HotButton: Assisted Suicide

[Jan]

[Please note that I deliberately didn't put this discussion in the 'Rampant, Irresponsible' thread because I *don't* want it to become a discussion of health care reform or socialized medicine or politics]

Reading that author Terry Pratchett is encouraging legislation empowering terminally ill patients to be able to end their lives on their own terms in this article I wonder how many people here support this or oppose it and why.

I'm very much in favor. One of my most deep-seated fears is the thought of becoming helpless or un-mindful and not being able to die. To my mind, living wills and final directives aren't enough.

What do you think?

Jan

[David Panzer]

As long as the patient makes the decision, rather than a doctor or nurse making the decision for them, I don't see the problem.

[OmahaStar]

What do you think?

My background comes into play with this answer.

My first job, while in high school, was a nurse's aide, working in a nursing home. I was there for about two years, and every single day, one resident or another would ask me to kill them. They were in pain, and all I could do was comfort them.

Of course, I'd never actually kill someone, but I was asked ... begged, repeatedly.

There were people on feeding tubes, or terminal patients, those who had it confirmed "you have 3, 6, 12 months" ... I saw people in final stages of their fight with cancer. I remember one little old man who had chewed tobacco and the cancer had taken his entire jaw.

Thinking about this is reminding me of people I haven't thought of since then. And with as much pain and death as I saw, I am 100% for this. When someone knows - as in, it's a fact, not just a whim or opinion, but confirmed by at least two doctors - that there is no hope, give them a choice. Let them die with dignity. Don't make them suffer needlessly.

[Doom Shepherd]

Yeah, as long as you really are sick, and it's your choice and no one else's (or if you're too far gone, but you left a living will or other instructions to that effect), I'm fine with that.

There's a slippery slope to watch out for, though. It's not that short of a slide from "permitting" to "encouraging" to "mandating," after all.

Yeah, I know the slippery slope's a logical fallacy. That DOESN'T mean that it's always wrong. Ask Pastor Niemoiller.

[Jan]

I don't think it would be all that difficult to have safeguards in place to prevent most abuse. No system is ever perfect but a system of verification that it's the patient's actual desire would have to be part of it.

Oddly enough, I'm not sure I would agree with assisted termination in the case of a coma patient although I'm entirely supportive of 'pulling the plug' if that's what has been previously directed. In the case of actively terminating a patient's life, I think that the patient should be the one initiating the action if motion is at all possible.

Jan

[Spoo Junky]

If I were that sick, I would hope that I could make the decision to end my life. I'd rather not be around if living meant I had to lay there waiting to die and in discomfort, especially since modern science can keep you alive even when all hope of recovery is gone.

Life is precious, but I'd give up the chance of maybe having a bit more joy in my life if in general my health was so bad that I was essentially already gone.

We had to put our dog down the other day. She had a heart tumour we didn't know about and it was obvious her time was short. Even so, the vet offered the chance to rush her to a local university that deals with animal surgery. She might of lived a bit longer but at what cost emotionally, physically, mentally, not just for us but for her too. People will say you can't compare a dog to a human, but she was human to us.

[Jan]

I'm sorry for your loss, SJ. Maybe she wasn't human but she was obviously part of your family and you loved her. It must have been a hard decision for you but you faced up to your responsibility to her.

Jan

[Spoo Junky]

Thanks, her body is not here anymore but she's still around in our memories and our hearts.

[WorkerCaste]

I am solidly in favor. Being the youngest child of the youngest children of fairly large families, I've seen a number of aunts and uncles (and unfortunately cousins, too) pass over the years, and there have certainly been cases where I know the lingering illness caused more pain, stress and emotional harm than the additional life gave in benefits. I can't say what decisions any of them might have made, but it wouldn't have surprised me if some availed themselves of a legal option for assisted suicide if it had been available. And, of course, I, like many of you, would like to have the option for myself should the situation warrant it.

That last brings up what I think is an interesting facet of human nature that I know I fall prey to. It seems very easy for people to believe that something wouldn't be a problem for us, but we worry about other people. One example is that I always hesitate to drive in a winter storm. Mind you, I'm confident of MY driving abilities, but I worry about the others on the road. I can see something similar in my feelings on assisted suicide. I know I'd never be influenced and it would always be my decision, but I worry about abuse in other cases. I think that is one of the things that always complicate these kinds of discussions. We can all easily agree that we would want the option, but we worry about others. Of course, the worry probably is appropriate, and in more truthful moments I would even concede that there might be circumstances where I could be adversely influenced. That's why I agree with everyone else that protections are important. Even so, I think it would be impossible to completely protect against abuse. The tough question seems to be, can we accept a few abuses for a greater good. To me, I figure the abuses are likely to exist anyways, and making it legal with controls will probably reduce abuse.

