excreationist

Note: I was writing this is a detached state of mind and it might seem a bit morbid - but I thought it might be an interesting topic to discuss.
-----------------

I think that many or most cases of depression involve the person not liking their life, and wanting things to be different or wanting to escape it altogether.
Now, of course, it would usually or always involve a malfunctioning brain... they might focus on negative thoughts far too much and get into a vicious cycle.

Maybe terminally ill people who want to die are depressed - they at least would be suicidal. How are terminally ill people different from (other?) depressed people? Some people might say that other people can be helped through medication, etc... well sometimes young suicidal people aren't helped very much by medication... and may be directed towards other treatments like electroconvulsive therapy (shock therapy). If that doesn't work, people would still say the young suicidal people are "depressed"...

How can people be sure that those who are terminally ill and feeling suicidal can't be helped with psychiatrists, medications, institutionalisation, shock treatment, etc? With young people they can take years to get over it or never really get over it at all - and it is called a mental illness. Why not call the suicidal thoughts that a terminally ill patient might have a mental illness? Perhaps it is because the public would think people with a terminal illness have a better reason to want to die... but remember that people with a terminal illness know they are going to die fairly soon... those who are young would ordinarily have many decades of life left.

If both kinds of people (the healthy suicidal people and the terminally ill suicidal people) have a mental illness, why does society treat this mental illness differently? In places where euthanasia is legal or semi-legal, suicidal terminally patients have their wishes granted - but other suicidal people are discouraged or even forced not to commit suicide.

I'm saying that maybe it is logical to treat these two groups of people the same. This would mean thinking that their suicidal thoughts are irrational, due to their mental illness, and/or allowing them the option of suicide (and assisted suicide). Giving them all the option of suicide (perhaps after a set amount of time of depression) would dramatically affect society but I'm not sure if it would ultimately make things worse or not. I mean after a while, people mightn't feel so guilty or angry if someone close to them kills themselves.

Jackalope

Uh, I think you're not paying too much attention to the meaning of the words you're using. "Terminal" means "if you're really lucky, you'll get to live out the next six months or so in terrible pain." It means that all the drugs in the world aren't likely to save your life. Which means the doctors usually don't feel bad about pumping you full of painkillers. So you're going to die, but at least you'll be doped up. On the other hand, some people might prefer a clean, quick death over a lingering one in the hospital.

Chronic conditions, on the other hand, won't kill you. They're often painful and/or disabling. And at least here in the US, the least likely to be treated with adequate doses of painkillers. Those are the conditions most likely to make someone suicidal. And then there are the conditions that involve disfunctions of the brain and nervous system. Is it still worth living if there's no one there to think anymore?

And don't forget, many of the drugs that are used for painful, chronic conditions have side effects that may also make life seem less worthwhile. Some of them are even toxic. It makes the decision a lot less clear-cut.

[To be fair, I have rheumatoid arthritis, and I'm currently on a whole shelf-load of toxic drugs because I think a shorter lifespan is an okay tradeoff if the alternative is a long life where I'm too disabled to dress or feed myself.]

excreationist

I did say this:
So at least in some of my post, I was saying that those with a terminal illness are expecting to die soon. When you say they are "doped up" with painkillers, this suggests that they aren't in terrible pain. And even if they are in terrible pain, wouldn't a suicidal person who is in chronic pain with a life expectancy of another 50 years have more pain ahead of them?

Yeah, and some people with healthy bodies might prefer a clean, quick death than a lingering one in a drawn out, lonely and meaningless life - that would last for decades longer.... my point is that those two kinds of people could be seen as being in the same boat.

I wonder why that is though...? Maybe using strong dosages of painkillers in the long term can adversely affect those who have to deal with everyday living. Or maybe people need more and more to get the same kind of relief from pain.

I thought those who advocated euthanasia mainly focused on the "terminally ill". I'm talking about the terminally ill who want to die vs. other suicidal people, including the elderly who are fairly healthy in body (but not in mind). In the case of a person wanting to die to prevent themselves severe Alzheimers, they are also unhappy with their situation in life and are unable to accept their present and future situation... for some people, they might think they can't live without their husband or wife...
As far as your question goes, it depends on how much a person thinks life is sacred. The point of my first post is about whether all those who want to die should logically be treated the same.

That might be why those with chronic conditions might be less like to have adequate dosages of painkillers.

