People with a low quality of life, who cannot look after themselves should not be kept alive. The majority of people with Alzheimer's should be terminated - just keep a few alive for research.
Etc etc etc.
That's what was being said in the early 90s.
'Doctors should decide when a patient should die - without reference to the patient's wishes, the wishes of the family, the opinion of other doctors, or any interference from the law'
'Young schizophrenics who are in good physical health should be terminated and their organs used for transplants'
Those were crazy times ...
On May 9th 1994 the Lords Select Committee On Medical Ethics came out TOTALLY against any form of euthanasia in the UK ... and that's how things should be.
Under NO circumstances should anyone in the medical profession be involved in actively ending the lives of patients.
People who do not wish to experience the unpleasantness of advanced old age, extreme disability, etc., should not demand that other people who are in such states be terminated by the medical profession ... or be given the right to kill themselves with medical assistance.
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I don't remember any of this being an issue in the 90s. There has always been a debate surrounding euthanasia and there was some discussion on the Netherlands' position on the matter, but that was it.
I'm not sure that anyone outside of a select few nutjob groups would have seriously considered this, much less doctors. That's what I said about evolution denial back when I first heard about it. How naïve I was.Denying people the right to end their own life is grossly inhumane. Depends entirely on the scenario. There are nutcases out there who want euthanasia for just about everything. For example, a scenario in which a person repeatedly states he wants to kill himself.
Letting suicidal people who can't think clearly terminate their lives is as idiotic as letting anorectic people starve themselves to death because it's what they 'want'.
Life is to be preserved, not taken away. Doctors are to heal, not kill. If a patient wants to die, it's the doctor's job to convince him or her to want to live on. Plain and simple.
Come to think of it, I remember being asked about this on the forum some time ago. Guess I'll have to get in there and actually address the reply I got in the near future:o.
<< Life is to be preserved, not taken away. Doctors are to heal, not kill. If a patient wants to die, it's the doctor's job to convince him or her to want to live on. >>Øyvind: Yes -- up to a point. Many people head for such a choice rashly and irrationally because of being mentally ill. However, there is such a thing as a perfectly rational motivation for euthanasia; if someone is examined and judged to be entirely sane and competent but still wishes to end his/her life, I think it can only be considered cruelty to deny that choice.
My father, now about to go into assisted living, made out a living will years ago to cover the issue of keeping him alive artificially after Alzheimer's disease turns his mind to mush. It boils down to one word: "Don't." And I think that is an entirely rational decision.
~David D.G.
Øyvind : What if, for example, a woman with terminal cancer who is in a state of constant pain wishes to end her life?David D.G. : I completely agree. People deserve to die with dignity, and when they choose to.
Firthy2002: Actually, I have heard one. I remember one anti-euthanasia speaker saying something like, "For people in a bad financial situations, for people who are afraid that they will be a burden on their family, I'm horribly afraid that the right to die may become the duty to die."
"People who wish to experience the unpleasantness of advanced old age, extreme disability, etc., should not demand that other people who are in such states be kept alive against their wishes ... or be denied the right to kill themselves with medical assistance."
@David D.G.
Øyvind: Yes -- up to a point. Many people head for such a choice rashly and irrationally because of being mentally ill. However, there is such a thing as a perfectly rational motivation for euthanasia; if someone is examined and judged to be entirely sane and competent but still wishes to end his/her life, I think it can only be considered cruelty to deny that choice.
Newton's Cat -- how about you come down with a terminal cancer -- a particularly painful one, at that -- and get back to us on how you feel about people having the right to kill themselves, with or without medical assistance? OK?
Actually, it´s only IF the patient and only if the patient wants it, what we call euthanasia. One thing is that you´re not in favour, another fairly different is LYING.
I'd say forcing something to remain alive when quality of life has gone to "terminal and constant pain" is a direct offense to "do no harm". Ending someone's life with a little dignity when they ask for it shouldn't be done unquestioningly of course, but once you're sure they know what they're asking?
<<Life is to be preserved, not taken away. Doctors are to heal, not kill. If a patient wants to die, it's the doctor's job to convince him or her to want to live on. Plain and simple.>>
But MadSerena, all doctors ALREADY have access to assisted suicide in the form of Nembutal and other peaceful drugs.
<<But MadSerena, all doctors ALREADY have access to assisted suicide in the form of Nembutal and other peaceful drugs.
Stop twisting my words. You're heartless because you are forcing me to die violently AND PREMATURELY while I am still able to. If I could get help to die anytime I wanted, I'd be calmer and I wouldn't jump off a bridge the minute I was diagnosed with cancer. What's your proposed treatment for quadraplegics? Sedate them into a coma for 40 years so they don't get any suicidal thoughts? So your anti-choice beliefs are actually INCREASING the suicide rate, especially among those over 75.
<<Stop twisting my words. You're heartless because you are forcing me to die violently AND PREMATURELY while I am still able to. If I could get help to die anytime I wanted, I'd be calmer and I wouldn't jump off a bridge the minute I was diagnosed with cancer. What's your proposed treatment for quadraplegics? Sedate them into a coma for 40 years so they don't get any suicidal thoughts? So your anti-choice beliefs are actually INCREASING the suicide rate, especially among those over 75.
This isn't fundie. It's a bit of an exaggeration, but I do think there are a few good ethical arguments against euthanasia/assisted suicide.
I think it's more childish and selfish to impose a death on someone that they do not want.
