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assisted suicide?
Posted: 28 May 2012 02:42 PM   [ Ignore ]
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What do you all think about this?  Should it be legalized?  For all individuals or only those in certain situations?  Are there any conditions that would make it unacceptable? 

Just wondering where everybody is on that.

skooo

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Posted: 28 May 2012 03:04 PM   [ Ignore ]   [ # 1 ]
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skuld - 28 May 2012 02:42 PM

What do you all think about this?  Should it be legalized?  For all individuals or only those in certain situations?  Are there any conditions that would make it unacceptable? 

Absolutely it should be legalized, but of course with stringent regulations.

At least it has to be allowed for terminal illness where the person is in great pain or discomfort.

It is out of compassion that a pet owner will put down a beloved animal which is suffering without remedy. It’s a grave error not to allow humans to do the same to themselves in a similar situation. Death with dignity.

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Posted: 28 May 2012 03:09 PM   [ Ignore ]   [ # 2 ]
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dougsmith - 28 May 2012 03:04 PM
skuld - 28 May 2012 02:42 PM

What do you all think about this?  Should it be legalized?  For all individuals or only those in certain situations?  Are there any conditions that would make it unacceptable? 

Absolutely it should be legalized, but of course with stringent regulations.

At least it has to be allowed for terminal illness where the person is in great pain or discomfort.

It is out of compassion that a pet owner will put down a beloved animal which is suffering without remedy. It’s a grave error not to allow humans to do the same to themselves in a similar situation. Death with dignity.

Yep.

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Posted: 28 May 2012 04:10 PM   [ Ignore ]   [ # 3 ]
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Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.

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Posted: 28 May 2012 06:51 PM   [ Ignore ]   [ # 4 ]
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macgyver - 28 May 2012 04:10 PM

Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.

Wow, I’ve always wondered about that.

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Posted: 28 May 2012 07:13 PM   [ Ignore ]   [ # 5 ]
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Thinking back at the movie “Soylent Green”, the method of euthanasia seemed far preferable than a long period of suffering without any compensating benefits.

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Posted: 28 May 2012 07:31 PM   [ Ignore ]   [ # 6 ]
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I also agree with Doug. I do not want to spend the last few months of my life in a hospital bed with machines keeping my body functioning. We spent $55 billion caring for people in the last two months of their lives in 2008 (source). To what end? So their relatives could visit and lament? That is not only an undignified way to die, it is a living hell. Lying in a hospital bed drugged out of my mind waiting to die reminds of a Harlan Ellison short story, I Have No Mouth, and I Must Scream.

No thanks. Say goodbye and let me go.

[ Edited: 28 May 2012 07:34 PM by DarronS ]
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Posted: 28 May 2012 08:14 PM   [ Ignore ]   [ # 7 ]
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DarronS - 28 May 2012 07:31 PM

I also agree with Doug. I do not want to spend the last few months of my life in a hospital bed with machines keeping my body functioning. We spent $55 billion caring for people in the last two months of their lives in 2008 (source). To what end? So their relatives could visit and lament? That is not only an undignified way to die, it is a living hell. Lying in a hospital bed drugged out of my mind waiting to die reminds of a Harlan Ellison short story, I Have No Mouth, and I Must Scream.

No thanks. Say goodbye and let me go.

What he said!

Take care,

Derek

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Posted: 29 May 2012 05:41 AM   [ Ignore ]   [ # 8 ]
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Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.

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This actually happened to my father-in-law and my favorite aunt. A hospice nurse used morphine in the way you described and my aunt’s doctor did the same for her as described by my cousin. My wife and I were at my father-in-law’s bedside until he died. In his case his heart was giving out causing extreme pain to his limbs; in effect he was dying by inches. My aunt smoked herself to death and destroyed her lungs. I’m 100% in favor of assisted suicide given the right conditions. We all have to go sometime and the thought of lingering in a bed, waisting away is abhorrent. Read Susan Jacoby’s book on the subject “Never Say Die”. It’s a real eye opener especially for us baby boomers.


Cap’t Jack

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Posted: 29 May 2012 09:57 AM   [ Ignore ]   [ # 9 ]
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I took care of my partner through 6+ years of Alzheimer’s disease.  I completely agree that we should have the right to end our lives, but choosing the moment is extremely hard, at least in the case of a progressive disease like Alzheimer’s.  Esther felt the same way I do, she had a copy of Final Exit on her bookshelf and a stash of meds.  But the beauty that is life slipped away so slowly and indistinctly that by the time I was sure she would have wanted to exercise the option to end her life, she was not remotely able to do it.  We, friends and family, spent years attending to her and witnessing a terrible death. Not all agony is physical.  If I were a braver man, or more sure of when I should impose my will, I suppose I’d be writing from a jail cell, but, I don’t have that kind of courage, or surety.  She died, stopped eating and slipped away, and it was way past time she would have chosen, there was almost nothing left, really. The cost to the family, financial and psychological were huge. 

