Political Position (Med Assisted Suicide)

NIKV69 · Tue Oct 20, 2020 5:49 pm

I am all for it. Couple of states already have it. HBO had an awesome Documentary on Death with Dignity and it was riveting. Why is it we humanely put our pets to sleep but we can't decide for ourselves to end our suffering?

Newark727 · Tue Oct 20, 2020 6:04 pm

I sorta feel like you should check out when you're ready to check out.

ltbewr · Tue Oct 20, 2020 6:05 pm

In the USA, there is strong moral, religious, ethical, psychological, fear of liability and use for financial reasons that have made it very difficult to have or use where available medical assisted suicide. In the states that do have it, it is very difficult, often requiring a court hearing to carry out. Still I suspect 100's are given a medical death/assisted suicide to end lives of irreversible pain and suffering without any state sanction, but done quietly by doctors, or set ups to keep releasing painkillers by the victim to chose their own time of death, with the permission of families to carry out, no criminal prosecution, no nosy coroners involved.

Tugger · Tue Oct 20, 2020 6:08 pm

The biggest issue is competency and the need to prove it. I do not know of an easy way to manage that. I know someone who in no way wanted what he now has. His mind is effectively gone, his "self". Brilliant person, now any conversation goes in circles of about 2-5 minutes then repeat. However he is happy and when asked mostly says he is fine. He hated this. The idea of a useless life, one that drains the joy (and the money quite frankly) from his family and erases his legacy, the memory of who he is in their minds.

He has expressed even now that he would like to just end. Die. But there is no way to do it. No authority would grant it. He appears happy, and yet is not competent to sustain making such a request. He forgets after a couple minutes. And such a request must come from the person and not from family (they are greedy of course, selfish!). All it takes is one family member who has nothing invested really from preventing anything to happen.

It is sad really. He is 82, a wonderful person but the person he was is gone. Body fading slowly, may die sometime soon but equally may last for 10 more years.

How do you avoid that? Put in a directive prior to a situation like this? But how would that survive any challenge? And you MUST have the ability to challenge because someone might change their mind.

(And don't get me started on the idiots who create the bogey man of "Death Panels" to disrupt and deny people healthcare. Just makes the whole situation a joke an undiscussable.)

Tugg

frmrCapCadet · Tue Oct 20, 2020 6:12 pm

Stoics felt it appropriate than when a person ran out of options suicide was the option. At the same time they repeatedly advised against lightly choosing it.

marcelh · Tue Oct 20, 2020 6:41 pm

Tugger wrote:
How do you avoid that? Put in a directive prior to a situation like this? But how would that survive any challenge? And you MUST have the ability to challenge because someone might change their mind.

I have a handwritten and dated statement (advance directive) and both my family and my general practitioner are familiar with the content. And I renew it regularly.

ER757 · Tue Oct 20, 2020 7:23 pm

marcelh wrote:
Tugger wrote:
How do you avoid that? Put in a directive prior to a situation like this? But how would that survive any challenge? And you MUST have the ability to challenge because someone might change their mind.

I have a handwritten and dated statement (advance directive) and both my family and my general practitioner are familiar with the content. And I renew it regularly.

Sounds similar to a DNR order. Looks like you've covered your bases. I am in favor of it too. I used to visit a "memory care" unit with my therapy dog and remember how sad it was watching people I could have a reasonable conversation with when I first started going there fade away into incoherence as months went by. I don't want to go out that way. I've also witnessed friends and family members waste away with terminal cancer. I know they'd rather have been put out of their misery

casinterest · Tue Oct 20, 2020 7:31 pm

I think the option should be there for those that need it.

I myself would rather let my ears and eyes feast on what is out there, even if my brain can't process it.
I will be dead for much longer than I am alive.

Interesting story I read years ago.

https://www.npr.org/sections/thetwo-way ... s-her-life

cpd · Tue Oct 20, 2020 7:33 pm

I’m fairly okay with it in carefully regulated circumstances.

If someone is suffering a debilitating disease and they have no quality of life anymore then it is something to consider, if they want it.

fr8mech · Tue Oct 20, 2020 7:49 pm

Generally, I’m ok with someone choosing when it’s time to go.

My wife and I discussed it when I was diagnosed a little under 4 years ago. (Happy to say that I am 3 years, 4 months cancer-free).

My concerns revolve around competency and the doctor involved in the procedure/process.

Competency issues are largely dealt with through Advanced Directives. But, even further, your family needs to be made aware, and they need to be onboard, or, at the minimum, accept the decision. My wife and I discussed it, but that conversation didn’t include the kids or any other family...because it would have been premature. But, had things taken a turn, certainly others would have been informed. But, the key is to have your “guardian” on your side.

