some saying it's proof of a failing justice and health system
September 17, 2014 9:34 AM   Subscribe

 
I find this very hard to internally parse.
posted by RolandOfEld at 9:57 AM on September 17, 2014


Edit: Or, I should say, I personally find this very hard to parse. Or something....
posted by RolandOfEld at 9:58 AM on September 17, 2014


This guy is pretty much the only kind of person I'm willing to support the death penalty for anymore -- there is no doubt in anyone's mind that he did it, that he knew he was doing it, and that he'd do it again. He is actively detrimental to society.

I'm fine with this.
posted by Etrigan at 10:02 AM on September 17, 2014 [4 favorites]


It's an opt-in death penalty for those so dangerously insane they can not be rehabilitated.

I don't see anything ethically challenging about this.
posted by 256 at 10:04 AM on September 17, 2014 [5 favorites]


It's an interesting question. And difficult.

* People should be free to live or die of their own choice
* It is still potentially problematic for the state to help, as an "evil" state could "help" all sorts of people who don't really want to die (slippery slope argument)
* Did we fail this person? Was/is there a cure and we just didn't find it?
* If there is potentially a way to "fix" this person but we don't know it, shouldn't we say "not yet, there may be a fix soon?"
* How long is too long to wait? 30 years? 15? 5? 1? Six months?

It seems ages ahead of the barbarism we treat our prisoners with here in the states.
posted by maxwelton at 10:06 AM on September 17, 2014 [9 favorites]


I don't see anything ethically challenging about this.

Not when it's apparently totally voluntary, but once the system -- guards, other inmates, etc. -- start pressuring people to "volunteer" themselves for euthanasia (for whatever reason) and make life more difficult for them if they don't, that might become its own separate death penalty crisis. Same issues as letting people voluntarily sell their organs, really: at which point is it still totally consensual volunteering and how do you prove it isn't?
posted by griphus at 10:07 AM on September 17, 2014 [19 favorites]


And, of course, the obvious mentioned by 256.
posted by maxwelton at 10:07 AM on September 17, 2014


Personally, I am more in support of universal access to euthanasia for anyone who wants it, than I am for this idea that some people deserve to have access to a medical suicide while others should make do. I feel no more ethically challenged by this than by any other euthanasia case, because if a medically monitored death is a right that some people have, then it seems like a right that everyone should have.

It is still potentially problematic for the state to help, as an "evil" state could "help" all sorts of people who don't really want to die to die (slippery slope argument)

That's an argument against any kind of euthanasia. Certain kinds of euthanasia are already legal in Belgium. That horse has already left the barn.
posted by muddgirl at 10:07 AM on September 17, 2014 [5 favorites]


Etrigan: You realize that others have been put to death when there was no doubt in anyone's mind that they did it, that they knew they were doing it, and that they would do it again, and it was later learned that they most likely did not do it, right?
posted by Cosine at 10:07 AM on September 17, 2014


And, yeah, it is a bit of a slippery slope argument, and it might work fine in Europe, but god knows the prison system in the U.S. may as well be a petri dish for that sort of thing.
posted by griphus at 10:08 AM on September 17, 2014


That's an argument against any kind of euthanasia.

I think the context of a prison -- specifically, the power differentials between the inmates and between the inmates and the institution itself -- is a big, big factor in the difference between euthanasia for the terminally ill, and euthanasia for people in prison.
posted by griphus at 10:11 AM on September 17, 2014 [4 favorites]


Etrigan: You realize that others have been put to death when there was no doubt in anyone's mind that they did it, that they knew they were doing it, and that they would do it again, and it was later learned that they most likely did not do it, right?

"Anyone" includes the accused.
posted by Etrigan at 10:11 AM on September 17, 2014 [3 favorites]


I think that in some ways this is also a failing of the mental health system. We can get someone out of delusional states and into reality ( he realizes he did terrible things and he can't change them) but we can't really fix impulse control issues.
I think it is cruel that we spend all this time to get these people in reality so they know what they've done and then tell them to stay in prison so they can't ever do it again. Of course with that they realize they are in prison and have no escape. Thanks to their treatment.

I think that this decision is okay . I don't like it but I think it is okay.
posted by AlexiaSky at 10:12 AM on September 17, 2014 [2 favorites]


Etrigan: You realize that others have been put to death when there was no doubt in anyone's mind that they did it, that they knew they were doing it, and that they would do it again, and it was later learned that they most likely did not do it, right?

In this case the man himself has admitted repeatedly that he did. And he is ASKING to be put to death. The odds of us learning later that he most likely did not do the things he admitted, repeatedly, to doing, and stated that he feared doing again, are pretty low.

