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Letters to the Editor

Death decisions

June 11, 2011

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Here’s a tip of the hat to the memory of Jack Kevorkian. Although some charisma and finesse might have made his message more acceptable, we must admit that, culturally, we are immature when it comes to dealing with end-of-life issues. In other words, we don’t want to think about death, which is especially puzzling since most Americans profess to be Christians.

Jack Kevorkian had the courage to act on a conviction that people had the right to choose a good death when life became unbearable. Many accused him of playing God. Nonsense, unless I can accuse someone of playing God whenever a pill is swallowed or when there’s a visit to the doctor’s office. I notice even Billy Graham spends a good deal of time in hospitals lately. Makes one wonder if he doesn’t trust God to make the right decision for him.

Kudos to Jack Kevorkian and all those other brave knights who dared get the conversation going. My hope is that someday Kansas will join Oregon and pass right-to-die legislation that will make end-of-life procedures more humane.

Comments

denak 3 years, 6 months ago

Whereas people do need to deal honestly and ethically with their impending death and with the social, moral and ethical questions around assisted suicide, Dr. Kervorkian was not a hero. What he was was a serial killer.

When investigated, it was found that 60% of his victims were not even terminally ill. In many cases, autopsies revealed that there was no anatomical evidence of disease. And contrary to what many believe, Kervorkian's victims were not old people who were in pain and dying. The majority of his victims were in mid-life ranging in the 40-60 range. Some of his victims were in their 20s. Very few in their 80s. (New England Journal of Medicine) Furthermore, many of Kervorkian's victims were mentally ill or suffered from Alzheimer's. Kervorkian very rarely consulted any of his victim's family doctors or specialist. It is important to note that Kervorkian was not a specialist in terminal illnesses. He was a pathologist. He was not qualified to determine whether or not someone was dying or capable of making end of life decisions any more than a urologist is capable of diagnosing and treating bone cancer. His first victim was a woman by the name of Janet Adkins whose doctors catagorically said that she did not have the mental capacity to make end of life decisions. The fact that she could not consent to her own death didn't stop him. He gave her a leathal injection in his van. So much for dying in dignity. When people think of end of life decision they don't usually think of being killed in a dingy white van. They think of dying in a hospital with their love ones surronding them. Kervorkian's victims didn't get that.

One can only hope that when it is Anna's time to go, that she is shown more mercy than Kervorkian showed his victims.

Crazy_Larry 3 years, 6 months ago

Link not working, Google "Dr. Kevorkian Part 1 EXCLUSIVE FOX News Interview by Neil Cavuto"

Crazy_Larry 3 years, 6 months ago

  1. "It is important to note that Kervorkian was not a specialist in terminal illnesses..."

  2. There are many doctors specializing in various diseases that lead to death, but there isn't a doctor that specializes in terminal illnesses in general.

  3. "He was a pathologist. He was not qualified to determine whether or not someone was dying..."

  4. Pathology is the study and diagnosis of disease.

  5. "His first victim was a woman by the name of Janet Adkins whose doctors catagorically said that she did not have the mental capacity to make end of life decisions. The fact that she could not consent to her own death didn't stop him. He gave her a leathal injection in his van."

  6. Adkins pushed the button herself and released the poison potassium chloride; Kevorkian did not give her a lethal injection. (see the Time Magazine article posted below)

As for some patients not being terminal, so what? There are a multitude of crippling, degenerative diseases that can leave a person in unbearable pain without a definitive expiration date. This is truly a disgraceful piece of wikipedia journalism. The distortion/creation and intentional omission of facts is disgusting.

Crazy_Larry 3 years, 6 months ago

http://www.time.com/time/magazine/article/0,9171,970389-2,00.html

Ethics: Dr. Death's Suicide (Time Magazine, June 18, 1990)

"As Adkins settled down on a small cot, she was attended by Kevorkian. He hooked her up to a heart monitor, slid an intravenous needle into her arm and started a harmless saline solution flowing through the tube. Then he sat back and watched the monitor as she pushed a big red button at the base of the machine. Immediately, the saline was replaced by a pain killer; one minute later came the poison potassium chloride. Within five minutes Janet Adkins, an Alzheimer's disease sufferer who feared an excruciating future, was dead of heart stoppage."

