Welcome to the Hotel Euthanasia

 

do-no-harm-300x234With the words, “In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others,” Governor Brown of California signed into law provisions that will allow terminally ill patients to kill themselves with the assistance of a physician.

There is so much wrong here it is hard to know where to begin.

Most importantly, the arguments in favor of physician-assisted killing use rights language to place a heavy thumb on the scale balancing personal interests with community and social good in favor of the needs of a handful of individuals. In doing this real harm is done to society and thousands of vulnerable citizens are put in harm’s way.

One need only to look briefly at the recent videotapes from Planned Parenthood to realize, regardless of one’s position on abortion, that a high level of coarseness about the value of human life can become endemic when the struggle with moral implications of terminating a potential life have ceased. The same callousness, over time, will now be ushered in at the end of life with the enactment of a law that allows this type of killing.

The CDC reports that in 2008, one in 10 elders had reported emotional, physical, or sexual mistreatment, or potential neglect, in that year. In a society that does such a poor job of protecting its vulnerable, it is naive to think that even the protections embedded in the California law will be sufficient to prevent coercion and misuse of assisted death. The idea that the elderly, the poor, the disabled, and the socially isolated will have their agency protected to freely choose not to suicide is fantasy – California dreaming on a grand scale.

The emotions experienced when a terminal diagnosis is made are complex, variable, and confusing. Fear often becomes a predominant emotion, and this, by definition, makes the terminally ill vulnerable, easily exploited, and subject to pressure from family or other interested parties – including the state. If one believes for a second that the medical profession can be trusted to be effective watchdogs over all of this, I suggest revisiting the Planned Parenthood videos.

Contemporary palliative medicine and hospice care can, with very rare exceptions, manage pain and suffering associated with impending death. Fears can be relieved and dignity of the dying supported, with compassionate interventions by doctors, nurses (especially nurses), social workers, psychologists and spiritual counsellors.

What is needed is assistance to the dying that protects their dignity and mitigates their fears in the form of more and better palliative and hospice care – not assisted dying in the form of active killing.

 

 

 

 

Published in General, Healthcare, Law, Science & Technology
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  1. BrentB67 Inactive
    BrentB67
    @BrentB67

    Judithann Campbell:If someone is intent on killing themselves, they will, but no one has the “right” to demand that society help them to kill themselves. I do not say this lightly. Like most people, I have been in excruciating physical pain- thankfully never for very long. Anyone who has experienced debilitating pain can understand why suicide is sometimes tempting, but assisted suicide is not a right. Suicide may be a right, but assisted suicide isn’t one.

    What if you have the funds to pay for the assistance and a medical professional contracts voluntarily to assist you? What is the states’ role in that if any?

    • #61
  2. BrentB67 Inactive
    BrentB67
    @BrentB67

    David Knights:

    Merina Smith:

    It is simply impossible to craft laws that narrow, David, because how can you craft a law that prevents other people from influencing a person to commit suicide? Can you forbid them to talk to anyone else? To counsel with anyone else? And the law is a teacher in many ways. People take their cues from what is legal or not to some degree. If assisted suicide is legal, the moral compunction against talking a person into sucide for any number of reasons is greatly, greatly reduced. And of course, the state has some real interests here too. It is just too easy for other interests to prevail in subtle ways no matter how narrowly the law is crafted. Bob is absolutely right about this.

    We pass laws against murder, but it still happens. We pass laws on how banking should be done, but banks still defraud their clients from time to time. Should we forbid banking? Should we forbid human contact for fear of murder?

    No, we pass laws; narrowly tailored and prosecute those who we catch stepping over the line. Because abuse might happen is no reason to otherwise trample an individuals most basic right, the control over their own freedom, including the freedom to choose to end their own suffering.

    Actually we pass laws specifically enabling banks to defraud clients.

    • #62
  3. Judithann Campbell Member
    Judithann Campbell
    @

    BrentB67: anyone, especially a medical professional, who purposely kills another person should be prosecuted by the state. Even if the person wanted to be killed.

    The word “purposely” is important here. As Merina has pointed out in another post, prescribing pain mess is not an exact science. No doctor should ever be given a hard time because he possibly gave a dying patient too much pain medication.

    I don’t believe that anyone is morally obligated to accept medical care that they don’t want. I once met a ninety three year old woman, very happy, very healthy, who told me that she threw out all her medications and stopped going to the doctor when she turned ninety. I fully support her right to do that, but if she had wanted me to play an active role in killing her, that is a totally different story.

