US Physician assisted suicide

beancounter

The Fire That Burns Within
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http://www.boston.com/news/local/ma...ide-concede/oXZDcgOUbqwhlqzb63FSPO/story.html

A MA ballot question was defeated during the US election this time with opponents expressing concerns about lack of controls and abuses.

I get the feeling that the potential law was written too broadly. If I beleive one of the commercials, a terminally ill person wouldn't even need a doctor present, they could just get a prescription, and end their life completely on their own.

Theoretically, I'm in favor of physician assisted suicide, but the potential abuses, and the human propensity to willingly harm others for personal gain concern me. So, under these circumstances, i would vote no.
 
Based on what I just read about the initiative on Wiki, I would have voted for it. There were, IMO, sufficient safeguards before the meds could be prescribed. Having a doctor there at the time they're taken wouldn't be necessary.
 
If I beleive one of the commercials, a terminally ill person wouldn't even need a doctor present, they could just get a prescription, and end their life completely on their own.

I have no problem with that.
I have enough legally-prescribed pills that I could easily OD if I wanted to, and I'm not even terminally ill.

If someone has a terminal illness and wants to end their life on their own terms, why shouldn't they be able to? I assume they would be given the prescription and instructions, I don't see why it would be necessary for a doctor to be present.
 
I have no problem with that.
I have enough legally-prescribed pills that I could easily OD if I wanted to, and I'm not even terminally ill.

If someone has a terminal illness and wants to end their life on their own terms, why shouldn't they be able to? I assume they would be given the prescription and instructions, I don't see why it would be necessary for a doctor to be present.
Who would be there? A family member, a nurse, no one, hospice?
 
Does it matter?

IMO, if someone is terminally ill and wants to die at home alone, or with a family member present, or with a nurse, they should be able to do so.

Hospice helps with this, so I guess if they legalized assisted suicide, they would be the ones to know how to handle things. It'd be a hospice nurse, most likely, and they know how to stay out of the way and support the patient's wishes.
 
That's fine. I just don't understand why it would be a problem for someone to just get a prescription and do it on their own, if they wanted.

Obviously, someone who wasn't physically capable of taking the meds would need some help. In this case, it would probably be best, legally, for a hospice nurse to be supervising
 
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As an aside - I have been very impressed with all the hospice workers I have met.

If I had had the stomach to go into healthcare, hospice work is the area I would have been attracted to - I think there's something very rewarding about easing someone's last days/weeks/months.
 
We see with animals all the time that people are very quick to euthanise to save themselves pain, inconvenience or financial burdens. On another forum I'm at, a member started a thread about her two dogs. The younger one is likely being euthanised in the next 2 weeks and she is considering euthanising the other dog because she thinks the dog will be sad without her friend. A vet would probably agree to it. Would people be so quick to euthanise human family members, if they were able to do so without the person's consent? Would they guilt an elderly ill person into ending their own life to save the younger members of the family from having to care and pay for them?

That seems to be the most frequent argument cited against legal assisted suicide, that it would be open to abuse. I don't know the answer myself. My mother and I agreed that my nan should be taken off life support after her stroke, because she was never going to talk or walk again. Luckily for us she had been very, very adamant when her full faculties were intact that she never wanted to live like that. But when the time came she might possibly have been able to understand what people were saying to her, but she had no ability to respond or make her wishes known. The doctors just had to take our word for it that it's what she wanted.
 
Having a doctor present or not really isn't the big issue. Having others abuse the law is what really concerns me. Is grandma, a quadriplegic spouse, a mentally challenged, etc child a financial burden? Do they have an insurance policy, or an inheritance, well then just off them, and claim it was suicide....

Kind of reminds me of "stand your ground" laws. Just kill someone and claim they were threatening you....
 
We see with animals all the time that people are very quick to euthanise to save themselves pain, inconvenience or financial burdens. On another forum I'm at, a member started a thread about her two dogs. The younger one is likely being euthanised in the next 2 weeks and she is considering euthanising the other dog because she thinks the dog will be sad without her friend. A vet would probably agree to it. Would people be so quick to euthanise human family members, if they were able to do so without the person's consent? Would they guilt an elderly ill person into ending their own life to save the younger members of the family from having to care and pay for them?

That seems to be the most frequent argument cited against legal assisted suicide, that it would be open to abuse. I don't know the answer myself. My mother and I agreed that my nan should be taken off life support after her stroke, because she was never going to talk or walk again. Luckily for us she had been very, very adamant when her full faculties were intact that she never wanted to live like that. But when the time came she might possibly have been able to understand what people were saying to her, but she had no ability to respond or make her wishes known. The doctors just had to take our word for it that it's what she wanted.

I have often thought of this and it is awful to think, that the person may have changed their mind.
 
Does it matter?

IMO, if someone is terminally ill and wants to die at home alone, or with a family member present, or with a nurse, they should be able to do so.

I agree that they should have a right to do so, however I'm bothered by the fact that it could be an unsuspecting family member that finds them afterwards. It can be traumatizing to find a dead body.

I really like the idea of someone like hospice being there just in case something goes wrong.
 
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I agree that they should have a right to do so, however I'm bothered by the fact that it could be an unsuspecting family member that finds them afterwards. It can be traumatizing to find a dead body.

I would hope that people in a position to consider legally-assisted suicide would think of their family members and let them know what they're planning to do ahead of time. I just don't think it should be anyone's right to tell someone they have to have a doctor present, if that's not what they want.

Having a doctor present or not really isn't the big issue. Having others abuse the law is what really concerns me. Is grandma, a quadriplegic spouse, a mentally challenged, etc child a financial burden? Do they have an insurance policy, or an inheritance, well then just off them, and claim it was suicide....

