Death with dignity

October 10, 2008 7:25 AM

Doctor assisted suicide for the terminally ill, or those in chronic pain, is an issue that some find themselves opposed to. Dan Savage, of Savage Love fame, writes about the death of his mother and the implications of religious opposition to such measures.
posted by sotonohito (99 comments total)

Well that made me all choked up in the cubicle.
posted by These Premises Are Alarmed at 7:44 AM on October 10, 2008

Well that made me all choked up in the cubicle.

And dabbing tears out of my eyes with a paper towel. Thank you for posting this.
posted by hecho de la basura at 7:45 AM on October 10, 2008

My father had given me a proxy some years before he fell ill. he didn't want to be resuscitated if something happened to him. Unfortunately, his "wife" (they weren't legally married) had strong opinions about it --and she didn't like me.

Sure enough. My father fell ill. The woman chose to not call me immediately. I didn't find out a couple of weeks afterwards that he had died and indeed been resuscitated to find himself trapped completely incapacitated now by dementia.

My father would scream every time he'd see me come into his nursing home room. Not in anger at me, but in frustration. I'd cry every time and apologize every time for not being there to stop his wife from what I knew was torture for him. He couldn't walk, he couldn't move his arms or legs, he couldn't even sit up.

My father, by the way, was one of the first Olympic athletes from Puerto Rico and also one of our island's first Olympic medallists.

He died of pneumonia two years, after that stupid woman's decision. I had seen him the night before and had told him that over my dead body I would let them keep him alive. He blinked back at me in tears and went to sleep.

He was dead the next morning.

I can't tell you the relief I felt. I knew he wasn't in pain anymore. Not just physical pain, but the emotional pain, the humiliation of having been such an active man in his lifetime to end the way he had ended.

To this day I cry thinking of those two long years he had to suffer.

My father died 5 years ago.

Nobody should be robbed of their dignity when it's their time to die.

Nobody.
posted by liza at 7:53 AM on October 10, 2008 [61 favorites]

What an incredibly moving account. Dan Savage has a gift for combining the profound, the touching, and the action-oriented.
posted by supercres at 8:02 AM on October 10, 2008

Started off okay until he lapsed into a sputtering, irreligious, um, . . . savage . . . fury at the end.

This part was cute, almost verbatim from some undergrad's Metafilter comment: Fuck your God. Really?

This one has nothing to do with God. Yes, many religious people are opposed to the issues he mistakenly conflates at the end (abortion, gay marriage, suicide). But their opposition to suicide--you know, what started to write his article about, since the others are very different and rest on other, though perhaps related, considerations--is founded on the asserted degeneration of society this proposition entails. Because for Dan Savage the sum of human existence is Dan Savage, he reduces the opposition to suicide to an opposition to Dan Savage. For the opposition, however, the sum of human existence is humanity, and they are opposed to a human society that is allowed selectively to destroy itself. (Because of the inevitable devolving of this issue along the slippery slope of government involvement in healthcare yadayadayada. . .)

Does he not understand that many of those opposed will die painful, suffering deaths too? Will be robbed of their imaginary socially-created "dignity"--though never their human dignity, because they remain human beings? So this isn't just some selfish God-says-so sort of thing.

It's a fundamental difference in worldview, and the two sides will ever, as now, argue past one another. So it's just going to boil down to which side cares more. Who's willing to give more money, fight more, speak out against, die for, etc.?
posted by resurrexit at 8:10 AM on October 10, 2008 [4 favorites]

Does he not understand that many of those opposed will die painful, suffering deaths too? Will be robbed of their imaginary socially-created "dignity"--though never their human dignity, because they remain human beings? So this isn't just some selfish God-says-so sort of thing.

I have to ask, resurrexit, that if this is the case, why should we not allow those who wish to choose to have a say actually HAVE that choice open to them? "Choice" does not mean "compel people to actually DO it."

"Fuck your God" isn't a statement I think is all that great either, but I took it as a frustrated lashing-out from someone who -- and he admits this up front -- just watched his mother die, and so probably isn't entirely himself right now. But the core of his point stands -- what exactly about granting an individual the right to choose how they want to end their days would perpetuate a "slippery slope"?
posted by EmpressCallipygos at 8:20 AM on October 10, 2008

This one has nothing to do with God.

Oh sure it does. Or at least "God" as intepreted by his/her/its earthly representatives who seem to think they have a right to make decisions for the rest of us.

But their opposition to suicide-- [snip] --is founded on the asserted degeneration of society this proposition entails..

"Degeneration" of society? Seriously? You're going to argue that forcing life support on someone who can make little to no use of it is a better use of society's resources and acclaim than say, using those resources to provide for those who really need them? Sad. Just sad. If someone wants to spend the rest of their life hooked up to a bunch of machines, good on them. But leave me out of it -- I want the plug pulled when I decide it's time to go, if it ever comes to that.
posted by bitter-girl.com at 8:29 AM on October 10, 2008

I think the two paragraphs before "Fuck your God" are the crux of the matter:

If religious people believe assisted suicide is wrong, they have a right to say so. Same for gay marriage and abortion. They oppose them for religious reasons, but it's somehow not enough for them to deny those things to themselves. They have to rush into your intimate life and deny them to you, too—deny you control over your own reproductive organs, deny you the spouse of your choosing, condemn you to pain (or the terror of it) at the end of your life.

The proper response to religious opposition to choice or love or death can be reduced to a series of bumper stickers: Don't approve of abortion? Don't have one. Don't approve of gay marriage? Don't have one. Don't approve of physician-assisted suicide? For Christ's sake, don't have one. But don't tell me I can't have one—each one—because it offends your God.

That is what strikes me as so petty about those who want to restrict other people's rights based on their religion. It is like they are saying "Well if I have to give up this choice then I ain't suffering alone. You should have to give it up too." In a civil society, your right to swing your fist ends at my face, and the converse to that is that as long as it ain't hitting my face, you can swing your damn fist to your heart's content and I can't say "boo" about it. A terminally ill person choosing to end their life to avoid months or years of inconceivable pain does not infringe upon your rights, and therefore you have no right, in a reason-based pluralistic society, to prevent them from making that choice.
posted by ND¢ at 8:33 AM on October 10, 2008 [24 favorites]

Oh wait, I forgot. It's not pettiness. It's all about a culture of life.
posted by ND¢ at 8:39 AM on October 10, 2008

liza wrote:

Nobody should be robbed of their dignity when it's their time to die.

liza, what could he have done to insure his wife couldn't overrule his wishes? Even if it were in writing she could have just ignored it correct? Is one totally at the mercy of the next of kin in this type of situation or is there another way of insuring that your will is paramount?
posted by any major dude at 8:42 AM on October 10, 2008

"Choice" does not mean "compel people to actually DO it."

"Not yet" would perhaps be the standard reply. It's the slippery slope dilemma I alluded to above. Sure, you want to die now; but what about in the future, when you're long gone, and your kids or kids' kids are in the hospital bed, and there are laws in place permitting someone to effect their desire that you die now?

You're going to argue that forcing life support on someone. . .

Nope, never said it. Doesn't flow naturally from my argument or personal beliefs.

I want the plug pulled when I decide it's time to go. . .

It's your choice, unpredictable exigencies aside, to get "plugged" in the first place. Don't want life support? Don't go to the hospital.

A terminally ill person choosing to end their life to avoid months or years of inconceivable pain does not infringe upon your rights, and therefore you have no right, in a reason-based pluralistic society, to prevent them from making that choice.

Really? In a democracy, a majority of people can't vote to do whatever they like to preserve what they feel to be an optimal society and prevent what they feel to be certain disaster in a future dominated by "medical ethics boards"? News to me. And re Iraq link: Agreed. Anyone truly pro-life regrets the waste of perfectly good humans in an unjust war. But that's fairly tangential to the issue of suicide. (Though national suicide . . . well, you might be onto something there.)
posted by resurrexit at 8:44 AM on October 10, 2008

I should mention that I am not neutral in this.

My father, suffered a stroke as a side effect of an undiagnosed cancer that had metastasized by the time it was discovered. He was kept "alive" and in horrible pain by the hospital for nearly a week. He might have been kept "alive" longer had it not been for a nurse who, at risk of his job, let us know that we could demand that my father be moved to a hospice.

At the hospital the doctors would not administer enough morphine to keep him out of pain, they said it might endanger his health. At the hospice they would not actually administer enough morphine to kill him, but they would at least remove the various life support machines and give him enough morphine that he was no longer in agony. He died a day after we moved him to the hospice, and I found that after the funeral and the grieving was done my commitment to the right to die movement had transformed from a vague belief that it was right into an unwavering and ironclad dedication.

resurrexit re: "fuck your god". The context, in case you hadn't noticed, was that Pope "Benedict" had proclaimed that we must all die when his god tells us to and not a moment before. It was hardly the random anti-religious rantings of a raving atheist, but rather a very specific objection to a very specific bit of evil from the head of the Roman Catholic Church.

If the religious think their sadistic god wants them to suffer horribly for months before finally being permitted the release of death let them suffer. That's their right. I do not, however, think that it is the right of the religious to force others to suffer because they believe that their god wants that suffering.

The nonsense about society degrading is a red herring in this issue as it is in the issue of gay marriage. Take away the "God doesn't want us to" argument and they have nothing to stand on. The religious wish not merely to refuse suicide themselves, but to compel others to suffer needlessly. No one has proposed forcing suicide on those suffering, only offering it as an option; it is the very existence of a choice that repulses the religious. To them there can be no choice: their god commanded that we suffer, so suffer we must and they have enshrined their theology in law.

You are, however, quite correct in that we are talking past each other. The opponents of the right to die are lying, reflexively and perhaps pathologically, about their motives and it is quite difficult to have a discussion where one side is completely dishonest about its motives. If they'd admit that they want to force a theocratic position on an unwilling nation we could have a discussion, instead they hide behind self evidently false rhetoric about social destruction. I cannot be blamed for the lies of my enemies, nor for the deleterious effects those lies have on debate.
posted by sotonohito at 8:45 AM on October 10, 2008 [21 favorites]

But their opposition to suicide--you know, what started to write his article about, since the others are very different and rest on other, though perhaps related, considerations--is founded on the asserted degeneration of society this proposition entails. [...] For the opposition, however, the sum of human existence is humanity, and they are opposed to a human society that is allowed selectively to destroy itself.

As far as I'm concerned, quantity-of-life-above-quality-of-life values are the very height of social degradation, and have been since they were first introduced. For me, the sum of human existence is human cultures, and human cultures are degraded by the insistence that the sole measure of "humanity" is a single binary value, alive or dead, rather than an entire spectrum of socially and individually determined qualitative judgements.

If we don't concentrate on how we're living, as opposed to how many are living for how long... well, we end up with today's society, in which scores upon scores of people live empty, lonely, painful, meaningless lives, and then are told that they mustn't ever kill themselves because "life is sacred". Funny, I thought "sacred" meant "this object should be treated with great respect and reverence", not "this object may be purposely degraded in any way short of final destruction, which is a no-no".

Then again, I don't have a 2000-year-old mafia to support my beliefs, so maybe it's no surprise that you're acting as if there's only one side to the pro-suicide argument.
posted by vorfeed at 8:59 AM on October 10, 2008 [9 favorites]

Really? In a democracy, a majority of people can't vote to do whatever they like to preserve what they feel to be an optimal society and prevent what they feel to be certain disaster in a future dominated by "medical ethics boards"?

