The big sleep
January 15, 2016 1:38 AM   Subscribe

 
This is great.

I've watched two close family members die an ugly, undignified death in the last year (both under palliative care protocols that their medical caregivers deemed appropriate). My grandmother is 83, nearly entirely blind and deaf, and bed-bound following a fall. She frequently says that she just wants to fade away, that she doesn't want to be alive in this condition, whenever her daughter leaves the room.

Her carers are following something they call a "reablement care plan" with the aim of getting her back to some level of independence, but that just seems woefully unlikely to happen given her physical and mental condition (not to mention her trauma and fear of standing/moving after three falls in twelve months, one of which shattered her femur).

If she were a dog, it would be considered humane to put her down. It seems wildly inhumane that a peaceful death on her terms isn't an option. She's been in chronic pain for over thirty years and has clearly stated that she doesn't enjoy the circumstances of her current existence...and there's nothing we can do about that as her family.

What I've seen this year seems to be the default option for getting old and/or dying in this country (UK), and I want nothing to do with it. I've never been an optimist, and so much of elder care and care for the terminally ill seems to be about misplaced optimism - prolonging time spent alive total instead of aiming to give as much good time as possible and then allowing the person to bow out when the going doesn't seem so good (and isn't going to get any better).

Fortunately, I've never been an optimist; I just hope I get a choice in the matter when the time comes.
posted by terretu at 2:33 AM on January 15, 2016 [39 favorites]


My neighbour (in her 80s) just died last week - it was a bit of shock as 2-3 months ago she was in out there weeding the pavers at 8am. And used to wander past every day dragging her shopping trolley. I have since learned that the death was due partly to her refusal of life-prolonging chemo-therapy. I thought it was quite an admirable decision. Quality over quantity.
posted by mary8nne at 2:43 AM on January 15, 2016 [9 favorites]


As the medical power of attorney for one dead parent, and no power of any kind for my other, I endorse the Shaw's actions with the highest of all high fives.

Death should bloody well be like sex: I say when, I say how ...and I say how much.
posted by taff at 2:43 AM on January 15, 2016 [56 favorites]


An exitinternational tag is there. I don't really know what anyone can say about this. People do what they do, ultimately. There are a lot of ways to go. People do it privately, all the time. Is it really necessary that the state facilitate it? Because, yes, I can see that people who've lived eight decades so fully and well would shudder at the thought of impairment, and would like to go on their terms. They spared themselves a few uncomfortable years (in Peter's case, a more profound loss), and loss of control, I'm sure.

Very concerned about how things would pan out if assisted suicide were rolled out in e.g. hospitals, where so much goes wrong, so often, usually for far less privileged people. And very uncomfortable with decisions about standards of quality and value of life being made in institutionalized settings, when there are, potentially, multiple vested interests, and (possibly worse?) uninvested agents, institution-level cost-benefit calculations, staff that get used to supporting dying.

As wrong as they get it, I generally believe in governments' obligation to support our wellbeing, but feel they should have as little as possible to do with facilitating death. So many people are unhappy, and have arthritis, and worse... I don't think it's an option that should be at all easy to come by, certainly not publicly condoned and facilitated. Those who have the will find their ways.
posted by cotton dress sock at 2:53 AM on January 15, 2016 [15 favorites]


Those who have the will find their ways.
But all too often "those who have the will" have to go to another country, far from home, and not take with them a relative whom they would dearly love to have by their side during their final hours. Because if they were accompanied, that relative could then be investigated for assisting a suicide.

There are problems to be overcome, sure. And I don't think that it should be made easy, per se. But it should be possible for an adult of sound mind and judgement to end their life at a point of their choosing. It's the one thing that's going to happen to every last one of us. That I can only choose when it happens with the official disapproval of my government, and that in doing so I may put my loved ones at risk of prosecution, is wrong.
Death should bloody well be like sex: I say when, I say how ...and I say how much.
This.
posted by gmb at 3:20 AM on January 15, 2016 [16 favorites]


This is a beautiful story--as much about lives well-lived as lives well-ended. Thank you for posting.
posted by duffell at 4:07 AM on January 15, 2016 [2 favorites]


Those who have the will find their ways.

Those who have the will don't always have the means.

Should I find myself in this position I certainly hope I have the ability to act on my will or that the law has changed. The current situation is unjust.
posted by deadwax at 4:17 AM on January 15, 2016 [13 favorites]


Yes.
posted by infini at 4:18 AM on January 15, 2016


I say when, I say how ...and I say how much.

That's not how sex works for me.

I must say it would be good if these people who know ways to induce a quick, certain, and painless death would speak to the peope who keep making such a botch of the death penalty.
posted by Segundus at 4:22 AM on January 15, 2016 [5 favorites]


I feel there is a false dicotomy of "a diginified death" vs an "undignified life". We should be aiming first for a dignified life - the life we all want with appropriate pain medication in times of pain, emotional support from people around us, (and support too for our family/friends so they can GIVE support - things like paid leave from work for them, including them in conversations during rounds, etc), well-trained and well-paid staff providing care in appropriate staffing levels, and the removal of financial considerations - what a horrible thought to be thinking it would be cheaper for the family to die now.

It is a difficult line, but the staff also need to give respectful space to those making the choice in care. During my father's recent hospitization there were so many things that were done right - he was provided 24 hour care from one nurse for whom he was the only patient in a private room, care was taken to keep the changeover in staff minimal, there was a large team supporting the nurse, we were given complete information so we could make informed decisions (previously families were excluded during rounds so it was left to an extremely ill patient to explain what the team had communicated - we were able to have a conversation with the team, see diagnostic reports ourselves, and point out history that was not always present in the charts). We did have one nurse who was very aggressive in telling us we needed to stop all treatment so my father would pass away - in such a dysfunctional way that she actually followed us around repeating herself over and over after we had asked her to give us space to process new information. Again, the standard of care was appropriate - I spoke to the nurse manager and the problematic nurse was transferred to another patient after the manager discussed her behaviour with her. We did ultimately decide to let my father go a week later when his conditioned worsened and the hospital was very supportive of our decision and included a follow-up meeting a month later to provide closure and answer any of our questions. And the only money we paid was $50 for a monthly parking pass.
posted by saucysault at 4:32 AM on January 15, 2016 [8 favorites]


I lost my mother in December. I sat with her for hours and hours over a weekend, morbidly watching her struggle with breathing, waiting for an end to mercifully come. While no one wants to lose a parent, it's even harder to watch a parent go through the sort of miserable and prolonged decline that our laws enforce.

Years before that, we had our beagle put down. She was old and frail and in pain. Our whole family was with her as the vet pushed a bare thimbleful of a purple fluid into Sally's vein and, in seconds, she was gone.

