Euthanasia - should it be legal or illegal? (v2.0)

Bubba

You questioned the uniqueness of each human life, but I don't think you refuted it.

I was not exactly questioning it; I will agree that in some ways each individual life is unique. But in other ways, humans are all the same. It is cliché, but 'We are all unique, just like everyone else.'

However every individual object is unique (every rock, every mess, every blade of grass, every sparrow), and that alone for other things does not make them valuable, so there must be something else besides uniqueness to make human life valuable I would think.

You have your life, and you can replace it with no other. Once it is gone, it is gone. Do you dispute any of this?

It depends. From the point of view of my boss where I work I can easily be replaced if I was gone (I am a glorified janitor). But then again, to my mother, I am irreplaceable. My point about uniqueness is that it is all from a perspective, it is all subjective. Also, from my point of view, well, if I was gone it won't matter much to me at that point.

That said, I should have perhaps made myself more clear. Rather than use the word, I should have explained my use of the word "intrinsic." That I believe human life has "intrinsic" value means that I believe that it is valuable in and of itself. I don't need to point to anything else to explain its value.

But unless you give an explanation then you are on a slippery slope. Anyone can say that anything just has value in and of itself and I do not see why your stance is any more right than theirs.

I believe that, for some, the question, "what is it that makes human life valuable," is an opportunity to rid themselves of lives that do not possess X, whatever X may be.

Even if it comes down to some X, that does not mean that those human lives without X must die. There could be other reasons beyond that in which death would be a mercy or justified.

Also, X could be something that is a fundamental part of whatever human life is, such as human genetic material. If the thing in question does not have human genetic material, then it is not valuable as a human life would be. If that is the case, that does not mean we have to kill it. I would miss my cats then.

Also, I don?t think Guin was talking specifically to you. From the start of this thread, there have been people saying ?Why wasn?t an MRI done?? and I have never heard a detailed explanation why not till she(?) spoke up. I think it was more of an FYI post.

 

While it may be true that hospitals do not have to provide excessive care, we're not talking about care in this case: we're talking about diagnosis so that a court can make a life-and-death decision.

They already had a diagnosis, and the technology involved was only questioned by the people who don't understand the technology and/or pathophysiology, or who didn't like what the diagnosis was. Holding out for a PET scan or MRI/fMRI is a stalling tactic, rather than a legitimate medical concern - the amount of damage demonstrated by the CT would not be magically reversed with PET or an MRI.

Maybe it's still the case that the hospital isn't legally required to perform either of those two scans, and maybe it's the case that the court doesn't have to have proof that is beyond a reasonable doubt, but maybe things should change.

Then write your congressman *and* the Supreme Court. "Beyond a reasonable doubt" is *a* standard of evidence, but not the only standard (e.g., preponderence of evidence, clear and convincing evidence, etc.) - there is a question as to whether 'reasonable doubt' is an appropriate standard. Further, the Supreme Court ruled that states have the right to set their own evidentiary standard.

Perhaps we should raise the bar of the burden of proof on the issues of the patient's wishes and diagnosis to match what is required in a criminal case. It doesn't seem right that euthanasia be treated as a less serious issue than capital cases.

Because that runs the risk of pushing for too high a standard of evidence. I'll give you a quick for instance; in Pennsylvania, for a living will to be valid and applicable clinically, it must be signed by two witnesses and be on the patient's chart. If there is only one witness, then legal is called to see whether it is valid. There are further constraints, too, as this does not get into any family conflict issues. THe problem is worsened when you go across state lines into West Virginia, which on top of the two witnesses rule, also requires notarization; so if your wishes are clearly known in PA, they might not be admissible in WV, because they don't meet the necessary standard. By making the standard "beyond a reasonable doubt", you are grossly overestimating people's ability or willingness to meet the legal criteria regarding their own wishes. Your standard would prevent people from being able to direct their own care, based purely on the letter of the law, ignoring its spirit. You are making an already difficult situation worse.

I agree that I wish things had been clearer in Terri's case; but for many people, a conversation is all they have - the positive upshot of this case is a renewed interest in living wills. Many people simply trust their friends and loved ones to do what's right for them, but never bother to explicitly state what they would want in every context. By nature we aren't that Napoleonic - we can't anticipate every situation, and therefor could potentially fail this new standard of evidence you propose, simply because they couldn't anticipate it.

The obvious alternative -- where "iffy" cases such as Terri's lead to cases where doctors use spurious diagnoses to kill patients despite their wishes -- is repellent to me.

