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Main Forums => The Roundtable => Topic started by: Nathaniel Firethorn on January 20, 2006, 11:56:36 AM

Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 20, 2006, 11:56:36 AM
There's been some news lately about the Supremes upholding physician assisted suicide in Oregon. Just wondered what the folks on this board thought about this.

I think I'd support it, personally, but it would have to be tightly controlled to prevent abuse. I have some personal reasons concerning my immediate family members (now deceased) for saying this.

- NF
Title: Physician assisted suicide
Post by: The Rabbi on January 20, 2006, 12:01:57 PM
I am opposed to PAS.  Doctors take an oath to preserve life, not end it.
But I was also opposed to the Bush Administration's attempt to circumvent the will of Oregon voters, who voted for this twice overwhelmingly.
Title: Physician assisted suicide
Post by: onions! on January 20, 2006, 12:16:25 PM
For those that are fully informed & in their "right mind"s I support it 110%.

I believe that being able to choose your time of death is the ultimate freedom.

I also honk & wave every time I go through Flint by Dr.Jacks prison.
Title: Physician assisted suicide
Post by: Guest on January 20, 2006, 12:32:43 PM
It is an awfully long, convoluted way to go for something that should be simple. One ought to be free to go into the pharmacy, buy any pills one wants (and can afford), and take as many as one prefers - for any purpose, whatsoever.
Title: Physician assisted suicide
Post by: Moondoggie on January 20, 2006, 01:10:16 PM
I believe that "life" is the most personal possession that we can have.

If it doesn't belong to the individual, then who does it belong to?

I support the idea that it is the individual's personal and unassailable decision to end their life on their own terms.  The State should have no say in the decision.

I believe that it should be facilitated in the manner/time/place chosen by the individual within reasonable limits.

Pills would be my first choice, carbon monoxide second.

Watching my FIL die from inoperable cancer, begging for more morphine, resolved me to make sure I never find myself in that situation.

YMMV.
Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 20, 2006, 01:59:27 PM
Quote
Watching my FIL die from inoperable cancer, begging for more morphine, resolved me to make sure I never find myself in that situation.
Very early on a hot day in July, my phone rang. It was my mom, in hysterics, followed by a policewoman. Mom had discovered my dad, in the garage. He'd bought a pistol, concealed it from her, then gone out and shot himself to relieve his suffering from terminal prostate cancer.

Ditto.

- NF
Title: Physician assisted suicide
Post by: Moondoggie on January 20, 2006, 02:44:02 PM
Nathaniel...

Very sorry for your loss and the circumstances.

The impact on those left behind is one of the major reasons why I tend toward pills or CO as my exit strategy.
Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 20, 2006, 02:53:39 PM
Damnable thing is that he told me that he'd asked his oncologist how much morphine would be fatal. The answer: Either "It would take a truckload" (and the guy was lying) or "It wouldn't take a truckload" (and Dad misheard it.)

My money's on the second scenario. Turned out that Dad had easily enough morphine squirreled away to do the job. The hospice came looking for it the day he died.

So, for lack of the research skills necessary to find one single, easily available number, and for one misheard syllable, he put my mom through one final piece of hell.

My grandmother didn't go out much better. She died in Wilkes-Barre Hospital, after weeks of pain, screaming that she wanted to go home. The reaction of the staff was to sedate her. So she went home.

- NF
Title: Physician assisted suicide
Post by: onions! on January 20, 2006, 03:17:49 PM
You both have my condolences.

My own expierience mirrors yours.On Labor Day 1998 @ 5:03 p.m. I sat w/my Grandfather as he finally died from complications of colon cancer.This extremely strong man spent his last three weeks becoming more & more distanced from his family(my Mom,her idiot brother,& I spent most of that time w/him).The hospice nurses at the VA in Battle Creek,however,became extremely important.How he could pull himself out of his misery to gruffly ask for(& finally beg for)morphine I just don't know.Those people were angels though.The amount of strength that they had to summon to go to work everyday is beyond me.