The doctor. Assuming that there is competent consent and the laws are in place; should your doctor be required to assist you? Can the doctor refuse to assist based on personal, e.g. religious or moral reasons?

Getting past that, you choose a different doctor because yours has refused to assist you, what happens? What kind of relationship do you have to develop with this new doctor? Will this doctor have a duty to review your medical records and current condition and prognosis? Will he have a responsibility to dissuade you if he doesn’t feel the “treatment” is warranted, or will he just “rubber stamp” the procedure?

frmrCapCadet · Tue Oct 20, 2020 8:28 pm

Doctors are not required to participate in these decisions in any state which I know. On the other hand doctors and hospitals* need to make their religious biases and prejudices on policy clear and easily available. Ultimately the decision needs to be a 'rubber stamp', with the person making the decision they think right for themselves.

* hospitals which are funded near 100% by patient insurance and the government ought not to be allowed to hold monopoly rights as most of them do now.

NIKV69 · Wed Oct 21, 2020 1:25 am

cpd wrote:
I’m fairly okay with it in carefully regulated circumstances.

If someone is suffering a debilitating disease and they have no quality of life anymore then it is something to consider, if they want it.

If a woman can't do whatever she wants with her body why can't a terminally ill person in horrible pain do the same?

Tugger · Wed Oct 21, 2020 1:50 am

[quote="NIKV69]
:checkmark:

If a woman can't do whatever she wants with her body why can't a terminally ill person in horrible pain do the same?[/quote]
You know, in a nutshell, that really is that entire argument.

Tugg

Aaron747 · Wed Oct 21, 2020 2:54 am

NIKV69 wrote:
cpd wrote:
I’m fairly okay with it in carefully regulated circumstances.

If someone is suffering a debilitating disease and they have no quality of life anymore then it is something to consider, if they want it.

If a woman can't do whatever she wants with her body why can't a terminally ill person in horrible pain do the same?

Zero disagreement. Unfortunately the fundies (pick any religion but in US Christianity has the most pull) are dead against this. Call me cynical but there wouldn’t be much for clergy to do if everyone had advance directives and could pass in peace.

b4thefall · Wed Oct 21, 2020 8:57 am

I agree with it. I understand in cases of dementia etc the argument is iffy. However, if somebody is suffering from a terminal illness or simply extreme old age, and is 100% mentally ok, then I believe they should be able to end their suffering at a time of their choosing. I have personally witnessed enough end of life suffering to last me a lifetime. There is no need for it in this day and age if the person in question has had enough.

Sokes · Wed Oct 21, 2020 10:01 am

I believe it can't be the decision of the family.
The patient's will is tricky.
I therefore conclude it should be mostly within the doctor's (several doctors') judgement.

Sokes · Wed Oct 21, 2020 10:06 am

How is abortion related to euthanasia?
The right comparison would be:
If the patient is too much of a burden for the family, the family can decide for euthanasia.
If a sixty year old had a stroke and is unable to go to work, what is the family to do?

cpd · Wed Oct 21, 2020 10:28 am

NIKV69 wrote:
cpd wrote:
I’m fairly okay with it in carefully regulated circumstances.

If someone is suffering a debilitating disease and they have no quality of life anymore then it is something to consider, if they want it.

If a woman can't do whatever she wants with her body why can't a terminally ill person in horrible pain do the same?

The main thing is to make sure that we don't have cults and others persuading people into these options. Give them chances to consider the option carefully with the agreement of medical experts who can say, yes, that person is really struggling along, no quality of life, living in significant pain, etc.

Although we should remember that not everyone with debilitating diseases is like that. One of my former colleagues was a wonderful guy by the name of Dr Paul Brock, he was a Director of our disability unit who suffered from Motor Neurone Disease:

https://www.une.edu.au/about-une/facult ... paul-brock

Such a kind, friendly, nice person to be around. He required assistance and helpers with him all the time but it didn't impede him from doing his job very, very well. He was extremely well respected by all of us and we were all deeply upset when he passed away. Listen to his keynote. One of the best. I totally agree with UNE, he was very generous and he never let that disease beat him, at least not that we were aware of. It's such a privilege to work with people like that. When I'd be in the elevator and he'd roll in on his motorised wheelchair with his assistant, he was always beaming - positive and nice to everyone. This was many times, always the same. Or if we were working with him and his unit on some joint project it was always easy.

frmrCapCadet · Wed Oct 21, 2020 2:13 pm

The advantage of having a medical person involved is assessing the situation. An ailing person has a certain chronic/terminal condition, which will progress at an (un)certain rate. At what point does that person decide to go to comfort care only. How long and acute will the pain or debility last before death comes. What easy steps can be taken to shorten those days. Up to this point there is no objection in any US state. The medical industry does not do all that great a job here. Doctors are reluctant to advise a person that they have reached that point. i.e., patients/family are not told that further treatment will increase the pain and debility and things will not get better. There are kindly ways of saying 'we can treat you and you may live a week or a month or two longer but your life will become misery for you and your family'.

