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Euthanasia: In favor or opposed?
Some questions to get you thinking:
Should patients be allowed the right to die?
Are doctors obligated to assist patients with their dying wish?
Should assisted suicide be illegal?
Feyisayo Anjorin 50+
Samuel Price
To die with dignity is a human right.
Varlan Allan 10+
Hava Owens
Euthanasia has happened in the medical field and in the U.S. It has been going on before it was even legal in Oregen and Washington and all over the U.S. It needs to stay out of the medical field because it has no business being in it. It should be illegal everywhere along with dnrs and no drastic measures. The no drastic measures are things like medicine that a patient needs to recover from their illness. If the patient has no drastic measures on his charts the patient dies from a curable infection because most medicine are considered drastic measures as far as the medical staff is concerned and therefore will not be given. It is whatever the medical staff thinks is no drastic measures not what the patient thinks.
Therefore anything from no drastic measures and do not resuscitate and euthanasia needs to stay out of the medical field cause these things kill patients who are otherwise curable. People better really think about that. I have experienced this myself and I could not believe what I actually saw happen in the medical field when these things are in place. Euthanasia is not even legal in our state but still practiced. I would love to see laws enforced to have any medical profession who is involved with this be put in prison where they belong to live out their life for stealing the life of their patient.
Hava Owens
Edward Webber
As for doctors being obligated, not at all. If they don't wish to perform assisted suicide, they can work at a hospital which does not perform them, or has dedicated staff which will. That said, hospitals should have the right to refuse employment to a doctor who refuses to perform such procedures, as it hurts the business of the hospital. If there is an employee willing to perform ALL duties, they should take preference to those who refuse some of them. In short, free market business.
I fail to see the complexity of this topic. People either forcibly claim ownership of another person (pro-slavery) or they respect the human rights of everyone.
Barry Palmer 50+
When he finally passed, my wife and I promised each other we would not go through anything like that. We have had many conversations about dying and death, and we have power of attorney for each other.
Brian, I can well understand your dilemma. Part of western society has long had an attitude toward death that makes it seem unnatural. Dylan Thomas' poem, "Do not go gentle in that good night" exemplifies this attitude. But to someone in excruciating pain, this notion would seem laughable if anything could.
"I want you to consider a world in which doctors could write a prescription for euthanasia. How would that change our perception of doctors?"
In this regard, our perception of doctors must change in the context of changing our perception about life, dying and death. Death is a natural part of life. If doctors could and would write a prescription for euthanasia, it would certainly change my perception of doctors for the better. Fighting death to the bitter end may seem glorious, but the reality is altogether different. If a doctor could legally participate in assisted suicide, but refuses, I would consider that doctor unrealistic, or possibly inexperienced, and would have a hard time trusting him at all.
In the west, and especially in the USA, we honor people who fight and die for freedom. Well the opposite of freedom is slavery, and the situation of most people who seek assisted suicide is far worse than slavery.
Brian Cox 20+
However, I want you to consider a world in which doctors could write a prescription for euthanasia. How would that change our perception of doctors? Current practice dictates that a doctor must always keep you alive and well, regardless of your circumstances. If euthanasia was legalized, a doctor would suddenly be involved in the prescription of death.
Do you think only certain factions of doctors should be considered Euthansizers?
Would this be similar to those who conduct abortions?
How would you be referred to these types of doctors?
Stewart Gault 30+
I think it would be incredibly cruel and arrogant to call such doctors dealers of death as the media surely would, they would be doing a very brave act and a real act of treatment for those who wish to die.
p.s are you studying at Queens Belfast? if so what are your thoughts on it?
Brian Cox 20+
Stewart Gault 30+
p.s At first I totally thought you were the physicist Brian Cox
Robert Winner 50+
Anisha Rikhy
Stewart Gault 30+
Hava Owens
Rob Clark
As about the doctors, I think there should be "courses" for that, so only trained, professional and experienced doctors can do this, rather than any old doctor, because no doubt there would be loads of scandals and inquiries about this sort of thing.
If the patient is too incapacitated to make a decision (i.e too much pain or a coma), there should be something like a general consensus among the closest family.
In the end, I quote the famous Game of Thrones "you will see exactly what life is worth, when all the rest has gone"
Brian Cox 20+
At the minute, no programs for euthanization exist as the process is still an illegal process. Your proposal has been considered previously, but many doctors (palliative care and anesthetists included) feel euthanizing is contrary to their vocation. They argue they would lose patient trust if they were able to provide a euthanizing service.
It is a difficult balance between patient competence, motivation, family pressure, and medical opinion. However, even if all parties are in agreement, no single person typically wants to be responsible for the permanence of ending someone's life.
Rob Clark
I can understand why doctors feel that way, because they live to save people. But I guess that the way I see it is that a person can be saved through death. I know I'd much rather be put out of my misery than be suffering in one way or another.