I agree - it's quite fortunate that your scenario didn't occur. Assertions to the contrary are counterfactual and represent ideology dominating fact.

But about the fact that Terri was in a hospice, I will remind you: TERRI SCHIAVO WAS NOT SUFFERING FROM A TERMINAL ILLNESS.

Strictly speaking, that's correct - in the sense that the PVS condition would lead to her death by secondary causes like dehydration were no medical intervention put into place to correct the underlying disease process. The issue is not as cut and dry as you make it, however, because, strictly speaking, diseases like diabetes *are* terminal illnesses, because of their pathophysiological effects. Terminal illness is a gray area in medicine and law, which is why it is seen as a prima facie definitio

 

Last post for the time being...


Enforcer, I'm not sure I can give you an answer that is satisfactory. There are certain things we take as given -- self-evident -- and I believe the value of human life is one of those things. Perhaps someone else with a greater grasp on philosophy (or simply more time and patience) can justify this to you, but I'm not in a position to do so.


Sith, I think you're being presumptuous in so quickly dismissing all those who believe an MRI or PET scan was warranted. There were neurologists who believed the CT scan is insufficient for the diagnosis that was made. I sincerely doubt that they're all ignorant or unduly biased.

And even if it was a stalling tactic, what of it? What's the rush in killing Terri Schiavo? She wasn't going anywhere, and most of you were adamant that she was incapable of feeling pain.

Death row inmates can file for appeals (at least to some degree, if not indefinitely) even if it is a stalling tactic. Should we deny for the innocent what we grant for the convicted?


I certainly understand that there are different standards of evidence; why do you apparently think a standard that is lower than what is required to execute a criminal is good enough for life-and-death cases such as these?

The standard could be too high? For every instance you give, a counter-example is obvious: if the standards are too low, the decision may be based not even on an unrecorded conversation, but on what a family member merely supposes what the patient might have wanted.

There are two concerns, after all: respecting those who clearly express the wish to die in very specific circumstances, AND PROTECTING EVERYONE ELSE. You don't seem to give a thought to the last group, and that's worrying, to say the least.

You write: "I agree that I wish things had been clearer in Terri's case; but for many people, a conversation is all they have - the positive upshot of this case is a renewed interest in living wills. Many people simply trust their friends and loved ones to do what's right for them, but never bother to explicitly state what they would want in every context."

But should that be enough? Many people trust their friends and family, but many friends and family members are untrustworthy. Taking a family member's word on the patient's wishes obviously opens the door to lying about their wishes for their own ends. If you don't like my idea of a burden of proof that matches capital criminal cases, I would love to hear your ideas on how to prevent such abuse. Heck, I would love to see you at least recognize the possibility of such abuse.


It's amazing -- and damn frightening, if I may say so -- to see you argue that Terri was close enough to being terminal, despite your admission that my assertion to the contrary is correct, "strictly speaking."

You write, "Her underlying condition would lead her to die, as she could not perform any of the cognitive functions necessary for self-maintenance beyonf [sic] homeostasis."

A man paralyzed from the neck down could not perform any of the physical functions necessary for self-maintenance, either. Even though paralysis is not considered terminal, yours is precisely the sort of reasoning that makes quadriplegics fair game.

Their "underlying condition" would lead them to die.


You apparently want the burden of proof as low as possible and the category of those who can be euthanized to be as broad as possible. That opens the door to all sorts of abuse, but that doesn't seem to bother you.


Finally:

"'Hospice'" used to refer to a place where people would go when they were close to dying. It may soon mean a place where people are taken to be killed."

Or not. It depends if people choose to be swayed by bad rhetoric.

Such a statement isn't an argument. It is itself nothing more than rhetoric, and what is there to make us believe that your rhetorical proclamation is sound?

I think hospices may soon become places where people are taken against their will to

 

Life is a terminal illness. And in her case she chose to die when she became bulimic. Also, her continued state would've deteriorated to the point where she would've died any way. Having a brain dissolving isn't exactly something someone can return from. It's not like she was going to get up from her wheelchair and start dancing.

 

Fire, I think it's astoundingly callous for you to write, "And in her case she chose to die when she became bulimic."

I seriously doubt that anyone intentionally chooses to become bulimic, much less chooses to become bulimic with the intent to die from it. I've always thought that we should be compassionate towards those who have disorders like bulimia and addictions like alcoholism. If their problems lead to an untimely, early demise, we should not act as if they either chose to die or deserved to die.

Unless you have the same attitude for all bulimics, you're demonstrating what I think can only be called outright contempt for Terri Schiavo. And this is at least the second time you've made a comment like this.

