Euthanasia

[sparkle10184]

If a person is suffering they should have the right to end their pain. If there is absolutely no hope of recovery and the patient is in severe agony, then why make them keep living?

[TikindiDragon]

But legislation that prevents euthanasia (at least in the case of assisted suicide) is just wrong. And the idea of suicide actually being illegal is laughable. If I manage - what will you do - imprison my corpse ???

As far as I am aware the legal punishment for attempted suicide (when suicide was illegal) was, wait for it, death by hanging.

 

This may seem rather amusing, but it must be noted that suicide (or attempted suicide) was a felony, which would result in all of one's property passing to the crown and not to one's relatives.

[Kestra15]

If a person is suffering they should have the right to end their pain. If there is absolutely no hope of recovery and the patient is in severe agony, then why make them keep living?

Because of the legal (and for some, moral) implications of being responsible for killing them (which, I hasten to point out, is different to letting them die i.e. palliative care/LCP). Even if I didn't have the moral outlook of not being responsible for directly, intentionally ending a life, there would be legal implications should the patient's relatives take exception to the action.

 

EDIT: Took my half an hour to find this post.

 

Very good post. I believe we personally disagree about abortion in general, but it's cool that you support personal rights in that way. Very consistent I know this topic is about "American politics," but since you touched on it, are assisted suicide laws progressing in the UK?

'Right to die' man loses legal battle for assisted suicide: http://www.guardian.co.uk/society/2012/aug...drome-right-die

 

'Right to die' man dies: http://www.guardian.co.uk/uk/2012/aug/22/t...es-right-to-die

 

As it stands, assisted suicide laws will never be passed in the UK - and while I have had contact with patients and close family who would have preferred to have that right and I understand their case, I as a medical professional do not support such laws and will not assist with any form of life-taking should such laws pass.

 

Why will it never pass? While I hate the cliche of a 'slippery slope,' it is one of those times where I feel it is a rather apt description, and the main reason it will not pass is in fact to protect the medical profession as a whole - and to protect the public as well. It would be possible - not easy, but possible - for a doctor to abuse that system. Harold Shipman, one of histories biggest serial killers, is often used as an example as to how much a system can be abused and also the catalyst for a lot of change in current medical legislation in order to stop such atrocities from ever happening again - and introducing a 'right to die' clause would allow such repeat acts to happen with comparative ease. So in order to protect patients - especially the vulnerable, the elderly, those with diminished mental capacity, those without family or friends to support, those of 'no fixed abode' - an assisted suicide law would be extremely difficult to bring to bear and if it ever was brought about, it would have to be a phenomenally tight system.

 

As for protecting the medical professionals; it may be that the patient has expressed a wish for their life to end. It may be they are sound of mind, have capacity and consent, and that three/four/five doctors have all agreed and witnessed to one another's agreement from a medical perspective, and the person may be assisted in a controlled environment. I can assure you that even in those circumstances, there will be a family member of a patient who will make a complaint - lack of dignity in the death, lack of respect, it wasn't the patient's wishes, it was a torturous way to die, or just good old ambulance-chasing - a loophole in the law will be found, or some insignificant clause would have been broken, and suddenly every person involved in that case - the doctors, nurses, auxiliaries, pharmacists - will have their lives and livelihoods on the line.

 

It's not ever going to be worth the risk I'm afraid, callous as it sounds. I do not take offence to people requesting DNE/DNR (like my grandfather and a lot of ICU patients), I support wholly the Liverpool Care Patheway, which is more about making a patient comfortably rather than actually encouraging their death. But I will personally not intentionally help end the life of another human being in a pre-meditated set of circumstances. I believe in a sanctity of life (not the sanctity of life, as I interpret that as an absolutist view and I do not believe that I can be absolutist in my personal morality), and I believe in preserving life where it is viable to do so, I do believe in supporting and comforting those who are approaching the end of their life. I understand why some people do want to die - having directly dealt with locked-in patients, with terminal patients, with those in such hopeless conditions that death does seem the preferable option. But I myself could never take actions that support a rather definitive end to life - I do not wish to be a murderer or an accessory to murder, even if that person chose to die. I could not live with that on my consciousness.

Edited January 19, 2013 by Kestra15

[Fuzzbucket]

I TOTALLY support the LCP. But I would also point out that Harold Shipman did his thing while the law was totally against assisted suicide. Laws will not stop such people. He's not the only one.

