That_Annoying_KidSire of TitlesJoin Date: 2003-03-01Member: 14175Members, Constellation
Lets avoid philosophical differences, you know the ones that come from base points that can't be swayed and reduced the discussion to lecturing back and forth while ignoring the other like water off a ducks back
Were not talking about people with depression wanting to commit suicide, were talking about people with lou Gherigs who are in fear that they will loose the ability to swallow and thus be prevented from drinking overdoses of medicine on their own accord and then be locked into slowly dying whilst a family watches from the wings.
One of the more interesting cases mentioned in the documentary (has anyone else seen it?) was a 23 year old rugby player who became quadriplegic after a sports accident chose to use dignitas, it was the youngest instance of euthanasia. Is it okay for this young gentleman to want to do this, as his condition is not going to improve? What about the 86 year old husband of who had eyesight problems, amongst other things. He and his Wife died together (she was in much dire straights) He would have been easily able to continue living, but didn't want to do so and thought it best to pass with his wife?
I think the documentary is a powerful look into what goes on first hand, and it's good to at least shake the cobwebs off taboo that has accrued over death
KassingerShades of greyJoin Date: 2002-02-20Member: 229Members, Constellation
<b>To Chris:</b>
You ask why help depressed people get better when they probably will be miserable the rest of their lives? You seem to assume life is supposed to be hard and miserable. Life [i]is[i] mostly good if you're in good health. If you have proper nutrition, people you care about and a decent mental health, life is more good than bad. I know, for a lot of people this is not the case, but that means that we need to improve conditions for people to prosper. You also seem to think that changing a person in any way stops them from "existing" somehow, becoming a something else. First off, that is to me pretty ridiculous, and even if it so (which seems to be a matter of definition) why is that a bad thing? You disagree with the notion that life in itself is a valuable thing, saying that life has to "acquire" a value. Hopefully most people disagree with you about this, but even if I grant you that, why isn't it better to treat people to give them the possibility of a good life? Sure it might fail, but that means that we need to increase the effort. Proper mental care improves the lives of people.
Your reasoning that dying is better than living only makes sense when depressed. And as lolfighter pointed out, that is temporary if you seek proper help.
So for your hypothetical depressed suicidal friend: Spend you energy on getting them to seek help, and years later they can be thankful. Saying it's better to die... that both cold and lazy.
<b>Back to the general topic of suicide tourism etc.</b>
We had a lecture about "passive assisted death", "assisted sucide", "euthanasia" or "active assisted death" and "mercy killing" at uni earlier this year. The distinction between the four is important.
<b>Passive assisted death</b> - Probably legal in all western countries. It simply means not actively keeping people alive any longer, stepping down on treatment, no resuscitation etc.
<b>Assisted sucide</b> - Making the means for suicide avaible for the patient. E.g. a doctor leaving a large amount of strong anesthesia on the table beside patient, allowing the patient to kill themselves.
<b>Euthanasia</b> - A doctor actively shortening the life of someone after repeated requests from the patient. E.g. injecting lethal amounts of anesthesia.
<b>Mercy killing</b> - Someone (doctor) decides the patient's life isn't worth living, kills of patient.
The lecturer was a physician working with end of life treatment, and he strongly opposed it along with most doctors, partly because he felt it's unnecessary. His argument was that patients with terminal diseases often get terribly depressed, but often get over it given some time and no longer wish to suicide. He also argued that pain treatment is getting better and better, and that we should focus on getting better at treatment instead of encouraging suicide. Most doctors are against it also because they don't want to be the ones doing the euthanasia. In the Netherlands however it quite common, with 2% of deaths being from euthanasia.
<!--quoteo(post=1774535:date=Jun 12 2010, 11:38 AM:name=That_Annoying_Kid)--><div class='quotetop'>QUOTE (That_Annoying_Kid @ Jun 12 2010, 11:38 AM) <a href="index.php?act=findpost&pid=1774535"><{POST_SNAPBACK}></a></div><div class='quotemain'><!--quotec-->Were not talking about people with depression wanting to commit suicide, were talking about people with lou Gherigs who are in fear that they will loose the ability to swallow and thus be prevented from drinking overdoses of medicine on their own accord and then be locked into slowly dying whilst a family watches from the wings.<!--QuoteEnd--></div><!--QuoteEEnd-->
While Lou Gherig's is physically worse, depression has its own physical symptoms and can really feel like your body is falling apart and you have absolutely no ability to do anything. Even if it is basically mental (ie your muscles work, but your brain is working in a way that keeps your from doing so) the side effects can be staggering. I have 3 relatives (only one biological) that have severe depression that is not based on life choices or negative events at all. All three have had at least one (one has this at least once a year) period where they won't get out of bed for over a week because they just can't bring themselves to do this. I also know that some mental illness can bring incredibly disturbing thoughts involuntarily and cause someone to not want to live with that memory. Only those who are completely disconnected, such as during schizophrenic episodes should be barred from being able to make such a decision at some point just because they have those episodes.