    • #63
  4. J. D. Fitzpatrick Member
    J. D. Fitzpatrick
    @JDFitzpatrick

    F – 18:

    Merina Smith:

    F – 18:so freedom for all has to be restricted because it might be abused by some.

    Two excellent articles on this at The Federalist today:

    http://thefederalist.com/2015/10/06/my-mom-just-died-of-brain-cancer-heres-why-she-opposed-assisted-suicide/

    http://thefederalist.com/2015/10/06/our-deepening-love-affair-with-death/

    We are unworthy of making our own decisions, therefore we must let others make them for us….

    Suppose physician-assisted suicide is illegal. What on earth would stop you from killing yourself if you wanted to?

    The point is to not sanction this kind of death with the imprimatur of the state.

    • #64
  5. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Joseph,

    Thank you so much for writing this.  I am horrified by what California has done and the quite logical and foreseeable consequences.

    I work in palliative care in cancer, but spent the early part of my career with kids with developmental disabilities and Fetal Alcohol Syndrome.  Working with these kids and there families really shaped my views of how we as a society determine the value of life.

    Always glad to hear your perspective.

    • #65
  6. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    BrentB67:

    David Knights:

    Merina Smith:

    It is simply impossible to craft laws that narrow, David, because how can you craft a law that prevents other people from influencing a person to commit suicide? Can you forbid them to talk to anyone else? To counsel with anyone else? And the law is a teacher in many ways. People take their cues from what is legal or not to some degree. If assisted suicide is legal, the moral compunction against talking a person into sucide for any number of reasons is greatly, greatly reduced. And of course, the state has some real interests here too. It is just too easy for other interests to prevail in subtle ways no matter how narrowly the law is crafted. Bob is absolutely right about this.

    We pass laws against murder, but it still happens. We pass laws on how banking should be done, but banks still defraud their clients from time to time. Should we forbid banking? Should we forbid human contact for fear of murder?

    No, we pass laws; narrowly tailored and prosecute those who we catch stepping over the line. Because abuse might happen is no reason to otherwise trample an individuals most basic right, the control over their own freedom, including the freedom to choose to end their own suffering.

    Actually we pass laws specifically enabling banks to defraud clients.

    What JD said.  I didn’t say that suicide won’t happen without this culture-of-death law, but it sure will happen a lot more often, and to people who would have recovered from the wish, given time.  With a stamp of approval from the state. Let that sink in. The state thinks your suicide is hunky dory, will even encourage it as time goes by.  And I would like to point out that this law invites someone else into the suicide, making them a party to it, AKA as murder.  One of our members, a nurse, has a horrified post about this over on the member feed.  I would feel exactly as she does were I a nurse.  Now, I hope they will allow medical people to opt out of this, but how has that worked out for those who are against some types of third party reproduction in CA?  Not very well.  How has this worked out for Kim Davis? Those who push prog culture are just not very happy when others don’t play along.

    • #66
  7. Owen Findy Inactive
    Owen Findy
    @OwenFindy

    Judithann Campbell: BrentB67: anyone, especially a medical professional, who purposely kills another person should be prosecuted by the state. Even if the person wanted to be killed.

    This I’m not convinced of.  Assume person A is terminally ill and has decided he wants to die.  Assume he’s of sound mind and body, and he has signed a document that shows he’s of sound mind and body and wants to die.  Assume the State protects the right of contract, and that person A has hired person B to kill him.  Assume this contract is documented.  Assume the State investigates each such death, the documents, and the body, and can determine person B did not defraud person A, and did exactly what person A hired him to do (but that it prosecutes any case where there’s evidence of foul play and punishes any person found guilty).  Assume the State protects a person’s right to do what he wants with his life.  What about this situation still causes you to say person B should not be allowed to uphold his side of the contract?

    • #67
  8. Owen Findy Inactive
    Owen Findy
    @OwenFindy

    J. D. Fitzpatrick: Suppose physician-assisted suicide is illegal. What on earth would stop you from killing yourself if you wanted to?

    Well, it would be nice if I could buy morphine at Walgreen, instead of using my Glock.

    • #68
  9. donald todd Inactive
    donald todd
    @donaldtodd

    I have seen this a few times now and think it might be mistaken for something else.

    When a person is dying he or she stops.  He or she stops swallowing.  No food.  No water.  Water will choke that person.  The best that might be done is to put a small bit of ice in the mouth and allow it to melt.  A trickle of water will make its way down to the stomach.  Not  enough to maintain life but enough to keep the throat moisturized.

