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by After serving eight years in jail for administering a lethal injection to a disabled man; Jack Kevorkian, sometimes known as “Dr. Death”, is back in the news with his subsequent parole in June. During the 1990’s Kevorkian claimed responsibility for at least 130 assisted suicides, and was the most vocal and active proponent of the assisted suicide movement. The frail 78 year old Kevorkian claims he will not assist in any more suicides, and even claims shouldn’t have done so in the past, maintaining that he should have been advocating for the legalization of assisted suicide instead. Some are concerned that this new publicity will bring the issue of assisted suicide to the forefront again after it all but disappeared from the public eye after Kevorkian’s incarceration.
In 1997, the U.S. Supreme Court recognized no federal constitutional right to physician-assisted suicide (PAS), but affirmed that state legislatures may choose to legalize it. Currently Oregon is the only state that has voted in favor of PAS.
The debate on the ethics of legally assisted suicide has three main streams of thought. The first is that it is just plain morally wrong and should under no circumstances be provided, while some feel that euthanasia is ethically legitimate in rare and exceptional cases, while finally some would advocate that assisted suicide should be a legal and viable option in the care of dying or terminally ill patients.
This topic interests me because I feel any decisions made about it can have dramatic ethical effects on the shape of our society in the future, and it would be interesting to read the thoughts and opinions of other Omninerds on this issue.
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There is one very important distinction to make, and that is the difference between euthanasia and physician assisted suicide. I probably should have included this in the article, but honestly I didn’t realize this at the time of the posting. In euthanasia, the doctor (or someone) actually hooks you up to the equipment (lethal injection most likely) and administers the poison with his “own hand”.
Assisted suicide is usually a situation where a doctor prescribes a lethal amount of some pill or medicine that can kill you at your request, and you ingest it yourself. Since Kevorkian alone participated in both euthanasia and assisted suicide in a relatively short time, I think for subject of this debate we should probably treat them as one and the same.
From the desk of the karma deserving;
The WWII generation and their ilk have been very proper to show the Gen-X, Y and Pi that the most productive members of society survive. They did this at the expense of putting there pup’s in day care 24/7. Our kind worked, bought 5K sq foot homes, SUV’s and everything else that made a soul happy.
Now that we are in the sundown of our lives, we look to these kids to help us. We want a relationship with those that we left behind.
Our kids will say: “take the pill, and give us the TSA”
Peace and Bob
After I read this 3 or 4 times (one has to change the rhythm of one’s mind to read Plumbbob, Mr. Moderator), I realized that it was along the lines of another thing I was worried about if PAS or euthanasia becomes allowable by law. Not at first of course, but over time as we get used to it; will this eventually become a way of ‘ridding oneself’ of the burdens of aging parents?
why is it that we continue to give the worst of the worst criminals, those sentenced to death, the soft, easy manner of death, i.e., lethal injection, and at the same time deny it to the common man who never got arrested, worked all his life, and paid taxes, but who got a terribly painful and lethal disease? i have a living will, but laws will not allow a physician to administer an overdose of barbiturates to me intravenously if i want to die that way, which i feel is kindness. why should i lie in a bed struggling to breathe, taking medicine to help me breathe, when what should happen is that i do not breathe at all since it is my time to die? if the scourge of the earth is granted the quick, painless death by lethal injection, then why can't i get it legally myself?
The differences and comments between the two situations given are not necessarily meant to be reasons against an individual’s desire to end his or her life, but are shown so that questions for society as a whole can be taken into consideration.
On one hand we have a prisoner that was tried and put through a long legal process and finally determined to be unfit for life (or whatever you want to call it) by a jury, and sentenced by a judge; and all of it under public scrutiny. On the other hand a single person determines in private, or amongst close family members, that they are unwilling to suffer through life any longer, but cannot for whatever reason go through with suicide on their own, and want a professional to aid them in ending their life.
One difference then is the amount of people involved in making the decision to end a life, and the (theoretically) reduced potential for anything to be hidden or secret.
This doesn’t necessarily make it right or wrong in everybody’s mind perhaps; but as a society, a system of justice is all we have to go on.
The subject of capital punishment is a contentious one in itself, and has been abolished in the states of Alaska, District of Columbia, Hawaii, Iowa, Maine, Massachusetts, Michigan, Minnesota, North Dakota, Rhode Island, Vermont, West Virginia and Wisconsin. Other states, such as New Hampshire, that have it have not performed any executions since 1939. To use one contentious action to condone another is a bad route to follow in any set of circumstances.