Why we can do something so humane for an animal yet refuse to extend that humanity to ourselves is beyond me.
posted by Thorzdad at 6:05 AM on January 15, 2016 [33 favorites]


I completely understand the fears of the state allowing the corporations that run our healthcare to push suicide for profit purposes. I would fully expect abuses of that kind to be tried, and that we would need strong protections against them.

However, I am also considering that I come from a family not known for long lives or peaceful dying (on both sides) and while I will do my best to live and die better than my parents and their parents did, I don't know how much genetic doom awaits me when it comes to painful, slow, degenerative death.

I live in a world in which peacefully opting out of the terrors of Alzheimer's or Lou Gehrig's, or even prolonged dying due to incurable cancer, is not allowed, but guns are easy to come by. I pay attention to stories about self-chosen suicide at least partly to learn how people do it successfully, because I am afraid that I am going to have to follow in their footsteps, alone and afraid and with no way of warning my family without endangering them legally.

Right now we can never choose peace; we can only choose between traumas.

I can't help feeling like we could come up with a better system.
posted by emjaybee at 6:18 AM on January 15, 2016 [12 favorites]


If the Shaws' relatives knew of their plan to commit suicide (a criminal act), would they not have been criminally culpable for failing to tell the police and stop them? Is the state exercising discretion to not press charges out of compassion and/or desire to avoid bad publicity?
posted by acb at 6:22 AM on January 15, 2016


Kevin Drum: My Right to Die
When I'm within six months of death, I can ask my doctor for a prescription sedative that will kill me on my own terms—when I want and where I want. Will I ever use it? I don't know. I suspect that taking your own life requires a certain amount of courage, and I don't know if I have it. Probably none of us do until we're faced with it head-on.

But either way, I won't have to die before I want to out of fear that I'll lose the capacity to control my own destiny if I wait too long. Nor will I have to die alone out of fear that anyone present runs the risk of being hauled in by an overzealous sheriff's deputy. I'll be able to tell my wife I love her one last time. I can take her hand and we can lie down together on our bed. And then, slowly and peacefully, I'll draw my last breaths.

I don't want to die. But if I have to, this is how I want it to happen. I don't want a "suicide party," but neither do I want to suffer needlessly for months. Nor do I want to cause other people any more pain than I have to. I want to go out quietly, with my loved ones at my side.

When he signed California's right-to-die bill, Gov. Brown attached a signing statement. "I do not know what I would do if I were dying in prolonged and excruciating pain," he wrote. "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."

Nor would I.
posted by zombieflanders at 6:34 AM on January 15, 2016 [16 favorites]


My dad just passed away on Wednesday. He had a very aggressive cancer he found out about it two weeks ago and went in to the hospital last Thursday.

As long as I can remember, Daddy has talked about a peaceful death on his terms. His mother died after a long miserable battle with Alzhiemers and 10 years in a nursing home. He feared that death.

He was a terribly healthy man and was rarely sick. When they admitted him, he told everyone that would listen that he was DNR. He knew he was dying and did not want to linger. He ordered my mom and I to not be there when he died and if he'd had his preference we would have never seen him once he was admitted.

Initially the hospital staff couldn't handle it when he joked that they should just "sit on the morphine bag" to help him get out the door faster. They'd shush him and tell him he couldn't talk like that. But as he declined, and he did so very rapidly, they began to understand. He complained to Mom and the nurses that if he was a dog they would put him down and it would be a mercy.

Tuesday morning, he begged the palliative care nurse for a time estimate. When she said any where from a day to a week, he moaned. He then declared, "I'll be done with this on Wednesday."

I reminded him that it was Tuesday and he said in a very weary voice, "It's gonna be a long damn day."

Shortly after that they upped the morphine to deal with his pain and he slept. He wasn't really cognitive from then on.

He passed minutes after Mom and I left his room to go get lunch on Wednesday.

That last day, the only reassurance was that he wasn't conscious. I know it was hard on the nurses who were trained to heal to have to sit back and watch a healthy and hearty man decline that quickly. It was hell for me and Mom to hear the death rattle and know there was nothing that could be done to help him.

The palliative care nurses did all they could within the limits of the law to help him along. Everyone in that room knew that the law was the only thing that kept us from "leaning on the bag."

I'm grateful he went as quickly as he did and that they took as much care to make him comfortable. I'm happy that I got some time with him when he was still cognitive. I wish I could have saved him the last day but despite my fear that the doctors would prolong it, I am pleased with how they respected his wishes as best they could.

I honestly think that until you see this sort of thing up close, until you've seen the long painful, it's hard to imagine how someone could willingly want to die when there might be an option to fight. Hopefully we can progress to the point where this is a valid option and the caregivers are prepared to offer it.
posted by teleri025 at 6:38 AM on January 15, 2016 [101 favorites]


teleri025, I'm so sorry. I still miss my dad. Hugs to you.
posted by emjaybee at 6:48 AM on January 15, 2016 [9 favorites]


Hm. While I agree that medical end of life decisions should be a competent person's own decision, when I actually read the article I found myself fairly surprised to learn that neither of them were particularly suffering in ways most of us would recognize as suffering, particularly Pat, whose only cited ailment was what sounded like fairly typical and treatable arthritis. It just read to me that they had simply grown older, but were by no means infirm or debilitated. It's not like either of them was constantly suffering or on the verge of a mind-emptying dementia: Peter complained he could no longer follow long, complex arguments in academic papers; well, neither can most people. I guess what bothered me is that it seemed like Peter's self-regard and pride in his younger self's superiority led him to deprecate his older, less capable -- *differently*-capable? -- self, and at the same time, and maybe even more troublingly, influence Pat to do the same.

I'm sure this interpretation of their situation will draw jeers from a lot of MeFites. But as someone entering middle age I have been thinking a lot about the inevitable changes that happen as one grows old, that are starting to happen to me as well, and what that will mean for my own later years, as aches grow more persistent, the eyeglass prescriptions stronger, the stamina diminished. I see my parents struggle, yet find value in lives that are dogged by lessened capacities. Contemporary youth-obsessed culture constantly suggests in ubiquitous music, tv, news, and film that a continuously vital, active, sharp life is most worth living. I hope that transition doesn't lead me, or other people, to opt out of the potential pleasures and rewards possible in the possibly quieter, less physically-capable and less-active years, simply because they lack the drama and adrenaline rush and acclaim afforded to the accomplishments of youth.
posted by aught at 6:48 AM on January 15, 2016 [15 favorites]


My condolences to all of you who are sharing these stories. There's a lot here to think about.
posted by blurker at 6:48 AM on January 15, 2016 [1 favorite]


It just read to me that they had simply grown older, but were by no means infirm or debilitated.

I agree to an extent, but one of the problems with the current state of the law is that if you wait until you are infirm or debilitated then you will be denied the means to die as you wish. So if you want to die, say, with your partner, or at least on your own terms, you find you must take action early - earlier than may be chosen otherwise.