So, maybe some kind of legal protocol would have helped.  Some way to legally force nature’s hand. It would be enormously difficult to design though.  How can any of us know when life will not be worth living.  It is not that I don’t believe that point can be reached, but even in the late stages of the disease there were fleeting moments when it was clear that there were tiny glimpses of beauty in Esther’s life.  What kind of courage does it take to say, “This is the moment, end it now”?  How can anyone make that decision for you?

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Posted: 29 May 2012 09:59 AM   [ Ignore ]   [ # 10 ]
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That’s a much, much tougher issue, Jeciron. I don’t think the answers are nearly so clear or easy then, which is why I picked the easier case first. (Best to establish the principle with the easy case).

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Posted: 29 May 2012 10:06 AM   [ Ignore ]   [ # 11 ]
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This is one of those things that seems so obvious as to not need discussion.  And yet Assisted Suicide and Dr Kevorkian is/was usually the butt of jokes, as if it’s crazy to even consider it.  I’ve never done the research, but something tells me if you were to dig deep you’d find most objections would be religious.  Any religious folks here willing to argue against assisted suicide?

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Posted: 29 May 2012 10:17 AM   [ Ignore ]   [ # 12 ]
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I agree with the principles stated here, but one problem is the person assisting.  There is a spectrum of caring, and Jeciron was at one end.  I’ve met others who would easily administer a cyanide drip if the person’s cold lasted more than three weeks.  This goes not only for relatives but also doctors.  I see regulation as a very difficult problem in the light of this problem.

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Posted: 29 May 2012 01:44 PM   [ Ignore ]   [ # 13 ]
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macgyver - 28 May 2012 04:10 PM

Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.


I believe your assertion that “this happens much more frequently than anyone understands”.  I also think that most people don’t realize that it does happen a lot, because most people would rather not think about it, or acknowledge it.

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Posted: 29 May 2012 04:01 PM   [ Ignore ]   [ # 14 ]
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TimB - 29 May 2012 01:44 PM
macgyver - 28 May 2012 04:10 PM

Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.


I believe your assertion that “this happens much more frequently than anyone understands”.  I also think that most people don’t realize that it does happen a lot, because most people would rather not think about it, or acknowledge it.

Perhaps, but perhaps also because we as physicians don’t really think of it as assisted suicide. We see it as providing comfort to a dying patient with a hopeless and painful condition and if death is the ultimate outcome well that was always going to be the case anyway.

This is always done as part of a unified family decision of course. The term assisted suicide is not used. We call it comfort care but the family is informed that the expected course is that the patient will eventually stop breathing in large part due to the medication. It never really takes on the Kavorkian sort of tone.

The difference is that Kavorkian was trying to push a subject into the public consciousness. We as physicians are trying to quietly take care of our patients.

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Posted: 29 May 2012 04:34 PM   [ Ignore ]   [ # 15 ]
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macgyver - 29 May 2012 04:01 PM
TimB - 29 May 2012 01:44 PM
macgyver - 28 May 2012 04:10 PM

Doug really summed it up well.

What most people don’t realize is that this happens much more frequently than anyone understands. Most physicians have performed a form of assisted suicide at some time in their careers. Nearly all of us have had terminally ill patients whom we treat with morphine to control pain. As the pain increases we often need to increase the morphine dose to higher and higher and eventually to lethal levels to keep the patient comfortable. Morphine suppresses the respiratory drive and in most of these patients its the morphine not the disease that leads ultimately kills them.


I believe your assertion that “this happens much more frequently than anyone understands”.  I also think that most people don’t realize that it does happen a lot, because most people would rather not think about it, or acknowledge it.

Perhaps, but perhaps also because we as physicians don’t really think of it as assisted suicide. We see it as providing comfort to a dying patient with a hopeless and painful condition and if death is the ultimate outcome well that was always going to be the case anyway.

This is always done as part of a unified family decision of course. The term assisted suicide is not used. We call it comfort care but the family is informed that the expected course is that the patient will eventually stop breathing in large part due to the medication. It never really takes on the Kavorkian sort of tone.

The difference is that Kavorkian was trying to push a subject into the public consciousness. We as physicians are trying to quietly take care of our patients.

I understand the contingencies and am not advocating a different course.  Except that the general public’s avoiding consciousness of the actualities of such practices seems problematic to me, in that a large number of members of the public will someday be involved in such a decision for a loved one.  So I might agree with Kavorkian in his attempts to have us face up to end of life decisions more directly and honestly.

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