OK, it's theoretically possible that this man is suffering from some kind of profound and debilitating 30 year long delusion in which he has convinced himself that he committed rapes and murders which he did NOT, in fact, commit. But does anyone on this thread believe that to be extremely likely?
posted by like_a_friend at 10:16 AM on September 17, 2014


"Van Den Bleeken, now in his fifties, had requested a transfer for treatment at a specialized psychiatric center in the Netherlands or, failing that, a mercy killing."
posted by wreckingball at 10:17 AM on September 17, 2014 [8 favorites]


I think the context of a prison -- specifically, the power differentials between the inmates and between the inmates and the institution itself -- is a big, big factor in the difference between euthanasia for the terminally ill, and euthanasia for people in prison.

If he had an incurable, untreatable brain tumor, would the question be any different? Should inmates not have access to the same right to die as non-inmates? That's certainly an argument that could be made - we take away many rights to bodily autonomy from inmates, this would just be one more. I haven't looked up the specific number of inmates who've been granted a medical suicide for physical ailments, but the article implies that they do occur.

I am a bit troubled by the fact that his request to go to a specialized clinic in another country was denied, but then again I'm not especially pro-euthanasia in the first place.
posted by muddgirl at 10:19 AM on September 17, 2014


That's certainly an argument that could be made - we take away many rights to bodily autonomy from inmates, this would just be one more.

That's the crux of it for me. I mean, I, personally have no idea what the ethical thing to do here is and I'm super glad it's not a decision I have to make because I both oppose the execution of prisoners and support euthanasia as a general concept. But prison, at least in the U.S., is so miserable, cruel and inhumane and effects the psyche of the inmates to the extent that I can see such a thing turning prisons here into abbatoirs, in many cases regardless of whether the person electing suicide even committed a crime or not.
posted by griphus at 10:24 AM on September 17, 2014 [4 favorites]


"Not when it's apparently totally voluntary, but once the system -- guards, other inmates, etc. -- start pressuring people to "volunteer" themselves for euthanasia (for whatever reason) and make life more difficult for them if they don't, that might become its own separate death penalty crisis. Same issues as letting people voluntarily sell their organs, really: at which point is it still totally consensual volunteering and how do you prove it isn't?"
This is Belgium we're talking about, not Mississippi or North Korea, you're projecting American problems onto a place where they're entirely irrelevant. As often hilariously incompetent as the Belgian governments may get, this kind of malfeasance is pretty inconceivable here.
posted by Blasdelb at 10:24 AM on September 17, 2014 [1 favorite]


I'm not saying that in this case he didn't do it, I am saying that we might want to be careful about saying the death penalty is fine when there is no doubt the accused did it.
posted by Cosine at 10:28 AM on September 17, 2014


...you're projecting American problems onto a place where they're entirely irrelevant.

Yes, that's why I followed my statement up with "and it might work fine in Europe."
posted by griphus at 10:28 AM on September 17, 2014 [1 favorite]


"All those commissions, doctors and experts concerned about the well-being of the murderer of our sister. Nobody has ever shown us that much attention," [the sisters of one of his victims] said.
I've heard this argument innumerable times before--but from Americans arguing that someone should be put to death. That it's a waste of resources to keep someone alive, that there's so much concern for prisoners, that prisoners get three meals a day and healthcare, which is more than their victims can say, etc. I find it quite striking to see it repeated here, and wonder what it says about the possibly universal need for better victims' services.
posted by MeghanC at 10:30 AM on September 17, 2014 [5 favorites]


OK, it's theoretically possible that this man is suffering from some kind of profound and debilitating 30 year long delusion in which he has convinced himself that he committed rapes and murders which he did NOT, in fact, commit. But does anyone on this thread believe that to be extremely likely?

And more to the point, would that not also be a valid reason for seeking euthanasia?

And yes, as griphus is saying, introducing this in the US, where the prison system is a massive mechanism for torturing people for the crime of being poor and/or black (and where one of the most common criticisms is that it's not barbaric enough), would be an entirely different proposition.

I don't see anything ethically challenging about this, given that Belgian penal system seems basically civilized.
posted by 256 at 10:31 AM on September 17, 2014


And more to the point, would that not also be a valid reason for seeking euthanasia?

Yes, absolutely--I actually struggled for a way to phrase that, but opted to let it go.

cosine: We can argue for maximum clarity at all times certainly, but it seemed obvious to me that what Etrigan meant by "no doubt" was actually not any doubt, not the sham of "no doubt" often provided by the U.S. and its bullshit failure justice system.
posted by like_a_friend at 10:36 AM on September 17, 2014


like_a_friend: Agreed, the state murdering people gets me a little hot under the collar, if I went off there I apologize, should have sloooowed down.
posted by Cosine at 10:43 AM on September 17, 2014


once the system -- guards, other inmates, etc. -- start pressuring people to "volunteer" themselves for euthanasia (for whatever reason) and make life more difficult for them if they don't, that might become its own separate death penalty crisis
Okay, that's a horrible possibility, but what's the alternative? "If the justice system breaks down, some inmates might be subjected to fates worse than death and escape via suicide" is almost by definition still an improvement over "If the justice system breaks down, some inmates might be subjected to fates worse than death and unable to escape".

