Euthanasia

[fonso]

Is physician assisted mercy-killing acceptable in your opinion?

For me, I would have to say yes. I would knowingly take the life of a friend or relative if it would ease them of immense suffering.

[Tigerlilly]

Isn't this also denying the patient the right to live as he/she chooses?

To an extent, it would be a form of paternalistic control. I believe in maximizing the autonomy of the individual, unless doing so greatly injures or makes life fairly unlivable for others.

If the patient cannot be taken care of by the family, and it's acting as a large burdeon, and the patient is going to die anyway, I do not think it is just for them to sacrifice their savings, life, home etc. If the patient is very old, hasn't contributed much to the family, I think the duty to die strengthens.

Usually, I am for voluntary, but there are cases in which pepole are either in a comatose state with little or no chance of recovery, or where providing a treatment will only extend the life of the patient a few weeks or so, and they won't get any better. The procedure is wasteful at that point. They should, instead, provide either palliative care, or allow for Euthanasia.

Up until the point of death, the patient is presumed to be a sentient being -- even if in a coma -- and unless there is a plasma shortage or a lack of transplantable kidneys, shouldn't everything be done to maintain that situation?

Only if the person has a desire in a living will or if the family/society can reasonably maintain the patient without going to dramatic means. I wouldn't support invasive operations on people who are in comas with little chance of recovery.

I don't think there is much point in maintaining a comatose patient who is terminally ill, because it's just a waste of resources. They should keep it for a little while, and see what happens, but after a period of a couple weeks, they should stop if nothing can be done.

Being in a coma is as close to death anyway. THere is no pain, there is no pleasure. It's the living dead. You cannot experience or have any life, or any hope of life.

My comment about doctors not knowing everything doesn't just apply to the medical knowledge of when a patient will likely die, it also applies to the quality of life of that particular patient.

That's why I think there should be some evaluation and discussion with the patient (provided that he's competent) about what his quality of life is. THe best source for autonomy and utilitarian happiness judgement in this situation is the person under question.



I would think we would have to assume that, barring instructions to the contrary, any given person would want to live -- and this desire should supercede any common good that might be achieved by accelerating the patient's death.[/quote]

I wouldn't want to live if I knew I were in a coma or if I knew my staying alive (despite the fact I will die) would cause my family great economic/social hardship. I wouldn't want to be that costly for nothing. Costing thousands, if not millions of dollars for care that will only lead to keeping me alive to die shortly, I think is wrong.

In an ideal world, I realize, everyone would get every kind of care possible. But because there are only so many resources at any given time, an imminently dying person should not receive the balance of transfusable blood -- which would extend life for a few hours, let's say -- that could otherwise be used to save the lives of a number of others in the same hospital.

I agree. That's partly what I mean by extraordinary measures. Food and water yes, but not things that require large, expensive operations, resources that can be used for other people. If the patient will have a long time to life (several monthes with bearable pain and suffering), then it's fine. But lingering few weeks only to die at the end of a train of expensive treatment and care is unbalanced.

But considering the example of euthanizing the imminently dying person, it is necessary to use an additional set of different resources in order to perform the euthanasia, whether it's an overdose of potassium or morphine or whatever.

They should administer lethal injections. It costs relatively cheap sums. About a few cents to a few dollars. The big cost with "execution" isn't the method, it's the appeals process, so the treatment is rather cheap.

I would think that actual utility would depend on the amount of resources designated for the case -- the patient -- versus the need for those resources in other cases.

I totally agree, but I think utility also plays a role i the patients desire to die. Whatever gives them the most mercy/happiness, is what should be done as a general Rule, unless a greater happiness can be achieved while minimizing damage.

And what is the difference between euthanizing an imminently dying patient and allowing that patient to die?

Extending the dying process, many times, leads to a worse, more painful death. When they "let" someone die, they are letting them succumb to dehydration, starvation, sickness. They slowly deterioriate and finally die. This can be bad and costly. Active Euthanasia would be cheaper and more Humane. It would lead to more dignity and less pain.

Does it matter how long this patient has to live? Does it matter how much they are suffering even if they have not indicated a wish to die?

