Massachusetts May Soon Change How the Nation Dies

Hugh Pickens writes "Lewis M. Cohen reports that this Election Day, Massachusetts is poised to approve the Death With Dignity Act, a modernized, sanitized, politically palatable term that replaces the now-antiquated expression 'physician-assisted suicide.' Oregon's Death With Dignity Act has been in effect for the past 14 years, and the state of Washington followed suit with a similar law in 2008. But the Massachusetts ballot question has the potential to turn death with dignity from a legislative experiment into the new national norm, because the state is the home of America's leading medical publication (the New England Journal of Medicine), hospital (Massachusetts General), and four medical schools (Harvard, Boston University, University of Massachusetts, and Tufts). If the act passes in Massachusetts, other states that have previously had unsuccessful campaigns will certainly be emboldened to revisit this subject. The initiative would allow terminally ill patients with six months or less to live to request from their doctor a prescription for a lethal dose of a drug. Doctors do not have to offer the option at all, and patients must make three requests, two verbal and one written. They must self-administer the drug, which would be ingested. The patients must be deemed capable of making an informed decision. 'It's all about choice,' says George Eighmey, a key player in instituting the Oregon law, defending it against repeal and shepherding it into reality. 'You decide. No one else can decide for you. No can can force you into it, coerce you into it or even suggest it to you unless you make a statement: "I don't want to live like this any more" or "I'm interested in that law out there, doctor, can you give me something to alleviate this pain and suffering."'"

Comments

Question:

[Mitreya]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

Or is this aiming to legally protect doctors who are assisting patients?

Re:Question:

[mcmonkey]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

Or is this aiming to legally protect doctors who are assisting patients?

Yes, and yes.

Re:Question:

[poetmatt]

Uh, he said yes.

I am taking a stab at the dark here, but I'm assuming they meant a prescription drug approach that is guaranteed and quick, as opposed to "might not work and leave you crippled". Not that I would want to do that, but I can surely guess that terminally ill folks would rather like to be able to choose when they die of their own volition.

Re:Question:

[Firehed]

I imagine this allows ill patients to get access to something that will bring a much cleaner and painless death than downing an entire bottle of painkillers; i.e. more like a cyanide capsule.

It's easy to buy a lethal dose of caffeine (fairly cheap!) off Amazon, but going by how having way too much coffee feels, that would be a pretty crappy way to off oneself. Seems to go against that whole "dignity" thing they're aiming for.

Re:Question:

[Anonymous Coward]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

No, of course not. Go home and down a bottle or two of OTC pills. Chances are it'll be lethal But by law, that is called "suicide".

Or is this aiming to legally protect doctors who are assisting patients?

Perhaps a bit of that yes. But chances are this law is to also enable those who wish to participate to be legally exempt from suicide clauses within life insurance policies (at least one would hope there would be provisions in this law for that).

Re:Question:

[werfu]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance? : For a young kid, no, but for a elderly totally. Anybody will tell you to simply shell out a hundred buck to get heroin or coke and buzz away your life. But can you simply imagine how an old lady would feel trying to get coke/heroin in a shady neighborhood? In fact there's most chance she would get mugged of her cash and left in pain.

Re:Question:

[Anonymous Coward]

More importantly, if you're tied to a hospital bed slowly dying from cancer in its last stages you couldn't go try to score even if you wanted to.

Re:Question:

[h4rr4r]

So then how do people get illegal drugs?
Are doctors supplying those?

You know you can just buy carbon monoxide, right?

Re:Question:

[thePowerOfGrayskull]

Possible, but hardly "with dignity". You could still be found and rushed to a hospital, stomach pumped and kept alive. Plus quite likely getting forced into some kind of psychological treatment.

Even if not, there are other nasty side effects associated with any of the easily available methods.

So while it's possible to suicide on your own, it's difficult to manage with a minimum of discomfort.

Re:Question:

[h4rr4r]

Is there much of a difference between prescription opiates and street ones? Seems like everyday you hear more and more about the prescription ones being sold on the street or abused by radio personalities.

Re:Question:

[ByOhTek]

You can, but to do so in a manner that will have a high probability of death rather than furthering injury (and hence suffering) is a trickier matter. The doctors can just make it less likely that your attempts will instead increase your suffering.

Re:Question:

[Reformed Lurker]

I don't think alcohol poisoning necessarily can be described as "Death with Dignity"....

Re:Question:

[Artraze]

> Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

Yes.
To elaborate: It's difficult to acquire a lethal dose of a drug that is easy to administer and will result in guaranteed, peaceful death without little to no chance of (partial) survival. Sure you can drink bleach or try to OD on alcohol or acetaminophen/paracetamol or any number of things. But they can be quite unpleasant and/or leave you alive but even worse off.

> Or is this aiming to legally protect doctors who are assisting patients?

Less so, I'd wager. Realistically, people rarely ask questions if someone suffering and wishing to die dies in their sleep. Doctor: "They died in their sleep last night". Family: "Ah, well their suffering is over at least". Pretty much never: "I bet you turned their morphine up you bastard!". Of course, that really requires the patient to be literally on their death bed, but either way I think the point of this is entirely a way to reduce suffering of the terminally ill and not really about doctor liability.

Re:Question:

[localman57]

You can overdose from alcohol; people do it all the time. They call it "alcohol poisoning." Others overdose on heroin and other opiates. Others, barbituates. In fact, almost every "downer" drug can be lethal, even the over-the-counter drugs like alcohol

There's a big difference between "can" and "will". Any of those things "can" kill you, but probably won't. The body really, really wants to live. Most likey you'll end up in the hospital, which will try to nurse you back to health. In some states, you can also be committed to an institution against your will after a suicide attempt. I think the goal here is a suicide which is reliable, comfortable, and peaceful, and doesn't leave your corpse in a disturbing state for your descendants. Achieveing all four of those things at the same time is tricky.

Re:Question:

[MozeeToby]

It's easy to get a lethal dose, but it's less easy to get a lethal dose in forms that many of these people can actually take. It's hard to swallow a fist full of sleeping pills if you're on a feeding tube 24/7. Heck, it can be hard to swallow pills if you have a stroke. Then there's the fact that none of the drugs you mentioned produce death in ways that are at all pleasant. A terminal patient who wants to end their life shouldn't have to worry about spending their last conscious moments vomiting themselves to death. And that's if they don't botch it (not taking enough, vomiting up the pills before your body metabolizes them, etc).

Letting doctors prescribe a lethal dose means a single large injection of morphine and it means being unconscious in seconds and dead in minutes, with virtually no failure rate.

Re:Question:

[Anonymous Coward]

You do realize that we're talking about people who may be confined to a bed in a hospital?

Options for overdosing become much more limited when you're hooked up to monitoring equipment and the stomach-pump machine is in the next room.

Re:Question:

[mwvdlee]

You'd think a country that executes prisoners humanely (as much as I'm opposed to death penalty, atleast they're not tortured) would want the atleast the same humane treatment for it's citizens that actually choose to die.

Re:Question:

[mcmonkey]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

You said "no", I call bullshit. You can overdose from alcohol; people do it all the time. They call it "alcohol poisoning." Others overdose on heroin and other opiates. Others, barbituates. In fact, almost every "downer" drug can be lethal, even the over-the-counter drugs like alcohol.

You got the second question right, though.

My experience is there is a stark contrast in the availability of illicit drugs. If you're in college or familiar in certain other subcultures, illegal drugs are quite easy to find. If you are not in one of those circle, however, and adverse to involvement of legal authorities, those same drugs may be all but impossible to obtain.

As for lethal alcohol poisoning, it's actually not that easy. Yes, it happens all the time, which is why I laugh every time I hear about it. "Wow, that guy REALLY wanted to die."

Re:Question:

[sunking2]

It's to protect the doctors. The truth of the matter is many doctors who have patients in these situations routinely make more than enough medication available for someone who wants to take that option. Most won't go so far as actually assisting, but they typically make the option there. This also means there is a much greater chance of not having things work out as planned and creating a bigger mess of a bad situation. Hopefully this helps that.

Re:Question:

[mwvdlee]

Even if you could get somebody to score that amount of drugs for you and even have them help you take it, chances are the hospital people would notice (what with all the monitoring equipment) and interfere well before the dosage would be lethal.
You can't very well ask medical personel to just stand by while you slowly die; it wouldn't be fair to them. The only correct way would be one that is instantly fatal.

Re:Question:

[TheCarp]

Yes and no. Most people are not medical experts and, shouldn't have to become so just to die with some dignity.

The thing is, what kills one person may not kill another and most things that you can eaisly get your hands on, and even most prescriptions, are within dosage ranges that are quite safe. Yes, you can kill yourself many ways, but, many of those ways are less effective than you might think.

I personally knew a guy who tried to off himself with barbituates. He failed, woke up several days later. This is actually fairly common with that route.

Also many terminally ill patients are in no condition to do that research and administer the drugs without help.

Which is why, I think we really need the second... Doctors able to help.

I plan to vote for this one. I have worked among the medical community (at MGH no less), I have been there when my family had to have stern words with doctors who somehow interpreted our grandfather's DNR order as "Recessitate and put on a ventilator".

This is such an important issue for so many reasons. So many people in ongoing pain that don't need to be, so many families that need to move on. I hate to bring it to money but.... 50% of health care costs are spent in the last 5 years of life.....and for what? The fact that so many doctors opt to not have chemo and opt to die rather than hang on like so many of their patients are made to should say something.

Don't get me wrong, if someone wants to fight to the biter end, and get as many waking moments as possible, regardless of their quality, more power to them. However, what compassion is there in forcing people to go on living who have nothing to look forward to except deterioration in a bed?

I honestly think Bill Hicks described the situation best in his comical suggestion that we use terminally ill people as stunt doubles in action films. "Do you want your grandmother to die in a sterile hospital bed, he translucent skin so thin you can see the last beat of her heart, or do you want her to meet Chuck Norris?.... wow Chuck just kicked her head clear off, my grandma is no longer in pain...this is the best movie ever!"

Re:Question:

[mcgrew]

Uh, he said yes.

DOH! Had what my mom calls a "senior moment" and young folks call a "brain fart". But what he said was "it's hard to get lethal drugs" which is obviously false.

A bullet works, too, but it leaves more of a mess for someone to clean up. I understand haning one's self isn't a bad way to go. Slitting your wrists might be a little painful, particularly if the blade isn't sharp.

I'm assuming they meant a prescription drug approach that is guaranteed and quick, as opposed to "might not work and leave you crippled".

I've known a couple of people who have had nearly fatal overdoses of illegal drugs, who would have died had someone not found them, and none of them wound up crippled. And have you ever seen someone dying of cancer? They're already crippled.

I see this as a good thing; the last few weeks of a cancer patient's life is nothing short of hell itself. Yes, I lost a dear friend to cancer a few years ago, I would not want to die like she did. I'd far rather have a bullet to the brain.

Re:Question:

[h4rr4r]

You sure can ask medical people to stand out of the way. What the hell do you think a DNR is?

Nearly nothing short of a helmet made of C4 is instantly fatal.

Re:Question:

[MozeeToby]

Doctor: "They died in their sleep last night". Family: "Ah, well their suffering is over at least". Pretty much never: "I bet you turned their morphine up you bastard!"

Pretty much never isn't good enough. If you're a doctor, are you really going to risk your career on the off chance that you get a family who is so overcome with rage that they demand a toxicology screen on their dead loved one? How about twice? How about 100 times over the course of your career? (sounds like a lot, but if you only practice for 20 years that would be less than one patient every two months). How about we have it nice and legal; so the decision is documented and acknowledged by the family and no one has to risk getting their life destroyed for doing what more and more people are of the opinion is the right thing to do.

Re:Question:

[jythie]

That is one of the key points. Yeah, overdoses happen and people die from them, but much of the time an overdose doesn't kill the person (humans are a lot harder to poison then people think) and then leave you feeling even more miserable. I have known several people who tried to commit suicide via ingestion of various pills and survived.

And, of course, some people are just law abiding and, even if they will be dead, still do not want to break the law to do it.

Re:Question:

[jythie]

No difference no, but the doctor could tell you exactly how much to take (too little will not be enough, too much will trigger the body's instinct to evacuate itself).. and of course there is the issue of not everyone knows where to get street drugs so those might not be an option they can access. I know I wouldn't have the first clue how to go about getting such things.

Re:Question:

[h4rr4r]

What would the toxicology screening find?
That a dose of morphine that would not have killed a normal person might have done him in? Or that since he was on morphine for so long he was on an unusually high dose?

Re:Question:

[mcgrew]

The doctors can just make it less likely that your attempts will instead increase your suffering.

If you're in your last month of cancer, there is no way possible to increase your suffering. I cannot imagine a worse way to die.

Re:Question:

[ShanghaiBill]

Is it really that difficult to acquire a lethal dose of a drug without doctor assistance?

For you or me, probably not very difficult. For someone terminally ill and bedridden, somewhat more difficult.

But this issue is not just about the availability of drugs, or any other practical concerns. It is also about principles. The government of a free society simply has no right to get involved in such a personal decision, and has no right to force someone to live longer than they desire.

The death penalty is a similar issue for me. I oppose the death penalty not out of any sympathy for the typical scum that get executed, but because a government that claims a right to kill its citizens will be difficult to restrain on any lesser issue. Governments simply should not have the right to kill us.

Re:Question:

[MozeeToby]

Fatal levels of whatever the doctor prescribed? And once you get that it gets to be pretty easy to search the pharmacy records and see that "Doctor K ordered 10 doses of morphine and 1 syringe" at 1AM and the patient died at 1:30.

Re:Question:

[capedgirardeau]

You need to double check how human the lethal injection process is.

There are really ugly and tortuous problems with it all the time, same with the electric chair, hanging and firing squad.

Re:Question:

[Golddess]

Obviously I do not speak from personal experience, but nitrogen asphyxiation is supposed to be nice and painless. So just need to figure out where to acquire a tank of nitrogen and a mask.

Re:Question:

[Anonymous Coward]

Yes and no. Most people are not medical experts and, shouldn't have to become so just to die with some dignity.

If dignity is a right everyone in the US is fucked.

Re:Question:

[fahrbot-bot]

I would also like to offer that if one is found dead, even of apparent suicide with only months to live, an autopsy will likely be performed to rule out other causes. Being found with a prescription for a suicide drug, and confirmation from your doctor, will make things much clearer and simpler. It may also help with other legal or insurance issues related to your death. Actually dying in the hospital, or other medical facility, would probably help too.

Re:Question:

[h4rr4r]

Which is why so many states are switching from that mess to a single barbiturate dose.

Re:Question:

[Golddess]

That's the part that kind of got me about TFS. Requiring the person to make both written and verbal requests, and to ingest it themselves (which I am presuming to mean they cannot ask someone else to put it in their mouth), I wonder what percentage of people that would restrict this from.

Re:Question:

[h4rr4r]

One trip to the pharmacy and one to a welding supply store.

Re:Question:

[TheCarp]

Not only that but.... standard issues apply. Even if you can get heroin, how much will kill you? You don't even know the purity. This is before we have to consider that you may not be able to prepare it, as several people have pointed out... these are often people confined to bed. You think it may be hard to obtain, try finding a dealer who will deliver to the hospital, then mixing it up, and injecting it.... each step of which, many patients will be unable to do.

Also, what kills one may not kill another. For as many (its actually few believe it or not, overdoses are rather uncommon, a few thousand a year accross the whole country... they seem bad because they are so tragic, but, rare) as OD, there are many more who take the same dose and live.

This is why its best to let a professional handle the operation. Put in safegaurds, put in documentation steps, require witnesses, whatever it takes but....let the doctors do it.

Re:Question:

[smooth wombat]

You need to double check how human the lethal injection process is.

Right, because the person that was bludgeoned to death with a hammer or repeatedly stabbed with an ice pick or was raped for hours or days then repeatedly suffocated to the point of death but not quite before having bleach shoved down their throat was killed quickly and humanely.

Re:Question:

[NatasRevol]

how about death with strippers, puking, and car crashes!

Re:Question:

[h4rr4r]

What does that have to do with it?

The death penalty is not vengeance, it is only preventing the person from continuing to be a danger to others. Society does not set out to murder, only protect itself.

Re:Question:

[Anonymous Coward]

You'd think a country that executes prisoners humanely (as much as I'm opposed to death penalty, atleast they're not tortured)

No, research the cocktail. We put a paralytic in for no other reason than to ensure we can't tell if they're in pain, and since there's no sign of pain, we "know" the dosage is right! It's all about making us, not the executee, feel better.

Re:Question:

[tnk1]

The major need for a doctor and prescription drugs is to make sure the job is done right the first time, and in a way that will not traumatize your relatives (beyond the fact you're going to be a corpse at the end of the process). A failed suicide will leave a very real chance of you being even worse off, and under the current system, kept alive in that state and possibly in a padded room to boot.