The former system is probably less likely to break down, too. Someone with an escape hatch, even one as awful as suicide, likely has no incentive not to report others' behavior on their way out. Someone with no certain escape might be pressured to keep quiet to avoid the chance of making their mistreatment even worse.
posted by roystgnr at 10:58 AM on September 17, 2014


The way I see it is:

If you support the death penalty in any form, you support the death penalty.

Over the years, I've become 'ok' with this. Im wondering how those who claim to be against the death penalty, but find it 'ok' in this situation feel.

Seriously. How?
posted by hal_c_on at 11:21 AM on September 17, 2014


Over the years, I've become 'ok' with this. Im wondering how those who claim to be against the death penalty, but find it 'ok' in this situation feel.

Seriously. How?


I'm not sure that I actually am okay with this although I am against the death penalty, but there's a big difference between believing that the state has sufficient authority over someone's life to end it and believing that an individual person has that authority over themselves.
posted by Mrs. Pterodactyl at 11:26 AM on September 17, 2014 [10 favorites]


hal_c_on: Because they are not even remotely the same thing, one is the state killing me against my will, the other is choosing to die.
posted by Cosine at 11:35 AM on September 17, 2014 [1 favorite]


Yeah, um... there's a huge difference between the state killing you, and you deciding to end your life. Like, such a big difference I'm kind of perplexed that you're even drawing an equivalency.
posted by feckless fecal fear mongering at 11:50 AM on September 17, 2014 [3 favorites]


Yeah, um... there's a huge difference between the state killing you, and you deciding to end your life. Like, such a big difference I'm kind of perplexed that you're even drawing an equivalency.

In the United States I am sure we could find some way to make them the same, especially if there was somehow a dollar to be made in it. But both as an abstract concept, and in the specific context of this case, yeah, they are definitely not the same thing.
posted by like_a_friend at 11:53 AM on September 17, 2014


""All those commissions, doctors and experts concerned about the well-being of the murderer of our sister. Nobody has ever shown us that much attention," they said."

To me, this is NOT evidence we need to be more cruel to prisoners, but it is a problem in how much we financially invest in the care of survivors vs the people who committed a huge amount of damage and are now in prison. We should be willing to care for, or house and provide for, people extensively damaged by criminal behavior much more than we do (of course I think we should do this for anyone regardless if their suffering and need comes directly from criminals/abusers).

Meaning we sometimes DO spend more emotional and financial resources on the sad guilty feelings of perpetrators than on survivors who we often claim are "clinging to anger" if they're living with long term or even life long damage to their ability to function due to coping with the emotional aftermath or physical/mental problems they have in the aftermath.

This is extremely ethically complex, my heart hurts for people who have endured terrible suffering at the hands of others, and even for people who have caused and live with terrible pain of their own actions.

And I really simply don't find any easy answer on the subject of euthenasia. I can see reasons to have it be legal but I can also see arguments against it's legality in any circumstance due the complexity of how that will really be determined and carried out.

I think the fact that he requested better psychiatric care and living conditions and was denied makes this an even bigger huge human rights issue even more than the already complex moral issue of euthanasia.

I have literally sat with a man who sexually abused me and listened to him cry and convulse in pain over his own behavior wanting to die. I asked him to live if he's truly sorry. But if he simply wanted to die for him because it's easier that would change my stance-- I guess what I mean is I don't want to live with someone killing themselves FOR my benefit.That isn't what I want.

While I don't think people who DO have anger toward abusers should be shamed or forced to be more forgiving (I actually like my anger to be exactly how it likes to be, and I'm ok with that and like that freedom. I believe I can love and even care for the well being of someone while ALSO being really really pissed at things they done to other people). I don't think it's universal that survivors want more suffering or death on those who have harmed them, especially when I still think so much of criminal behavior has way to many implications in the environment than makes for a clear "free will" argument about those who do terrible things. I'm not even sure free will exists, though I imagine something like it does, just not in the detached autonomy from biological forces and environmental and social pressures we think of it as existing.

I still feel like that he asked for better conditions OR merciful death, makes me think he has some hope left--- that there is more that could be done-- why did he want that particular program? Why aren't there similar programs in his own country?
posted by xarnop at 11:56 AM on September 17, 2014 [1 favorite]


More to the point: hal_c_on, suppose this guy was eligible for parole, and immediately upon release he requested assisted suicide. (As it seems almost certain, based on his own statements, that he would.) Would that still be some kind of death penalty?

Does the mere presence of the state make it a kind of death penalty, even if the state has not requested, suggested, or in any way endorsed his decision? (Which it didn't--the whole point of the article is that he had to sue to get the right granted).