"Adkins, a 54-year-old Portland schoolteacher, was suffering from the early stages of Alzheimer's. A strong, lively woman who loved hang gliding and mountain climbing and playing her flute, she was not yet very sick; the week before her suicide she beat her 32-year-old son in a tennis match. It was more her dread than her disease that drove her to seek Kevorkian's help. Even before her illness she had joined the Hemlock Society, a group that supports terminally ill patients' right to die by means including assisted suicide."

"Adkins read about Kevorkian and got in touch with him in Michigan, where the legality of assisted suicide is murky. Her three sons urged her to try experimental treatments for Alzheimer's. But when the therapy failed -- her memory continued to fade and her beloved flute playing became impossible -- she vowed to go through with her decision. Her husband Ronald, an investment broker, flew to Detroit with her, all the while hoping she would change her mind at the last minute. Just in case, he bought her a round-trip plane ticket."

Fred Mertz 3 years, 6 months ago

Why shouldn't I be able to kill myself regardless of health or age? It is my life, my body and my decision. Heck a woman can kill a developing fetus because it is her body so why shouldn't a person be able to kill themself with or without the aid of someone?

Ron Holzwarth 3 years, 6 months ago

You are able to do it, and if you're successful, you cannot be prosecuted no matter what the laws on the books are. .

But if you're not successful, there's not a criminal punishment. Instead you get sent to a psych ward and they give you pills that are supposed to make you get better.

SnakeFist 3 years, 6 months ago

The phrase "good death" is an oxymoron. Death is the ultimate evil. In life you may be temporarily deprived of a right or two and may experience some unhappiness, but in death you are permanently stripped of all rights and never again experience happiness.

We have an obligation only to respect rational decisions. Choosing to sacrifice happiness to end physical pain is an irrational decision. In the healthy it is a result of naive idealism, and in the sick it is the result of fear - neither of which is rational.

jafs 3 years, 6 months ago

That's fascinating.

So, if somebody if of sound mind, legally competent, you wouldn't respect their decision to end their own life?

Seems a bit extreme to me.

jafs 3 years, 6 months ago

I think it is the basic right of each individual to choose whether they wish to live or die.

And, there are clear tests for mental competence.

If somebody passes those, I see no validity to others taking over any decisions from them.

SnakeFist 3 years, 6 months ago

I would respect them by saving their rational self which wants to live from their irrational self which wants to die.

My whole point is that someone who wants to die is not of "sound mind" (i.e., they are not making a rational decision) about their situation. Being rational is not necessarily an all-or-nothing affair - a person who wants to die may be rational on other matters, but not with regard to wanting to die.

So if a heartbroken, emotionally tortured seventy-year old who is in good health and legally competent wanted to die, you would honor that decision? You'll probably say that's different from someone with a terminal illness who is in pain and has only a few days to live. But why is the nature of the pain (emotional versus physical) or the number of days one has to live with the pain important? Those are arbitrary distinctions without which we cannot prevent anyone from committing suicide once we accept that suicide is rational.

Fred Mertz 3 years, 6 months ago

Heck, I think if an 18 year old healthy adult wants to end their life then so be it. It is their life their choice.

Ron Holzwarth 3 years, 6 months ago

I don't think that's a very good idea. In the case you described, that's a permanent solution to a temporary problem.

One of the things that you did not consider when you made that posting is the effects that suicides have on others.

I think that I can draw a rather obvious conclusion as to your life experiences so far that you have known or cared about very few people that actually did do it and were successful.

jafs 3 years, 6 months ago

Yes - I honor the right of each person to choose whether they wish to live or not. It's not my choice, or my right, to decide that for them.

As long as they are mentally competent - passing the tests for that - that is their decision and not mine to make.

SnakeFist 3 years, 6 months ago

I know, that's what is so sad - that people would rather take the easy way out and embrace death than fight it. The philosopher Stewie Griffin once said, "The only reason we die is because we accept it as an inevitability."

Ron Holzwarth 3 years, 6 months ago

"The only reason we die is because we accept it as an inevitability" does not make any sense at all, because physical death is going to occur no matter how we feel about it.

But, he may have meant it in a metaphorical sense.

Crazy_Larry 3 years, 6 months ago

"in death you are permanently stripped of all rights and never again experience happiness."

