Physician Assisted Suicide: for or against?

[Arachnodisiac]

I think that every individual should have the choice - and right now they don't.

For those that choose palliative care and pain control, awesome! Glad it works for them.

I'm advocating for the ones who want something different and I can't imagine anyone in EMS not advocating for the option. Note that I don't prescribe mandatory euthanasia - I just believe it should be on the table.

Originally Posted by Salmon Slayer Lenny

I've worked in EMS in pretty much every capacity for over 23 years and I think that is one of the most naive and ignorant statements ever made? You make an association fallacy implying everyone is of the same thought process to support your own ideology. The same philosophy applies to those in medicine.



I am neither wholly for or against it. Yes, people can suffer. But on the other hand, if properly applied, palliative care and hospice care do very well to end or limit suffering. In actuality, it hastens the process along.



I'm also not opposed to those having the right to choose. The problem is that all too often, it's the simple fix and people that support it are playing god. I've seen many, many, many terminal patients that have no interest in ending their life. Yes, some do and with certain criteria, I think it makes sense whether I support it personally or not.



It needs to be well regulated, well thought out, well researched and properly applied. I don't think any one physician or any one institution should be forced to implement P.A.D. The problem with this is when one group feels their rights supracede the rights of others. Instead of people making blanket statements, account for the fact that this would easily be accomodated.



Quite simply, the College of Physicians and Surgeons does not support a blanket P.A.D policy. It's not fair to every physician to force this on them. Their should be specialists that work in this area and it should be left to them. Think about it, how long is a referral going to take as well as the screening process? IF you think it will just be hastened along and fast tracked, it kind of defeats the purpose. There will be some that it is the right decision for, there will be many it will not be.

[Arachnodisiac]

Nope, I'm not confusing it.
And it someone is chronically ill from a mental health disorder, and they are compliant with their meds and still want to terminate, I'm ok with that too. (Provided there are maybe some special stipulations for mental health cases.)

Originally Posted by Salmon Slayer Lenny

And Arachnodisiac, I think you are confusing the shot gun to the head with brain matter everywhere, the C.O poisoning and the hanging with suffering. This is an example of blurred lines confusing 'terminal suffering' with mental health diseases. One does not equal the other.

[Okotokian]

Used to be against it on principle, but as I've gotten older and worry more about long-term, debilitating illness, I've come around to a position of "Hmmmm I might need that some day". Prior to any legislation being proposed, I figured I'd just open the old gun cabinet if that time ever came.

[Sneeze]

Most have you have completely lost your minds and morals.

Human life is the most precious thing in the universe and it should be fought for, tooth and bloody nail until the bitter end.

Just because its inconvenient or painful doesn't mean it should be ended. Life doesn't always fit yours (or my) definition of perfection. Pain is life. Give me death long and slow or make it quick, it doesn't matter. I would take 80 years of agony for just a glimpse of how great the world is.

They will not be ending me easily. Individuals can choose, fine indeed - curious though how AO's typical leftists are now over a sudden all about the individual and their rights.

Steve Earl had a great quote, not about the same subject but I see a similarity.

"Could you take that long walk with me
Knowing hell is waitin' there
Could you pull that switch yourself sir?"

Nope, its easier to sit at home and tell yourself its the best decision while a Dr. sends your loved ones to Never-Never land with what you tell yourself is a painless, quiet, uninvolved death. Shoot me in the face when my time comes and keep your eyes open when you do it.(if you can) Then head home and tell the internet how progressive you are.

[bobtodrick]

I'm for it.
One of the reasons used by the people who are against it is that it isn't natural for us to decide, or a doctor to assist in someone taking their own life.
But it also isn't natural that we have artificial drugs and medicines that prolong life, but take away any sense of dignity or quality of life from the sufferer.

[Salmon Slayer Lenny]

Originally Posted by Arachnodisiac

I'm advocating for the ones who want something different and I can't imagine anyone in EMS not advocating for the option. Note that I don't prescribe mandatory euthanasia - I just believe it should be on the table.

I respectfully disagree. The problem here is that you are attempting to speak on behalf of all EMS practitioners which is quite simply impossible for you to do. Just like no one can speak on behalf of all physicians. The reality is whether you can't imagine it or not, there will be people in EMS that not only don't advocate for the option, they simply won't support it. It is the law of averages and statistics whether you or I like it or not.

You're response should be more along the lines of "I would like to think (or believe) that no one in EMS..." So you are trying to enforce your beliefs on other EMS practitioners.