The suffereing/pain only matters if they want to die. If they find it enjoyable to live through the pain/suffering, then by all means they can. The problem is when they have little time left to live, yet they want to extend their life through expensive, difficult operations that someone else could use (time and resouce wise) who won't have that same problem.



This would seem to be a loss of utility, to use additional resources to hasten the death of someone who will die soon anyway.[/quote]

I think that when the patient "doesn't want to die, but must" the ethics of euthanasia can become a bit questionable.

They can be yes. It coud possibly be abused, but it would have to have checks and balances to prevent such abuses. I think it could have merit, though in limited circumstances.

(Hopefully, you make a distinction between those who don't have the capacity to make a decision and those who knowimgly want to live...?)

Of course, but I also know there are some people who want to live at all costs, no matter what type of damage it does. I listed before the example of the woman who cost the government over 6 million dollars on life support, was never going to get better, and only died.

In the other case, the old, terminally ill lady cost her only daughter her career, her savings, and her house. These cases occure in the thousands. In those cases, I cannot see the moral side of keeping them alive. IT would be sad to kill t hem, yes, but I don't think immoral.

I have no problem in situations where an individual has a living well specifiying not to be kept on life support, or when a patient is truly suffering and wishes not to be a burden to family.

I agree. But personally, if they are unconscious and no longer on life support, I would rather give them active euthanasia than letting them die. It's cruel and they are nigh dead anyway.

In situations where the patients will is unknown, my support for euthanasia is a bit more reserved. While doctors may feel quite confident in their abilities to make accurate prognoses, involuntary euthanasia, as ST88 pointed out, implies more medical certainty than we have. [/quote]

[ST88]

I believe in maximizing the autonomy of the individual, unless doing so greatly injures or makes life fairly unlivable for others.

If the patient cannot be taken care of by the family, and it's acting as a large burdeon, and the patient is going to die anyway, I do not think it is just for them to sacrifice their savings, life, home etc. If the patient is very old, hasn't contributed much to the family, I think the duty to die strengthens.

This view would be caught up in in the definition of the "fairly unlivable" condition that the extension of life might place the family. If the savings of the family is the concern, then I would suggest a hospice for palliative care. But I'm not sure what you mean by "hasn't contributed much". Are you talking about monetary value, or maybe something else?

I don't think there is much point in maintaining a comatose patient who is terminally ill, because it's just a waste of resources. They should keep it for a little while, and see what happens, but after a period of a couple weeks, they should stop if nothing can be done.

Being in a coma is as close to death anyway. THere is no pain, there is no pleasure. It's the living dead. You cannot experience or have any life, or any hope of life.

You might be confusing coma with persistent vegetative state. I believe coma is merely a form of neural shock in which the brain refuses to wake the body until such time it thinks its ready. It may never be ready, sometimes we just don't know. PVS I think is sometimes referred to as brain dead, which might be what you're referring to, and this is not a point of contention for me, as, to me, brain dead = dead.

I wouldn't want to live if I knew I were in a coma or if I knew my staying alive (despite the fact I will die) would cause my family great economic/social hardship. I wouldn't want to be that costly for nothing. Costing thousands, if not millions of dollars for care that will only lead to keeping me alive to die shortly, I think is wrong.

I might agree with you, but that hardly matters. Not everyone feels this way and we shouldn't assume that everyone would not want to be kept alive barring any alternative information. Even if doctors can plainly see that the patient is an insufferable bastard, inflicting his psychological tantrums on the rest of his family who can clearly barely afford to care for him, we should assume that this life has value. If your arguments rests with money, then in my opinion you should be working on the cost of Health Care on a political level.

Food and water yes, but not things that require large, expensive operations, resources that can be used for other people. If the patient will have a long time to life (several monthes with bearable pain and suffering), then it's fine. But lingering few weeks only to die at the end of a train of expensive treatment and care is unbalanced.

How do you define what is a long time and what is a short time? Weeks to months? Do we order the patients on a list like the suitability of organ donor recipients? There are some decisions on procedures which have figures like this: Procedure 1 will give Patient A a 30% chance of a full recovery and a 50% chance of instant death -- Procedure 2 will give Patient A a 30% chance of survival to 18 months, and a 50% chance of survival to 6 weeks. (Missing percentages are either outliers or intermediate values.) You're the decision maker, what do you do?