I watched my father die extremely slowly, in extraordinary writhe inducing pain for several years. I do not know if he would have chosen euthanasia if it was an option but I do know he was denied that option because he was generally in care and physically infirm. He didn't care much about the law and it wasn't his respect for the law that denied him the option.
posted by deadwax at 7:09 AM on January 15, 2016 [10 favorites]


I think just being done is a perfectly valid reason for one to end one's life, suffering and impairment are incredibly subjective and it is no one's place to judge or question. Offer help and support, sure, but choosing death can be a reasoned and rational decision.

I am not religious and one of my firmest beliefs is that our lives belong to us. We don't have the power not to die, but we should certainly have the right to choose how to die, if that grace is granted us through circumstance. Criminalizing suicide and euthanasia, rather than more sensibly regulating them to minimize potential misuse, is an affront to free will.

When (and if, of course) I get older, my one goal might be to be able to quietly tend my garden without pain. It might be to be able to enjoy time spent with my children. It might be being able to taste food or read books or walk in the woods. I don't know yet what my hard line will be, but I do know that it will necessarily be the most personal decision I will make. I honestly hope that the state will have come to terms with the fact that it is my decision by then, but given the current backsliding even in matters of reproductive freedom, I fear that we will be no closer in 50 years than we are today.
posted by lydhre at 7:10 AM on January 15, 2016 [17 favorites]


Death terrifies me. I has for the past year and a half since my father died. My humor these days is not the pitch black variety that it was earlier. He died in his sleep, and as far as anyone knows, it was the most peaceful way to die of a heart attack.

I really hope that when I reach the point at which I am facing death that I can look at myself and think "I'm tired, it's time to let this go." Right now, I don't know if I ever will. I've faced some pretty severe depression and even during that, the idea of suicide never appealed. I envy the religious, those with the certainty of life after death. I don't believe, I wish I could believe, but I don't.

I admire the Shaws so much. They acted in a way that I hope I can if I ever reach that point. I don't know if can or will, but I think that rationally choosing a way out is a sane choice. In Darkness Visible (a book I keep recommending to people) Styron remarks on how suicide can be a rational choice for those with untreatable depression. We understand the desire for release from constant physical pain and one of the manifestations of depression is a psychic (for lack of a better term) pain. I think their aging was causing this sort of pain, although in a different way than depression. What they did seems to early for me, but I respect their decision to die when they did.
posted by Hactar at 7:11 AM on January 15, 2016 [5 favorites]


I also know that I have no desire to go through what he went through, or drag my friends and family through the five years he took us through. If I ever receive news like he did I will give serious consideration to acting quickly - while still able.
posted by deadwax at 7:12 AM on January 15, 2016 [1 favorite]


Hm. While I agree that medical end of life decisions should be a competent person's own decision, when I actually read the article I found myself fairly surprised to learn that neither of them were particularly suffering in ways most of us would recognize as suffering, particularly Pat, whose only cited ailment was what sounded like fairly typical and treatable arthritis. It just read to me that they had simply grown older, but were by no means infirm or debilitated. It's not like either of them was constantly suffering or on the verge of a mind-emptying dementia: Peter complained he could no longer follow long, complex arguments in academic papers; well, neither can most people. I guess what bothered me is that it seemed like Peter's self-regard and pride in his younger self's superiority led him to deprecate his older, less capable -- *differently*-capable? -- self, and at the same time, and maybe even more troublingly, influence Pat to do the same.

People should be able to end their own lives when those lives do not seem worth living to them, particularly when there are no obvious ameliorations. It's hard to imagine a clearer case for this than when looking at two people not in financial hardship, not recording any depression, with no life history of mental troubles or addiction, no life history of abusive relationships, etc. If we can't look at those people and say that they are able to evaluate their own lives rather than trying to argue that they are suffering from false consciousness, where is the limit? Surely everyone who sees themselves diminishing in capacity is suffering from "false consciousness" if we are all expected to enjoy being more and more differently capable over time? Who can we trust to make judgments about their lives if this "you don't want to lose capacity because of ableism" line of reasoning is followed?

We're not talking about "I don't want to give up going to the park; I would be happy if I could have assistance to go to the park, and if society provides that I will be able to participate in the way I want" or "I don't want to give up reading; I would be happy if I had someone to read to me" or "I used to enjoy group activities but have slowed down; I would be happy if I could find a group whose pace matched mine". We're talking about "even with assistance I can no longer do the thing that is a core part of my being".

I have a relative who has been dwindling for the past twelve years. She has not enjoyed her "differently capable" time, and in fact I have had to hear her murmur "I want to die, I want to die" on multiple occasions. Her "different capacity" was never fun. It was bearable up to a point, but it was a haunting and difficult process because she knew that each day would be worse, and her different capacity has been, as with the people in the OP, a matter of dwindling mental abilities.

I feel like there's a lack of respect for intellectual pursuits in this line of reasoning. If being able to read complicated stuff is your most important thing, the thing that has organized your life, then the loss of that is a critical blow. It's not the same as being unable to pursue a hobby; it's the loss of a core part of your identity.

For some people, they're going to want to process that loss and go on - and absolutely, as a society we should provide all the supportive stuff that anyone could need. But I think we have to trust people to be able to evaluate their own lives and make their own decisions. If these two can't be trusted to know their own lives, who can be trusted? The state? Strangers? The police? If two smart people who've obviously thought things through and are not hurting for social or material resources can't be trusted to make their own decisions, then no one in all the world should be allowed to do this, and we need an aggressive and militant state intervention in all aspects of life, because obviously no one can be trusted to evaluate their own interiority about anything.,
posted by Frowner at 7:18 AM on January 15, 2016 [64 favorites]


Amen Frowner. When we told my uncles about Daddy's death, one of my aunts was distraught that the cancer wasn't found earlier. To her thinking, finding it earlier would have meant he could have been saved. But I know my dad, I know how he did not cope with physical weakness and nausea. I've seen chemo and I know how devastating it can be.

At least with the suddenness of this, he wasn't obliged to try and fight. Or worse yet, to sit around for months knowing the end was near. He had enough time to communicate his plans, treat my mom to a nice dinner or two and say his goodbyes.

For a man who was defined by his ability to physically do things, being infirm and weak was one of the greatest indignities of old age. To go through chemo would have been hell for him.

I truely understand the Shaws desire to leave on their own terms. We only get one life and no one else should be able to dictate how and when it is lived or how it ends.
posted by teleri025 at 7:42 AM on January 15, 2016 [3 favorites]


emjaybee: I completely understand the fears of the state allowing the corporations that run our healthcare to push suicide for profit purposes. I would fully expect abuses of that kind to be tried, and that we would need strong protections against them.