That out of control leftist wacko (note, satire) George W Bush, urged and signed a bill while governor of Texas that public monies not be available after a certain period when a body was being kept artificially alive in a hospital at public expense. I will ask for myself, long before that point, how many good days will this treatment give me versus how many bad days. And how good will the good days be, and how bad the bad days.

A great majority of those who arrange for the drugs in states where 'death with dignity' is authorized never use them. Good medical care ensures they live with some happiness (philosophy meaning) and not too much pain until the end. The family looks back on those last weeks remembering it was hard, but a treasured time of their life.

Advancing senility is the hard one. I think I know what I would do, but no state grants a mentally non compos mentis person the right to drugs to end their life. Catch 22 cranks in.

jetmatt777 · Thu Oct 22, 2020 3:07 am

I don't think there should be any restrictions on it even if not terminally ill, other than receiving a prescription (can't have the drug sold on the shelf). You should not be the property of your government. You exist inside their legal and financial framework, but your choice to exist should be yours. Suicide is illegal anyway (not that you would ever see a jury), why not make it safer and easier to digest for loved ones. Even someone who is not terminally ill, if they want to kill themselves at least give them a painless option and allow the family to not have to walk in on Steve or Mary Ann hanging from the ceiling fixture. The family is going to go through enough pain as it is, why double down on it by having them discover the dead body in a likely gruesome manner?

luckyone · Thu Oct 22, 2020 3:38 am

frmrCapCadet wrote:
Doctors are not required to participate in these decisions in any state which I know.

What states are you referencing? A physician is needed to write the order for the medication as far as I’m aware, and as a psychiatrist I get involved in the decision making assessment not infrequently.

seb146 · Thu Oct 22, 2020 6:03 am

luckyone wrote:
frmrCapCadet wrote:
Doctors are not required to participate in these decisions in any state which I know.

What states are you referencing? A physician is needed to write the order for the medication as far as I’m aware, and as a psychiatrist I get involved in the decision making assessment not infrequently.

I am for death with dignity. We have a state ballot measure that looks to legalize psilocybin therapy for PTSD. I am for it. There is an ad running that claims it helps with end of life decisions. How do you feel about this? What do your peers feel about this?

Kiwirob · Thu Oct 22, 2020 6:59 am

NIKV69 wrote:
I am all for it. Couple of states already have it. HBO had an awesome Documentary on Death with Dignity and it was riveting. Why is it we humanely put our pets to sleep but we can't decide for ourselves to end our suffering?

Religion is the problem, its the same stupidity that drives the anti abortion debate.

Sokes wrote:
How is abortion related to euthanasia?
The right comparison would be:
If the patient is too much of a burden for the family, the family can decide for euthanasia.
If a sixty year old had a stroke and is unable to go to work, what is the family to do?

It's the same people who are anti abortion that are also anti euthanasia.

Sokes · Thu Oct 22, 2020 9:13 am

Germany:
My granny had a blood vessel problem, but she was nearly 90. My parents expected the blood vessel will bust and she will die fast from it. However the blood vessel started leaking slightly. She collapsed at the reception of the doctor. The doctor called the hospital van. In the hospital a doctor said:
"If she had to be 10 years younger we would start all type of action now. But if she becomes conscious at all she would have brain damage and live maybe another half year, possibly with pain and probably bedridden.
My mother could have objected, but she didn't.

India:
My father in law had his third stroke. It was night and we came to know when my mother in law checked on him. The nurse in the government hospital first asked if he is a bedridden patient. "Yes"
He was mostly skin and bone by that time. The nurse took the blood pressure. She said blood pressure is normal, must be psychological, take him home.
"Psychological?", I asked. Here the nurse became uneasy and called the doctor. The doctor took blood pressure again. He said it's what is called a medical emergency.
He said I could take an oxygen bottle and bring him with my car to the next big city.