    I don’t believe that hospice will intentionally dehydrate a person but given my experience I suspect that a bit of ice is the most that they can offer to a person who cannot swallow anymore.

    • #69
  10. Joseph O'Neill, MD, MPH Inactive
    Joseph O'Neill, MD, MPH
    @DeepStateDoc

    Owen Findy:“Most importantly, the arguments in favor of physician-assisted killing use rights language to place a heavy thumb on the scale balancing personal interests with community and social good in favor of the needs of a handful of individuals. In doing this real harm is done to society….”

    I’ve seen many assertions from conservatives that allowing suicide degrades the “respect for life” which in turn will rot the nebulous “society”, “the common good” or “the community”. I’m on the edge about this, because it makes some sense to me, but nothing I’ve seen from conservatives amounts to a solid argument establishing this claim. A good argument would contain the building blocks of fact, and the connective tissue of logic. This seems to be another fuzzy, collectivist fear: an unsupported fear that if we leave individuals free, it will be very bad for the collective.

    (Can anyone direct me to a solid argument?)

    What I never hear from conservatives on this topic is reverence for the right to life — the foundational right of all others — of the individual contemplating suicide. Because of their collectivist fear, they seem to jettison their usual support of individual rights. An immediate corollary of the individual’s right to his own life is his right to end that life. This doesn’t imply that physicians should help them, so maybe the CA law is bad in that respect. But, do conservatives at least accept a person’s right to end his own life?

    Suicide is a common occurrence, and a sad one.  That said, I believe that people have the right to do what they wish so long as it doesn’t impact others.  My argument is that this law on physician-assisted suicide will impact others.

    • #70
  11. Joseph O'Neill, MD, MPH Inactive
    Joseph O'Neill, MD, MPH
    @DeepStateDoc

    Doctor Robert:This trend has already gone too far.

    Five years ago Hospice providers in southern CT set up to dehydrate my uncle to death. He had not been near death but was precarious. They had his wife of 55 years give him morphine, valium, atropine until he was unresponsive. She was directed, if he showed any pain, to give more valium. This is a recipe for pulmonary, renal and eventually cardiac failure.

    Coming to visit him I was astonished to find this combination and undertook to fluid resuscitate him, he did respond and lived another week.

    The complaint I filed with the CT dept of MD licensing was followed up and no wrongdoing was found.

    I don’t mind an old man dying but I object to medical therapy that deliberately hastens death, especially in the absence of personal and family consent.

    Primum non nocere

    F – 18: We are unworthy of making our own decisions,  therefore we must let others make them for us….

    If you take a purely libertarian stance – that there is no role for law to protect the vulnerable there is no point in arguing. We simply disagree.  If that is your stance you will need to, in my view, also explain why government is justified in supporting a military or police force

    • #71
  12. Joseph O'Neill, MD, MPH Inactive
    Joseph O'Neill, MD, MPH
    @DeepStateDoc

    Doug Watt:We have become like the Spartans. A child or the elderly that were no longer able to contribute to Sparta were taken out to the wilderness to die.

    I’m reminded of the deputies that were assigned to Terry Schiavo’s room to ensure that she did not receive a drop of water, much less food to ensure her court ordered death. I wore a badge at one time, but if I had been ordered to her room that badge would have been on my supervisors desk and I would have walked out the door of the precinct without any regrets.

    The issue of parenteral nutrition and hydration in those who are unable to feed or drink themselves because of a cerebral catastrophe or other condition or who are near death is a complex one.  There is a fine line to walk between hastening death and artificially prolonging life.  I am not familiar enough with the Schiavo case to make a direct comment but, as I recall, her designated surrogate made a decision that others in her family tried to override.

    • #72
  13. Joseph O'Neill, MD, MPH Inactive
    Joseph O'Neill, MD, MPH
    @DeepStateDoc

    Bob W:In theory, the right to die on your own term makes sense. However, it is impossible to allow it legally without creating a coercive atmosphere which encourages people to die who otherwise wouldn’t want to. It would be easier to create a warp drive than to find a way around that simple conundrum.

    well and succintly said

    • #73
  14. Joseph O'Neill, MD, MPH Inactive
    Joseph O'Neill, MD, MPH
    @DeepStateDoc

    donald todd:I have seen this a few times now and think it might be mistaken for something else.

    When a person is dying he or she stops. He or she stops swallowing. No food. No water. Water will choke that person. The best that might be done is to put a small bit of ice in the mouth and allow it to melt. A trickle of water will make its way down to the stomach. Not enough to maintain life but enough to keep the throat moisturized.