I would expect that insurance companies pushing a speedy cheap death would run into resistance from another big fish: the nursing home providers. Their very business model relies on "life at all costs" and their coercive ability to Hoover up every last dime and assets for their customers, since many families are unable to provide that kind of care on an ongoing basis. Being able to eat a pill and shuffle off cheats them from a huge revenue stream that won't be given up without a fight.
posted by dr_dank at 7:47 AM on January 15, 2016 [1 favorite]


teleri025 - peace be with you and the memory of your dad

I honestly think that until you see this sort of thing up close, until you've seen the long painful, it's hard to imagine how someone could willingly want to die when there might be an option to fight.

This is so true. My husband and I talk about it all the time because we have been witness to so many deaths. Both long and short, painful and peaceful. We want to be able to choose my way out if we get that chance.
posted by Sophie1 at 8:01 AM on January 15, 2016 [4 favorites]


Physician-assisted suicide was made legal in Canada in a Supreme Court decision last year, and takes effect in February. Too bad it was way too late for Sue Rodriguez. The Ontario government is currently running surveys and studies as to how the populace wants it implemented.

About bloody time, I say. We have no choice in when we enter this world, we must therefore have the absolute right to leave it on our own terms.
posted by feckless fecal fear mongering at 9:12 AM on January 15, 2016 [4 favorites]


An excellent article and even better thread, my sincere thanks to all of you for sharing your stories and experiences here. The choice to end one's life is not always irrational or horrifying, and I'm thankful to live in one of the very few U.S. states that recognizes that my life is, first and foremost, irrevocably my own--including deciding, if it should come to that, when it should end.

The Shaws sound like truly remarkable people.
posted by LooseFilter at 9:14 AM on January 15, 2016 [1 favorite]


The decision to end my life, should I make it, is my own, and if I have nothing else, I have that -- the decision should be up to me, not the state, not the hospital, not the doctor, not the hospice, not the insurer, not the church, certainly not the odious politician and lawmaker. They can all cluck and scold till the curtains come down, but when the curtains come down, I want to be the one pulling them down, unless fate has some other end in store for me.
posted by blucevalo at 9:45 AM on January 15, 2016 [5 favorites]


I'm watching my father's health decline. He's a stubborn fool which only compounds the problem. The VA is a 3 hour drive away, I tell them to try one of the new programs that can get him to a closer hospital. He's mad because one time they wouldn't help him get a hearing aid because some testing nurse wouldn't let him take the test because some powder residue from previous ear cleaning (that day, by a clinic or whatever) was there. Not sure the details, but now he refuses to get a hearing aid.

His lower back is constantly in pain and he can never get comfortable. I ask if they can RX him opiates, he says they insist he go to a chiro, but he doesn't have much money to go visit a chiro every week (also, Chiro? really?) I said to ask about PT, at least. Of course... "No..."/silence... I showed him a couple exercises I learned while in PT, he seemed slightly curious but that's about it, don't think he pursued it.

Refuses to use a cane or walker his friend got him.

It's only been a couple years to see him going downhill, but it makes me so sad. His vision isn't too well either. He just seems like he's not doing that well, and I don't think he can get much better without having a local doctor actually helping him fucking out (and him taking that help).

I don't want him to go, but I feel like if it were an option, at least it would be something.

Then you have my Christian mom (Dad's an atheist and doesn't seem to care, just expects death to be the big sleep AFAICT)... Mom's like "must do everything possible to prevent death" (though she's finally accepted suicide as possibly legit. My sister committed suicide and mom respected her passing... She, years ago, told a friend whose son hung himself in the garage that god told her "he was sick" (e.g. depression). She seems to have accepted this concept, that suicide (at least as part of depression) is just as much an illness/sickness that takes someone as a physical ailment like a heart attack. But I don't think she can accept death with dignity and respect and autonomy, so in that case, it's like... even if it were available to my Dad, I don't think he'd take it, out of respect for my mom, but also... not just her religious convictions, but I don't think he'd want her to feel left alone/behind...

Ugh, it's just so sad. Death is on my mind a lot, especially w/Lemmy, Bowie, & Rickman... And especially Bowie's epic passing with the album... I dunno.

I think the point of "you can't take you're life you're sick and you don't know better" and the conflict with "well you're perfectly well, you shouldn't be allowed to kill yourself"... Is a double-bind bullshit excuse for moralists. Just like Pro-Lifers who want to take away a woman's choice (at least the idea that there's another life there, I can at least understand), but when it comes to suicide, you can fuck right off.

If you don't ever want to kill yourself? Fine. Don't.

If you worry about the other person's family? Fine, that's fine. But let that be between the people who have to deal with it personally, it's not your right or job to busybody morality police THEIR lives because of your fears/concerns that may or may not be relevant to you personally. How YOU would react if you were in a situation is YOUR choice, not your right to impose on others.

I can understand concerns about *how* assisted suicide happens and safeguarding it, but that's a different question than outright prohibition which takes away dignity, choice, and meaning to those who in theory have the right to life, "liberty" and the "pursuit of happiness". If Suicide isn't the ultimate expression of these things (the liberty to pursue happiness by ending one's life... or recognizing there is no more happiness to be had for them in this life FOR THEIR OWN DEFINITION OF HAPPINESS... The FREEDOM to not be compelled to live in a life they do not want. How is that "freedom"?)

Clearly I have feelings on this issue.
posted by symbioid at 10:02 AM on January 15, 2016 [6 favorites]


I apologize if my tone is taken as personal - I do not mean it to be a personal attack on anyone in this thread, just on certain moralities that make others suffer.
posted by symbioid at 10:03 AM on January 15, 2016


My grandparents (mom's father and step-mother) have broached this topic regularly during conversation since I was a teenager, essentially laying the foundation and clarifying for the last 15 years or more that they want to go on their own terms, no nursing homes, no hanging around after a certain level of mental or physical decline. I have immense respect for their decision and want to support them as much as possible, but they're very well off and surely have all of the resources and information they need. I don't know their specific plans but I have no doubt they have them. I am incredibly grateful they've been openly discussing this for so long.

My mom is understandably conflicted. I think she wants to be supportive and I know she understands, but he's her dad. Her response seems to be 'well, I can't stop you', but said with love. I couldn't possibly blame her. It's easier for me, I think. It's kind of kicked off that same discussion between my parents and me about what they want when it comes down to that. I appreciate that a lot, too.

G-pa's 80 and in the past year has had some serious health issues. He's still in relatively good physical condition and great mental condition. G-ma is 75 and a little better off, but they've been watching their friends die in greater numbers for the past 5 years or so and it's wearing on them. I feel like the topic (understandably) comes up more often now. I don't know what their preferences would be if they were free to do things how they want--if they'd have family there or not, if they would let people know beforehand or not--but I do wish they had the freedom to make those choices without having to worry about legally endangering the people they discuss them with.

They're well off and have the resources they need to make things happen, and probably more or less the way they want. That makes all of this easier now, and I'm sure will make it all much easier when it's time. I wish this was an option available to everyone who wanted it.
posted by suddenly, and without warning, at 10:03 AM on January 15, 2016


This is an issue where I just can't see the other side of the argument.

