LKPAC Posted July 11, 2017 Share Posted July 11, 2017 29 minutes ago, Jdabrowski said: For those against Physician Assisted suicide, how much of your decision is based on religious beliefs? Not trying to stir the pot but this is an interesting topic to read. Having worked with hospice I can see the validity of physician assisted suicide is certain situations like ALS patients and others of course. Definitely a factor for me, I admit. I will help people heal, I will help people understand, I will help ease suffering, all to the best of my ability. I will not take life or aid in the taking of life. That is not my role. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted July 11, 2017 Share Posted July 11, 2017 44 minutes ago, sas5814 said: Would that it was that simple. If every circumstance could be anticipated and every pain ameliorated then your point would be valid. Having spent a good chunk of my career where resources are scarce the kind of intense management you allude to just isn't there. I have seen excellent end of life care and I have seen things get out of control for the patient before resources have been brought to bear. I have seen people waste away slowly and miserably from different things after losing control of their body functions and their dignity is lost and no medicine ends their mental and psychological suffering. It is too complicated an issue to believe that all end of life care is or will be perfect. Life is messy. Why should death be any different? We help people manage their messy life. We help people manage their messy death. We should not purposefully kill people. It's wrong. Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 11, 2017 Share Posted July 11, 2017 But to know a diagnosis like ALS and being in the patients shoes. Will I ever bring it up to them first as a provider? No. But personally knowing how bad ALS can get I would not want to be a prisoner in my own body like that. I had a patient tell me what she felt in her last 2 months of life before she no longer spoke. She told me that the worst thing was not that she could not move anything although that was frustrating for her, but that she could FEEL everything and do nothing about it. I really think it comes to personal choice and more importantly a patients choice. It's not being heartless, its showing empathy to that patient. This could very well be something you change your mind on when you are in that place yourself and you are the patient and worse we fully understand exactly what will happen and how. Link to comment Share on other sites More sharing options...
CAAdmission Posted July 12, 2017 Share Posted July 12, 2017 For those who support physician assisted suicide, would you support a patient with intractable pain from migraine headaches who wished to commit suicide? Link to comment Share on other sites More sharing options...
PACdan Posted July 12, 2017 Share Posted July 12, 2017 Watch "How to Die in Oregon" It's a 2011 documentary on the subject of physician assisted death that explores the subject through the lens of patients going through the medical aid in dying process. Link to comment Share on other sites More sharing options...
TWR Posted July 12, 2017 Author Share Posted July 12, 2017 CJAdmission, migraine is not a terminal illness although as the patient they might feel that way. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted July 12, 2017 Share Posted July 12, 2017 Life itself is terminal. Migraine pt is going to die anyway, soooo.... Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 12, 2017 Share Posted July 12, 2017 You are missing the point. You must have a terminal illness deemed with less than 6 months to live (I believe). This is why I asked the question about religion because how far will you let it interfere with your job? Someone posted about we are healers. Does that mean the Catholic provider does not need to prescribe birth control to a patient with a heavy cycle or acne out of control purely because they do not believe it? There are guidelines to being able to get physician assisted suicide. If you don't want to provide it, there are others with more compassion for a patient who will allow that patient to once again regain control of their own life. That is what the patient wants. Even if they do not choose to go through with it, they just want to feel that they are in control of their disease and life, and not the other way around. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted July 12, 2017 Share Posted July 12, 2017 1 hour ago, Jdabrowski said: You are missing the point. You must have a terminal illness deemed with less than 6 months to live (I believe). This is why I asked the question about religion because how far will you let it interfere with your job? Someone posted about we are healers. Does that mean the Catholic provider does not need to prescribe birth control to a patient with a heavy cycle or acne out of control purely because they do not believe it? There are guidelines to being able to get physician assisted suicide. If you don't want to provide it, there are others with more compassion for a patient who will allow that patient to once again regain control of their own life. That is what the patient wants. Even if they do not choose to go through with it, they just want to feel that they are in control of their disease and life, and not the other way around. Wow....look at how you pose your questions. "How far will you let it interfere with your job?" "There are others with more compassion for a patient...." I am a (deeply flawed) Catholic and my faith doesn't interfere with my job at all. On the contrary, it makes me a much better provider. Your comments about Catholic providers not prescribing medications for menometrorrhagia or acne shows your ignorance of Catholicism. Just like with giving morphine to a terminal patient, prescribing hormones for menometrorrhagia or acne is fine. The same with oopherectomy, hysterectomy or salphingectomy when done to cure a disease. It is the INTENT of the action that matters. Give heavy doses of morphine to relieve pain at the risk of unintentional death? That's okay. Intentionally giving someone a lethal dose of medications with the INTENT of ending their life - that's murder. Link to comment Share on other sites More sharing options...