I had seen the final days of a stroke patient before. For the first two strokes it was me and my wife who took care of him. When he didn't recover after the second stroke I said to my wife:
"He is around 85. With each stroke he gets worse. I'm against more medical care. "

I asked the doctor if I'm obliged to take him to the next big town. He said no, we can also take him home. "We have enough population in India. "
I phoned my wife what she wants to do. She kept mum. My mother in law said we take him home.
He died IIRC three days later. He never regained consciousness, but once we saw some tears. I wonder if he did hear us.

The decision has to be made, or at least be supported, by medical personnel. At a minimum doctors need to get a right to object.
One can't expect loving relatives to initiate the final call.
One mustn't give relatives the right to get rid of their obligations, not to speak of conflict of interest with inheritance.

I appreciate the attitude of the medical personnel in the government hospital.
When the party is over, the party is over.

frmrCapCadet · Thu Oct 22, 2020 1:11 pm

luckyone wrote:
frmrCapCadet wrote:
Doctors are not required to participate in these decisions in any state which I know.

What states are you referencing? A physician is needed to write the order for the medication as far as I’m aware, and as a psychiatrist I get involved in the decision making assessment not infrequently.

Sorry I wasn't more clear. Doctors in Washington State can write the Rx for assisted death, but they are not required to do so.

luckyone · Thu Oct 22, 2020 2:19 pm

seb146 wrote:
luckyone wrote:
frmrCapCadet wrote:
Doctors are not required to participate in these decisions in any state which I know.

What states are you referencing? A physician is needed to write the order for the medication as far as I’m aware, and as a psychiatrist I get involved in the decision making assessment not infrequently.

I am for death with dignity. We have a state ballot measure that looks to legalize psilocybin therapy for PTSD. I am for it. There is an ad running that claims it helps with end of life decisions. How do you feel about this? What do your peers feel about this?

My very broad and blunt rule of thumb is how hard is it it to get someone to stop using a medication. I’m a cautious skeptic regarding the use of psychedelics. Currently, we are on the back end of approval for ketamine for the treatment of depression, and my concerns are similar with psilocybin.

The evidence is not clear whether these substances are actively modulating neurotransmitters in a long term stable fashion or simply giving the patient a euphoria (ie we’re giving them a controlled high), and the half lives are quite short, meaning they don’t last long in the body. Unlike most antidepressants, which have a fairly standard dose-response window, psychedelics can vary widely. Further, patients exhibit a tolerance effect wherein they quickly can require higher doses to receive the same effect, and patients can very quickly find themselves at street level recreational doses. Particularly with ketamine, similar medications in its class do not replicate the reported effect, which one would expect to see.

I have no reservations about these medications uses in applications such as short term anesthesia (which ketamine has been for decades), but its only been approved for depression for two years or so and I’ve already seen it causing problems with people shopping around in emergency departments for it, physicians running pill mill style ketamine clinics, and street diversion—this is not a problem with say, Prozac. Coming in the heels of the opioid mess I’m not for loosening controls on these medications that can so easily be abused, at least from a perspective of endorsing their use in regular, long term uses. Up to date it has largely been done in limited, highly controlled environments. As proud as I am to be a physician, I’m also not blind to the fact that once these things hit “the market,” they start being prescribed at the primary care level by poorly informed, though well-intended primary care providers (I’m shuddering right now at the thought of ARNPs and PAs dolling this out en masse) who are overwhelmed and just start prescribing these things to people who ask for them. I know this happens because I get called to clean up the mess after “I don’t feel comfortable writing this anymore,” or “I need your help,” or “they insist they need more and I’m not comfortable writing this dose.” And by that time the genie is out of the bottle.

Kiwirob · Thu Oct 22, 2020 3:16 pm

I watched a documentary a while back re assisted suicide, it was a UK patient who went to Switzerland, they showed the death, it was nice and peaceful, my question is why aren’t the same drugs used for assisted suicide also used for executions in the US?

Tugger · Thu Oct 22, 2020 4:51 pm

Kiwirob wrote:
I watched a documentary a while back re assisted suicide, it was a UK patient who went to Switzerland, they showed the death, it was nice and peaceful, my question is why aren’t the same drugs used for assisted suicide also used for executions in the US?

Basically no pharmaceutical company will or wants to have their medications connected with executions. So they will enforce their supply chain so the state cannot obtain any.

Tugg

NIKV69 · Thu Oct 22, 2020 8:57 pm

Tugger wrote:
Kiwirob wrote:
I watched a documentary a while back re assisted suicide, it was a UK patient who went to Switzerland, they showed the death, it was nice and peaceful, my question is why aren’t the same drugs used for assisted suicide also used for executions in the US?