Abortion? I'm as pro-choice as they get, but I do understand the other side's arguments, even if I don't agree with them.

Death penalty? Totally get both sides.

Assisted suicide / euthanasia? I don't get it. Why wouldn't you allow people to end their life on their terms? Put some safeguards around it, OK - mandatory wait time or medical oversight or psychological evaluations or whatever - but this unilateral refusal to allow people to do with their own life as they wish - it's just an alien concept to me.
posted by widdershins at 10:12 AM on January 15, 2016 [3 favorites]


It's horrible to imagine being with your parents and then leaving, knowing that they are going to die right then. I can't bear to think of that moment. But it's also horrible - and depending on your experience, maybe more horrible - to watch a parent decline, in pain and misery, until they are so far gone that they die. "Natural" death very often is pretty horrible, as far as I can tell. My one grandfather died in his sleep of a heart attack, rather unexpectedly, and that seems to be the best way to go for the individual. But the shockingness of it was also hard for the survivors, and the fact that my frail, elderly grandmother suddenly no longer had her lifetime companion and carer right there was very hard. My grandmother died in the hospital after a bitter, painful, lonely decline, the sale of the family house and six months in a nursing home. For us as the survivors, there was a relief - it wasn't shocking because she'd been dying for a while, and she was so miserable that we took some consolation that death was a relief to her. But for her, it was a bad way to go.

My point being that there's a lot to be said for people choosing when to die so that their family is prepared and knows they're not in pain. People should be able to handle things how they want, but it's a choice among alternatives which are in general very cruel.
posted by Frowner at 10:13 AM on January 15, 2016 [4 favorites]


One of the most interesting things I learnt about assisted suicide is that it has a very strong cultural component, which can be difficult to safe-guard against. In Belgium for example, in the Flemish-speaking north assisted suicide is far more common that in the francophone south. [link]
posted by Braeburn at 10:19 AM on January 15, 2016 [2 favorites]


A great story, and written well, too. People making choices that they were damn sure competent to make, and having access to the means to act upon that choice, and doing so together -- it's great.

They're admirable.

They lived really good lives. They died really good deaths. They didn't slowly stagger out the door screaming in agonizing pain, or stumble out the door blindly and/or in the terror which Alzheimer's and many other forms of dementia bring. They went on their terms. Ultimate self-determination. Rational, thoughtful self-determination.

They said their goodbyes to everyone. Like "Hey, we're going on out the door now, we sure did enjoy your company, think of us on a sunny day, 'k?"

Willie didn't write this but he sure sang it well:
Remember me when the candle lights're gleaming
Remember me at the close of a long, long day
And it would be so sweet when all alone I'm dreaming
Just to know you still remember me

*

It is no one elses business, damn sure not the law -- the long nose of the law. What a huge suck it is that cops and then homicide detectives came nosing around this family in this time.

In some ways it's just totally comical, in that it's against the law -- what, they're going to arrest us if we pull the plug on our own life? Absolutely ridiculous. Not at all funny, but it is damn sure comical, and damn sure ridiculous.

It's the ultimate rational, thoughtful self-determination.

I love it.

~~~~~

My mother took off May 2014 at 93 years of age. The last 20 years of her life she was in real pain, and most particularly the last ten -- shoulders shot, hips shot, bone on bone. Thank god for pain management -- she had what was available, morphine, it eased that pain some but she damn sure knew exactly what time that next pill was going to come from the nurse in the assisted living place she spent the last ten years of her life in. And if that nurse didn't come in with that pill, like, pronto, my mother sure let them know. Or she'd let one of us kids know, and those people felt a real burn -- I can with phone calls make flags run up and down poles, and so can one of my brothers and so can one of my sisters. They took good care of our mother. If/when they slacked, they felt pain.

Without pain management it would have been screaming agony. With pain management it was real pain, some days worse than others. My mother would never have taken her life because Jesus, so that wasn't on the menu for her. (Though she sure let us know that she was ready to have Jesus to shake a leg already, take her to those heavenly gates.) She was razor sharp, absolutely lucid til her last day -- she'd started a new book that morning, got to like chapter two, set the book down, had lunch, and then the fade came gently and she was out the door in 12 hours. A damn good death.

She had us seven children, and some of our cousins also, and as noted above, none of us were shy in calling that assisted living place if things weren't just so. Without that she'd have been just been warehoused, laid/splayed in a bed in soiled clothing, there were plenty of people in that same place -- even in that same wing she was in -- who had an entirely different experience, because they had no one looking out for them.

Before anyone rushes to judgment on people choosing to go on their own terms, I'd sure like you to spend a week in old people warehouses. You might find yourself singing a different song.

~~~~~

I found out in her last months that her favorite poem was O Captain! My Captain! by Whitman, written just after Lincoln was shot, almost immediately after guiding this ship through that horrible, brother against brother war. We'd never really talked poetry, her and I, and that opened a door for us, late but better than never. And I told her about how my father oft spoke about "Crossing The Bar" and my one night asking him about it at our kitchen table and him reciting that poem and telling me what he knew of Tennysen, who wrote the poem. So I got all the information I could about both poems, and also about The Winds Of Fate by Ella Wheeler Wilcox, a poem I like a lot yet wouldn't set off her religious alarm bells. It turned out a nice big envelope of poetry, loved by us both, and we talked about them much, and other poetry also. We had a nice, long conversation the night before her death. Those were good hours. Those were good phone calls.

I loved her.

She loved me.