For the same reason, that doctors are there to supervise lethal injection executions, a doctor will need to be there to make sure that the method and means are sound and also to ensure that there are no conditions that might complicate the process.

Additionally, the law ensures that you have assistance without that assistant being charged with a crime afterward. Suicides using perfectly effective methods can easily fail, and when they are done by disabled people, are much more likely to fail without assistance.

I don't know how I feel about legal suicide myself. In theory, they aren't impinging on my rights simply by doing so, so it's not my business.

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

Hopefully, someone does the smart thing and leaves the funding for the actual actions to a nice, private charity organization made up of people who agree with it.

Re:Question:

[Reformed Lurker]

Both ways sound like they are more in the "death by misadventure" category.

Re:Question:

[TheCarp]

I posted about this recently but... some friends of mine almost found out about this the hard way.

Through various circumstances, they came to have someone living in a primitive hut on their land. It was actually their hut, and they had given him permission to stay there. He helped out with the animals, and it was an amicable arrangement.

One day it was noticed that he hadn't fed the animals, but he had said he was going to be busy the night before, so they figured he had just been up late...and didn't check on him until later. When they found him, he was barely alive, dieing of what appeared to be an intentional overdose.

The police and paramedics came out, making annoyed comments about having to trudge so far into the woods. They got there to find him still barely alive, and informed my friends that they were very lucky... had they gotten there after he died... it would have meant autopsies and investigations...because finding a body is not the same as finding a dieing person.

Which is all the more reason to allow this sort of thing to be properly taken care of and documented, so there is never any question of "whodunnit".

Re:Question:

[fyngyrz]

So then how do people get illegal drugs?
Are doctors supplying those?

No, legislators are creating the supply out of thin air via the "war on drugs", which created and maintains the profitable black market to sell them in. Without the war on drugs, they (obviously) wouldn't be illegal, they wouldn't be so expensive because they wouldn't be black market, and easy access to them could be had by consenting, informed individuals. Oh, and we'd have more tax income, and considerably better quality control so that the results people desire would actually be what they got.

Of course, that would end the welfare program for LEOs and the private prison system, both with very strong Washington lobbies, so it isn't going to happen.

You know you can just buy carbon monoxide, right?

That's a nasty way to go. Headaches, all the oxygen starvation symptoms... ugh.

Re:Question:

[SuricouRaven]

Easy enough for a healthy person - helium would work. Just don't get the cheap balloon gas, they dilute it with air. This isn't about healthy people, though - these are terminally ill, many stuck in hospital, some unable to even get out of bed without assistance.

Re:Question:

[Anonymous Coward]

The thing is, chronic pain makes people very suceptible to manipulation. I've been there. I don't know how to describe it, beyond that you get stupid. I just wanted the pain to stop. I didn't want to die, per se, I just wanted the pain to stop. Fortunately, in spite of Govt healthcare (VA) I got an accurate diagnosis, and treatment. However, for 2 years, if someone with a stethascope had "counseled me on my options" I would have chosen it.

that's the "Gotcha" that I don't have a good answer for. Chronic pain really, really sucks. Had this been Massachusets, the VA could have saved half a million dollars, and I'd be dead, for no good reason but to save half a million dollars. As bad as the VA is, you know that the health insurance companies will find a perverse incentive for doctors who help their patients "die with dignity"

Re:Question:

[SuricouRaven]

I imagine that a plastic bag, a hose and some sellotape will do as well as a mask. Nitrogen from a welding supply store, or helium from party supply. But remember these are terminally ill people - some of them will be bed-bound, and many unable to travel without assistance.

Re:Question:

[h4rr4r]

CO poisoning is quick. We are not talking about breathing over minutes or hours. We are talking about just a couple lung fulls. You won't have time for most of the nasty effects.

Re:Question:

[SuricouRaven]

But it is vengeance. It is human nature to seek revenge - a simple instinct that evolved long before agriculture, to enforce the social rules of a tribe. People today might call it 'justice' to try to sound more enlightened, but as Wombat demonstrates, it's the same old drive. You can't defeat it without first acknowledging it.

Re:Question:

[Joce640k]

You're missing the point.

The point is to die openly and with dignity. You can tell people you're going to do it. You can arrange things legally. You can say goodbye. They might even want to hold your hand or be in the next room when you do it.

It's completely different than letting somebody come home to a dead body or get a phone call from the police because the neighbors are complaining about a bad smell...

Re:Question:

[Mysticalfruit]

As a resident of Massachusetts, I plan on voting for this as well. The reason? When I was a kid, a friend of my parents died of inoperable brain cancer. In the end, he suffered terribly and even at age 10 I could see needlessly. He didn't die with dignity, he died in misery. I would think if I ever found myself in that situation that once the doctors told me, "Look, the seizures are going to get worse, everything is going to get really bad" that I would while I still had my facilities I could say, "That's not how I want to go, I don't want my children to remember their father like that."

With that all said, I hope to never be there, but I want the option and more over I want to give the option to others.

Re:Question:

[dyingtolive]

For that matter, you can overdose on lead, but either are hardly dignified ways to die.

Also, I tend to pass out before dying of alcohol poisoning. That either means I'm a pussy for passing out too early, or too hard to die of alcohol poisoning. Either way, it doesn't seem possible for me.

Re:Question:

[shaitand]

"A bullet works, too, but it leaves more of a mess for someone to clean up. I understand haning one's self isn't a bad way to go. Slitting your wrists might be a little painful, particularly if the blade isn't sharp."

For the sake of someone who might consider any of these things they are all bad ways to go. Most people don't know enough about bullets and human anatomy to be certain they don't end up a vegetable or paralyzed. Hanging is a horrible way to go along with drowning, it is a slow and painful process and most of the rope you would buy at the store will stretch when your weight is applied. My aunt hung herself on a closet door and I'll never forget the long fingernail grooves in the door.

Suicide is extremely selfish but if someone is going to do it a combination of drugs to put you to sleep and a heavy gas are what you need. Take strong pain killers, muscle relaxers, etc. Get a CO2 tank and a solenoid you can put on a timer then go into an enclosed space like a closet. The drugs put you to sleep, the gas makes sure you don't wake up. If I'm wrong somehow, or you didn't have enough drugs, or you otherwise find it unpleasant, just open the door to the enclosed space.

Re:Question:

[AK Marc]

Were there that many problems with a guillotine in good repair? I know that the most common ones used for low-level people were rarely sharpened, possibly leading to problems, but one in good repair? Any issues?

Re:Question:

[shaitand]

Problem with that policy is that if a doctor giving a patient lethal doses of morphine is overlooked you don't have any way to catch the sick bastard who is murdering patients. After all, you can't ask them after the fact.

Re:Question:

[shaitand]

The lethal injection is believed to be about the most painful and horrible death imaginable. The body is immobilized so that it LOOKS peaceful but that perfectly still individual is believed to be in a state of pain comparable to burning over their entire body.

The lethal injection isn't used because it is humane. It is used because the drug companies like getting $250,000 a shot.

Re:Question:

[Anonymous Coward]

Seppuku - is that not dignified? Is that not balls to the fucking wall?

Eating a caffeine overdose is nothing like Seppuku.

captcha - pirates ------- YAAAAAAAAAAAAAAAAEErr

Re:Question:

[tragedy]

if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

It seems like in pretty much every case where the public would have to pay for this, the alternative drawn-out death would also need to be paid by the public. At a rough estimate, the long drawn-out death would probably cost around two orders of magnitude more than the physician assisted suicide. So, the economic argument of "I don't want to pay for this" falls flat. The _emotional_ argument of "I don't want to pay for this", where people feel that, by paying for it with public money they become somehow responsible for the death, still has some legs. Personally I still find it pretty weak.

Re:Question:

[flimflammer]

You think that because you can ultimately kill yourself with carbon monoxide that terminally ill patients actually want to go that way?

They might as well put a bullet in their temple.

The whole point is for a peaceful, clean death with as little pain as possible.

Re:Question:

[Firethorn]

I know I wouldn't have the first clue how to go about getting such things.

I'm so clueless about the drug underground that I figure that if I went looking for them I'd end up buying baking powder from a cop.

Not having done drugs, I figure I'd avoid buying them from a officer in uniform, but you get the idea.

Re:Question:

[realityimpaired]

Is there much of a difference between prescription opiates and street ones? Seems like everyday you hear more and more about the prescription ones being sold on the street or abused by radio personalities.

Briefly, yes. Not quite so briefly, it depends on your metabolism. The prescription opiates are usually encapsulated in a way that slows down their breakdown in your system, in an attempt to prevent them from being useful as a recreational drug, but other than that they're essentially the same. If you know what you're doing, chemically speaking, you can break down the encapsulation before taking the drug.

Drugs like codeine and oxycodone break down into morphine when exposed to your metabolic system. How much, and how quickly, depends on you. Some people digest the stuff very quickly so the effect wears of early, some digest it very slowly. The latter group is one of the reasons that they control the dosage that you can lay your hands on... people *have* lethally overdosed on codeine because they don't digest it very quickly, and so when they take one pill there's no effect within the half hour or so that they are told to expect it. So they take another. And another. And another. Eventually, the body starts breaking the stuff down, and they get a dangerous dose in a relatively short period of itme.

Legality of the war on drugs aside, if a person wants to commit suicide they will find a way. But methods like alcohol poisoning (suggested above) or overdose on illegal drugs are messy and unreliable, not even considering the very good point that was made here. Acquiring a lethal dose from a doctor is simply a way to guarantee that it'll be quick and painless, and legal. Most of the people who would consider taking advantage of something like this aren't really in a position to go out and buy drugs off the street anyway... this is an end of life/palliative care option.

Re:Question:

[fuzzyfuzzyfungus]

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

Hopefully, someone does the smart thing and leaves the funding for the actual actions to a nice, private charity organization made up of people who agree with it.

Why would you handle the costs of a lethal dose of anesthetics differently than a sub-lethal dose(or, more likely, a substantial sequence of sublethal doses)?

If medical care is state-financed(either in the form of direct aid to the poor or in the form of compulsory insurance risk pooling) the public does have an interest in curtailing treatments viewed as excessively costly for their benefit(because resources are hardly finite); but they really ought to be careful about tampering with the independence of other people's doctor/patient interactions lest other people return the favor. In the case of assisted suicide, it's almost certainly going to be cheaper than the alternative, so somebody who chooses it is hardly picking your pocket(if you are on the hook somehow for his care, he's doing you a favor) so it's hard to object on absolute cost grounds, and do you really want to start tampering with patient autonomy if you are against the option that is cheaper for everybody else?

Re:Question:

[Anonymous Coward]

Obviously desire for euthanization should be ruled a crime punishable by death.

Re:Question:

[Kyusaku Natsume]

Aside from that, legally accepted euthanasia protects the family and the deceased to make the proper insurance claims. All life insurance policies become void in case of suicide, but in case of legal euthanasia they should apply.

Re:Question:

[Desler]

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

So you'd rather pay more for keeping them alive out of Medicare rather than the much cheaper option of letting them choose to end their life? In the end, they are going to end their life whether you condone it or not.

Re:Question:

[wonkey_monkey]

I understand haning one's self isn't a bad way to go. Slitting your wrists might be a little painful, particularly if the blade isn't sharp.

I'd far rather take the drugs, if only for the sake of the people who'll find me.

Re:Question:

[jammer170]

Which then quickly leads to another problem - why would the public pay to keep all these people with terminal illnesses alive? This leads to a push to have people utilize assisted suicide, because the public won't want to pay for those that refuse it. This is why its best if the government and public tax dollars just stay the hell out of health care.

Re:Question:

[guises]

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

Hopefully, someone does the smart thing and leaves the funding for the actual actions to a nice, private charity organization made up of people who agree with it.

I get the perspective that there are some things which are acceptable for individuals that are unacceptable for government. Not to get political on this, but the issue surrounding gay marriage seems like a perfect example - some people think it's wrong and that's fine, people are entitled to their opinions, but government can't be allowed to play favorites.

The idea that people should ever be forced into dependency on private largesse for their basic needs, including health, is repugnant to me however. Barring extravagant or otherwise wasteful practices, it seems to me that the government's job is to give us choices.

Re:Question:

[frosty_tsm]

While you make good points, we must keep in mind what sorts of costs could be introduced by a heavy-weight process.

A good example is from the criminal system: life sentence vs death penalty. Death penalty cases are more expensive than usual cases due to the burden of proof, multiple rounds of appeals, etc that are intended to make 100% sure an innocent man isn't executed (which sadly still happens occasionally). Would something similar get introduced here? Tests to make sure the person is competent, not coerced, maybe have to spend a week off of pain killers to ensure the drugs aren't doing the talking, etc. Paperwork, paperwork and more paperwork. We wouldn't want a bad doctor to cover up their mistake by saying "it was assisted suicide".

Re:Question:

[fm6]

The big issues is: How do you prevent somebody from being pressured into taking their own life? It's a big issue for the disabled and infirm. Ben Mattlin, who's been fighting spinal muscular atrophy all his life, writes

I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”

http://www.nytimes.com/2012/11/01/opinion/suicide-by-choice-not-so-fast.html

I happen to disagree, mainly because I want the option of a clean exit when my my time comes. But it's a reasonable concern.

Re:Question:

[_UnderTow_]

Reductio ad absurdum. You sound tea party-ish.

Re:Question:

[compro01]

The helium doesn't stop it from panicking at CO2. As long as you're breathing something at least inert, you can flush CO2 just fine. But as you suggest, humans aren't well equipped for detecting low-oxygen environments, an ability that is mostly exclusive to burrowing animals.

You don't even need to go as exotic as helium, nitrogen will do the same. There's a dozen or so accidental deaths per year caused by displacement asphyxiation due to improper storage or handling of liquid nitrogen.

Re:Question:

[tnk1]

You mistake me. I don't care much about cost, I care about intent. If a doctor uses a loophole in a law so he can over-prescribe, and thereby assist in a suicide, that has nothing to do with me. I didn't agree to it, and he's misusing my money. I am not responsible for other people's actions that they take despite my preferences and when I have no chance of having any impact on the situation.

If, however, I vote for a law that specifically sets aside tax money for assisted suicides, then I am consenting to and materially aiding assisted suicides. Since I have a vote that I can use to express my opinion, I am bound to not vote for something I disagree with.

Now, if Candidate A said nothing about allowing tax money to be used for assisted suicide, but his other promises were in line with what I felt was right, I could, in good conscience, vote for him, as long as I did my best to try and gauge his actual opinion and platform. If he then sent tax money to assisted suicides, that's a problem for me, but I am not being hypocritical for voting for him because I made the best, most consistent decision I could at the time. Obviously, I'd reconsider my vote for him next time.

The problem with the government involving itself in things like healthcare is that it has the power to make people complicit with things that they don't agree with, and indeed, find horrendous. Would a pacifist vote for a war, even if he felt that the outcome might be positive for his own country? No. He'd believe that the country would be better off without fighting a war at all.

Look, no one wants to be involved in your life decisions less than I do. I have elderly relatives who have been in a bad state, and I totally get why someone might want to die, and why it might be considered humane to let them. I just don't think it is the right choice. If you really don't want me to oppose you, then don't force my hand. You should have the right to make decisions for yourself, good or bad. The problem comes when you want me to finance what I consider to be your bad decision. I won't do it, and I can't close my eyes and pretend that it's okay for me to vote for the candidate supporting it just because they are better on some other, less important items.

Re:Question:

[TheCarp]

Ugh really? Last stats I saw were as I posted, 50% in the last 5 years... is it really that high? Do you have a citation for that?

I mean, I totally believe it, its not hard to look at the cost of some minor medical procedures (or what my 5 day stay for pneumonia was billed to the insurance) and say that bumping that up to critical care situations with a dieing patients.... I can see how that would add up astronomically very quickly.... but wow.

Re:Question:

[Whatsisname]

Not all policies, many will still payout on suicide. Sometimes there are conditions, like the insured has to have the policy for a certain amount of time before its in force, often 2 years, but either way, the claim "All life insurance policies become void in case of suicide" is false.

Re:Question:

[Greyfox]

On the other hand, leaving an autoerotic asphyxiation "accident" for your parents to find might be an idea "thank you" for that upbringing they gave you. And all you really need for THAT is a batman costume and a belt. I mean, if you're gonna kill yourself ANYWAY, right? It really just depends on how you feel about your family...

Or you could opt for THIS idea on how to shuffle off this mortal coil with style!

Re:Question:

[tnk1]

Government doesn't "give choices", it removes people's choices to do what they would prefer to do.

Private charity has never been this useless thing that left people in gutters to die alone and malnourished. Why do you think that quite a few hospitals are named after Christian saints? People did not have to die miserably before government health care plans. Indeed, places like medieval Europe were known to be some of the most charitable places that have ever existed in history. Everyone, from high to low felt it was their duty to aid the poor and spent lavishly to do so. While it is true that this was a more backward time in many respects, it was not a cold world devoid of caring for other people.