Not in this constitutional democracy where the founding fathers knew that without safeguards the minority would be subject to the tyranny of the majority. You can't get together and vote to do whatever you like to preserve what you feel to be an optimal society if that infringes on the rights of all citizens guaranteed in the Bill of Rights. A bunch of people may think that mandatory church attendance or the denial of voting rights to minorities or any number of crazy shit may preserve what they feel to be an optimal society and they can go take their feelings about what makes an optimal society and fuck themselves.
posted by ND¢ at 9:00 AM on October 10, 2008 [7 favorites]

It's the slippery slope dilemma

You're putting us on.
posted by piedmont at 9:01 AM on October 10, 2008 [2 favorites]

It's the slippery slope dilemma I alluded to above. Sure, you want to die now; but what about in the future, when you're long gone, and your kids or kids' kids are in the hospital bed, and there are laws in place permitting someone to effect their desire that you die now?

....The very laws permitting the INDIVIDUAL the right to choose the manner of THEIR OWN DEATH would PREVENT those potential future laws, though. In other words, I'm not seeing how we get from "giving the individual the final say in this matter" to "taking those rights away from the individual again and giving them to a third party." You say there's a slippery slope, but I'm not seeing the actual slope that gets us FROM one point to the next; to me, it looks more like the point you fear is on a different hill entirely.

Moreover, we already HAVE laws in place that in effect achieve the very thing you fear. A child can be appointed the parent's health proxy; what's to stop a child from saying that "in my position as health proxy, yes, I assert that my parent didn't want to be rescussitated" whenever they wish?
posted by EmpressCallipygos at 9:03 AM on October 10, 2008 [4 favorites]

The nonsense about society degrading is a red herring in this issue. . .

Is it? You haven't addressed it. You simply jumped right onto the I hates teh god bandwagon and skipped what I, and countless non-religious others, have suggested is the real issue. This is not motivated by "God says so"--though it does bolster the enthusiasm of many in the opposition to the suicide movement.

Your last paragraph is just crazy ad hominem and will not be addressed.

If we don't concentrate on how we're living, as opposed to how many are living for how long. . .

So you'd like a subjective definition of humanity; a majority of the population at present would have their objective definition preserved. Get some more people and try to convince them. But don't just asperse the others without explaining how your subjective humanity will not degrade itself into a you-can't-live-anymore-because-I-say-so mess.

You can't get together and vote to do whatever you like to preserve what you feel to be an optimal society if that infringes on the rights of all citizens guaranteed in the Bill of Rights.

There is no right to kill yourself in the Bill of Rights.
posted by resurrexit at 9:03 AM on October 10, 2008

Because for Dan Savage the sum of human existence is Dan Savage, he reduces the opposition to suicide to an opposition to Dan Savage.

Maybe his Mom too, but maybe that doesn't count, since it's just somebody who loved him.

Seriously, I hardly think Savage is right about everything, and I agree that there are ethics issues at work here beyond religious ones, and yes, "fuck your God" is over the top. But to say "for Dan Savage, the sum of human existence is Dan Savage" seems like an odd combination of a tautology and a low blow. Of course his own experience shapes most powerfully shapes his perception of the human experience. How is this different from anyone else? And how do you propose to remove this factor? Because if "the sum of human existence" is actually anything at all, it is an aggregation of these individual experiences, many like the one he shared.

I definitely think it's fair to test the angles of this ethical slope and the fastness of footing thereon, to consider that an unmindful society could wake up one day in a world where people are so careful to protect the right to die that the choice to live isn't given due respect (or, worse, not given due protection), to consider that the ideal of an elimination of suffering has its own problems.

But I don't think it's fair to invalidate visceral accounts like Savage's that serve to illustrate some real emotions and issues involved in death simply because some of his statements are more tenuous than others, or because he's probably governed by the same inside-his-skin perspective most humans are, maybe more so while he's still in the grip of immediate grief.
posted by weston at 9:04 AM on October 10, 2008 [2 favorites]

We're about as likely to agree on where life should end as we are to agree on where it begins.
posted by anifinder at 9:09 AM on October 10, 2008

weston: How is this different from anyone else?

You're totally right; unmitigated selfishness impels all those opposed to a right to suicide. It's not that we don't want Dan Savage or him mother to decide when they'll die--I'm trying to soften my tautological low blow here, for which I apologize--we just don't want anyone deciding when anyone dies.

Because those of you, e.g. Empress, are right who say 'right now' we get to decide when we die. My point is that we're opposing you NOW because, what if, in the not-too-distant future, we aren't the deciders anymore, and there's a tradition in place of people making decisions about when people die. That is simply inhuman. I hate that and will oppose it with all my democratic ability.

We're about as likely to agree on where life should end as we are to agree on where it begins.

Well said. There will always be opposed those who support an arbitrary distinction and those who do not. Who will win?
posted by resurrexit at 9:16 AM on October 10, 2008

resurrexit I think my last paragraph is the most accurate description of the situation that exists. Let's try to follow the "logic" of the people opposed to assisted suicide:

1) People are allowed to make the *choice* to end their life with the assistance of a doctor.
2) ....
3) ZOMG human life is totally devalued and Medical Death Squads are killing anyone suffering from anything worse than a hangnail!

There is simply no possible way for step three to follow from step one.

So far you, like all the others, have offered no actual explanation for your claims, just the assertion that it will happen. That somehow, by granting people a choice, that choice will soon be forced on the unwilling. I think part of the problem is that people like you are so invested in forcing others to abide by your agendas that you cannot conceive of people who are uninterested in micromanaging the lives of others. Assisted suicide does not mean that your grandmother will be killed by roving gangs of doctors.

Claiming that somehow the right to die means forced death down the road is exactly the same as claiming that somehow gay marriage means being forced to have gay sex somewhere down the road. There is simply no connection between the two. Unless, of course, you believe that your god is the only thing standing between society and total barbarism and that if we allow assisted suicide he'll withdraw his divine protection from America.

Just as in gay marriage, I note that the civilized parts of the world have already legalized assisted suicide and (amazingly) have not turned into death dealing dystopias where the elderly and infirm are stalked by killpacks.
posted by sotonohito at 9:24 AM on October 10, 2008 [4 favorites]

> It's the slippery slope dilemma I alluded to above. Sure, you want to die now; but what about in the future, when you're long gone, and your kids or kids' kids are in the hospital bed, and there are laws in place permitting someone to effect their desire that you die now?

There is no slippery slope. The right-to-die principle that Dan Savage writes about is one of becoming able to assert autonomy ("I choose when to die") where it's currently unavailable. In Dan Savage's description, there is no delegation of that decision to a third party; it is only up to third parties to enforce the decision.

> It's your choice, unpredictable exigencies aside, to get "plugged" in the first place. Don't want life support? Don't go to the hospital.

These decisions are the consequence of incremental changes in state. There is no simple go-to-the-hospital-and-live vs. avoid-the-hospital-and-die binary tree. Progressive debilitation does not provide an obvious moment to pull the switch; some horrible conditions can be recovered from, some can managed into a state where the patient can have an acceptable-to-them quality of life.

I think that there are some very good arguments to be heard against death-with-dignity proposals, such as how the mentally disabled can be made to understand the options available to them. Tangentially, 'dignity' is an appealing name for this, but it also strikes me as misleading when the primary aims are palliative; ending a life that would otherwise be trapped in unending suffering or complete mindlessness.

Claims that this is a slippery slope, and dystopian fantasies of a medical establishment running amok in cahoots with an all-powerful areligious government is not a good argument at all. The matters of personal autonomy and delegation of authority are well-addressed already, so pick something more plausible to argue, in the context of the world we currently live in, please.
posted by ardgedee at 9:25 AM on October 10, 2008 [2 favorites]

Er, meant to add:

Show me the steps that will be taken to lead to our hypothetical killpack dystopia. Either that or stop trying to run other people's lives.
posted by sotonohito at 9:30 AM on October 10, 2008

Because those of you, e.g. Empress, are right who say 'right now' we get to decide when we die. My point is that we're opposing you NOW because, what if, in the not-too-distant future, we aren't the deciders anymore, and there's a tradition in place of people making decisions about when people die. That is simply inhuman. I hate that and will oppose it with all my democratic ability.

And that's perfectly understandable. The disconnect is coming from how you are connecting that dystopian possibility to THIS question. Because THIS question is about giving US the power to be the decider, and the situation you describe is about taking that power AWAY from us again. How does GIVING a person power lead to a situation where we take that power AWAY from them again?

And secondly, why not wait until that point is actually proposed BEFORE fighting it, rather than fighting something else because this second and unrelated potential thing could maybe possibly happen if the stars align in a given way?
posted by EmpressCallipygos at 9:31 AM on October 10, 2008

I'm definitely for assisted suicide in principle, for all the reasons that Savage addresses in his article (and, not that he's reading this, but my condolences to him). In practice, there doesn't seem to be a proposal so far that provides adequate protection against:
- decisions made under depression;
- pressure against and manipulation of disabled patients (whose lives are often undervalued by society - how many times have you heard an able person say something along the lines of, "Gee, I don't think I could live like that!" about a disabled person's life? How often do you think they hear it?);
- patients whose families don't have the money for end-of-life care, but do have the funds for assisted suicide.

If we could just get it together on those aspects, that'd be great, but as it stands, well.
posted by bettafish at 9:37 AM on October 10, 2008 [5 favorites]

Someone else's answer regarding the leap from your step one to three (which you and I both know is enjoyably hyperbolic): "In an era of cost control and managed care, patients with lingering illnesses may be branded an economic liability, and decisions to encourage death can be driven by cost. As Acting U.S. Solicitor General Walter Dellinger warned in urging the Supreme Court to allow states to ban assisted suicide: 'The least costly treatment for any illness is lethal medication.' Many people with disabilities have long experience with prejudicial attitudes on the part of able-bodied people, including physicians, who say they would 'rather be dead than disabled.' Such prejudices could easily lead families, physicians and society to encourage death for people who are depressed and emotionally vulnerable as they adjust to life with a serious illness or disability. To speak here of a 'free choice' for suicide is a dangerously misguided abstraction."

Is that so hard to fathom?

Claiming that somehow the right to die means forced death down the road is exactly the same as claiming that somehow gay marriage means being forced to have gay sex somewhere down the road. There is simply no connection between the two.

The first premise: in the future, someone will decide when someone will die. For the reasons given above, I feel this is plausible.

The second premise: in the future, someone will decide when someone else will have gay sex. I agree with you here, there is no connection between gay sex now and mandated gay sex in the future. There are no similar economic or prejudicial motivations that would make someone powerful demand that someone powerless have gay sex. So like I said way above in the comments, this issue is nothing like the suicide issue.

Thanks, though, for casting yet another of your anti-religious straw men into the arguments.
posted by resurrexit at 9:39 AM on October 10, 2008 [2 favorites]

unpredictable exigencies aside, to get "plugged" in the first place. Don't want life support? Don't go to the hospital.

Bull. Fucking. Shit. Lemme clue you in on a little something -- if I get into a horrifying car crash on the way home today, and my cell phone is burnt to a crisp and they have no idea who to get a hold of right away, and rush me to the hospital -- guess what? Chances are probably pretty good that the hospital is going to put me on life support. Tattoo "DNR" on my chest and they're still gonna do it -- for all they know it's my boyfriend's initials. So there's no real element of choice there, which you address only as "unpredictable exigencies." But guess what? Same thing applies if I fall over in the street and have a massive, brain-destroying stroke, same thing applies in a lot of situations...situations I don't have control over. If I was at home dying of massive cancer, as my grandmother did once she told the hospital to pound sand and went home, then I would not, obviously, choose to go to a place that would force me to follow THEIR guidelines and terms.

The difference between your world and mine is that I want my loved ones -- who have all been VERY clearly informed of my wishes -- to have to right to demand my unplugging in ANY event, especially if I am no longer capable of making those decisions for myself. And there are far too many people who think they shouldn't have that right ever, which is just wrong. I do not want to go on living as a hunk of charcoal, I do not want to go on living in a body without a functioning brain, I ESPECIALLY do not want to be kept alive as an incubator without my consent. (In Ohio, where I live, if you are even one week pregnant, they will not allow the disconnection of life support no matter what. It's nine months on the tubes for you, girly!) That's so beyond the pale it makes me ill to think of it.