My Grandmother suffered a massive stroke not quite two years later.Unable to care for her myself,I chose the best nursing home that I could find & visited often.She was unable to speak but was cognizant & could nod yes & no well enough.After a while we could almost carry on a conversation.I admit that this lead to me having false hopes for the future.I believe that being trapped in her own body & being totally dependent on others for everything would be just about the most horrible existence possible.She agreed.I remember sitting outside under a tree w/her in the springtime w/the flowers blooming all around when she told me that she wanted to die.She just wanted to be w/Grandpa.It was another six or so months before she died about 1 p.m. on the Sunday before Thanksgiving 2003.In hindsight,she seemed to become more relaxed as her time approached & I went the opposite way.My own fear & ignorance made me angry that she left me & it took the better part of a year(& plenty of soul searching)before I realized just much of an ass I had been.I was finally happy that her suffering had ended & that she was at peace.

That said,no matter how clean & nice the nursing home/hospice ward,the daily grinding plaintive moans of"kill me" & "let me die/go!"were just...tough.I felt totally wrung every time I left there.

I wouldn't knowing wish that expierience on anyone.Period.
Title: Physician assisted suicide
Post by: Preacherman on January 20, 2006, 03:18:38 PM
I'm afraid I completely oppose physician-assisted suicide, not only on religious grounds (which I accept I can't foist on others), but because in every single country where this is allowed (legally or merely "winked at") the doctors come to the point of making the decision themselves as to who should die, and when.  They no longer consider the patient's wishes, but make the decision on the grounds of what they think is best for the patient, whether he/she would agree with them or not.  (All too often, of course, their decision is influenced by the fact that the hospital isn't being paid - or not being paid enough - for the use of the patient's bed, or needs it for someone else!)  This is "playing God" to an absolutely unacceptable extent, and happens routinely in England and other European countries (there was a news report about it in England just this week, IIRC).
Title: Physician assisted suicide
Post by: onions! on January 20, 2006, 03:23:23 PM
"the doctors come to the point of making the decision themselves as to who should die, and when."

That is exactly why I support Dr.Jack.He didn't go looking for victims-they came to him.
Title: Physician assisted suicide
Post by: Declaration Day on January 20, 2006, 03:32:13 PM
I support Physician assisted suicide.  I believe that we have the right to decide when life is no longer worth living.
Title: Physician assisted suicide
Post by: Justin on January 20, 2006, 03:35:27 PM
You know, if they'd just legalize the ability to sell a Kevork-o-matic at Walmart, this entire discussion would be completely moot.
Title: Physician assisted suicide
Post by: Ron on January 20, 2006, 04:08:47 PM
Quote
You know, if they'd just legalize the ability to sell a Kevork-o-matic at Walmart, this entire discussion would be completely moot.
It used to be that if someone was terminal and in much pain they were "cautioned" that taking too many of these here pain killers will cause you to fall asleep and never wake up.

I am opposed to PAS and believe that we should let doctors remain healers.  

Compassion for those that are terminal and in unbearable pain dictates that they be given the "tools" to make the end of life decision themselves.

It is a fine line but it shouldn't be crossed.
Title: Physician assisted suicide
Post by: Standing Wolf on January 20, 2006, 07:24:27 PM
Massage therapist-assisted suicide, maybe.

Doctor-assisted suicide? Hah! Every doctor I've consulted in the past twenty years has been nothing but an exceedingly expensive pill pusher. What a bunch of bums!
Title: Physician assisted suicide
Post by: stevelyn on January 20, 2006, 07:53:40 PM
Quote from: Declaration Day
I support Physician assisted suicide.  I believe that we have the right to decide when life is no longer worth living.
+1.


The law and court decision isn't forcing anyone to participate in PAS. It does keep .gov off the backs of those eho choose to make an informed decision to die with dignity.
Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 21, 2006, 01:55:27 AM
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
Title: Physician assisted suicide
Post by: Preacherman on January 21, 2006, 03:53:23 AM
Good questions, Nathaniel.  I'll do my best to answer from my perspective.