    I don’t believe that hospice will intentionally dehydrate a person but given my experience I suspect that a bit of ice is the most that they can offer to a person who cannot swallow anymore.

    True.  loss of appetite and thirst is part of the dying process.  Forcibly or artificially feeding can actually cause discomfort and provides no ultimate benefit.

    • #74
  15. Doug Watt Member
    Doug Watt
    @DougWatt

    I cared for my dad who had Alzheimer’s. He reached a point of refusing to eat or drink. When that point lasted for 24 hours I called his primary care physician and he advised me to call hospice. When he was admitted I was told that he would be evaluated and there was a chance that he would be moved to an Alzheimer care facility. When I met with the hospice physician she told me that in her opinion that he was not going to leave hospice. I knew she was right and she was. What hospice did for my dad and I was provide an environment that when I couldn’t be there a volunteer would read to him and hold his hand. Hospice allowed me to hold his hand, talk to him, and say my Hail Mary’s as he took his final breaths.

    • #75
  16. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    I can’t say enough good about hospice.  They provided, free of charge, all kinds of equipment and visits from a home nurse.  She was a bright and cheery person who helped keep my Dad comfortable and apprised us of what to expect.  There’s an oppressive feel in the house when death is nigh, and she helped dispel that.  Imagine what a fun bonus it was when we got to talking and realized we’d been in the same church congregation 30 years earlier!  She brought the grace of God to a very difficult time.

    • #76
  17. Doug Watt Member
    Doug Watt
    @DougWatt

    The conscience issue is interesting when it comes abortion or euthanasia. Whose conscience might be comprised becomes the question. Does a physician, pharmacist, or hospital that refuses to provide abortions or euthanasia face coercion by the state to do so because it has been made legal.

    The ACLU has filed and will continue to file lawsuits against Catholic hospitals that refuse to provide abortion services. The premise for these lawsuits is that these hospitals receive federal health care dollars. Left unsaid is by law these hospitals cannot refuse to treat Medicare and Medicaid patients, much less refuse to care for these patients when they come to the ER.

    • #77
  18. CuriousKevmo Inactive
    CuriousKevmo
    @CuriousKevmo

    donald todd: The state is so badly in debt

    No way, that can’t be true, why just the other day I read how Governor Brown fixed it all.    We be fine now.

    • #78
  19. BrentB67 Inactive
    BrentB67
    @BrentB67

    Judithann Campbell:BrentB67: anyone, especially a medical professional, who purposely kills another person should be prosecuted by the state. Even if the person wanted to be killed.

    The word “purposely” is important here. As Merina has pointed out in another post, prescribing pain mess is not an exact science. No doctor should ever be given a hard time because he possibly gave a dying patient too much pain medication.

    I don’t believe that anyone is morally obligated to accept medical care that they don’t want. I once met a ninety three year old woman, very happy, very healthy, who told me that she threw out all her medications and stopped going to the doctor when she turned ninety. I fully support her right to do that, but if she had wanted me to play an active role in killing her, that is a totally different story.

    You are advocating prosecution and possibly incarceration for a medical professional acting of their own free will and conscience assisting someone also making a choice of their own free will. Neither of which are harming anyone outside of the 2 consenting, contracting adults.

    I hope you will recall that position when a state powerful enough to impose your views imposes its views on you.

    • #79
  20. BrentB67 Inactive
    BrentB67
    @BrentB67

    I bet a majority of the folks on this thread would be against repealing Medicare, Medicaid, and all their associated state programs and entitlements.

    When you surrender to the state to provide for your care, you surrender to the state.

    If you don’t want the state influencing medical decision on end of life care then stop expecting the state to pay your bills.

    No government entity ever disperses a nickel without a string (or in this case, potentially a noose) attached.

    If you want the freedom to solely determine your end of life and other medical care then immediately renounce all federal or state medical payment programs, demand your taxes be reduced, and save your funds or purchase an insurance policy to your liking.

    A state powerful enough to give you what you think you want/need is equally powerful to take it all away including your life on its terms.

    • #80
  21. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    CuriousKevmo:

    donald todd: The state is so badly in debt

    No way, that can’t be true, why just the other day I read how Governor Brown fixed it all. We be fine now.

    I’m sure it must all be fine now because we are building that high speed train between LA and Fresno, aren’t we?  It only costs a few billion per mile, and heck, there are literally dozens of people who will use that line every day!  So worth it.

    • #81
  22. Judithann Campbell Member
    Judithann Campbell
    @

    BrentB67: The original Hippocratic Oath forbade both euthanasia and abortion, thousands of years before Christianity. Do you believe that Hippocrates and all the doctors who have ever agreed with him were merely statists trying to impose their will on others, or could it be something else?