The biggest problem with government "charity" these days is that I think it actually contributes to the sense that you are not required to do anything to help other people but vote for someone who will get the government to do it for you. Indeed, even, in the unlikely event I wanted to give 95% of my income to a charity, I can't because the government is sucking down at least 20% of it to start with.

I firmly believe that there are enough people in this country who would contribute to form a non-profit to support candidates for supported assisted suicides and other causes. Indeed, if you spent 2,000 dollars to contribute to that goal, in lieu of a political contribution, you'd probably see your money be more effective than it would have ever done getting a politician elected, even one that you support. I would, of course, try to persuade you to not do so, but I'd respect your right to make that decision just like you respected my preference to not be made complicit with your aims.

If enough of these hot buttons were taken off the table in this way, I think we'd have a better chance at electing good candidates to office.

Re:Question:

[Greyfox]

I'm pretty sure doctors don't supervise executions in any state that still conducts them. Something to do with the oath they took to "do no harm." The guy who hooks you up has some base training and that's about it. A number of executions have been botched or gone worse than they should have, due to this.

Re:Question:

[jammer170]

It is hardly reductio ad absurdum - there is nothing false, untenable, or absurd about that result, and if you feel there is, go ahead and prove it. I think you don't understand that reductio ad absurdum can be a valid argument, in addition to a logical fallacy. It is up to the opponent to prove it is logically fallacious, not simply label it. I've provided a link, feel free to peruse them at you leisure. I will say it is fairly telling that you followed it up with an ad hominem attack - something that is always logically fallacious.

Re:Question:

[Luckyo]

You can overdose on water too. Or pretty much any food. So?

Fact is, human body is extremely resilient. The stuff that is generally available is pretty likely to just cripple you in a horrible way but your body with help of modern emergency medicine will pull through it without fatality, or you will at least survive for quite a while in a fairly terrible agony before expiring. Which may sound good to the freaks that think that life of a terminal cancer patient or AIDS patient is worth living (hint: in most Western countries if you tried to keep an animal with symptoms like those alive, you'd be convicted of animal cruelty). Specialist drugs on the other hand have a very good chance of ending your life in a reasonably painless and quick fashion. Personally, if I had to choose how to suicide, I'd ask for sufficient amount of intravenous morphine.

Considering that OP talks about oral stuff, that is off the table. But there are plenty of specialist drugs that would do the job almost as well. Drinking low grade poison like ethanol on the other hand means a fairly slow and painful death at best and life with some very painful damage from non-fatal alcohol poisoning at worst. Which defeats the entire point of euthanasia in a sound manner.

Which is perhaps your goal?

Re:Question:

[goodmanj]

Many. But the goal of the law is not to allow every terminally ill patient to end their life, it's to allow at least *some* to die with dignity, while making damned sure the law isn't abused by doctors or family members. It errs on the side of caution.

Re:Question:

[Luckyo]

He's not. The argument presented is one of the biggest and most difficult ethical problems with assisted death. How long before society, family, and other people who have to bear the burden of a terminal patient who wants to live until the end start pressuring such a person to choose death for their own comfort?

This is a very real issue, and trying to pretend this has something to do with politics rather then ethics is quite a low blow that indeed belongs in the politics and has absolutely no place in medical ethics.

Re:Question:

[Luckyo]

Bullet requires significant expertise and is far from guaranteed. I know of a case where a guy put an 7.62 assault rifle to his head and pulled a trigger in a suicide attempt. Half of his face went flying (literally) and but modern medicine allowed him to survive. As far as I know, he's still alive today, and it's been over ten years.

Re:Question:

[Luckyo]

Death penalty is a very bad example due to the fact that it's an anathema to entire western justice system. Its cornerstone is "better ten guilty men walk free then one innocent is put in jail".

Unfortunately a certain Western country allowed its justice system to be perverted for profit of private jails and political pandering to the lowest denominator and chose to throw this principle away. It's a highly unethical choice and hence makes for a very bad analogy of any kind in relation to something as ethically complex as euthanasia.

Re:Question:

[Luckyo]

And it's even further away from a reasonably painless death.

Re:Question:

[Luckyo]

Actually you will. It's debatable if your brain will have the ability to process these however due to massive lack of oxygen which is needed to register the necessary impulses.

But while it may not take minutes of breathing, it will take minutes of blood circulating with CO instead of O2 to die. Make no mistake there, it's not a fast death by any stretch, nor a painless one. It's just more or less guaranteed one after a certain critical mass is reached.

Re:Question:

[Luckyo]

Oh, it gets MUCH better.

Did you know that that keeping an animal alive with disease that has symptoms on the level of terminal phase of AIDS or cancer would earn you a conviction of animal cruelty in most Western countries?

Re:Question:

[n7ytd]

Suicide is extremely selfish why? If someone doesn't want to be alive anymore, shouldn't they be allowed to make that decision and stop living? What's selfish are all the other dipshits who are selfish in not wanting to let the person go.

Judging from the context that the GP was using (suggesting better ways of ending one's life than a self-inflicted bullet or hanging) maybe he was referring to the horrible scene that is left to be discovered by someone else?

My best friend's father killed himself when we were freshmen in college. His youngest daughter found his body in their kitchen. Not a pleasant last memory of dear-old dad.

Re:Question:

[quacking duck]

I don't know how I feel about legal suicide myself. In theory, they aren't impinging on my rights simply by doing so, so it's not my business.

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

Hopefully, someone does the smart thing and leaves the funding for the actual actions to a nice, private charity organization made up of people who agree with it.

Everyone in civilized society disagrees with how some of their tax dollars go toward things that they don't agree with.

Hypothetically, since you're not forced to have an opinion on this yet:
If this practise were to become legal and then government subsidized, it's very possible that government involvement/subsidies in health care have also increased, including some coverage of long-term care.

Since we're talking strictly emotionless dollar figures, when totalling the costs for ending a life vs. extended duration care, surely it would be cheaper to subsidize the former?

This is of course disregards having a fully private funded private charity. Government would certainly be involved anyway, in regulating it, auditing it, ensuring person is of sound mind, etc. All that invariably costs taxpayers money, even if the government doesn't give a single cent to the charity itself. It also drives up the costs to the charity, making fully-private funding even harder.

Re:Question:

[camperdave]

You don't have to buy carbon monoxide. You can make it yourself.

Re:Question:

[White Flame]

No, it's not vengeance. It's a judgement that the person is incapable of ever returning to productive society, and is more humane and in theory should be less burdensome than locking them up and throwing away the key. It's the equivalent of taking a farm animal out behind the barn with a shotgun when they become an irredeemable burden.

I can't say I'm completely pro death penalty, but the above is the rationale behind it, not vengeance.

Re:Question:

[camperdave]

Nothing will satisfy the need for vengeance. You could feed the person feet first into a wood chipper and it will not provide closure. So why try to stoop down to the level of the killer? Just kill them and be done with it.

Re:Question:

[shaitand]

I guess if you have nobody who cares about you then you could dodge the selfish bullet. But you will give people who care about you a lifetime of self blame otherwise. Selfish.

Re:Question:

[shaitand]

Your best friend no doubt blames himself. Maybe they don't admit it, maybe not all the time but you can't help it. Whether they find you or not suicide means everyone who cared about you will live with guilt for the rest of their lives.

People contemplating suicide are selfishly only considering their own feelings.

Re:Question:

[shaitand]

Possibly but not likely. The gas will disperse when the door is opened into the much larger space of the room and since it is a heavy gas it will settle to the floor (settle being a loose term here, heavy gas will dissipate altogether from most spaces in a reasonably short time). CO2 or the other gases mentioned like helium and nitrogen are inert (no fire or explosion risk) and are only harmful in a heavy enough concentration to deprive you of oxygen. In lower concentrations they are present in the atmosphere all the time.

If you use a timer you can have the gas tank output for only a couple hours and then shut off.

All that said. I'm definitely NOT advocating anyone do this. Suicide isn't the answer and people considering it aren't considering the fact that their family and loved ones will blame themselves no matter what you say or do. Call 1-800-273-8255 instead.

Re:Question:

[tragedy]

Because no ethical red flags would be raised if people suggested that. As it stands, I don't see how physician assisted suicide in terminal cases is the gateway you believe. I mean, sure there are inhuman scum out there who might believe that terminal patients who can't pay for their own care are better off just killed, but, without the killing option, why wouldn't those same people just say that terminal patients who can't pay for their own care should be left to die in the street. You seem quite comfortable with the idea that poor terminally ill patients should just die already (or possibly that they should be taken care of, but only if they happen to be fortunate enough to have charitable acquaintances).

Re:Question:

[vorpal22]

In response to comments about deliberate opiate overdoses (I logged in and now can't find the original post), if you're opiate-dependent, and you try to overdose on opiates as a euthanasia measure, it may be difficult to achieve reliably given a heightened tolerance, and then you run the risk of failing and not having even a maintenance dose of opiates to stave off pain and severe withdrawal symptoms.

There is also the issue of many opiate medications also containing acetaminophen, and acetaminophen poisoning is one of the most horrific, slow deaths you can imagine.

Killing yourself with prescribed medication is not a good idea, unless it is specifically prescribed for that purpose. Having a severe, chronic illness that left me in extreme pain with virtually no quality of life for three years, after a failed suicide attempt via high doses of opiates, benzodiazepines, nonbenzodiazepines, and alcohol, I realized that it is all too easy to screw up, even with very careful planning, and the consequences you face after the fact can be quite overwhelming and far-reaching.

Re:Question:

[tragedy]

How long before society, family, and other people who have to bear the burden of a terminal patient who wants to live until the end start pressuring such a person to choose death for their own comfort?

How long before? I have some news for you - it's not exactly new news and, as a matter of fact, it predates recorded history and almost certainly the development of language itself - this already happens and has happened for a long time. It's not just for the terminally ill. You might look up the practice of Sati, where a grieving widow throws herself on her husband's funeral pyre, sometimes with a little assistance from family or community if she's nervous about it.

People being pressured to take the suicide option, either in the form of direct suicide or just avoiding medical treatment, is a real ethical problem. The causes of the pressure are sometimes financial and sometimes emotional, and sometimes some of each. The financial reasons are obvious, the emotional stuff is more complicated. As far as the financial goes, I've always found it an excellent argument for a strong public healthcare system since it spreads the burden as widely as possible so that, if a patient must be a burden on people, they can at least be so anonymously. For the emotional side, there's never going to be a solution. At least physician assisted suicide is better than the situation for the people who attempt suicide by not seeking treatment in the first place, or who hide their medication and pretend to take it in order to hasten death. In the end, the best you can do is hope that the physician doing the assisting acts ethically and is good at getting a read on the real situation.

Re:Question:

[tragedy]

Whoops, you miss the point. I don't care about the expense, I care about the complicity. There's a lot of things people do on principle that cost more than the alternative because the cheaper option is not the morally sound option.

If you think I missed that point, then you didn't read past the third sentence in my post. The _fourth_ sentence was:

The _emotional_ argument of "I don't want to pay for this", where people feel that, by paying for it with public money they become somehow responsible for the death, still has some legs.

You just didn't make it very clear which argument dominated your disapproval in your original post. Actually, the fact that you wrote: "then I become responsible for paying for it" rather than "then I become responsible [by] paying for it" suggested to me that it was the financial argument rather than the emotional that was swaying you.

In any case, I find the complicity argument unconvincing. Mainly because of the sheer impossibility of finding any system of anything that everyone can agree on. At some point you have to be able to shrug your shoulders and say: "I don't agree with it, but the link between my actions in paying my taxes and the personal choice of some far-removed terminal patient is so ridiculously tenuous my culpability is effectively nil" If you can't do that, pretty much nothing can ever get done.

Re:Question:

[Harvey Manfrenjenson]

The lethal injection isn't used because it is humane. It is used because the drug companies like getting $250,000 a shot.

Citation, please? My understanding is that a lethal injection uses three drugs which are commonly used in medical practice and are not particularly expensive.

Re:Question:

[rtb61]

Which will be the launch for a new bout of Republican schizophrenia.

a) You are poor so you should just die and no longer be a burden on tax payer dollars.
b) Suicide is a sin and you should live for as long as possible except.
c) If your oppose Christianity you should die.
d) Liberal death panels at work.

The real problem will always be with greedy impatient inheritors and the rich and greedy feeling threatened by their own families. This will become messy and a great point of political distraction.

Re:Question:

[isorox]

The lethal injection is believed to be about the most painful and horrible death imaginable. The body is immobilized so that it LOOKS peaceful but that perfectly still individual is believed to be in a state of pain comparable to burning over their entire body.

The lethal injection isn't used because it is humane. It is used because the drug companies like getting $250,000 a shot.

I'm anti-death penalty (it inevitably leads to killing innocent people for starters), what's wrong with a 9mm pistol to the back of the head? Or a bolt through the brain at an abattoir?

Re:Question:

[Compaqt]

So, yeah, I'm up for spending $2000 to "assist" political candidates to the netherworld.

Re:Question:

[cyn1c77]

"A bullet works, too, but it leaves more of a mess for someone to clean up. I understand haning one's self isn't a bad way to go. Slitting your wrists might be a little painful, particularly if the blade isn't sharp."

For the sake of someone who might consider any of these things they are all bad ways to go. Most people don't know enough about bullets and human anatomy to be certain they don't end up a vegetable or paralyzed. Hanging is a horrible way to go along with drowning, it is a slow and painful process and most of the rope you would buy at the store will stretch when your weight is applied. My aunt hung herself on a closet door and I'll never forget the long fingernail grooves in the door.

Suicide is extremely selfish but if someone is going to do it a combination of drugs to put you to sleep and a heavy gas are what you need. Take strong pain killers, muscle relaxers, etc. Get a CO2 tank and a solenoid you can put on a timer then go into an enclosed space like a closet. The drugs put you to sleep, the gas makes sure you don't wake up. If I'm wrong somehow, or you didn't have enough drugs, or you otherwise find it unpleasant, just open the door to the enclosed space.

How about:

(1) carbon monoxide inhalation

(2) stepping in front of a train.

Most people would probably find that easier than connecting a CO2 tank to a valve. And you know you never have the right tube fitting when you really *need* it.

Re:Question:

[cyn1c77]

You'd think a country that executes prisoners humanely (as much as I'm opposed to death penalty, atleast they're not tortured) would want the atleast the same humane treatment for it's citizens that actually choose to die.

The longer you prevent someone from killing themselves, the more taxes they pay.

The estate tax is just the icing on the cake.

Re:Question:

[Jessified]

Assisted suicide is probably cheaper than extended palliative care, not that money should be a deciding factor. Treating breast cancer is also expensive. But I guess one wouldn't really be objecting based on cost, that would just be the cover so it doesn't seem like one is impinging on the personal decision of another.

Anyways, another suggestion I might add is that those that use assisted suicide may not donate organs, so that there can be no question that they were pressured into it for that reason, or that they might kill themselves to save a loved one or something.

Re:Question:

[kenorland]

Suicide is extremely selfish

What a hateful thing to say.

Take strong pain killers, muscle relaxers, etc. Get a CO2 tank and a solenoid you can put on a timer then go into an enclosed space like a closet. The drugs put you to sleep, the gas makes sure you don't wake up. If I'm wrong somehow, or you didn't have enough drugs, or you otherwise find it unpleasant, just open the door to the enclosed space.

Your bad suggestions just underline the need for physician assistance.

Re:Question:

[FatLittleMonkey]

Get a CO2 tank and a solenoid you can put on a timer then go into an enclosed space like a closet. The drugs put you to sleep, the gas makes sure you don't wake up.

Don't forget to put a sign on the door to that room, "WARNING: Excess CO2. Do Not Enter Without FULL Breathing Equipment." Just in case someone tries to interrupt and passes out before they can "rescue" you. Happens occasionally in ship's ballast holds and large water tanks.

If I'm wrong somehow, or you didn't have enough drugs, or you otherwise find it unpleasant, just open the door to the enclosed space.

The CO2 can be enough to make you pass out, but not enough to kill you. Leaving you with enough brain damage, after you are found, to not be able try again. (Still you might be happier.)

However, personally, I'd just use a simple mask with warmed, humidified N2. You don't feel the loss of oxygen without the CO2 build up, you just fall asleep then quietly die. It's always amazed me that the US gas chambers didn't do something that simple and humane.

Re:Question:

[FatLittleMonkey]

Needlessly elaborate. Remember, Madam Guillotine was as much a show as a method of execution. [Plus a modern version would use a hydraulic ram to push the blade, instead of relying on the speed of the drop. Much more failsafe.]

Try simple nitrogen bubbled through warm water and breathed through a mask, if you want to be "humane" when you murder someone back.

[Although as I said elsewhere, if you feel your society is now too humane to torture criminals, stop killing them. It's not complicated.]

