Physician assisted suicide

[280plus]

My life insurance pays without regard to the cause of death after the first (I think it was) 2 or 3 years it goes into effect.

Most life insurance has a 2 yr exclusion for suicide.

Thanks all, I was under a bit of a misconception. I must have missed the 2 year part. I'll go look.

Sorry, I was thinking of an "accidental" death and dismemberment policy Dad had. We couldn't collect because he died of "natural" causes. He died thinking (and telling us) that this policy would pay off his house. Poor guy got scammed and never even knew it. I told the woman I talked to on the phone that he must have "accidentally" got cancer cause he sure didn't get it on purpose. Didn't work.

[The Rabbi]

It's kind of interesting that the religious leaders here are the only ones so far who are opposed. Trouble is, Preacherman makes a chillingly good argument.

So, lemme throw the question back at Rabbi and Preacherman. Actually, it's a couple of questions:

* Should suffering, terminally ill people have the right to end their own lives?
* If they want to do so and are not capable of doing it themselves, should they have the right to get help?
* If so, who should help?

Personally, I believe God gave us intelligence and free will for a reason, and it wasn't to prolong useless agony.

- NF

First, let me reject the premise of the question.  A lot of people here are basing their views on their own experiences watching loved relatives die in horrible pain.  I had the same experience with my father a'h btw.  It is sad and tragic and the biggest tragedy is that it is unnecessary.
My older brother is a hospice doctor in KY so deals with this all the time.  He tells me his patients' biggest fears are 1) Horrible pain and 2) Being abandoned.
Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.
Next, obviously Preacherman and I share the belief that life is not our own so not ours to end.  It is pointless arguing that to someone who doesn't believe so I wont.
But I will point out that often the last months or even weeks of a person's life are the most valuable, to him and to those around him.  Suffering has a value, like the rest of life.
Again, physicians are entrusted to heal people or relieve suffering.  Killing them is a violation of that trust.  Preacherman is right that eventually the doctor's ability to "euthanize" the patient becomes license to do so when the doctor thinks the patient has had enough.  Do you really want your doctor making the decision it's your time?  And with health care costs being a major concern it becomes in the state's interest to promote this kind of behavior.
No one will stop someone from putting a gun to his head and pulling the trigger.  But the doctor doesnt need to be the one steadying his aim.

[pauli]

personally, i find the idea that the state has the right to tell you that you must remain alive against your own wishes to be one of unspeakable hubris.

[Firethorn]

Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.

And meanwhile you have the DEA going after the very pain doctors for prescribing too much pain medication.  After all, the pain wracked person might sell some of the stuff, or it might be a sob story...

Anyways, the choice should be there, I think.  Just because we can help 9/10's of the population now, there's still the 1/10th we can't.

[The Rabbi]

Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.

And meanwhile you have the DEA going after the very pain doctors for prescribing too much pain medication.  After all, the pain wracked person might sell some of the stuff, or it might be a sob story...

I discussed this with my brother as well.  The DEA does not "go after" pain doctors.  They go after frauds, cranks, and abusers of the system.  Any doctor who knows what he is doing and knows how to work with the DEA will have no problems at all.  His one-time boss was prescribing doses of morphine that would be lethal for most of us and never had an issue.

[Nathaniel Firethorn]

The logical premise for:

First, let me reject the premise of the question.  A lot of people here are basing their views on their own experiences watching loved relatives die in horrible pain.  I had the same experience with my father a'h btw.  It is sad and tragic and the biggest tragedy is that it is unnecessary.

is based on:

Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.

which is refuted by:

He was taking a bolus every time as soon as the machine would let him and practically begged for it. My guess was that over time the levels in his system had risen to the point that the next bolus finally did him in. She died in 94, he in 98.

I'm beginning to believe that moral absolutism may have different social effects than moral relativism, but it can cause just as much trouble.

- NF

[The Rabbi]

So lemme understand you:
My older brother's experience, as a practitioner in the field of pain management for a number of years, backed up by extensive research, peer experience, as well as his own work, is refuted by some non professional's one-time experience and "guess" as to what happened??  No, I don't think so.

[Nathaniel Firethorn]

With all due respect,



And, as long as we're engaging in testimonials, I'd like to see a reference in NEJM or similar that states that 100% of pain is controllable.

- NF

[The Rabbi]

I don't see your brother in the membership of this forum, so why is he being invoked to attack someone else's position?

Maybe because he is an expert in this area with wide experience.  Or are you going to scoff that off and only trust yourself because you know better, even though your experience in pain management consists of taking aspirin?

[The Rabbi]

Oh, right. Silly me for daring to know better about what I would want for myself in that situation.

That obviously is not what we are talking about.  I don't care what you want.  Heck, go off yourself right now for all I care.

[Firethorn]

Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.

And meanwhile you have the DEA going after the very pain doctors for prescribing too much pain medication.  After all, the pain wracked person might sell some of the stuff, or it might be a sob story...

