board77

You are all going to hate me. I know. No, I'm not obsessed with death, but I do find end-of-life issues fascinating. I had no plans to start this thread until I read yov's thread on animal rights and saw people discussing what the appropriate treatment for end-of-life animals was.

I do have a clear hope in starting this thread: I support people's "right to die" in theory, but struggle to provide a cabining principle for this right. Where does it begin? Does it begin at all? As yov asks on the animal rights thread, how are we even to define a right? Is it a "moral" right? (After Glucksberg, you can assume I am not looking to find a constitutional right for Americans, at least not until the composition of the Court shifts further left.)

For those who support a "right to die", term used loosely, I am sure you would agree it is easier to say that a terminal patient, with three weeks to live, should be afforded the "right", than a teenager who has broken up with her first significant other and thinks life isn't worth living. One might even say that we should "force" that teenager to see that life is worth living, whether through counseling, becoming involved in the world of the living, etc. But there are an immense number of cases in the middle. What if one is diagnosed with cancer, with a reasonable chance of survival? With HIV, but with the possibility of many healthy years ahead? Has experienced third-degree burns over ninety percent of his body? Has been stricken blind, by disease or accident?

I worry that this topic may hit too close to home for many people. I tend to be distinctly inexperienced with life, and even I have had some RL occasion to confront these questions, dealing with a formerly suicidal teenage sister, a teacher and friend whose cancer ultimately was pronounced terminal and who wanted to die before she lost all her "dignity" (something she was not granted), a young childhood friend and leukemia sufferer who always wondered what the "better" way to go would be...

I know of the ethical dilemmas. What of coercion, of those who do not have families to speak for them? What if doctors begin to tell people it is in their best interest to die? Is life ALWAYS the right choice? Is it the ultimate value, regardless of how much pain and suffering one experiences, and how short it is to be? What if people who think they want to die now, would ultimately have wanted to live - even for a limited period of time - if they could get past the current amount of pain and hopelessness? (I understand from my college medicine and ethics class that this is true of many severe burn victims - there comes a point at which all ask to die, but almost 80-90% ultimately are thankful they weren't allowed to kill themselves.)

And on the other side, what about the 10% in that case, and who knows what percent in other cases? What of people who could be forced to live out their lives in the utmost pain (like my teacher), without their last wish - to have family and friends remember them as they were - granted? If there is a "right", is it not one of self-determination?

I am looking for insight, if people are willing to discuss. I will understand if you are not; I know this is the second very controversial topic in a row that I have proposed.

Controversial threads are good!

I don't rightly know how to answer though - you say you have "a clear hope" for this thread - what do you mean?

I can only say that while I agree that people should have a certain right to make a decision, the term euthanasia for me is an abomination, because of how it's fraught historically.

You put the pros and cons pretty clearly, so there's nothing much to add to that right now.

Basically, I think humans want to survive as much as possible. Those who are happy and healthy look at those who suffer and think "how can they want to go on?" - partly I think because when you're well it's so much harder to imagine suffering, but partly I think this is also a secret wish to be rid of those who remind them of their own mortality.
If people who are suffering want to die, you'd need to look at what causes this wish. Is it that they just have a world view in which you have to be "useful" to be allowed to live? Or do they really suffer so badly that they would prefer to be relieved of their suffering? In this case, it is theoretically alright, I think, to grant them the right to make the decision, even if it's just a depressed teenager. The only problem that remains is of course: what of the chances that the situation that causes the death-wish improves? These I think can never be certainly assessed, and it is to be hoped that if someone loses hope, there'll be someone there to renew their hope.

I'm not sure if you addressed that problem, but I think it makes a big difference on whether someone just commits suicide, or whether we are talking of euthanasia, i.e. active murder in the belief to be doing something useful for the person or society.
You seem to cover both in your first post.

My problem is more with the latter, because that's the one that can be abused.
If someone wants to jump off a bridge or so, well, that's too bad, but it's that person's decision, and surely everybody can decide for themselves what to do with their body.
For someone else to decide whether your life is worth living or not is whole different kettle of fish!

Fortunately, I've not been faced with this problem really, but if I think of those of my relatives who have died of pretty nasty illnesses, I don't think anyone of them ever wished to be killed prematurely. And of those people I knew who committed suicide, none of them was in a situation which the world surrounding them would have considered hopeless, or even dramatic - it was just a decision they made, nobody can tell whether they were deluded or whether they'd now prefer to live if they had the choice - but they chose, and even though I think it was an idiotic choice I also think it's not for me to say.

LOL, bit of a confused post, I'm afraid, but this is too difficult to have a simple opinion on.

truehobbit wrote:

If someone wants to jump off a bridge or so, well, that's too bad, but it's that person's decision, and surely everybody can decide for themselves what to do with their body.

This idea horrifies me!

Let me explain though: the idea of a person of sound mind and body wishing to end their own life horrifies me. I cannot conceive that there are life problems of such extremity that there is no solution to them other than leaving life. Having said that, I have heard of cases in war or famine etc where those caught in the events have made a conscious decision to end their own lives after balancing the probable consequences of remaining alive. I cannot pass any comment on such states of extreme desperation.