 

I HOPE you are wrong about the law never changing. There are a number of MPs - including mine, bless him ! - who have voted FOR a change. It is TOTALLY wrong that I will have to travel to Switzerland to get such help otherwise.

 

And if - as one can - I have filed my enduring power of attorney, there is NOTHING any relative who is not named on that could do to take action against ANYONE. That's why my mother, for instance, has filed one. So that my life at all costs sister, for instance, can't legally interfere, and I get to pull the plug.

 

Staff in other countries don't get sued over this stuff. BECAUSE the law has been written so that they can't as long as all the safeguards are followed.

 

When I was a little kid, I knew of a few cases in our village where the doctor would be making his house calls. The conversation would go something like this:

 

Good morning Mrs X, how are you today ?

Well, doctor, much the same as yesterday, but I was very sorry to wake up today. I didn't mean to do that.

Well, Mrs X, I expect we can make sure that doesn't happen again if you'd like.

 

And - it didn't.

 

Those were the days.

[earthgirl]

I don't quite agree with euthanasia, when it comes to both humans and animals.

 

And I also disagree, even more so, with keeping a person or animal alive when they want to die, or suffer and they are beyond saving. Keeping them alive with machines/meds is prolonging their agony when they don't want it, due to selfish reasons.

 

Personally if I found out I had a condition and my life would be beyond saving and suffered greatly, I'd just ask everyone to let me die on my own. :/

 

My opinion is that euthanasia is murder, regardless. And since it usually comes after said life has been prolonged when it shouldn't have, it gets a big no from me.

I'm all for natural death. When the time comes, it comes and no one has the right to decide when that is, be it sooner or later.

Edited January 19, 2013 by earthgirl

[Kestra15]

I TOTALLY support the LCP. But I would also point out that Harold Shipman did his thing while the law was totally against assisted suicide. Laws will not stop such people. He's not the only one.

 

I HOPE you are wrong about the law never changing. There are a number of MPs - including mine, bless him ! - who have voted FOR a change. It is TOTALLY wrong that I will have to travel to Switzerland to get such help otherwise.

 

And if - as one can - I have filed my enduring power of attorney, there is NOTHING any relative who is not named on that could do to take action against ANYONE. That's why my mother, for instance, has filed one. So that my life at all costs sister, for instance, can't legally interfere, and I get to pull the plug.

 

Staff in other countries don't get sued over this stuff. BECAUSE the law has been written so that they can't as long as all the safeguards are followed.

 

When I was a little kid, I knew of a few cases in our village where the doctor would be making his house calls. The conversation would go something like this:

 

Good morning Mrs X, how are you today ?

Well, doctor, much the same as yesterday, but I was very sorry to wake up today. I didn't mean to do that.

Well, Mrs X, I expect we can make sure that doesn't happen again if you'd like.

 

And - it didn't.

 

Those were the days.

I do agree with your views, but the problems are as I stated above; the protection of patients from an abusive system, and the protection of the professionals from being held accountable for the action.

 

That doctor in your village...what stopped him from doing that to a cantankerous old lady he just didn't like? What regulated his actions? Were they just actions? Were all his patients consenting, or have the capacity to consent to that particular course of action? Was he morally right to do what he did? Because while laws would never fully prevent another Shipman, we did change them to make it much, much harder to do what he did. His acts, heinous as they were, actually motivated a lot of positive change in the British health system, tightening and redefining all sorts of laws - capacity and consent, access to drugs, controlled drugs, their regulation and distribution, accountability of the health-care professional, social services, regulation of HCPs...I know it is of no benefit to those who suffered losses at his hands, but what he did has created so much positive change. He was the accident waiting to happen, and because of our reaction to that it means a lot more people will likely be saved.

 

There is a loophole in any and every law, and there are people who will devote so much time and money to find that loophole. There's enough trouble and criticism for the LCP as it is, so having voluntary euthanasia would be a mine-field legally - and even if you had staff who were morally willing to accept that responsibility, it would then be expecting them to put their lives and their careers on the line in order to end yours. Once you've got through just those two clauses alone you're going to be left with oh-so-few possibilities.

 

I do understand that, as well as a right to life, people should have a right to death. A dignified (if there is such a thing) death on their terms, not wasting away to become a former shadow of themselves. It's why my Grandad asked us to end his life. But in this case I do feel it is a 'needs of the many' situation - the number of people who could and would be negatively affected by such a law outnumber those who it would benefit. On a single-case example then yes, it seems immoral. But in the wider scope of things, I feel it would lead to much darker, murkier problems legalising euthanasia than it would be as it is now.