Re:Question:

[dmr001]

As a physician who frequently attends my patients of dying of cancer and other terminal conditions, working closely with our hospice service, I assure you can be varying levels of suffering among those in their last weeks. Most people (but not all) can be made more comfortable with opiates for pain and air hunger (especially those dying of pulmonary disease); benzodiazepines (like diazepam and lorazepam) can provide relief for anxiety, and anti-cholinergics can help with excessive secretions. We try to have the patient in control to the extent possible. Here, in Oregon, where the Death with Dignity Act has been playing out for years with a marked lack of apocalypse, one of its attractions and advantages is that doomed patients can control their own destiny without devolving it onto family members and the medical system. One claim is that this also substantially decreases another form of suffering: the loss of control of your own misery (and destiny).

Re:Question:

[Immerman]

N2 gas chambers - I suspect it has something to do with the fact that hypoxia tends to cause giddiness before unconsciousness, and the death penalty has always had a certain vengeful element to it. Nobody wants to watch the execution of the (wo)man who killed their _____ and watch them cheerfully fall asleep, there's no catharsis in that. Not that there tends to be much anyway, but beforehand most people tend to assume there will be some in watching the person who wronged them suffer on their way out.

Shoot, if we wanted to be *really* humane we could just let them breathe pure nitrous oxide. As I understand it a lungful or two makes the world seem a thoroughly delightful place, a couple more will drop you unconscious, and then if you continue to breathe it you suffocate in your sleep shortly thereafter. Actually that seems like a great option for assisted suicide to me, except for the fact that someone else might decide to "save" you by removing the mask and letting you wake up to massive brain damage due to oxygen deprivation. I think that a big factor in assisted suicides methods may be to make such windows of "opportunity" as small as possible in case anyone has a crisis of conscience after the process has begun. It's one thing to watch your terminally ill mother take a pill/injection and fall into a final slumber, another entirely to watch her fall asleep and then sit there for several minutes knowing you could save her life just by removing a mask.

Re:Question:

[Immerman]

I don't know, I think the vast majority of terminal patients could manage the three requests and actively taking a pill held within range of their lips. Short of coma patients (who presumably/hopefully aren't actually suffering), those who have suffered damage to the verbal centers of the brain (in which case it would be difficult to conclusively assert that they understand the choice they're making), and those suffering total paralysis (can't even hold a pen with their teeth) I think most mentally competent individuals could manage it. Sure in a world of billions a tiny percentage is still technically many, but context matters.

The real losers will be those suffering from dementia with brief windows of lucidity - but I think starting carefully is a good idea. Once we get our culture past it's unhealthy horror of death and find a new relationship with it, *then* we can start worrying about those poor individuals who are still being forced to suffer through their last days.

Re:Question:

[AK Marc]

Try simple nitrogen bubbled through warm water and breathed through a mask, if you want to be "humane" when you murder someone back.

Wouldn't CO be quicker than N2? And why bubbled through warm water? Couldn't you pick any "pure" gas that wasn't O2 (Ne, He, H, whatever)?

Re:Question:

[FatLittleMonkey]

And why bubbled through warm water?

Gas let out of a room-temperature bottle will drop sharply in temperature. It is also likely to be dry. Near-freezing, dry "air" is uncomfortable to breath. Warm water makes it difficult to tell you are breathing anything odd. Although I take this from people breathing bottled oxygen for long periods; Perhaps death comes quickly enough that it's not an issue... but can't say I've ever tried killing myself using this method... "It would be impossible to discuss the subject without a common frame-of-reference."

Couldn't you pick any "pure" gas that wasn't O2 (Ne, He, H, whatever)?

Yes. Although I'd skip hydrogen. It would work, but you're releasing a flammable gas into a closed environment. Not good for the people who find you. But anything else that doesn't cause discomfort, or carry a strong smell. I chose nitrogen because, you know, {waves arm in direction of Earth's atmosphere}.

Wouldn't CO be quicker than N2?

The problem with CO & CO2 is that we apparently have a mechanism for detected higher levels in the blood, and for many people it's triggers the feeling of suffocating, the panic. By using an inert gas, without oxygen, you bypass that mechanism, preventing that last-second panic. The whole point is to die peacefully, after all.

Re:Question:

[AK Marc]

The problem with CO & CO2 is that we apparently have a mechanism for detected higher levels in the blood, and for many people it's triggers the feeling of suffocating, the panic.

I specifically avoided CO2 for that reason. The breathe reflex is triggered not by hypoxia, but high levels of CO2 in the lungs. The people that hold their breath for a long time (pearl divers and such) just get used to ignoring the breathe reflex, as it's not triggered by an actual need to breathe, but a poor feedback mechanism that measures something other than the required chemical. So yeah, CO2 (unless you are asleep at the time) would likely be an unpleasant way to go. But CO will replace O2 in the blood, even in the presence of O2, and will not cause harmful (painful or unpleasant) side effects. The plus with CO is that you don't need a sealed environment, just enough CO that the body uses it instead of the O2.

I've watched someone pass out from hypoxia from huffing helium. It was funny how they were functioning 100% (well for them, you have to have some existing issues to helium yourself into unconsciousness) up until the moment it looked like someone pulled the plug on a robot. They didn't slow down or anything, just switched off. Give them more non-O2 once they are out, and they'd be dead without ever even knowing.

Re:Question:

[KingMotley]

On the other hand, I don't condone it, and if it became subsidized by government money (at some point in the future), then I would then be forced to have an opinion on it because then I become responsible for paying for it.

Why aren't you forced to make an opinion on it NOW -- because you ARE PAYING for forcing someone who does not want to live any longer -- to prolong their NATURAL lifespan by forced "medical help". In many cases, this could be considered cruel punishment.

Re:Question:

[sixsixtysix]

taking a guess, but because of shitty government contracts they must use brand x from company z (who did donate all that campaign cash, after all).

Re:Question:

[shaitand]

" anything that leaves someone that cares about you feeling bad is selfish"

Yes it is. Every time you choose your feelings over the feelings of others it is selfish. But death is a little different than telling your uncle that he undercooked your steak. You can't correct those feelings and they never go away.

"want to let someone go on in a worthless futile existence"

For the terminally ill that is one thing. For the rest, a worthless and futile existence is a feeling, not a reality. Emotions are subjective, on some level we've all chosen to feel how we feel. Which means that as long as you are alive there is a chance of encountering something that makes you feel differently about your lot. For instance, if you can't find meaning in what you have for yourself, you can find meaning in what you can do for others.

"maybe some people deserve a lifetime of self blame"

Maybe they do but suicide isn't selective. Everyone who cares about you including the ones you care about will have that same lifetime of self blame. Even people who just know you and work with you.

Re:Question:

[shaitand]

I don't think ease of application was the point of the exercise. If a couple hundred dollars worth of stuff and the effort of connecting a solenoid and plugging it in are enough to stop you then maybe you shouldn't be committing suicide.

At least in the case of carbon monoxide the procedure is basically the same. But carbon monoxide can be dangerous for those who find you.

Re:Question:

[shaitand]

"You are extremely selfish and ignorant of the facts. This topic is not about someone taking their own life because of"

The story was about that. Most post was in reference to suicide in general.

Re:Question:

[Shirley Marquez]

Although it's easy enough to get lethal doses of various poisons, the drugs that lead to an easy painless death (mostly opiates) are carefully controlled and require a prescription.

Re:Question:

[Luckyo]

You make it sound like it's easy to stop murder, theft and so on. Just add "no murder and theft" language into law.

Wait, don't we have that already?

Re:Question:

[AgentPaper]

Sorry, no. You're thinking of a PCA (patient controlled analgesia) pump, which has very rigorously programmed lockout settings to prevent accidental overdose. PCAs, in most hospitals, also require the use of a two-person physical lock to change the settings, neither of whom can be the prescribing physician - so now your hypothetical doctor has to have at least two nurses employed at that hospital and on that unit who are willing to be complicit in his/her scheme, and who will also be willing to risk their jobs, licenses and felony jail time by reprogramming the PCA, which may or may not also involve falsifying medication administration records. Finally, a PCA can only be used by a patient who is awake, alert and has sufficient dexterity to push the dosage button. (We routinely catch family members of patients on PCAs pushing the button for their sick relatives, in the well-intended but misguided belief that they are relieving the patient's pain. First-time offenders are escorted from the premises by Security and barred from the patient's room unsupervised. Do it again and the police get involved. That kind of incident is also quite likely to earn the hospital a visit from the "friendly" local DEA field office, with hordes of federal agents crawling over every flat surface in search of even a nanogram of potentially unaccounted-for drugs. Hence, hospitals have ZERO sense of tolerance for PCA follies.)

Incidentally, Jack Kevorkian's original suicide machine was largely based on the PCA pump concept. The problem was, most of his patients were so far gone that they couldn't push the button themselves, so he had to do it for them... which neatly hopped over the border from "assisted suicide" to "homicide." Oops.

That said, there are scores if not hundreds of ways you can die in a health care setting. Unfortunately, the vast majority of them A) take an extended period of time, B) are acutely painful or distressing to the patient or those around him/her, and/or C) involve the use of life support systems with built-in alarms, the tampering of which would be rapidly caught by staff, who are then duty bound to resuscitate the patient. Those that are rapid, painless and effective (for example, most hospital staff would tell you they'd pick IV insulin for their hypothetical final exits - you lose consciousness within minutes and go into PEA/asystole shortly thereafter) also require the cooperation of a medically trained and licensed outside party to effect - for which, see also "homicide." Back to square one...

Re:Question:

[FiloEleven]

Dammit! I had successfully stayed away from Bash for quite a while. Now I lost two hours thanks to your link.

In other news, I also just lost the game.

Re:Question:

[mcgrew]

(2) stepping in front of a train.

There are two things wrong with this method. First, assisted suicide is for those who are already dying and probably can't reach a railroad track. More importantly, his is incredibly selfish -- how would you like to be the guy driving the train?

Re:Question:

[mcgrew]

Here, in Oregon, where the Death with Dignity Act has been playing out for years with a marked lack of apocalypse, one of its attractions and advantages is that doomed patients can control their own destiny without devolving it onto family members and the medical system. One claim is that this also substantially decreases another form of suffering: the loss of control of your own misery (and destiny).

I couldn't agree more.

Re:Governor Romney

[YodasEvilTwin]

Oh man. Poe's Law.

Drone

[Anonymous Coward]

Predator drone attacks for everyone now.

Re:Drone

[Luckyo]

Sad detail: most victims of drone strikes survive. Quite a few of them end up with permanent damage. Human bodies are very resilient.

What drugs and what protections from failure?

[gr8_phk]

What drug would they prescribe? And what if a person starts taking it and then changes their mind after half of it? Ideally it would be a drug that does not damage the person if it doesn't kill them. Otherwise botched self administrations might just harm people or make them worse off but still alive. I'm not sure how much of an issue this is, but it seems worth considering.

Re:What drugs and what protections from failure?

[h4rr4r]

Why not just barbiturates?

Quick and can easily be given in such high doses that survival is no concern.

Re:What drugs and what protections from failure?

[ByOhTek]

It will probably be in single pill form - i.e. you can't take half of it unless you are seriously trying to screw yourself or the system.

Re:What drugs and what protections from failure?

[RoknrolZombie]

What drug would they prescribe?

Weed, of course. Not only is it the cheapest and easiest to acquire, but it's obviously fast acting and effective considering the reported accounts of overdose.
/sarcasm

Re:What drugs and what protections from failure?

[MozeeToby]

Pills won't work for many of these patients, many are intubated or have a feeding tube, others are physically incapable of swallowing a pill because of the very diseases and disorders that are making their lives a living hell. A simple injection of morphine or something simple. Almost impossible to screw up and virtually guaranteed to produce painless death.

Re:What drugs and what protections from failure?

[BradyB]

It will probably be in single pill form - i.e. you can't take half of it unless you are seriously trying to screw yourself or the system.

There are commercials on the radio, and they say it could be upwards of 100 pills. I know it's a political add, but there might and I say MIGHT be some truth to it being more than 1 pill.

Re:What drugs and what protections from failure?

[SuricouRaven]

With two problems:
1. Patients can't put it in themselves. Self-injection needs training even for healthy people, and these are not healthy. Stroke victims, arthritic ninety-year-olds, people who couldn't hold a pen.
2. You can't require someone else do it. Many doctors would refuse, considering it a violation of their oath and ethical code. Even if the individual doctor would, hospital policy or professional associations may forbid it.

The closest thing to a solution for that I've found is a morphine pump. The doctor hooks it up, but the patient then has to perform the final act of pressing the button to start it.

Re:What drugs and what protections from failure?

[MaXintosh]

There's quite a few drugs that have very low lethal doses with multiple delivery routes. Fentnyl or carfentnyl can easily be delivered in a lethal dose in the microgram quantity. And there are more derivatives that we haven't explored much because they're too active that likely would suffice..

Re:What drugs and what protections from failure?

[goodmanj]

the one to allow towns to decide whether to allow specific grocery stores to sell wine, which the ads interpreted as meaning that convenience stores would sell beer to teenagers if the question passed (a blatant lie, but it kept the question from passing and protected the profits of the state liquor stores).

As a side note, that ballot question eventually passed in Massachusetts, and my local convenience store put out a couple of baskets of withered vegetables for a few months, which apparently qualified it as a grocery store, and then started selling beer and wine by the truckload. The veggies are long gone, but the beer remains. I see no signs that anything's being sold to minors, I have no objection to widespread sale of beer and wine, and this doesn't say anything about "death with dignity". But the naysayers were absolutely right that the beer-and-wine law would be used in ways the voters did not intend, and we should keep that in mind for the future.

Re:What drugs and what protections from failure?

[riverat1]

I tried that one, smoked a whole fat Thai stick by myself in less than a half hour.

Re:What drugs and what protections from failure?

[goodmanj]

I checked my facts, and you're right, I misremembered the results of the election. Mea culpa.

But as for your suggestion to vote against the big money interests, I'm not sure the Mass beer and wine thing is a good example. You had the big-money liquor stores doing battle against the big-money supermarkets, each funneling their money through non-profit small-business groups and police groups. That ballot question was a money-flinging clusterf*ck of epic proportions all around.

"Physicial assisted-suicide"

[ildon]

How is this term at all antiquated or even at all inaccurate for this situation?

Re:"Physicial assisted-suicide"

[MozeeToby]

It's antiquated because the last time someone really tried to push for it, he became a pariah to some people and a joke to others; which is why we needed a new term to introduce to people so that it doesn't carry the baggage of the previous attempts.

Re:"Physicial assisted-suicide"

[mwvdlee]

Because the physician doesn't really assist any more than a rope vendor assists a hanging.

Re:"Physicial assisted-suicide"

[Golddess]

Unless I misunderstand the typical roll of the physician in a physician-assisted suicide, or unless your rope vendor will tie a noose for you and offer suggestions as to the best way to hang oneself, I think the physician assists at least a little more than the rope vendor does.

Lot more dignity than a self-inflicted gunshot

[crazyjj]

At least this will allow someone to go with their family around (and without the mess).

Of course, doctors have been doing this sort of thing "off the books" forever. When I was a kid and a certain person I knew was dying, his doctor gave him a orders not to let his nurse inject him with this particular syringe of morphine (wink, wink).

Re:Lot more dignity than a self-inflicted gunshot

[h4rr4r]

One of my greatest regrets is not noticing when a doctor did this. They left the morphine drip machine unlocked and showed us how we must not turn it up. I was only 14, but I really wish I would have realized what they were trying to tell us at the time.

Re:Death with Dignity.

[Joehonkie]

Where does this even mention "the elderly?" It mentions people with terminal ilnesses, which can start very young indeed.

Re:Death with Dignity.

[BonzaiThePenguin]

Terminally-ill patients who wish to die are a drain on society. You're conflating two separate issues.

life insurance

[tippe]

I wonder what life insurance companies have to say about this. Specifically, does exercising your right to "die with dignity" automatically cause you to forfeit any life insurance that you might have? If so, that's going to doubly suck for the family you leave behind, especially if you have unpaid debts that'll be passed down to them...

Re:life insurance

[theNetImp]

I would hope anyone seriously considering that would weigh all the options and outcomes.

Re:life insurance

[plover]

Some insurance policies have specific suicide language in them, barring a claim for a suicide for a policy in force for less than a year, for example. That prevents someone from buying a million dollar policy today and killing themselves tomorrow so their family can pay off their debts.

In a way, I suppose it's like a waiting period for guns: it interferes with you doing something regrettable in a heated response to a bad situation.

Re:life insurance

[h4rr4r]

Life insurance will NOT GO TO DEBTORS.

Life insurance is payed to the beneficiary not the Estate. Life insurance can not be claimed against for debts of the deceased since it was never paid to him.

Creditors will lie to you about this, they will attempt to swindle you out of the money.

Re:life insurance

[Anonymous Coward]

Per the act: "The attending physician may sign the patient’s death certificate which shall list the underlying terminal disease as the cause of death." So the insurance company might not even get to know.