Just as in gay marriage, I note that the civilized parts of the world have already legalized assisted suicide and (amazingly) have not turned into death dealing dystopias where the elderly and infirm are stalked by killpacks.

Indeed.
posted by bitter-girl.com at 9:41 AM on October 10, 2008 [3 favorites]

I have no objection to assisted suicide for moral or religious reasons.

I just think it's too terrible a tool to hand to American HMOs. They're already horrible enough, having powerful incentives to deny care. But I think that pales before the likely misconduct of HMOs that have, somewhere in their database, "Assisted suicide -- $875 one-time" next to "Palliative home care -- $2500/month" and "Hospice care -- $7600/month."
posted by ROU_Xenophobe at 9:42 AM on October 10, 2008 [2 favorites]

Your favourite optimal society sucks.
posted by bokeh at 9:43 AM on October 10, 2008 [1 favorite]

I note that the civilized parts of the world have already legalized assisted suicide and (amazingly) have not turned into death dealing dystopias where the elderly and infirm are stalked by killpacks

...but the civilized parts of the world also don't have American HMOs.
posted by ROU_Xenophobe at 9:44 AM on October 10, 2008 [3 favorites]

Thank you Dan Savage. Thank you again for everything you write. I will be voting Yes on Initiative-1000, for my husband, my family and for myself.
posted by Craig at 9:47 AM on October 10, 2008

anymajordude wrote :
liza, what could he have done to insure his wife couldn't overrule his wishes? Even if it were in writing she could have just ignored it correct? Is one totally at the mercy of the next of kin in this type of situation or is there another way of insuring that your will is paramount?


This is where having a good lawyer, more than a proxy, is sooOo important. Because had he had a lawyer sit all the parties down and sign affidavits, she wouldn't have been able to easily pull the shit she did.

I would have had to sue her to have the courts forcibly remove her from his side and bar all contact, which would then have entailed get a court appointed whatevertheycallthem for my father, which would have meant I'd not necessarily be that person or anybody from his immediate family.

In other words, it would have had to get ugly, we would have had to spend tens of thousands of dollars in legal fees. Needless to say, court cases like these are rarely expedited, so for a year or 18 months my dad would have been in legal limbo. And did I really want strangers making making decisions about his health while the rest of the family bickered?

You can understand why I chose not to pursue that line of action.

BTW, I turned my previous comment into a blog post :

The day before my father died
http://culturekitchen.com/liza/blog/the_day_before_my_father_died

If you can vote for Proposition 1000, I urge you to do so.
posted by liza at 9:48 AM on October 10, 2008

bitter-girl, I agree with your first paragraph completely. Same thing applies to anyone, anywhere, regardless of their desires.

The difference between your world and mine is that I want my loved ones -- who have all been VERY clearly informed of my wishes -- to have to right to demand my unplugging in ANY event, especially if I am no longer capable of making those decisions for myself.

Big, big difference between unplugging--I have similarly advised my friends and loved ones to "Don't be cruel" if I'm in this position--and the affirmative act of killing yourself.

Anyway, this is getting borderline on GYOBFW on my part, so I'll be sitting back to watch.
posted by resurrexit at 9:50 AM on October 10, 2008

It's the slippery slope dilemma

So let me be the severalth person to say that you need to get your errors of logic straightened out before you go throwing terms around. It can be a slippery slope, where through gradual changes one goes from an acceptable proposition to an unacceptable one (from death with dignity to physicians killing people who are too much trouble to deal with) or it can be a dilemma, which as the prefix "di-" indicates, puts one in a place where you have to choose between two undesirable outcomes (painful "natural" death or pleasant suicide). The phrase "on the horns of a dilemma" has to do with bulls, not rhinos or moose. So one or the other, please.

Anyway, Savage is pretty much right on in my books. Most of these "religious" people who oppose things like gay marriage and assisted suicide seem to think that everything is a slippery slope which really says more of their apocalyptic world-view than it does about what actually happens in society. Why morphine is an affront to God while antibiotics are not is a question that no one ever seems to answer.
posted by GuyZero at 9:51 AM on October 10, 2008 [1 favorite]

*looks around*

Nope, the Netherlands definitely is still a civilized country. And we've had these laws for quite a while now. In 2005 there was a European report on this issue that was very positive about Dutch laws as well.

And to think the current government coalition of three parties has two of them with the word "Christian" in the name.
posted by DreamerFi at 9:54 AM on October 10, 2008 [2 favorites]

Guy zero--ahh, an uncorrected mistake there. Only slippery slope is intended according to your clarifications.

I just feel like killing myself.
posted by resurrexit at 9:56 AM on October 10, 2008

Religion/society isn’t the only roadblock to end-of-life issues. Even if the patient has a living will with do-not orders, these can be ignored.

If someone goes to a hospital and the document isn’t on file, or if there is an emergency situation and it’s not know, the docs will not stand by and do nothing – they will do all they can to preserve life even if it means hooking you up to all kinds of machines. Unless they know to not do this, they will.

Likewise, if a patient’s relatives direct the docs to keep the patient alive by any means available, the docs will follow the relative’s orders. Do not kid yourself that it doesn’t happen and your relatives know your wishes and will follow these. There is such emotion involved in making this type decision and when it’s all on your relative’s shoulders, they have their own emotional needs in the mix.

I have been involved in these situations on a very personal basis and have much sympathy for all of us who are faced with such a dilemma. The best-case scenario for you, the patient, may be to have a catastrophic event before medical assistance arrives if you’re against mechanical life support. But at what stage of acceptable existence do you believe your life isn’t worth living? That’s a seemingly impossible distinction to spell-out prior to the unique event that you’ve just experienced. So, we’re sometimes left with the decision of what to do after an event.

For the most part, society is against suicide in any form. There’s a small rift in that blanket attitude when medically aided/allowed/assisted suicide is under discussion. Who can say what is in the best interest of the other person? Hopefully, your relative will put your wishes and needs above their own, but each event is unique. It’s a sliding scale in some cases when you’re asked about your loved one’s wishes as you’re standing in the hospital with all of the medical experts asking you, the layperson, for a decision.

Another personal example about life-support decisions:
My father was put on life support against his wishes – but his wife directed differently, so he was kept there for over a week before the machines were disconnected. He had a living will that did nothing. Her need to come to terms with the situation trumped his directive. It was the right decision for her, but perhaps not the right decision for him. Whose needs outweigh the other’s? I can see both sides of this dichotomy.

When my hubby became critically ill and all of a sudden was whisked away to ICU, I was not let in until they had him stabilized. I had no idea why he was there, or what they were doing to him. I was his advocate, yet had no ability to control what was happening to him. Neither did he. Fortunately for him, he had a DNR statement on file that they followed, so he was not hooked up to assistive devices. But, how much more difficult would the situation have been if he had? I knew that his final hours were entrusted to me if he couldn’t speak for himself: I was going to follow his wishes – not simply my own. Yet, I had no medical training. Was his life on my hands if I made a “wrong” decision? It’s an enormous burden.

Yet, I want to have the ability to make that decision as an individual. I cannot see how having a society making such a blanket decision can be any more sucessful for me, in my unique situation. There are no 100% correct answers because we cannot even agree on the definition of life. How are we going to agree on the definition of when death is allowed/approved? I don't want a big government/society making that edict for me even if what remains is a flawed/personal judgement instead.
posted by mightshould at 9:58 AM on October 10, 2008 [1 favorite]

Let us look into the future. In vitro genetic testing discovers gene for homosexuality, parents decide to terminate. AIDS like virus with links to behavior the "majority" finds aberrant, why find a cure just help em out the door with dignity mind you with dignity. Finally as less of us are able to afford health insurance and actuaries and ceo's are left to make decisions for us regarding quality of life the offer of a death with dignity becomes the only decision where the word dignity is the bottom line.
posted by pianomover at 10:03 AM on October 10, 2008

This one has nothing to do with God.

Of course it does. The Catholic Church, at least, specifically prohibits suicide (based, I believe, on Thou Shalt Not Kill). Your line about degeneration of society is so much humanistic BS that I have never once heard coming out of a religious person's mouth.
posted by adamdschneider at 10:09 AM on October 10, 2008

I couldn't get past the first two paragraphs. Not because my mother went through prolonged pain before her death almost 6 years ago. Rather it was because of the strip of personal ads (including a closeup photo of some guy's crotch) down the left side of the story. The juxtaposition was a little too freaky for me.
posted by suki at 10:09 AM on October 10, 2008 [1 favorite]

So you'd like a subjective definition of humanity; a majority of the population at present would have their objective definition preserved.

The problem is much more nuanced than that -- there is clearly some balance between objective and subjective factors in our society, given that no one is suggesting that we put ourselves on these life-preserving machines at birth, nor is anyone (except you) suggesting that we ought to kill people "because we say so". The problem is, your argument allows for no balance whatsoever, because you believe that the slightest inch in the other direction will automatically become a mile. Good for you, but that's not reasonable, and it's not the way society actually works, either. We have many, many things which are socially permitted, yet not taken to the logical extreme in some mad rush toward destruction; in fact, that covers nearly everything.

Get some more people and try to convince them. But don't just asperse the others without explaining how your subjective humanity will not degrade itself into a you-can't-live-anymore-because-I-say-so mess.

First of all, aspersing the status quo is how I'm trying to convince people, right here and right now. I don't know how else I can do that, other than by pointing out that I believe our current values are harmful to society, and by describing alternate values which I believe would be beneficial.

As for the explanation, it's simple: the same way your objective humanity doesn't degrade itself into a everyone-is-on-machines-from-birth-forever mess. Throughout human history, the slippery slope has rarely been even remotely as slippery as you're claiming it is, as others have pointed out. You seem to have an incredibly narrow view of what "humanity" and "human society" can be... one which is not borne out by either history or sociology. "Life" does not have to be the paramount human social value.

At any rate, this is all somewhat moot to begin with: you want me to explain why X isn't going to happen, yet I never said it would, and you offer no line of reasoning which explains why you think X would happen -- just that it will, definitely, no matter what. "Sometime in the future, X will happen". That's not an argument, it's an assertion, and as such, carries very little weight.
posted by vorfeed at 10:11 AM on October 10, 2008

I'll step out of my personal guidelines about cursing on MetaFilter and say that "Fuck your God," which is juvenile on the surface, has some deeper meaning to it. Allow me to explain:

There is no section in the Bible which says, "Thou shalt provide an exuberant dose of morphine to the ailing who will soon be judged by Me, should they request it" and no bits like "Yea, thou thy father might be bursting with tumors, still must he be strapped in and kept from yanking out his IV, for all things are glorious in My Sight." I think we can remember the religious outcry in the Schiavo case and the frantic search through Old and New Testaments for some revealing passage — I recall something vaguely relevant being found. Perhaps the issues are conflated because their leaders have lured the populace into believing so; however, you cannot ignore that most of the cry against assisted suicide comes from the religious "culture of life" types. Sometimes they dress it up a little, the same way their loathing of homosexual weddings starts with "sanctity of marriage" and ends up with "the reproductive family is the basic unit of society," but make no mistake, the huge overlap exists.

When the religious advocate removing choice from people who will then be kept alive like the pitiful dog in The Fly II, this robs terminal patients who wish for a swift passage of their dignity and accords all of that dignity, honor, and choice to God. God gets to decide that. Only God can decide when we live and die (unless we're in a war with them, but that's okay because someone said he had a chat with God and it's all cool). God is revered; we traded your dignity in and got you a bedpan instead. We will make sure you get long use of it.