However, I know if it was my mum or something which was in this condition, there would be a big part of me not wanting to let go.
Also just slightly off topic, I find it a bit strange how many countries 33 states in America (I think it's 33...) can give out the death sentence, but not euthanasia. I know thats a bit of a weird thing to say, but if people are so morally just to say when someone can be put in the chair or not, they can rather do that to someone rather than help someone relieve their pain.
But again, it's different to passing the sentence than actually carrying it out I suppose. I think however, whoever passes out the sentence (talking about both capital punishment and euthanasia) should do the deed. I suppose its harder in terms of euthanasia, because if the patient decides they want it, then they are supposed to kill themselves...
I dunno, I'm kind of arguing with myself now haha
Hava Owens
Hava Owens
Linda Taylor 50+
I don't think it will ever get to the point where doctors can write a prescription for it. First of all, the pharmacists will not be willing to fill that script and imagine trying to transport or store it safely. I think it should be an in-office/hospital or bedside procedure with the physician in attendance to pronounce.
I also agree with Stewart, there will be physicians that can ethically help and others that cannot based on their own morality. That needs to be respected. Maybe there should be a sub-specialty or board certification in thanatology. Evidence based practice and such. I think the best physician for this is the general practitioner who has developed a therapeutic relationship with the patient and has a broader understanding of the situation and ramifications of the decision. They would also know the patient, hopefully for years, and can best coordinate the procedure into a treatment plan.
I think there is a huge difference between euthanasia and assisted suicide. I would really have to think about Rob's suggestion that the family and physician can end someones life, even in a coma. Imagine the possible abuses there. I would have to think about it.
Brian Cox 20+
Linda Taylor 50+
It is patient choice and everybody else should stay out of it. There would be no abuse at all if we could get that in place.
Hava Owens
I do think that if it were legal it would be even more dangerous. There are psychopath and lazy medical staff who do not mind killing people. I could just see them telling the family of the poor patient/victim that the patient is suffering so lets abide by the patients wishes and kill them, or if the patient said ahead of time they would want to be euthanized if they went into a coma the psychopath doctor could simply put the patient in a drug induced coma and the patient is euthanized. Euthanizing can also cover up drug overdose mistakes made by doctors. If we do not make it so easy for drs to cover up mistakes by use of euthanasia then maybe there would not be as many mistakes made. There should also be heavy consequences for doctors who do use euthanasia.
I have seen dnr being used to kill as well as no drastic measures. These two things are legal and are being used in the wrong way by what I call psychopath doctors. Also euthanasia is being used even though it is not legal. So with that said, I can only imagine what would happen if it were legal in the medical field.
Instead any medical staff who participates in it should spend their life in prison maybe this will set an example to the psychopath uncaring lazy doctors. It seems the only thing that will make a psychopath do the right thing is the fear of prison. That would at least help the situation although not stop it completely.
Elisabeth Buffard 500+
Brian Cox 20+
In a perfect world, we would all be in complete control of our own destiny. The pursuit of dignity through autonomy is an essential facet of human freedom.
However, how can those lacking competence (coma, brain trauma, severe depression, etc.) provide a reliable source of personal opinion? Shouldn't we protect these people?
Most historical cases of euthanasia eventually fall into the debate of competence.
Edward Webber
The debate of assisted suicide (which need not even be assisted, but available) tramples on the rights of those who are competent. Competence is simply a red herring used to prevent any euthanasia at all. After all, even non-assisted suicide remains illegal in some countries. In more countries, advising a person as to how to commit suicide means prison. In yet more countries helping someone properly commit suicide means prison.
The ACLU of America defines the prohibition of assisted suicide to be cruel and unusual punishment. I tend to agree. Forcing makeshift non-assisted suicides ensures the person dies in agony, or worse, doesn't die at all, when there are proven clinical methods of pain-free death.
Hava Owens
Edward Webber
"It has gone on like this since the beginning of time."
Are you really using the "it's tradition" argument? Dogma is not a path to progress. If we all lived by dogma, we'd still be worshiping the sun on a flat earth below a firmament with bloodletting as a cure-all.
"Medical staff should not be responsible for taking or to help take a life. That would be up to the patient."
You are partially correct. Being a doctor is a profession, which is defined by a job description. You change the job description and the responsibility changes. It's quite easy. If you don't want to do the job, you don't apply for the job. It is basic employment. If you wish to avoid aiding in suicide, don't work for a place which requires it.
"That would be up to the patient."
You are entirely correct, and the doctor's job is to aid the patient in their treatment. Put simply, if life is the ailment, suicide is the treatment. If a doctor does not wish to perform euthanizing, there are thousands of other careers out there.