 

And in fairness, it wouldn't take much to find a quick and easy way for you to kill yourself if you really wanted to.

I'm all for natural death. When the time comes, it comes and no one has the right to decide when that is, be it sooner or later.

So you have never taken any medication or vaccination? That if you caught an illness you wouldn't see your doctor about it and just let it run it's course and eventually kill you, if that was the goal? Even when the cure is as simple as two tablets a day for a fortnight, or a few injections?

Edited January 19, 2013 by Kestra15

[Fuzzbucket]

I can't answer about that in public. But in that particular village - yes, there was a safeguard

 

What right - they asked him (they did. PM me if you want to know more... ONLY KESTRA !)

 

There are all those angels of death in nursing homes even now...

 

And Tony Nicklinson couldn't find an easy way to kill himself - nor could Diane Pretty. If I were in a position to DIY - sure. But what about all the people who AREN'T ? I am well aware of how I could effectively do it, and I have the necessary on the premises. I used to work for a doctor, and he gave me a lot of VERY useful info. He also arranged his own death, when he had frontal lobe dementia... Others are not so lucky !

 

It's tough. But I think assisted suicide needs to be legal. I would prefer to die in my own country than in Switzerland.

[catstaff]

And in fairness, it wouldn't take much to find a quick and easy way for you to kill yourself if you really wanted to.

That's not always possible.

 

What about with diseases such as muscular dystrophy or Parkinson's or ALS, that erode at one's mobility along the way to becoming terminal? If I can barely lift a teaspoon of mashed potato and get it safely into my mouth, I'm highly unlikely to be able to either lift a gun to my head (assuming one was anywhere I could get at it) and hold it steady while pulling the trigger or cut my wrists badly enough to insure bleeding out.

[earthgirl]

So you have never taken any medication or vaccination? That if you caught an illness you wouldn't see your doctor about it and just let it run it's course and eventually kill you, if that was the goal? Even when the cure is as simple as two tablets a day for a fortnight, or a few injections?

well, If I can be cured and my condition can be kept under control with meds and vaccines, then yes. I will accept taking them as long as they keep the pain away and make me feel better.

I was talking about terminal conditions where these things don't help anymore and keeping me on a life-support machine would just keep me in misery. Well, no to that.

[Kestra15]

That's not always possible.

Agreed, it isn't always feasible and practical. But if you are determined to end it, you can find a way.

 

One of the flip sides though is this; what right do you have to insist that another person takes a life?

[Zovesta]

If they ask for it, let em go.

 

If they're in a state where they cannot decide for themselves and do not have a relatively high chance of recovering, let the family decide whether they want to keep paying to keep them alive for a chance that they might make it or just let them go.

 

Myself, if I should ever get that bad, just let them kill me, no sense in letting my family's cash go to waste when it could be going to more important things.

 

And should it be because of depression... their life really is their own and I don't think people should really have a right to prevent people from that. Naturally, if you were a loved one, you would try to talk the person with depression out of it, but in the end, I don't think there should be a law against letting people kill themselves this way.

Edited January 20, 2013 by Zovesta

[cfmtfm]

If they're in a state where they cannot decide for themselves and do not have a relatively high chance of recovering, let the family decide whether they want to keep paying to keep them alive for a chance that they might make it or just let them go.

If they can't decide for themselves, let them live until they can decide - I'd only want to end their life if they were completely 100% sure they wanted to die.

[TikindiDragon]

If they're in a state where they cannot decide for themselves and do not have a relatively high chance of recovering, let the family decide whether they want to keep paying to keep them alive for a chance that they might make it or just let them go.

 

Myself, if I should ever get that bad, just let them kill me, no sense in letting my family's cash go to waste when it could be going to more important things.

Just a point on this - of western countries this only really applies in the US. Pretty much everywhere else has universal health-care, so the cost of keeping a person on life support is not an issue.

[Fuzzbucket]

If they can't decide for themselves, let them live until they can decide - I'd only want to end their life if they were completely 100% sure they wanted to die.

How exactly can a PVS person, a person in a coma, a person who has no sign of brain activity, a person unconscious after a massive stroke or - as my sister, a doctor once saw in the ER, someone still "living" whose head had been run over by a BUS - or whatever ever be in a position to say what they want ?

 

I have filed a directive that states that I do not wish to live after I hit that point. I hope that SOMEONE out there will help.