"Fuck your God" shows that one does not give dignity and honor to someone else's God. That God doesn't get to decide, and that God's followers may not steal the choice from others. "Fuck your God" may not get your dead mother's dignity back, but it doesn't leave it in the invisible hands of someone who, assuming they exist, could hardly need it anyway.
posted by adipocere at 10:15 AM on October 10, 2008 [9 favorites]

Is that so hard to fathom?

Is it so hard for you to fathom that the depressed, the disabled, and the poor have the exact same rights to personal decision-making as the rest of us do? Yes, there are things we ought to do to ensure that people make these serious decisions as free of undue pressure as possible -- and fixing our crappy profit-first health care system is first on the list -- but that doesn't mean that people aren't capable of making these decisions at all.

The paternalism here is disgusting, and quite revealing as well. Again: why, we can't kill these people, that would be cruel and inhumane! Instead, we must artificially force them to live on, often in unrelenting pain and/or with little or no ability to move, until they finally die from "natural" causes, all the while ignoring their pleas to the contrary!

Come on. We treat our pet cats with more respect than this.
posted by vorfeed at 10:27 AM on October 10, 2008 [2 favorites]

We treat our pet cats with more respect than this.

I had my cat euthanized last week because, due to age, her body completely shut down. She stopped eating, could barely get up and walk, and just shit where she lay.

Why should I not be allowed to be eutanized if I can no longer take care of myself?
posted by C17H19NO3 at 10:41 AM on October 10, 2008 [1 favorite]

>The paternalism here is disgusting, and quite revealing as well. Again: why, we can't kill these people, that would be cruel and inhumane! Instead, we must artificially force them to live on, often in unrelenting pain and/or with little or no ability to move, until they finally die from "natural" causes, all the while ignoring their pleas to the contrary!

Because it's not like I haven't formed my views about assisted suicide by listening to the opinions of actual disabled people on the subject, or anything. And it's certainly like I'm not a clinically diagnosed depressive who's been on SSRIs since my late teens --

Oh, wait.
posted by bettafish at 10:49 AM on October 10, 2008 [2 favorites]

resurrexit Yes, actually its quite hard to fathom. We're talking about a starting point of granting people the right to make decisions about their own lives. Decisions which are currently mandated by the state. You're talking about somehow, by magic apparently, putting decisions about our lives into our hands turning into the state making decisions for us. You are arguing that control over the end our life continue to be in the hands of the state so that control over the end of our life not be in the hands of the state.

Ironically here in Texas, a place where assisted suicide is ranked along with devil worship, we find that, I think in large part because control of the end of our lives is in the hands of the state, HMO's are removing life support from people who *don't* want to die. Texas, while standing strong against assisted suicide, has a "futile care law" that allows doctors to remove life support from people, against their wishes, if they can't pay for it. [1]

In other words we have the exact situation you claim to be against, not in some dystopian future as the result of idiots like me who think we ought to be in control of our own deaths, but right this second as the result of wise people like you who think the state should be in control of our death. It'd be funny except that the Hudsons ar mourning their daughter, fully aware of the fact that neither she, nor they, had any choice in the matter.

ROU_Xenophobe As I pointed out above, right now our "culture of life" is granting that decision to HMO's despite the fact that assisted suicide is illegal. Which, I think, rather takes the air out of that argument.

[1] Unfortunately the story was only carried by a few papers, the Houston Chronicle among them, and it appears to be archived away. The Wikipedia article on Sue Hudson, the dead baby, has some links.
posted by sotonohito at 11:03 AM on October 10, 2008 [2 favorites]

My wife's grandmother - one of the greatest women I've ever met - went in to the hospital for surgery at age 88. She came through the surgery fine but after a couple of days in the recovery room she developed an infection. The infection gradually ate away her skin, starting from her legs and working its way up. It was too much for her old body to beat.

The doctors all agreed that there was nothing left to do and that it was only a matter of time. She had consistently told us that if she was ever in this situation we should pull the plug. The entire family agreed that this fiercely independent woman would want nothing to prolong her life, and should die as comfortably as possible. She was released from the hospital and sent home under the care of an in-home hospice provider. A Catholic hospice provider. She had no machines to help her breathe or eat: only a morphine drip to keep her numb to the pain and occasional water swabbed from a damp washcloth on her tongue.

Her family took shifts and sat watch as this once lively, wonderful, life-filled woman slowly died - essentially waiting until she starved to death or the infection ate her. We had few meaningful exchanges with her - her mind was far, far away from her body - and could only sit and watch her go. We literally went from praying at the hospital for her recovery to praying at her home for a comfortable death.

That week made me sad about and angry at those who are so strongly opposed to right-to-die laws. Here was a Catholic group - allegedly committed to allowing persons to die with dignity - that was ensuring that a helpless old woman would drag out her life only until her body refused on its own to continue.

There are surely gray areas all over this debate. But after the plug is pulled - when it gets to the point when medical science acknowledges that death is imminent, and an entire extended family wishes for a quick, painless death over a week-long period of watching the body slowly shutdown - it's hard to see that as anything but black and white.
posted by AgentRocket at 11:04 AM on October 10, 2008

There are surely gray areas all over this debate. But after the plug is pulled - when it gets to the point when medical science acknowledges that death is imminent, and an entire extended family wishes for a quick, painless death over a week-long period of watching the body slowly shutdown - it's hard to see that as anything but black and white.

Oh, absolutely. But right-to-die laws never seem to be restricted to those post-plug moments, and that's what concerns those who are (or whose loved ones are) most vulnerable to being caught in the gray areas.

I'm very sorry for your loss.
posted by bettafish at 11:17 AM on October 10, 2008

mightshould's point about DNR's and Living Will directives not being adhered is spot on. My mother has a DNR and an "advanced health care directive" (aka living will). At 90, she had to have surgery. I spoke with the surgeon beforehand and he said:"I notice your mother has a DNR. Is this what you want for her?" I was shocked, but managed to answer: "No, this is not what I want, it's what she wants."
By extension, that's what I wanted to - but I was trying to make a point.
The biggest surprise was when the surgeon then said: "I see. Well you should know that if she arrests during surgery, we may not follow that order."
What. The. ***?
I found out that surgery is apparently a 'special case' - and all the planning in the world won't stop a hospital or surgery staff from doing what they think is best (and will keep them from a malpractice suit).
Another point is: If this really about "God's will", then shouldn't we be taken off any artificial support and allow that will to manifest itself naturally? Don't get me wrong, I support right-to-die, I'm just asking those who would follow religous 'law' - it strikes me that our surgeries, procedures, and other techniques for prolonging life are far more intrusive in "God's will" than any right-to-die initiative.
Of course, if the last paragraph is true, then we have to foresake all medicine, vaccinations, blood tranfusions, antibiotics - talk about a slippery slope!
posted by dbmcd at 11:21 AM on October 10, 2008

The paternalism here is disgusting, and quite revealing as well. Again: why, we can't kill these people, that would be cruel and inhumane! Instead, we must artificially force them to live on, often in unrelenting pain and/or with little or no ability to move, until they finally die from "natural" causes, all the while ignoring their pleas to the contrary!

Who is arguing that? There is a false dilemma--and I stand educated on its meaning--between suicide and artificial life support. It presupposes that one is on artificial life support in the first place. There is another option: just living with, and dying from, whatever's killing you. For most of human history, that was the only option. No one's trying to FORCE anyone to DO anything. If YOU get on life support, that's YOUR deal.

Agent Rocket: a helpless old woman would drag out her life only until her body refused on its own to continue.

That is the definition of death. Life goes on until it doesn't. Death is natural. What is wrong with that?
posted by resurrexit at 11:22 AM on October 10, 2008

You're totally right; unmitigated selfishness impels all those opposed to a right to suicide.

I certainly didn't say this.

I don't think we were discussing unmitigated selfishness. I was addressing the statement "for Dan Savage the sum of human existence is Dan Savage." I'm sure Dan Savage is aware of other humans outside of himself, and I haven't seen any evidence or argument that Dan Savage is some particularly hide-bound specimen of humanity, so the only reasonable interpretation of that statement left for me is the one which seems tautologically true: Savage's understanding of humanity is largely shaped by living inside Dan Savage's life, family, skin, brain, by having experiences like the one he just wrote about. And that's pretty much true for everybody, even altruistic people opposed to the right to suicide.

But if we *are* discussing unmitigated selfishness, I don't think it's an easy row to hoe to claim that people motivated by a desire to see their loved ones suffer less and who would willingly give up precious time with them to accomplish this goal are deep in its throes. You're on far better footing arguing that these people *might* be shortsighted (because it could lead to an increased acceptance of death as a solution to human suffering or struggle in situations outside of those near the end of the course of a terminal illness and that has far better footing).

we just don't want anyone deciding when anyone dies...what if, in the not-too-distant future, we aren't the deciders anymore, and there's a tradition in place of people making decisions about when people die. That is simply inhuman.

I'm afraid that as long as there is death, it's an inevitable part of the human experience, having to make decisions from which life-and-death consequences flow. I agree with your concerns about the problems associated with it, but I think there may be ways of coming to grips with the issue that don't necessarily implies a loss of humanity or genuine respect for life. And I think accounts like Savage's humanize the issue rather draining the humanity from them.

But on the other hand:

"Fuck your God" shows that one does not give dignity and honor to someone else's God.

"Fuck your God" says that you've discarded even any pretense of civility and respect for your neighbors, that you're only too happy to take the easy way out and generally spit on what they may find sacred rather than look for any common ground. I can excuse that in a moment of real and human grief, and Savage has my sympathy because it's not hard to imagine that's probably where he justifiably is at this moment. But it also blemished what might have been an entirely sympathetic narrative for some people.
posted by weston at 11:24 AM on October 10, 2008

Folks who know me know that I am a deeply spiritual person.

Despite that, if I were a member of a religion that sought to restrict my access (let alone others') to assisted suicide, I would quit that religion immediately. That's how strongly I feel about this issue.
posted by kalessin at 11:28 AM on October 10, 2008

P.S. @weston,

"Fuck your God" says that you've discarded even any pretense of civility and respect for your neighbors, that you're only too happy to take the easy way out and generally spit on what they may find sacred rather than look for any common ground.

It may be difficult to believe, but while Savage's words were not the ones I would have used, I strongly sympathize with caving to the temptation. The situation with respect to my ability to take action on what I feel is my "right to die" has gone so far, and rhetoric used so extreme in seeking the limitation of that right, that I feel that the other side has already discarded pretense of civility and respect.

From my point of view, and I suspect from Savage's own point of view, I'm not the aggressor in this situation. As the victim, I already feel that I don't have any respect or civility I can count on, and therefore if I cave and become disrespectful or incivil myself, it's not really that unforgiveable.
posted by kalessin at 11:31 AM on October 10, 2008 [2 favorites]

right now our "culture of life" is granting that decision to HMO's

Man, this pisses me off. Find me someone, other than a shareholder, who is happy with this situation. No one in the "culture of life" is making that decision to let little babies and old women and pet cats die; THAT is the result of a despicable BUSINESS decision made by profit-driven insurance companies who pay the hospital bills when we can't.

A solution to this is not to have a managed insurance plan where someone else decides what care you get. Just pay for your own care! Easy! Or don't, if you're like the rest of the 99.9% of us who can't, but then you just die at home if/when you get sick. Now THERE's a dilemma.

But DON'T blame this on people who care about life. No one is happy with this outcome. It sucks for everyone.

But noooo, what's the offered solution? Let people start deciding when they'll die? That'll factor nicely into the aforementioned insurance business model. I can hear my agent now: "COMPREHENSIVE HEALTH AND LIFE INSURANCE SPECIAL THIS MONTH, ONLY $10,000 A MONTH! OR $10 A MONTH, IF YOU SIGN THIS FORM SAYING YOU WILL KILL YOURSELF IF YOU GET SICK!"