Basically no pharmaceutical company will or wants to have their medications connected with executions. So they will enforce their supply chain so the state cannot obtain any.

Tugg

This could change if more states legalize it.

Ken777 · Thu Oct 22, 2020 9:09 pm

In the early 70's a person I worked with was dying of lung cancer. He was very far down and in a lot of pain, He asked for more morphine and when that was mentioned at the nurses station a young nurse basically said, "it's too soon since his last dose and can stop his breathing". An older nurse with a lot more experience pointed out that medical risks are not of concern because he is dying and what he needs is relief from the horrible pain." He got the shot and died a brief time later, but in far less pain.

SO who would deny him that shot and who would help provide it?

luckyone · Thu Oct 22, 2020 9:38 pm

NIKV69 wrote:
Tugger wrote:
Kiwirob wrote:
I watched a documentary a while back re assisted suicide, it was a UK patient who went to Switzerland, they showed the death, it was nice and peaceful, my question is why aren’t the same drugs used for assisted suicide also used for executions in the US?

Basically no pharmaceutical company will or wants to have their medications connected with executions. So they will enforce their supply chain so the state cannot obtain any.

Tugg

This could change if more states legalize it.

Legalize what? An increase number of states legalizing physician assisted death will not influence a pharmaceutical company to sell to to a a state for the purposes of capital punishment. Were a state to attempt to circumvent any of those attempted supply chain restrictions they would likely find themselves the recipients of a hefty lawsuit.

luckyone · Thu Oct 22, 2020 9:40 pm

Ken777 wrote:
In the early 70's a person I worked with was dying of lung cancer. He was very far down and in a lot of pain, He asked for more morphine and when that was mentioned at the nurses station a young nurse basically said, "it's too soon since his last dose and can stop his breathing". An older nurse with a lot more experience pointed out that medical risks are not of concern because he is dying and what he needs is relief from the horrible pain." He got the shot and died a brief time later, but in far less pain.

SO who would deny him that shot and who would help provide it?

That used to be unofficial standard practice in many places. Patients in the end stages of life in the hospital were eased out. Now it's often officially done but usually by hospice and palliative medicine teams. I, personally, would give the shot. It's easy to forget in the era of litigation that medicine is about reducing suffering.

seb146 · Thu Oct 22, 2020 10:20 pm

luckyone wrote:
seb146 wrote:
luckyone wrote:
What states are you referencing? A physician is needed to write the order for the medication as far as I’m aware, and as a psychiatrist I get involved in the decision making assessment not infrequently.

I am for death with dignity. We have a state ballot measure that looks to legalize psilocybin therapy for PTSD. I am for it. There is an ad running that claims it helps with end of life decisions. How do you feel about this? What do your peers feel about this?

My very broad and blunt rule of thumb is how hard is it it to get someone to stop using a medication. I’m a cautious skeptic regarding the use of psychedelics. Currently, we are on the back end of approval for ketamine for the treatment of depression, and my concerns are similar with psilocybin.

Your whole post is very informative. Thank you.

I didn't want to quote the whole thing because I also am wondering what antidepressants do for someone with a terminal diagnosis? I mean: if a person is given, say, six months to live and they get their affairs in order and do things they wanted to do, how do antidepressants help? My father-in-law had pancreatic cancer that moved very quickly. He was only on pain meds. I don't know if antidepressants would have done much. But, that was the closest I have ever been to anyone with terminal cancer.

luckyone · Thu Oct 22, 2020 11:30 pm

seb146 wrote:
luckyone wrote:
seb146 wrote:

I am for death with dignity. We have a state ballot measure that looks to legalize psilocybin therapy for PTSD. I am for it. There is an ad running that claims it helps with end of life decisions. How do you feel about this? What do your peers feel about this?

My very broad and blunt rule of thumb is how hard is it it to get someone to stop using a medication. I’m a cautious skeptic regarding the use of psychedelics. Currently, we are on the back end of approval for ketamine for the treatment of depression, and my concerns are similar with psilocybin.

Your whole post is very informative. Thank you.

I didn't want to quote the whole thing because I also am wondering what antidepressants do for someone with a terminal diagnosis? I mean: if a person is given, say, six months to live and they get their affairs in order and do things they wanted to do, how do antidepressants help? My father-in-law had pancreatic cancer that moved very quickly. He was only on pain meds. I don't know if antidepressants would have done much. But, that was the closest I have ever been to anyone with terminal cancer.