On the other hand: Those of sound body who are suicidal are not, by and large, of sound mind. Depression is the major cause of suicide - and that horrifies me also, and for the same reason as above. I cannot accept that there are mental illnesses of such severity that the only resolution is suicide, that there are not alternatives that can be offered by society and the medical profession to mitigate the circumstances.

Laureana has written very bravely and honestly about her son's situation and the courage that it takes for him and for those who love him to keep going is more than I can imagine - but to allow him to suicide because of his depression?! I reject that so completely! I am sure that Laureana hopes and works for the day when his depression can be overcome and he can lead a balanced and fruitful life.

And I'm not sure that Tolkienpurist was speaking about suicide under the influence of mental illness. In any case, I will address what I define as euthanesia: aiding a person who is not of sound body to ease their death when death seems inevitable and imminent in any case.

So for me, euthenasing someone who has contracted HIV would be completely inhumane, irresponsible and unloving; euthenasing someone who has full-blown AIDS and is suffering daily, with no hope of cure, until death comes - I think aiding that person to die IF THAT IS THE PERSONS' EXPRESS WISH is a humane, responsible and loving act.

In other words, I see no benefit to anyone of allowing someone to die a long, slow, painful death - or a long, slow, undignified death, as can happen in the last stages of multiple sclerosis for example. There is no pain, but there is complete helplessness and lack of dignity.

If the dying request to be eased into death, I see no reason to deny them that.

I live in a state where physician-assisted suicide has been legal for more than a decade. In that time fewer than 200 people have used the law to die. You have to be within six months of death from a terminal illness, and you have to be competent—those don't always go together.

However, I've heard that many more people than that have used the law to obtain a lethal prescription, which they then never use. Dying with pain, not being sure how much worse it might get before the end, is terrifying. The lack of control is total. The lethal prescription makes people feel that they have some control—"if it ever gets too bad, I can end it." For many people that gives them the strength to trust their caregivers and to die naturally. This seems to me humane.

Euthanasia is still illegal here, and I support that. But I would say the assisted suicide law is a good thing.

I support people's right to die. The questions that I'm trying to resolve now, for myself, centre around where the line should be drawn.

Lord_Morningstar, I hope that is not an obscure reference to thoughts of bringing about your own death?

I don't know you, but if that is the case, I beg you to please call someone. A help line would do if you don't feel you can contact someone you know.

I will PM you.

If I'm making a stupid assumption, please forgive me but I am concerned.

Damn, I just realised that the ‘for myself’ in my post could be read wrongly. No, I don’t intend to die any time soon, I was simply saying ‘in regards to my own moral views’. Hope I didn't give anyone a fright (or undue cause for celebration...)

Phew! You may ignore my stickybeak PM then.

A few quick thoughts from me, as it is past midnight and I am mentally and physically spent.

1. Read "Night Falls Fast: Understanding Suicide" by Kay Redfield Jamison (who also wrote "An Unquiet Mind" about her own struggles with bipolar). Don't read it if you are down. By getting into the suicidal mind and explaining it so compellingly, she makes suicide almost attractive. I had to put it down part way through, for my own safety. One of her major points: it is extremely rare for someone to commit suicide who is not depressed, bipolar, schizophrenic, or a borderline personality. Suicidal thoughts are a key diagnostic feature of these diseases. So asking for death, while being of sound mind, is highly unlikely.
2. What is PAS?
3. Euthanasia can be appropriate in some cases. I was involved in one, in which the woman was in the later stages of dementia caused by numerous strokes. She did not speak or comprehend the speech of others. The strokes also left her vulnerable to aspiration pneumonia, as her mouth and throat muscles were weakened and she was prone to getting food into her lungs. She was in the hospital, wildly fighting to breath, and trying to tear off the oxygen mask because she did not understand why it was strapped to her face. Morphine calmed her enough so that her mindless struggling stopped, and she was able to rest easy. But morphine also made her breathing more shallow, so that she was less able to fight the pneumonia. She did not last the night. If she had not had the morphine, she might have survived - this time - only to go through the same thing again the next time she got food in her lungs. A feeding tube was out of the question - she would have torn it out, and not understood at all why people were trying to do that to her. Euthanasia - literally "a good death" - was IMHO appropriate in this case.
4. My uncle had the beginnings of full-blown AIDS, was living on the streets, and had lost all hope. His daughter found him, brought him out West to her place, got him on medication, and got the AIDS in remission. But when he first got here, he was still in complete dispair. One day, he was in a freak accident on the freeway, in which he was sideswiped by a speeding driver, spun around, sideswiped again, and his car totalled. He walked away without a scratch. He suddenly realized that yes, he had an ultimately fatal disease, but that did not mean that he knew the time or manner of his death. Meanwhile, he could have a good life. That was 20 years ago.
5. Thank you for your kind words to me, Imp, and your concern for others. Better to make a mistaken assumption (which is not "stupid" by the way) than to say nothing.

2. 'Passive assisted suicide?'

*~Pips~*

Physician Assisted would be my guess.