Eff insurance companies and eff suicide.
posted by resurrexit at 11:39 AM on October 10, 2008 [1 favorite]

Oregon has had the Death with Dignity Act for over ten years. Funny how Savage mentions the Netherlands, and not Washington's liberal neighbors to the south.
posted by captainsohler at 11:52 AM on October 10, 2008

weston re: "Fuck your god" wrote "you've discarded even any pretense of civility and respect for your neighbors"

Wrong order. His neighbors (in this case essentially the whole USA) discarded even any pretense of civility or respect for him by forcing him to abide by a theocratic law. You can't demand my respect while having no respect for me. You can't demand civility from me while treating me in an uncivil fashion. What could be less respectful, less civil than saying "fuck you buddy, my god says you've got to suffer in agony and I'm going to force you to submit to my god's sadistic demands"? I literally cannot imagine anything less respectful or civil than forcing others to submit to the whims of a religion.

"Nevermind your beliefs, your pain, your thinking, I've got a 2,000 year old book so do what I say". There's a lot of words to describe that sort of behavior; civil and respectful aren't in the list.

Think about it: he just watched his mother die in pain because religionists said, in essence "God wants this". What response other than "fuck your god" is appropriate? Any being who wants that should be dismissed with as much venom, disrespect, etc as possible.

resurrexit But the point, which you haven't addressed, is that this took place right here in Texas. Home of some of the most rabid "culture of life" types in the USA (and, I should mention with the blessings of Bill O'Reilly stalwart of the Culture of Life).

Self evidently the very forces you claim can, must, protect us from such things have failed miserably in that task. The nasty part of me argues that this is because a) most "right to lifers" don't actually give a damn about babies after they're born, and b) they never cared about people who weren't white anyway, and c) the whole thing is a pathetic lie given that most of them support war and the death penalty.

But the point is that you've been telling me that we must offer up the pain of those suffering from terminal illness as a sort of sacrifice to prevent this sort of thing from happening. Its bad, you say, for people to suffer but the alternative would be worse. If we let people take control of their own deaths then maybe, possibly, down the slippery slope, the HMO's would start killing people for profit. But the shield of pain hasn't worked. People are still forced by the state to die in agony rather than being allowed to end their own lives quickly and painlessly and, despite their pain, the HMO's are still killing for the bottom line.

How's this sound for an alternative: make it entirely the decision of those dying. Pass a law that takes the decision completely out of the hands of the HMO's, doctors, government, etc and puts it entirely in the hands of those dying. No more plugs being pulled without consent, no more suffering at the demand of the state, instead we'd chose when we die.

Because right now we've got the worst of both worlds. HMO's are killing for profit *AND* those suffering horribly can't end their pain. Your "solution" doesn't work, the Hudson case demonstrates beyond any possible counterargument that your "solution" has failed miserably. Since your position is a complete and utter failure (and I hope that in the face of evidence you'll concede this point) how about we try the other way? Or must we continue to offer up our pain as a futile sacrifice to attempt to ward off the HMO's?
posted by sotonohito at 11:53 AM on October 10, 2008 [4 favorites]

My mother just passed away a little over 3 weeks ago. She'd been suffering from cancer for years, but a wide variety of treatment options kept her alive and in relatively good health (at least from the standpoint that you wouldn't know you were making arts & crafts with a woman who was terminally ill). She had a lot of energy.

The last time I saw her, about 2 weeks before she passed, she was on an oxygen tank. The nurse said she didn't "need" it to breathe, per se, but that it was more of a soothing comfort for her.

She had always told us, when buying her dream home in rural Colorado, "this is the house I will die in" - years before anyone, including her, ever thought her cancer would return and take her life. So, her wishes were respected and she did in fact live her final moments in a temporary bed that was hauled into the living room for her.

She'd also made it a point that she never wanted to be kept alive by machines. That if the choice came, she'd rather they just pulled the plug and let her go quietly than to sit there comatose for days on end, being forced to hold on against her will.

Because of that request, the hospice nurse who would visit her daily told my sister and I "when she's ready - she'll give up and go quietly", and she had enough pain medication to knock out a fleet of elephants. About a week before her death, she stopped eating. We figured she had made her choice. 2 days later, she was unable to drink anymore fluids. They could've forced fluids into her system through an IV, but she also refused that option. Any fluid that she'd tried to drink would immediately flood her lungs.

In her frail state, it was assumed she wouldn't live more than 2-3 days without water - but she managed to hang on for 5 more days. Passing away 15 minutes into her husband (my stepfather)'s 60th birthday. After all, she promised him she would be there for it.

It's fair to say she chose her time to go. My stepfather, and the nurses who were present, all said she went quietly, didn't go into convulsions, and didn't appear to be in any pain since they were able to use an oral liquid morphine dropper.

Sure, my sister, stepfather, and I had all wished to see her stay around as long as she could. But, in those final weeks, she just wasn't the woman we knew anymore. She could barely talk, needed help just to walk around, and faded in and out of sleep for most of the day. Effectively, she was being kept alive as a comfort to us - certainly not to her. For all that this woman has done for us and the people she loved, it would be the epitome of rudeness and insensitivity to keep her alive against her will. She just wanted peace. And, she certainly deserved it - laser surgery, chemotherapy, radiation treatment, chemo pills - I can't imagine having to go through all of that only to find out that it basically extended her life maybe another 2 years.

It was worth it to her, and to us, because those were 2+ years of spending time with her at her fullest of energy, laughing and carrying on like there was nothing wrong. She even had us fooled that maybe all the doctors were wrong.

If my mother had been forced to hang on, and was forced onto machines that breathed for her, IVs that kept her fed, and god-knows-what-else that would make her more machine that human - it wouldn't have improved anyone's quality of life, certainly not hers. Life should be about quality (my mama taught me that), and she got all the qualities of life she'd wanted until the very end. It's sad, but in a way, it's beautiful.

She ended on her own terms. Not on the terms of an uninvolved religious zealot who doesn't truly understand that "value of human life" thing they're always yammering on about.
posted by revmitcz at 12:09 PM on October 10, 2008 [1 favorite]

Savage's words were not the ones I would have used

That's enough for me. Choose to voice your argument rather than your anger and you're more than halfway there.

I buy adipocere's point that there can be legitimate arguments behind that anger, but I think it actually highlights my point -- the arguments he articulated were far more convincing than "fuck your God."

I strongly sympathize with caving to the temptation.

I definitely do too. Watch me enough and I'm sure you'll see me cave just like anybody else.

rhetoric used so extreme in seeking the limitation of that right, that I feel that the other side has already discarded pretense of civility and respect

That's why it's so important, otherwise there's nothing left but escalation.
posted by weston at 12:11 PM on October 10, 2008

sotonohito: Self evidently the very forces you claim can, must, protect us from such things have failed miserably in that task. The nasty part of me argues that this is because a) most "right to lifers" don't actually give a damn about babies after they're born, and b) they never cared about people who weren't white anyway, and c) the whole thing is a pathetic lie given that most of them support war and the death penalty.

Ooh. That is a nasty part. Better get that checked out.
posted by resurrexit at 12:18 PM on October 10, 2008

This is a touching thread, for the most part. I have yet to decide how I am going to vote on this in a couple weeks and I have to say, I am very conflicted. I am absolutely in favor of ending suffering and full patient (informed) autonomy. In medicine, we all know what the order "Morphine drip. Titrate to comfort." means. I've written it many times.

But in the U.S., we don't do this kind of thing well. There aren't enough doctors and they don't have enough support services, particularly social workers and mental health professionals. Too many people don't have access to effective treatments, and I hate the idea that someone might choose assisted suicide because they have no other good alternative. Mistakes happen all the time, even when hard working people really mean well. 20% of us even have advance directives and they are often not available at the time they are needed. Worse, families and doctors often ignore them. Couldn't we just fix everything else first, before we do this? Yeah, right.

Medical ethics have clearly been moving in this direction and, assuming we can save the health care system, I think this will definitely come to pass broadly in our lifetimes, and I'm all for it. I just don't know if we're ready for it. I'll probably vote for it in the end, but like I said I'm just very conflicted.
posted by Slarty Bartfast at 12:25 PM on October 10, 2008

Your "solution" doesn't work, the Hudson case demonstrates beyond any possible counterargument that your "solution" has failed miserably. Since your position is a complete and utter failure (and I hope that in the face of evidence you'll concede this point) how about we try the other way? Or must we continue to offer up our pain as a futile sacrifice to attempt to ward off the HMO's?

You have obviously misunderstood my position.
posted by resurrexit at 12:30 PM on October 10, 2008

Great. Now that I'm done weeping my eyes out at my desk I can sniffle for the rest of the day.

This is one of those things you shouldn't be able to decide for other people, especially if you haven't been in the situation. Like abortion.

Thanks for the link.
posted by threeturtles at 12:36 PM on October 10, 2008 [1 favorite]

revmitcz: Your story was very touching. I am glad your mother was able to go out on her terms. We should all hope for this.

I guess I just don't understand your last sentence (Not on the terms of an uninvolved religious zealot who doesn't truly understand that "value of human life" thing they're always yammering on about.). What terms would an uninvolved religious zealot have had other than those upon which your mother died? Honestly, until I read that sentence, I was expecting to read "And that's just how God would have wanted mama to die."
posted by resurrexit at 12:37 PM on October 10, 2008

eutanized

Er..EUTHANIZED.

it's starting already
posted by C17H19NO3 at 12:46 PM on October 10, 2008

resurrexit:
There is no right to kill yourself in the Bill of Rights.

If you're read the Bill of Rights that closely, surely you've also read the Ninth Amendment, which says, essentially, "Just because this document doesn't explicitly spell out a particular right doesn't mean the people don't possess that right."
posted by Amanojaku at 12:47 PM on October 10, 2008 [7 favorites]

No one's trying to FORCE anyone to DO anything. If YOU get on life support, that's YOUR deal.

I watched my mother die six weeks ago. She went into surgery - minor surgery, completely unrelated to the infection and other issues that killed her - and, as noted by dbmcd above, the doctors put her on life support against all her wishes and her DNR because that's what they do in surgery and in the recovery room, regardless of what you want. My brothers and I, stunned and shocked by how fast it all went from "everything is fine" to "your mother is tenuous and we've put her on a respirator" couldn't do anything about it. So no, it isn't always your deal, resurrexit and it's a little facile, to say the least, to suggest that anyone who goes to the hospital is asking to be put on life support.

However. They took her off the respirator and she lived two more weeks and then at the very end, the ICU nurse quietly, gently told us that if we didn't put her back on life support she wouldn't make it and that was our choice. She, the nurse, could make my mother comfortable for a little while or she could call the doctors and start the machines going again.

We had the strength at that point to make the choice that our mother wanted - and we knew she wanted it because for years and years and years she had not only told us she wanted it but often refused all medical care in fear of a terrible, blasphemous, wrong Terry Schiavo type situation. And I do say blasphemous, because I cannot imagine anything that would go more against gods' wishes, any god worthy of belief, than forcing someone to stay alive with medical technology when their time has clearly come. Neither could my mother and I will always be grateful to that ICU nurse and to the doctors who mysteriously could not be found and for that last hour that I sat and held my mother's hand and talked to her as she left.