During a period of clarity both might want to make a decision to end their existence, in the same way someone with Lou Gherig's disease might want to end their life early because of what they expect to happen. I don't think that someone should be denied the ability to decide for themselves when they are rational, and being diagnosed with depression should not be a reason to deny them that ability when they are thinking clearly. Currently there is a thought that anyone who would want to commit suicide while depressed is not rational, and wanting to commit suicide is a basis for a depression diagnosis. There must be an acceptance that someone who is depressed can have periods of clarity where they can express a desire to commit suicide without that being an automatic sign of further depression.
I'm sorry if I'm jumping in the middle here and may be off topic I apologize
Since depression can be treated with medication/active support groups AND monitoring by friends. I've seen far too many cases when the afore mentioned group slipped through the cracks and found a way to do it on their own, if they want to they'll find a way. I think <u>general</u> depression is hardly fitting to find it's way on the medically induced and supervised suicide list. However, there was a recent case I think either in Canada or the US where a woman who had been married for close to 70 years lost her husband and was literally falling apart (unable to eat, sleep, etc...) asked her physician if he could help. While the answer was no I think in that particular circumstance where she only wanted to join her husband (religious implications of suicide apart) may be acceptable.
So while extreme depression as a cause for assisted suicide may be a valid point it is also a very fine line to walk for doctors and law makers it will be a hotly contested issue for a long time.
On to the debates regarding terminal illnesses I'm all for it, when someone is diagnosed with a particularly rare/fatal cancer for example and is given a 4 month estimate to live don't give them chimo to prolong their life for 6-8 months is extremely painful, it gets bad. The do no harm oath that doctors swear is broken when they go down that route and patients should be given the choice to end it there and then.
Once again sorry for jumping in the middle of the conversation that may have ended/resolved, however I do hope it gives more food to thought from another if only slightly different angle.
<!--quoteo(post=1788623:date=Jul 29 2010, 07:22 PM:name=Llama_Killer)--><div class='quotetop'>QUOTE (Llama_Killer @ Jul 29 2010, 07:22 PM) <a href="index.php?act=findpost&pid=1788623"><{POST_SNAPBACK}></a></div><div class='quotemain'><!--quotec-->On to the debates regarding terminal illnesses I'm all for it, when someone is diagnosed with a particularly rare/fatal cancer for example and is given a 4 month estimate to live don't give them chimo to prolong their life for 6-8 months is extremely painful, it gets bad. The do no harm oath that doctors swear is broken when they go down that route and patients should be given the choice to end it there and then.
Once again sorry for jumping in the middle of the conversation that may have ended/resolved, however I do hope it gives more food to thought from another if only slightly different angle.<!--QuoteEnd--></div><!--QuoteEEnd--> I don't disagree regarding assisted suicide in cases of terminal cancer, I've made that much clear earlier in the thread. However, I do disagree about the "do no harm" bit. Chemotherapy is unpleasant in its own right, but it does usually prolong the patient's life. Furthermore, the decision to undergo chemotherapy rests with the patient. There is little ambiguity here: The patient is offered the option to undergo or refuse treatment, and the doctor will act in accordance with their wishes.
There is potential for problems if the patient decides to forego treatment though. Let's take your example: Cancer, 4 months' life expectancy without treatment (probably several of those in rapidly declining health and mounting discomfort), 6-8 months life expectancy with treatment (some/most of those with marginally declining health and discomfort, but all of them with the side-effects of chemotherapy). The patient decides against treatment but can't bring themselves to commit suicide or ask for assisted suicide (yet). Months down the line the patient is bed-ridden, suffering, but still lucid. They are regularly dosed with painkillers to ease their suffering. They have expressed their wish to end it, but are no longer themselves able to commit suicide, and the laws of the land forbid assisted suicide. Meanwhile, the patient's suffering increases, and the morphine is no longer helping. The patient requests increased doses, but has already reached the allowable limit. Any more could kill the patient. The patient doesn't care: Either the doses ease the pain or they're fatal, either way the patient doesn't suffer.