So you are kind of hastening your death - but your motive would be to reduce discomfort and/or increase pleasure during your life... I think those who contemplate suicide are thinking similar things... they are considering escaping the negative aspects of life completely.

winstonjen

Quality of life is most definitely preferable to quantity to most people.

If nothing else, 'depression' caused by terminal illnesses is natural - who wants to endure unrelenting pain for months on end, when death is the only release? If you want to yourself, that's fine, but I wouldn't want to, and I'd hate people keeping me on life support 'for my own good'.

Some people will say 'but there's always hope'. A miracle happens rarely, such as in the case of a spontaneous remission, and it's highly unlikely - less than 1%. Should we keep all of them alive just so SOME of them will recover? I'd say no. And yes, I could live with myself if I helped someone to die who had a 10% or so chance of recovery. Why? Because it's their life, their death, their choice.

Jackalope

Grr. I hate how this board software won't do quotes correctly...

To your points:
The idea that one would require more and more painkillers over time is only partially true. For the most part, chronic pain patients don't increase their drugs beyond the point where they can function. In fact, one of the arguments for medical marijuana is that it's easier to titrate the dose of an inhaled drug than it is for an oral one. Most of the reluctance to use painkillers has to do with the DEA's ridiculous "War on Drugs" and a christian mentality that suffering is somehow good for the soul.

Yes, I am possibly shortening my lifespan, but I am lengthening the length of useful life. The type of disease I have causes permanent damage if not controlled. Even if the autoimmune process were to just miraculously stop, I'd still be stuck with the damage that's already occured. My best chance for a useful and productive life is to do everything I can to prevent any more damage.

This has less to do with pleasure and more to do with the simple desire to remain self-reliant. The drugs I'm currently on indirectly deal with the pain, mostly by halting the disease process. Even if I were on painkillers that totally obliterated the pain, I'd have to worry about the ongoing damage preventing me from having any sort of productive life.

winstonjen

This is from an article here - <a href="http://www.smh.com.au/articles/2002/11/25/1038173695743.html" target="_blank">http://www.smh.com.au/articles/2002/11/25/1038173695743.html</a>

A 79-year-old woman commited suicide because she was tired of life. Although it was a tragedy, IMO, her suicide does not directly harm anyone else. Other people were saddened, I am sure, but you could just as easily say that they were being selfish by wanting them to live when they don't want to.

Here's a section of her suicide note - "An atheist, she wrote in her final statement: "The life of an individual, voluntarily terminated, is of small importance compared with the death statistics relative to crime, accident, war and other similar causes of human demise which are viewed by society as a whole with regret, but accepted with relative equanimity.

"Why is there pressure against helping or allowing people who have had enough of living ... to fulfil the longing for final peace?""

Davo

excreationist,

You seem to be arguing, or assuming, that the desire to die is always irrational and indefensible. Admittedly, in most cases, a paternalistic approach to suicide is appropriate, because the person contemplating suicide is likely to lead a worthwhile life after you intervene. Similarly, many people who contemplate suicide are just going through a temporary mood of depression and despair. Failing to intervene would disrespect the value of their lives. This particularly applies to teenagers, who often experience a terrible emotional rollercoaster during their adolescence and then grow up to live happy lives. In such cases, disrespecting their autonomy by intervening in their suicide attempts is outweighed by the respect you should have for their life.

In the case of terminally ill patients, their desire to die may not be nearly as irrational, and the choice between respecting their autonomy and respecting their life may lean most logically towards the former. You only need to read case studies of terminally ill patients who are going through unbearable pain and suffering, and whose suffering will not end until they die, to realise that a desire to die in such cases may not be irrational at all, and to intervene would be an illogical disrespect of their autonomy.

I'm not quite sure I understand your logic on this one. Yes, terminally ill patients know they are going to die fairly soon, but how does that make their reasons for wanting to die any less warranted? And surely the fact that young people have many decades of life left would ordinarily count as a good argument for preventing their suicide, as they would most likely move out of their bout of depression eventually.

There may, of course, be cases in which a person who is not terminally ill may nevertheless be rational in desiring to die. These cases would be rare, but I don't think it's too shocking to say that we should respect such persons' autonomy. In ordinary cases, however, our response to the terminally ill and our response to young, healthy people who are suicidal should be different.

Acinom

Wow. That's one helluva suicide note.

In my philosophy class we're studying Kant, who offered up suicide as a prime example of an immoral act.