Originally Posted by Arachnodisiac

Nope, I'm not confusing it.
And it someone is chronically ill from a mental health disorder, and they are compliant with their meds and still want to terminate, I'm ok with that too. (Provided there are maybe some special stipulations for mental health cases.)

This statement to me seems to defy any logic that any right to die legislation would encompass. So you are then implying that chronic mental health issues is a 'terminal disorder' that causes undue pain and suffering and would allow these patients the right to die?

If this is the case, you will not only need to redefine and rewrite the Mental Health Act but also the Psychology and Psychiatry professions as well as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria for such disorders. The DSM-5 is the gold standard for metal disorders.

Herein lies the problem, people want to be guided by their own feelings and emotions but discard evidenced based practice. This happens on both lines drawn in the sand. I'm trying to be pragmatic about it and look at both sides of the argument and come to an informed conclusion.

We need to be guided by level heads and clear minds, not the extreme left or the extreme right or simple emotion. This is a very complex issue with so many layers that we can't possibly comprehend the totality of it. Even if right to die legislation is passed, that's just the proverbial tip of the iceburg. I'll go all in and bet you that someone with a history of chronic depression will not be on the inclusion list.

[Salmon Slayer Lenny]

Originally Posted by bobtodrick

I'm for it.
One of the reasons used by the people who are against it is that it isn't natural for us to decide, or a doctor to assist in someone taking their own life.
But it also isn't natural that we have artificial drugs and medicines that prolong life, but take away any sense of dignity or quality of life from the sufferer.

bobtodrick,

you bring up a great point. There has been a point in health care that palliative care and hospice care didn't necessarily prolong life but rather 'prevented death'. If these things were withdrawn (oxygen, tube feeding, blood pressure medications, IV fluids for dehydration) and the patient were medicated to be comfortable, nature typically (not always) takes its course pretty quickly in a lot of instances.

In Alberta, there have been huge advances within AHS with respect to advanced care planning and goals of care designation. These have become the standard of care which I think people should review before we start talking about the past, we should look at the present and the future.

Advanced Care Planning - http://www.albertahealthservices.ca/info/page12585.aspx

Goals of Care - http://www.albertahealthservices.ca/frm-103547.pdf

[ctd]

Society has in the past had a form of suicide for the frail or weakend. They would walk off into the woods to face their demise against nature. Many society's practiced this up untill modern medicine.Then we forced people to adhere to modern way of life.

[xxclaro]

Originally Posted by Sneeze

Most have you have completely lost your minds and morals.

Human life is the most precious thing in the universe and it should be fought for, tooth and bloody nail until the bitter end.

Just because its inconvenient or painful doesn't mean it should be ended. Life doesn't always fit yours (or my) definition of perfection. Pain is life. Give me death long and slow or make it quick, it doesn't matter. I would take 80 years of agony for just a glimpse of how great the world is.

They will not be ending me easily. Individuals can choose, fine indeed - curious though how AO's typical leftists are now over a sudden all about the individual and their rights.

Steve Earl had a great quote, not about the same subject but I see a similarity.

"Could you take that long walk with me
Knowing hell is waitin' there
Could you pull that switch yourself sir?"

Nope, its easier to sit at home and tell yourself its the best decision while a Dr. sends your loved ones to Never-Never land with what you tell yourself is a painless, quiet, uninvolved death. Shoot me in the face when my time comes and keep your eyes open when you do it.(if you can) Then head home and tell the internet how progressive you are.

Fine, you go ahead and try to live as long as you want, that's your right. Your right ends with you though, and others should have the right to kick off if they need to. I highly doubt you have any idea what 80 years of misery feels like, and seeing how wonderful the world is? Some of these people see little but the inside of the same room for years on end. I'm glad you have as life that you feel has great value, that's awesome, but not everyone has your life. Let them do as they please.

[sns2]

Originally Posted by Sneeze

... curious though how AO's typical leftists are now over a sudden all about the individual and their rights.

I don't think this issue is simplistic enough to be put in a left / right box. That whole system of labeling people is for simpletons. If a person is so predictable that they can be neatly labeled on a two-dimensional spectrum, I would say they need to spread their wings. Life just ain't that cut and dry, even though some narrow minded people would like to make it so. This issue is a perfect example of that.

[Sneeze]

Originally Posted by xxclaro

Some of these people see little but the inside of the same room for years on end. I'm glad you have as life that you feel has great value, that's awesome, but not everyone has your life. Let them do as they please.

You, and no other man is qualified to judge the value of a human life.

