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Old 01-04-2003, 04:34 PM   #21
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But ultimately we ALL have that right - any one of us could kill ourselves with not that much effort, and without enlisting the endorsement of the AMA. If it's that right and moral and good, why do they need the doctors?
Because sometimes the patients become too weak to commit suicide without help. THAT'S when they need the doctor's help.

Yes, we all have that right - except those unlucky enough to be quadraplegics, or who have MND and can't move their arms. By making euthanasia and assisted suicide illegal, all we are doing is removing that option from those that are too weak to do it alone.
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Old 01-04-2003, 04:45 PM   #22
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Here's some interesting (and I think somewhat surprising) facts about euthanasia:

http://www.deathwithdignity.org/reso...a_11-16-00.htm

Feel free to read the study - I'm going to post part of it to save space:

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Objective To determine the attitudes of terminally ill patients toward euthanasia and PAS, whether they seriously were considering euthanasia and PAS for themselves, the stability of their desires, factors associated with their desires, and the proportion of patients who die from these interventions.

Of the 988 terminally ill patients, a total of 60.2% supported euthanasia or PAS in a hypothetical situation, but only 10.6% reported seriously considering euthanasia or PAS for themselves. Factors associated with being less likely to consider euthanasia or PAS were feeling appreciated, being aged 65 years or older, and being African American.

Factors associated with being more likely to consider euthanasia or PAS were depressive symptoms, substantial caregiving needs, and pain.

At the follow-up interview, half of the terminally ill patients who had considered euthanasia or PAS for themselves changed their minds, while an almost equal number began considering these interventions. Patients with depressive symptoms and dyspnea were more likely to change their minds to consider euthanasia or PAS.

Conclusions In this survey, a small proportion of terminally ill patients seriously considered euthanasia or PAS for themselves. Over a few months, half the patients changed their minds. Patients with depressive symptoms were more likely to change their minds about desiring euthanasia or PAS.
Here's some statistics the discussion mentioned:
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They also show that, contrary to general perceptions, depression and hopelessness, rather than pain, seem to be the primary factors motivating patients' interest in euthanasia or PAS.

Additional information regarding patients' attitudes and practices related to euthanasia and PAS is needed. First, few of the patients previously interviewed regarding euthanasia and PAS were terminally ill....Furthermore, studies of patients have been largely one-time assessments; yet, because euthanasia and PAS are irreversible actions, longitudinal assessments of patients' attitudes and preferences are important. Also, to our knowledge, no study has followed up patients until death to determine what proportion of patients actually use euthanasia or PAS. Finally, no study has determined whether families were comfortable with the deaths when patients requested and died by euthanasia or PAS.
A good resource for studies on euthansia can be found at pubmed:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

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Old 01-04-2003, 04:48 PM   #23
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I see. But why did they need several months to change their minds? If treatment really was that good, it shouldn't have taken so long (IMO).
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Old 01-04-2003, 05:00 PM   #24
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winstonjen,

I'm not arguing that treatment is the best, or that there aren't situations where euthanasia or PAS isn't warranted, or anything like that. All I'm saying is that - this issue is complicated and needs further study.

Doesn't it bother you at all that some patients who requested PAS eventually changed their minds? When I read that, it made me very glad that we don't just carry 9 mms in our offices and as soon as a patient mentions suicide, we whip it out and shoot em. I know that's not what you are advocating - but it appears to me that any restrictions on euthanasia are being met with opposition.

In some ways, many of my objections to euthanasia parallel my objections to the death penalty. Although they are obviously much different issues, one thing they do have in common is finality. It would sure suck to find out later that 1) the guy was innocent after all or 2) the guy really didn't want to die, he just needed to hear his famly tell him he was loved.

If I ever do prescribe that pill, I want to be sure I'm doing the right thing. And I want to re-evaluate my decision every single time, because there is not just one right and easy answer.

I also want assurance from the society that is looking to me to 'save them' that they will make a firm committment to research pain and mental illness. And no I won't just "wash my hands of the issue" and make the nurse do it. If it's right and moral, than it should be done by the doctor, not passed off to the nursing staff.

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Old 01-04-2003, 05:04 PM   #25
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Originally posted by scigirl
.......
In some ways, many of my objections to euthanasia parallel my objections to the death penalty. Although they are obviously much different issues, one thing they do have in common is finality. ....

I also want assurance from the society that is looking to me to 'save them' that they will make a firm committment to research pain and mental illness. And no I won't just "wash my hands of the issue" and make the nurse do it. If it's right and moral, than it should be done by the doctor, not passed off to the nursing staff.

scigirl
Excellent post, excellent points. :notworthy

If we bumped off everyone who ever had a suicidal mood/thought when they had it, we'ld have rather a catastrophic population decrease ---- not to mention that in more serious cases, people can and often do recover (with or without treatment) from suicidal depressions.
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Old 01-04-2003, 08:25 PM   #26
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Doesn't it bother you at all that some patients who requested PAS eventually changed their minds? When I read that, it made me very glad that we don't just carry 9 mms in our offices and as soon as a patient mentions suicide, we whip it out and shoot em. I know that's not what you are advocating - but it appears to me that any restrictions on euthanasia are being met with opposition.
I support controls and restrictions being put on any legalised form of euthanasia. What I am trying to say is that I feel that there is a big difference between a temporary suicidal urge from a depressed teenager, for example, and a sustained request from a terminally ill patient. When their insides are leaking out, and every moment is agony, do we REALLY want them to live, just for the sake of living? Of respecting the 'sanctity' of life?