To expand the scope slightly, (but not to health care in general, Jan ), what should the effect on life insurance be? Life insurance is voided in the case of suicide. Should that be true for terminal patients who take advantage of a legal assisted suicide option? Insurance companies aren’t likely to do that on their own, so should any law legislation include a requirement for the insurance industry? Also, are there circumstances beyond terminal illness where assisted suicide should be allowed? What about debilitating diseases that leave a patient able to live indefinitely, but without any significant quality of life?

PS Spoo Junky, I've been through that a couple of times and I know it's hard, but I also know that I took comfort in being confident it was the right decision. Dogs are wonderful companions and become a close part of our families. We see them and interact with them more than almost all but our nuclear family, so, yes, there is a basis for comparing them to humans. I am sorry for your loss.

[Jan]

That last brings up what I think is an interesting facet of human nature that I know I fall prey to. It seems very easy for people to believe that something wouldn't be a problem for us, but we worry about other people. One example is that I always hesitate to drive in a winter storm. Mind you, I'm confident of MY driving abilities, but I worry about the others on the road. I can see something similar in my feelings on assisted suicide. I know I'd never be influenced and it would always be my decision, but I worry about abuse in other cases. I think that is one of the things that always complicate these kinds of discussions. We can all easily agree that we would want the option, but we worry about others. Of course, the worry probably is appropriate, and in more truthful moments I would even concede that there might be circumstances where I could be adversely influenced. That's why I agree with everyone else that protections are important. Even so, I think it would be impossible to completely protect against abuse. The tough question seems to be, can we accept a few abuses for a greater good. To me, I figure the abuses are likely to exist anyways, and making it legal with controls will probably reduce abuse.

There's the potential for abuse with pretty much anything. As it is now, you hear fairly regularly about how a spouse or loved one killed the other to end their suffering. Probably far more instances exist where a medical professional helps covertly. But you do make a valid point about people being influenced which is why the safeguards will have to be given long and careful thought. Also why I reluctantly have to only support it in the case of diagnosed terminal illness or Alzheimer's. It shouldn't be an option for an elderly person who might be pressured into thinking that s/he's a burden.

To expand the scope slightly, (but not to health care in general, Jan ), what should the effect on life insurance be? Life insurance is voided in the case of suicide. Should that be true for terminal patients who take advantage of a legal assisted suicide option? Insurance companies arenÆt likely to do that on their own, so should any law legislation include a requirement for the insurance industry?

I'm no expert but the few times I've ever actually read a life insurance policy there was a time limit for non-payment due to suicide, anywhere between six months to two years. I don't think that's unreasonable and there might also need to be some affidavit or health statement that no terminal disease has been diagnosed at the time the policy is taken out.

Also, are there circumstances beyond terminal illness where assisted suicide should be allowed? What about debilitating diseases that leave a patient able to live indefinitely, but without any significant quality of life?

Above I mentioned Alzheimer's But thinking a little more perhaps there could be a clause in pre-prepared final directives/living wills as to just what level of quality of life a person would want sustained. I know that in my own case I'd really hate a lifetime of paralysis even if it didn't require extreme measures to keep me alive.

Jan

[Ranger 6 and 7/8]

Hey Jan, I've been working in the insurance field going on 16 years now. SO maybei can spread some light on the subject.

I'm no expert but the few times I've ever actually read a life insurance policy there was a time limit for non-payment due to suicide, anywhere between six months to two years. I don't think that's unreasonable and there might also need to be some affidavit or health statement that no terminal disease has been diagnosed at the time the policy is taken out.
Jan

1) On the exclusion in life insurance policies---Yes most policies have that short term exclusion. Some have even left it as a permanent exclusion. so you would need to weigh that when comtemplating assisted suicide. What is more, you are required to explain ANY complex health problem you have been diagnosed or treated for within 6 months prior to the effective date and up to one year after your effective date. Cancer is one that is scrutinized along with ANY mental health issue.
This makes sense, because if you think about it what would stop a person from getting a $1million policy commiting suicide right after signing the papers.