Often it isn't known that at the end of the expensive treatments death is inevitable. I think this is the main problem, that it just isn't known at the point of decision-making how successful a given treatment will be.

And what is the difference between euthanizing an imminently dying patient and allowing that patient to die?

Extending the dying process, many times, leads to a worse, more painful death. When they "let" someone die, they are letting them succumb to dehydration, starvation, sickness. They slowly deterioriate and finally die. This can be bad and costly. Active Euthanasia would be cheaper and more Humane. It would lead to more dignity and less pain.

That's not quite what I meant. To me, removing a feeding tube or a breathing tube is a worse form of euthanasia than administering the chemical cocktail for the reasons you describe. But what I was talking about was allowing the patient to die while providing "regular" care -- as in a hospice environment. What would be the difference between allowing a patient to die in this way and administering the lethal injection?

The suffereing/pain only matters if they want to die. If they find it enjoyable to live through the pain/suffering, then by all means they can. The problem is when they have little time left to live, yet they want to extend their life through expensive, difficult operations that someone else could use (time and resouce wise) who won't have that same problem.

I don't see what this has to do with euthanasia. This is simply the denial of care to someone who won't benefit from it. This is done all the time. Smokers don't get priority for organ transplants, for example, and not everyone gets the procedures they want done for just those reasons.

I think you're overlooking the benefits of palliative care. I support efforts towards expanding palliative care in this country, but I won't go so far as to advocate euthanasia because of my support for (for lack of a better phrase) sanctity of life. If suffering can be alleviated with drugs, isn't that worth more in terms of the simple experience of living than the savings obtained by ending life?

[Tigerlilly]

QUOTES: ST88

This view would be caught up in in the definition of the "fairly unlivable" condition that the extension of life might place the family. If the savings of the family is the concern, then I would suggest a hospice for palliative care. But I'm not sure what you mean by "hasn't contributed much". Are you talking about monetary value, or maybe something else?

I think a hospice should be allowed first, but only if they can actually take away the pain. In many cases, there are pains and suffereing that can't be ameliorated by Hospice or palliative care, or in some countries, there aren't any.

By meaning they haven't contributed much, I mean in contributions to the family money, time, or emotinally. The less they do for the family, the less one should care about them. They are them more distant. I am not saying, however, that you should euthanize them because of that. It just one of the reasons to increase the duty to die (I think it was labled uneven resource distribution in the family). If they take more than they have given, then they have more of a duty to die that someone else who has not).

You might be confusing coma with persistent vegetative state. I believe coma is merely a form of neural shock in which the brain refuses to wake the body until such time it thinks its ready. It may never be ready, sometimes we just don't know. PVS I think is sometimes referred to as brain dead, which might be what you're referring to, and this is not a point of contention for me, as, to me, brain dead = dead.

I mean people who are in long-term, little hope of recovery Comas or people who are braindead, and are just being kept functioning on life support.

If the coma lasts more than a few months and no one can see an end in sight, it costs too much imo.

Not everyone feels this way and we shouldn't assume that everyone would not want to be kept alive barring any alternative information. Even if doctors can plainly see that the patient is an insufferable bastard, inflicting his psychological tantrums on the rest of his family who can clearly barely afford to care for him, we should assume that this life has value. If your arguments rests with money, then in my opinion you should be working on the cost of Health Care on a political level.

I don't think everyone would want to either, but everyone can't do what he wants to all the time. THere are some situations in which people have to do the greater good even if it wouldn't be good for themselves.

If a family and state can afford them, and continued existence isn't proposing a significant burden, then I see no problem keeping them alive.
Of course his life does have value, yes, but I am weighing his value im a terminal, demented state against the value of happiness of the family. I read of too many examples where some selfish old woman took her family for a ride on her deathbed, costing them everything. Then she died, and they were left with nothing but bills. This is wrong. They have a duty to their families to not destroy the lives of their loved ones, I think.