Originally Posted by sns2

I don't think this issue is simplistic enough to be put in a left / right box. That whole system of labeling people is for simpletons. If a person is so predictable that they can be neatly labeled on a two-dimensional spectrum, I would say they need to spread their wings. Life just ain't that cut and dry, even though some narrow minded people would like to make it so. This issue is a perfect example of that.

You can try to twist the issue into a pretzel all you want. At the end of the day its a very simple issue. Right or wrong, black or white. Either suicide is acceptable to you or not, because giving men the power over other men to decide the value of their life is a completely unacceptable notion.

[Salmon Slayer Lenny]

Originally Posted by Sneeze

At the end of the day its a very simple issue. Right or wrong, black or white. Either suicide is acceptable to you or not, because giving men the power over other men to decide the value of their life is a completely unacceptable notion.

Sneeze, not to pick on you but I couldn't disagree more with this. I feel that anyone who thinks that this is a simple black or white issue, I don't believe really grasps the enormity of it or is completely informed.

I highly value life, but I also deplore suffering. Which do I value more? It's not a black or white answer.

Also, then who is able to determine the value of a human life if not man?

[walking buffalo]

Originally Posted by Salmon Slayer Lenny

bobtodrick,

you bring up a great point. There has been a point in health care that palliative care and hospice care didn't necessarily prolong life but rather 'prevented death'. If these things were withdrawn (oxygen, tube feeding, blood pressure medications, IV fluids for dehydration) and the patient were medicated to be comfortable, nature typically (not always) takes its course pretty quickly in a lot of instances.


In Alberta, there have been huge advances within AHS with respect to advanced care planning and goals of care designation. These have become the standard of care which I think people should review before we start talking about the past, we should look at the present and the future.

Advanced Care Planning - http://www.albertahealthservices.ca/info/page12585.aspx

Goals of Care - http://www.albertahealthservices.ca/frm-103547.pdf

Why should an individual have to suffer through the time of medical intervention and death? To me, this seems to be an obvious condition in which to help a Human extinguish their life.

Originally Posted by ctd

Society has in the past had a form of suicide for the frail or weakend. They would walk off into the woods to face their demise against nature. Many society's practiced this up untill modern medicine.Then we forced people to adhere to modern way of life.

Current and past societies practice(d) assisted suicide through medications. It is only those societies dominiated by government (court) control that have been forced through threats of incarceration to not follow these tradtional routes to death.


I have and am currently dealing with this issue. There is NO question in my mind that we MUST allow people to die, and to help when needed.

When my father was sick with cancer, we were prepared to do what he asked. His passing was beatiful.

My grandmother is on her deathbed as I type this. There is no hope for her to regain any health, Depsite her earlier verbal wishes to pass away, now that she cannot communicate, she will have to lay in bed and wither away for a few or many more days.....

[bobtodrick]

Sneeze, good on you.
But your beliefs end where mine begin.
My mother has led a life for the last five years that would have most right to lifers sniveling in their boots.

You want to bring up quotes:
Joe South 'Walk a mile in my Shoes'

"Walk a mile in my shoes
Uh, before you abuse, criticize and accuse
Walk a mile in my shoes, yeah"

[MAC]

Originally Posted by Sneeze

You, and no other man is qualified to judge the value of a human life.


You can try to twist the issue into a pretzel all you want. At the end of the day its a very simple issue. Right or wrong, black or white. Either suicide is acceptable to you or not, because giving men the power over other men to decide the value of their life is a completely unacceptable notion.

Neither are you qualified to decide a persons value when they have made their own informed choice



No one is deciding anyone's fate. This is about an individual deciding their own and the ability to have help in carrying out their wish when unable to do so physically.

You would be very fortunate to live out your life and never be faced with a loved one that caused you to question your stance. The easy way out is to do nothing and stand on your morals about life. If that would be acceptable or not will depend on your understanding and compassion for your loved one.
When faced with reality, it is not black and white and packed full of emotion.

MAC

[Salmon Slayer Lenny]

Originally Posted by walking buffalo

Why should an individual have to suffer through the time of medical intervention and death? To me, this seems to be an obvious condition in which to help a Human extinguish their life.

walking buffalo, you seem to be implying that all patients suffer. Also, with your bolding of parts of my statement are implying that when removing these things, again, patients suffer. They may, but they don't need to.

Again, you seem to be making a blanket statement for all terminal or palliative patients based on your own current experiences. You are being guided by your heart and emotion, I understand that. I've lost enough of my own family members through similar experience. I've also cared for and seen many more terminal and palliative patients. I've also seen a lot of 'good experiences' where patients have been amazingly managed, kept comfortable, and died with dignity.