So you've died and confirmed this assertion? If someone is living in constant agonizing pain there is no happiness in life. Wanting the agony to end is not an irrational desire.

You seem naive and irrational to me.

SnakeFist 3 years, 6 months ago

No, I haven't died; so the only safe assumption I can make is that there is neither happiness nor unhappiness after death. If there is a Heaven (and assuming I go there) then that's great, but any assumption that there is a Heaven would be based on faith and not reason.

You're conflating happiness with pleasure and unhappiness with pain when those are very different things. A person can be in great pain and still be happy.

You seem like someone with a lot opinions you've never bothered to examine closely.

Crazy_Larry 3 years, 6 months ago

Death is the ultimate evil? Right! Keep flappin' your mouth (fingers). My opinions aren't the ones that need examined.

Ron Holzwarth 3 years, 6 months ago

"in death you are permanently stripped of all rights and never again experience happiness."

That is strictly opinion.

verity 3 years, 6 months ago

This is something I have given an lot of thought to. At one point I came to the conclusion that since taking a life is wrong, then taking your own life is wrong. However, after seeing someone die in extreme pain, I think that I would want an extra dose of morphine even if it shortened my life. (Note to SnakeFist---life is not automatically happy, certainly not when you are in extreme pain and it's not going to stop.)

Unfortunately, Dr. Kevorkian was not a good poster child for his cause. We need an intelligent conversation about this, especially as medicine improves the capacity to keep people alive even when they might prefer to not continue their life. We need to study the law in Oregon and it's results. I couldn't find the figures now, but from what I remember from a few years ago, there were only a small number of people who applied and only half of them ever used the medication to end their lives, but knowing that they had that choice gave them some comfort and a feeling of control.

Ron Holzwarth 3 years, 6 months ago

I have a relative that chose to move to Oregon partly because of the "right to die" law.

Crazy_Larry 3 years, 6 months ago

It's not in a doctor's, religion's, or government's, best interest to let people off themselves because once a person is dead the money spigot is turned off.

SnakeFist 3 years, 6 months ago

Excellent logic - kill yourself to spite the government.

Crazy_Larry 3 years, 6 months ago

Life is a sexually transmitted terminal illness.

Ron Holzwarth 3 years, 6 months ago

"Who wants to arrive on the next plane as a preemie?"

You sure don't want to step into the River Styx when the boat isn't waiting!

SnakeFist 3 years, 6 months ago

There is nothing objective to life? There is no commonality of experience? How do parents raise children if they can't base their advice on their own experiences? How can we communicate at all if we're completely alien to one another?

SnakeFist 3 years, 6 months ago

So you don't place any limits on suicide? If someone says they're in pain and want to die, and they seem otherwise rational, you say let them do it because you cannot judge whether their desire is rational or not? I assume you've never raised (or been) a teenager, and I certainly hope you're not a therapist.

Happiness and pain are two different things. We do things everyday that cause us some amount of pain, e.g., exercise, go to work, or attend class, because we know it leads to happiness. The pursuit of happiness always trumps the avoidance of pain - that is an objective truth.

Cait McKnelly 3 years, 6 months ago

"The pursuit of happiness always trumps the avoidance of pain - that is an objective truth." This is no more objective than the statement that God made the world in seven days. How old are you? 18?

Cait McKnelly 3 years, 6 months ago

Oh and by the way, what if the avoidance of pain is the pursuit of happiness to a particular person? Please resolve that grasshopper.

SnakeFist 3 years, 6 months ago

Please, take a class on ethics. People have been thinking about these issues for thousands of years, and you could benefit from knowing a little about their conclusions. Until then, you're just wasting everyone's time.

Cait McKnelly 3 years, 6 months ago

You wish to force people to live that don't want to and want to lecture me on "ethics"? That's laughable.

labmonkey 3 years, 6 months ago

The question of killing yourself in extreme circumstances should be a conversation between you, your loved ones, and your God. I have already told my wife that if I am found to have Alzheimer's when I get older that I will live as much lucid life as I can, then kill myself while still lucid as to spare her years of her life taking care of me when she could mourn me (or clean up after throwing a good riddance party) and get on with her life.