As I asked in another post; how do you apply public policy to the relative few without drastically changing society over time? Often times in ethical issues such as these, it’s the few that drive the debate for many.
if the scourge of the earth is granted the quick, painless death by lethal injection, then why can't i get it legally myself?
I think in most cases these scourges of the earth don’t think in terms of death as being necessarily “granted”, (and would rather not be “helped along”.)
As a side note I’m praying that your post was hypothetical in nature, and you are not really under the circumstances you described. If you are, God be with you.
I just recently wrote a paper dealing with the issue of Physician Assisted Suicide and why I believe that it should remain illegal in this country. My main argument was that if we as a nation were to legalize physician assisted suicide and it were to become a common practice in the other forty-nine states beside Oregon, I think that we would find that the face of our healthcare system and our healthcare professionals would begin to change. When doctors begin their profession, they have to take what is known as the Hippocratic Oath. By taking this oath, doctors have agreed to “do no harm". The trust and respect of Physicians from their patients would be harmed if they were seen as being ready to help aid their patients in the act of suicide at any time. Another good point that this argument leads to is the idea that perhaps if suicide were an option for patients and their physicians, health care professionals as well as hospice workers might not give as much attention to pain control and things such as palliative care if they view suicide as a practical alternative.
If we allow physicians to assist their patients in committing suicide what is to keep us from allowing a physician to euthanize a patient for other reasons than the patient’s own best interest. I think that there is a definite balance between a person’s own rights and decisions and the governments hand in helping them make decisions, however I think that if someone chooses to take their own life that they should just do it and not involve anyone else in the process, especially a medical professional. If we allow such things to go on that we, as a nation, will find we are headed down a steep slope and that the face of our healthcare system will change, and probably not for the better. The line needs to be drawn somewhere and I think that not allowing physician assisted suicide is a good place to draw it.
I feel that physician assisted suicide should not be legalized in America and should be made illegal in Oregon. The legalization of PAS would change the face of healthcare, change the way that healthcare professionals are viewed and trusted by their patients, open doors to more unethical practices within the healthcare system. Instead of legalizing PAS, doctors should be encouraged to continue placing emphasis on offering terminally patients and their families the opportunity to receive counseling, palliative care, and enhanced pain management
- Leanna
I just recently wrote a paper dealing with the issue of Physician Assisted Suicide and why I believe that it should remain illegal in this country.
Sorry - I don't buy your arguments.
I'd say I'd be more willing to trust my physician if he were required to honor a patients decision to die. Why should I trust a doctor who doesn't have to do so?
The Hippocratic Oath's charge to "do no harm" seems irrelevant. You define it as harm to assist a patient to die - the patient in question wants to die, and doesn't consider it harm.
You cast it as the doctor being "ready to help their patients in the act of suicide at any time" - that's more than a little disingenuous. The reality is that, where PAS is legal, there are still extensive protocols that must be followed. You consistently try to recast this as if the decision is being made by the health-care workers, rather than the patient. The whole point is to make it the patient's decision, not the health-care professionals'.
I think that if someone chooses to take their own life that they should just do it and not involve anyone else in the process
A person confined to a hospital bed has damn few options along those lines. Allowing them to enlist the help of their physician means that they can avoid a lot of painful and degrading ways of dying. But I guess your argument makes it clear that you're more interested in the presence of life, no matter what its quality.
Your arguments don't make their burden.
My question is should physician-assisted suicide be allowed? In my paper, I present that under certain circumstance, such as Schiavo’s situation, physician-assisted suicide can be practiced. But, for more general ground, I do think physician-assisted suicide should not be legalized, because without public monitor and strict standard to lay the line, it may have potential abuse effect. At the same time, practice will violate the doctor’s duties and responsibilities. According many surveys, same like more and more people support the practice of physician-assisted suicide and called it is the right to die. I agree with the person has the right to choose how he or she want to die, but physician can’t to assist. Being a doctor the duty is ethically to help patient live, cure the illness and save their lives. Dr should find better way to provide effective pain management other than to help end the patient’s lives. Once the option of assisted suicide was given, patient may have to make choice to live or to die. Even if the patient may not want to die, because the long time illness, he or she feels they are the burden to their family, relatives, or other worries, the option of to assisted suicide can give the choice to let go. In such case, it is better to not offer the option. So far, most physician-assisted suicide occurs in secret, and takes place with no one monitor. So who can guarantee what is really happen behind the scene. Therefore, I vote to against legislation of physician-assisted suicide, and better pain management and good hospice care should be offered.
