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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Phil on December 16, 2013, at 13:30:09
Mental patients, people in severe pain for years, Alzheimer, etc. When the vet was talking about euthanasia for Jules, he said we have it all wrong. People should have this option too.
I know that if I was in severe pain I would want that option.
What do you think?
Posted by sigismund on December 16, 2013, at 14:47:47
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
The laws in Oregon are good, aren't they?
Posted by Phil on December 16, 2013, at 15:48:11
In reply to Re: should we have the Right To Die?, posted by sigismund on December 16, 2013, at 14:47:47
Didn't know that
Posted by Poet on December 16, 2013, at 15:54:15
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
I believe we should have the right to die, also. Yes, I've sign a do not resesitate statement, but that is only if I'm coding, it's wanting to allow someone to take those IVs out if I am incapable of doint it on my own that I want to sign an okay for.
I'm sorry to hear of the loss of Jules. My oldest cat has kidney failure and I know when the time comes I will not let her suffer.
Poet
Posted by alexandra_k on December 16, 2013, at 15:59:55
In reply to Re: should we have the Right To Die?, posted by Poet on December 16, 2013, at 15:54:15
i think so, yes. the right to a dignified death, even.
though... this can be a separate issue from whether others have duties around assisting our wishes on this.
Posted by Phillipa on December 16, 2013, at 17:42:27
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
Phil there is already euthanasia for people. About 15 years ago husbands Mother age 64 was diagnosed with ALS and decided in the hospital she didn't want to die this way she choice to die then. All the family including me was in the room when the docs came in to discuss it. With agreement of the family. She was allowed to remove O2 and she was given a drink of her cocktail she liked at dinner. And a morphine drip was started. Three days later she died. She would have lived for years. She chose not to. She could walk, talk, cook at the time.
I was also told by my pdoc that I could chose to live or die that is unassisted. Phillipa
Posted by sigismund on December 16, 2013, at 17:57:24
In reply to Re: should we have the Right To Die? » Phil, posted by Phillipa on December 16, 2013, at 17:42:27
Well yeah, PJ, ideally, but if you are poor or don't have a good doctor, you won't get opiates here, you might not even get benzos. There's something of a discipline and punish underlying psychology.
Posted by alexandra_k on December 16, 2013, at 18:11:34
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
people do have this option in some cases. from within the law, i mean.
do not resuscitate orders are about letting a person die. refraining from intervening to keep someone alive.
providing increasing amounts of morphene for the purposes of pain relief with the knowledge that one is approaching and will eventually provide lethal dose.
i think these things do happen rather a lot. the public tends to hear about the odd problematic case where things go wrong... but there are lots of cases where things seem to run smoothly enough...
i used to know someone who was on an ethics board at the hospital. as an ethics professor. in that capacity. the board would be comprised of a bunch of different people... managers. nurses involved in the particular patients care. doctors involved in the particular patients case. social worker. etc. not quite a jury of your peers, but something approximating...
mental illness cases are thought to be harder. depression. etc. the thought is typically that you wouldn't want someone to kill themselves during an episode when they might go on to recover. when it might be the case that later in their life they would be grateful to be alive. most people seem to have this intuition. there are problems with it, though. future discounting. etc. problems of personal identity and what (if any) obligations we have to future selves / to ourself down the track...
then of course problems of chronicity. how long do you have to feel this way before it seems like you really aren't going to get better? how many years must one suffer for?
currently i'm thinking...
it might be a little like immunisation...
don't ask 'what can immunisation do for me' but ask 'what can my being immunised do for others?' people do think of it as weighing costs and benefits to themselves... but perhaps this is the wrong way to think on it. you have the power to make the world a better place... in some way. so maybe you have a duty...
(i expect more than half a room of philosophers would turn on me at this point)
heh.
i remember being in australia, actually... one of my friends was severely anorexic. eventually... a couple of my friends managed to bundle him up into their car and drive him up to hospital. when he was too weak to protest. they said... he actually seemed relieved. his demise was gradual... and there was some kind of group delusion where everyone seemed to think that he couldn't really be that bad or someone would have done something... and so this seemed to result in nobody doing anything. and then when people really started to step things up (us, going to uni counselling and to the managers of the hall etc) people attempting to actively prevent our intervening (because if we were right it was only going to make them look bad, one can suppose).
and then he fell into a coma from hypoglacemic shock from refeeding and they nearly lost him...
