Assisted suicide - How far can it go?

Turin said:

None of our states have assisted suicide as you describe it. We have Death with Dignity for people who are suffering horribly and actively dying.
There is a big difference - educate yourself.

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Actually I am not sure this is true. Might be about my perception of what "actively dying" means,

Q: Who can participate in the Act?
A: The law states that, in order to participate, a patient must be: 1) 18 years of age or older, 2) a resident of Oregon, 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that will lead to death within six (6) months. It is up to the attending physician to determine whether these criteria have been met.

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Frequently Asked Questions

For example, a patient with a brain tumor that currently is not impinging on crucial life functions (where imminent death is expected). The patient may not even be in severe pain (intractable or otherwise). But the doctor might tell the patient to expect the pain and alteration of life functions within 6 months. The patient may want to have the ability to make this decision BEFORE those functions get that bad.

Clearly that class of patient is not in the throws of death or suffering horribly.

year2late said:

As a practicality, we can always alleviate suffering. But the side effect of alleviation of suffering is sometimes death. If you keep giving morphine (or whatever)until there are no complaints or behavioral signs of pain, it could clearly hasten death. This is not euthanasia, it is comfort care.

Primarily I am for assisted suicide if a patient has the ability to understand and make the decision for himself. Otherwise it should be comfort care.

Weird thing is that I have had two family members in my home on hospice this year. They clearly had enough medication to kill themselves if they wanted to. There was never any need to ask for more.

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I don't see a difference between euthanasia and comfort care that hastens death.

My condolences on the loss of your family members.

Scrabaholic said:

I don't see a difference between euthanasia and comfort care that hastens death.

My condolences on the loss of your family members.

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There is a huge difference, actually.

Comfort care is meant to give enough medication (or whatever) in order to temporarily relieve pain. The dose is not intended to cause death - but if the person is very ill...the dose may hasten death.

On the other hand, the EXPECTED outcome each and every time with euthanasia is death. The elimination of current and future suffering.

chromium said:

I really don't see where you get off wishing to install such a nanny state, and this is coming from a socialist. In the context of this thread, you're coming from a position that self harm, even when it's far from guaranteed (like a motorcycle), is always irrational.

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I am supported and controlled by my parents -- they are my de facto guardians. I have Autism and Depression.

Scrabaholic said:

I don't see a difference between euthanasia and comfort care that hastens death.

My condolences on the loss of your family members.

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Very sad. People in these situations are really suffering. A person who lost $200,000 gambling online is not.

year2late said:

There is a huge difference, actually.

Comfort care is meant to give enough medication (or whatever) in order to temporarily relieve pain. The dose is not intended to cause death - but if the person is very ill...the dose may hasten death.

On the other hand, the EXPECTED outcome each and every time with euthanasia is death. The elimination of current and future suffering.

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there are cases where not enough pain medication can be given ... that is a fact

people do not like to think that they could die in agony suffering for weeks, choking on their own bodily fluids unable to feel comfort....they can and do

_Sal said:

there are cases where not enough pain medication can be given ... that is a fact

people do not like to think that they could die in agony suffering for weeks, choking on their own bodily fluids unable to feel comfort....they can and do

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I am a critical care nurse and I disagree, The problem is where they are. If they are at home, it is possible they cannot be managed well enough. But in almost 35 years I have never had a patient that was dying that I could not make comfortable. Ever. (specifically speaking to the ones on comfort care)

By the time they are choking on their own bodily fluids and in severe intractable pain, they are likely not competent to make an assisted suicide decision anyway. The whole point of assisted suicide is for the patient to make a competent informed choice to end his life NOW. This decision cannot be made by another competent person on his behalf. A DPOA or other agent cannot authorize this.

Like I said, there is a huge difference between comfort care and assisted suicide.

In comfort care (or hospice care) if the amount of drug(s)is not sufficient to create comfort, the nurse simply calls the doctor to get an order to give more, In a home hospice situation it is more than possible that the nurse would be authorized to have a prolonged stay to control the pain.....or the home hospice patient could be urgently admitted to the hospital for more active control of pain.

If you have factually seen patients on comfort care not be made comfortable may I ask specifics?

Given the protocols for both my brother and my mother on home hospice....I never felt like this would be an issue. Worst case is that they would have been immediately taken to the hospital to achieve comfort.