Link to the 2012 Ballot Questions (pdf). This question is #2:
http://www.sec.state.ma.us/ele/elepdf/IFV-2012.pdf

Re:life insurance

[edcheevy]

I signed up for some term life insurance a few years back and the contract explicitly permitted suicide. That surprised me but I confirmed it with the agent. I image this doesn't apply to everyone (maybe it's not allowed in whole life plans), but I have a standard plan from a major carrier.

Unfortunately my wife also read the fine print so now I have to watch my back...

Re:life insurance

[IndustrialComplex]

Unless it is a student loan and the beneficiary is a cosigner.

Normally I'd argue that the cosigner does own that debt as well, but the point of a cosigner is due to the fact that students often have no credit rating, and thus the cosigner is agreeing to make sure that the payments are met in case the person turns out to be a deadbeat. It really wasn't intended to be to ensure that the payments were met in case the person turns out to be dead.

Re:life insurance

[tippe]

Yeah, I guess I wasn't very clear in my original question. When I stated the question, I was actually thinking of the situation my wife and I are in (we have a shared mortgage, bank account, etc and we both work and pay our debts off together). If I now die, she's on the line to pay off all of the debt, so in my mind, she's effectively "inherited" that debt (or at least my half of it). Although my original question sure does read that way, I wasn't trying to imply that debt could be passed down through different generations (i.e. parents to children)... I was just wondering if some people taking advantage of "death with dignity" will unknowingly screw their spouse out of insurance money because their insurer considers the death to be suicide.

Re:life insurance

[Anonymous Coward]

There is nothing to argue here.

A co-signer is agreeing to be on the hook for payments--student loan or otherwise. It doesn't matter what you think it was or wasn't intended to do, a cosigner is a co-signer regardless of the loan type.

So to take it a step further, being beneficiary of a life insurance policy or not is irrelevant: If you're a co-signer on ANY loan for the dead person you are responsible for that loan unless they the loan contract either states that the loan dies w/ the patient, or they pay for death/disability insurance which pays off the loan on their death. If you are co-applicants for lines of credit you're obligated there as well.

Re:life insurance

[h4rr4r]

She is not inheriting anything, those debts are already hers.

Once you head down this road you make preparations ahead of time, divorce if necessary.

Re:life insurance

[AK Marc]

But the debt is applied against the estate, as is everything not explicitly protected. My father died with more debt than assets. We are waiting the 180 days to see if the creditors claim against the estate. Until the probate is closed, we can't inherit anything without inheriting the debt. The "protection" against this is to not touch the estate. But it seems cruel sometimes that you can't take a framed photo from the estate without risking piles of unrelated debt.

Re:life insurance

[AK Marc]

I moved out of the US, and outside the US, it seems that suicide isn't as excluded. Though there is a 1-year clause here where they won't pay for suicide in the first year.

Re:life insurance

[Quirkz]

Hint: if your wife does you in, it's not suicide. :)

Re:life insurance

[IdolizingStewie]

I thought most policies cover suicides if the policy has been in place for several years beforehand anyway.

Re:life insurance

[realityimpaired]

I signed up for some term life insurance a few years back and the contract explicitly permitted suicide. That surprised me but I confirmed it with the agent. I image this doesn't apply to everyone (maybe it's not allowed in whole life plans), but I have a standard plan from a major carrier.

Most life insurance policies permit payout in the event of suicide, but there's usually a moratorium on that clause for a period of X months from taking out the policy. Something like "From 6 months following the purchase of the policy, suicide will be considered an accidental death and insured appropriately". It depends on the policy, of course, but I've never heard of a life insurance policy that didn't cover suicide after a certain period.

Re:life insurance

[camperdave]

It really wasn't intended to be to ensure that the payments were met in case the person turns out to be dead.

Actually, this is not so. The cosigner is there to ensure that the debt gets repaid regardless of how the main signer fails to pay.

Re:life insurance

[toddestan]

Death by marriage?

What about terminally ill witches?

[jest3r]

Do terminally ill witches get to die with dignity too now or do they still get hanged?

Re:What about terminally ill witches?

[Nyder]

Do terminally ill witches get to die with dignity too now or do they still get hanged?

Hanged? We burn witches in these parts. Tie them up to stake, and bust out the smores. Witch burning tonight!!!

Re:What about terminally ill witches?

[TheGratefulNet]

only 'athiest witches for abortion'.

(stupid flanders...)

Re:What about terminally ill witches?

[plover]

Do terminally ill witches get to die with dignity too now or do they still get hanged?

No, they are given the dignity of a funeral pyre. It's just that they get preferential seating at the event.

Re:What about terminally ill witches?

[TheGratefulNet]

damn, got the quote all wrong. its 'gay witches for abortion'. doh!

Details of the Ballot Question

[Anonymous Coward]

http://www.sec.state.ma.us/ele/ele12/ballot_questions_12/quest_2.htm

Re:Death with Dignity.

[dyingtolive]

I don't think that's how I'd interpret any of that. Consider this: You're 90-something, you shit yourself continually, you forget what you are doing periodically, and it's painful to continue to exist. That is, you are in constant pain. The 'solution' to this is that you keep munching down pain pills that slowly kill the rest of your organs, offering up delightful side-effects all the while.

I don't think that's a societal issue in the way you are thinking it is, unless your idea of a solution is to have "old people in pain" pride parades where you spread awareness of their constant pain and agony, or something, because you think that will make it go away?

Finally

[SuperMooCow]

We'll be able to recycle all those old phone booths into suicide booths!

Re:Death with Dignity.

[MozeeToby]

No dude, sorry. Imagine that I'm paralyzed down half my body, can't breath without oxygen, can't take a piss without someone helping me, and knowing that there is no chance at all that I will ever get better, that in fact I will most likely get worse every day until the day I die. Sorry, there's no dignity in that. Let me go. Painlessly, cleanly, and by my own decision, but let me go. Freedom over your own body should be the ultimate freedom, telling someone in that position that you won't let them die isn't just insensitive, it's downright cruel and selfish.

Terry Pratchett documentary: "Choosing to Die"

[TehCable]

I highly recommend Terry Pratchett's 2011 documentary "Choosing to Die." You may watch the full film on youtube here: http://www.youtube.com/watch?v=slZnfC-V1SY I found the documentary extremely informative and moving.

Re:Terry Pratchett documentary: "Choosing to Die"

[shutdown -p now]

Unless the guy who wrote it is himself in a situation where assisted suicide is a valid and desired option, as it is for Terry, I don't see how he can contribute anything meaningful. He raises some interesting points about this particular bill, but then ventures off in the usual direction of "we never did it that way, so it's wrong" and "it's more compassionate to let people die a natural death". The latter, in particular, makes him sound like a religious nut, since as a medical practitioner he should know full well what kind of suffering (that cannot be alleviated) some people have to go through before they finally die.

Re:Terry Pratchett documentary: "Choosing to Die"

[dyingtolive]

That article presents valid observations of what the bill doesn't do, but dresses them up as elements forced upon the individual:

-First, this bill does not require that the mental state of the patient be assessed by a psychiatrist.
Immaterial, I say. The bill also stipulates that it is only an option for people with less than six months to live. Having been to psychiatrists for issues much more insignificant than "I will literally die before the next time I unpack the seasonal clothes I'm wearing today", I can say that I've either seen shitty psychiatrists, or issues can often take longer than six months to work through. Regardsless, you can't flip a switch and make someone better. In the meantime, you are motherfucking DYING (with all the perks that come with your particular disease).

-Secondly, the requirement that the patient has “six months to live” in order to request these lethal medications is generally understood by those within medicine to be an unreliable prediction.
This is perhaps the most valid point to be made in the entire article. I would expect this point to be passed on by a truely caring and sympathetic doctor. Perhaps the stretch of time needs to be better reevaluated into something taking the level of pain or discomfort the individual is seeing over whether or not they'll ever actually recover from it.

-Furthermore, although proponents claim the bill offers a compassionate option, it is actually constructed in such a way to make the act of suicide incredibly isolating. The bill does not require any family members or next of kin be notified of a patient’s decision to kill herself.
And it doesn't prevent them from notifying as many people as they want of their decision either. It enables the individual to make one of the last few decisions they possibly have avaialble to them themselves. That can't possibly be a bad thing. Forcing someone to have to talk about their suicide plan is as horrible and emotionally scarring (on all parts) as forcing someone to see their unborn baby prior to an abortion. It's sick.

-The real fallacy of this bill is that it presents suicide as simply one option among many as patients navigate through the choices surrounding a terminal diagnosis.
When all outcomes trend toward a predictable and forecasted death in the near future, what options do you have remaining? This section also talks about how allowing this type of suicide would violate the Hipocratic Oath, but I argue that enabling someone to continue spending the remainder of their life in pain and agony is tantamount to torture, and certainly causes more harm than a painless death.

The cynic in me notes that there's a stunning amount of money to be had in people dying, and notes that the people who are receiving that money are the ones campaigning against this.

IANAL

[mfh]

Hey lawyers, could a "living will" work here? Would I be able to not proxy my dignified death to someone trusted when I was incapable of doing it myself? From my perspective if a person accepts that death happens to all of us, we owe it to society to leave the world sooner rather than leaving a huge bill to eat away at the inheritance of loved ones.

Re:IANAL

[Anonymous Coward]

The way this law is written only the patient himself or herself may request the prescription. Not parents with a terminally ill child, not the children of the dying, not the hospital administrator, not the attending physician or the nurses watching over. The patient.

Of course, enforcing that that is the case is its own can of worms.

Re:IANAL

[mfh]

Well a living will executes demands and requirements from the perspective of the person, so the request is being made in advance by the person... not by a family member or anyone else.

For example, if I don't want to be resuscitated, I can put DNR in my living will. They cannot legally resuscitate me.

So it's the same if you put in a living will that if you ever become terminally ill and will die within 6mths, that you are hereby requesting the prescription to be given to you by a proxy.

Re:Death with Dignity.

[Immostlyharmless]

It's not that we don't like seeing sick old people, it's just that sometimes sick, old people, are tired of being sick, old people. They are in chronic pain, they are incontinent, they have skin break down that doesn't heal. They frequently fall and break bones, sometimes time after time after time. Why should someone who is in chronic pain, constantly shitting themselves who doesn't have the physical strength to turn themselves in bed or possibly finish a meal because they are too tired, be forced to go on simply because their body doesn't know it's time to quit? If a person decides they've had enough, why is that not good enough for you to accept? The summary and accompanying articles states very plainly that the law says it has to be initiated by the person involved and that they have to make that statement 3 times. What part of that are you not getting?

Re:Death with Dignity.

[WhitePanther5000]

Did you read TFS? I wouldn't call it "trying to kill them off" by requiring the patient to explicitly request it 3 times when they only have 6 months or less to live.

Personally, I'm in favor of acts like this. I would much rather die on my own terms, when I'm ready, than to wait a year in bed with agonizing pain while the cancer claims me. We allow this for dogs, but until recently we haven't been humane enough to allow it for humans.

pain relief

[slashkitty]

those statements just sound like they want pain relief. "doctor, can you give me something to alleviate this pain and suffering" I'm sure a lot of people say this everyday. They don't want to die and they might get better.

Re:pain relief

[compro01]

1. Which they would if we had anything that would alleviate it.

2. This proposed law only covers terminally ill persons who are expect to live for less than 6 months.

Re:pain relief

[Xtifr]

Massachusetts: where your doc can give you a final friend, but not weed.

Well, maybe now they'll be able to give you some as long as it's really "killer weed". :)

Re:pain relief

[bolthole]

"Alleviate pain" is a whoole lot different from "take my life away" !!

Why is there no research into simply turning off pain receptors or some such? !
With all the disgusting surgeries out there, i figure there has to be some sugery for "turn me into someone with non-functional nerve endings"??

Or most likely.. there IS.. but the problem with that, is that there is a not-quite-zero chance of some of these patients NOT dying after all. SO, risk analysis by businesses done:

a)provide guaranteed effective death pill on demand.
No lawsuits. WIN!!

b) provide something that would actually "alleviate pain" literally... but since it's permenant, will result in some percentage of lawsuits.
Nope, go with option a.

This is disgusting

Re:pain relief

[goodmanj]

Massachusetts: where your doc can give you a final friend, but not weed.

Actually, that's the very next question on the ballot. No joke.

People with strong religious convictions

[Anne_Nonymous]

People with strong religious convictions are the ones who have opposed Death With Dignity in other states. They should be free to suffer to death in there own excrement, vomit, and drool if they like. They should also not attempt to control how others choose to live or die.

Re:Death with Dignity.

[Nyder]

I don't think that's how I'd interpret any of that. Consider this: You're 90-something, you shit yourself continually, you forget what you are doing periodically, and it's painful to continue to exist. That is, you are in constant pain. The 'solution' to this is that you keep munching down pain pills that slowly kill the rest of your organs, offering up delightful side-effects all the while.

I don't think that's a societal issue in the way you are thinking it is, unless your idea of a solution is to have "old people in pain" pride parades where you spread awareness of their constant pain and agony, or something, because you think that will make it go away?

I don't know about other people, but I will not live that way, I plan on dying in my 60's. Unless technology changes in such a way that I got better options. But then unlike most people, death isn't what scares me.

Re:Death with Dignity.

[TheGratefulNet]

its about giving the individual CONTROL OVER THEIR OWN BODIES.

you know, like women have been fighting for and fighting to maintain.

and certain religious groups want to pull that control back.

really, the only groups yelling against this are the religious based ones. their god says that killing yourself is wrong, and so they go to great lengths to outlaw it FOR EVERYONE. even those that don't subscribe to their belief system.

a person's life and body is their own. they are free to do with it as they wish.

Physician-assisted suicide

[DanTheStone]

"Suicide" is considered a loaded term with bad connotations, as people desiring death are considered "mentally ill", so the newspeak term does not include it.

some sense at last

[thephydes]

I hope this spreads to other countries. What is proposed is a good step that I would support 100% if I lived there. My wife works runs a palliative care ward and the stories she tells me about patients wanting legislation like this are common.

Re:some sense at last

[Poeli]

Euthanasia is already legal in The Nederlands and Belgium since 2002. The law there has simular requirements as this proposal. There is even discussion to extend the law to the case of alzheimer patients and under age patients.

Re:some sense at last

[anerki]

On the contrary, this spread from many countries to America.

The list on Wikipedia is sadly incomplete, but in Belgium for example this has been normal for quite a while (by law since 2002). Either by stopping treatment (breathing apparatus, kidney apparatus, etc.) or intravenously giving the patient a lethal dose of x (not entirely sure it's a poison or the like, it could be just a high dose of salt or whatever.

http://en.wikipedia.org/wiki/Euthanasia_and_the_Law

Well and good too.

Re:some sense at last

[wbav]

You sir deserve mod points for this. I'd give them to you if I had them. I'm facing the same very real possibility in a few years with my own father. We live in Oregon and I'm grateful for this law.

Dear "editors"

[oldhack]

When you write "the nation dies", with the singular conjugation for the verb "die", you're implying dying of the nation as a collective entity.

Did you guys even get a GED?

Re:Death with Dignity.

[dyingtolive]

Oh yeah, absolutely. The moment I start to go, I'm offing myself. I'll take oblivion over living in my own filth, forgetting who I am every day, and being too frail to actually interact with the world. I'll EASILY take the end over that.

Re:Death with Dignity.

[thePowerOfGrayskull]

The reason why the elderly who are in medical care don't have dignity is because we as a civilization have setup a structure where such people are considered a drain on society.

Ever watched someone die of cancer? No matter how well cared-for they are, there is absolutely nothing dignified about it.

The "drain on society" has nothing to do with people dying a slow, painful and drawn-out death that can't be averted with modern medicine. Nice attempt to confuse the issue though.

Re:Well...

[theNetImp]

"Participation under the proposed law would be voluntary. An unwilling health care provider could prohibit or sanction another health care provider for participating while on the premises of, or while acting as an employee of or contractor for, the unwilling provider."

Two birds with one stone

[larry bagina]

I think we should go all the way here. Let's be honest -- social security and medicare are not going to be there for us and who wants to be old anyway? I propose that at age 65 (or perhaps earlier as needed) all men be issued two bottles of viagra, a key of pure (98% minimum) Colombian flake cocaine, and a week's worth of services from three strippers.

The advantages should be obvious -- it's cheaper for everyone and certainly more enjoyable. What better way to die than while high as a kite and busting a nut inside a foxy coed? Certainly beats spending months in a hospital bed hooked up to a machine.

Re:Two birds with one stone

[Mal-2]

I think we should go all the way here. Let's be honest -- social security and medicare are not going to be there for us and who wants to be old anyway? I propose that at age 65 (or perhaps earlier as needed) all men be issued two bottles of viagra, a key of pure (98% minimum) Colombian flake cocaine, and a week's worth of services from three strippers.