I find "not my job" to be the most baseless of all of the regurgitated talking points regarding euthanasia. If you don't want to do a job, don't apply for it. There is always someone who has _all_ of the patients' interests at heart, not just the ones they agree with.
Your entire argument of "should" is meaningless. Employers post job descriptions, employees fill them. If you don't wish to do the job, don't apply. There will be no shortage of doctors willing to take the job, after the doctors who feel they have the right to dictate what employers "should" do head to the unemployment office.
Juan Camilo Tovar Castro 10+
Brian Cox 20+
----
A grandmother "Sara" has progressive, debilitating rheumatoid arthritis and diabetes leading to kidney failure. She is requiring dialysis at the cost of $40,000 (£28,000) per year. She will survive for the next 10 years with adequate treatment, but needs caregivers to help her wash, clothe, and manage her cooking. Although she loves seeing her grandchildren, she knows she is a financial burden on the family. She is suffering, her lifestyle is worsening, and she cannot help be depressed by her situation.
Sara decides the best outlet is euthanasia, and she consults Dignitas in Switzerland.
----
For the sake of argument, assume Sara is competent. This case highlights the importance of motivation.
Has Sara been motivated by her own free will? Or has she been motivated by her family's will?
Does she feel she is a burden?
Barry Palmer 50+
Just how important is it to Sara that she has become a burden rather than a productive caregiver within her family? To Sara, this change could be a complete reversal of her very identity, and be intolerable. How can someone outside the family judge this?
In this case, if I was Sara's physician, I would have some long talks with her to get to know her better before making a decision. And the physician always has the option to suggest that the patient see someone else.
As for the shades of grey, at some point a decision must be made that the patient is competent and not acting under duress. If those two facts can be established, the decision belongs to the patient.
Obey No1kinobe 50+
It already happens passively. Letting people die rather than medicate or additional surgeries.
Brian Cox 20+
Euthanizing patients passively seems dignified and painless, but the reality is somewhat different.
Active euthanization is similarly not ideal. Dignitas specializes in this process and they have developed what they believe is the best form of euthanasia. Imagine you want to end your life - the process is as follows:
During a Dignitas visit, you and your family are interviewed in the equivalent of a hotel room. A single Dignitas employee video records the interview and asks you to expressively state you would like to end your life. You are given some last time with your family before they are asked to leave the room. At this point, an anesthetic and lethal drug cocktail is administered. Your family is then called back into the room to hold you as you slowly pass away. The whole process takes less than an hour.
Hava Owens
Obey No1kinobe 50+
Actively ending life versus withholding treatment. Treatment might range from switching a respirator off to forgoing radical surgery or even antibiotics.
Another dimension is the physical and mental capability of the person.
If a person has their faculties and is suffering and wants to end their life that is very different to a coma or dementia.
But if someone wants to end their life I tend to think that is their choice.
That is not to say this might be a selfish choice if you have dependents especially etc
My personal rule is not to kill myself in the heat of the moment, but to wait until tomorrow to think about it.
But ultimately if the pain was extreme and endless if hope had gone and existence was torture I would reserve the right to end it
We had a tough call recently with a relative with severe dementia. Its not easy when they are beyond reason.
Every situation case by case I guess.
Agree it might cause more suffering to switch of a respirator if the person is aware than something more active. It maybe nearly impossible to avoid all suffering whether physical or emotional in these situations.
The dignatis approach doesn't sound to bad to me when you compare it to some alternatives.
In the end people are choosing what they think is the least bad option of a whole bunch of crappy options.
If it is their choice to die, its tragic, but I'm okay with that. Is it black and white, is it risk free, might people off themselves because of the financial burden, its very complex, but I suggest keeping people breathing as long as possible is not always the most humane thing to do.
The life is sacred motto oversimplifies the issue. Quality of life is also sacred.
Linda Taylor 50+
It should be a treatment plan worked out between the physician and the patient with input from other stakeholders. But the decision rests entirely with the patient
I hope it is there if I ever need it.
Brian Cox 20+
As I have stated above, certain factors such as motivation, competency, and patient-doctor trust are all at odds during a euthanasia consultation. These issues confound even adamantly expressed consent for assisted suicide.
I think it is important to remember that doctors see death every day, but they never forget a patient they could have saved.
Linda Taylor 50+
If you have a problem with discussing this with your patients then don't. Refer them to someone who can. But I would be very angry if we were having a discussion about the end of my life and all of a sudden you break my trust and tell me you won't work with me here. There is nothing to be confounded about. Be frank, upfront and no trust will be at risk.
And boo hoo that physicians never forget the patient they could have saved. I got my own list. This is NOT ABOUT YOU. Never forget that.
Brian Cox 20+
Linda Taylor 50+
Peter Law 30+
I remember David Steel's abortion bill. I was all for it; it was designed to help those who really needed it & was fenced in with all sorts of safeguards to ensure it was not abused. Today, well........
