Assisted death.

[Admin]

http://news.bbc.co.uk/1/hi/health/4763067.stm

I actually saw this on the news and I didn't like the argument against allowing this.

It's not something that I've considered in great detail so this is just a superficial reaction (at the moment).

Arguments against were based on morality, religion, and personal opinion.

The thing is, this is not being proposed as compulsory, merely as a right to die for terminally ill patients at a time of their choosing.

So, in principle, should people, who are terminally ill and facing a short future that offers increasing pain and suffering before their inevitable death, be allowed assistance in achieving an early death?

I believe they should, and I can't see any good reason why the choice should be denied them. If they are religious, or have other oppositions, they're free not to take up the choice.

[Lord Muck oGentry]

John,

Here is a link to the bill itself:
http://www.publications.parliament.uk/pa/ld200506/ldbills/036/06036.1-4.html#j001

I haven't come to a firm opinion about it yet, but I think it's essential to know the wording of the bill.

[Jocky]

I have profound reservations about the wisdom of allowing euthanasia. I can see the obvious "freedom" argument in favour, but this is one freedom which is fraught with peril. If you get it wrong, you can't go back and try again ...


Arguments against were based on morality, religion, and personal opinion

Sounds slightly like you are equating these three things. No False Analogies please! I think that moral arguments are permissable in this context.

However, here's a practical one. If people have the right to decide to die, there will be pressure upon them to make that choice. Pressure from society, from relatives, and most of all pressure they put upon themselves because they feel they are a 'burden'. There is a real danger that such pressure will be an undue influence wihch will result in people making inapproriate decisions to end their own lives prematurely.

[Admin]

Arguments against were based on morality, religion, and personal opinion

Sounds slightly like you are equating these three things. No False Analogies please! I think that moral arguments are permissable in this context.


I'm equating them in the sense that they are all subjective in nature. My point being that why should a right be denied me (or whoever) due to someone else's subjective assessment of right and wrong.

Of course, it's easy to argue the case for assisted death if an obvious case is cherry-picked. If I know that I have six weeks of excruciating pain ahead of me with certain death at the end of it then why not end it early?

However, cases are not always clear cut and this is not a black and white situation. It's probably just as easy to argue against by picking out someone who is persuaded that an early death is in their best interests where in fact it's in others' interests (inheritance issues for example).

Not an easy issue, but I do think that, in principle, we should have the right to an early death if the circumstances are right.

[Jocky]

I'm equating them in the sense that they are all subjective in nature. My point being that why should a right be denied me (or whoever) due to someone else's subjective assessment of right and wrong.

I agree that all these modes are subjective - but that does not make them equivelant ot each other, or irrelevant to this point. IMHO There are legal and ethical questions to which no one objective answer exists, this being one such. As you rightly say, every individual case is different and therefore any generalised solution is going to be inapproriate for somebody's specific situation.

'Rights' are denied as a result as a consequence of subjective opinions all the time: for example when a court puts a gagging order on someone, which comes down to the subjective (although informed) opinion of a judge.

I accept your point of principle, but this is not an ideal world. I'm not sure that turning the principle into a legal 'right to die' would be a very good pragmatic solution.

Is it better that some people die unnecessarily in order to prevent others from having to live in pain, or is it better the other way round? :-\

My preference is to live (no pun intended) with the status quo. Like capital punishment, the big problem is that mistakes cannot be undone after the event. Once you're dead you're gone, whatever Derek Acorah might say ;)

[Admin]

I pretty much agree with that. The only part I question is:



Like capital punishment, the big problem is that mistakes cannot be undone after the event.


I accept the capital punishment argument (I'm not in favour) but I think assisted death should only be used when the person is terminally ill anyway.

Having said all that I have, I should acknowledge that I haven't looked into this deeply - my OP was just a reaction to the bad arguments against that I saw on the news.

[Jocky]

I think assisted death should only be used when the person is terminally ill anyway

Oh yes, I understand that is your position (I'd have disagreed much more strenuously if I thought you were proposing general euthanasia!!)

The problem with "terminally ill" is that nobody can be sure how long there is to go or what quality it will be, until very close to the end - and sometimes not even then. Legislation framed in this kind of way could leave doctors with an agonising decision about whether someone was 'terminally ill enough to count', or something. I know they have agonising decisions as things stand, as well - but I feel that legislating further would not necessarily make things any better.

I'm not a doctor though. Any MDs around with an opinion on this?


my OP was just a reaction to the bad arguments against that I saw on the news

I appreciate your dislike of 'woo' arguments, and I hope I've flagged up a few more pragmatic ones which make sense.

I still think that there is a place for subjective moral positions in debates of this specific kind, though. Perhaps a different thread to discuss this question more generally would be in order - skeptics are often attacked as "amoral", as if not believing in God turned us all into monsters >:D whereas in fact we are all such good little boys and girls :angel:

[Aardvark]

Why not just let the patient decide??

Informed consent.

If my QOL becomes that bad I would to be able to make the decision, the problem is that what we classically consider to be end stage may leave us with no ability to act.

For which of these would we want to pull the plug on ourselves, would we still have the capability?

