Jackalope

I beg to differ. As a non-terminal patient with chronic pain issues, I have found that adequate treatment is actually quite hard to obtain. Or even minimally appropriate treatment. There are a hell of a lot of drugs out there that are used to get around the issue of using narcotic painkillers...many of which have far worse side effects than Oxycontin, Fentanyl or morphine. But they're not narcotics, so they're used instead. Inadequate pain control is an extremely common cause of suicide in young, non-terminal patients.

Wait til you see someone with cluster headaches (the migraine's evil cousin, sometimes called "suicide headaches"). Or one of the various inflammitory forms of arthritis (many patients express dispair that the disease won't kill them). Or any number of diseases and injuries that leave one alive but in agonizing pain. The american medical establishment for the most part is neither reasonable nor humane in the case of non-terminal patients.

And some people simply have no wish to live on for years once they've hit a certain level of disability. And it should be their right to choose. Right now, the law decrees that if you're too disabled to do yourself in, you're not allowed to ask anyone to help you die. This seems inhumane to me.

To quote something I said at the first interview with my current doctor:
This just doesn't seem fair to me. If I were a dog, I'd have been put down by now. And it would have been considered merciful. The risk of addiction seems a fair tradeoff if I can have a semi-normal life again.

I lucked out. She's a reasonable person, and relatively unafraid of the DEA checking her prescribing records. I know too many gimps who weren't nearly as lucky with their doctors.

--Lee

Gurdur

Jackalope raises a very important point --- but with all respect, it's a bit at varience with the main topic.

Permanent severe pain is a killer; and the pussy-footing around with pain control is a bloody disaster.
Still, one word in defence of the medicos; it's not so much the prejudice of the medicos, but rather of one by society at large expressed through the bureaucratic control of medicine ( ooo ! opiates ! bad ! ) and through the teaching of young, inexperienced medicos in the uni's.

However, there's a flipside to it; back in the late 19th century, you could get pretty much everything legally and easily through your friendly neighbourhood chemist (apothecary); the results were widespread arsenic addiction, laudanum (opium in wine) addiction and abuse of strychine (as a muscular stimulant).

The whole attititude towards severe pain managemnet needs a happy medium, not the end of the pendulum's swing now shown ( Pain ? please go away !)

BTW, there are some interesting middle-ear and cochlear-nerve pathologies that while not terrible in themselves do regularly drive patients to suicide within 3 weeks of expression of pathology.

Scigirl, Jackalope, please pardon me if I seem to be just rambling. A bad habit of mine.

Jackalope

I was thinking more that whenever the idea of physician-assisted suicide comes up, people only ever consider terminal patients. There are plenty of conditions that won't kill but will make life utter misery. And while some of them can be treated, in the US they often aren't. These are the same type of problems that in animals, we usually euthanize them to spare them the misery. We consider it merciful. For some reason, it's considered unthinkable to do the same for a person, even when they beg for mercy.

I personally don't think that palliative care in the US is done acceptably for non-terminal patients. They're denied adequate pain control and often access to drugs that might treat the underlying disorder that's causing the pain. But they're also denied the chance to opt out cleanly. I'd rather that the palliative care improved, but sometimes even that doesn't work to give the patient an acceptable quality of life. Why deny them the chance to choose for themselves?

Palliative care for the dying is getting pretty good. But for those that face decades of pain and disability, the quality of care sucks big green donkey dicks.

--Lee

Jamie_L

Absolutely. And I try to always keep this in mind when I form opinions about situations like this. I may form an opinion, but in the back of my mind I always remind myself that I don't know how I would react in such a situation. I try to temper my judgement of others with that same inner voice.

There are many situations where you just don't know what you would do until you are in that situation. You may have thoughts and hopes and beliefs about what you would do. But do you really know?

Of course not.

Jamie

AnthonyAdams45

'From my experiences and observations, it is very easy for people to take the moral high ground (eg. pro-lifers, anti-stem cell research, etc.) when they are not affected by such issues personally'

What makes these position the moral high ground? I am certain that my commitment to euthanasia, complete with living will directing what treatment is permissible to sustain my life and under what conditions, is the moral high ground.