That was my mother's choice to make and she had made it long since, as I have. My father made the same choice and died at home. We honored their wishes and their decisions. It isn't anyone else's decision to make. I think if someone had tried to hook my mother back up to the respirator, intubate her and bang on her heart that my brother and I would right now likely be arguing for justifiable assisted homicide. There is no time that this decision is ever not a personal one and nobody else has any say in it whatsoever. There is also no time in which it is an easy decision to make but there are many times, in this world of medical miracles that will keep your vegetable self breathing far too long, when it is clearly the right one.
posted by mygothlaundry at 12:48 PM on October 10, 2008 [11 favorites]

resurrexit :
I guess I'd have been better served by using your line, sure ;)

But, what I meant is that (like in the case of Savage's "fuck your god" line) if someone had said "no, no, we must do all we can to keep her alive" and not give her the choice to just go out in peace without all the machines doing the work for her -- they can just go fuck themselves.
posted by revmitcz at 1:01 PM on October 10, 2008

Because it's not like I haven't formed my views about assisted suicide by listening to the opinions of actual disabled people on the subject, or anything. And it's certainly like I'm not a clinically diagnosed depressive who's been on SSRIs since my late teens -- oh, wait.

Because it's not like I haven't formed my views about assisted suicide by listening to the opinions of actual disabled people on the subject, or anything. And it's certainly like I'm not living with an incurable chronic pain disorder which may eventually lead to disability-- oh, wait. Looks like I can play the same card you can!

Again, this is about choice. I never said that people have to commit suicide, or even should commit suicide, merely that they should be able to decide for themselves. You're the one making decisions for other people, not me; as far as I'm concerned, all people should be able to choose to live, or not, just as they themselves personally wish. To deny this choice to the disabled and depressed is to give in to precisely the same forces which claim that these people cannot live fulfilling lives, and must therefore be forever patronized by their "betters"... for their own protection, of course! Sorry, but I don't buy that, particularly because I may wish to make this choice for myself one day.

No one's trying to FORCE anyone to DO anything. If YOU get on life support, that's YOUR deal.

As others have pointed out, life support is not always -- or even often! -- a choice, mostly because of the life-above-all-else cultural values you seem to be advocating. Besides, why is turning on life support THEIR deal, but turning it off again is suddenly YOUR deal? For that matter, what's the real difference between voluntary pallative-care-only hospice and voluntary assisted suicide? The intention is the same, the motivation is the same, the need for a care provider to carry out the particulars of the decision is the same, and the end result is the same. The only difference is an intervening period in which someone who wishes for death must wait for it, an intervening period which seems quite cruel when forced on people who do not wish to wait for it.

There is another option: just living with, and dying from, whatever's killing you. For most of human history, that was the only option.

Are you actually, seriously suggesting that we recently invented suicide? I'm sorry, but this statement is ridiculous. Some ancient civilizations explicitly considered suicide to be superior to dying in bed; others tolerated or even celebrated suicide under a number of different circumstances, including illness; still others proscribed it in almost every case. In short, views on suicide and euthanasia varied wildly throughout the ancient world, and, one can assume, during pre-recorded history. "Living with, and dying from, whatever's killing you" was by no means the "only option" for our ancestors, which is one of the reasons why it makes little sense to make it the "only option" in our own society.

Again, you seem to have a tremendously narrow idea of history. "Most of human history" did not occur between 1 B.C. and today!
posted by vorfeed at 1:03 PM on October 10, 2008 [5 favorites]

Look, my apologies for not qualifying the statement the second time I made it; I had done so earlier (above, "It's your choice, unpredictable exigencies aside, to get "plugged" in the first place."). I am sorry about your parents.

That said, maybe I misunderstand you; I am opposed to assisted suicide and yet I agree with everything you said in your post except possibly the last sentence.

I get the impression that some of you here think I am arguing that people who are dying should be hooked up to a life support mechanism in a hospital and not be allowed to die. Is that true?
posted by resurrexit at 1:12 PM on October 10, 2008

*the statement = "No one's trying to FORCE anyone to DO anything. If YOU get on life support, that's YOUR deal."
posted by resurrexit at 1:17 PM on October 10, 2008

and *you is mygothlaundry.
posted by resurrexit at 1:18 PM on October 10, 2008

As I pointed out above, right now our "culture of life" is granting that decision to HMO's despite the fact that assisted suicide is illegal.

No. What would be an example would be if the HMO denied your father hospice care or made actually getting hospice care very difficult, implicitly because euthanizing him was cheaper. What you're talking about in that example seems more like DEA nonsense than anything else, like a friend's father who couldn't get morphine for his endstage terminal cancer because it's addictive.

Look, I want people to be able to die painlessly. I just don't trust American HMO's to not deny funding to more expensive options when assisted suicide or euthanasia are legal alternatives, or at least I don't trust them to make palliative care or hospice options so, well, inconvenient is the wrong word, that it's rarely chosen even by people who want it. I don't trust them not to require that if you want hospice care, you need certification of the terminal nature of the illness by five different specialists and unrelated administrators, and you have to deliver the paperwork in person to their office three counties over, and there's still a three month delay.
posted by ROU_Xenophobe at 1:20 PM on October 10, 2008

Again, this is about choice. I never said that people have to commit suicide, or even should commit suicide, merely that they should be able to decide for themselves. You're the one making decisions for other people, not me; as far as I'm concerned, all people should be able to choose to live, or not, just as they themselves personally wish. To deny this choice to the disabled and depressed is to give in to precisely the same forces which claim that these people cannot live fulfilling lives, and must therefore be forever patronized by their "betters"... for their own protection, of course! Sorry, but I don't buy that, particularly because I may wish to make this choice for myself one day.

Actually, if you'd actually read what I wrote, you would notice that I want everyone to be granted choice through a robust law that protects them from abusive loopholes. Get off your high horse and stop projecting.
posted by bettafish at 1:22 PM on October 10, 2008

Not going to contribute anything substantive to the discussion, other than to heartily echo the sentiment "Fuck your God!" You as a religious person, as misguided and intellectually pathetic as you are, are free to pursue any code of behaviour you deem appropriate, but your right to do so ends where it affects my ability to carry out my life as I wish to. Why should I feel compelled to indulge in your fantasy of an invisible, vengeful, man who lives in the sky? If I made up an equally illogical story, claiming it gave me comfort but also, by the way, it required you to change your behaviour in matters as essential as how you were able to choose how to die, what would you say to me? I must be right because I have so much faith in my story? Fuck your imaginary god.
posted by Turtles all the way down at 1:29 PM on October 10, 2008 [3 favorites]

It is how I'm reading what you're saying, resurrexit. I don't see the difference, myself, between unplugging someone and letting them die and offering them the option of ending their life before they even get to that point, as vorfeed has eloquently argued above. I'm not a doctor or a nurse, I don't know for sure what my mother got at the very end. I'll never know whether the ICU nurse gave my mother morphine and ativan to ease her passage or whether she actually sped it up but either way I'm grateful to her.
posted by mygothlaundry at 1:31 PM on October 10, 2008

I get the impression that some of you here think I am arguing that people who are dying should be hooked up to a life support mechanism in a hospital and not be allowed to die. Is that true?

Personally, I get the impression (since reading your comment at 11:39) that you're arguing that if people who are dying are hooked up to a life support mechanism in a hospital, they should not be helped to die by removing said support. I read your postion as: they should not be hooked up to machines in the first place, but if they are, a "natural" death is still the only option, and while nothing must necessarily be done to stop it, nothing should be done to hasten it, either. If that's incorrect, please clarify.

As I said above, I don't really see a moral difference between removal of life support, pallative-care-only hospice, and assisted suicide, provided that all are voluntary. Thus, I don't really see the point in your distinction, though I'm willing to grant that you do.

Actually, if you'd actually read what I wrote, you would notice that I want everyone to be granted choice through a robust law that protects them from abusive loopholes. Get off your high horse and stop projecting.

You're the one who replied to a statement of mine, which was not even directed to you, with a bunch of angry projection and high-horse crap. If you can't take it, don't dish it out.

Besides, the articles you linked to have very little to do with "choice through a robust law that protects them from abusive loopholes", and very much to do with "we oppose assisted suicide, full stop", so you can't be surprised that I assumed you agreed with them. I mean, it's not as if NotDeadYet.org is a nuanced, middle-of-the-road organization. The front page says, "other national disability rights groups have joined NDY in opposing legalized assisted suicide". There's nothing there about loopholes, and there's nothing there about choice. Same with noassistedsuicide.com: "Patients have a right to care, not suicide". What, am I supposed to believe that they meant something else, but "noabusiveloopholes.com" was taken? Give me a break.
posted by vorfeed at 1:44 PM on October 10, 2008

Don't want life support? Don't go to the hospital.
posted by resurrexit at 8:44 AM on October 10

sounds great dickhead let me know how i could have gotten my grandmother the morphine she needed so that at least when she finally was allowed to die she could have done so without unbearable pain

oh hang on grandma let me just pop on down to the heroin dealer so we can choose not to go to the hospital
posted by Optimus Chyme at 1:45 PM on October 10, 2008 [5 favorites]

It amazes me that you all don't understand 'the slippery slope'. The slippery slope protects us from bad people using bad things to harm innocent people.
You see, if we had allowed Saddaam Hussein to continue stockpiling all those weapons of mass destruction it would obviously have been the beginning of a slide down one of them slippery slopers. Next thing he would have invited all them alkidas in and trained them to hurt us. (Usians) This then would have hurt us where we would really have felt it. Gasoline would have shot up to three dollars a gallon. But by taking care of things preemptively we avoid the slippery slope. You all understand slippy slopes now. You better or I will commence to splain how this right to self determination works in regards to the right to self extinction.
posted by notreally at 2:12 PM on October 10, 2008 [1 favorite]

Man. Does this ever suck.
Mrs. notreally says I have to apologize.
Sorry. My bad.
posted by notreally at 2:17 PM on October 10, 2008

I missed the part in the Bible that says once you've extended someone's life, you must keep extending it until that person dies in agony. Once you've accepted the responsibility of prolonging life, you also have to accept the responsibility of ending it well.
posted by shetterly at 2:59 PM on October 10, 2008 [2 favorites]

@weston,

I don't feel like you heard me. I think you just heard my semi-moderating tone. Let me say this again. I strongly sympathize with Dan Savage saying "Fuck your God". Because I am more compromise and community oriented, I don't think I would use precisely those words, but in this discussion, I'm already there, mouthing the same words. The folks who, moral and religious, use legislation to keep me from being able to exercise my rights because they're uncomfortable with my exercising my personal ethical and moral choice to exercise those rights have driven me to feel like "Fuck your God" is the only effective thing I can say.

I don't feel listened to. I don't feel like the respect that I came to this situation offering is being reciprocated. I don't feel like anything other than, "I'm glad you calmed down, now we can talk" is being said, which really does nothing to make me feel like my arguments and expectations are being respected.

I only come out of the "discussion" feeling like I've been quite effectively silenced.
posted by kalessin at 3:26 PM on October 10, 2008 [1 favorite]

I guess if I lived every day with the spectre of being told God had condemned me long ago for my sexuality I'd be ambivalent as well. So yeah, Fuck God, if God is your idea of a cudgel for taking away people's autonomy and dignity and providing a cover for institutionalized child-rape. And fuck the delicate sensibilities of people that don't get that simple fact.
posted by docpops at 4:01 PM on October 10, 2008 [1 favorite]

As a child, I watched the mother of my father's friend die slowly and in great pain from cancer. This was her choice, and she lived, then died with great courage and strength. I admire her for that.

Later, I worked in a nursing home. I saw dignified, obviously chosen deaths. I saw an angry woman starve herself to death because she thought she was being disposed of by being put in a nursing home and because the doctor didn't believe her stomach hurt (an autopsy found stomach cancer). I saw people die easily, others died hard. Very hard.

Then AIDS hit. I watch more people die hard, hard deaths.

Now, my mother has Alzheimer's. She's begged us kids for the last 20 or more years to kill her if she ever got dementia or became mentally incapacitated.

Not letting people make their own choices not only forces suffering, but belittles the courage and strength of people like Mrs. Hilburger, my father's friend's mother.