The advantages should be obvious -- it's cheaper for everyone and certainly more enjoyable. What better way to die than while high as a kite and busting a nut inside a foxy coed? Certainly beats spending months in a hospital bed hooked up to a machine.

Isn't this known as the John Entwhistle Retirement Plan?

Re:Death with Dignity.

[h4rr4r]

Or maybe we like planning for our futures. Short of one of these laws my plan is manufactured by Remington if that day should ever come.

Re:Why not? It worked so well in Germany in 1939

[Attila Dimedici]

You do not even need to look to Germany. Try googling "Liverpool Care Pathway News".

Touchy subject

[Celtic Ferret]

This is a really charged topic full of misinformation. From religion to media misrepresentation to healthcare to politics to insurance - it is extremely difficult to obtain factual, helpful information for someone who wants to check out easily, cheaply and comfortably. The only thing I'm aware of is helium and when the "powers that be" figure that one out it will either become a controlled substance or outrageously expensive (or both).

Check "Final Exit" by Derek Humphry at your local library or online (http://www.finalexit.org/).

Re:Touchy subject

[h4rr4r]

Why not carbon monoxide? Or Nitrogen? Or Argon?

The welding supply store will have lots of options.

Re:Death with Dignity.

[sunking2]

Getting old is terminal. At least for everyone but me.

Re:Death with Dignity.

[Empiric]

Just to note, though I'm averse in general to the "religion says its wrong, therefore its right" form of rationale...

There are no prohibitions of suicide in Judeo-Christian scriptures.

Any Drug We Choose?

[RevSpaminator]

I'll take a lethal dose of THC along with a palate of Oreos. :)

Re:Any Drug We Choose?

[scarboni888]

Too bad there's no such thing:

http://answers.yahoo.com/question/index?qid=1005120803779

Re:Why not? It worked so well in Germany in 1939

[h4rr4r]

Choosing to kill yourself and killing others is quite different. If you cannot see that you are beyond help.

Off topic, sort of...

[NotQuiteReal]

Shouldn't the availability of such "end-of-life" drugs settle the "cruel and unusual" question in death penalty states? I mean if something like Propofol is so pleasant that it is the target of abuse, it should be perfectly fine for a pleasant, relaxing send off when a death row prisoner's time has come.

Bringing it back to "death with dignity", noone will force it, or even suggest it, but LWOP prisoners should also be offered the same option...

(lol - spell check on Propofol offers "Foolproof")

Re:Off topic, sort of...

[SuricouRaven]

There was a BBC program on this subject. They investigated many historical methods of execution, deciding on which was the 'ideal' method. Criteria were chosen: It had to be reliable, easily administered by persons of little training, not require difficult-to-source materials, clean and painless. The eventual winner was aspixiation with nitrogen, which met all of these criteria. This idea was then presented to the leader of a pro-death-penalty pressure group in the US.

He rejected it immediately, on the grounds that it was inhumane... to the victims. How is it justice, he asked, for a murderer to die peacefully if his victim did not?

There we have the problem of execution. The death penalty has many purposes. It is a deterrent. It is a way to dispose of those too dangerous to ever free. But it is also a way to satisfy people's base desire for revenge, to see the guilty made to suffer slowly and painfully. Nitrogen could have been introduced a century ago with ease - but it isn't politically viable: It's just *too* painless to satisfy that desire to inflict punishment. If the death doesn't hurt, people feel that the scales of karma remain unbalanced.

Re:Off topic, sort of...

[frosty_tsm]

No death for the guilty will erase the pain of those who lost their love ones or the victims.

Would the pro-death-penalty group leader have preferred a torturous method? Or one that matches the way the victims died? There is a logic to it, but it would not be palatable for a civilized society (aside from perhaps ancient Rome).

Re:Off topic, sort of...

[SuricouRaven]

Yes, he would have. He outright stated as much, repeatidly saying that a painless death would be 'inhumane' to the victims as it would deny the severity of the crime.

'Civilised' is a very subjective term.

Re:Off topic, sort of...

[SteveFoerster]

Wouldn't it be nicer to be asphixiated with nitrous oxide? Remember kids, just say N2O!

Re:Off topic, sort of...

[FatLittleMonkey]

Americans over-complicate things. Voting, health care, banking, death penalty.

If you want the criminal to suffer for their crimes, torture them to death. If your society has moved on and wants to be more humane, stop killing them.

Re:Why not? It worked so well in Germany in 1939

[Andy Prough]

Or this wonderful tidbit from just 2 summers ago: "Almost half of Belgium's euthanasia nurses admit to killing without consent": http://www.dailymail.co.uk/news/article-1285423/Half-Belgiums-euthanasia-nurses-admit-killing-consent.html

Re:Death with Dignity.

[mwvdlee]

Nobody is forcing anything on anybody.
Please read TFA or even TFS and explain how anybody but the person himself gets to decide on his own life?

Re:Stupid Law

[Anonymous Coward]

You're dense. Some people may work around it, but it's considered suicide, and anyone who helped them is looking at criminal charges. What's idiotic is thinking that it shouldn't be made legal just because some people do it anyway - isn't that a reason it shouldn't be illegal?

Next, we'll have ObamaCare demanding that the Catholics offer this option.

Oh, you're one of those people. The Catholic church has never been told to provide anything that any other employer hasn't been told to. What you're referencing isn't some kind of attack singled out against them, it's them not getting special treatment and exemption from the laws that apply to everyone else.

Die happy, and make yourself useful -

[na1led]

Do I get to watch a movie on a big screen as I die, seeing how beautiful the world once was. Lying in a nice comfy bed with pleasant music as I slowly slip away. Later, they can turn me into soylent green for all you chumps to enjoy!

Re:Death with Dignity.

[mwvdlee]

The laws are more strict than that. Unless all of the above is true AND you have less than 6 months to live, you don't get to decide on your own life.
The thing is that this mostly concerns people that are incapable of just jumping of a bridge or other "traditional" means of suicide or who simply wouldn't want to put their loves ones through the inevitable fallout of a "normal" suicide.

Re:Why not? It worked so well in Germany in 1939

[h4rr4r]

Even if the DailyFail was being truthful, they shaved what a couple days of misery off the end of a life. Sounds wrong, but not quite so horrible. If I end up in that condition I hope someone is so generous.

Re:Death with Dignity.

[shadowrat]

I'll take oblivion over living in my own filth, forgetting who I am every day, and being too frail to actually interact with the world.

Are you kidding? why I remenber a time when the days were just a blur and i had absolutely no bowel or bladder control. I was the center of everyone's world. All attention was paid to me. Everyone hung on my every move or utterance. I was the king of the universe. The day i stopped shitting in my pants was the day my life started going downhill. I welcome incontinence, my old friend's return.

Re:Death with Dignity.

[mcgrew]

Or in other words, we don't like seeing sick old people. So we try to kill them off.

It's not for your sake, it's for their sake. Have you ever seen someone die of cancer? I'll tell you, it isn't pretty. I can't imagine a more hellish way to die. And what do you consider "old"? My friend Linda was only 49 when she died of cancer, even children get cancer.

You're thinking wrong. It's not for your sake unless it's you who is dying in the most horrible way a person can die. It has nothing to do with "dignity" but everything to do with not making someone die by torture. After seeing the hel Linda went through, I'm al for this.

Re:Death with Dignity.

[Anonymous Coward]

The term suicide -- which is generally defined as the "act or an instance of intentionally killing oneself"-- is not specifically used in the Scriptures; however, the injunction against killing embodied in the Ten Commandments, i.e., "Thou shalt not kill" (Exodus 20:13), dealing with the unlawful homicide of another human being, would also forbid the murder of self. The very fact that the Almighty is the Giver Of All Life and "formeth the spirit of man within him" (Zechariah 12:1), tells us that it is not within our right to arbitrarily terminate our own life, against His permission. "Because man goeth to his long home, and the mourners go about the streets: Or ever the silver cord be loosed, or the golden bowl be broken, or the pitcher be broken at the fountain, or the wheel broken at the cistern. Then shall the dust return to the Earth as it was: and the spirit shall return unto God Who gave it" (Ecclesiastes 12:5-7).

To understand suicide to be sin against God and against self, is in keeping with the LORD Jesus Christ's statement concerning the Spirit of the Moral Law, where "love is the fulfilling of the Law" (Romans 13:10). "37 Jesus said unto him, Thou shalt love the LORD thy God with all thy heart, and with all thy soul, and with all thy mind. 38 This is the First and Great Commandment. 39 And the second is like unto it, Thou shalt love thy neighbour as thyself" (Matthew 22:37-39). God requires, both in His Law and Gospel, that all moral agents choose the highest good of God, and of our being in general, for its own sake, as our ultimate purpose in life, i.e., a supreme love for God and an equal love of our neighbour as we would love ourselves. "For no man ever yet hated his own flesh; but nourisheth and cherisheth it, even as the LORD the Church" (Ephesians 5:29).

Neither the modern legal nor medical definitions of suicide entail the Scriptural aspect of suicide being the transgression of the Moral Law, where both God and man are denied the love that are rightfully due them. "If a man say, I love God, and hateth his brother [much less, himself], he is a liar: for he that loveth not his brother [or, himself] whom he hath seen, how can he love God Whom he hath not seen?" (1John 4:20). The supreme hatred of one's self and life, where a morally capable individual voluntarily terminates his own life, is also preeminent contempt of the "God [Who] Is Love" (4:16). Especially for True Christians, the very idea of disposing of our own lives as if we were the masters of them, is unthinkable. "For none of us liveth to himself, and no man dieth to himself" (Romans 14:7).

http://www.whatsaiththescripture.com/Fellowship/What.Bible.Says.Suicide.html

I always just thought "Thou shalt not kill" extended to self, but apparently there's more to it.

Re:Insurance?

[Revotron]

That is a very interesting question and prone to many interpretations. The safest answer in this case would be "it depends."

Death with Dignity.

[Anonymous Coward]

Do not go gently into the night, rage, rage against the dying of the light.
        The only death that is dignified is one that is fought against tooth an nail.

The upper left corner of the US...

[BenSchuarmer]

pioneers in death with dignity and voting by mail. Now Massachusetts is gonna get all the credit?

Re:Insurance?

[h4rr4r]

Usually they do not exclude suicide except for a short term up front. A few months to a year is the common exclusion term.

Re:Editors

[Revotron]

All the good editors couldn't stand the pain of editing Slashdot submissions and took a road trip to Oregon to end it.

not opposed; take it a step further

[WillgasM]

I've always thought the bans on assisted suicide were stupid. If someone really wants to go, let them. Hell, if a perfectly healthy person really wants to kill themselves, let them. The argument has always been that suicidal people must not be of sound mind. I'd say that so long as they can give any sort of semi-logical reason for wanting to die, let them. Preferably give them a way/place to do it that allows us to quickly harvest their organs. Human life is not special or sacred; it's our free will that should be cherished. Personally, I don't think I'd ever go out like this. If I was terminal, I'd much rather spike a golf ball of heroin or slap a grizzly (and film it). At the very least, load me full of dangerous amounts of psychotropics and see if I say anything profound before I go.

One step beyond please

[udippel]

While I am fully for this legislation, I'd want to go one step further. With 18 / 21 a human is allowed to vote, to marry, to become a bankrupt. You name it. What this person is not allowed, is to switch herself off. That is already wrong. Of course, we can't allow this out of a temporary misery; like being left by the partner, losing at the roulette table or just boredom.
Off the cuff I'd argue for 3 counselling sessions, 2 with a doctor and 1 with a psychologist, with a fortnight in between each, to obtain a certificate to legally terminate one's own life. All this 'suicide is wrong' mantra stems from ancient times, and is inherited through religion. The trouble of linking it with a terminal disease is obvious: Who could certify that the life expectancy is 6 months or below? Plus, there are cases when suffering is not necessary terminal (living consciously in an iron lung could be). So, let's not be arbitrary and vague and nannying. Let us legislate what fits into the 21st century, and that is the legal right to fully determine one's own destiny. From cradle (better: adolescence) to grave. Over.

Re:Death with Dignity.

[N0Man74]

Or in other words, we don't like seeing sick old people. So we try to kill them off.

The reason why the elderly who are in medical care don't have dignity is because we as a civilization have setup a structure where such people are considered a drain on society.

We don't think they are a drain on society. We think they are cash-cows. We can take their (and/or possibly their family's) life-time accumulated wealth, all the money their health insurance (or Medicaid) will allow, and pour it into high cost healthcare.

They aren't a drain on a society, only to the people that love them. For everyone else, they are an opportunity.

The simple facts

[fnj]

I can't believe what a bunch of ignorant wild speculation is contained in the comments on this page. No one has even bothered to find out what Massachusetts Ballot Question 2 actually proposes. But it's simple enough in a nutshell.

It would be assured that the patient is adult, informed, and competent; ORIGINATES the action HIMSELF; is really facing imminent and certain death as determined by both attending and consulting physicians; confirms his wish three times with plenty of time enforced to think it over; and has to sign a form in the presence of witnesses meeting prescribed qualifications. Medication would be prescribed which would be certain to result in a humane death. I have been told by the opposition it consists of 100 Seconals to dissolve in water and drink promptly[1], but the measure does not appear to specify such. A big overdose of morphine would work just as well if not better (yes, morphine can be taken orally; it just requires more of it). It's what is used now "off the record" in hospitals when a patient is in irreversible unbearable agony and his body is betraying his dignity, if he is lucky enough to have access to a physician or nurse willing to risk everything to REALLY help him the only way that counts. Don't pretend it doesn't and won't happen even without the protection of the law. The law just prevents criminalization of what is one of the kindest and most caring acts it is possible to undertake.

It is prescribed that the death certificate shall specify the cause of death as the diagnosed disease, NOT "suicide". This is important. The patient is not "choosing death". That is HOGWASH. The patient is choosing the MANNER and TIMING of death. That is all. The death is already ordained.

The measure would specifically outlaw (and prescribe punishment for) coercing the patient, forging a patient request, or suppressing a recission by a patient of his own request. It would not allow the active participation in the ending of the patient's life. Contrary to the opposition hysteria, it is specifically NOT, repeat NOT, an assisted suicide measure. It is a lifting of sanction against suicide under controlled circumstances, and an above-board way for the patient to acquire the means without the risk of screwing up and having the effort come out badly. It is nothing MORE than this.

Anyone who opposes this measure is a DAMNED EVIL BASTARD who should rot in hell.

[1] The opposition expresses horror at this "dangerous" (WHA???) method of self termination, as if falling asleep for the final time is some kind of torture.

Re:The simple facts

[goodmanj]

Mod parent up. I too was very worried about the possible misuse of this bill... until I took the time to read it. All the objections and complaints made here are dealt with by the fine print.

Re:Massachusetts General is the leading hospital?

[Andy Prough]

It's the primary teaching hospital attached to Harvard Medical School. So, it's considered a big deal in some circles. I'm sure some would tell you that it may not exactly live up to its billing in all cases.

Re:Why not? It worked so well in Germany in 1939

[Daetrin]

Okay, this is getting marked as flamebait, presumably because of the Nazi tie-in, and maybe he is going a little overboard with attributing malicious intent to people. However i've been hearing about this bill a fair bit lately from some disabled friends of mine, and they are kind of concerned. Here's one of the articles that's been passed around: Suicide by Choice? Not So Fast.

So less "evil Nazis out to kill you and take your property" and more "doctors making ill-informed opinions about what they think is best for you but actually isn't", but it still is a concern for a lot of people.

Re:Why not? It worked so well in Germany in 1939

[h4rr4r]

No that was propaganda.
My family lived through that horror you jackass. The Nazis only used that message for the outside, the people knew what was going on and could do nothing about it without also facing their deaths.

Read the proposed law. We are not in 1939 and there are no Nazis checking how we vote.

Re:Why not? It worked so well in Germany in 1939

[Andy Prough]

Except Godwin proposed ALL online discussions would devolve into a conversation about Hitler and the Nazi's. THIS discussion is about EXACTLY what the Nazi's used as their primary tool to steal property and money from massive numbers of their own populace - euthanasia.

Re:Why not? It worked so well in Germany in 1939

[fnj]

This is a straw horse and a damnable tactic. You know perfectly well this measure is VOLUNTARY, that the request MUST always originate from the patient, and that 100% of people on both sides of this argument deplore the state ordained eugenic killing that went on in Germany. If you are trying to produce a genuine reason to oppose the measure under current discussion, you have FAILED utterly.

Good For Them

[wbav]

I've got karma to burn, and this thing is personal to me.

I take offense to the start of the summary. It is called death with dignity for a reason. There are people out there with very terrible diseases they didn't ask for. For example ALS that robs the victim of the use of their muscles. Over time the diaphragm goes out, and if pneumonia doesn't get the poor soul they eventual die from lack of oxygen, much like drowning. The sick and twisted part is while the person can feel the pain they can't even express their discomfort. My father has ALS. I may have it some day. I live in Oregon and I'm proud that this law gives me and my father a chance to end things on our own terms without saddling our loved ones with even more medical bills.