As to those moral cowards who do not live up to their own standards, this doesn't say anything against those standards, only those who are too weak to live up to their beliefs. And those persons are numerous on both sides of the equation.

scigirl

Jackalope -

Thanks for sharing that story. I guess hearing it makes me think our research priorities might be messed up. Or at the very least, we need more research into these issues, desparately. One hurdle seems to be people's attitudes that chronic pain is "all in your mind" or other such nonsense.

scigirl

Jackalope

Actually, the DEA and their "everyone who has gotten more than one narcotic painkiller prescription must be a drug-seeking addict" is the biggest hurdle. Next after that are insurers and Medicare deciding that some drugs are "too expensive" even when everything else has been tried and failed.

I have relatively good drug coverage, and I've still run into that wall from time to time. And I know more arthritis patients who should be on one of the monoclonal antibody drugs who can't get their insurance to cover it. But it'll cover joint replacement surgery after the damage is done. Stupid stupid stupid. :banghead:

Puck

scigirl, that's not a dignified death. Leaving loved ones to clean your brain matter off the walls? The average person doesn't know proper dosages of what drugs to effectivly OD. It's usually harder to OD than people think, often one will simply pass out and puke up the drugs before they take effect.

I've been caregiver to two loved ones who were terminal. My beloved Uncle had cancer beyond hope when diagnosed. Being an intelligent independant man, he meant to overdose when things got out of hand. Can you imagine how it felt to this person who had been the captian of his ship for over 70 years to be told he did not have the right to determine when he wanted to check out?! When we brought in Hospice, he had to sign a contract that he wouldn't kill himself. He was going to do it anyway, but at that point I had to explain to him that the authorities would be looking at me if he did. They might think I was explicit in his crime. Especially since I checked out books from the library on the topic for him in my name.

When I made a trip home, I received a call from Hospice that he had taken a turn for the worse. When I got back, there was a large bottle of reds missing. Maybe they were stolen by an unsavory guest that visited while I was away. Maybe he took them and that explained his bad turn. I'll never know for sure.

As for pain control for terminal or cronic pain? Please. My Uncle took a fall 24 hours before he died. He came out of his shit fog because of intense pain. He was drugged enough to knock out an elephant, but the pain broke right through and it was a nightmare. I requested Thorzine and to get him into a coma state if that's what it took. Hospice nurse and psyche decided to talk to a Dr. friend to get dosage reccomendations, Dr. reccomemded something less. Of course it didn't touch the pain and I had to raise cain with nurse to get the Thorzine. Once we got it in him and it was able to get into his compromised system, he went into the blessed coma like state, and finally was relieved from that horrible pain. I'll never forget sitting on that bed trying to comfort him and his wild eyes begging for relief, saying over and over, 'it hurts so much sweetheart, worse than anything ever yet'. I think he may have broke his back in the fall...the cancer had spread bad enough to have gotten in the spine and made it weak.

I couldn't have done it without Hospice, they are amazing. But there is only so much they can do and then the patient should have the right to ask for death. Period.

Want more nightmare care stories? I got 'em. The medical profession are heros in my book, but there are times when they should hand a person the right pills and tell them and their family how to use them. And be brave enough to step in and do it themselves if need be. There are times when what they must do according to law is cruel. They don't mind helping bring a life into the world, why is easing one out so distasteful? Why are we so freaked out about death? In a loved one I can see it, but as a professional caregiver? Isn't that a part of caring? It's not like death is a rare thing, everyone does it. Dr.'s usually want to dis-associate right at the end and leave the family to deal with it. BS. Don't quit on me when I may need you the most, doc.

We have wonderful health care in the US, but we are sorely lacking when it comes to end of life and cronic pain. Not many in the medical profession want to face these things, and seem to choose happy care with good outcomes or the money making illnesses. When in reality, helping paitents with the hardest stuff should bring about the most rewards; the trust a human gives a doc to see them through to death would be an honor I would think. I know that I felt sad at my losses, but honored that it was me that was chosen to hold a hand when a loved one had to face the scareist thing any of us will ever do. I've been trusted by two people to be there for them at the worse, and I am left amazed.

winstonjen

I disagree. If they TRULY defended life, wouldn't they find a way to save everyone? Bombing a clinic seems excessive, and what if they killed the woman and the foetus as well?

winstonjen

I agree. The reason why I consider those unaffected by these issues to 'claim the moral high ground' is because they act to bigoted and arrogant, when they do not have first hand experience, and when they refuse to listen to those who have.