I do not want to spend a long time dying in pain. If I can make that decision for my pets, why can I not make it for myself?
posted by QIbHom at 4:02 PM on October 10, 2008 [1 favorite]

Frankly, the "debate" over Death With Dignity acts confuses the hell out of me. I hear slippery slope, HMO problems, people with disabilites, etc and so on. Basically a whole lot of vague worrying. Why don't we take a look at the first law of its kind in the United States, the Oregon Death With Dignity Act. From Wikipedia:

Under the law, a capable adult Oregon resident who has been diagnosed by a physician with a terminal illness that will kill them within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient's life. The request must be confirmed by two witnesses, one of whom cannot be related to the patient, be entitled to any portion of the patient's estate, be the patient's physician, or be employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient's medical records and confirm the diagnosis. The patient must be determined to not suffer from a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time.

The law protects doctors from liability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute restrictions. Participation by physicians is voluntary. The law also specifies a patient's decision to end his or her life shall not "have an effect upon a life, health, or accident insurance or annuity policy." --Full Text of the Law

Can anyone tell me what's wrong with this law? What is there here that is so worrying and problematic? As a resident of Oregon, I've seen plenty of vague, wishy-washy initiatives. This is not one of them. I find this law to be one of the most clear, well-defined, and comprehensive laws out there. Problems about people killing themselves when there's no illness? Not allowed. Problems with people with disabilities killing themselves? Only allowed if the disability isn't mental. Doctor may be wrong about diagnosis? Requires a second opinion. Doctor may be forcing patient into it? Requires two witnesses. Witness may have conflict of interest? One witness required to be someone with documented lack of conflict of interest. Patient changes their mind? Patient must confirm a second time, and has the option to call it off at any point in time. If they do, they have to start the process all over again. Physicians shouldn't be forced into this? Physician participation is voluntary. HMO/Insurance worries? Mandated that this not be taken into account. Crazy social degredation via culture of death? As of 2007, 341 people have ended their lives under Oregon's Death with Dignity Act. The law has been in place since 1995. That's approximately 26 people per year.

Seriously, what worry is left that isn't already covered? Objections to this law seem to me to be fronts for religious mandate, plain and simple, as I can't see any other issues you'd have with this law.
posted by Axle at 4:07 PM on October 10, 2008 [7 favorites]

The stories in this thread reminded me a lot of my maternal grandmother's death. She had a severe stroke and my mother, her only child, was told that she'd die in a week if a feeding tube was inserted. She lasted two years, comatose and unresponsive. This was the late 70s, when there was no possibility of pulling the plug. My father died at 70 of a heart attack from which they couldn't resuscitate him, and I always thought what an easy death he'd had by comparison; a bit of pain, and an hour and a half in the hospital.

My mother is in her 70s now, and she's terrified of it happening to her; I have firm instruction and she has DNR paperwork. I can barely imagine what it would be like to know I faced not just a long dying, but terrible pain at the end as well, or for her to face that. I hope if she does, she's able to end her life on her own terms.

I'd vote for I-1000 in a heartbeat if it were on my ballot.
posted by immlass at 4:16 PM on October 10, 2008 [1 favorite]

A couple of years back my mom died of pancreatic cancer. She was able to take care of herself in her own apartment until the last month of her life (with some support from my brother living close by). During that last month she moved into my brothers place so she wouldn't have to spend her last days in a hospital. He took time off of work and took care of her until she passed. I traveled back home to Germany and joined them for that last month.
It had always been my mom's expressed desire (same as pretty much everyone else in my immediate family) that she didn't want to go on life support if there was no reasonably degree of hope for recovery and that she'd rather not suffer needlessly if it could be helped (she feared the moment she wouldn't be able to end things herself if needed). We had a nurse that would come by and provide basic medical care for her making sure that she was comfortable and ok. However it fell to my brother and I to obtain and administer any required medication including morphine for pain. Knowing my mom's stance on the subject and after some cryptic conversations loaded with odd figures of speech with the nurse and my mom's oncologist (who of course weren't allowed to address the subject openly) my brother and I started to squirrel away morphine on a regular basis. We had to keep a log of injections as morphine is tightly controlled in Germany. We knew that at least the nurse knew because there was a clear discrepancy between the used containers and the log but she understood what was going on and didn't intervene. Just in case you're wondering... we weren't withholding any morphine whenever my mom asked for it.
My mom was able to enjoy these last weeks. She spend all her time with us, talked a lot, had some cathartic moments of a confessional nature, made her peace with things, tied up a few loose ends... aside from the cancer eating at her it was actually a very good time, a very precious time for all of us. There was a sense of peace and beauty in everything. Then the cancer started getting the better of her and within a few days she was quickly fading. Eventually at the end of one particular day she stopped responding to us at all. She didn't move her limbs or eyes, didn't react to sound or touch. Her breathing became very labored and heavy, it sounded like she was gasping for air and choking. It seemed that if she was still aware she was truly suffering now.
At this point my brother and I decided to use the saved up morphine to help her with that last step. From her previous treatments she still had a "port" implanted in her checst (for administering chemo treatment directly into her blood stream). We got 2 syringes ready and were going to inject a massive dose of morphine directly into the port, both him and I at the same time. However, when we stepped up to my mom's bed she had just passed away. For a moment before the grief hit us we actually had to laugh... it was so like her. She never liked to ask for help and would try to do things quickly herself before someone had a chance to help her that had just offered to help. Typical!
Anyhow, of course we were relieved not having had to go through with this. But it was clear to us then and is clear to us now that we were about to do the right thing. We both would do the exact same thing again today under the same circumstances. To watch my mother choke to death slowly while she was no longer capable of moving or doing anything else about it... there was no dignity in it, no peace, just struggle and a silent plea for mercy.
So I'll join the chorus of those that say "Fuck your god". And as all the ones that have said it before probably would agree... that statement refers to the particular proclaimed true god of those who see it as their duty to enforce their moral and ethical standards on others. Someone said it before in this thread... if you think this is disrespectful then you need to think again. Maybe the disrespect starts the other way round when people try to take away the freedom of choice from others. If anyone had shown up and tried to force their moral superiority on us while my mom was laying choking and wheezing on her bed we would've probably beaten their ass and thrown them out on the street. And rightly so.
There was dignity and peace in my mother's last weeks with us. There was no such thing in her last hours. Anybody who thinks it would be better to force someone to ride everything out until the bitter end, even if it means endless hours of agony and suffering, needs to shut up and experience this stuff first hand. If they still think the same way after that... they need their head examined.
posted by Hairy Lobster at 4:56 PM on October 10, 2008 [3 favorites]

Isn't the right to die inherent in the act of living?

Axle Seriously, what worry is left that isn't already covered? Objections to this law seem to me to be fronts for religious mandate, plain and simple, as I can't see any other issues you'd have with this law.

Well, since you asked, it's this part, "a capable adult Oregon resident who has been diagnosed by a physician with a terminal illness that will kill them within six months." Six months seems awful abitrary. Why not just leave it at "terminal illness"? Some physically or emotionally agonizing illnesses can drag on longer than six months and/or may have their stage or progression inaccurately assessed. Why should someone who's been given a year to live have to wait and suffer if he chooses to end it sooner?
posted by notashroom at 7:21 PM on October 10, 2008

I agree, it is arbitrary. I was trying to see what there is about the law in its actual form to inspire such worrying in people. If it were up to me, I'd want the law to be more around a year to 2 years, but being the compromising person I am, I'm cool with it.
posted by Axle at 9:53 PM on October 10, 2008

Anyway, this is getting borderline on GYOBFW on my part, so I'll be sitting back to watch.
posted by resurrexit at 11:50 AM on October 10 [+] [!]

Then you go on to post 9 more times in the thread (by my count). There has got to be a Mefi Law about this that states that when someone says they are going to bow out, or sit on the sidelines, or avoid a thread, that they are bound to post more in it (typically many times more). I have seen it happen so many times it's not funny. In my head there's this little "wait for it..." that I hear as soon as I see such a statement, and then when inevitably the person posts another comment, an accompanying "...aaaand there it is!".
posted by marble at 10:19 PM on October 10, 2008

bettafish, fwiw, I read your post the same way vorfeed did, I was very glad when he responded as he did. He wasn't on a high horse- maybe your post was just worded badly.
posted by small_ruminant at 10:25 PM on October 10, 2008

I missed the part in the Bible that says once you've extended someone's life, you must keep extending it until that person dies in agony. Once you've accepted the responsibility of prolonging life, you also have to accept the responsibility of ending it well.

This really sums it up for me. If God didn't want us to end lives with a minimum of pain, then why did he give us morphine?

Frankly I'm for assisted suicide even for the depressed who are not terminally ill. We could make excellent use of their organs. I know I would have happily taken this option at several points in my life. I could have saved what, 5 people who wanted to live? But we're nowhere near that (yet, haha) and it's uncomfortably radical for me to even mention it. And it is not really the topic of this post. Sorry.

I worked in a nursing home for awhile. Nobody died on my hall while I worked there, but there were at least two that I futilely wished would be able to find peace as soon as possible. They were both so addled with Alzheimer's that they did not open their eyes, and their faces were grimaces of constant pain and discomfort. No communication whatsoever, no recognition of anything or experience of any pleasure that would take that pain away. I can only imagine how painful it was for their families. Hopefully they do not suffer any longer (it's been 4 years since I worked there).

How dare we withhold painless release from those who desire it? It's nothing short of torture, in my opinion. What is the point of humanity if we are going to be so inhumane to people who have not harmed or wronged us, are in pain, are dying anyway, and want to leave immediately?

The fear of dying in pain gives me nightmares. I want a high dose of morphine when the time comes. None of this forcing me to go without food or liquid til I die at the end. That's just brutal.

We all deserve the death we seek. Even the cruel, despicable ones among us.
posted by marble at 10:35 PM on October 10, 2008

Marble, if it's any comfort, I've seen studies suggesting that the fear of dying from thirst or hunger is greatly exaggerated in our culture. It's a hard way to go if you want to live--any way is. But for people who are weak or who want to die, you pretty much just get weaker until you slip away. I saw an article somewhere about refusing sustenance in a hospice. It recommended having a few ice cubes or popsicles available, so you could suck on them now and then to avoid a dry throat, which is painful.

I've never fasted for more than three days, but the third day was always the easiest. I'm not afraid of dying by hunger and thirst. Some religious communities think starvation is honorable suicide, because it takes a couple of days if you refuse liquids, or a few weeks if you only refuse food--you have time to reconsider or get your affairs in order.

Morphine makes sense. Strangulation seems to be fairly quick and painless, but drowning is hard on the lungs. I used to think freezing to death would be good, but it seems that toward the end, people dying of cold think they're overheated--it's not uncommon to find people who froze to death who have removed some or most of their clothes.

We've had four beloved cats die after long lives with us. We tried heroic measures to save the first, and only prolonged his pain. We were with the other three when a vet injected them. Some people say the drugs we use to euthanize animals are kinder than the ones we use to execute humans who are believed to have committed serious crimes.

Well. My current hope is to go into the woods or the desert and fast when the time seems right. My only fear is that someone will prevent me.
posted by shetterly at 12:37 AM on October 11, 2008

resurrexit :
you've been mefi-mailed to clear up confusion. I didn't, personally, take offense to your response to my comment, and I hope my follow-up comment didn't come off that way.

Sorry for the off-topic here, just wanted to clear that up.
posted by revmitcz at 12:48 AM on October 11, 2008

Too many posters are conflating assisted suicide with DNR and being hooked up to machines, mechanical feeding etc. You can already, legally, refuse these things. Assisted suicide is the *active* ending of life. It is a much different beast. It is *this* that many disability groups are against. It is this active ending of life option that could prove to be too tempting to bottom of the line thinking HMOs. It is not difficult for me to imagine feeling pressured to suicide rather than cost my family hundreds of thousands of dollars. As a person with disabilities and health issues, I've struggled against feeling guilty for "costing too much" throughout my life. Refusing to artificially extend life is acceding to nature, actively suiciding is not letting nature take its course, it's changing that course.