Quote
Should suffering, terminally ill people have the right to end their own lives?
In my belief system (Christianity), life is God's gift, and only God can take it back again:  so suicide is always sinful.  In times past, suicides were denied burial in consecrated ground because of this, but nowadays, we accept that anyone who commits suicide is, by definition, not in his/her "right mind", and is under some awful compulsion, so this stricture is no longer applied.  For those who hold to my belief system, therefore, I would say that suicide even in the case of terminal illness is not acceptable.  However, I also hasten to add that I cannot and do not wish to impose my beliefs on those who don't share them - so for those from other (or no) belief systems, they must be guided by their own conscience.

That said, the Catholic Church's position is that if one is in serious pain, and terminally ill, one has the right to be pain-free.  It is not sinful or wrong to prescribe large amounts of medication to control pain, even if this has the effect of shortening life - the intention is to decrease pain, not to kill.  This is a fine moral distinction, but it's there, and I agree with it.  It's the same with abortion:  this is always and everywhere considered mortally sinful, but in a case where (for example) a woman who's two months pregnant is diagnosed with cancer of the cervix, and the operation to save her life will also kill the child within her, this is not considered abortion.  The object, the intention, of the operation is to remove the cancer.  A side-effect of the operation is the death of the child.  The harm to innocent life is regretted, and is not the primary intention or purpose of the surgery:  therefore, the termination of the pregnancy is not considered to be abortion as such, and is not considered wrong or sinful.

This is known in moral theology as the theory or principle of "double effect".  An action may have two (or more) results or consequences.  As long as the primary intention, or effect, is morally and/or ethically good and acceptable, the secondary effect associated with the primary effect, even though bad in itself, is allowed.  However, if the primary effect is evil, the secondary effect is never acceptable, even though it may be good.

Quote
If they want to do so and are not capable of doing it themselves, should they have the right to get help?
Here I have to say no, in the context of Christian belief.  If it's wrong for you to kill yourself, how much more so to implicate another in your wrongdoing!  Of course, if you don't believe that what you are doing is wrong - in other words, if you're operating out of another belief system, not Christianity - then you'll have to make up your own mind on this.

However, it's not wrong to seek help for pain relief, even if this means a life-shortening effect in terminally ill patients, and Catholic doctors, nurses and hospitals are explicitly permitted to offer such pain relief - see my explanation above.

This does create problems where (for example) a patient may want to end his/her life, and appeals to others for help, but they can't morally do so on the basis of their own beliefs.  It also creates legal problems under laws such as those pertaining in the USA, where many patients in great pain complain that their doctors won't prescribe adequate strengths and/or quantities of pain-killing narcotics, for fear of running foul of the DEA and the War On Drugs.  Special legal exemptions have had to be made for medical personnel in hospices, for example, where the use of pain-killers is much higher than in normal hospitals, otherwise they would not be able to function.

Quote
If so, who should help?
This is a problem for the patient to work out with those who share his/her belief.  I absolutely reject any attempt to make it a legally binding duty on medical personnel to assist the patient to die.  Quite apart from the moral issues raised, this also brings up the point I made in my earlier post, that sooner or later, those medical personnel are going to be making the decision themselves - if not for their own convenience, then for the benefit of the hospital employing them.

Another legal problem here is the relationship between the patient and his/her family on the one hand, and the medical establishment on the other.  Let's say the patient is in great pain, and asks the doctor to help him/her to die.  The doctor agrees, and provides the drugs, or prepares and administers a lethal injection, or something like that.  Later, it emerges that the patient belonged to a very religious family, who are unanimous in their assertion that the patient would never, ever have asked for something like that, and any attempt to say that he/she did so can only mean that this was coerced by the hospital and/or the doctor.  They sue.  Who wins?  Basically, that doctor and/or hospital are in a no-win situation...  even if they are found innocent in court, they'll be smeared forever as "Doctor Death" or "The Hospital Of Death".  Only when all parties are able to consult and agree on this can there be any suggestion of willing assistance by medical staff - and, as I said earlier, this is open to enormous abuse, which is very likely to occur.