I discussed this with my brother as well.  The DEA does not "go after" pain doctors.  They go after frauds, cranks, and abusers of the system.  Any doctor who knows what he is doing and knows how to work with the DEA will have no problems at all.  His one-time boss was prescribing doses of morphine that would be lethal for most of us and never had an issue.

Hmmm...
http://www.aapsonline.org/painman/actionsagainst.htm
http://www.cpmission.com/main/painpolitics/rise.html

Then there's the case of Richard Paey, nasty drug addict, using pain pills.  Convicted of dealing even though the prosecution admitted he took every pill himself.  Of course, once he got into the prison system(no longer earning a living and paying for his meds), they had to find him treatment or face cruelty charges.  He now has a morphine pump.  Go figure.

[Vodka7]

I thought I was done with this thread, but when a rabbi tells someone to go kill himself, that conversation is just too much fun to leave early.

My older brother is a hospice doctor in KY so deals with this all the time.  He tells me his patients' biggest fears are 1) Horrible pain and 2) Being abandoned.
Pain management has come a long way in the last 20 years (probably in the last 5 too).  There is no reason for people to suffer terrible pain from cancer as long as it is managed properly.

I will concede that, properly managed, modern medicine can negate the majority of most patients' pain.  I make a point here to repeat your phrasing of properly managed because I will never concede that medicine can cure everyone's pain, or even manage it to the point where it is unnoticeable to the patient.  I myself have never experienced any physical pain that I was not sure was going to be gone in a certain period of time.  I can't imagine what the mental effects are of having a constant pain that will only end when you die, even if that pain is a properly managed one.

This leads me into your next point--the second biggest fear of your brother's patients, that of abandonment.  Your entire argument is based upon medicine being able to control physical pain to a suitable level--not once do you mention what science has to offer for patients suffering mental or emotional anguish.  This suffering is equally as valid an argument for active euthanasia as any other type, and yet you ignore it completely.

I do not argue with your brother's information--I merely disagree on where to place the emphasis.

Suffering has a value, like the rest of life.

I apologize for the shamefully quoting this out of context, but we agree here.

Again, physicians are entrusted to heal people or relieve suffering.  Killing them is a violation of that trust.  Preacherman is right that eventually the doctor's ability to "euthanize" the patient becomes license to do so when the doctor thinks the patient has had enough.  Do you really want your doctor making the decision it's your time?  And with health care costs being a major concern it becomes in the state's interest to promote this kind of behavior.

I disagree--physicians are, in my mind, entrusted to end suffering.  A small point in all other instances, but crucial here.  You can also read my earlier post for why I disagree with Preacherman's argument.

No one will stop someone from putting a gun to his head and pulling the trigger.  But the doctor doesnt need to be the one steadying his aim.

AE needs to be legalized to protect patients that have the willpower but not the physical mobility to end their lives.  Not everyone in the last weeks of his life has the capability to push a button, pull a trigger, or swallow a pill.

[The Rabbi]

This leads me into your next point--the second biggest fear of your brother's patients, that of abandonment.  Your entire argument is based upon medicine being able to control physical pain to a suitable level--not once do you mention what science has to offer for patients suffering mental or emotional anguish.  This suffering is equally as valid an argument for active euthanasia as any other type, and yet you ignore it completely.

I ignored it because it wasnt relevant to the discussion.  But since you bring it up: a patient's mental state obviously has a lot to do with their quality of life.  Profound depression is obviously not uncommon in terminally ill patients.  Anti-depressants have been extremely helpful in this role.   Further, merely having a physician concerned with the patient and interacting with him goes a long way to easing patients' minds.  My brother reports that he has seen patients who have spent sometimes years in the medical system and he was the first doctor who sat down with the patient and told him exactly what was going on, what the prognosis was, what he could expect and so on.  This was actually a relief.
Family dynamics play into the total care picture as well.  As you can imagine, people often have dysfunctional families and a critical illness seldom makes that better.  There isnt a whole lot doctors can do about that.

Again, physicians are entrusted to heal people or relieve suffering.  Killing them is a violation of that trust.  Preacherman is right that eventually the doctor's ability to "euthanize" the patient becomes license to do so when the doctor thinks the patient has had enough.  Do you really want your doctor making the decision it's your time?  And with health care costs being a major concern it becomes in the state's interest to promote this kind of behavior.

I disagree--physicians are, in my mind, entrusted to end suffering.  A small point in all other instances, but crucial here.  You can also read my earlier post for why I disagree with Preacherman's argument.

Here is part of the Hippocratic Oath, that all doctors take:

Hippocratic Oath -- Classical Version

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

Doctors take an oath not to do what the Oregon law permits.  I think that is significant.

[pauli]

Doctors take an oath not to do what the Oregon law permits.  I think that is significant.

doctors used to take an oath as stated. then again, doctors also used to take that oath, swearing by a number of greek gods. these days, different schools have different oaths, if any.

besides, hippocrates himself didn't follow the oath, specifically in regard to the clauses you mention. then again, he didn't write it, either.