My question is should physician-assisted suicide be allowed?
And I don't think you've at all made your case that it shouldn't.
Maybe you should link to your paper - the shortened (I assume) arguments you make here just don't cut it. They assume facts not in evidence, they create unlikely hypotheticals, among other faults. This post doesn't add to the previous one, so my response to that still stands.
Look: I get it. Your personal feeling is that people shouldn't ask physicians to assist in suicide. Fine. Don't do it - suffer whatever indignities may come. That's your choice. But your arguments don't support the point that I shouldn't be able to have my doctor's help if I should choose it, and it's presumptuous and arrogant that your feelings should override mine in my life.
you should probably find out more about the topic before writing a paper. eg, the difference between physician assisted suicide and euthanasia. by virtue of being in a vegetative state, no doctor could assist Terry Schiavo in committing suicide. thus her case did not concern assisted suicide, it concerned withdrawal of life support and/or euthanasia.
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Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 18 December 2006
Although I think the world would be a much happier place if the laws of the land were aligned to the laws of God (and people followed them), I don't think that's feasible. Really, I think the government should keep it's hands mostly off of just about everything - possibly extending to things such as education, and definitely including welfare. This would seem to indicate a legalization here, but not so fast: The government must protect the rights of individuals from abuse at the hands of others, and this situation is ripe with potential issues in that arena.
For example, how would one give another "permission" to kill you? A written statement? A verbal OK? A notarized document? I think the likely answer would be the most stringent documentation you could expect someone to accomplish - without resorting to unassisted suicide, that is. I can picture legal hearings, automatic appeals, etc. - lots of wasted time and money to split hairs when the person is just trying to die. Why not remove the risk of murders everywhere forging "killing permission slips" and just make people kill themselves on their own if they really want to die so bad?
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 18 December 2006
Oh I don't know...say you are in a lot of pain and there is no treatment. So either you die now or you'll live for years with a lot of pain.
Besides, people have the right to choose if they want to die or not.
RE: Legalization depends on how much it is a legal issue by gnifyus :: NR7 :: on 18 December 2006
Oh I don't know...say you are in a lot of pain and there is no treatment. So either you die now or you'll live for years with a lot of pain.<<
Pain is something that in today’s modern day medicine can in almost all cases be controlled, or alleviated. If a person is in constant pain to the point that they feel they want to die, what they need is a better pain doctor, not assisted suicide. The majority of patients who desire death are typically depressed, and depression is also an ailment that is typically treatable by means other than suicide. Suicidal tendencies due to depression for whatever reason are usually a cry for help, and making it too easy to simply end one’s life might eventually lead to tragedies that could have had a happier outcome.
RE: Legalization depends on how much it is a legal issue by Liz_Miracle :: NR5 :: on 18 December 2006
gnifyus, what is your medical background? I agree that there are cases when you can "get a better pain doctor", however there are many cases when pt's have to take so much pain medicine to function that it keeps them from functioning mentally. There are also many circumstances where depression cannot be managed despite many efforts.
The questions is really a question of quality of life. Have you ever known anyone with a seriously debilitating pathology, say ALS? If so, then you might find that sometimes there are not "happier outcomes". There are also many elderly who feel just as trapped for whatever reason, be it illness or social isolation.
All religious debate aside, if someone has no quality of life and feels as though they are simply a drain on society then should they be allowed this option? How do we decide who is allowed to have PAS and who isn't? In the hospital all a pt has to do is say, "I don't want to be resuscitated" and a doctor documents it and they are allowed to die. Why aren't they allowed to ask for it before it gets to that point?
RE: Legalization depends on how much it is a legal issue by Liz_Miracle :: NR5 :: on 18 December 2006
ADDENDUM: pt = patient
RE: Legalization depends on how much it is a legal issue by gnifyus :: NR7 :: on 19 December 2006
First, thank you for your input.
I agree that there are cases when you can "get a better pain doctor", however there are many cases when pt's have to take so much pain medicine to function that it keeps them from functioning mentally. There are also many circumstances where depression cannot be managed despite many efforts.
This is exactly why this issue becomes such a hot debate; there are always extraordinary cases where no help can be found, no matter how hard everyone tries. I just don’t want it to get to the point where no one tries anymore and just ends it all without seeking alternatives first. These exceptions are probably what is really driving the debate; but how do you apply public policy to the relative few without drastically changing society over time?
The question is really a question of quality of life.