Above I mentioned Alzheimer's But thinking a little more perhaps there could be a clause in pre-prepared final directives/living wills as to just what level of quality of life a person would want sustained. I know that in my own case I'd really hate a lifetime of paralysis even if it didn't require extreme measures to keep me alive.
Jan

2) You would need to check the validity of a medical directive with your physician as there are a growing number of Healthcare facilities that are using releases that many of us sign without thinking that will invalidate your directive while in their care. It states that you recognize that they are a "Right to life" facility/physician and that you recognize and agree that they do not acknowledge the validity of a medical directive and they will use any means necessary to prolong your life while in their care.
While this is not an issue for many, for myself and others who have directives in place and have moral objections to some medical procedures (i.e. blood for Jehovah's Witnesses, and the use of certain medications for scientologists), this is yet another obstacle to our freedoms guaranteed under the Constitution.

So as regards assisted suicide, it falls into a category with the refusal to use blood or prescription drugs. Even though it is a personal decision, the current law and society make those who believe in the ethical availability of it social outcasts.
If you are comtemplating the use of it, it is definitely something that will need the support of family and friends to avoid legal complications.

[WorkerCaste]

I'm actually kind of suprised insurance will pay on suicide at all. I just always assumed they wouldn't, regardless of how long the policy had been in place. In addition to the scenario where someone got a big policy and immediately committed suicide, I can also easily envision having a big policy in place, then having an economic downturn get you to thinking that you can provide for your family by taking your own life. Seems like a risk insurance companies wouldn't want to take on.

I also found the observation about medical directives interesting, Ranger. It does make sense, but I hadn't really thought about it. Figured everyone should probably have a living will, especially as they age, but didn't consider that the facility or Physician would ask you to waive it with paperwork at admission. The only hospital aournd me is a Catholic hospital, so I wouldn't be surprised if they had that. I take it they do need to put something in front of you in the "permission to treat" paperwork that states that they will disregard such medical directivies. Can they just ignore it without that kind of waiver? Do you actually have to sign/initial, or can they just post the policy somewhere?

[I love Lyta]

As you well know, Jan, I'm all for it.
Nuff said.

[DGTWoodward]

To SPOO JUNKY

The principle you mention is a very valid one.

We treat our pets with all the honour and dignity we would love to have demonstrated on ourselves and yet we still deny them to ourselves, it is quite mad.

My maternal grandmother was one of the backbones of our family. When dad left us for his 'other' she was there to help in every and anyway possible, She was always a hard worker and an extremely healthy, strong and vitally active lady who always cherished this activity, even well into her 80s, stating many times that she would loathe to be in a situation where she could do nothing for herself or be totally dependent on anyone. The very thought was anathema to her.

And then one day, just out of the blue and during our evening meal, she had a massive stroke.

When she eventually regained consciousness the doctors did not even know if she would be able to continue to breath unaided. She had had a very dense stroke and had lost total movement on her right side.

The number of times we were called and told to 'expect the worst' well, how do you describe a situation like that. Yet that was when fate decided to play its cruelest twist.

Despite the massive stroke and the calls telling us to expect the worst, her physical bodily strength that was just part of her, kept her alive for another 13 months! She last some 400 more days, locked in the prison cell of her own body - a torture she hated for every single living second - until her systems eventually gave up. It was in no way any less than sheer torture.

I know all the arguments about how people are not animals, that we owe it to them to try to keep them alive for their sake, because every day they live longer is one day bringing a cure to your condition that much closer. I have heard it all. But in that argument, something is lost.

So...where justice, mercy and dignity? My grandmother was just one person, of which there must be what...? Thousands, hundreds of thousands?

Justice and dignity.

[circularREASON]

I've mentioned before that I have certain viewpoints in regards to life / death / choices and maybe even responsibility.

However I do support the persons right to decide ( in terminally ill cases ) when to end their own life.

There has just been a case in the uk where a woman (forgive me for not remembering her name) basically wanted the right to die when her muscle wasteing disease becomes unbearable - without fear her husband would be prosecuted for assisting her to fly to switzerland to end her life. I for one cannot imagine the horror of having to make a decision like that about myself. A decision which lets face it cannot be taken lightly.

It must be hell for the Gentleman to have to watch his wife die slowly over time. Unfortunately the Politicians and doctors do not see these people all day, every day to see the hell they go through.

To SpooJunky.

I know how you feel. When i was about 20 years old ( many moons ago ) a family pet of ours died - a cross Jack Russell / Lakeland Terrier. An amazing dog. When it died, it crawled up onto my sisters knee, licked her hand and died.

10 years later we had another jack russell terrier called bonnie. bonnie suffered from a heart condition. And when she passed away, she crawled onto my sisters knee, licked her hand and died.

In effect they become family. They are as human as we are. When a they die a part of us goes with them to the big doggy heaven in the sky (or Coriana 6 where lorien will be waiting for them.....)