1 Severe intractable pain of end stage malignancy
2 Severe pulmonary distress caused by Lung CA
3 Unresponsive psychotic states
5 Severe personality shift with no comprehension of self or being
6 Persistent vegetative state
7 Severe circulation collapse of end stage congestive cardiac failure
8 After several major CVAs have destroyed most of your past and present
9 Same but caused by trauma or dural haematoma
10 dually incontinent and severe depression

I was with some Palliative care people today who said that pain alone should never be a reason as they can make anyone pain free, so why do we have this image of pain in terminal illness.

So my question is, what would be the specifics for YOU, how would you know when were at this point.??

Intrinsically I would like the option of a suicide pill and hope that I would have the sense to take it before I could no longer make the decision and follow through.

[Jocky]

Certainly all those end stages could be quite unbearable :( and anyone could see why someone in that position may wish to bring it to an end.

It is also understandable that someone (Doctor or loved one) might feel that the greatest good under the circumstances was to assist the patient in doing so.

As things stand, anybody doing this could find themselves charged with a range of different criminal offences, depending on the circumstances. The rights and wrongs of the situation can then be tested in court

However if the law changes, the circumstances surrounding assisted suicide would not always be so tested - the patient's signature on the declaration would exonerate the doctor making the prescription, and would also make it very difficult to act against anybody who may have applied undue pressure on the patient while they were making the decision.

Not everybody is equally strong-minded and well-informed - and of course nobody is at their decision-making best when in great pain or suffering from the kind of mental disturbances to which you allude.

This is a difficult question, and it seems to me to comes down to where you feel that the biggest risk lies - the risk of some people dying slow and terrible deaths which could be avoided, or the risk of other people dying needless deaths which could be avoided.

My concern is that if the end of life is "fast tracked" in this kind of way, great wrongs could be done and never discovered.


So my question is, what would be the specifics for YOU, how would you know when were at this point.??

I don't know. I find it difficult to imagine that anybody (other than perhaps medical personnel with substantial personal experience of this kind of thing) could possibly know.

Do you?

[doubting thomas]

I have always made my family aware that if i end up in a vegetative state through an accident or some horrible disease then i would not want to live.

The thought of lying completely immobile in a bed having to have people look after my every need 24hrs a day scares me greatly.

What is the point of living if you cannot move, think or talk to anyone.

[Aardvark]

I am starting to see both sides of this debate.

I may well come down on a middle ground where a special court is set up to fast track end of life request applications. This would have to be an MDT approach with a reaction time of less than one week.

The alternative I suppose is to stay as we are and test each action after the event, but this leaves doctors working in a grey area.

I am not sure that I would know when I considered my own life to be beyond salvage.

In short Jocky, you make some good points and I am now fence sitting

[Jocky]

I think the idea of a 'fast track' way of testing such applications is a very interesting one. I haven't heard it proposed before.

The political difficulty with such a thing is that it would be rather expensive, compared to a simple patient-signs-declaration thing which is obviously cheap.

In a sense, I'm on the fence too. I don't like the idea of a slow painful death, for me or anybody else. I do feel that a change in the law like the current proposal would be a dangerous step, but that is not to say that I take a moral position that it is wrong to do this under any circumstances. There are those who do take such a position.

As I said earlier in this thread, I think that moral positions of this type are understandable, even if skeptics do baulk at such positions when they are expressed in religious terms.

[Hazen]

I have always made my family aware that if i end up in a vegetative state through an accident or some horrible disease then i would not want to live.

The thought of lying completely immobile in a bed having to have people look after my every need 24hrs a day scares me greatly.

What is the point of living if you cannot move, think or talk to anyone.


I'm of much the same opinion here, but there is the possibility that advances in medical science may in the future be able to treat the condition from which you suffer.

[median]

So, in principle, should people, who are terminally ill and facing a short future that offers increasing pain and suffering before their inevitable death, be allowed assistance in achieving an early death

Take the above example and substitute the word 'animal' for the word 'people'. Does the reaction change?


I don't know. I find it difficult to imagine that anybody (other than perhaps medical personnel with substantial personal experience of this kind of thing) could possibly know.


Here for me lies an answer. The decision should be left to those qualified to make those decisions.
Those who would understand if new treatments would be available within the timescale.

As for so called religious arguments against I would point out that possibly less than 300 yrs ago there were such argumenst against the use of anaesthetics (http://www.general-anaesthesia.com/objections.html).

Would we like to return to those times?

[Admin]

http://news.bbc.co.uk/1/hi/wales/5045832.stm

I've been partying and drinking (mother's birthday today) - but I saw this link and wanted to leave it. What a sad story. :(

[Hazen]

Just to take things a step further:

http://www.guardian.co.uk/frontpage/story/0,,1792711,00.html

[Aardvark]

sob :'(

[Lord Muck oGentry]

Just to take things a step further:

http://www.guardian.co.uk/frontpage/story/0,,1792711,00.html


Two points struck me immediately about this. The first is that Doyal dismisses as a legal fiction the distinction between what is done and what is allowed to happen, although this distinction is embedded in everyday moral thinking. The second is that, having dismissed the distinction, he seems to think that we are left with an obligation to end life in many more cases. Yet the distinction is usually collapsed ( in my limited experience) by those who argue for preserving life by heroically prolonged intervention.

Anyway, here is a link to further reading on medical ethics, from a source to which Doyal has contributed:

http://www.ethics-network.org.uk/Ethics/eendlife.htm#acts