Most antidepressants take 4-6 weeks to have a full dose-appropriate response. An antidepressant in a terminal situation can indeed make it easier for someone experiencing depression due to a terminal situation to have some quality of life or meet the goals you have described. There are some antidepressants that we also use their side effects to our advantage such as poor sleep, loss of appetite, as there are some medications that make you sleepy and increase your appetite.

NIKV69 · Thu Oct 22, 2020 11:31 pm

luckyone wrote:
NIKV69 wrote:
Tugger wrote:
Basically no pharmaceutical company will or wants to have their medications connected with executions. So they will enforce their supply chain so the state cannot obtain any.

Tugg

This could change if more states legalize it.

Legalize what? An increase number of states legalizing physician assisted death will not influence a pharmaceutical company to sell to to a a state for the purposes of capital punishment. Were a state to attempt to circumvent any of those attempted supply chain restrictions they would likely find themselves the recipients of a hefty lawsuit.

I confused your remark with FAS. Sorry.

frmrCapCadet · Fri Oct 23, 2020 1:28 am

Depression and disconnecting can be confused rather than distinguished at the end of life. The most heart rending examples of this are a parent dying while their children are still young or very young. At a certain point the dying patient comes to the psychological realization that they no longer can control or affect what will happen to their child or children. At that point the person accepts that it is no longer their responsibility, let alone within their control. Even for older people need to come to terms with this, certain things, really everything, is no longer on their agenda.

Dutchy · Fri Oct 23, 2020 8:10 am

"Political Position (Med Assisted Suicide)", I think it is a strictly personal choice. If you ever in that situation and you do not want one, then don't, but don't say that others can't either. on whatever. grounds. But it should not be a right either, I mean a doctor should never be forced to administer the drug against his personal beliefs.

Euthanasia can be done in the Netherlands if a patient is terminally ill and is in the latest stages of the illness. The procedure is: your doctor gives his/her ok and a second doctor is called in to determine if the first doctor is right in its assessment. Of course, a major point is if it is actually the will of the patient, over a certain period - should not be one moment yes and the next no for obvious reasons. If everything is found right, then euthanasia can be done. After the fact is done, paperwork must be submitted to a medical/ethical committee and they will check if everything has been done according to the book. If they are satisfied, then it is fine, if not, the case could be turned over to the public defender and the physician could phase criminal charges. So this is being treated very seriously over here, but in the end it is a medical procedure, not a criminal one.

The gray areas which are discussed in the Netherlands, people who have lost their free will: dementia patients. Many have expressed their will that if they are in the later stages of dementia, they don't want to live anymore. The problem arises that they cannot express their free will anymore, but. the circumstances are met when they could. I donot think our society has reached a satisfactory solution to that.

c933103 · Mon Oct 26, 2020 6:43 am

I am 100% supportive of it, although individual agreeing with this should be in clear sane situation and have multiple confirmation in separate time.

TTailedTiger · Mon Oct 26, 2020 7:05 am

I'm fine with it as long as the patient takes the drugs themselves. I watched a video of an assisted sucide in Canada and the doctor straight up injected them with the barbiturates. I cannot support that. Doctors have no business actively ending a life. And you should have to be of sound mind at the time of death. In a few countries like the Netherlands the doctor will euthanize you even when you are not of sound mind. That is beyond reprehensible in my opinion. In this example the lady obviously had changed her mind and didn't want to die but the doctor told the family to hold her down. It just seems like a backdoor for kids to get their inheritance faster or get rid of the burden of taking care of their family.

https://www.telegraph.co.uk/news/2018/0 ... a-patient/

TTailedTiger · Mon Oct 26, 2020 7:17 am

jetmatt777 wrote:
I don't think there should be any restrictions on it even if not terminally ill, other than receiving a prescription (can't have the drug sold on the shelf). You should not be the property of your government. You exist inside their legal and financial framework, but your choice to exist should be yours. Suicide is illegal anyway (not that you would ever see a jury), why not make it safer and easier to digest for loved ones. Even someone who is not terminally ill, if they want to kill themselves at least give them a painless option and allow the family to not have to walk in on Steve or Mary Ann hanging from the ceiling fixture. The family is going to go through enough pain as it is, why double down on it by having them discover the dead body in a likely gruesome manner?

There are already painless options to for one to end their life if they so choose. I won't discuss them here because I don't feel it is appropriate for this site and don't want to give anyone who may not be in the best state of mind any ideas.

frmrCapCadet · Mon Oct 26, 2020 1:00 pm

At the end of my life I would like to leave my kids/grandkids my small pile of money - not hospitals (most are money corrupt), doctors (although increasingly those in the bottom 2/3rds(?) are less than thrilled with their jobs), and nursing home/Alzheimer wards national chains (less said the better).