The thing about assisted suicide is you can never know the intentions of the assister. If someone is suffering from the initial depression of finding out about an illness, perhaps that is not the time to talk about ending your life. Also, if someone wants to fight for those last couple years of life, then they should be able to without a death panel...I mean an end of life counselor trying to convince them to give up. It should be the patient's choice whether to fight through the pain, or to die comfortably.

kernal 3 years, 6 months ago

Do some research. Start with hospice workers, grief counselors, estate attorneys and case workers. I suspect if you look further, you can find your own answers to your questions rather than try to get another argument going.

kernal 3 years, 6 months ago

SnakeFist, I have to assume you've never watched anyone die a long and painful death from an illness that cannot be cured. Until you have, keep your opinion about end of life choices to your self.

You may also want to have an attorney prepare a document for you to give to your doctor and local hospital to keep you alive at any cost regardless of your pain or chance of recovery.

SnakeFist 3 years, 6 months ago

What I hear you saying is this: "I am so afraid of undergoing what I witnessed, that I will kill myself to avoid it." Rational decisions cannot be based on that kind of fear.

I don't need to prepare a document to have myself kept alive - that's the default position; society assumes everyone wants to live unless they say otherwise. Why do you suppose we make that assumption?

Interestingly, the choice to reject life-saving treatment (as expressed in an advance directive) is highly unstable. Even more interestingly, people don't even realize when their choices change. See, for example, Winter, L., Moss, M. S., & Hoffman, C. (2009). Affective forecasting and advance care planning: Anticipating quality of life in future health statuses. Journal of Health Psychology, 14(3).

Cait McKnelly 3 years, 6 months ago

What I hear you saying is: "I am afraid of death and the subject of death." Rational decisions can and should be made on that kind of observation and yes, fear of the same happening to the self. That's called "experience". I highly distrust your last paragraph but withhold judgement until I can read the article for myself. Ultimately, the goal of advance directives is to keep the dying process within the control of the person. However, the way that ADs are ignored and voided by families and designated powers of attorney are a horror in and of themselves. A very few people may not be aware when their choices change but the ability to and incidence of families and DPOAs ignoring those directives simply because they have the legal power to do so is far worse.

Linda Endicott 3 years, 6 months ago

You think you know everything, don't you, Snake? My mother died from cancer. She knew she had cancer, but she chose not to tell anyone, not even her children, and she refused any medical treatment for it at all. The changes came along so gradually that none of us around her every day noticed them until it was too late to do anything about it. She was a tough old bird and was able to hide her pain from us much longer than a lot of other people would have been able to. When the changes became apparent, it was because she had lost so much blood that she was no longer totally coherent. This was when we realized something was wrong and insisted she go to the doctor. She did, and knew what he would say, which he did...that her body was so riddled with cancer that there was no hope at all except to try and make her as comfortable as possible in what time she had left. She went into the hospital, where she was only lucid for one more day, and then she went into a coma. No point in life support by then, we just sat there and waited, day by day, while she slowly died in front of our eyes. They used a catheter on her. She wasn't conscious, so they had to come in every day and suck the congestion out of her lungs. Even though she supposedly wasn't aware of this, and never spoke to anyone again, her body certainly protested this treatment. She would thrash around and practically scream every time the nurses did it, which was several times a day. And we had to watch her go through this for seven long days, before the end finally came. Exactly what kind of "happiness" did she have during those last seven days, Snake? I don't care about your d*mn ethics...you go through something like that and then tell me again what your idea of ethics is...

jafs 3 years, 6 months ago

The reason that you have to have instructions to prevent end of life measures is that doctors are bound by their oath to keep you alive.

My mother had lung cancer, and after a certain point of treatment by chemotherapy, didn't want to continue any longer. She talked about it with her oncologist, got his take on the quality and length of life she would have if she continued, and decided to stop chemo.

She was competent, intelligent, and aware of the realities of the situation.

We were sad, of course, but respected her choice.

In your version, we talk her out of it/try to have her declared incompetent so we can make the decision for her?

Seems incredibly disrespectful to me.

kernal 3 years, 6 months ago

Snake, the person I was referring to was in pain for over two years; It was his decision to stop the treatment for his cancers (yes, he had two different cancers going on at the same time).

You are hearing me wrong.

Your postings indicate you have so many fears of your own about death, that I really don't know how you can stand to face your own mortality every day.