To this point my father hasn't asked for this; however, when the time comes he can. There's no reason we shouldn't allow that. It is far less dangerous than eating a bullet and gives family time to prepare. Fuck the submitter. It is about dignity.

Re:Good For Them

[MartinSchou]

May I suggest you look into getting your hands on some good old-fashioned nitrogen?

Not nitrous oxide - just pure nitrogen (N2).

It makes up 78% of our atmosphere, and as such, humans do not have a natural response to too much nitrogen in the air that we breathe (unlike CO2).

If you breathe pure N2, you will pass out very quickly, and if you keep breathing it, you will be brain dead within maybe 10 minutes.

A few people (I think it's 1 in 1,000 or 10,000) have an adverse reaction, but otherwise it will be a quick, quiet and painless death.

And, you know, accidents do happen, where people happen to work in a small basement with a large dewar of liquid nitrogen ...

Re:Good For Them

[wbav]

My point was as an Oregon resident there's no need for something like that.

If my father says he wants to die quickly and painlessly, that's his choice. If he wants every possible medical procedure done that might extend his life even a second longer that's his choice as well. I do not, nor should I, have a say in what happens.


A side note, most people don't have basements in a climate that is this wet. Also stairs are difficult to navigate using a powered wheel chair.

Re:Good For Them

[MartinSchou]

The basement was mostly an "excuse".

To be honest, I suspect that this kind of death will simply look like the victim expired naturally, so you could probably arrange for this to be done in the bedroom with a simple breathing mask, while still allowing loved ones to be with him.

Re:Why not? It worked so well in Germany in 1939

[h4rr4r]

They also ate breakfast and used that to fuel their killings. Should we ban breakfast?

Re:Death with Dignity.

[Empiric]

"Thou shalt not kill" is properly rendered as "you shall not murder", as it meaning the general case cannot be supported by reference to the rest of the Old Testament. Though some English translations render this as "kill" along with "murder", going to the original Hebrew makes this distinction clearer.

Prohibitions of suicide that some denominations have, are inferential interpretations. As I said, there are no direct prohibitions of suicide, and when it has been recounted to have occurred with figures in the bible, no censure of the act is stated.

This leaves us with evaluating the circumstance according to broader religious principles of caring for people's welfare--and in cases where a person has concluded their Earthly existence is worse than not having it, I cannot see condemning it, as the bible does not.

Not available during US Presidential Elections

[shanec]

One slight item missing from the article...

"Due to the fear of mass suicides from the mental anguish caused by elections, the Death With Dignity Act would be suspended three months prior to all elections. "Not wanting to live like this (being exposed to non-stop presidential advertisements)" would not be sufficient excuse to superseded a very important aspect of the law, said spokesperson Dr. Marcia Angell. Everyone choosing this option must be "deemed capable of making an informed decision." It's well documented that during an election season, this is virtually, if not completely impossible."

Re:Why not? It worked so well in Germany in 1939

[Andy Prough]

I'm not trying to say that all euthanasias are a malicious murder. This is not a religious rant. I'm saying that historically (and in modern times as well), this is a VERY slippery slope to go down. "Euthanasia" has been used far too often as a device to grab property and money from a person by simply murdering them. There's a great movie on the subject that just came out this year - "Bernie" - about a "justifiable" murder of an elderly woman in Carthage, Texas in which her money and property were used for the good of the local community after she was "done away with".

Numenorean Kings

[Spy Handler]

had the ability, when they realized that their time came, to lay down and die peacefully at will.

But I suppose in Massachusetts the blood of Numenor does not run true.

Re:Stupid Law

[tnk1]

And that is why they fight against it in the only way they are allowed to: politically.

If you really want religion out of politics, at least make it so that they don't become morally required to start voting against what you want. I know it won't stop all of that stuff, but I know a lot of people, including myself, would be happy to leave you to your own choices if you don't make me pay for them.

I'd love to ignore you, but I can't ignore you if you make me pay for your decisions because then I become complicit. If some doctor helps somebody kill themselves somewhere, I have nothing to do with that. I don't approve, but I can't stop you, and ultimately it is your choice as an individual to do the right thing. If I vote for a guy who says, "I will make you pay for it, even if you don't believe in it", then I can't avoid it and I'm going to vote against that guy. That's what it comes down to.

Look at it from the perspective of the people who are opposing you, and you will find that it becomes a lot easier to get done what you would like to get done if you understand where they can and cannot compromise.

Psssh, Hippocratic oath!

[yters]

Used to be that doctors, who hold control over the life and death of many, had to take the Hippocratic oath that they would not abuse their power. Now the oath is all but defunct, and many medical schools don't even require the oath. With legislation such as this, there is no way after the fact to ascertain whether the patient actually asked for death or not, and even whether the condition is critical is often a judgment call of the doc. Under the guise of humanitarianism, such legislation removes the checks, as slight as they may seem, that keep a doctor from abusing their power. For a forum that uses the slightest provocation to complain about the erosion of our rights, you all seem remarkably silent about the erosion of your very right to life!

Re:Psssh, Hippocratic oath!

[wbav]

Give me one good reason my father should have to "drown" slowly as his diaphragm gives out due to ALS, feeling the pain of his lungs screaming for air even when his muscles can't respond. The patient has to give notice in writing, which is traceable. Usually the family is involved. It is not a surprise. Quit with the conspiracy theories there's a time and place for them, but this isn't it.

Either you're an evil, sadistic human or stupid. Take your pick.

Re:Psssh, Hippocratic oath!

[wbav]

As with most people here, you apparently don't have personal experience. The doctor doesn't have to tell a person with a terminal debilitating disease that they are a drain on love ones while have little or no quality of life. It is obvious. When you have to have someone else wipe your ass and all you can do is watch TV, what kind of life is that?

Re:Psssh, Hippocratic oath!

[shutdown -p now]

What about my right to die?

Re:Psssh, Hippocratic oath!

[yters]

You've always got that right. It's very difficult to take it away from you.

Re:Psssh, Hippocratic oath!

[goodmanj]

Never mind whether you're wrong on ethics, you're wrong on facts. The patient must sign a written declaration in front of two witnesses, one of whom must be an outsider (not a family member, a medical professional responsible for the patient's care, or a beneficiary of inheritance.) This pretty much slams the door on the "psycho doctor" theory.

The Massachusetts law scared the crap out of me too, until I actually took the time to read it. This, and almost every other objection, is explicitly addressed in the fine print.

Re:Psssh, Hippocratic oath!

[shutdown -p now]

Ironically, you only have that right when you're a healthy adult in practice - just go buy a gun and blow your brains out - but then why'd you want to? On the other hand, once you're paralyzed below neck and stripped to life support machinery, it suddenly evaporates, just when you need it most.

Re:Psssh, Hippocratic oath!

[yters]

That's an edge case that is not worth risking my right to life over. If someone is concerned about that happening to them in the future, they can take proper precautions in the present. We can't make the law cater to every individual's whim, some people will always be unhappy.

Re:Psssh, Hippocratic oath!

[shutdown -p now]

Your right to life is not infringed in any way - the procedure still requires you to make a request yourself, and there is a considerable paper trail here. If anything, it's still too strict, since it requires the suffering patient to be capable of administering the drug to himself, which is not always possible.

That "edge case" is surprisingly common in modern world, with our advances in medicine extending life and sickness well beyond what it used to be in the past. If you have never seen it first hand among your relatives, count yourself very lucky. You're also, frankly, a jerk, because you wave away the extreme suffering that those people go through as some kind of inconsequential and irrelevant minor issue, while taking the largely hypothetical threat of you being euthanized without your request or consent way too seriously - to the point of bordering on paranoia.

Re:Psssh, Hippocratic oath!

[yters]

Once the principle guaranteeing my right to life is undermined, that provides precedent for the state to further undermine my right to life. This is already happening with abortion, and euthanasia is merely another step towards the state taking control over an individual's birth and death. If you have any libertarian streak in you, you should be up in arms against euthanasia. On the other hand, if you want others, such as the state, to control the critical portions of an individual's life, then you are the enemy.

Re:Psssh, Hippocratic oath!

[shutdown -p now]

I'm not a libertarian, but I don't want the state to control any portions of an individual's life, which is precisely why I'm pro-euthanasia. When I decide that I don't want to live anymore, I don't want the state to be an obstacle in my way.

And what the hell do abortions have to do with that? Fetuses aren't persons, they don't have rights.

Re:Why not? It worked so well in Germany in 1939

[h4rr4r]

Care to elaborate?
Are there no cases were murder is acceptable?

I take it you have never watched a loved one die a slow death over the course of weeks or more.

If I believed in a hell I would tell you to go there.

In Armstrongs famous words

[anerki]

That's one small step for man, one giant leap for mankind.

Re:Death with Dignity.

[SuricouRaven]

The reason they have no dignity is that biology SUCKS. We didn't evolve to live forever. Clams did, jellyfish did, humans didn't. There comes a time when it all falls apart: Your skin sags, your joints seize up, your hearing fails, your eyes fog, your hair falls out. Then your mind starts to go. You spend your final days a trembling wreck in a care home, eating the soft foods your toothless jaw can still handle and interrupting the nurse every five minutes to tell her you need to go home to feed that cat that died twenty years ago. There is no dignity there. Medical technology can slow this process down, and has achieved wonderful things in that field - what was once knocking on death's door is now only middle age, with many fifty-year-olds still in excellent health - but slowing is all it can do. Unless there is a revolution in medicine, it can only delay those inevitable years of senility.

Re:Death with Dignity.

[dyingtolive]

Fantastic. Good for her.

Now don't force everyone else who might not be so talented or gifted to live such a constant and eternal nightmare.

Re:Stupid Law

[SuricouRaven]

Actually, they *do* get an exception. The big outrage isn't about churches. It's about businesses which are owned by Christians or closely affiliated with churches - Hobby Lobby leads the legal action. The exception is limited to 'official' churches only. Hobby Lobby's owners argue that as they are Christians in a church which forbids contraception, their first-amendment protection of their religious beliefs extends to the company they own, and as such the mandated contraception coverage is unconstitutional.

The problem I have with that idea is just that it makes a mockery of the law. There's no point in having a law if anyone can just declare 'I'm religious, I'm exempt!' What's to stop someone from declaring that their religion forbids paying taxes, or a manufacturing company claiming to be exempt from environmental protection laws because it's owners believe the end of the world is due in a matter of years?

Re:Why not? It worked so well in Germany in 1939

[anerki]

There's a difference between having verbal consent from the patient, the family, the doctors in the hospital and the hospital management (which is often the case (all of the previous)) instead of doing the paperwork. I remember this on the news a couple of years ago, the 'against' group was acusing people of murder, the 'for' group was just stating the law is black or white, while reality is very grey indeed.

Why even have the terminal illness requirement?

[Anonymous Coward]

It should be a fundamental human right that people should be able to choose how, when and where they end their life...Whether they are facing a terminal illness or they are healthy and just tired of living.

Re:Why even have the terminal illness requirement?

[wbav]

If someone is "healthy" but wants to commit suicide that indicates they are not healthy. Something is wrong (usually mentally). It absolutely is the responsibility of everyone to get that person help so they can be truly healthy.

Re:Why even have the terminal illness requirement?

[udippel]

If someone is "healthy" but wants to commit suicide that indicates they are not healthy. Something is wrong (usually mentally). .

Thanks. I hope you'll never be responsible for others. I can only agree as far as 'spontaneous' is missing in your proposal. A constant and consistent wish to die cannot be linked to the sanity of a person. On the contrary, it should be everyone's right to de-terminate his life. Because it doesn't belong to anyone else, least the state government.

Re:Why even have the terminal illness requirement?

[wbav]

I've had a friend commit suicide (presumably depressed but not diagnosed) and I have a father with ALS.

There is no logically good reason someone healthy and happy would commit suicide. I do wish someone had taken responsibility for my friend before he jumped in front of a train. And no that isn't the responsibility of the state government. It is the responsibility of every citizen.

Re:Why even have the terminal illness requirement?

[udippel]

I do wish someone had taken responsibility for my friend before he jumped in front of a train. And no that isn't the responsibility of the state government. It is the responsibility of every citizen.

That's what I meant with 'spontaneous', exactly. It is like we ought to take the responsibility when a hot-blood in a rage tries to beat up someone else, or two people get into rage against each other, and step in between and calm them down.
But when someone, despite of calm and quiet constitution and despite of counselling wants to switch herself off in cool blood, we can only accept that wish. Nobody must be able to determine for me that I have to continue to live against my persistent desire.

Re:Why even have the terminal illness requirement?

[wbav]

I have a hard time wrapping my head around the fact that if someone no longer has a desire to live (part of our nature, instinct if you will) that they can still be considered healthy. Maybe there is a case I can't imagine, but as you might be able to tell I work in the realm of reality instead of theory. If such a case exists (and I always leave open that possibility, I'm not infallible) then you do have a valid point.

Re:Death with Dignity.

[Quirkz]

You may be setting your sights a little low. My grandparents on one side were playing tennis into their early 80s, and my grandma on the other side really only started slow down when she was nearly 90. My dad is 62, and he still does carpentry for a living - admittedly he's much more focused on management than the physical labor, but he can still swing a hammer pretty well. I know there's a lot of genetic variance, but 70 ain't necessarily that old, unless you've got serious health problems.

Re:killing

[AK Marc]

I thought the conservatives believe you should have the freedom to do what you want. Apparently that excepts when you are doing things to yourself (drugs, suicide, etc.).

Neither party is very consistent.

Re:Why not? It worked so well in Germany in 1939

[AK Marc]

They did not use the dictionary definition of "euthanasia," but "murder." They didn't kill or help kill those who were suffering (unless you are so intellectually dishonest to count the pain they inflicted on the targeted as the suffering they were trying to end). The Nazis used murder to steal. Linking euthanasia to the Nazis is like linking jet planes to them. If you fly in a 777, you are a Nazi-loving murderer.

Re:Pressure from insurers

[shutdown -p now]

If the people in question want to die faster themselves, I don't see anything wrong with this. This is first and foremost about human suffering, not about money.

Re:Hippocratic Oath

[wbav]

Actually it is the other way around. Which is more harmful, dying peacefully in one's sleep or spend six months in a hospital bed with 24/7 care as the muscles in your chest degrade from ALS to the point that you can no longer breathe? In these cases death is assured, it is the amount of pain inflicted that we're talking about now.

Re:Why not? It worked so well in Germany in 1939

[AK Marc]

"doctors making ill-informed opinions about what they think is best for you but actually isn't", but it still is a concern for a lot of people.

I thought the point was that you were getting more control over your options, not less.

Re:Death with Dignity.

[Kaenneth]

Same reason they don't let people on Death Row commit suicide, they are not allowed to control their own lives anymore.

Alternate View on the Subject

[Koreantoast]

I'm neutral on the issue, but I think it's worth looking at an alternate view on the issue: http://www.nytimes.com/2012/11/01/opinion/suicide-by-choice-not-so-fast.html (Pay Wall)

NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.

There are solid arguments in favor. No one will be coerced into taking a poison pill, supporters insist. The “right to die” will apply only to those with six months to live or less. Doctors will take into account the possibility of depression. There is no slippery slope.

Fair enough, but I remain skeptical. There’s been scant evidence of abuse so far in Oregon, Washington and Montana, the three states where physician-assisted death is already legal, but abuse — whether spousal, child or elder — is notoriously underreported, and evidence is difficult to come by. What’s more, Massachusetts registered nearly 20,000 cases of elder abuse in 2010 alone.

My problem, ultimately, is this: I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”

Perhaps, as advocates contend, you can’t understand why anyone would push for assisted-suicide legislation until you’ve seen a loved one suffer. But you also can’t truly conceive of the many subtle forces — invariably well meaning, kindhearted, even gentle, yet as persuasive as a tsunami — that emerge when your physical autonomy is hopelessly compromised.

I was born with a congenital neuromuscular weakness called spinal muscular atrophy. I’ve never walked or stood or had much use of my hands. Roughly half the babies who exhibit symptoms as I did don’t live past age 2. Not only did I survive, but the progression of my disease slowed dramatically when I was about 6 years old, astounding doctors. Today, at nearly 50, I’m a husband, father, journalist and author.

Yet I’m more fragile now than I was in infancy. No longer able to hold a pencil, I’m writing this with a voice-controlled computer. Every swallow of food, sometimes every breath, can become a battle. And a few years ago, when a surgical blunder put me into a coma from septic shock, the doctors seriously questioned whether it was worth trying to extend my life. My existence seemed pretty tenuous anyway, they figured. They didn’t know about my family, my career, my aspirations.

Fortunately, they asked my wife, who knows exactly how I feel. She convinced them to proceed “full code,” as she’s learned to say, to keep me alive using any and all means necessary.