DL717 · Mon Oct 26, 2020 3:44 pm

If you just don’t want to live anymore, no. You need proper mental health care. If you have a terminal condition, then that’s up to you and your family.

Channex757 · Tue Oct 27, 2020 1:57 pm

My only issue is with the use of the word suicide. That's not what is happening here, which is a death with dignity and compassion.
Suicide implies desperation or disturbance of the mind. If it's a dignified death with medical help then using an emotive term like suicide cheapens it.

Otherwise I'm all for letting doctors do what they have been quietly doing for thousands of years and helping patients die peacefully. Just write into law that coercion will attract a stiff penalty if someone wants (for instance) to bump granny off legally for the money.

Sokes · Sun Nov 01, 2020 11:22 am

Some days back my mother in law died of Corona. Already 1,5 years back she was sick for six weeks. The last year she complained that her legs are paining. She would prepare food and wash clothes on the washing stone, but one could see that her household wasn't run properly any more. Most of the time she was lying down.
She and most of her six children had/ have overexcitable brains. Even if there was nothing to worry, she would worry. Her blood sugar was always above 250, even above 350, for maybe 8 years.
(I always objected my wife to buy a washing machine for her. Washing clothes was her daily exercise.)
Indian doctors don't give insulin. Most old are not smart enough to use it. The young are not trusted with it. And then uneducated people have all kind of suspicions, so better not to give insulin.

Because of blood clot she went into the Intensive Care Unit, came out of it again, developed a second one, went into the ICU again. Kidney was secondary trouble. That morning we got a phone call that she is on the ventilator.
I said to myself what nonsense to put her on a ventilator. However a few hours later she died. She was skin and bone already when she entered the hospital.

In industrial countries there are institutions for the bedridden. However in India a family member has to take care. My mother in law aged a lot in the time she had to attend to her bedridden husband. There is a saying that the patient gains one year, the caretaker looses five years.
In an earlier topic I wrote that a nurse tried to send me home when I came with my unconscious bedridden skin and bone father in law at his third stroke.

I want to thank all doctors and nurses who have the courage to decide when enough is enough.

L410Turbolet · Sun Nov 01, 2020 12:59 pm

seb146 wrote:
I mean: if a person is given, say, six months to live and they get their affairs in order and do things they wanted to do, how do antidepressants help? My father-in-law had pancreatic cancer that moved very quickly. He was only on pain meds. I don't know if antidepressants would have done much. But, that was the closest I have ever been to anyone with terminal cancer.

My mom and my uncle died from pancreatic cancer in the lst three years. My mom, a nurse, took the antidepressants and the painkillers, she was incredibly brave and even though she ws on the pump that fed her through a hole in her stomach, she did relatively well for the 11 out 15 months that she was given to live between the diagnosis/operation and death.
My uncle, a pharmacologist, the nicest person you could possibly meet (sometimes too nice for his own good), totally changed once he went through the surgery, refused anti-Ds, thanks to professional deformation was obsessively focused on the medication he was given, was incredibly nasty to his wife who cared about him to the very end, he was like stuck turntable player, he could not talk about anything else but his disease. He was like another person. Has seen the same with my friend's dad, who made for her much more chronically ill wife, life an absolute hell once he was diagnosed with some strange blood cancer.
Or is it because women tend to be much tougher cookies when it really matters...!?!?

seb146 · Sun Nov 01, 2020 6:36 pm

L410Turbolet wrote:
seb146 wrote:
I mean: if a person is given, say, six months to live and they get their affairs in order and do things they wanted to do, how do antidepressants help? My father-in-law had pancreatic cancer that moved very quickly. He was only on pain meds. I don't know if antidepressants would have done much. But, that was the closest I have ever been to anyone with terminal cancer.

My mom and my uncle died from pancreatic cancer in the lst three years. My mom, a nurse, took the antidepressants and the painkillers, she was incredibly brave and even though she ws on the pump that fed her through a hole in her stomach, she did relatively well for the 11 out 15 months that she was given to live between the diagnosis/operation and death.
My uncle, a pharmacologist, the nicest person you could possibly meet (sometimes too nice for his own good), totally changed once he went through the surgery, refused anti-Ds, thanks to professional deformation was obsessively focused on the medication he was given, was incredibly nasty to his wife who cared about him to the very end, he was like stuck turntable player, he could not talk about anything else but his disease. He was like another person. Has seen the same with my friend's dad, who made for her much more chronically ill wife, life an absolute hell once he was diagnosed with some strange blood cancer.
Or is it because women tend to be much tougher cookies when it really matters...!?!?