anewconvert Posted July 12, 2017 Share Posted July 12, 2017 11 hours ago, CJAdmission said: For those who support physician assisted suicide, would you support a patient with intractable pain from migraine headaches who wished to commit suicide? See.... slippery slope. This is why slippery slope is a logical fallacy. You will always be able to find some scenario that a specific action will "inevitably lead to" and you attempt to make the other person prove a negative. No one is advocating for assisted suicide for pain 2/2 a non-terminal disease. To the best of my knowledge no law in the united states allows for it. You have to be in the terminal phase of a disease that is going to kill you, two physicians already involved in your care have to agree that you are in that phase and that you are of sound mind to make this decision, and you have to be capable of taking the medication without assistance. As for whether or not it is murder, that is a legal definition, not a moral one. If the law says "that's not murder" it isn't murder. You may morally disagree with that law, but that doesn't change the fact that it is no longer murder. All that to say, physician assisted suicide practiced in states where it is legal is not murder and calling it so is a red herring. Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 12, 2017 Share Posted July 12, 2017 I was merely stating how it can be an ethical gray area for those who are devout Catholics (for which I do have contact with). I have clearly stated previously that there is no right or wrong answer but was curious as to how someone's religious beliefs could interfere with this decision. For which it has been said by someone that their religion is the reason they are against it. Also I was raised Catholic but do not practice it anymore. Link to comment Share on other sites More sharing options...
CAAdmission Posted July 12, 2017 Share Posted July 12, 2017 6 hours ago, anewconvert said: See.... slippery slope. This is why slippery slope is a logical fallacy blah blah blah... Nicely done, sidestepping the question. People who support assisted suicide state they do so on the grounds of supporting self-determination and a humanitarian desire to end suffering. So I again put to you a simple scenario: Your patient is a 36 year old female with a history of intractable migraines. She has over a decade history of daily (essentially continuous) severe migraines. She is on 100% disability and rarely leaves her house secondary to pain. Every attempt at therapy has failed. She has been seen by multiple specialists, including a psychiatrist who deems her to be of sound mind. She comes to you and states she has no meaningful quality of life and after 10 year can no longer bear the suffering. She wishes to end her life. Do you support this request? Why or why not? Link to comment Share on other sites More sharing options...
CAAdmission Posted July 12, 2017 Share Posted July 12, 2017 9 hours ago, TWR said: CJAdmission, migraine is not a terminal illness although as the patient they might feel that way. See above. That's not what I asked. I would welcome your response to the inquiry above, too. Link to comment Share on other sites More sharing options...
BruceBanner Posted July 12, 2017 Share Posted July 12, 2017 9 minutes ago, CJAdmission said: Nicely done, sidestepping the question. People who support assisted suicide state they do so on the grounds of supporting self-determination and a humanitarian desire to end suffering. So I again put to you a simple scenario: Your patient is a 36 year old female with a history of intractable migraines. She has over a decade history of daily (essentially continuous) severe migraines. She is on 100% disability and rarely leaves her house secondary to pain. Every attempt at therapy has failed. She has been seen by multiple specialists, including a psychiatrist who deems her to be of sound mind. She comes to you and states she has no meaningful quality of life and after 10 year can no longer bear the suffering. She wishes to end her life. Do you support this request? Why or why not? Not that you asked me but I personally wouldn't. For fear of legal reprisal, and that's not my role. I cant defend it logically---I'm just not comfortable with it. Someone else may be. As far as the general question of physician assisted suicide (called "medical aid in dying" here in CO), I support it for verified terminal diseases with a 6 month or less prognosis. 6 months is an arbitrary time frame, but a line has to be drawn somewhere. Because yes, life itself is terminal. I actually voted no on it; the only reason being there was no provision in there that said the drugs had to be administered in the presence of a physician. This---to me---opened the door to surreptitious administration from family and caretakers who may have ulterior motives, such as inheritance, life insurance, etc. Link to comment Share on other sites More sharing options...