 

The money thing though - if a family wants to pay and IF there is ANY reason to suppose that the person in question would have wanted it - it is their prerogative, Thank goodness for civilised and universal health care in both my countries. And for the LCP in the UK/

Edited January 20, 2013 by fuzzbucket

[catstaff]

Agreed, it isn't always feasible and practical. But if you are determined to end it, you can find a way.

 

One of the flip sides though is this; what right do you have to insist that another person takes a life?

I don't.

 

I have no problem whatsoever with anyone... friend, family member, or medical professional... choosing not to participate in an assisted suicide.

 

However, if a patient in circumstances such as I suggested in my previous post wants to call time, I do believe they should have the right to find whatever assistance it is they need in carrying out their own wishes. I can think of at least one means of assistance that would require the help of a medical professional, that wouldn't involve said professional actually administering a lethal injection or anything like that.

 

But, what the medical professional could do, is get the patient set up on one of those push-button pain medication pump doohickies that I've seen. Those things that dispense morphine or whatever other painkiller into a feeder thing in an IV line that's running saline by means of a button the patient can push or not as he chooses, to allow him to treat his own pain as needed to a point without having to wait the extra time to call for help and wait for the nurses to get things set up. Those pump things have some kind of regulators that only permit a certain amount of dosage within a certain amount of time to prevent the patients from an accidental overdose. Remove or disable the regulator, and the patient can now OD himself at his own wish.

 

Again, if you personally are unwilling to do something like that, I can't and won't argue with your conscience. However, I do think that if a medical professional is willing to do it, and the patient is requesting it, neither of them should have to fear prosecution for doing it.

[Fuzzbucket]

It's not only prosecution in terms of the law. There's also the small matter of family members who disagree with the decisions made, trying to sue privately. I HATE the way people do that - especially the ones who do it because ( I firmly believe) they think it is a nice way to get themselves a bit of CASH

[Kestra15]

But, what the medical professional could do, is get the patient set up on one of those push-button pain medication pump doohickies that I've seen. Those things that dispense morphine or whatever other painkiller into a feeder thing in an IV line that's running saline by means of a button the patient can push or not as he chooses, to allow him to treat his own pain as needed to a point without having to wait the extra time to call for help and wait for the nurses to get things set up. Those pump things have some kind of regulators that only permit a certain amount of dosage within a certain amount of time to prevent the patients from an accidental overdose. Remove or disable the regulator, and the patient can now OD himself at his own wish.

What you're referring to there is a PCA Pump (Patient-Controlled Analgesia). And morphine et al are Controlled Drugs. So the HCPs who sign out the drug and prep it for administration (because you need two to sign for CDs), and whoever sets the pump and takes off the safety (that's assuming the software and hardware will even allow it, since PCAs are made to specifically deliver microlitres at a push, not millilitres) would be just as responsible as if they actually injected the person themselves.

 

As I mentioned, it legally comes down to it being a protective measure not to have assisted suicides, and I would personally vote against such measures if they were to be introduced. I really, really do feel for the poor souls who have no option left but to die and cannot even manage to do that, but my concern is the abuse such a system would offer and how many more people would be wrongly killed if it was ever introduced. And that's not because I think my moral belief should be imposed on others; it's more that the very real risk of abuse of that system would, I feel, hurt and kill far more than it would help and release.

 

If such a law did come to pass in the UK, it would have to be beyond iron-clad, and that would take a long time to do so. If they could make it bullet-proof beyond a doubt then I would not oppose it, but I don't believe it ever could be so well-written as to leave the HCPs blameless. It would also have to be something that is not open to abuse by the system, some sort of check-and-balance method by which any request for voluntary euthanasia is checked and triple-checked - reviewed by an MDT most likely - so that there isn't the opportunity for someone to take unilateral decisions. And there would *have* to be an opt-out clause for those professionals who cannot or will not undertake such an action. If something was proposed that would maximally protect the public and the profession I would be satisfied, take the opt-out clause, and let it progress.

 

Consider this; up to half of families are reportedly not informed that their relative has been put on the LCP. Some patients are put on the LCP to reportedly 'ease the strain.' There is much controversy around doctors making judgements without the consent of the patient or even mentioning it to them, and letting those who could have realistically recovered and returned to a good quality of life stay on the pathway without reassessing or removing them. That's on a pathway for those who are already dying, we're just trying to make it less painful for them. If that's the controversy around simply letting Nature take it's course, how much worse could it get for voluntary euthanasia? We would have to have the LCP up and running perfectly before any euthanasia law had a snowball's chance in hell of getting passed.

