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The Economist: right to die


No Excuses

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IT IS easy to forget that adultery was a crime in Spain until 1978; or that in America, where gay marriage is allowed by 37 states and may soon be extended to all others by the Supreme Court, the last anti-sodomy law was struck down only in 2003. Yet, although most Western governments no longer try to dictate how consenting adults have sex, the state still stands in the way of their choices about death. An increasing number of people—and this newspaper—believe that is wrong.

The argument is over the right to die with a doctor’s help at the time and in the manner of your own choosing. As yet only a handful of European countries, Colombia and five American states allow some form of doctor-assisted dying. But draft bills, ballot initiatives and court cases are progressing in 20 more states and several other countries (see article). In Canada the Supreme Court recently struck down a ban on helping patients to die; its ruling will take effect next year. In the coming months bills will go before parliaments in Britain and Germany.

http://www.economist.com/news/leaders/21656182-doctors-should-be-allowed-help-suffering-and-terminally-ill-die-when-they-choose

Interesting topic that IMO deserves more traction. We should be progressing towards having the right to assisted death at a faster pace hopefully. The model in OR seems to be working well.

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Yes, I've posted on it many times.

 

the advances in medicine make death a choice and life a burden in many cases, yet that choice is naturally both difficult and has numerous hurdles.

 

the right to die is as important as the right to life.

 

The MIL keeled over a few months back, luckily the wife was there and EMT responded in minutes,no pulse or heartbeat......and a signed DNR.

 

Did you know you need a special/different DNR for emergency responders?

 

After cpr and intubating she was brought back and days later resumed consciousness, at which point we asked her wishes as far as removing support, she nodded no......days later she doesn't remember any of it.

 

slowly coming back after months.

 

I've made the choice to end life several times, it always comes with a price.....as does life

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Dignity.

I think that's the key point here.

 

A noble goal that is difficult to achieve.

My dad died after a good meal with his sons, of course keeled over on the porch with ants crawling on him left a bit to be desired in the dignity part.

 

still better than many., certainly better than my mother who I chose to watch drown on her own saliva over days....... over the alternative.

 

 

life sucks at times and death with dignity is largely a illusion.

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I'm for it.

Sometimes it seems as if we're kept alive beyond any possible reason for living, except there's still money to be bled.

 

It's definitely about dignity, and it's also about personal choice when faced with terminal illness or severely debilitating condition that comes at the end of life.. something like ALS is a good example.

 

~Bang

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Yeah, I'm a big quality of life guy. Spent too much time in nursing homes. There is a point of pain, suffering, and decline where a person exists, but does not live. There should be a right to die.

 

Mind you, as I write this I think of teen suicide rates and think that we need to be careful. There should be a right to die and I know when we say this we are all primarily talking about the elderly or in some cases, people with extreme illnesses, but there are a subset of those for which the prerogative to live needs to be pushed too. We need to support life medically, with mental health, and other means... the right to death is only after other means are exhausted (I think) That probably goes for all facing their mortality in some fashion.

 

I do know that I never want to live on machines. I never want to be a nursing home zombie drugged out of my mind on pills or rolled around without a functioning mind. On the more difficult side, would I want to be Stephen Hawking unable to move, dress, feed myself, but be mentally intact? It's a very complex issue.

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This may get me called a lot of names, but should people be allowed to put a FINANCIAL limit on their "suicide contract" or whatever you call it?

Should my father, say, who spent six years in a nursing home, at a cost of around $12,000 a month, have had the right to, say, execute a document that says "if keeping me alive costs more than $250,000, then I'd rather chose suicide, and leave my family a bigger estate"?

Or is the desire to provide an estate (or not be a financial burden) not a good enough reason?

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I certainly would not like it to be financially based. I fear the ease of abuse and pressure from "loving" relatives in this case. Besides, what if Dad was osteoporotic. He just had his fourth surgery to repair a broken bone, but otherwise he's in good health, good spirits, and mentally astute... but the price of the operations kick him over the edge. Hospitals can be darned expensive as can be nursing homes.

 

You really would run the risk of ending the lives or stopping care for people who are relatively well.

 

Mind you, I do think "extraordinary care" requirements need to be a part of the consideration.

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Note that, if the patient is mentally competent, then he can change the terms at any time.

Which is where the danger of abuse lies. If the family pushes the patient who has not been deemed incompetent they can take advantage of them.

 

I'm looking at the worst case vs. the best case. Just not sure that I want life and death to boiled down to money and the size of the inheritance estate. It should be about the person's best interests... no their families.

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Something tells me that the standard of whether someone is competent will be somewhat different, when the patient is saying "I want to be killed", than when he's saying "please no".

I confess, I really don't know how dad felt about the last six years of his life. Whether he would have wanted such an option. (Although I'm absolutely certain that I would want it).

Dad never expressed any desire to end his time in the nursing home. For the first year, I'd say he was both competent, and content. He wasn't really happy. But then, he didn't want much in life. Laying in bed, and having somebody get him up three times a day, and take him to eat with a few buddy's, then back to bed till the next meal, was a pretty good life, for him. Now, the last three years? Yeah, he pretty much resented the fact that they kept getting him up, to feed him.

I don't KNOW if maintaining him, that way, was better than a lethal injection, or not. I don't think he was mentally competent, for the last 3-4 years. I'm not certain whether he was, for the first two.

In short, I think that questions of whether someone is competent, or whether it is a mercy for them to die, are often really grey areas.

Part of me is grateful that I didn't have the power and responsibility of making that decision, for dad.

(And part of me is rather ashamed, that I'm so ignorant of his life, and his wishes, that I don't know).

I wonder the same things, about mom. Frankly, it's at least possible that it would have been a good thing, if she had died, 2-3 years ago.

----------

But, here's some things that I do know:

If Dad had told me, after a year in the nursing home, when his mind was pretty clear, and when I, at least, considered him competent to make major decisions, that "hey, I can see the writing on the wall. I'm never going to leave here. I may live for a long time. My heart's good. I'm big and strong. I eat well. But I can't stand up, and never will. I spill food on myself when I eat. I can't get to the bathroom. (And don't even know when I need to). I really don't want to spend another five years in purgatory, in a state of 'not quite dead yet'. I'd rather just quit now, and save my heirs a half million dollars", that society would not have allowed him, or anyone else, to make that decision.

The mere fact that he expressed that desire, would be considered proof that he can't make it. And the same would be said of anyone else expressing that opinion.

Whereas, if he had executed such a document, ten years earlier, then the document would establish that these wishes aren't just the rantings of a mind that might be decaying. That they aren't some thoughts that he just recently came up with.

A document like that also eliminates the desire to play "well, he doesn't really mean that, let's just ignore him".

----------

And I am absolutely certain that, if such a document existed, it would be filled out, signed, notarized, and sitting in my fireproof safe, right now.

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I made my living will while going through the process of diagnosis for my MS.  I agreed to fulfill the role of my dad's medical power of attorney only after he gave me a living will so that I will never be in a position of guessing his desires on life and death.  

 

I have had discussions with my sister-in-law, a family practice doc in WA where they recently passed a law allowing assisted suicide.  She has misgivings about the law and the potential need for her to authorize it.  Still, I think I have won her around to the need felt by many hopeless, suffering patients.  We would put down our dog if it was in pain and no longer able to enjoy life, all in the name of humane treatment.  However, a human deserves less "humane" treatment?

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