I miss her. A lot.

~~~~~

I've written all over this site about Alzheimer's, and my fear of it, which is huge. Terror, more-like. It's come down the paternal line in my family -- my fathers mother, then my father and all of his sibs. A horror show. I will absolutely pull the plug if/when I find that stuff coming on to me.

Harvard wants my brain -- the Harvard Brain Tissue Resource Center wants people with serious mental illness to donate their brain upon their death; I have this manic depression thing going on, and a sister has schizophrenia, pretty sure my father was manic depressive also. So they're wanting to have my brain, and I damn sure want them to have it -- if it could help alleviate the suffering of another, if it can be diced and sliced by some brilliant doc and help said doc find something of interest, I sure do want that to happen.

I'm going to have to do it in a hospital parking lot though, because I damn sure want someone to have my eyes, and Harvard wants my brain, and I'm perfectly fine with medical students hacking into the husk of me to learn how the knee-bone's connected to the ankle-bone etc and etc, and then throw what's left into the fire. Because of the stupid laws here, I can't have someone in the medical field do this for me, it's going to have to be a do-it-yourself sort of thing, using the method presented by that California woman in the Previously linked below, then having a friend call the hospital in twenty minutes and tell them I'm in an unlocked pickup outside in their parking lot, so they'll come and grab the body and harvest whatever is needed. (Of course whatever friend I ask for that help will have to use my cell phone, so they don't get arrested. So lame....)

Previously -- A woman in California helping others when they wish to make a choice.
My take on what that woman gave us.

Previously -- another couple decided to go together
My take on that couples choice.
posted by dancestoblue at 10:43 AM on January 15, 2016 [8 favorites]


Why wouldn't you allow people to end their life on their terms?

I'm generally against formally legal euthanasia in the US because I don't want that in insurers' toolkits. In the US, I think it will mean that patients who want to try expensive care will find (even more of) an endless string of informal and "accidental" roadblocks in their paths until they give up and agree to euthanasia.
posted by ROU_Xenophobe at 11:04 AM on January 15, 2016 [6 favorites]


We treat our pets better than people in many ways.
posted by twidget at 11:17 AM on January 15, 2016 [2 favorites]


I sometimes think about death. I can't imagine how I'll go, but I often come to the conclusion that I'm not going out like THAT (insert horrible form of death here). I can imagine doing this myself. Why not on your own terms?

If you think about it, this is the height of intellectual freedom...to own and operate your own demise, on your own terms, when you want to do it. That they did so successfully is pretty amazing.
posted by Chuffy at 11:20 AM on January 15, 2016 [1 favorite]


I'm sure this interpretation of their situation will draw jeers from a lot of MeFites. But as someone entering middle age I have been thinking a lot about the inevitable changes that happen as one grows old, that are starting to happen to me as well, and what that will mean for my own later years, as aches grow more persistent, the eyeglass prescriptions stronger, the stamina diminished.

No jeers from me, aught. Just a very real and pressing assertion--coming from a mind attached to a body that's been undergoing constant autoimmune attack since about 1991 but that otherwise looks normal and healthy to outside observers--that your assessment of personal quality of life is valid for you only, not for anyone else. We're the only ones who have any degree of insight about our personal, internal lives, and no amount of policy or philosophy can make that problem budge an inch.
posted by late afternoon dreaming hotel at 11:49 AM on January 15, 2016 [4 favorites]


Having seen my grandparents and one of my parents linger for long enough for it to feel almost cruel to them, I am strongly of the belief that the benefits of allowing euthanasia far outweigh the risk of insurers abusing it.

People who are the sort to fight until the very end, no matter how hard it gets, will not choose suicide just because their insurance company are being shitty. They already are being shitty, yet their shittiness doesn't even begin to compare to the hell that is the years-long cycle of failing health, infections leading to hospitalization followed by stabilization, then being sent to a nursing home and having the cycle repeated over and over again.

Maybe I'll tell the full story later, but for now, suffice it to say that fighters will fight, because that's how they roll.
posted by wierdo at 11:53 AM on January 15, 2016 [4 favorites]


Honestly, as someone who is also starting to notice aging (an old hip injury that used to trouble me mildly once every couple of years has become a constant mild presence even with careful stretches and exercise; I slipped in the shower (!) the other day and while it was because I'd spilled a very slippery new conditioner it still seemed like a harbinger) I am in dread of two things far more than death: terrible charity care and homelessness.

I'm afraid that I'll end up poor and covered in bedsores, lying in my own effluvia in a charity ward somewhere, too weak to get out of bed but force fed so I can't even starve myself. I fear dementia and mental deterioration followed by years of hallucinated agony. One of my great aunts died that way and it was brutal, even though her care was actually okay. But the economy is turning to utter shit and I'm sure I'll be poor when I'm old.

I'm afraid, too, of being old and homeless and living on the street in pain. It kills you after a while, but I'm a physically robust person and I could easily be wandering around sick, mad and hallucinated after I lose my house.

I know there's a plausible fear that people will be pushed to kill themselves when they have treatable but expensive conditions, but I'm equally afraid of not being able to kill myself when I can't work anymore.

Dying, how long it's likely to take and how much it's likely to hurt have been on my mind a bit lately.
posted by Frowner at 11:56 AM on January 15, 2016 [12 favorites]


Physician-assisted suicide was made legal in Canada in a Supreme Court decision last year, and takes effect in February.

The deadline to craft a new law has been extended by four months by the Supreme Court.

posted by ricochet biscuit at 12:29 PM on January 15, 2016


I'm generally against formally legal euthanasia in the US because I don't want that in insurers' toolkits. In the US, I think it will mean that patients who want to try expensive care will find (even more of) an endless string of informal and "accidental" roadblocks in their paths until they give up and agree to euthanasia.

This is it for me, really. Even in Canada. To have it formally recognized and institutionally supported might lead to a culture in which people don't want to be a burden to their families, and e.g., as was saucysault's experience, find well-meaning staff push particular solutions from their own value frameworks, at a time when patients and families are vulnerable, and the "informed" part of informed consent might be compromised.

(An example of this kind of pressure, different situation - as recently as this decade, immediately post-partum Aboriginal women were strongly encouraged by nursing staff and social workers to undergo sterilization. Some women were methadone patients, and had a lot of kids, which staff did not support; those women also had alternative frameworks of family structure and support that the nurses and social workers didn't want to see or appreciate.)

I also worry that if euthanasia becomes a strong cultural norm, there might be less of an impetus (and money around) to investigate treatments for diseases like Alzheimer's, like the ultrasound treatment that has shown some promise in animal studies. What happens to research and advocacy for better care when a culture decides that certain kinds of people, or people in a certain state, aren't inherently valuable - regardless of any individual's subjective determination of the value of their own experience?
posted by cotton dress sock at 12:52 PM on January 15, 2016 [6 favorites]


Why is their mere existence more "inherently" valuable than the quality of their existence?

Why do you assume "well-meaning staff push particular solutions from their own value frameworks, at a time when patients and families are vulnerable, and the "informed" part of informed consent might be compromised. "

This appears to be only a problem when someone who disagrees with your "value framework", no? That is - we already have that situation right now with the default pressure to not ever ever take your life. Isn't that an imposition from someone's own value framework?