anewconvert Posted July 12, 2017 Share Posted July 12, 2017 1 hour ago, CJAdmission said: Nicely done, sidestepping the question. People who support assisted suicide state they do so on the grounds of supporting self-determination and a humanitarian desire to end suffering. So I again put to you a simple scenario: Your patient is a 36 year old female with a history of intractable migraines. She has over a decade history of daily (essentially continuous) severe migraines. She is on 100% disability and rarely leaves her house secondary to pain. Every attempt at therapy has failed. She has been seen by multiple specialists, including a psychiatrist who deems her to be of sound mind. She comes to you and states she has no meaningful quality of life and after 10 year can no longer bear the suffering. She wishes to end her life. Do you support this request? Why or why not? Fine, I'll play your game: No, I don't support that. The rationale behind assisted suicide is to hasten the end of the near term inevitable in a way that minimizes suffering. Those who qualify to assisted suicide in this country have overwhelming odds that they will die from their disease in the near term with no reasonable hope of recovery. A person with intractable migraine does not face death from his/her disease. There is hope that an understanding of the disease will progress to a treatment for their suffering, something that does not exist for a person who qualifies for physician assisted suicide. That last sentence being the key part of this discussion. You want to side rail the actual discussion because your position functionally boils down to your imposition of your morality on another person. The laws are narrowly crafted to mitigate abuse, mitigate coercion, and insure that only those who face no hope of recovery are eligible. You motives for your attempts to take the discussion outside of those bounds are obvious. You disagree with this on moral grounds. That's fine. That is your right, but I and others don't share your morality on this matter and should not be subjected to it. Should you wish to not participate in the matter that is your choice, but others should be forced to suffer through needless pain because it makes a portion of the population uncomfortable. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted July 13, 2017 Administrator Share Posted July 13, 2017 On 7/11/2017 at 5:30 AM, anewconvert said: Yeah... that is called a slippery slope. It's a logical fallacy for a reason. How do you know the slippery slope is a logical fallacy? Seriously, how do you know? You were told it, right? That's appeal to authority, another logical fallacy. Let's go back throughout the last 50 years and see what all was called out as a slippery slope fallacy, and then let's see how many of those dire predictions have, in fact, come true. I think you'll find that, suspiciously, plenty of them have, in fact, come true. Thus, my empirical observation is that "the slippery slope is a logical fallacy" is a logical fallacy. Link to comment Share on other sites More sharing options...
CAAdmission Posted July 13, 2017 Share Posted July 13, 2017 1 hour ago, anewconvert said: You disagree with this on moral grounds. That's fine. That is your right, but I and others don't share your morality on this matter and should not be subjected to it. Should you wish to not participate in the matter that is your choice, but others should be forced to suffer through needless pain because it makes a portion of the population uncomfortable. This, unfortunately, has not been the stance of the government of late. Once suicide becomes a right, they will force clinicians to participate. For example, there are many people that hold abortion to be murder (me among them). The Supreme Court has ruled that a pharmacist with a similar belief can be forced to provide abortifacient medications: http://www.lifenews.com/2016/06/28/supreme-court-allows-state-to-force-pro-life-pharmacists-to-sell-abortion-pills/ There are also ample examples of a variety of wedding-related businesses with sincerely held religious convictions getting sued for not wanting to participate when Fred and Bob decide to tie the knot. (Hint: never force me to make a wedding cake I don't want to. It will have some special ingredients.) I am also still having problems with the logic of the compassion of this all. Y'all would damn a 36 year-old migraneur to perhaps 40 years of a hellishly painful existence, but you are happy to hasten the end for someone with only 2 months to live with pancreatic cancer? Why don't both have equal right to say enough is enough? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted July 13, 2017 Administrator Share Posted July 13, 2017 13 hours ago, Jdabrowski said: If you don't want to provide it, there are others with more compassion for a patient who will allow that patient to once again regain control of their own life. I'm sorry, but you do appear to have badly misspelled "willing to kill patients for money". Was that what you meant to say? If providers who provide medicines which heal, heal, then providers who provide medicines which kill, kill. And "for money" is an assumption, of course, but I doubt providers are spontaneously providing lethal prescriptions without compensation. At least one I know charges a premium for it. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted July 13, 2017 Administrator Share Posted July 13, 2017 9 hours ago, anewconvert said: If the law says "that's not murder" it isn't murder. You may morally disagree with that law, but that doesn't change the fact that it is no longer murder. So the treatment of Alan Turing was OK? Tuskegee syphilis experiment, just fine? Nazi experimentation on human subjects? Link to comment Share on other sites More sharing options...