There is also a reality where a terminal patient can be adequately medicated to the point they are comfortable. If they aren't, it's a failure of the patient, their care giver(s) or the system somewhere. There's no excuse for that.

[HunterDave]

Doctors already have the choice of ending someone's life and people go to court in order to stop them from doing it. The only difference is that they disconnect the patient from life support and allow them to die of dehydration. So, what are people saying, allowing someone to die over a period of a week is just nature taking it's course and speeding up the inevitable is unnatural and unethical? IMO it's much more ethical to end someone's suffering than it is to allow it to continue.

Brain dead....who cares? I could think of no greater horror in life than to be fully conscientious and totally aware of everything going on around me but trapped in a non-functioning body and unable to communicate. That to me sounds like a story out of the Twilight Zone.

[Salmon Slayer Lenny]

Originally Posted by HunterDave

Brain dead....who cares? I could think of no greater horror in life than to be fully conscientious and totally aware of everything going on around me but trapped in a non-functioning body and unable to communicate. That to me sounds like a story out of the Twilight Zone.

That's why they do EEG's now on these patients. EEG is one of the best predictors for brain function prognosis,

The 'brain dead' you are talking about and thinking of would have a 'flatline' EEG and would be demonstrating no brain function therefore, have no consciousness at all. Liken it to an ECG of your heart. With no electrical activity in the brain there is no awareness, feeling, or suffering. This isn't to say that comatose patients don't feel, aren't aware, or don't suffer. They can, absolutely.

This brings up another interesting observation and dilemma. There have been numerous documented cases of patients that have been in 'persistent vegitative states' for extended periods, (up to 19 years that I have found) that have gained consciousness.

[Okotokian]

Originally Posted by Sneeze

Human life is the most precious thing in the universe and it should be fought for, tooth and bloody nail until the bitter end.

.

And that's a fair belief for you to hold. NO legislation should ever be able to take away your life if you believe that.

But what if I don't believe that? Why should my rights be limited by your belief?

[fish_e_o]

Originally Posted by Okotokian

And that's a fair belief for you to hold. NO legislation should ever be able to take away your life if you believe that.

But what if I don't believe that? Why should my rights be limited by your belief?

death is just another part of life. imo


freedom should be given to people to do whatever they want as long as it doesn't hurt anyone else

[Sneeze]

Originally Posted by bobtodrick

Sneeze, good on you.
But your beliefs end where mine begin.
My mother has led a life for the last five years that would have most right to lifers sniveling in their boots.

Actually the statement is "Your rights end where mine begin".

Suicide is wrong. Life doesn't always fit your (or my) definition of perfect. It's my line in the sand. Lots of tough talk but start passing out 22 shorts and opening the doors to the long term care facility and it would be a much easier moral dilemma (albeit exactly the same).

Additionally, our government and health care system couldn't organize a two car parade - and you guys want to give them the keys to the gas chamber.

[sns2]

Originally Posted by Sneeze

You can try to twist the issue into a pretzel all you want. At the end of the day its a very simple issue. Right or wrong, black or white. Either suicide is acceptable to you or not, because giving men the power over other men to decide the value of their life is a completely unacceptable notion.

If you think life is black and white that is certainly your prerogative. That's what a general discussion is for - people learning by hearing others' viewpoints. I have learned lots already that I never considered.

[walking buffalo]

Originally Posted by Salmon Slayer Lenny

walking buffalo, you seem to be implying that all patients suffer. Also, with your bolding of parts of my statement are implying that when removing these things, again, patients suffer. They may, but they don't need to.

Again, you seem to be making a blanket statement for all terminal or palliative patients based on your own current experiences. You are being guided by your heart and emotion, I understand that. I've lost enough of my own family members through similar experience. I've also cared for and seen many more terminal and palliative patients. I've also seen a lot of 'good experiences' where patients have been amazingly managed, kept comfortable, and died with dignity.

There is also a reality where a terminal patient can be adequately medicated to the point they are comfortable. If they aren't, it's a failure of the patient, their care giver(s) or the system somewhere. There's no excuse for that.

You have no idea of my knowledge, experience or guiding factors on the matter, nor could you have true knowledge of another individuals suffering. I think it's time for you pull the plug on your claims of blanket statements and implications. Your response is so far out of context that I am doubtful of your qualifications to offer them.

"adequately medicated to the point they are comfortable".... and you include the patient as being responsible.... more blanket talk?