Healthcare should be fixed yes, but that's not realistic any time soon. and it's very expensive.

How do you define what is a long time and what is a short time?

If they have a few hours/days/weeks to live, or about a month, then it's too short. If they hve years to live, then it's far better.

It's also not worth the trouble if all they are going to do is linger and live in a hospital for the remainder of their lives, with no real chance of recovery. They might as well send the person home and make room for others who aren't like that. THey should be taken out and given palliative care, if effecitve. If it's too bad, then they should Euthanize.

Procedure 1 will give Patient A a 30% chance of a full recovery and a 50% chance of instant death -- Procedure 2 will give Patient A a 30% chance of survival to 18 months, and a 50% chance of survival to 6 weeks. (Missing percentages are either outliers or intermediate values.) You're the decision maker, what do you do?

I would ask the patient what to do first. If he is totally incompetent, he cannot make that decision, and even though I might not be (legally) yet able, the moral solution I would pick would have to depend on how bad the condition is. IF it's bad and they are terminally ill, I would pick A.

With procedure 2, they will maybe have a 30% chance only to live less than 2 years, in the same painful, disgraceful state. 6 weeks is nothing. That's less than a college powerpack semester. The entire time, they will most likely linger in the hospital untill they die.

A is the best overall chance, since it gives full recovery, and they have a 50/50 % chance of living or dying. With the others, they, quite soon, have a 100% chance of dying, but living in the same quality condition.

Often it isn't known that at the end of the expensive treatments death is inevitable. I think this is the main problem, that it just isn't known at the point of decision-making how successful a given treatment will be.

That's what I mean. ONe should expend so many resources for a treatment that will have no or little effect. Also, if it is known that the person is suffering from something els ethat will kill them soon anyway, it would be pointless to go through a whole huge procedure to cure/fix the fixable problem.

That's not quite what I meant. To me, removing a feeding tube or a breathing tube is a worse form of euthanasia than administering the chemical cocktail for the reasons you describe. But what I was talking about was allowing the patient to die while providing "regular" care -- as in a hospice environment. What would be the difference between allowing a patient to die in this way and administering the lethal injection?

It depends. I don't really know what goes on fully in palliative care. I know they try to relieve suffereing, but I don't know what medicines or whatnot they provide. I know they don't do anything that can help the patient, just drug him down and provide emotional support. I don't know how much it costs either.

If palliative care is wanted, and it has good prospects of success, that should be used. If the person is coma/vegatative or if they cannot be helped by pain killers unless they are made comatose, then I don't think palliative care is necessary.

Right now, I think that about 90% of all cases of pain can be fixed through pain killers, but there are cases that are common where they cannot be, yet. Perhaps one day. Also, if they don't want to live anymore, and it's voluntary, I think they should have access to both. Whatever they want. Sometimes it's not just about pain. It's about living through sickness or no relatives to come see you.

What would be the difference between allowing a patient to die in this way and administering the lethal injection?

THe lethal injection would probably be faster and cheaper, and have the same end result: painless death. Concieveably, based on the case, the lethal injection might be more human than the palliative lingering. It really depends.

I don't see what this has to do with euthanasia. This is simply the denial of care to someone who won't benefit from it. This is done all the time. Smokers don't get priority for organ transplants, for example, and not everyone gets the procedures they want done for just those reasons.

That's part of the reasoning to have Euthanasia. You don't provide care to someone who won't benefit from it. It's "passive euthanasia." I take it a step further and don't do passive, but active in these cases if they refuse to acknowledge this and nothing else can be done.

If suffering can be alleviated with drugs, isn't that worth more in terms of the simple experience of living than the savings obtained by ending life?

If their suffering can be allievated to their satisfaction, yes. They should gain access to palliative care, but I know there are cases in which they cannot help. My ethics book lists examples and statistics, I think. Sometimes it's not just physical paint that is the problem.

[bookie]

i my opinion mercy is wrong, and no body has the right to take a life of another person no matter what. Not even a doctors. God is the person that give use life and only he should have the right and the law to take it away.

[The Happy Humanist]

i my opinion mercy is wrong, and no body has the right to take a life of another person no matter what. Not even a doctors. God is the person that give use life and only he should have the right and the law to take it away.