I am conflicted in this issue. There are a, very few, horrible diseases that I can understand this desire for suicide. For example there is a disease of the brain that causes the pain center to fire constantly. The pain is not in any part of the body, so there is no real way to alleviate the pain. One can knock the patient out, but they will still experience pain as evidenced by stressed vital signs.

However, this is an extreme outlier case. Good policy is not made by following extreme outliers. Good policy is made by considering the most common public health considerations. It is far more likely that someone could wind up needing a great deal of extensive treatment, could wind up needing a lot of assistance for daily living and be given this "option" to die. How do we tell if the choice is a logical thought out choice, and not a choice arising from (a realistic reaction of) depression? If you are healthy and able bodied and depressively suicidal, you are assisted to choose life. But under this thought, if you are suddenly severely disabled to a point that other people think "I couldn't live like that" it is suddenly a good thing to want death?

How do we tell if this is an honest, personal choice and not a choice out of concern for the cost to their family, both emotionally and financially. Do we allow someone to devalue their life this way? What about the family of a minor who has a severe birth defect, are they allowed to "compassionately" kill this child rather than deal with the disability to avoid the supposed suffering? These are the slippery slopes alluded to above. These are the slippery slopes that I think too many people avoid thinking about and insist are unrealistic. These are things that are realistic consequences of a legal assisted suicide option under the current US health system.

These are not concerns borne of religion and a "culture of life", these are the very real concerns of a person who has struggled both physically and emotionally to live. It has been very hard work to choose to live, but my life has been -- and is -- worth it. There were times in the past I was not convinced it would be.
posted by Librarygeek at 5:10 AM on October 11, 2008 [1 favorite]

There are a, very few, horrible diseases that I can understand this desire for suicide.

Well, good thing we aren't going by your understanding. As I stated earlier, Oregon's law is very specific. The disease must be terminal, meaning you will never be cured of the disease, and you must be diagnosed with only 6 months left to live. I wouldn't call that an "extreme outlier". There are a lot of people with illnesses like that.

How do we tell if the choice is a logical thought out choice, and not a choice arising from (a realistic reaction of) depression?

Again, the DSM-IV contains specific criteria for depression. The law in Oregon requires you to undergo psychological evaluation before proceeding with the process. Those people who are depressed will be rejected.

How do we tell if this is an honest, personal choice and not a choice out of concern for the cost to their family, both emotionally and financially. Do we allow someone to devalue their life this way?

First, so what if it is a choice based on emotional and financial cost? You're going to tell them they shouldn't be allowed to stop the emotional, financial, and physical costs? Second, why do you feel this is cheapening their life? What does that even mean? You're going to tell someone with a good reason to kill themself, that they can't because they're cheapening their life?

Do we allow someone to devalue their life this way? What about the family of a minor who has a severe birth defect, are they allowed to "compassionately" kill this child rather than deal with the disability to avoid the supposed suffering? These are the slippery slopes alluded to above. These are the slippery slopes that I think too many people avoid thinking about and insist are unrealistic. These are things that are realistic consequences of a legal assisted suicide option under the current US health system.

I don't see anyone avoiding thinking about slippery slopes. I see a lot of people asking how your slippery slope would come into play. In order to change Oregon's law, the majority of the populace would have to vote for a revision. Same goes for a new law. You're telling me the populace isn't smart enough to see the difference between an old person in significant pain wanting to end their suffering, and the parents getting the right to kill a minor who can't even voice their opinion on the matter? Cause there's a big gap between taking pills yourself as an adult, and killing a child. Your talk of consequences is foolish when you haven't even laid out an argument as to what would bring forth those consequences. Did you read the very real and not made up statistic I posted? Let me show you again:

As of 2007, 341 people have ended their lives under Oregon's Death with Dignity Act. The law has been in place since 1995. That's approximately 26 people per year.

Yup, sure looks like a slippery slope to me. That's 13 years that this law has been on the books, and only 341 people have used it. Are there any "kill your disabled child" laws on the books since? No. Are there any "euthanize your old relative" laws? No. When exactly is this slippery slope supposed to kick in?

These are not concerns borne of religion and a "culture of life", these are the very real concerns of a person who has struggled both physically and emotionally to live. It has been very hard work to choose to live, but my life has been -- and is -- worth it. There were times in the past I was not convinced it would be.

I'm glad you've chosen to take the hard road and grace us with your presence. I mean that unsarcastically. But with all due respect, did you have a terminal illness with 6 months left to live? No? Then the law wouldn't apply to you. And you can be damned certain that I would vote against any law that tried to make available the means to kill people who are physically healthy. Granted, the means to kill ones self exist all around us, but making those means readily available to those who have a long life ahead of them is foolhardy. The people who are affected by the law in question are people with 6 months left to live. They're never going to get better, as modern medicine can't cure them. That's it though. Those are the only people this law applies to.
posted by Axle at 9:23 AM on October 11, 2008

You can already, legally, refuse these things. Assisted suicide is the *active* ending of life. It is a much different beast.

As I said above, I do not see a difference between asking a doctor to turn off your machines so that you may die, and asking a doctor to inject you with morphine so that you may die. The one may seem less "active" to an observer, but I doubt that it seems that way to the doctor, or to the patient. Why should we make them both suffer through their painful roles for hours or days or weeks, simply so other people can feel better about their choices? This doesn't seem like "a much different beast" to me.

Also, most people don't die quickly when their life support is removed -- there are stories in this very thread of people who had to watch their relatives suffer for hours, even though everyone involved agreed it was time for them to die. IMHO, assisted suicide has everything to do with life support, mainly because post-support-removal is probably the most common scenario in which assisted suicide would be requested in America.

Good policy is not made by following extreme outliers.

This isn't an extreme outlier issue. Every single one of us will die. Thanks to medical advances, most of us will live longer than our parents did, who lived longer than their parents did. Whether or not people who linger after they want to die should be helped to die isn't an "outlier", it's an issue which will personally affect almost every one of us, especially if we have family.

How do we tell if the choice is a logical thought out choice, and not a choice arising from (a realistic reaction of) depression?

Again, people suffering from depression have the same right to decision-making the rest of us do, so long as they haven't been committed. This question goes both ways: how do you tell if their decision is not a logical thought out choice? Is it just because they're depressed and/or disabled? That seems vastly unfair to the depressed and the disabled.

I don't find it unrealistic to require some period of counseling and treatment for depressed people who want to die, just in case they are not truly sure or can be helped through other means, but the idea that they cannot choose death at all is repellent.

How do we tell if this is an honest, personal choice and not a choice out of concern for the cost to their family, both emotionally and financially.

In what way is concern for one's family not honest or personal? If your family is pressuring you to die, that's one thing, but to suggest that they have no bearing on the decision at all is totally unrealistic. Of course they do; most of us consider the impact on our family if we're going to get married or move or change jobs, and I don't see why this major decision should be any different.

What about the family of a minor who has a severe birth defect, are they allowed to "compassionately" kill this child rather than deal with the disability to avoid the supposed suffering?

First of all, like Axle, I'm not seeing much "slippery slope" action here. This is pretty clearly a separate issue from voluntary euthanasia, because the law says that minors cannot consent. Also, the vast majority of parents are not going to kill a disabled but otherwise healthy child to begin with... weren't you saying something about not making policy based on outliers?

As for euthanizing infants who are not healthy, this is already done today, to some extent. Plenty of people choose to abort children with severe defects, or, if they are born alive, choose to refuse extraordinary treatment. We don't talk about it much, but passive, pallative-care-only euthanasia happens to severely ill infants in hospitals all the time. It's a shame, but the simple truth is that often there is not much which can be done for them medically, other than to try to make them comfortable as they die. Why is it all right for us to choose to put kids like this through the pain of dying "naturally", but not all right to give them an injection and let them die quietly and painlessly?

these are the very real concerns of a person who has struggled both physically and emotionally to live. It has been very hard work to choose to live, but my life has been -- and is -- worth it. There were times in the past I was not convinced it would be.

You chose to live, yet you would ask us to make this choice for others... can't you accept that they must have precisely the same rights in this matter as you did, including the right to come to the opposite conclusion?

Choosing death does not "devalue" life. It ends it. Life is given its value through the way we live and die, not just when and for how long... and having to do so on someone else's terms sure seems like a devaluation to me.
posted by vorfeed at 10:10 AM on October 11, 2008 [3 favorites]

Librarygeek, "extreme outliers" are at the center of liberty. If they weren't, no one would care about rights for minorities.
posted by shetterly at 11:41 AM on October 11, 2008

This is a troublesome discussion. I do believe in the right of a person to choose when they die. It is from that belief that anything I say must proceed.

I am not certain that there is any circumstance in which it is correct to deny an individual that right of choice. Please, do not construe my lack of certainty to mean a lack of questions, or a lack of willingness to consider limitations. How many depressed teenagers want to die? Should they be 'allowed', or even, assisted? Or prevented, whenever possible? Probably they should be prevented and treated. What of the same situation, but for an adult? I do not have an answer.

This issue becomes much clearer when considering the situation for the chronically ill, and even more, for the terminally ill. Their choice, the final option.

And yet, invited to consider a hypothetical "slippery slope", and the chorus of those saying no such slope existed as regards this issue, I did conceive of the very thing I learned later in the thread, had taken place: A health insurance organization effectively being the party making the choice. Which can perhaps be rendered less emotional (for some of us, anyway) by placing it in a more general category of suicide becoming a financial decision.

So, what'll it be, ma? You gonna take this here shot of eternal oblivion, or you gonna choose to bankrupt the entire family?

What a horrible ugly situation to face, whether as the person suffering, or the person faced with such a situation. There is some validity in noting that, in the hands of the insurance provider, at least guilt is removed from the family, but the motivation is all the more ugly, as then the decision isn't between bankruptcy and death, but rather, between life and profits.

Mind, this situation is not purely a product of profit-motivated healthcare. Even nationalized healthcare systems come to the point where the decisions regarding applications of resources must be made. Then there are decisions about who gets organs for transplant? Many are ready to deny new livers to alcoholics, or new lungs to smokers. Someone has to make that decision.

The Oregon law appears to set most of these problems aside. We can all be reasonably certain this was not one of those bills written in haste and passed without careful consideration. Is it strong enough to avoid the problems? Sounds like it, but maybe it does error too much in one direction, yet that is the one direction that can be corrected. The other direction is irreversible.
posted by Goofyy at 1:56 AM on October 13, 2008

It's worth going to the Oregon Death with Dignity Act website to read the reports. They've got 10 years of data on how this option has been used by the people of Oregon.

During 2007, 85 prescriptions for lethal medications were written [...]. Of these, 46 patients took the medications, 26 died of their underlying disease, and 13 were alive at the end of 2007. In addition, three patients with earlier prescriptions died from taking the medications, resulting in a total of 49 DWDA deaths during 2007. This corresponds to an estimated 15.6 DWDA deaths per 10,000 total deaths.

As in prior years, most participants were between 55 and 84 years of age (80%), white (98%), well educated (69% had some college), and had terminal cancer (86%).

[...]

All patients had some form of health insurance: 65% had private insurance, and 35% had Medicare or Medicaid.

As in previous years, the most frequently mentioned end-of-life concerns were: loss of autonomy (100%), decreasing ability to participate in activities that made life enjoyable (86%), and loss of dignity (86%). During 2007, more participants were concerned about inadequate pain control (33%) than in previous years (26%).

Etc. I find the point about more prescriptions being written than being used quite intriguing. I wonder if for some it's a measure of extra security or personal control.

And thank you for sharing the article, even if it did get me all teary-eyed.
posted by epersonae at 8:39 AM on October 13, 2008