I, personally, will not ever take antidepressants. I do not trust their side effects and how they ultimately effect the brain. I was asking the question how antidepressants make people cope even with those people knowing they will die shortly?

I don't think women are stronger than men when it comes to death. I think it is easier for women to accept death. I tell people I will be run over by a bus, so I am always ready to go. Life happens, and so does death. Others do not view it that way. I don't think it is a matter of one being stronger than the other. I think that is an individual thing.

Kiwirob · Sun Nov 01, 2020 7:30 pm

Dutchy wrote:
"Political Position (Med Assisted Suicide)", I think it is a strictly personal choice. If you ever in that situation and you do not want one, then don't, but don't say that others can't either. on whatever. grounds. But it should not be a right either, I mean a doctor should never be forced to administer the drug against his personal beliefs.

Euthanasia can be done in the Netherlands if a patient is terminally ill and is in the latest stages of the illness. The procedure is: your doctor gives his/her ok and a second doctor is called in to determine if the first doctor is right in its assessment. Of course, a major point is if it is actually the will of the patient, over a certain period - should not be one moment yes and the next no for obvious reasons. If everything is found right, then euthanasia can be done. After the fact is done, paperwork must be submitted to a medical/ethical committee and they will check if everything has been done according to the book. If they are satisfied, then it is fine, if not, the case could be turned over to the public defender and the physician could phase criminal charges. So this is being treated very seriously over here, but in the end it is a medical procedure, not a criminal one.

The gray areas which are discussed in the Netherlands, people who have lost their free will: dementia patients. Many have expressed their will that if they are in the later stages of dementia, they don't want to live anymore. The problem arises that they cannot express their free will anymore, but. the circumstances are met when they could. I donot think our society has reached a satisfactory solution to that.

My grandfather had dementia, that’s no way to live a life. It shouldn’t even be a question about what to do with people in the later stages. It’s putting them out of there misery, it really annoys me that we treat our animals with more care and consideration than we do with our criminally ill elderly. I wouldn’t want to put my children through what my mother and her siblings had to endure with my grandfather.

NIKV69 · Sun Nov 01, 2020 7:38 pm

Kiwirob wrote:
My grandfather had dementia, that’s no way to live a life. It shouldn’t even be a question about what to do with people in the later stages. It’s putting them out of there misery, it really annoys me that we treat our animals with more care and consideration than we do with our criminally ill elderly. I wouldn’t want to put my children through what my mother and her siblings had to endure with my grandfather.

God sakes alive. I would have printed this myself. In fact the HBO documentary had a woman who said "We don't let our animals suffer" It's so true.

moo · Sun Nov 01, 2020 11:48 pm

Medically assisted suicide (or in other words, euthanasia) is something that is often discussed, sometimes put to society for a vote, and always emotive in discussions.

Despite the arguments for it, and I agree that there is ample evidence in some cases where its a preferred outcome some of the time, I have yet to see any proposal which completely protects any medical professionals involved, and that is where I draw the line. Unless the law simultaneously guarantees the medical professionals immunity for anything other than deliberate acts of murder, it's too dangerous in our litigious society.

My wife is a doctor providing eldercare services in the community, including end of life care - she sees disputes between siblings regularly over opinions about a parents care or situation, including legal action against other siblings, the residential home and the doctor regarding treatment decisions taken either in conjunction with another sibling or the patients medical EPOA. Imagine an assisted suicide medical professional being exposed to that.

Another aspect my wife regularly sees is the patient splitting their EPOA between medical and financial - typically the medical EPOA goes to a daughter or grand daughter, but the financial EPOA goes to a male related to the family. This creates disjointed funding issues for the medical care, but its also pretty darn common to find that the financial EPOA refuses any treatment or care which sees their inheritance diminished - they would rather see their relation live in a poorer state, foregoing treatments or luxuries such as an en suite room for the sake of some more money after their death.

Bring assisted suicide into the mix and it gets difficult for the doctor - seeing patients having their EPOAs enacted, and then the EPOA enacting an euthanasia option that the patient may or may not have put on record, all for the sake of a larger inheritance later on.

And woe betide any medical professional who is later found to have got some paperwork wrong...

This is a really really difficult area to get right, and someone along the way is always going to suffer - whether its the patient, relation, medical professional or whomever.

frmrCapCadet · Mon Nov 02, 2020 12:41 am

What state (or political entity). There have been no difficulties that I have seen in Washington or Oregon states.

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