I question what counselling they used to convince the terminally ill. To me, I'm curious as to what methods they used - brainwashing, false hopes and lies are possibilities - there isn't any other way I can see.
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Old 01-05-2003, 11:02 AM   #27
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Jen, I agree - but once again you are shining a spotlight on the extreme cases, not the normal cases. Remember that article suggests that most people who request eu/pas are indeed not terminally ill.

I wonder - do you have hospital experience? I don't mean to sound snotty - I just wonder where you are getting these scenarios. I sincerely hope that they aren't occuring in Australia! Here in the USA, people aren't dying in agony with their guts spilling out and the doctors and nurses standing around saying "well look at that." (Ok maybe they are in teaching hospitals! No, not even there.)

I think it's important when talking about euthanasia to leave the rhetoric and extreme examples that everyone can agree on at home. . . and talk about the larger percent of cases that are controversial. Jen, nobody that I know that's working in the health care field (and that includes a lot of people) wants to see scenarios like that either.

Actually I think we agree on most issues here - I just want to make sure that if we do start legalizing euthanasia and PAS, that those concerns I addressed earlier are met: 1) safeguards, and 2) a committment by society to reduce the need for euth/PAS in the first place.

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Old 01-05-2003, 03:50 PM   #28
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Originally posted by scigirl
Jen, I agree - but once again you are shining a spotlight on the extreme cases, not the normal cases. Remember that article suggests that most people who request eu/pas are indeed not terminally ill.

I think it's important when talking about euthanasia to leave the rhetoric and extreme examples that everyone can agree on at home. . . and talk about the larger percent of cases that are controversial. Jen, nobody that I know that's working in the health care field (and that includes a lot of people) wants to see scenarios like that either.
I agree, so my suggestion is to legalise PAS/euthanasia for those people in those extreme situations, and take all other cases on a case-by-case basis.
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Old 01-05-2003, 07:55 PM   #29
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winstonjen asked, "Also, why do pro-LIFErs bomb abortion clinics and KILL people?"

Put yourself in the place of a pro-lifer. They don't believe in taking a life when unnecessary. However, they support killing to stop other killing. That is, if a madman is on a shooting spree, and someone can only stop him by killing him, then a pro-lifer would support killing the madman. In this case, the killing is necessary.

Now, add to this idea of "killing to stop a killer is okay if there is no other option" the concept that a fetus is just as much a person as an abortion doctor. Now, add in that the pro-lifers have been trying legal means for 20-30 years, and the "murders of fetuses are still occuring". If these assumptions are believed, then killing the abortion doctor that is about to kill a fetus is okay.
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Old 01-05-2003, 10:45 PM   #30
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Originally posted by scigirl
.....
I think it's important when talking about euthanasia to leave the rhetoric and extreme examples that everyone can agree on at home. . . and talk about the larger percent of cases that are controversial.
Indeed. :notworthy

Quote:
Actually I think we agree on most issues here - I just want to make sure that if we do start legalizing euthanasia and PAS, that those concerns I addressed earlier are met: 1) safeguards, and 2) a committment by society to reduce the need for euth/PAS in the first place.
Again, :notworthy

As for assisted suicide - which is what we're talking here - there is an interesting legal parallel in Germany to abortion.
In Germany, it is illegal for a doctor to assist with an abortion --- but there is no legal penalty, as long as the patient went to the required counselling session beforehand.
This means a doctor cannot be forced to carry out an abortion, but if he/she does (after the patient has received counselling), then there is no penalty for the doctor (or patient) whatsoever.

The Netherlands and Sweden have the most interesting laws on assisted-suicide etc.; I recommend digging up the info from there (still, you probably know all of this already; my apologies if I'm simply stating what you know already).

Quote:
Originally posted by winstonjen

....When their insides are leaking out, and every moment is agony, do we REALLY want them to live, just for the sake of living? Of respecting the 'sanctity' of life?
Many terminally-ill do wish to die with dignity, and with some semblance of normality; you appear to assume the opposite.

Furthermore, consistant, long-term suicidal ideation is most often a consequence of psychiatric illness ---- and being very ill can lead many to such, even when they are not terminally ill.
It would be a crime to help or allow someone to kill themselves just because they pathologically felt like it.

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I question what counselling they used to convince the terminally ill. To me, I'm curious as to what methods they used - brainwashing, false hopes and lies are possibilities - there isn't any other way I can see.
Puh-leeeze --- no-one goes around brainwasing the terminally ill.
And a whole branch of palliative care for the terminally ill exists - the hospice system.
Why not find out what they actually do, instead of imagining the most dramatic slurs ?

Hospice patients are fully aware they are terminally ill - that's hy they get sent off to hospices, it's so they can die with some semblance of comfort.
A hospital's job, OTOH, is to try every which way in aggressive physical therapy to heal the patient or to at least stop them from carking it; making decisions about who or who should be allowed to die --- especially with assistance --- is a terrible burden to ask doctors to take on; and they are the ones most qualified.
Doctors usually have an extremely high commitment to healing their patients; it's a nasty blow to them to ask them to bump off the patients instead.
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