I get that there are concerns about institutional issues, and we should recognize those pitfalls and deal with them as they arise and hopefully figure out some contingencies before hand, even... It would be folly to pretend there won't be some such pressures, and we should also acknowledge class as a factor in such pressures... But in the end, personal autonomy in this situation, I think, still holds more value... I mean, isn't that, ultimately, the most inherent respect you can give someone? To see their choice as valid? Isn't that more "inherent" and true to dignity than forcing them to bow to your definition of inherent value?

I see your concern about treatment about Alzheimers (as an example). But let's look at it like this...

What you're saying, here is that the individual's "value" is more as one to suffer for the sake of potential scientific solutions to a given problem. That is - their personal autonomy and desire to be free from suffering/pain (however they may define it) is secondary to the better good. In other words, you hold that it is better to force an individual to suffer a disease they do not wish to suffer from in order to benefit the possible greater good.

This is fine as a choice may be left to an individual. But you're essentially doing the same sort of thing, only instead of with saying "we should kill people for expediency's sake" you're saying "people should suffer for scientific knowledge's sake". The problem with both of these are that they, once again, reduce the individual to something that, in fact, is not an inherent subjective individual... You are, instead, objectivizing them for purposes that you deem socially acceptable/moral/good.

I'm not particularly clear here, but I hope my critique makes some facsimile of sense.

Again, I'm not saying your concerns aren't valid... We definitely shouldn't just rush into things and we should ensure safeguards, but we should also start to get rid of this taboo (and ultimately, that's what we're dealing with, I think - beyond the politics... a particular sort of taboo - an affront to whatever is "holy" or "sacred" or we deem to be a threat to God's omnibenevolence & omniscience ("How dare you insolent humans think you know better than I when the proper time for your passing to come truly is?") I use the God example at the end, there, but it doesn't even have to be a literal religious issue (though that seems to be where a lot of that sort of thinking comes from). But there is something, I think, at the core of humans... perhaps it's the life-wish and the desire to avoid facing death under any circumstances... This desire to ultimately turn fate over to the Cosmos instead of granting it to our own hands. A fear of hubris? I mean, this is something that runs deep in our psyches, much more than whatever particular moral framework we are choosing...

Something about the sacred order, and the pollution of the world by our acts... Karma... Frankenstein... Icarus... All these things are really in this mix when we say people shouldn't make these decisions.

The decision towards death, I think, hits our greatest Judeo-Christian Myth of our original mortality - sin... pride, arrogance, hubris... Biting the apple of knowledge condemns us to death. "We, knowing... like gods... and thus, condemned to mortality and death..." If we take that gnosis and apply it to ourselves, we act in god's stead, like Lucifer himself, ascending to the throne and that scares a LOT of people...
posted by symbioid at 1:13 PM on January 15, 2016 [2 favorites]


my grandmother died on tuesday, after a years-long struggle with severe alzheimers, diabetes, and other health issues. my mom and her siblings, several of whom are doctors and nurses, decided that my grandma should enter hospice care a few months ago. so she died at home, made comfortable with a combination of morphine and ativan, with her long-time caregiver rosa, my aunt, and a hospice worker playing piano in the room with her. i don't know that she would have ever chosen physician-assisted suicide or anything of that nature back when she first started to experience the ravages of alzheimers, as she was a pretty traditional catholic lady, but man did seeing her go through that ever impress upon me the need for that option to exist. seriously, fuck alzheimers.
posted by burgerrr at 1:41 PM on January 15, 2016 [2 favorites]


Why is their mere existence more "inherently" valuable than the quality of their existence?

Because judgements about the quality of one's life are subjective and personal. If there's a broader consensus around what kind of life - or who - is and isn't valuable, that leaves people who do value "compromised" lives, and find dignity in them, more vulnerable to abuse and neglect. In saying that all people are inherently valuable, by default, when the cultural space for those decisions is more grey than black and white, the line gets moved on a case-by-case basis. That is always going to be up to the individual. There's nothing I can actually do to stop it, and I don't actually want to. I just think it should be a private decision. Laws and practices that push the line make value judgements seem more "objective" than they are.

instead of with saying "we should kill people for expediency's sake" you're saying "people should suffer for scientific knowledge's sake".

No, I'm really not. People will do what they'll do. I think pushing the needle on a cultural level could have the effects I talked about above.

Regarding religiosity etc.: I am not a deist, or religious at all, I don't believe in anything but natural laws, though I probably do have some sort of inchoate, proto-defensive response to the idea of threat to life in general. That said, when people in my life have come to the point of needless suffering, I've been horrified at the effects of life-extension measures. What happened in those instances was that hospices implicitly supported passive euthanasia, with a lot of pain relief. (Passive euthanasia is legal in Canada, where I am.) Not beautiful, always, but not painful, as far as staff were able to determine (and they were very sympathetic to levels of observable pain, and careful in their calculations, based on experience).

I think going as far as active euthanasia could set very uncomfortable and questionable practices in motion. I basically do not trust that with active euthanasia, monitoring procedures are likely to be as effective as I think they need to be (for a variety of reasons), in order to protect vulnerable people.

Did you by chance read that piece on forced sterilization? I think it demonstrates how values can be imposed in a healthcare setting.
posted by cotton dress sock at 2:21 PM on January 15, 2016 [4 favorites]


And, I think equating "dignity" with intellectual capacity does violence to the idea that there are other ways of being that are valuable, at least to some.
posted by cotton dress sock at 2:28 PM on January 15, 2016 [5 favorites]


There are also people who think that euthanasia is selfish because it denies others the opportunity to cultivate moral satisfaction. The Federalist's reaction to Kevin Drum's article was to write:
The dying afford their family a chance that is quite literally once-in-a-lifetime: the opportunity to fulfill their familial duties to the greatest and most actualized extent possible.

It is true that Drum will save his wife a lot of stress and trouble if he simply ingests a lethal dose of secobarbital while they lie in bed together. But he will have cheated her out of something that is hers by right: the chance to realize her wedding vows and her matrimonial commitment to the fullest possible degree by conferring upon her husband the last and most important measures of care and comfort she can give him. Parents who kill themselves cheat their children out of a similar blessing: the opportunity to repay, in however small and incomplete a way, the debt of life and succor all children owe their mothers and fathers.
I personally do not agree that children own their parents a "debt of life and succor" (teenagers are on to something when they point out that they didn't ask to be born), and I feel that the measures of care and comfort one spouse owes to the other should be defined by mutual agreement between the comforted and the comforting.

But I do think it is important to acknowledge the cultural strain in the U.S. that likes to define and impose moral codes on other people's very personal business. Euthanasia will be another round in the culture wars because of people who cannot handle the radical notion that everyone should have a right to determine how/when they reproduce and how/when they die.
posted by sobell at 3:00 PM on January 15, 2016 [7 favorites]


Why do you assume "well-meaning staff push particular solutions from their own value frameworks, at a time when patients and families are vulnerable, and the "informed" part of informed consent might be compromised. "

Because it happens. It happened to me, as I briefly touched on above.

To expand on what I said, when my father was admitted to the ICU he was lucid but having trouble breathing. With his lungs fighting off an infection (bacteria/virus/fungi - it hadn't been determined yet) he became confused from lack of oxygen and refused medical care. My mother, sister, and I then took over his medical decisions and under the consultation of his entire medial team of eight specialists we decided that a ventilator would give the doctors the chance to diagnose and treat the respiratory disorder, but, there was the chance he would not improve - in which case we may have to make the decision to pull all life support. We made an informed choice and he was improving under their care while receiving massive doses of painkillers.