CAAdmission Posted July 13, 2017 Share Posted July 13, 2017 10 hours ago, anewconvert said: If the law says "that's not murder" it isn't murder. You may morally disagree with that law, but that doesn't change the fact that it is no longer murder. "The law" once said that slavery was swell. Did that make it right? I have no reason to believe that the Supreme Court is any wiser than the rest of the dopes that infest our government. Link to comment Share on other sites More sharing options...
Joelseff Posted July 13, 2017 Share Posted July 13, 2017 Is Hospice/comfort care not adequate to ease the patient along as they die a natural death that we have to "assist" or initiate death? Sent from my SAMSUNG-SM-G891A using Tapatalk Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 13, 2017 Share Posted July 13, 2017 14 hours ago, rev ronin said: I'm sorry, but you do appear to have badly misspelled "willing to kill patients for money". Was that what you meant to say? If providers who provide medicines which heal, heal, then providers who provide medicines which kill, kill. And "for money" is an assumption, of course, but I doubt providers are spontaneously providing lethal prescriptions without compensation. At least one I know charges a premium for it. In terminal illness there is nothing else to heal. The studies show most people do not even use the medication. They just want the control back in their life instead of knowing their disease/cancer isn't controlling them. For the ALS patient I cared for, yes we did everything we could to help her in her 13 month stay with us. But at the end every person in that center talked about why wasn't this an option for her (Minnesota doesn't have it). Just because someone writes the Rx for this to happen does not mean you are killing them. I can hand you a gun but I am not pulling the trigger. But if my patient wants to go with dignity and not feel like they have ZERO control about when they go, or does not want to feel trapped as ALS patients can, why shouldn't we honor the patients wishes? We do that anyway when they are no facing death? They ultimately chose their treatment path, and if my patient who is terminally ill and is facing that they will get as much information as possible for me about it, and if I can't further assist them I will find someone who can. Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 13, 2017 Share Posted July 13, 2017 14 hours ago, CJAdmission said: "The law" once said that slavery was swell. Did that make it right? I have no reason to believe that the Supreme Court is any wiser than the rest of the dopes that infest our government. I do believe this is going to the court system in the UK with a patient demanding the right to die with dignity. Link to comment Share on other sites More sharing options...
CAAdmission Posted July 13, 2017 Share Posted July 13, 2017 56 minutes ago, Jdabrowski said: But if my patient wants to go with dignity... It seems like "dignity" is always a central issue here. Can someone please define what they intend this term to mean? I have seen patients in miserable, painful circumstances approach the end of their life with what I wold consider to be dignity (and even a sense of humor at times). Conversely, I have seen many perfectly health people without a shred of dignity. Is it "dignified" to be in a nursing home wearing diapers and needing someone to change you? Link to comment Share on other sites More sharing options...
Jdabrowski Posted July 13, 2017 Share Posted July 13, 2017 It comes down to personal perspective. Yes there is a dictionary term, but these choices are for a patient to decide. We have advanced directives that state a patient does not want to be on life support and such, why can't this be included? Could we argue that taking people off life support is murder as well? Again there really is not right or wrong answer here. It is incredibly hard to argue when there is a personal bias about it. More of less this is a topic where we should keep an open mind to all possible answers because it can go in any direction such as the chronic intractable migraine patient, the ALS end stage patient, the cancer patients, etc. Link to comment Share on other sites More sharing options...
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