I don't see anything contradictory in suicide. What is our life if not our own? And if I cannot have the power to self-terminate, then what do I have the power to do?

winstonjen

I don't see anything wrong with it either. Suicide can be rational in certain cases - suicide to avoid spreading the ebola virus to your neighbours, jumping out of a building (eg. 9/11) to escape an inferno.

Some Christians believe that suffering is God's punishment and we have no right to escape it. If they want to inflict that upon themselves, fine, just leave me out of it.

case

Well, I was going to start a thread on suicide, though from a slightly different angle. But, I may as well jump in this one. Having just finished a heated argument on the topic with a co-worker, I have some things fresh in my mind. (Also, in no coherent order, but so it goes.)

Let me present two different senarios: First, a depressed teenager. Let's name him Droopy. Droopy has just been dumped by his girlfriend. He has few friends, an acne-pocked face, low self-esteem...you get the picture. Over the course of a few months, Droopy becomes more depressed. He sees little hope for his life, and doesn't see much of a point in living it anymore. So, one night, after scribbling an incoherent note about a cruel world, he swallows a number of bottles of various pills with a bottle of vodka.

(I realize this is entirely too stereotypical, but bear with me.)

Now, our second scenario: Let us call him Buck. A strapping young example of a male, Buck has just graduated from high school. He played football all four years, and was also on the wrestling team. Buck has the good fortune to graduate from high school while his country is in the middle of a war. Let's say this war has been going on for a few years, and causaltiy rates on the front are high. Buck, being the upstanding citizen that he is, enlists in the Marines, and goes to fight for his country. His mom and dad are proud.

Stereotypical, yes. But what do both of these scenarios have in common? Both Buck and Droopy consciously put themselves in situations that can get them killed.

Now, I didn't write this post to start a debate about the validity of suicidal behavior (though that might make an interesting topic). What I did want to demonstrate was how two seemingly different acts can be construed in two very different ways, but have the same outcome. To most people, I would think, Buck isn't being suicidal. He is going to serve his country, defend democracy, whatever. Droopy, on the other hand, is acting on an impulse out of depression and selfishness. But both of their actions could easily lead to the termination of their lives.

This is, I think, why so many people have such difficulty when it comes to suicide: it is a completely selfish act. Buck's actions can easily be justified, even praised. Heck, we have yearly parades for the Buck's of the world. Droopy, on the other hand, is seen as a social outcast who must have been suffering from some sort of mental illness. Otherwise, he would have listened to the Smiths for six months and moved on with his life.

I think it is this same line of thinking that divides people on the whole euthanasia subject. Let me give another example: Ethel, an 80 year old grandmother who is suffering through terminal brain cancer. Ethel probably won't live much longer, but the doctor's can't be sure. Her chance of remission is slim to none. Ethel decides that she doesn't want to suffer through what could months more of agonizing pain. Nor does she wish to spend the rest of her days on morphine. So, Ethel enlists the help of a sympathetic rogue nurse, Caterina, to inject her with potassium chloride, of some other concoction.

I think most people can empathize with Ethel, and don't see this as a suicide. Thus the term euthanasia. I doubt many people would want to say that their grandmother offed herself. But again, a similar physical act (though with much more certain results) viewed in a much different light. In this case, some view this as a personal choice to end pain and suffering. Others view it as a selfish act to end personal pain and suffering.

Now, let's change things a bit. Let's say Buck, along with graduating from high school, just got dumped by his girlfriend. He barely graduated, and knows he won't make it in college. He never really wanted to play football, but did so only to please his father. He sees nothing good in his future, and decides to enlist in the Marines, knowing full well that his chances of survival are slim to none. Let us suppose that Droopy is confused about his sexuality. He is mercissly teased at school, and at home. He routinely gets beaten up by the school bully. Heck, it might even be Buck. He hates the world he lives in, and attempts suicide.

Now what do we think of Buck and Droopy?

The point of all this incoherent rambling, of course, is to demenstrate that society views the same action in very different ways, depending on the pretenses under which it was performed. Of course, we may not always know these. But society will justify actions (in the case of Buck), or condemn them (Droopy), depending on said societies values. If a society values self sacrifice, then Buck's actions will be viewed as heroic, even if his reasons for doing so were whole-heartedly not. If a society values individuality, then Ethel's actions will be respected. If a society needs to justify intervention, then it can classify certain behavior as "abnormal", or mental unsound, and hospitalize someone against their will. In America, we have all three.

Okay, I'll shut up now.