I hope you're joking; I hope you're just saying this to get a rise out of people, because if you're not, I think you're demonstrating a staggering absence of compassion and humanity.

 

Bubba,

So it was Illinois. I stated in my first post about the state that had declared a moritorium on executions that I wasn't exactly sure which state it was, only that it was in the Midwest.

Also, the governor was elected by a majority of the people, so as the people's representative, yes, he acted in their stead.

And, I said entire state to differentiate it from a town, city or county.

However, a simple mistake about which state did it, does not change the fact that such a moritorium was declared.

My comment about the perjured testimony was in response to your repeated statements about how many appeals convicted murderers get. It was in no way an attempt to show that our criminal justice system should be done away with, only that it is flawed and every care should be taken to ensure that justice is done properly.

I'm sorry that you feel that Terri Schiavo did not get her share of 'due process.' 21 times in court is a lot more than most convicted murderers get, the appeals process is limited to 4 or 5, unless compelling NEW evidence is found.

Thanks, Quix, for explaining the differences in the various medical tests that certain people have been clamoring for.

Since the additional tests would not have provided the NEW compelling evidence that the Schindlers would need to prove their case, the court acted responsibly.

Again, as Quix said, if you don't like the law, write your congressman and try to get it changed.

You keep saying that you are not claiming that Terri Schiavo was murdered, yet your comment regarding the Taliban makes me think otherwise.

The Pilgrims came here to be free to worship God the way they saw fit, not the way somebody else, usually the government, told them they had to.

That right, to freedom of religion, has been recognized as also meaning that people have the right to be free of religion, any religion, itself.

No, I don't think it is cowardly to accept medical care.

But, I do think that when one's religion is insistent that life is valuable, and that one does not have the right to interfere with God's will for when one's life should end, that refusing the medical care that would prolong that life for however long, until God ends it, is very courageous.

EDIT #1:

When I asked you to state at what point life would have no meaning for you, I believe that is a simple question to answer. If you believe, as the Pope did, that no human being is ever a vegetable or an animal, then say so. If you believe your life should be artificially prolonged as long as medical technology allows, then say so.

A living will allows you to state that you do want aggressive medical treatment, as long as possible, it isn't just about refusing treatment.

It's not a trick question or a trap question.

EDIT #2:

On the subject of how much intellectual capacity you would lose if you lost 40% of your intellect, normal IQ is 100, below 75 is considered retarded.

Genius IQ starts at 132 and goes up.

So, if you have an IQ of 132, that would make you a genius. Lose 40% of that and your IQ falls to 52.8.

So, you would be breathing and maybe able to feed yourself, unless your loss of intellect was a result of oxygen deprivation.

In which case, you might not even be able to do that much.

 

Fire, I think it's astoundingly callous for you to write, "And in her case she chose to die when she became bulimic."

It is, huh? What do you think the end result is of any eating disorder? Certainly not leading a productive, healthy life.

I seriously doubt that anyone intentionally chooses to become bulimic, much less chooses to become bulimic with the intent to die from it.

At some point the conscious decision was made to become bulimic, whether under duress or not; it was her choice to become that way. Unless you're suggesting someone stuck their finger down her throat and forced her to become that way.

I've always thought that we should be compassionate towards those who have disorders like bulimia and addictions like alcoholism. If their problems lead to an untimely, early demise, we should not act as if they either chose to die or deserved to die.

I am being compassionate toward people with eating disorders, but I won't take pity on those who refuse to get help. Even an alcoholic can choose to get help every now and then. They don't just wait until they bleed out. Even if a relative knows they try to get them help. In the end, though, the result is the same, death. Do you deny this fact?

Unless you have the same attitude for all bulimics, you're demonstrating what I think can only be called outright contempt for Terri Schiavo. And this is at least the second time you've made a comment like this.

Contempt? There's no contempt there. I am merely stating a fact. She was an adult, not a child, she made the choice to do that. It's not contemptuous to say that if you're an adult and you form an eating disorder that you choose death.

I hope you're joking; I hope you're just saying this to get a rise out of people, because if you're not, I think you're demonstrating a staggering absence of compassion and humanity.

You mean the sort of compassion that's shown toward gays by the religious? *snort* No. I do have compassion for what's happened, I just don't wish to live under the delusion that she didn't choose death by way of her actions.

 

Sith, I think you're being presumptuous in so quickly dismissing all those who believe an MRI or PET scan was warranted. There were neurologists who believed the CT scan is insufficient for the diagnosis that was made. I sincerely doubt that they're all ignorant or unduly biased.