What do you do in this situation? The law is clear: You are not allowed to kill the patient even if this is in accordance with their wishes, and as increased doses could be fatal, you must withhold any additional morphine, even if this causes the patient to suffer. Should you go ahead and attempt to ease their suffering anyway, your life will be ruined with lawsuits. So what DO you do? Your choice is obvious: You withhold the morphine. No court will convict you. None of your peers will condemn you. Even the family of the patient will understand that your hands are tied. But as you go to bed that night you're probably still thinking about the patient, unable to sleep that night because their nervous system is on fire. It's an unpleasant situation, and not just for the patient: Your conscience is at odds with the law. You can't follow both.
I always believe the Hypocratic Oath should have been superceded by a "work to ease the suffering of their patient." On a basis of physical pain. When it comes to mental strain it becomes more complicated because of ill-minded individuals who might earnestly believe that suicide is the end of their suffering (I have a medically recognised/significant fear of death and yet also frequently experience bouts of serious suicide contemplation due to medication I take), just because a patient may be convinced that suicide is their solution does not mean it shall be. In these cases I feel right to suicide should be withheld.
Now if you don't mind the tablets are working and this window isn't going to jump out of itself...
Comments
Were not talking about people with depression wanting to commit suicide, were talking about people with lou Gherigs who are in fear that they will loose the ability to swallow and thus be prevented from drinking overdoses of medicine on their own accord and then be locked into slowly dying whilst a family watches from the wings.
One of the more interesting cases mentioned in the documentary (has anyone else seen it?) was a 23 year old rugby player who became quadriplegic after a sports accident chose to use dignitas, it was the youngest instance of euthanasia. Is it okay for this young gentleman to want to do this, as his condition is not going to improve? What about the 86 year old husband of who had eyesight problems, amongst other things. He and his Wife died together (she was in much dire straights) He would have been easily able to continue living, but didn't want to do so and thought it best to pass with his wife?
I think the documentary is a powerful look into what goes on first hand, and it's good to at least shake the cobwebs off taboo that has accrued over death
You ask why help depressed people get better when they probably will be miserable the rest of their lives? You seem to assume life is supposed to be hard and miserable. Life [i]is[i] mostly good if you're in good health. If you have proper nutrition, people you care about and a decent mental health, life is more good than bad. I know, for a lot of people this is not the case, but that means that we need to improve conditions for people to prosper. You also seem to think that changing a person in any way stops them from "existing" somehow, becoming a something else. First off, that is to me pretty ridiculous, and even if it so (which seems to be a matter of definition) why is that a bad thing? You disagree with the notion that life in itself is a valuable thing, saying that life has to "acquire" a value. Hopefully most people disagree with you about this, but even if I grant you that, why isn't it better to treat people to give them the possibility of a good life? Sure it might fail, but that means that we need to increase the effort. Proper mental care improves the lives of people.
Your reasoning that dying is better than living only makes sense when depressed. And as lolfighter pointed out, that is temporary if you seek proper help.
So for your hypothetical depressed suicidal friend: Spend you energy on getting them to seek help, and years later they can be thankful. Saying it's better to die... that both cold and lazy.
<b>Back to the general topic of suicide tourism etc.</b>
We had a lecture about "passive assisted death", "assisted sucide", "euthanasia" or "active assisted death" and "mercy killing" at uni earlier this year. The distinction between the four is important.
<b>Passive assisted death</b> - Probably legal in all western countries. It simply means not actively keeping people alive any longer, stepping down on treatment, no resuscitation etc.
<b>Assisted sucide</b> - Making the means for suicide avaible for the patient. E.g. a doctor leaving a large amount of strong anesthesia on the table beside patient, allowing the patient to kill themselves.
<b>Euthanasia</b> - A doctor actively shortening the life of someone after repeated requests from the patient. E.g. injecting lethal amounts of anesthesia.
<b>Mercy killing</b> - Someone (doctor) decides the patient's life isn't worth living, kills of patient.
The lecturer was a physician working with end of life treatment, and he strongly opposed it along with most doctors, partly because he felt it's unnecessary. His argument was that patients with terminal diseases often get terribly depressed, but often get over it given some time and no longer wish to suicide. He also argued that pain treatment is getting better and better, and that we should focus on getting better at treatment instead of encouraging suicide. Most doctors are against it also because they don't want to be the ones doing the euthanasia. In the Netherlands however it quite common, with 2% of deaths being from euthanasia.