50YearResident 3 years, 6 months ago

If you realized your post was supposed to go someplace else, then why did you post "nothing", only being confused? Why not delete your worthless post? Now I am confused.

SnakeFist 3 years, 6 months ago

My guess is that many people are in favor of suicide because its easier to have someone you love kill themselves, and pretend it was what they wanted and that you were just honoring their wishes or preserving their dignity or some other obvious rationalization, than to help them deal with their pain, pay the medical bills, and, in general, help them to live.

I can understand how, if you've been through that, you don't want to admit that you should have saved your loved one rather than be complicit in their death.

Cait McKnelly 3 years, 6 months ago

You obviously have never been through the dying process with a loved one. Or you have never loved anyone enough to care. Your time will come, grasshopper, and you will look back on this and understand the hubris of your statements.

SnakeFist 3 years, 6 months ago

You realize, of course, that the strength of your protestations belies your feelings of guilt, and, more importantly, makes my point. Someday those feelings of guilt will surface and you'll have to deal with them, but, until then, keep that lid screwed down tight.

Throughout history, people rationalized the euthansia of their beloved pets. It worked so well that we now rationalize the euthanasia of beloved persons in our life. Clearly it is easier for us not to see them in pain or have to pay their medical bills, and if we can convince ourselves that they actually wanted to die then so much the better.

Cait McKnelly 3 years, 6 months ago

My jaw dropped reading this. You really haven't got a clue, do you? I attended my mother at her death and I can assure you, that woman had an iron grip on control of her life and death to her very last breath. When she chose to terminate dialysis and permit herself to die I had nothing to do with her decision and I had no desire to challenge her on it, preferring, instead, to spend the last few days of my mother's life with her in peace and love rather than trying to convince her to live a life she found overwhelmingly burdensome, painful and no longer worth fighting for when her best outcome was another six months of so called "life". I spent 36 years as a nurse; 11 years as an LPN and 26 as an RN. A good half of that career was spent attending to and caring for the dying. I'm not just talking out of my a$$ here. I think you evidence your own guilt, fear and inexperience by mirroring on to me and accusing me of your guilt.

verity 3 years, 6 months ago

SnakeFist, you appear to have no idea what you're talking about. Have you ever witnessed the agony of a family having to decide when/if to turn off life support? Even the decision to let the doctor put a "Do not resuscitate" order on a chart when the person themselves wants that is very painful. And watching someone in horrible and excruciating pain from cancer waiting for the doctor to get to the hospital so he could order more morphine is not a memory I will ever be able to erase. Do you actually think that a person in terrible pain wants to continue that pain just so they can stay alive?

Ron Holzwarth 3 years, 6 months ago

SnakeFist: "My guess is that many people are in favor of suicide"

Obviously, that statement was made by someone that has not lost very many relatives and friends to suicide.

Cait48: "Your time will come, grasshopper, and you will look back on this and understand the hubris of your statements."

It seems to me that a lot of people never look back and realize very many of their miistakes. At least, not in this life.

jafs 3 years, 6 months ago

Unbelievable.

If you think it's easy for somebody to have a loved one commit suicide, you're living on another planet.

Cait McKnelly 3 years, 6 months ago

I think all y'all should run, not walk, to Kansas City, Kansas Community College and take a course they offer called The Grieving Process. http://www.kckcc.edu/Media/Website%20Resources/pdfs/syllabi/PSYC0115.pdf I actually think it's a bit of a misnomer of what the class really is as I see it as not just about the "grieving process" but an actual course on "death" and "death education" (technically called thanatology). Too many people in this country avoid the subject of death and distance themselves from it, both on a personal and societal level. Even our funeral practices are designed to distance ourselves from death. Death is a dirty word to many people and they treat the subject like a lot of people treat sex; something to be swept under the carpet. The reality is that both are natural human functions in the process of life and that from the minute you are born you are in the process of dying. I suggest that if anyone is interested that they research thanatology online and in the process try to set aside cultural and religious prejudices toward the subject.

Katara 3 years, 6 months ago

You are absolutely correct. So many people avoid the subject of death. It is as if they fear by talking about it, they will drop dead right there themselves. So many people die without a will. So many people never tell their family and friends what their wishes are regarding their death and the treatment they want to have prior to it.

It is something you should discuss with your family members, your doctor and your religious adviser.