Euthanasia is the same sort of deal. I would happily face jail to put a loved one out of misery, if really necessary, & hopefully one of my loved ones would do the same for me. I would not trust the system with that sort of power however. They should keep the peace, & dispose of the trash period. That way we could all sleep well at night.
:-)
Brian Cox 20+
I think it is important to examine euthanasia from every perspective. When I first faced this issue of euthanasia, I felt compelled by personal choice, freedom, etc. It was only until I began to look at the consequences of such legislation, both personally and professionally, that I began to adapt my views.
I would like to talk about the similarities and differences between abortion and euthanasia, but I will quickly run out of room :)
Obey No1kinobe 50+
Lindsay Newland Bowker 50+
It is very hard for some people to understand.
As a patient for very advanced cancer I experienced pain beyond measure for which no relief was possible except a few hours peace in a morphine induced stupor. I was lucky to recover from that but if that had been something I had to endure for the rest of my life, I would have begged for euthanasia or assisted suicide. It should come as no surprise that it is very very common for people suffering at such extremes to request euthanasia or assistance with suicide.
When there i s no cure and no possibility of comfort or awareness and the patient has requested it, by advance directive or by active communication at the time, it is cruel to withold it and criminal to make it a crime..
Brian Cox 20+
However, from my research and interviews, I have found doctors report it is very uncommon for patients (even those in excruciating pain) to request euthanasia.
I can understand why you can empathize with someone willing to take their own life, but are you glad you never sought out such a permanent solution?
Lindsay Newland Bowker 50+
If you interviewed the spouses, close friends or relatives of patients with terminal illness involving extreme pain, inability to eat or other very extreme symptoms or even hospice volunteers or nurses you'd get a very different research result., Brian. It is very common for patients to ask for reassurance that loved one's will insure a dignified death
At hospital or medical established palliative care or even hospice .conferences, I am always astonished at how out of touch doctors are with patient needs. Astonishing that would be true of palliative care which is a patient directed acceptance of death. Palliative care is still having trouble finding a foothold in hospitals and the establishment finds it very difficult to embrace the idea that people choose a dignified death. Hos[ice has helped pave the way for a more patient centered approach that focuses on the acceptance and preparation for dying. In time palliative care will gain acceptance and hopefully evolved a more patient centered awareness within the medical profession.
In answer to your personal question my extreme pain and other symptoms (mostly from the treatment not the disease..extreme chemo and radiation) I was not terminal and I was on such a m,edical roller coaster in and out of emergency rooms ( not easy when you live on a remote island island ) I never got to that choice.
Brian, we are never "dying persons" we are living persons right to our last breath. The quality of that diminished and ever diminishing life is critically important and particular to each patient. that must be honored.
If you want to understand euthanasia spend some time as a volunteer in hospice or palliative care or with people in the advanced stages of terminal illness. Witness and attend that suffering. Talking to doctors will not yield much valuable patient centered information.
Brian Cox 20+
As far as honoring patient life, I think I have demonstrated my aversion for ending it artificially during our conversation. I truly believe in patient respect and dignity and feel I should never be part of/witness a 'solution' as permanent as assisted suicide.
In the future, I plan on spending copious time with patients. As a medical student who has never been a patient, I am far from an expert on this subject. People like you are the true experts, which is why I am determined to find out what you think and feel.
Lindsay Newland Bowker 50+
Sounds like you may have a belief system based struggle with the idea of pain relief that may hasten death or other extreme situations in which patients may seek a dignified death, I think when you have your first experience with a vibrant person in full livingness trapped in an out of control body, trapped in suffering beyond comprehension your belief system might update itself on the spot when that person says "Doc can you help me?"
Brian Cox 20+
Hava Owens
Lindsay Newland Bowker 50+
You have a very nice bed side manner...I encourage you to see the movie WIT available on netfix or from amazon http://www.amazon.com/Wit-Harold-Pinter/dp/B00005MKKV/ref=cm_cr-mr-title
As a patient I can tell you it is a very accurate patient centered account of extreme illness. This one doesn't involve euthanasia or hastened death ..the patient is in a clinical trial.
As you are so interested in this important humanitarian issue, I am sure you will find a way to be a one on one companion to people with terminal illness who are suffering at the extremes. Bringing that experience back to medical school and into formal medicine will be a great service to the may who suffer at extremes.
There is a very long way to go. The very few palliative care units trying to take root in hospitals are often referred to as "the death squad"..a long way to go to close this care gap in modern medicine.
Stewart Gault 30+
Brian Cox 20+
Varlan Allan 10+
Brian Cox 20+
Varlan Allan 10+
Brian Cox 20+
http://www.qub.ac.uk/methics/CoxB.pdf