But again, the onus of proof is on those who would simply dismiss the conclusions of the neurologists who actually studied the case and reached a diagnosis of PVS. Physicians sometimes disagree ? it does not mean, however, that the minority opinion is de facto right or requires placation. Some physicians require more ?evidence? than is warranted or needed to accurately reach a conclusion ? that does not therefore mean that physicians who made the diagnosis based on compelling, less thorough evidence were unwarranted in their conclusions. There is no compelling reason to get this extra evidence unless one is simply buying time (i.e., hoping for a governmental intervention).

And even if it was a stalling tactic, what of it? What's the rush in killing Terri Schiavo? She wasn't going anywhere, and most of you were adamant that she was incapable of feeling pain.

Except that she didn?t want it, so therefore it shouldn?t be done. You need to get this into your head, and I don?t know how to do it, because it clearly hasn?t sunk in.

Death row inmates can file for appeals (at least to some degree, if not indefinitely) even if it is a stalling tactic. Should we deny for the innocent what we grant for the convicted?

Get off this. This is an awful analogy, and is in no way comparable to a patient in PVS. There is no parallel between a legal appeals process and forgoing medical treatment. I'm tired of this "argument" and having to rebut it. Read a freaking book on the subject before you post this asinine blather again. I'll happily point you to a few fundamental resources.

I certainly understand that there are different standards of evidence; why do you apparently think a standard that is lower than what is required to execute a criminal is good enough for life-and-death cases such as these?

First, because the cases are disanalogous. Second, the Supreme Court has argued that states can set the standard for what constitutes sufficient evidence. If you don?t like it, write them.

The standard could be too high? For every instance you give, a counter-example is obvious: if the standards are too low, the decision may be based not even on an unrecorded conversation, but on what a family member merely supposes what the patient might have wanted.

Yep. But sometimes that?s the best we have to go on. You don?t seem to get just how your overly legalistic standard can hurt people, and that?s a shame.

There are two concerns, after all: respecting those who clearly express the wish to die in very specific circumstances, AND PROTECTING EVERYONE ELSE. You don't seem to give a thought to the last group, and that's worrying, to say the least.

Quite the contrary ? I give them more thought than you do; you just choose to characterize your position as the high ground, when it simply reflects an incomplete understanding of the medical, legal, and psychosocial issues involved. You choose to make difficult issues overly simplistic, and therefore render significant harm to those unfortunates who get caught in your way.

But should that be enough? Many people trust their friends and family, but many friends and family members are untrustworthy. Taking a family member's word on the patient's wishes obviously opens the door to lying about their wishes for their own ends. If you don't like my idea of a burden of proof that matches capital criminal cases, I would love to hear your ideas on how to prevent such abuse. Heck, I would love to see you at least recognize the possibility of such abuse.

In an ideal world, everyone would be crystal clear on their intentions and wishes, and would take the time to understand all the possible medical interventions that can be used. But they don?

 

Made a mistake in my math! 132 - 52.8 = 79.2. Still a pretty low IQ figure, barely above what is considered retarded and below what is considered average or normal.

But, as I said, if you want to be kept alive by artificial means as long as medically possible, a living will can be written to include that.

 

Update: California is now considering an 'assisted suicide'law that would make it legal for people with a terminal illness with 6 months or less to live to have assisted suicide available.

Don't have all the details yet, it's still being debated in the Legislature.

 

I imagine they would be basing it on Oregon's model.

 

I think some further details of this issue are:

-The patient needs to have 2 or 3 doctors confirm he/she has 6 months to live.

-Psychological evaluations, appeals, and alternatives to be absolutely sure that the patient is of sound mind.

-Only the patient can make the decision, nobody else.

-The patient has to be able to swallow the pill, so the doctors can avoid violating the Hippocratic oath by assisting suicide.

I support it as long as there is this strict criteria in place for it. I?d like to have the choice for myself to end my life if I?m going to die in excruciating pain in 6 months anyway. I would also hate to burden my family emotionally and financially.

 

Thanks, Quix, they are!

cal-silverstar,

There are people who are terminally ill who are not of sound mind, what about them?

I know Parkinson's, and certain brain tumors, mess up a person's thinking.

There are people who are terminally ill with certain diseases, such as Parkinson's, where it is impossible to tell if/when they have only six months left.

However, many of them are in unbearable pain. Pain meds may be one answer, but that incurs the risk of making the patient an addict.

I hope these issues will be considered as well.

EDIT: And what about terminally ill people who can't swallow, like some stroke victims?