Quality of life is another thing that is subjective enough to be almost indefinable by legislative means. Certainly the ALS example would probably in most cases fall under the “better off dead” category; but what happens when the definition begins to change over time? It can be conceived that each case as time goes on, may have a slightly higher quality of life attached to it. This very thing can be seen in the Kevorkian timeline where, yes, some of his cases were people with no hope and a terrible quality of life, but in his ten year period many of the cases were not quite as bad. Some of the autopsies revealed no trace at all of whatever disease the person claimed to have. Granted, Kevorkian was acting as an activist and maybe even an anarchist in many ways to try and make his point.
In the hospital all a pt has to do is say, "I don't want to be resuscitated" and a doctor documents it and they are allowed to die. Why aren't they allowed to ask for it before it gets to that point?
I think there is a big difference between ”Do not resuscitate”/removing life support and PAS/euthanasia. When life support is removed we are taking away a machine that was keeping the body alive which wouldn’t be alive without it; when PAS/euthanasia is used, a machine or device is brought anew into the picture and another person or people are involved in actively seeking the death of someone who in many cases is cognizant of the proceedings.
In general I think the PAS issue is an easier thing to think about when taken on an individual case by case basis. When a general policy has to be formed to include everyone, that’s where the hard questions start to come out. My problem with PAS/euthanasia becoming legal is not so much about whether it is right or wrong in these individual cases, but what it can eventually turn into as time passes. I could very easily see 100 years from now; a guy loses his job and his girlfriend leaves him. He walks down to his local euthanasia clinic, signs a few papers, lays on a gurney or table waiting for the technician to come back from break, and ends it all.
(Or what if life imprisonment is decided to be “no quality of life?)
RE: Legalization depends on how much it is a legal issue by Anonymous :: NR0 :: on 20 December 2006
i.e. Soylent Green.
Medical Experience.. by gnifyus :: NR7 :: on 19 December 2006
gnifyus, what is your medical background?
To answer the question, I am not in a medical profession, but many of the same arguments have been made by people who are.
I’m posting twice to your reply because the first post had a lot of words and I didn’t want to go in too many directions in one reply. By asking the above question (and by reading your nerdlog) I’ve deduced that you are in the medical profession. By asking this I am really not trying to antagonize; but do you think that people in the medical field are more qualified to decide and debate this issue?
RE: Medical Experience.. by Liz_Miracle :: NR5 :: on 19 December 2006
gnifyus, no I do not think that medical professionals are necessarily more qualified to debate this issue. I was asking in reference to your comment about obtaining a better physician, because, it's not always something that can be fixed and I felt like the topic was being oversimplified. There are physicians who devote their entire career to being "pain doctors". I suppose this entire discussion is likely being oversimplified.
I find it appropriate that you responded to this separately as it is a sidebar from the conversation at hand.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 18 December 2006
So where does the need for assisted suicide come in?
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 19 December 2006
When the patient want the doctor to assist them in suicide. You know...no disrespect...but how do these 'prophets' know what God wants. Perhaps God agrees that assisted suicide is the best option.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 19 December 2006
My point is that there is no need for assisted suicide to be legal for a person to be able to choose to live or die. In other words, why can't they just kill themselves?
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 19 December 2006
Oh please, you saw what they did to suicidal people. Either they get arrested for disturbing the peace, or they get locked up in a mental institute. In this society, you have no right to kill yourself. Suicide is almost seen as something illegal to do.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 20 December 2006
If you think suicide shouldn't be illegal (and I would tend to agree with you in some cases), then you should be arguing for that - not for assisted suicide.
Is it really illegal? by VnutZ :: NR8 :: on 20 December 2006
As I've never really been into researching / reading about suicide ... I'm completely in the dark. Is it actually illegal? And if so - what are the consequences? After all, you're already dead.
RE: Is it really illegal? by gnifyus :: NR7 :: on 20 December 2006
It does't actually appear to be illegal in the U.S. in most places, but actually assisting someone is, or has become illegal since states like Michigan added the law to the books in response to Kevorkian.
RE: Legalization depends on how much it is a legal issue by gnifyus :: NR7 :: on 19 December 2006
I think from reading about some of Kevorkian’s cases, some of the people were too debilitated to commit suicide on their own, or wanted a clean painless (and sure) way to have it happen. I think the latter is the most common; the people didn’t want a messy death, and so Kevorkian was able to provide the equipment and/or chemicals (usually carbon monoxide) to ‘get the job done.’