BTW, if assisted suicide is OK when you remove life support such as a feeding tube or a respirator, why is a lethal injection not OK?
--I remember one anti-euthanasia speaker saying something like, "For people in a bad financial situations, for people who are afraid that they will be a burden on their family, I'm horribly afraid that the right to die may become the duty to die."--
What he may mean is that euthanasia, by tolerating it now under the guise of "the patient wants", may become compulsory in a future little by little. However, take for granted that it´s happening right now is a strawman, and it´s deeply dishonest.
<<BTW, if assisted suicide is OK when you remove life support such as a feeding tube or a respirator, why is a lethal injection not OK? Both result in and intend death. One is more humane than the other, however.>>
When you remove life support, you're aren't shortening a life...you're stopping prolonging a life by artificial means. They are different things, even if both cause death. It doesn't forbid it. But, yeah, that oath does have some outdated concepts (forbids abortion), so that's why that oath isn't a central part of my argument... i just mentioned it as a "plus". Anyway, the "do not harm" thing is still pretty much important to us.
Yes it does: I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
No it wouldn't prohibit them, because harm isn't intentional in this case, it's an undesired effect. We only recommend a treatment, when the potentional benefits are greater than the potential negative effects.
Anyway, ALL medical treatments are potentially harmful.
Why should the fact that it is "undesired" make a difference? It's still harm, and IT'S STILL FORSEEN.
Sometimes treatment WILL be harmful - take chemotherapy for instance. Sometimes the treatment is worse than the cancer itself.
That's just a way of avoiding responsibility for one's actions.
Consent is necessary when you start/finish ANY treatment...life support isn't different. Emergencies are the only exceptions.
Again, the patient (or the family in his/her name) has the right to stop or reject any treatment, even if that decision will cause his/her death. And to let someone die is very different than to kill, it's not a thing of semantics...when you let an illness follow its natural curse, you are not shortening a life.
So yes, people do have responsabilities in their own health. We diagnose and recommend treatments, but the patients are the ones who make the choice and are responsible of their choice...they can't force us to do things we aren't obliged to do, though (like assisted suicide), we have rights too.
We are doctors, not babysitters, deal with it. And you were the one complaining about paternalism...hypocrisy much?
Yes it does:
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
Women aren't even mentioned. And Internists (whatever sex) shouldn't perform surgery if a Surgeon (whatever sex) is available, so it kinda applies.
Why should the fact that it is "undesired" make a difference? It's still harm, and IT'S STILL FORSEEN.
Sometimes treatment WILL be harmful - take chemotherapy for instance. Sometimes the treatment is worse than the cancer itself.
Intentions ARE important, you fail at Medical Ethics.
If to treat is significantly better than not to treat, and benefits of the treatment are greater than its negative side effects, you're helping NOT hurting. Period. Everything has a price.
This applies to chemotherapy too...we will only offer chemo to a patient if the treatment will improve his/life in a significant way, so it will be worth the side effects. BTW, the patient can reject chemo anytime.
OK this is the last time i'll answer you. This discussion is getting off-topic and repetitive.
Consent is necessary when you start/finish ANY treatment...life support isn't different. Emergencies are the only exceptions.
But if a patient chooses to stop treatment, doesn't that mean that they've given up on life? Shouldn't you "convince him or her to live on", as another poster said?
So yes, people do have responsibilities in their own health. We diagnose and recommend treatments, but the patients are the ones who make the choice and are responsible of their choice...they can't force us to do things we aren't obliged to do, though (like assisted suicide), we have rights too.
Unplugging a respirator IS assisted suicide. There's nothing "passive" about it. The "difference" is just something that makes you feel better.
We are doctors, not babysitters, deal with it. And you were the one complaining about paternalism...hypocrisy much?
You wouldn't be forced to assist suicides if it were legal.
Why do you have to campaign so vigorously against it? You're just increasing suffering. Why is self-starvation OK, but a lethal injection not OK?
Women aren't even mentioned. And Internists (whatever sex) shouldn't perform surgery if a Surgeon (whatever sex) is available, so it kinda applies.
Yes, I concede this point. It does defer surgery to those trained in it. I'm quite certain I saw a line in the oath forbidding women to practice medicine, though.
Intentions ARE important, you fail at Medical Ethics.
If to treat is significantly better than not to treat, and benefits of the treatment are greater than its negative side effects, you're helping NOT hurting. Period. Everything has a price.
But forcing patients to die slowly through terminal sedation could be construed as harm. The oath NEVER mentions weighing the pros and cons and then making a decision.
All it says is "do no harm".
Consent is important, but so is the outcome. Doctors frequently increase morphine dosages in terminally ill patients without telling them that "this next dose might be the last".
This applies to chemotherapy too...we will only offer chemo to a patient if the treatment will improve his/life in a significant way, so it will be worth the side effects. BTW, the patient can reject chemo anytime.
OK this is the last time i'll answer you. This discussion is getting off-topic and repetitive.
I think you're skirting the issue of "causing harm". Just because one form of harm is being traded for another doesn't make it any less of a "harm".
@Jen:
Assisted suicide...this is a tricky one. On one hand, if a patient is in chronic pain, and no chance of recovery, it should be his/her right to choose death. However, the physician should still have the right to abstain on moral grounds--I know I wouldn't sleep well knowing I assisted someone's death, even if they did want it. There really is no easy answer on this one. And definitely not one that no one gets hurt with.
Confused?
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