[fish_e_o]

Originally Posted by Sneeze

Actually the statement is "Your rights end where mine begin".

Suicide is wrong. Life doesn't always fit your (or my) definition of perfect. It's my line in the sand. Lots of tough talk but start passing out 22 shorts and opening the doors to the long term care facility and it would be a much easier moral dilemma (albeit exactly the same).

Additionally, our government and health care system couldn't organize a two car parade - and you guys want to give them the keys to the gas chamber.

1. i would never expect a non willing physician to end a life.

2. i would hope that people are putting everything they wish to happen in their personal directives or living wills. this way decisions can be made ahead of time with a level and clear head. be very clear, very specific and update on a regular basis there shouldn't be issues.

[bobtodrick]

Originally Posted by Sneeze

Suicide is wrong. Life doesn't always fit your (or my) definition of perfect. It's my line in the sand. Lots of tough talk but start passing out 22 shorts and opening the doors to the long term care facility and it would be a much easier moral dilemma (albeit exactly the same).

Additionally, our government and health care system couldn't organize a two car parade - and you guys want to give them the keys to the gas chamber.

By your belief system suicide is wrong.
According to Stats Can, 53% of Canadians believe in a 'god'.
So very nearly 1/2 the population doesn't hold themselves to your belief system.
As far as I'm concerned...being that you cannot prove your belief system (proof and faith being entirely different) you have no right to dictate to those who believe in the right to medically assisted suicide in certain cases.
If in fact you turn out to be right...then God (if there is one) will get to deal with people who've committed the sin of suicide...but you have no rights over what I choose.

[catnthehat]

Originally Posted by Sneeze

. Shoot me in the face when my time comes and keep your eyes open when you do it.(if you can) Then head home and tell the internet how progressive you are.

I had a pretty good acquaintance do just that at the request of the other- I think he is out of jail now, and basically said he would do it again if asked.
Cat

[Wild&Free]

if your belief system prohibits you from prematurely ending your life, don't do it

do not use your personal belief system to interfere in the choices of others.

[Salmon Slayer Lenny]

Originally Posted by walking buffalo

You have no idea of my knowledge, experience or guiding factors on the matter, nor could you have true knowledge of another individuals suffering. I think it's time for you pull the plug on your claims of blanket statements and implications. Your response is so far out of context that I am doubtful of your qualifications to offer them.

"adequately medicated to the point they are comfortable".... and you include the patient as being responsible.... more blanket talk?

walking buffalo, I'll ignore the ad hominem argument for now. Let me assure you that I am more than qualified...

And yes I include the patient as being responsible for their care. The care of any patient is a team effort, and the team starts with the patient. If patients under report their discomfort or if they don't accurately report it subjectively, who are we or how are we as caregivers to objectively determine this?

[Salmon Slayer Lenny]

Originally Posted by bobtodrick

By your belief system suicide is wrong.
According to Stats Can, 53% of Canadians believe in a 'god'.
So very nearly 1/2 the population doesn't hold themselves to your belief system.
As far as I'm concerned...being that you cannot prove your belief system (proof and faith being entirely different) you have no right to dictate to those who believe in the right to medically assisted suicide in certain cases.
If in fact you turn out to be right...then God (if there is one) will get to deal with people who've committed the sin of suicide...but you have no rights over what I choose.

We can't assume that every person who believes in a 'god' doesn't support the idea of P.A.D. Nor can we assume that every person who doesn't believe in a 'god' does support it.

Second, the proof in their belief system that you require or would want isn't possible. While you have your own belief system without God or faith, it's still a belief system. You can no more prove your belief system than I can mine.

Lastly, who's to say that God thinks suicide is a sin, or that P.A.D is suicide? And even if it is considered a sin, what's there to deal with? No one sin is any greater than another.

I'm not God, but I believe that He is capable of seeing a much bigger picture than we can possibly even comprehend.

I personally have 'faith' in 'God' and I don't believe that this topic is irreconcilable with what scripture says.

[canuckoutdoornut]

Originally Posted by Newview01

If people believe that assisted suicide will not be followed by the government eventually taking this into their own hands, they need to give their head a shake. This has nothing to do with tinfoil hats either. In the Netherlands, even children up to the age of 12 can choose to die with their parents approval, and up to 16 with only minor parental involvement. It is most certainly a slippery slope that reeks of something along the lines of 'post term abortion'.

Couldn't agree more. It must be excruciating to go through the stories mentioned here and watch someone struggle. But letting government, especially this current federal one, try to take leadership on this is asking for trouble IMHO.