And in the hospital, patients are allowed advancing levels of pain medications (etc) that should control the pain in short order.

year2late said:

I am a critical care nurse and I disagree, The problem is where they are. If they are at home, it is possible they cannot be managed well enough. But in almost 35 years I have never had a patient that was dying that I could not make comfortable. Ever. (specifically speaking to the ones on comfort care)

By the time they are choking on their own bodily fluids and in severe intractable pain, they are likely not competent to make an assisted suicide decision anyway. The whole point of assisted suicide is for the patient to make a competent informed choice to end his life NOW. This decision cannot be made by another competent person on his behalf. A DPOA or other agent cannot authorize this.

Like I said, there is a huge difference between comfort care and assisted suicide.

In comfort care (or hospice care) if the amount of drug(s)is not sufficient to create comfort, the nurse simply calls the doctor to get an order to give more, In a home hospice situation it is more than possible that the nurse would be authorized to have a prolonged stay to control the pain.....or the home hospice patient could be urgently admitted to the hospital for more active control of pain.

If you have factually seen patients on comfort care not be made comfortable may I ask specifics?

Given the protocols for both my brother and my mother on home hospice....I never felt like this would be an issue. Worst case is that they would have been immediately taken to the hospital to achieve comfort.

And in the hospital, patients are allowed advancing levels of pain medications (etc) that should control the pain in short order.

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that was not my experience this summer at all

the doctor after being in palliative care for over 20 years was fearful of administering too many meds and did not like to be questioned

the dying was a nurse who begged, and pleaded to die

nope

she wasted away to nothing and died in screaming agony at under 70 lbs with a massive abdominal tumour that created agony even when they placed her into a "sleep coma"

it was beyond inhuman what this poor woman suffered...had she known it would end this way she would have offed herself weeks before

it was the doctor's care...I NEVER want to see that doctor again and there may well be legal action

conclusion....plan all you want, but **** happens....if I get ANY kind of abdominal cancer I will not leave it up to the medical profession to decide my level of suffering, I will end it swiftly myself

what are they gonna do, punish me? screw them

_Sal said:

that was not my experience this summer at all

the doctor after being in palliative care for over 20 years was fearful of administering too many meds and did not like to be questioned

the dying was a nurse who begged, and pleaded to die

nope

she wasted away to nothing and died in screaming agony at under 70 lbs with a massive abdominal tumour that created agony even when they placed her into a "sleep coma"

it was beyond inhuman what this poor woman suffered...had she known it would end this way she would have offed herself weeks before

it was the doctor's care...I NEVER want to see that doctor again and there may well be legal action

conclusion....plan all you want, but **** happens....if I get ANY kind of abdominal cancer I will not leave it up to the medical profession to decide my level of suffering, I will end it swiftly myself

what are they gonna do, punish me? screw them

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I am sorry for her (and your!!!!)agony.

Palliative care or hospice? There can be an amazing difference.

If the patient is on comfort care the patient should have been given enough medication to manage the pain. I would say that was an awful doctor. But like I said, there is a difference between palliative care and hospice.

Palliative care can be administered to people whom they are still actively treating.

So the idea is that if you are still being treated for your disease (trying to improve your condition) they will keep in mind that you are seeking this end over death and will be more reluctant to give an amount of medication that would make the patient hemodynamically unstable.

In hospice - where improvement or cure of condition is not the goal the hemodynamic situation (read blood pressure, breathing etc) is no longer a concern.

What you stated would be well outside of the norm for hospice.

By the way. I have clearly and emphatically stated I am in favor of assisted suicide. emphatically. With the caveat that the person requesting be in a mental condition where they personally are able to legally consent - no DPOA, next of kin, or living will.

But I am anguished that she went through that . It should never have happened like that if she was on comfort care.

Also, after over 30 years of critical care, I have never heard the term "sleep coma" do you know what they used? I am curious what that is.

If I was the nurse and a comfort care or hospice patient was writhing in pain and the doctor would not help, I would immediately go up the chain of command. That being said....I have never ever encountered such am atrocious situation.

And with two family members on hospice this year - one in hospital then home...one on home hospice only...the safeguards for comfort were multilayered and there were contingency plans in place. If It matters, one had great insurance and the other had Medicaid (for the indigent). They both got treated the same...with the same safeguards.

But again, I am clearly in favor of assisted suicide with the caveats I mentioned earlier,