While Lou Gherig's is physically worse, depression has its own physical symptoms and can really feel like your body is falling apart and you have absolutely no ability to do anything. Even if it is basically mental (ie your muscles work, but your brain is working in a way that keeps your from doing so) the side effects can be staggering. I have 3 relatives (only one biological) that have severe depression that is not based on life choices or negative events at all. All three have had at least one (one has this at least once a year) period where they won't get out of bed for over a week because they just can't bring themselves to do this. I also know that some mental illness can bring incredibly disturbing thoughts involuntarily and cause someone to not want to live with that memory. Only those who are completely disconnected, such as during schizophrenic episodes should be barred from being able to make such a decision at some point just because they have those episodes.
During a period of clarity both might want to make a decision to end their existence, in the same way someone with Lou Gherig's disease might want to end their life early because of what they expect to happen. I don't think that someone should be denied the ability to decide for themselves when they are rational, and being diagnosed with depression should not be a reason to deny them that ability when they are thinking clearly. Currently there is a thought that anyone who would want to commit suicide while depressed is not rational, and wanting to commit suicide is a basis for a depression diagnosis. There must be an acceptance that someone who is depressed can have periods of clarity where they can express a desire to commit suicide without that being an automatic sign of further depression.
Since depression can be treated with medication/active support groups AND monitoring by friends. I've seen far too many cases when the afore mentioned group slipped through the cracks and found a way to do it on their own, if they want to they'll find a way. I think <u>general</u> depression is hardly fitting to find it's way on the medically induced and supervised suicide list. However, there was a recent case I think either in Canada or the US where a woman who had been married for close to 70 years lost her husband and was literally falling apart (unable to eat, sleep, etc...) asked her physician if he could help. While the answer was no I think in that particular circumstance where she only wanted to join her husband (religious implications of suicide apart) may be acceptable.
So while extreme depression as a cause for assisted suicide may be a valid point it is also a very fine line to walk for doctors and law makers it will be a hotly contested issue for a long time.
On to the debates regarding terminal illnesses I'm all for it, when someone is diagnosed with a particularly rare/fatal cancer for example and is given a 4 month estimate to live don't give them chimo to prolong their life for 6-8 months is extremely painful, it gets bad. The do no harm oath that doctors swear is broken when they go down that route and patients should be given the choice to end it there and then.
Once again sorry for jumping in the middle of the conversation that may have ended/resolved, however I do hope it gives more food to thought from another if only slightly different angle.
Once again sorry for jumping in the middle of the conversation that may have ended/resolved, however I do hope it gives more food to thought from another if only slightly different angle.<!--QuoteEnd--></div><!--QuoteEEnd-->
I don't disagree regarding assisted suicide in cases of terminal cancer, I've made that much clear earlier in the thread.
However, I do disagree about the "do no harm" bit. Chemotherapy is unpleasant in its own right, but it does usually prolong the patient's life. Furthermore, the decision to undergo chemotherapy rests with the patient. There is little ambiguity here: The patient is offered the option to undergo or refuse treatment, and the doctor will act in accordance with their wishes.
There is potential for problems if the patient decides to forego treatment though. Let's take your example: Cancer, 4 months' life expectancy without treatment (probably several of those in rapidly declining health and mounting discomfort), 6-8 months life expectancy with treatment (some/most of those with marginally declining health and discomfort, but all of them with the side-effects of chemotherapy). The patient decides against treatment but can't bring themselves to commit suicide or ask for assisted suicide (yet). Months down the line the patient is bed-ridden, suffering, but still lucid. They are regularly dosed with painkillers to ease their suffering. They have expressed their wish to end it, but are no longer themselves able to commit suicide, and the laws of the land forbid assisted suicide. Meanwhile, the patient's suffering increases, and the morphine is no longer helping. The patient requests increased doses, but has already reached the allowable limit. Any more could kill the patient. The patient doesn't care: Either the doses ease the pain or they're fatal, either way the patient doesn't suffer.
What do you do in this situation? The law is clear: You are not allowed to kill the patient even if this is in accordance with their wishes, and as increased doses could be fatal, you must withhold any additional morphine, even if this causes the patient to suffer. Should you go ahead and attempt to ease their suffering anyway, your life will be ruined with lawsuits.
So what DO you do? Your choice is obvious: You withhold the morphine. No court will convict you. None of your peers will condemn you. Even the family of the patient will understand that your hands are tied. But as you go to bed that night you're probably still thinking about the patient, unable to sleep that night because their nervous system is on fire. It's an unpleasant situation, and not just for the patient: Your conscience is at odds with the law. You can't follow both.
Now if you don't mind the tablets are working and this window isn't going to jump out of itself...