Cait McKnelly 3 years, 6 months ago

/blush Was that because I beat him into submission? Seriously, I hope it's because I provided valuable information.

Ron Holzwarth 3 years, 6 months ago

"Living too long" can sometimes present problems. I am reminded of one of my great grandmothers that once sadly remarked to my mother that she had outlived her husband, one of her children, and every single one of her friends.

But she was an incredibly peppy woman. She more than once talked about the other residents in the nursing home in a very experated fashion about "all the old people here!" But in age, she was the oldest one there!

And, many times she would be reached on the telephone but simply be to busy to talk right now, because some game was being played, and she did not want to lose her place!

I was very disappointed to learn of her death, because there were great big plans for her next birthday, she was going to be 100 years old. But, she died only a few months before that.

SnakeFist 3 years, 6 months ago

For those who prefer to base their opinions on fact rather than emotion, you might look at:

  1. Fried, T. R., et al. (2007). Inconsistency over time in the preferences of older persons with advanced illness for life-saving treatment. Journal of the American Geriatrics Society, 55(7). This is one in a long line of studies that show preferences regarding life-saving treatment to be unstable.

  2. Sharman, S. J., et al. (2008). False memories for end-of-life decisions. Health Psychology, 27(2). This study shows that people don't realize when their preferences regarding life-saving treatment change.

  3. Winter, L., et al. (2009). Affective forecasting and advance care planning: Anticipating quality of life in future health statuses. Journal of Health Psychology, 14(3). This study proposes that errors in affective forecasting (i.e., people's atempts to anticipate their future preferences) are the causes of preference instability.

There are dozens of supporting and related studies, just search PsychINFO.

Linda Endicott 3 years, 6 months ago

Apparently you are under the mistaken notion that all people in our society get the same choices for end-of-life decisions...this is not the case... One of my aunts went to the ER one night with an excruciating headache...they admitted her to the hospital, and the very next day she went into a coma...the doctors put her on life-support while they did tests, but they basically told the family that they didn't know what had caused the headache or the coma, but that she appeared to be brain-dead... Now, medicine doesn't know everything yet...her children wanted to keep her on life support, and hoped against hope that she'd come out of the coma and recover, though the doctors didn't give them much hope, they had to admit it might be a possibility, albeit a small one... Unfortunately, my aunt had no health insurance, and none of her three chidlren had much money...and so the doctors and the hospital administrators told her family that they basically had no choice in the decision...if they did not choose to take their mother off of life support, the hospital would take them to court and force them to do so...which probably would have happened; the same thing has happened in many other cases... Her children then decided to take her off of life support, not able to afford a protracted legal battle...she died the same day... So don't be too sure about that "default position" to keep yourself alive...life support is very expensive, and if you think you may ever have to go that route, I hope you have d*mn fine insurance...

Cait McKnelly 3 years, 6 months ago

No one has ever said that people who choose to create an advanced directive can't/won't change their minds about it. The Midwest Bioethics Center in KC, which had a lot to do with pioneering the advance directive in the '70's, has always recommended that people with ADs re-evaluate them annually and go over them with their DPOA. If there are shifts in how a person feels these re-evaluations can and should catch them. DPOAS are also usually aware of any shifts and ultimately they can (and frequently do) over ride an AD. You talk as though advanced directives are written in stone. They aren't. I have no idea what your personal experience with this is and why you have the beliefs that you do but it leads me to believe that you have very little actual, practical experience with advanced directives.

jafs 3 years, 6 months ago

As cait mentions, all of that is easily dealt with by re-examining your directives each year, which is the basic recommendation.

My mother had such directives, and was consistent in them from the time she first had them until the time she died.

Crazy_Larry 3 years, 6 months ago

Life is a sexually transmitted terminal illness.

Cait McKnelly 3 years, 6 months ago

A strange way of putting it but, ultimately, true. It's like saying that the base cause of all human death is lack of oxygen.