A nurse who was not part of the team or decision cornered my sister and told her our father was going to die and we were just prolonging his suffering. The nurse was thanked for her opinion but told we would discuss his care in the morning with his health care team after the daily diagnostics had been performed. We were being realistic but the doctors had advised us it was too early to make that decision (this was either his second or third day in ICU). She then spent the next 30 mins following my sister around the ward, repeating that she needed to make the decision to pull the plug now (without our mother present), spoke to me several times on the phone telling me my father was rapidly declining (his chart indicated otherwise when I checked) and twice called me to tell me that he would die within the hour and to immediately come to the hospital (he didn't, either time, but I think she was deliberately ramping up our stress levels). She very much had an opinion - as is her right, but it was not her place to force it upon us and make the choice for us. She was found by the nursing manger to not be as responsive as expected to his vital signs, for example when his blood pressure would drop instead of following the agreed on protocol to give him medication she would delay for thirty minutes and call the doctor to confirm she should give the medication. I must emphasis that this was the ONLY medical professional who acted in this way, but she could have an impact on the lives of thousands of people.

There have been several studies indicating there has been a gender bias in some areas practising euthanasia, which is an area to investigate and create legal and medical safeguards to protect vulnerable populations.
posted by saucysault at 3:02 PM on January 15, 2016 [8 favorites]


We treat our pets better than people in many ways.

Eh, not really. While a pet in terminal pain can indeed be euthanized, many more pets are killed simply because people can't or won't pay for absolutely treatable issues. With humans, you just get put in crippling debt for life (in the US --- in some countries, you actually get treated _and_ dont have to be in debt forever, amazingly). I'd rather be in debt than dead of a totally treatable issue.
posted by thefoxgod at 3:44 PM on January 15, 2016 [4 favorites]


Thank you for the link, saucysault. For the link-averse, it's a report from Oxford's Anscombe Bioethics Centre, reviewing research on assisted suicide in those places it's legal. Concerns include

- normalization of suicide; increases in suicide rates, especially among older people, and those living with physical and mental illnesses (and in some cases, grief); suicide "contagion"
- discrepancies between health care workers' and patients' ideas of quality of life: "among 153 emergency care providers, only 18% of physicians, nurses, and technicians imagined they would be glad to be alive with a severe spinal cord injury. In contrast, 92% of a group of 128 persons with high-level spinal cord injuries said they were glad to be alive. "
- concerns among disabled people that there may be pressure to end their lives prematurely
- nurses "intentionally shortening lives of patients without patient consent" (Belgium)
- extension of life ending without request to newborn infants with disabilities (The Netherlands)
- misconceptions about palliative care on the part of assisted-suicide seekers (Switzerland)

Chunky quote, sorry:

Current challenges in the culture of healthcare in the UK

If legalized, assisted suicide or euthanasia would be implemented in the context of NHS. In this regard it is important to be realistic about the current state of healthcare in the UK and failures that can occur and that have occurred, for example, in Mid Staffordshire and in the implementation of the Liverpool Care Pathway for the Dying Patient. These problems were not confined to one Trust or one Pathway but reflect cultural challenges within the NHS. How might assisted suicide or euthanasia be implemented in an environment of targets and ‘tick-boxes’ that sometimes operate to the detriment of patient care?

....

There are common patterns which emerge in each of these jurisdictions: in every jurisdiction numbers have increased over time and continue to do so; there has also been a shift from permitting assisted suicide for cancer victims to include more cases of other diseases. In Europe, this includes non-terminal conditions such as neuro-psychiatric conditions and multiple co-morbidities (for example, those associated with old age). Supposed safeguards such as psychiatric referral have also declined in frequency (see below for further details). Essentially, the practice has become more widespread and more routine.

posted by cotton dress sock at 5:13 PM on January 15, 2016 [7 favorites]


In an odd moment of synchronicity, just as I was catching up on this thread, CBC Radio was reporting that the first Quebec physician assisted death has been confirmed (link is to National Post).
posted by hurdy gurdy girl at 6:07 PM on January 15, 2016


I'm not a religious person. This is an issue I struggle with as far as my take on it goes.

I guess what bothered me is that it seemed like Peter's self-regard and pride in his younger self's superiority led him to deprecate his older, less capable -- *differently*-capable? -- self, and at the same time, and maybe even more troublingly, influence Pat to do the same.

I'm sure this interpretation of their situation will draw jeers from a lot of MeFites.


No jeers here. Those of us who do not have disabilities now are only temporarily able-bodied. I can't help but think that the Shaws had their minds poisoned by a deeply bigoted attitude towards people with disabilities that said "Oh, the moment I lose the ability to do this or that, it's all over." Then they literally poisoned themselves.

How you think about yourself as someone who may not have a disability now but who may well have one in the future is critical. What are you doing to promote an accessible society now? Because, quite frankly, you have skin in the game right now, whether you know it or not.

Liz Carr:

The most high-profile disabled people on TV are wannabe celebrities, athletes or people who want to die by way of assisted suicide.

It's alot to think about. It doesn't exist in some kind of vacuum. Giving people the tools to alleviate their own pain and suffering humanely is a good thing, too, in my mind.

Did you by chance read that piece on forced sterilization? I think it demonstrates how values can be imposed in a healthcare setting.

In the context of attitudes towards disability, this isn't a rhetorical question.

The idea that we couldn't ever again make a mistake as grave as "putting in a brain needle and stirring the works" is hopelessly naive.

This isn't a terrible thought:

Death should bloody well be like sex: I say when, I say how ...and I say how much.

But it's hard for me not to err on the side of caution, tilting slightly towards this:

I also worry that if euthanasia becomes a strong cultural norm, there might be less of an impetus (and money around) to investigate treatments for diseases like Alzheimer's, like the ultrasound treatment that has shown some promise in animal studies. What happens to research and advocacy for better care when a culture decides that certain kinds of people, or people in a certain state, aren't inherently valuable - regardless of any individual's subjective determination of the value of their own experience?

Given the Quebec report hurdy gurdy girl cited above, this is a pretty relevant discussion by doctors in Canada about how some of them would prefer to be able to advise on assisted suicide, and others who are against it for reasons that are more complicated than just "I don't agree with it." Some of those reason have to do with how they want to separate it from palliative care.

For me it rides on this knife edge of whether or not we're talking about people deciding other people shouldn't be here (or them internalizing that argument themselves), or people deciding, rationally, that they're personally in too much pain and suffering to carry on.
posted by mandolin conspiracy at 8:19 PM on January 15, 2016 [7 favorites]


More Liz Carr here.
posted by mandolin conspiracy at 8:25 PM on January 15, 2016 [1 favorite]


I'm sure this interpretation of their situation will draw jeers from a lot of MeFites. But as someone entering middle age I have been thinking a lot about the inevitable changes that happen as one grows old, that are starting to happen to me as well, and what that will mean for my own later years, as aches grow more persistent, the eyeglass prescriptions stronger, the stamina diminished.
A jeer, I guess: it is pretty condescending for someone in, what, your early 40s?, to assume that two 87-year-old people couldn't tell what was the normal slowing down of aging and what was pathological, and, for that matter, to decide what normal features of old age were becoming intolerable for them.
posted by gingerest at 12:23 PM on January 19, 2016 [3 favorites]


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