this truly benefit? Definitely not the patient. And in the grand scheme of things, isn't the patient our first priority? Isn't patient comfort supposed to be one of our basic treatments?

If or when that day comes that I have such a debilitating illness that I cannot care for myself, that I am a burden to others, and that there is no quality of life, I will do my very best to take those steps to ensure that I do not linger.

[DwayneEMTP]

Annie! You're back! We've been missing you!

Awesome, and heartbreaking post....

[CytochromeP450]

I'm going to be honest, I did not read the entirety of everyone's posts, so excuse me if I step on some toes. I'm also going to try to keep this brief...

1) The "slippery slope" argument is a LOGICAL FALLACY and should not be used.

2) Define "life". It is very difficult, but as soon as we take the reductionist view, that it is the sustaining biological processes, then you have completely sidestepped the very "essence" of life which you were seeking to protect. Thus it is necessary that we impose some other parameters on our definition of life - quality, capacity, legacy, etc. And from this we end up drawing a conclusion that assisted suicide is ethical.

3) I haven't seen any specifically, but if someone is opposed to a physician assisted suicide because of a Christian perspective, I can offer some interesting ideas that might make you a little more comfortable with it from a religious point of view. I wont bring them up unless specifically asked because it can quickly derail this thread.

I think that's all I've got for now.

[DFIB]

Suicide from a Christian perspective. I am interested. You can PM me if you don't want to post here although I don't think that it would derail the thread. only spice up the conversation.

[DwayneEMTP]

PM my ass!

You two are the perfect ones to have this conversation! C'mon...I want to see!

[paramedicmike]

That might make for a great spinoff thread, too.

[CytochromeP450]

Okay I am going to do my best to make this coherent, but it is late and I am trying to condense an entire semesters worth of study into a manageable post.

So I went to a small, Catholic, liberal-arts college. I am not Catholic, nor was the majority of the student body, but it offered some very valuable educational opportunities. One of the courses I took was called "Christian Healthcare Ethics". We discussed a lot of issues, such as abortion, HIV and contraception use, reproductive sciences and of course Physician assisted suicide (PAS).

In terms of euthanasia, there are two ideals that seem to be put at odds with each other -- compassion and sanctity of human life. The Christian perspective puts heavy weight into the sanctity of human life: we are created in God's image thus we must respect ourselves and one another. There are references that we are not the masters of our own lives, but merely stewards of the life given to us by God. But the idea that human life is to be held in higher regard than all other things is something that we seemed to decide with little cause. In fact, the action of Jesus on the cross directly contradict the idea that human life is most important. It was the sacrifice of this sanctity that gave it the significance it has. This is reiterated by early Christian martyrs in choosing to give up their lives rather than using any means possible simply to continue their existence. If we are to hold true that "being alive" is most importance, these actions become unethical. Instead they suggest that there are times when it is appropriate to relinquish your life.

The next piece to consider is the morality of the actions of a physician in providing this service. The Bible is pretty clear about murder. You shall not murder is one of the 10 commandments, plain and simple, and there are countless other references. However, I think we need to be more specific about motive. All these references are made in regard to a situation of violence. They contain phrases like "spilling blood upon the ground" and saying that assault on a man is an assault on God. But we are not talking about violence and retribution here. We are talking about an act of compassion, which could very well be argued is the TRUE ideal above all other ideals. Jesus says "love your neighbor as you love yourself". If the cessation of suffering would be the most loving thing someone could provide you with, are we not living the teachings of Christ when we provide euthanasia?

In trying to brush up a little on the details of what I remember, I actually found a passage in the Bible that directly supports euthanasia...

"Then he begged me, ‘Come over here and put me out of my misery, for I am in terrible pain and want to die.’ “So I killed him,” the Amalekite told David, “for I knew he couldn’t live." Samuel 1:9-10

Basically, what I am trying to get at is that if you take one single line out of context you can come up with an argument for or against just about anything. What we really need to do is look at the work as a whole, and see what the core ethics the book is trying to instill -- love, compassion, forgiveness.

I fear that I have not connected the dots as well as I intended, but that's the best I can do for the time being. Perhaps as specifics are brought up I can offer more insight.

Thanks for your interest!

[chbare]

Ultimately, the bible is rather nebulous and prone to contradict it's self. This essentially means that humans are free to interpret it in any number of ways and in essence cherry pick concepts that fit into their own personal view of the universe. I admit that I do it. Unfortunately, this leads to an inconsistent way of making sense of things and applying a logical, evidence based and consistent method of appreciating the syntax of the physical world.

This leads us to how I have to look at the physical world. I have to look at it based on reproducible evidence, logic and in the United States, through the lens of a very specific legal and medical system. Going away from religion, this brings us to medical ethics. One of the most important concepts of this has been patient autonomy. Allowing a well informed patient to make their own medical decisions is a critical component of how we do things. The way I look at medicine is that my job often revolves around educating my patient in a complete, understandable and bias free way to ensure they have as complete a picture of the situation as possible. Then it is my job to support their informed decision. This must occur regardless of my personal beliefs in a divine mechanism or lack thereof.

[DFIB]

Okay I am going to do my best to make this coherent, but it is late and I am trying to condense an entire semesters worth of study into a manageable post.

@ Cytochrome.

You are a brave person by walking the path of your last post on this particular forum that has a good following of atheist and agnostics that are crazy smart. I feel a little guilty for baiting you ... but only a little. You did a good job of detailing a broad panorama of ideas that can be interpreted from different portions of the scriptures.

I am indeed interested in your opinion as well as those of others such a chbare who has my deepest respect as one of the smartest guys I have seen on the internet. He will say no, but he has a keenly critical and analitical thought process. I have learned much from his writings and tutorials on Youtube.

I have not reconciled the different ideas regarding the 6th commandment but think you are spot on in the "thou shalt not murder" as opposed to "thou shalt not kill" conception. There are clear instances in the Bible where killing is not condemned even after the 10 commandments were delivered. Some of these instances are war, self defense and in defense of ones family, and in retribution for crimes committed. Although off the top of my head these instances are not condemned under the Ancient Pact or what we would know today as the Old Testament.

Under the New Pact or New Testament the 10 commandments are compacted into 2 great commandments in the words of Christ himself in Mathew 22 Jesus replied: "Love the Lord thy God with all your heart and with all your soul and with all your mind". This is the first and greatest commandment. And the second is like it: "Love thy neighbor as yourself".

The first commandment encompasses the first 4 commandments from the Old Testament and the second the last 6. This is seen when Jesus said "All the law and the prophets hang on these two commandments", being that the law and the prophets are synonymous with the Old Testament.

If we interpret "Love thy neighbor as yourself" as wishing upon your neighbor the same that you would wish upon ourselves then we would desire no harm to our neighbor that we would not desire for ourselves. This brings us to have to define harm. If harm is allowing our neighbor to suffer terribly living in feces and vomit their last days. We would have to consider if that is something we would desire for ourselves as well, or would we desire for ourselves a compassionate death as an escape from a horrible existence.

I make reference to a previous post I made [”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.”] end quote.

What did you learn in your class about the Catholic church considering suicide a mortal sin? I am not catholic so I am not well versed in this theology but find it to be very confusing as to what would be considered an exception to the rule.

EDIT: I reread your post and am sorry that I was redundant on some of your points.

Edited July 24, 2012 by DFIB

[DwayneEMTP]

See! I knew this was going to be awesome!!