50YearResident 3 years, 6 months ago

What is a good reason for me to continue to live if, 1) I no longer recognize my own family and life long friends because of Alzhimers. 2) I can no longer take care of myself, like eating, bathing, dressing and have lost control of my bladder and bowel functions and am bedridden. 3) I am in constant pain and require extreme care and medications just to stay alive. 4) I no longer have a desire to live. 5) I have always wanted to die with dignity. ???

funkdog1 3 years, 6 months ago

I think you'll change your mind after the first time you've sat next to a loved one who is dying of cancer. Most of us will have to go through this a few times. It is absolutely the most sickening experience ever. I'll never understand why we'll allow our pets to die with dignity and grace, but we don't allow our loved ones the same luxury.

jafs 3 years, 6 months ago

Those are questions best answered by the individual, I'd say, rather than others.

jafs 3 years, 6 months ago

Having the benefit of others is fine, but the decision is ultimately an individual one.

funkdog1 3 years, 6 months ago

"I really am not one to let (my) personal distress drive resolution of existential matters. Regarding those in the final stage of life, there remains the burden to which I've alluded and the question as to whether we adequately are meeting that burden.

"Dignity... grace... luxury" ... what are these things within the existential context?

(I don't mean to be callous; these are real questions for me.)"

I don't think you're being callous, but I do think you're being deliberately obtuse.

Cait McKnelly 3 years, 6 months ago

"For those who do not view life—and lives—as some "commodity," suicide, assisted or otherwise, clearly is lacking of anything approximating "dignity." "


How is permitting someone to die pain free, even going so far as to helping them truncate their life to avoid suffering, if that is what they wish, viewing life as a "commodity"? On the contrary, valuing quantity of life over quality is more of a "commodity" view. Squeezing a few more days out when those days are being "lived" ( word being arguably used) in agony is somehow more "dignified"? And those "experiences" you spoke of; who are they for? The person dying? Or the living? If it's the person that is dying, it's arguable that those "experiences" are pretty worthless given that they are, oh yeah, DYING. If they are for the living, how do you justify lessons being taught to you on the back of someone else's suffering? That's really very cruel, don't you think?

verity 3 years, 6 months ago

"Oh, wait, we're probably, effectively, already doing that."

No, we are not necessarily able to keep a person pain free AND alive, so you're arguing from a false premise. Often enough morphine to become pain free causes life functions to end.

I appreciate Cait's story of her mother choosing to quit dialysis. There are others who have chosen, when faced with terminal cancer, to not be treated. This may give them less time to live, but that time may be a better quality of life because they are not suffering from the side effects of treatment.

Whose stealing that time? Does that person not have the right to choose? Isn't it in choice that one has dignity?

I hope not to have to make that decision, but if I do, I want to have the freedom to make it.

Linda Endicott 3 years, 6 months ago

Pain from cancer is much more than a "discomfort"... And if you have to dope someone up so much to relieve the pain that they're no longer aware of what's going on around them, what have you really accomplished anyway?

deec 3 years, 6 months ago

Part of the reason terminal cancer patients are in so much pain is because a secondary effect of adequate dosages of opiates to alleviate their suffering would be to kill them. Doctors cannot authorize those dosages, because then they would be committing assisted suicide. So the dying person suffers, usually due to some religious relative's misguided attempt to not interfere with god's will, or the doctor's understandable desire to avoid prosecution for murder.

Cait McKnelly 3 years, 6 months ago

"....might we then generalize the conclusion and permit people to live "pain" free, e.g., through the legalization of opiates? (Oh, wait, we're probably, effectively, already doing that.)"


Actually, no we aren't. As verity pointed out, to effectively deal with real "end of life" pain issues would require opiates in quantities incompatible with life. Hospices and palliative care units across America perform a delicate balancing act on a daily basis that deals with attempting to relieve pain and still stay within the laws imposed by the Federal DEA. Not only does America not deal with death well, we don't deal with pain well either. Neither fits into the classic Puritan stoicism that founded a lot of this country and continues to pervade it's society. In fact, Europeans consider Americans barbaric in their approach to pain with a government more concerned about drug laws then allowing doctors to provide actual relief. So what do we do? Hospices and palliative care units really can't guarantee freedom from suffering. The fact that a certain number of people choose to commit suicide, be it actively or passively by refusing treatment, is a result of the fact that frankly, it honestly is the only way they can relieve their pain and suffering. Verity pointed out something else that I think is probably the real heart of the matter and the real definition of "dignity" in this situation when she said, "Isn't it in choice that one has dignity?" It's in being able to maintain control of one's own life (and death) and the ability to exercise autonomy that real dignity lies.

jonas_opines 3 years, 6 months ago

snakefist: "We have an obligation only to respect rational decisions. Choosing to sacrifice happiness to end physical pain is an irrational decision. In the healthy it is a result of naive idealism, and in the sick it is the result of fear - neither of which is rational."