but they kept him alive. even though... what are the stats on recovery from such a thing?
i don't know what to say.
i wished i was dead for a great many years. actually, i would have preferred to not have existed in the first place. in some religious arguments people are like 'pain exists because you couldn't have pleasure without something to contrast that'. but of course that is b*llsh*t. think of the brief life of an infant born where there isn't enough food... whose total existence is pain. do they have pleasure to balance that in their lifetime? of course they don't. why think pleasure has to be different? (pleasure and pain are neurologically distinct at any rate).
anyway...
now... i'm glad i'm alive. i'm glad i'm still here. i feel so much gratitude over the last few weeks, actually... sometimes i feel this as a slight betrayal of my former self / selves... like i'm not appropriately honouring their pain... but i guess it is like recovering from grief more generally... to think that the best way to honour the pain is to make it such that it wasn't for nothing. to try and do something so there is less pain in the world. if my experience of pain can be utilised so that there is less pain in the world than there would have been without my expeirence of pain then...
i guess...
that makes the world a better place.
Posted by Phillipa on December 16, 2013, at 20:57:34
In reply to Re: should we have the Right To Die?, posted by alexandra_k on December 16, 2013, at 18:11:34
Age is a bit part of it and is it terminal? Or can the person never ever expect to do the things that give them pleasure? Here in is the answer. Quality of life vs quantity. What one choses to do with their own life is their business. That is my thought and will stick with it. Phillipa
Posted by sleepygirl2 on December 16, 2013, at 21:24:27
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
Yes, but this could end up very subjective.
Posted by Phil on December 16, 2013, at 22:11:47
In reply to Re: should we have the Right To Die?, posted by Poet on December 16, 2013, at 15:54:15
Thanks
Posted by alexandra_k on December 16, 2013, at 22:29:50
In reply to Re: should we have the Right To Die?, posted by Phil on December 16, 2013, at 22:11:47
oh...
i don't know if you guys have such a thing... but in nz we have this thing called a 'living will' where you can express your wishes should something happen to you...
so if you are involved in an accident or suffer stroke or something and are in a coma and are unlikely to recover then would you be okay with their turning the life support off? things like that.
organ donation, too.
it can help ease the decision for family members / health professionals.
in those sorts of cases i think i would rather be let go. i mean... we do hear of people coming out of things like that... but i guess that realistically we also need to proritise who has access to the equipment when equipment is limited.
Posted by Phillipa on December 16, 2013, at 22:37:29
In reply to Re: should we have the Right To Die?, posted by alexandra_k on December 16, 2013, at 22:29:50
Yes we do one can name what life saving measures they wish or do not wish. One is do you want to be coded, One is do you want meds with held, one food with held, one water, one life support, and others it gets complicated, and since one doesn't have to have one that leaves it up to the family and doctors at times. It get complicated. Phillipa
Posted by alexandra_k on December 16, 2013, at 22:45:47
In reply to Re: should we have the Right To Die? » alexandra_k, posted by Phillipa on December 16, 2013, at 22:37:29
yeah.
cases of depression / anorexia etc are hard. cases of mental anguish / pain / suffering. it can be hard because when you are in the midst of it it can feel like things have never been any different and will never get to be any different. all there is is the eternal, horrible, now.
but often the depression does lift. eventually. i guess that is why doctors are reluctant to treat this similarly.
i have read a couple academic papers arguing that people should have the right to die in these cases. i didn't think on them overly much... but people are thinking about these issues, yeah.
apparently the pain of childbirth is pretty bad... the body has mechanisms for forgetting the pain. otherwise... women most probably would not go through that again, ha! maybe... hopefully... depression is like that.
?
Posted by Dr. Bob on December 17, 2013, at 3:21:37
In reply to Re: should we have the Right To Die? » Phil, posted by Phillipa on December 16, 2013, at 17:42:27
> Phil there is already euthanasia for people. About 15 years ago husbands Mother age 64 was diagnosed with ALS and decided in the hospital she didn't want to die this way she choice to die then. ... She was allowed to remove O2 and she was given a drink of her cocktail she liked at dinner. And a morphine drip was started. Three days later she died.
Withdrawing treatment, and treating pain, isn't usually considered euthanasia.
Bob
Posted by alexandra_k on December 17, 2013, at 3:51:00
In reply to Re: should we have the Right To Die?, posted by Dr. Bob on December 17, 2013, at 3:21:37
> Withdrawing treatment, and treating pain, isn't usually considered euthanasia.
doctrine of double effect?