 

However, many of them are in unbearable pain. Pain meds may be one answer, but that incurs the risk of making the patient an addict.

Not so much, actually. People who are genuinely in pain tend not to develop an addiction (when medication is used when there is no medical need, *then* addiction becomes a concern). The second issue is the "So what" factor; if the patient develops tolerance and dependency on the pain medication, they are still actively dying - 'addiction' is the least of their problems, and not as much of a concern.

 

Quix,

Was going to comment on the above, but I'll pm you instead.

 

Lady SJK:

Naturally, this issue is a tough call. As with all life and death matters, it?s best to be absolutely sure. How do we know if someone is not of sound mind would want to die? It goes back to my strong belief in erring on the side of life. The examples you cited should be taken on a case by case basis, using common sense. I also think that if the method of suicide is in pill form, it should be 2 pills combined together to have the effect. Again, this is to be absolutely sure and if it?s chemically feasible.

 

cal-silverstar,

That's why the law would have to be written very carefully.

And even if it parallels the Oregon law, the Justice Department has said that they will actively prosecute anyone who actually uses the law.

 

So the Feds are going to interfere in state legislation again? (Like medicinal marijuana?) Ugh.

 

Yes. States' rights, shmates rights, I guess.

 

The most stupid thing that I see with federal governments striking down these state or territory laws is that euthanasia is happening already everyday in every hospital around the world.

Denying it is happening is ludicrous and laws are put down so certain legislators can sleep better at night, not caring of the suffering of others.

 

That's our government for ya. Appealing to its base, in this case rabid Christian right-wingers that are pro-life when it suits them.

 

Well, if a person is not of sound mind, and they say they want to live, what should we assume? That they want to die?

There is a difference between knowing someone wants to die and not knowing if they want to live. For euthanasia, one should know that the person in question wants to die (or are already practically dead) if someone is to be euthanized.

 

The ironic thing is that I'm writing my dissertation on the topic of depressive disorders and their effect on the choice to forgo medical treatment.

Well, if a person is not of sound mind, and they say they want to live, what should we assume? That they want to die?

In Pennsylvania, you have to be competent (legal sense, not practical sense) to write a valid living will. You do not have to be competent to rescind it. So, let's say you are still of sound mind when you lay out the treatment options you want and don't want (in this case, you don't want dialysis). You are then admitted to a hospital and your living will is put on your chart, so your doctors know your treatment preferences. Your kidneys then shut down, leading to a build-up of urea and other waste products in your blood, which leads to delirium (legally unsound mind). If in this state of delirium you state "I want dialysis" - that section of your living will is rescinded, and the treatment is performed. You will have to reiterate your refusal of dialysis once you are considered competent again.

I do not know if this is true in every state; but I imagine something similar is in effect. States have a parens patriae interest in their citizens, hence the different standards of competency required to enact and rescind a living will.

There is a difference between knowing someone wants to die and not knowing if they want to live. For euthanasia, one should know that the person in question wants to die (or are already practically dead) if someone is to be euthanized.

Yep - Oregorn voted so, *twice*, but the asinine DOJ thought that they had trump power, despite ostensibly arguing for states' rights.

The ironic thing is that then AG Ashcroft went to Oregon to speak against PAS, and stated that if Oregon wanted it, they should vote on it, indicating it was basically up to them. A member of the audience had to tell him about the two statewide referenda supporting PAS. Despite this, he *still* threatened to prosecute doctors who assisted patients.

 

Enforcer,

Of course the presumption would be that the patient wants to live.

My concern with that qualification is that there are terminal illnesses, such as certain brain tumors, that render the patient mentally incompetent. My further concern is how do we deal with such cases from a legal standpoint. Do we use a panel of doctors to decide if their case is hopeless?

The problem is writing a law that is stringent enough to prevent misuse, without denying certain terminally ill patients recourse to the law.

 

I'm sorry, I misread someone saying 'what if they can't swallow' as 'what if they are not of sound mind to make the choice?' I was tired last night...

Bubba

Can you even justify it to yourself?

Also, can you at least say if there is anything wrong with my logic? The idea of arbitrarily saying that something has intrinsic value means everything can have intrinsic value and the idea of uniqueness not being enough to justify value I feel makes sense and I don't think I am missing anything.

Also, I do realize that we have lives beyond these boards, but please understand that this is frustrating to me. I have felt that if I cannot justify something and there is clear logic that that something is wrong, I would acknowledge and accept that, yet here I am feeling like I am on the other end of that situation and being rather stuck.

Anyone else want to take a stab as to what the value of life is?