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 19 December 2006
Do you guys ever watch "Cops"? There was this woman who tried to kill herself, so she took all the pills in her room. Let's just say she called 911 and ended up in the emergency room after three hours.....she couldn't take the pain anymore.
Maybe they should set up classes about how to efficiently and painlessly kill yourself.
RE: Legalization depends on how much it is a legal issue by gnifyus :: NR7 :: on 19 December 2006
This is actually a reason that advocates for PAS use; preventing botched suicides and other trauma that causes a person to maybe have an even lower quality of life when they are done. By providing supervision we can be sure that the chances of that happening will be much reduced.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 20 December 2006
I think that is a ridiculous argument (although I know you did not advocate it). If a person wants to attempt suicide in an ineffective manner, then they will reap the consequences of their actions. It is not the responsibility of the state to be ensure everyone does it "correctly."
If the idea is to allow private organizations provide this service to their customers, then I don't necessarily have a problem with it - as long as the organization is completely removed from the actions involved. For example, a customer could pay $XXX for a suicide "kit" containing enough sleeping agent to kill a horse along with proper instructions for use (e.g., don't take on an empty stomach). Alternatively, the customer could pay an extra $XXX for a "consultation" in which a company representative brings you the kit, answers your questions and reviews your plan. Anything crossing over into actually helping the individual perform the suicide (i.e., killing them because they want to die) would be against the law.
RE: Legalization depends on how much it is a legal issue by VnutZ :: NR8 :: on 20 December 2006
But isn't the whole deal with people that are physically unable to do it? It would seem obvious that someone who could kill themselves, wanted to kill themselves, would.
I dunno. This falls into that weird category. The one where kids bring guns to school, shoot an entire magazine into a crowded hallway and only wound people. A physical able person with an inability to kill oneself (or others) especially with tools is clearly an idiot.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 20 December 2006
I can't think of any circumstance in which a person couldn't kill themselves, unless they were completely unable to do anything but think (i.e., can't move or communicate to the doctors that they would like to not be fed against their will).
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 20 December 2006
An ignorant person might choose the wrong way to die. Oh I don't know...Someone who thought that swallowing 30 different kinds of flu pills will kill you immediately. Just like that lady on TV. I still think we should set up Suicide Information place to tell people all different kinds of suicide methods. A little inhumane, but at least it's educational.
RE: Legalization depends on how much it is a legal issue by Brandon :: NR9 :: on 20 December 2006
Again, it's the individual's responsibility, not their government's, to figure out an effective means of killing themselves. As for education, I'm sure anyone who was interested would be able to find more than enough information to plan an effective suicide by consulting the library or Internet.
RE: Legalization depends on how much it is a legal issue by Eye.Of.Sage :: NR6 :: on 20 December 2006
It won't cost that much.
The Hotline.. by gnifyus :: NR7 :: on 20 December 2006
Imagine; you call the Suicide Hotline and it’s the wrong one. Instead of getting someone to talk you out of it, you get a person giving you instructions on how to do it. I can also imagine as costs are cut, that the same person is doing both jobs, or maybe you push “1” for “talk me out of it” and “2” for “how to” instructions.
RE: The Hotline.. by Anonymous :: NR0 :: on 24 November 2007
... I have read many of your replies about places were they can come to get information on how to kill themselves... this idea in of itself is crazy... why not set up booths across the country and have it place 5$ in the slot, the door opens, walk in, sit down, and bam you get shot... this is taking it to the extreme but what you are talking about is basically the same thing... what would someone from out of town or from another country walks thought your city and see people reading "How to kill yourself in 5 easy steps!" or a big information station about killing yourself...there is no reason to make it a public issue.. death should never become public... this whole talk about public suicide is crazy... we are talking about assisted suicide for people who have no will to live and the only reason they are is because they have a feeding tube stuck in them or they are wired to a machine to regulate their bodily functions
RE: Legalization depends on how much it is a legal issue by gnifyus :: NR7 :: on 18 December 2006
First :
Although I think the world would be a much happier place if the laws of the land were aligned to the laws of God (and people followed them)
I guess we wouldn’t be in some of the messes we are in, and ethics debates wouldn’t even have to exist if that could happen.
The actual documentation needed is a great point. In the beginning I’m sure the paperwork would be tremendous, as it would be considered a monumental decision, but as time went on, like many things; that would probably slowly relax as assisted suicide and euthanasia becomes more commonplace.
If you are saying that people should be allowed to just kill themselves, then would you advocate for physician assisted suicide, but not euthanasia?