Fundamentally, one cannot ask another person to do that which is morally evil or repugnant to that person.  You may be my best friend, but if you ask me to help you to die, the answer will be "No".  I shall certainly help you in any way that I can, even to the use of pain-killers in quantities that may shorten your life:  but you can't ask me to ignore my own conscience.
Title: Physician assisted suicide
Post by: bermbuster on January 21, 2006, 04:23:55 AM
Quote from: GoRon
.....
It used to be that if someone was terminal and in much pain they were "cautioned" that taking too many of these here pain killers will cause you to fall asleep and never wake up.....
My cousin was found dead by her mother and brother when they came to pick her up for a doctor's appointment.  She had intractable back pain.  She was, I believe, smart enough to know about the potentiation of drug combinations.  It was ruled accidental overdose.  No one in our family believes she was suicidal.
Title: Physician assisted suicide
Post by: Jamisjockey on January 21, 2006, 06:05:52 AM
The .gov doesn't like losing taxpayers....

I am 100% supportive of legalizing suicide, period.  As far as doctors go, I think they should have the right to not provide assistance, and they shouldn't be allowed to suggest it.  
Life is the last bit of property we have sole ownership and control over.  
BTW, I'm an atheist.
Title: Physician assisted suicide
Post by: 280plus on January 21, 2006, 09:25:40 AM
Quote
It is not sinful or wrong to prescribe large amounts of medication to control pain, even if this has the effect of shortening life - the intention is to decrease pain, not to kill.
I watched both my father and stepmother succumb to nasty forms of cancer. It is my opinion that they both died of morphine overdose not the cancer. At the end for Mom, the nurse asked Dad to leave the room for a moment while she administered the morphine. When he came back, she was gone. When it was Dad's turn 4 years later he was at home and attached to a machine that fed his morphine in at a measured rate. However, he was allowed to have a "bolus" or extra manual shot once per hour, the machine timed this. 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. So, it appeared to me that PAS has been going on a long time but has been cleverly disguised as medicating for pain and wholly accepted. If you receive morphine and there is still pain, you have a right to more morphine up to and including the amount that will kill you.

If you asked me to expound on this a little more. I'd say the INSURANCE companies are the reason PAS is still not a viable legal option in this country. Because, as we all know, if you commit suicide, nobody collects the life insurance. The insurance companies want you to take every method available to you to save your life so that hopefully you survive and they don't have to pay out. If you go on record as having commited suicide at the hands of a physician they may not be legally bound to pay. If you take a gun and put it to your head and kill yourself, the insurance company is not obligated to pay. But if you step out in front of a bus and make it look like an accident...

ME? I'm all for PAS. We'll put animals out of their misery in this land but a human has to suffer up to and including the time of  "natural" unassisted death without any choice or say in the matter?? Sorry, I don't buy it.
Title: Physician assisted suicide
Post by: Mabs2 on January 21, 2006, 10:22:34 AM
Quote
Watching my FIL die from inoperable cancer, begging for more morphine
"We can't give you anymore, it could kill you," huh?
I really hate the way some things work.  It's the person's life, he or she should be able to do whatever he or she wants.
Title: Physician assisted suicide
Post by: bermbuster on January 21, 2006, 10:41:13 AM
Quote from: 280plus
.....
If you asked me to expound on this a little more. I'd say the INSURANCE companies are the reason PAS is still not a viable legal option in this country. Because, as we all know, if you commit suicide, nobody collects the life insurance. The insurance companies want you to take every method available to you to save your life so that hopefully you survive and they don't have to pay out. If you go on record as having commited suicide at the hands of a physician they may not be legally bound to pay. If you take a gun and put it to your head and kill yourself, the insurance company is not obligated to pay. But if you step out in front of a bus and make it look like an accident....
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.  Check your policy.
Title: Physician assisted suicide
Post by: Vodka7 on January 21, 2006, 10:47:55 AM
Quote from: Preacherman
I'm afraid I completely oppose physician-assisted suicide, not only on religious grounds (which I accept I can't foist on others), but because in every single country where this is allowed (legally or merely "winked at") the doctors come to the point of making the decision themselves as to who should die, and when.
This is the main secular argument against PAS/Active Euthanasia, and I shudder to see it on this forum.  Let's do a little re-writing to use this line of thought against another controversial issue:

"I'm afraid I completely oppose the right to bear arms, not only on religious grounds (which I accept I can't foist on others), but because in every single country where this is allowed (legally or merely "winked at") the gun-owners come to the point of making the decision themselves as to who should die, and when."

You can't deny rights to the law abiding based on the possible actions of criminals, even when the possible consequences are innocent deaths.

Our difference of opinion is that I consider the human body a human posession, and I believe that you consider it a sacred gift.
Title: Physician assisted suicide
Post by: Moondoggie on January 21, 2006, 10:48:17 AM
Most life insurance has a 2 yr exclusion for suicide.  If they don't pay after that they have to refund all of the premiums that were paid, plus interest.  That's what was taught in my "Risk & Insurance" class back in college.

In any event, I think the financial considerations are miniscule compared to continuing in excruiating pain with NO HOPE OF RECOVERY.

Another point to ponder for those on Medicare/Medicaid...the sooner you die the more of your estate that is left for your heirs and the less that the Gov't/Hospital collects.
Title: Physician assisted suicide
Post by: 280plus on January 21, 2006, 01:19:09 PM
Quote
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.
Title: Physician assisted suicide
Post by: The Rabbi on January 21, 2006, 04:04:25 PM
Quote from: Nathaniel Firethorn
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.
Title: Physician assisted suicide
Post by: pauli on January 22, 2006, 07:55:35 PM
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.
Title: Physician assisted suicide
Post by: Firethorn on January 23, 2006, 03:27:08 AM
Quote from: 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...

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.
Title: Physician assisted suicide
Post by: The Rabbi on January 23, 2006, 05:32:30 AM
Quote from: Firethorn
Quote from: 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.
Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 23, 2006, 11:45:33 AM
The logical premise for:
Quote
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:
Quote
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:
Quote
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
Title: Physician assisted suicide
Post by: The Rabbi on January 23, 2006, 01:14:47 PM
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.
Title: Physician assisted suicide
Post by: Nathaniel Firethorn on January 23, 2006, 02:16:24 PM
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
Title: Physician assisted suicide
Post by: The Rabbi on January 23, 2006, 03:07:36 PM
Quote from: Blackburn
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?
Title: Physician assisted suicide
Post by: The Rabbi on January 23, 2006, 04:25:51 PM
Quote from: Blackburn
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.
Title: Physician assisted suicide
Post by: Firethorn on January 23, 2006, 06:29:57 PM
Quote from: The Rabbi
Quote from: Firethorn
Quote from: 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.
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.
Title: Physician assisted suicide
Post by: Vodka7 on January 23, 2006, 08:37:19 PM
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.

Quote from: The Rabbi
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.

Quote from: The Rabbi
Suffering has a value, like the rest of life.
I apologize for the shamefully quoting this out of context, but we agree here.


Quote from: The Rabbi
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.

Quote from: The Rabbi
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.
Title: Physician assisted suicide
Post by: The Rabbi on January 24, 2006, 06:28:54 AM
Quote from: Vodka7
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.

Quote from: Vodka7
Quote from: The Rabbi
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:
Quote
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.
Title: Physician assisted suicide
Post by: pauli on January 24, 2006, 09:01:18 AM
Quote
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.