    • #82
  23. BrentB67 Inactive
    BrentB67
    @BrentB67

    Judithann Campbell:BrentB67: The original Hippocratic Oath forbade both euthanasia and abortion, thousands of years before Christianity. Do you believe that Hippocrates and all the doctors who have ever agreed with him were merely statists trying to impose their will on others, or could it be something else?

    The Hippocratic Oath has nothing to do with prosecution by the state.

    If a state medical board or some other panel (I am not sure the exact term) de-certifies or renounces a medical professional for participating in assisted suicide or abortion that is a civil matter.

    You are advocating a criminal prosecution. Nothing about the Hippocratic Oath is enshrined in criminal law.

    • #83
  24. Judithann Campbell Member
    Judithann Campbell
    @

    BrentB67: ok, Maybe criminal prosecution isn’t the answer. The risk of losing one’s licsence to practice medicine is probably more than enough to keep the vast majority of doctors away from assisted suicide. Either way, the doctor is being punished by the state.

    The Hippocratic Oath has been around much longer than any modern state, so modern states probably should take it into consideration. Citizens of a free republic should definitely take it into consideration when deciding issues like assisted suicide.

    • #84
  25. CuriousKevmo Inactive
    CuriousKevmo
    @CuriousKevmo

    BrentB67: A state powerful enough to give you what you think you want/need is equally powerful to take it all away including your life on its terms.

    So true and a point I don’t see/hear repeated enough by the leaders on the right.

    • #85
  26. BrentB67 Inactive
    BrentB67
    @BrentB67

    Judithann Campbell:BrentB67: ok, Maybe criminal prosecution isn’t the answer. The risk of losing one’s licsence to practice medicine is probably more than enough to keep the vast majority of doctors away from assisted suicide. Either way, the doctor is being punished by the state.

    The Hippocratic Oath has been around much longer than any modern state, so modern states probably should take it into consideration. Citizens of a free republic should definitely take it into consideration when deciding issues like assisted suicide.

    If the state is determining the ability of two consenting adults to voluntarily make contracts I am not sure that rises to the level of a free republic.

    • #86
  27. BrentB67 Inactive
    BrentB67
    @BrentB67

    CuriousKevmo:

    BrentB67: A state powerful enough to give you what you think you want/need is equally powerful to take it all away including your life on its terms.

    So true and a point I don’t see/hear repeated enough by the leaders on the right.

    You will almost never hear it from leaders on the right because they want to be in charge of the state, not free from it.

    • #87
  28. CuriousKevmo Inactive
    CuriousKevmo
    @CuriousKevmo

    Merina Smith: I’m sure it must all be fine now because we are building that high speed train between LA and Fresno, aren’t we?

    LA and Fresno?!?!?  Pffffft. That would be useless….it’s going to run between Merced and Bakersfield….WAY more useful.

    • #88
  29. Judithann Campbell Member
    Judithann Campbell
    @

    BrentB67: What is your definition of a free republic? Where you see “the state” regulating contracts, I see democratic majorities and their elected representatives. Free doesn’t mean perfect, nor does it mean that I will always agree with the majority, but the state does not exist on its own, at least not in America.

    I get the impression that you are in favor of assisted suicide. Am I right about that and if so, do you think it is possible that those of us who oppose assisted suicide might have reasonable concerns?

    • #89
  30. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    donald todd:When a person is dying he or she stops. He or she stops swallowing. No food. No water. Water will choke that person. The best that might be done is to put a small bit of ice in the mouth and allow it to melt. A trickle of water will make its way down to the stomach. Not enough to maintain life but enough to keep the throat moisturized.

    I don’t believe that hospice will intentionally dehydrate a person but given my experience I suspect that a bit of ice is the most that they can offer to a person who cannot swallow anymore.

    This has been our experience with hospice, too. In all the cases I’ve witnessed in our family, IV solutions have been given to our elders when recovery was still hoped for. At a certain point, though, it became evident that it was time.

    The elder did not want to eat or drink anymore, did not want any more tubes. Just wanted to be left in peace (with palliative medication on hand, though not necessarily asked for) to let nature take its course.

    If these deaths counted as death by dehydration, they did not seem especially painful or protracted. I suppose it’s possible that our all elders who died in this way had become too “locked in” to express distress, but the quiet dozing, vague smiles… Pain and terror had come earlier, but genuinely seemed to fade in the final shutting down.

    • #90
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