From this I learned how easy it is to be perceived as someone whose quality of life is untenable, even or perhaps especially by doctors. Indeed, I hear it from them all the time — “How have you survived so long? Wow, you must put up with a lot!” — even during routine office visits, when all I’ve asked for is an antibiotic for a sinus infection. Strangers don’t treat me this way, but doctors feel entitled to render judgments and voice their opinions. To them, I suppose, I must represent a failure of their profession, which is shortsighted. I am more than my diagnosis and my prognosis.

This is but one of many invisible forces of coercion. Others include that certain look of exhaustion in a loved one’s eyes, or the way nurses and friends sigh in your presence while you’re zoned out in a hospital bed. All these can cast a dangerous cloud of depression upon even the most cheery of optimists, a situation clinicians

Re:Alternate View on the Subject

[udippel]

I'm neutral on the issue, but I think it's worth looking at an alternate view on the issue:
[...]
To be sure, there are noble intentions behind the “assisted death” proposals, but I can’t help wondering why we’re in such a hurry to ensure the right to die before we’ve done all we can to ensure that those of us with severe, untreatable, life-threatening conditions are given the same open-hearted welcome, the same open-minded respect and the same open-ended opportunities due everyone else.

Who the heck says they shouldn't be given the same open-hearted everything??
What should and must be the priority is the self-determination of people and their inalienable rights to choose their own, personal, style of life, including handling suffering. If this was the case, and I very much wished it was, you'd have your Code Blue and I wouldn't. Trouble is, too many people consider me unhealthy, and the governments of this world do likewise try to nanny me into a prolonged life of their desire, in case.

Re:Alternate View on the Subject

[wbav]

Ben,

While I won't say I know how you feel, I will say I've been that family member who caught themselves sighing. It is a terrible thing on both sides. I don't believe my father has brought this up, nor has his doctors. We live in Oregon so this is an option for him if he wants it. He's already signed an advanced directive and let me and my mother know his wishes as to care. (Car accident for example.)

Does the possibility for abuse exist? Yes. It is limited in every way imaginable, but it still might happen. Similarly an advanced directive can be open to such abuse. That said, I much prefer these to be rights people can exercise at their discretion.

The problem is...

[kawabago]

If I had something like ALS I would want to live until I was no longer able to take my own life, then it would be time to end it. This law would result in me robbing myself of the last few days or weeks of life when I could still do things for myself.

Re:Stupid Law

[Americano]

Not entirely. Hobby Lobby and other private enterprises are certainly making a mockery of the law; but when some of the plaintiffs filing suit include the Archdioceses of Washington, New York, Pittsburgh, St. Louis, and Dallas - this is very much an issue for churches as well. The churches (as of now) only receive exemptions for components that largely serve ONLY the Catholic community; The argument of the Catholic churches in their complaints is that, since their religious teachings demand that they minister to and work with people of all faiths (and they employ people of other faiths, certainly), the requirement that they provide plans which offer contraception infringes on their religious freedoms.

Now, they could solve this by changing their hiring policies and firing all non-Catholics in their employ, but I hope you'd agree that that's a less-than-optimal solution for everybody involved.

For a pretty interesting review by an actual constitutional law scholar, check out this post, from Michael Dorf, Professor of Law at Cornell School of Law. It's not just Chick-Fil-A and Hobby Lobby whining that they're being infringed on, there are some actual legal concerns for the churches that need to be evaluated.

Re:Death with Dignity.

[realityimpaired]

Unless there is a revolution in medicine, it can only delay those inevitable years of senility.

Alzheimer's or Senile Dementia (two different diseases with different causes) are not a guaranteed part of growing old. My grandfather lived to 94, and was still living on his own when he died of an aneurysm. No sign of senile dementia or alzheimer's, nor any loss of dignity. He went in his sleep, and all indications are that it was painless. The hospital was able to keep him alive on life support until my mother was able to visit him and say goodbye, but he never regained consciousness. His brother, on the other hand, lived to 92, but suffered alzheimer's the last 10 years of his life.

Growing old does suck, but it's a dice roll how much it's going to suck. Some people manage to grow old with dignity, others don't. It's the human condition. That being said, people should be given the choice to opt out of life, if they've had enough of it, or if they are terminally ill.

Re:Stupid Law

[realityimpaired]

If you really want religion out of politics, at least make it so that they don't become morally required to start voting against what you want. I know it won't stop all of that stuff, but I know a lot of people, including myself, would be happy to leave you to your own choices if you don't make me pay for them.

If that includes abortion, doctor-assisted suicide, LGBT rights, etc., you would be the first person of (presumed) religious polticial leanings I've ever heard say that. Most of the people in that camp seem to go out of their way to make things difficult for anybody who disagrees with their beliefs.

You're welcome to your beliefs. I absolutely support your right to have those beliefs, and will *never* make fun of you for having them. As long as you respect my right to have and practice different beliefs, then we'll get along swimmingly.

Ability to refuse treatment ought to be enough.

[jensend]

I don't sympathize with those who say there's a need to start injecting patients with lethal drugs (or going out of our way to give people the opportunity to kill themselves that way). But I definitely do support people's ability to choose to refuse medical support and/or treatment - including food and water. Without that support, a natural death follows within a week or two.

Death by dehydration is much more peaceful and less painful than you'd think, esp. with a bit of palliative care. It's less traumatic and painful than many euthanasia techniques. Yes, it's slower than assisted suicide, but a couple of weeks of that is far from the "years of acute suffering without dignity" that euthanasia advocates wax grandiloquent about, and I don't think we should be in the business of causing quick deaths. Anyone who is unwilling to face a few days of dehydration before death really should reconsider whether their desire for death is sufficiently strong to act on.

Even in places where physician-assisted suicide is legal, studies have shown that when presented with the option more patients choose to forgo nutrition and die naturally (one example study in Oregon- "Terminally Ill Choose Fasting Over M.D.-Assisted Suicide", Psychiatric News).

For many people involved in euthanasia/ assisted suicide debates, the core issue is the distinction between choosing not to take actions to continue to sustain life and choosing to take actions to end life. Unless you wrap it in lots of euphemisms (like the title of the act under discussion) most people will voice moral objections to the latter. But even the Catholic Church recognizes that there's a point at which food and water are no longer providing a real benefit and using them is no longer morally obligatory. They and others will loudly disagree with each other about when that point comes, but we should be able to agree that individuals should be able to make that decision for themselves.

Unfortunately, both extremes of the euthanasia/assisted suicide debate have made efforts to keep people from seeing this as a real option, and while courts have usually upheld terminal patients' right to refuse food, water, feeding tubes, IVs, etc., there have been some poor laws and precedents that have muddied the waters somewhat. We ought to work to clear the legal waters, the misconceptions, and the disinformation.

We also ought to strongly encourage all adults to take some time thinking about these kinds of things and come up with a living will. Dealing with these kinds of questions after somebody who never made their intentions clear beforehand becomes unable to make the decision on their own inevitably leads to morally messy and personally nasty disagreements.

Re:Pressure from insurers

[goodmanj]

The bill requires that someone not financially connected to the patient witness his/her decision, and explicitly criminalizes coercion or deception. Yes, insurance companies and Medicare may stand to gain from it (which means we *all* stand to gain, through reduced premiums and taxes) but in the end, nobody is allowed to influence the patient's decision. The money is a side effect: death without suffering is the only goal.

Re:Death with Dignity.

[nevermore94]

Yes, I have. I just watched my dad pass away earlier this year. After being diagnosed with an aggressive brain tumor, I watched him degrade to the point that he finally quit breathing in a span of 3 months and held his hand as he passed. This was the hardest period of my life to date and just as hard watching my mom suffer through it as well as him. Although these changes could be a good start, they would not have been enough for him because he quickly lost the ability to use his arms so no writing, and then he lost control of his tongue so he could barely mumble words to us. But, he still made it fairly clear that he was ready to go. But, after we made the hard decision not to intubate him any more we just had to sit by and wait for him to get so weak that he finally lost the ability to breathe on his own and gasped his last. Anyone who thinks that it would not have been better to help him go quickly should have been there.

Re:Why not? It worked so well in Germany in 1939

[realityimpaired]

Any life intentionally taken without consent is murder. Pure and simple.

Amusingly, when I hear somebody make such a categorical statement on the subject as that, usually they are in favour of capital punishment.

Pray tell... what's your stance on that?

Restrictive conditions

[godel_56]

From TFA:

. . . and patients must make three requests, two verbal and one written. They must self-administer the drug, which would be ingested. The patients must be deemed capable of making an informed decision.

I can think of a lot of critically ill patients who would be incapable of meeting these criteria. What if you've had your vocal cords removed due to throat cancer, or if you have locked in syndrome or are otherwise paralyzed?

Where's the option of making a living will where you can lodge a request to be euthanized before your physical faculties fail you? What about the comatose patients who have no hope of cure but are bankrupting their families by massive medical bills while they're taking up a hospital bed?

Re:Insurance?

[compro01]

As long as the policy has been active for at least 2 years, they can't exclude suicide in Mass.

Re:Death with Dignity.

[Luckyo]

As someone who has worked with such people in my youth, I have a surprising revelation for you: quite a few of these people want to live as long as they can.

On the other hand, quite a few do not.

But trying to group everyone in certain group in a one box that is guaranteed to destroy any chance of you being able to understand the reality of this rather complex situation.

Re:Death with Dignity.

[Luckyo]

This is something that many that makes this argument miss: it should be a choice so people like ms. Ellison can choose their life, and those who cannot be like her and find their life torturous can choose death.

This is not a case of "one size fits all".

Hopefully there is limits

[hypnobuddha]

Patient: "I'm interested in that law out there, doctor, can you give me something to alleviate this pain and suffering." Doctor: "I already told you, the blister on your toe will go away in a few days. And besides, it's not a good enough excuse."

Re:Why not? It worked so well in Germany in 1939

[Luckyo]

That is incorrect on a factual level. If a person is drunk, and falls onto the road and under the wheels of my car ending up dead, I do not commit a murder, even through it matches your criteria perfectly.

Chronic illnesses need this option

[vorpal22]

Euthanasia needs to be extended to people suffering from chronic illness. As someone with severe Crohn's Disease who spent three years more ill than you can probably imagine if you haven't been there (constant fevers of 102-104F, diarrhea 20-30 times / day with seconds of warning, severely low iron requiring monthly blood transfusions, constant pain that was not properly controlled even by high doses of opiates, inability to eat - my weight dropped to 130 lbs and I'm 6'2", etc), I sympathize with the terminally ill, but when you have a chronic illness - especially one that does not respond well to medication - and your life is essentially a long road without dignity, support, or hope, you need the option to choose your own death - especially in a country like the US that does not offer decent medical care to its citizens.

I would strongly prefer to have cancer to Crohn's: at least with cancer, there is a winner, i.e. either you or the disease. With a chronic autoimmune disease, it's like a neverending battle of enough illness to incapacitate you completely, but never quite enough to cause you to die.

The only thing that kept me going during those three years was suicidal ideation, as it was a choice that I could make when it felt that I had no options and was otherwise completely helpless and powerless. The knowledge that I could kill myself if I chose to was the warm, fuzzy blanket that made it tolerable, and I spent much time researching and collecting things to give me the power to make that decision. I did ultimately try to kill myself and failed, but wish that I hadn't.

I'm fortunate enough to be healthy (relatively speaking) now, although I will have an ileostomy for life. It's not a nice thing at all, but given what I had to endure beforehand, it's such a tiny price to pay for the ability to live now that not a day goes by where I'm not thankful for it, even through the embarrassing incidents that arise as a result.

How about living with dignity?

[dinodriver]

Now that we can die with dignity, how about we focus on changes that will allow us to live with dignity as well?

The Simpsons comes to life, again.

[jms]

Mr Burns: "This man is costing my health plan five thousand dollars a day. I demand that he die with dignity!"

Re:tylenol

[lowlymarine]

Wait...to die by liver failure? Which is slow and excruciatingly painful, thus totally defeating the point? Great idea!

Re:Death with Dignity.

[Mal-2]

I used to see elderly people and think "I don't want to get old". Most of the time I still feel that way -- but the line of what is old has moved as I see people I have known all my life getting well into their 60s and 70s and not doing too badly. They are doing better than their parents did at the same age, and may well have 10 years or more of reasonably productive and pleasant life that their parents lacked.

At the same time, I look at my grandmother than died in her late 80s, and aside from going mostly deaf, things really weren't that bad for her until the last 18 months. On the flip side I look at my surviving grandmother who is about the same age now, but is miserable most of the time and unable to fully care for herself (though she adamantly believes she still can though she hasn't been able to for 15 years). She refuses to accept much of the help available to her because of this belief that she is still self-sufficient, then complains of being lonely and isolated. My mother said "I don't want to ever get that old", to which I said "no, you don't ever want to get that BAD, the age is irrelevant" (which she agreed with). To me, there is not that much difference between 70 with full mobility, senses, and mind, and 50 with the same.

I guess I'm saying my view has changed. I don't want to get decrepit, but old is just a number.

Re:Death with Dignity.

[dyingtolive]

Those are wise words, and your anecdote is quite surprising to me as most of the infirm I've been around (not as many, I'm sure) seemed quite miserable at the time. You would agree though that the fact that the majority of them desire to continue living doesn't mean we should necessarily deny the rest the means to stop?

Re:Death with Dignity.

[Luckyo]

Let me put it this way: I'm EXTREMELY for people being able to choose a way out, on one condition: it has to be THEIR choice, one they're not pressured into by anyone.

Death panel warning

[iMactheKnife]

The issue in Massachusetts, which has government provided universal health care, is that patient assisted suicide is a whole hell of a lot cheaper than treating a really sick patient. There will be pressure to let patients die. No problem, except that a patient in great distress is hardly a good judge of his or her recovery possibility. Also, by withholding pain meds (which they do) a patient can be too easily driven to sign the suicide form.

I hope the law guards this slippery slope adequately.

Who's being selfish?

[Immerman]

So instead they should selflessly suffer unspeakable physical or emotional pain indefinitely to save their loved ones from self-deluded guilt? Assuming of course the suffering has nothing to do with their loved ones, any guilt is purely a symptom of their own overinflated sense of importance, and is hardly the fault of the person that committed suicide.

Really though that's beside the point in the context of physician assisted suicide. We're talking about people who's imminent death is unavoidable - either they die gracefully in the time, place and manner of their choosing, or they waste away suffering horribly. They're not going to enjoy their remaining days, and if their loved ones have any shred of empathy neither will they. So what exactly is the point of "soldiering on"?

Our culture has an unhealthy horror of death, but it's by no means "natural" or "right". Many cultures have fully embraced the idea that individuals should be allowed to choose the time of their passing, and even animals will do so. At some point many elderly individuals human or otherwise simply lose interest in continued survival - their story has run it's course and there's no longer any real purpose to their continued existence so they stop maintaining it. Typically they will simply lose interest in eating and quietly waste away - generally seeking out some secluded spot with the last of their strength wanes so they can pass in peace. Should such individuals force themselves to continue to survive just so that their grandkids can continue to visit them on Christmas? Asking *that* of them is the height of selfishness.

Re:Who's being selfish?

[FatLittleMonkey]

Chill dude, it's just the sort of preface anyone should make when discussing suicide. "I'm not suggesting anyone do this", "Suicide is stupid/selfish/etc", "Think about the effect on your family/friends", etc, so that signalling approval in the minds of the vulnerable. Copycatting and normalisation is a significant risk with suicide. Nothing to do with terminal illness, which makes up a tiny proportion of suicides, just the regular old fashioned "an heroes".

Re:Who's being selfish?

[shaitand]

"So instead they should selflessly suffer unspeakable physical or emotional pain indefinitely to save their loved ones from self-deluded guilt?"

Yes. At least with regard to the emotional pain. Indefinite unspeakable emotional pain is exactly what committing suicide inflicts on those who are about you. Physical pain and terminal illness are a different discussion.

People who are going through a great deal pull themselves together and move past it every single day. Suicide means never having a chance to do that. I can't tell you how many people I know who attempted suicide at some point and lead generally happy lives now. Most swear they would never kill themselves, not even because they got beyond what they were struggling with that time but because they saw the emotional damage that the attempt inflicted on their loved ones.

One step at a time,

[Immerman]

one step at a time. We're talking about a cultural shift that does in fact have some potential for abuse, let's get it passed and some precedent established with those patients who can unequivocally express their current desires before we start expanding the scope.

Re:Suicide is extremely selfish

[shaitand]

"How is suicide selfish? It's your life, no one elses, so you should be able to end it how and when you want."

That is exactly what people going down the selfish path to suicide are thinking. But it isn't about whether or not you have the right. It is about what happens afterward, the permanent emotional damage to those you love. My comments were primarily targeted at people going through emotional pain. Terminal illness and physical pain are something else altogether.