Hello, bookie, welcome to the forum!

Now, what if that person has specifically left instructions that they are not to be rescusitated with extraordinary means? Let's say its a person that doesn't happen to believe in your God.

[bookie]

i feel that if i no doctor has the right to take the tube off a person if the person is dieing. if i was ill i would not want them to take me off the tube because they are not my God or the person that bring me to life ,so i feel that they do not have the right to make that decisions.

[bookie]

Hi Happy
i feel even if the person does not beleive in God it does not give the right to take their life or any body else.

[The Happy Humanist]

i feel that if i no doctor has the right to take the tube off a person if the person is dieing. if i was ill i would not want them to take me off the tube because they are not my God or the person that bring me to life ,so i feel that they do not have the right to make that decisions.

Well, that's fine for you, and I would not want to have any adverse affect on your ability to make end-of-life decisions for yourself. But apparently you want to go beyond that and make end-of-life decisions for other people, based on your worldview, which they may not share.

Think of it this way...How do we know for certain that life-extending procedures, artificial life-support systems and the like, are not interfering with God's plan? Remember, they didn't exist a century ago. We may be defeating God's will in implementing these things. As a matter of fact, we've gotten so good at this that we now are in a situation where around 80% of Emergency Room deaths are "consensual." That is to say, we can keep most traumatically injured people alive indefinitely, but they are not in any kind of condition that anyone would want to be kept alive in. A relative needs to be asked if the machines can be turned off - in 80% of the cases! Does that sound like God's plan? The day is coming when, a la Woody Allen, you may walk into an ER room and see a nose hooked up to life support, and the doctor may ask you if you want to keep great-great-grandpappy alive like this till cloning advances a little...

Obviously we (meaning your side AND my side!) need to think these things through a little more, and come to some kind of consensus, based primarily on compassion and wisdom, rather than dogma and (ugh!) politics.

[OccamsRazor]

Sorry about posting on an old topic but I wanted to pose a question and did not want to create a duplicate topic. So here goes:

A friend of mine works in emergency medical care. He has told me that on many occasions he euthanises people based on a quickly taken decision. Here is an example of a decision he took:
A sportscar had hit another car at a very high speed. In the sports car a man in his 20s was driving and his girlfriend was in the passenger seat. In the other vehicle there was a family of 2 adults and 2 children.
The air ambulance arrived and were instantly presented with 6 patients all with serious injuries including both occupants of the sportscar being covered in burns.
The helicopter could only carry away one patient and the ambulances were going to take some time to arrive.
The main issue is that severe burns require very quick transferral of the patient to a burns unit. Both the man and woman in the sportscar required a burns unit or both of them would die, if they could get to burns units then they may both have been able to survive and live a pain free (if somewhat scarred) life. My friend worked out a quick calculation (he tells me that there is a mathematical function to work out the probability of a patient surviving severe burns) and deemed that the man driving the sportscar had a higher chance of survival so he loaded him into the helicopter and gave the woman a lethal dose of morphene.

In such a case is he morally justified to euthanise the patient?

[The Happy Humanist]

In such a case is he morally justified to euthanise the patient?

That's exactly what I would want, if I were the patient. But here's the problem: Ideally, such cases should automatically be reviewed by an investigative body afterwards. Such investigations invariably result in refinements in protocol and other aids to the decision-making process for future cases. Like the review that takes place after a fatal shooting by a police officer, we invariably learn things from such proceedings, and find more ways to save lives. But that would entail making euthanasis legal. Because it is NOT legal, your friend couldn't report officially on what he did. Thus, he, and MANY OTHER health professionals, euthanize in a legal and informational vacuum. Yes, friends, I assure you, what was described above happens all the time. It will continue to happen all the time, as long as there is human compassion. Making it legal would not increase the incidence of such emergency euthanasing very perceptibly, since it is already a widespread practice, but it WOULD increase the chances of REDUCING the practice, by allowing the exchange of medical knowledge that might give EMTs alternate procedures to follow, procedures that could enable them to SAVE lives instead of TAKING them. If there were a God, would he not approve of such an idea?