Posted by Phillipa on December 17, 2013, at 20:17:29
In reply to Re: should we have the Right To Die?, posted by Dr. Bob on December 17, 2013, at 3:21:37
The morphine wasn't used for treating any pain. It was to ease her to her demise. Per her wishes. She chose this the doctors assisted with the agreement of the whole family. Phillipa
Posted by Dr. Bob on December 17, 2013, at 23:50:48
In reply to Re: should we have the Right To Die?, posted by alexandra_k on December 17, 2013, at 3:51:00
> > Withdrawing treatment, and treating pain, isn't usually considered euthanasia.
>
> doctrine of double effect?That applies to treating pain. One discussion of various distinctions:
> > The term "euthanasia" is usually confined to the active variety; ... "euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life". Physician-assisted suicide [in which the physician doesn't act directly] is thus not classified as euthanasia ... Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal. The use of pain medication in order to relieve suffering, even if it hastens death, has been held as legal in several court decisions.
http://en.wikipedia.org/wiki/Euthanasia
Bob
Posted by SLS on December 17, 2013, at 23:56:17
In reply to Re: should we have the Right To Die?, posted by Dr. Bob on December 17, 2013, at 23:50:48
> Physician-assisted suicide [in which the physician doesn't act directly] is thus not classified as euthanasia ...
Autoeuthanesia?
- Scott
Posted by SLS on December 17, 2013, at 23:58:39
In reply to should we have the Right To Die?, posted by Phil on December 16, 2013, at 13:30:09
> Mental patients, people in severe pain for years, Alzheimer, etc. When the vet was talking about euthanasia for Jules, he said we have it all wrong. People should have this option too.
> I know that if I was in severe pain I would want that option.
> What do you think?What might be the differences between autoeuthanasia and suicide?
- Scott
Posted by SLS on December 18, 2013, at 0:15:18
In reply to Re: should we have the Right To Die?, posted by alexandra_k on December 16, 2013, at 22:45:47
> cases of depression / anorexia etc are hard. cases of mental anguish / pain / suffering. it can be hard because when you are in the midst of it it can feel like things have never been any different and will never get to be any different. all there is is the eternal, horrible, now.
I agree.
That is an incredibly accurate insight that I needed a doctor to teach me.
> but often the depression does lift. eventually. i guess that is why doctors are reluctant to treat this similarly.Yes. However, some people develop Major Depressive Disorder that is expressed as a chronic, unmitigated, treatment-refractory depression that lasts for decades. The same is true of Bipolar Disorder, although the onset of illness is substantially younger (even in young children).
How do you judge judgment?
If someone is in the midst of a major depressive episode comorbid with ALS, and wanted to hasten death, how would you judge their decision? What if there were no ALS?
Heavy-duty.
- Scott
Posted by SLS on December 18, 2013, at 0:16:22
In reply to Re: should we have the Right To Die?, posted by alexandra_k on December 17, 2013, at 3:51:00
> > Withdrawing treatment, and treating pain, isn't usually considered euthanasia.
> doctrine of double effect?
What's that?
- Scott
Posted by Phil on December 18, 2013, at 12:32:59
In reply to Re: should we have the Right To Die? » Phil, posted by SLS on December 17, 2013, at 23:58:39
I guess it could be tricky with some mental patients, I don't know.
But I think guys like the one on 60 Minutes, I think he had pain 24/7 and wanted any way out.
I think we should have it. How many chronic patients are begging for death?
I can't watch a pet suffer, Why should friends or family have to?
Posted by SLS on December 18, 2013, at 12:43:06
In reply to Re: should we have the Right To Die? » SLS, posted by Phil on December 18, 2013, at 12:32:59
> I guess it could be tricky with some mental patients, I don't know.
> But I think guys like the one on 60 Minutes, I think he had pain 24/7 and wanted any way out.
> I think we should have it. How many chronic patients are begging for death?
> I can't watch a pet suffer, Why should friends or family have to?I agree with you, Phil.
- Scott
Posted by Phillipa on December 18, 2013, at 20:51:27
In reply to Re: should we have the Right To Die?, posted by Dr. Bob on December 17, 2013, at 23:50:48
That is exactly what I meant thanks for helping to clarify. Patients do have rights. And doctors I feel should respect them and help or assist. Phillipa
This is the end of the thread.
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