Far more rational than choices based off of that most irrational of emotions: hope.

kernal 3 years, 6 months ago

Okay, so I'm sitting here back at my keyboard and wondering why snakefist has read these books and papers he refers to. Could snakefist be a KU psych student?

Also wondering why we have a LTE from a woman in Oregon who writes a column for a newspaper in Oregon. Incidentally, she is 74 years old and I think assisted suicide is still legal there.

Linda Endicott 3 years, 6 months ago

It's an interesting question, which, of course, there is no answer...since no one has died and come back to tell us what it was like...

I suppose it's possible that death, in whatever way it comes to each of us, will not provide any relief, escape, or comfort...but that's a pretty terrifying thought, isn't it?

I would hate to think that all the physical suffering here on earth would only result in more suffering on a different plane...

Linda Endicott 3 years, 6 months ago

Possibly...but how do we know what happens when we die??

Brent Garner 3 years, 6 months ago

Is killing oneself wrong? If ending one's own life is ethical, then what are the circumstances which would justify such drastic action? On Sep 5, 2009 my 25 year old son took his own life. It became clear to his mother and me, as we dealt with the aftermath, that our son was deeply depressed. Based on bills we received it appeared he was talking to a counselor. Yet, due to his incredibly depressing financial situatioin, combined with his use of alcohol and his association with those who live only for the moment, he felt that there was no other way out other than to end his life. Sadly, he was wrong. Yes, a way out for him existed but it would have required change and sacrifice and humbling himself. These he was unwilling to do so he ended his life. Let me assure you that his action affected far more than himself. His mother and I stood ready to help him but he rejected us and pushed us away unwilling to listen. The pain I carry and will carry for the rest of my life caused by his suicide causes me to doubt the ethicalness of allowing self-termination or even assisted termination of one's life.

jafs 3 years, 6 months ago

I'm very sorry to hear about your son.

There are certainly situations in which people are depressed and see no way out that might change if they got the right kind of help.

If people are in that kind of place, I would certainly urge them to get help, and not give up.

But, I think it has to be ultimately up to each individual to decide whether they wish to live or die, as long as they are legally competent. I can't imagine anything more intimately personal than that choice.

If you don't mind talking about it a little bit, how is it that you weren't aware of how depressed your son was?

jafs 3 years, 6 months ago

The criteria that matters to me is legal competence.

If somebody is legally competent to make decisions, then that includes the decision to end their life.

verity 3 years, 6 months ago

Tange, do you actually understand what you are saying or are you just stringing words together?

verity 3 years, 6 months ago

Please get help, get back on your medication---if you are not terminal, I certainly don't want you to terminate yourself! :)

verity 3 years, 6 months ago

I'm paying attention, maybe I'm just not smart enough to understand you. Oh, a strange cat just walked across my patio---is that a portent of a canary in a mine?

verity 3 years, 6 months ago

Brent, after re-reading what I posted below to Tange, I realized that maybe this wasn't the place for levity and I did not mean to make light of the terrible thing that happened to you. You have my deepest sympathy. Never having had that experience, I won't pretend to have any idea how you feel.

As I stated above, this is something I have given a lot of thought to and had come to the conclusion that as taking a life is wrong, even taking your own is wrong. However, as I pointed out in my 6:44 post below, the Oregon law only pertains to people who are terminally ill and not someone who is struggling with depression and other problems. In my opinion, the ethics involved are completely different---I realize other people may disagree with me and would like to hear their opinions. I think that the person who is experiencing the kind of emotional pain (as opposed to physical and terminal pain) that causes them to take their own life is probably not able to understand what pain they will be causing others. I guess there is a similarity in that they see no other way out.

verity 3 years, 6 months ago

"On October 27, 1997 Oregon enacted the Death with Dignity Act which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose." The operative word here of course being terminally-ill.

Oregon Revised Statute: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx

PDF of Annual Report Oregon's Death with Dignity Act--2010: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year13.pdf

With all due respect, we are talking about two different things. In my opinion, the ethics involved are two different conversations.

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