But doesn't this law specifically deal with terminally ill patients? A quadriplegic spouse or mentally challenged child isn't, barring any other illness, terminally ill. I haven't read the proposed law for Massachusetts, but Washington and Oregon already have legalized physician-assisted suicide for terminally ill patients.

From the Washington Death With Dignity Act:
  • The patient must be an adult (18 or over) resident of the state of Washington
  • The patient must be mentally competent, verified by two physicians (or referred to a mental health evaluation)
  • The patient must be terminally ill with less than 6 months to live, verified by two physicians.
  • The patient must make voluntary requests, without coercion, verified by two physicians
  • The patient must be informed of all other options including palliative and hospice care
  • There is a 15 day waiting period between the first oral request and a written request
  • There is a 48 hour waiting period between the written request and the writing of the prescription
  • The written request must be signed by two independent witnesses, at least one of whom is not related to the patient or employed by the health care facility
  • The patient is encouraged to discuss with family (not required because of confidentiality laws)
  • The patient may change their mind at any time and rescind the request
  • The attending physician may sign the patient's death certificate which must list the underlying terminal disease as the cause of death

From the Oregon Death With Dignity Act:
Under the law, a capable adult Oregon resident who has been diagnosed, by a physician, with a terminal illness that will kill the patient within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. Exercise of the option under this law is voluntary and the patient must initiate the request.
The request must be confirmed by two witnesses, at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate, is not the patient's physician, and is not employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to be free of a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time. Should either physician have concerns about the patient's ability to make an informed decision, or feel the patient's request may be motivated by depression or coercion, the patient must be referred for a psychological evaluation.

Honestly, I suspect some terminally ill people just overdose on pills they've already been prescribed, as it is. The main change brought by a law would deal with things like life insurance. As far as I know, most policies do not pay out in the case of suicide. People whose families may not need the insurance money, people without a life insurance policy, or people who don't have family who would benefit from the policy could "accidentally" overdose with no legal percussions.

When I was in college, a guy my mom had dated years before was diagnosed with stage 4 lung cancer. He didn't have health insurance, was single, and had no children. One day he called 911 to get an ambulance at his house, hung up the phone, and blew his brains out; he was dead when they got there.
 
A quadriplegic person is terminally ill in the sense that there is no treatment, and they will remain that way for the rest of their life.

I don't have the specifics of the Massachusetts law, but I am aware that at least disabled persons group expressed concern about the law. Disabled people are often at the mercy of others, so that would lead me to believe that they were afraid of potential abuses.
 
A quadriplegic person is terminally ill in the sense that there is no treatment, and they will remain that way for the rest of their life.

I don't have the specifics of the Massachusetts law, but I am aware that at least disabled persons group expressed concern about the law. Disabled people are often at the mercy of others, so that would lead me to believe that they were afraid of potential abuses.
Paralysis is chronic, not terminal; it doesn't seem as if this law would apply here.
 
I think medical suicide should be honored as a reasonable choice for those who find life too unbearable to go on, and can find no help or reason to live, and it should be an acceptable form of medicine, within certain parameters. Like, if I was a quadriplegic, living in a state nursing home with all that that often entails, I might like to choose that option. There is not always help available, especially in this society (and honestly it enrages me when those who are against universal health care suddenly are all about preserving "life" when it comes to abortion and ending suffering through suicide - I mean, way to make life worthless if you have to live it in unmitigated pain, disease, or emotional suffering)...
 
From Ballotpedia.org:

According to the text of the initiative, the proposed measure would allow for a terminally ill patient to be given lethal drugs. A terminally ill patient would be defined as a patient being given six months or fewer to live. The patient requesting the medication must be mentally capable to make medical decisions while consulting their respective doctors. Patients would be required to submit their request orally twice and witnessed in writing, and the initial verbal request must be fifteen days prior to the written request and second oral request. The patient's terminal diagnosis and capability to make health care decisions must be confirmed by a second doctor.

I looked on the website of the group representing disabled persons that opposed the measure. They seem to have a lot of fear-based rhetoric on their side, and even use the phrase "old, ill, and disabled people." Which, going from the ballot initiative, doesn't necessarily apply. They also seem to oppose that a person can go to a different doctor, if the original doctor was unwilling to give the prescription. Well, why not? If I don't like what my doctor tells me, I can just go to a different one! They also say,

Assisted suicide is unnecessary because current law gives every person the right to refuse lifesaving treatment, and to have adequate pain relief, including palliative sedation to die in your sleep. Assisted suicide decreases self-determination by giving doctors and insurers the power not just to cure, but to kill.
Which I think is crap! Current law says I can refuse treatment (which may or may not be lifesaving), which may make my life longer and more agonizing that I want. And where does current law provide painkillers if I can't afford them, or that have no undesirable side effects? Is palliative care covered by the state health care?


Another "no on 2" group seems to be representing hospice workers, and on their website I saw several things pointing out that the law doesn't state anywhere that someone has to be present when the medication is taken. While I respect the work that hospice nurses do, this sounds like the groups (not necessarily the individual nurses) are concerned with losing some business, more than anything.
 
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Hospice care is 100 percent free for the patient in most cases, including the meds, nursing care, and any palliative treatments. My father was able to stay home with no hospitalizations, as he wanted, for the five months after his leukemia diagnosis because of the services hospice provided. Incidentally, even though he had virtually no pain with his disease process, there was enough oral liquid morphine in the prn meds they supplied my dad with to assist in the suicides of my entire extended family.
 
Emotional pain/suffering can be just as bad, if not worse, than physical pain/suffering. It scares me.
I'm on the fence with regard to whether or not physician assisted suicide should be legal, though.