Edited January 20, 2013 by Kestra15

[Fuzzbucket]

Kestra - you need to edit your second para - you have said the exact opposite of what you intended: not quoting as I am about to leave for a plane and the last thing you want is for it to stay here in my post.

 

Wait. Idea ! You MEANT to say:

 

And that's NOT because I think my moral belief should be imposed on others

I am certain sure you did, (based on our PMs as well as your posts !)

 

 

[Kestra15]

Kestra - you need to edit your second para - you have said the exact opposite of what you intended: not quoting as I am about to leave for a plane and the last thing you want is for it to stay here in my post.

 

Wait. Idea ! You MEANT to say:

 

 

I am certain sure you did, (based on our PMs as well as your posts !)

I just caught and edited that, then read your post Thank you for realising it was a mistake, and enjoy your flight!

 

In other news:

 

http://en.wikipedia.org/wiki/Groningen_Protocol - what do you all think?

[Shienvien]

Pay mind that there are people - myself included - who do believe that in many cases, preventing suicide is the right thing to do, even if it means watching the person and physically going and stopping them when it becomes necessary. I pretty much count not doing it equal to just watching how a person bleeds out after a car accident without moving a finger to help them.

 

Note that I've also stated that there are plenty of exceptions to this - cases where the person is suffering from something terminal and would die in days, months or three years anyway, when the person is already very old or suffering from some kind of progressive mental disease which ensures that the individual would not be the person s/he once was anymore, people who have suffered severe enough brain damage to never regain proper consciousness, very extreme cases such as full-body paralysis / lock in, etc...

In those cases I consider euthanasia not only justifiable, but completely right thing to apply, especially if asked for. I also don't consider 'it might become curable in five years' a valid argument when the examples in this paragraph are concerned.

(@Kestra: This also means that at least based on brief skimming, I am probably for Groningen Protocol.)

[cfmtfm]

How exactly can a PVS person, a person in a coma, a person who has no sign of brain activity, a person unconscious after a massive stroke or - as my sister, a doctor once saw in the ER, someone still "living" whose head had been run over by a BUS - or whatever ever be in a position to say what they want ?

 

I have filed a directive that states that I do not wish to live after I hit that point. I hope that SOMEONE out there will help.

 

The money thing though - if a family wants to pay and IF there is ANY reason to suppose that the person in question would have wanted it - it is their prerogative, Thank goodness for civilised and universal health care in both my countries. And for the LCP in the UK/

True, but there's always a chance that they could survive.

 

I don't know, maybe I'm wrong Maybe if after a certain period/amount of time, if they show no signs of recovery, they could end their life.

It really depends on the condition, I think (obviously with a wide range of injuries/disabilities/etc).

[TikindiDragon]

I just caught and edited that, then read your post Thank you for realising it was a mistake, and enjoy your flight!

 

In other news:

 

http://en.wikipedia.org/wiki/Groningen_Protocol - what do you all think?

Given that it requires full parental consent in order for prosecution to be waived I'd be in favour of it.

Edited January 20, 2013 by TikindiDragon

[Shienvien]

True, but there's always a chance that they could survive.

'No sign of brain activity', for instance, is an irreversible condition - the individual as a person is essentially already dead. Also depends which parts and how extensively are damaged, if we speak about generic brain damage, not utter lack of brain activity. Some parts are 'more essential' than the others.

 

 

[cfmtfm]

'No sign of brain activity', for instance, is an irreversible condition - the individual as a person is essentially already dead. Also depends which parts and how extensively are damaged, if we speak about generic brain damage, not utter lack of brain activity. Some parts are 'more essential' than the others.

As I said earlier in my post, it depends on the condition. I won't go into detail about loads of different conditions though.

[Zovesta]

Just a point on this - of western countries this only really applies in the US. Pretty much everywhere else has universal health-care, so the cost of keeping a person on life support is not an issue.

Indeed, I was only really referring to the US for that, lol. And I don't mean ' families pay money? KILL EVERYONE'. I'm saying that the family should have a say in whether or not to pull the cord if the person in question cannot have a say for themselves. The family members know them better than anyone, I just don't think it should be something decided that can or cannot be a choice by a doctor.

 

As for in pretty much every other country, I suppose let them live if there's a chance of them surviving but they still cannot decide for themselves.