And if he had, instead of a psychological debilitation, a case of terminal cancer while in prison, would it still be a death penalty?
posted by like_a_friend at 11:58 AM on September 17, 2014


> "If the justice system breaks down, some inmates might be subjected to fates worse than death and escape via suicide" is almost by definition still an improvement over "If the justice system breaks down, some inmates might be subjected to fates worse than death and unable to escape".

Granted, but prison shouldn't be a fate worse than death in the first place. The concept is to physically remove individuals who pose societal threats from the society itself. All the productivity and autonomy granted beyond that point is up in the air, but at best, it would rehabilitate those who are redeemable, and at worst it would permanently remove those who are not. That's the abstract version, at least.

There is the occasional minimum security golf club, but somewhere along the way, ensuring a sense of punishment became a focus for most prison systems—as if the social prejudices and legal statuses associated with being an ex-con weren't going to be bad enough. Instead of peace of mind being gained from knowing that person won't be able to harm anyone else, some people want revenge, and peace of mind comes from knowing that person is harmed or suffering as much as they harmed others.

So, when one of these truly irredeemable people still has the freedom to choose death rather than a continued life in prison, opinions get divided. I can't speak for anyone, but under this frame, people who aren't okay with it might want the prisoner to suffer or have his freedom (including the freedom to die) taken away in the same sense he's taken the lives and freedoms of others. People who are okay with it may be more concerned about the "removal from society" aspect rather than how exactly this removal is maintained.
posted by Johann Georg Faust at 11:59 AM on September 17, 2014 [2 favorites]


While I think in this case it may be the right decision, I'm rather creeped out by people saying that there is nothing 'ethically challenging' about euthanasia for an involuntarily confined person under total control of others. If you don't think there is anything complicating about those factors... yeah, creepy.
posted by tavella at 12:07 PM on September 17, 2014 [2 favorites]


I think this is the sort of slippery slope that gives teeth to anti-euthenasia groups. So we've gone from early opt-out for people like Terry Pratchett suffering from degenerative neurological disease to a psychological diagnosis of a person in a criminal justice system that's practically designed to make its inmates mentally ill.

The ethical arguments in favor of assisted suicide rest entirely on the principles of medical necessity and fully informed consent by a competent person. I don't see how that standard can be met for a mental illness diagnosed within any criminal justice system I'm familiar with.
posted by CBrachyrhynchos at 12:20 PM on September 17, 2014 [2 favorites]


Just some more thoughts. The historical and contemporary realities of consent and medical treatment within prison systems have been tainted by so much systematic abuse that the legal bar needs to be set much higher than the tests normally required for radical medical treatment or research participation. Quite possibly this is prohibitively high for prison inmates. No, it's not a death penalty, but we shouldn't pretend that Van Den Bleeken and Sir Terry are on the same legal playing field in requesting assisted suicide either.
posted by CBrachyrhynchos at 1:08 PM on September 17, 2014


I think the fact that he requested better psychiatric care and living conditions and was denied makes this an even bigger huge human rights issue even more than the already complex moral issue of euthanasia.

To be fair, he was requesting psychiatric care in another country. It seems relatively reasonable for one country to refuse to allow one of their prisoners to be out of their jurisdiction. The article states clearly that it's not even legally possible for such a thing to be granted; I'm forced to wonder if he asked for something huge he knew he wouldn't get in order to make the real request more likely to succeed.

So we've gone from early opt-out for people like Terry Pratchett suffering from degenerative neurological disease to a psychological diagnosis of a person in a criminal justice system that's practically designed to make its inmates mentally ill.

Most northern European and Scandinavian prison systems are really different from the horrorshow that is the system in the USA, so perhaps not really all that useful to judge them by those standards.

I mean, this is someone who knows what he did was wrong and doesn't want to do it again, so prison has served its rehabilitative purpose there. The thing is, he knows he will do it again if set free. So his choices are rot in prison until he dies, or opt out. I know which I'd choose, in a heartbeat. Psychiatrists are in agreement that he can't be cured, and I'm at a loss trying to understand why an incurable mental illness that causes distress should be treated any different than an incurable physical illness.

Yes, of course, one must be vigilant to ensure there's no coercion in the system. The Belgians seem to be doing that, and I'd be fairly surprised if his lawyer would be attached to this if he thought there was any coercion involved.

Then again, I pretty firmly believe that anyone capable of forming informed consent--which multiple psychiatrists think he is, according to the article--has the absolute right to end their lives when they see fit. Doubly so if one's choices are life in prison or knowing you will not be able to stop yourself from hurting other people.
posted by feckless fecal fear mongering at 1:42 PM on September 17, 2014 [2 favorites]


So his choices are rot in prison until he dies, or opt out.

You're describing an inherently coercive situation. I think there's a significant danger in considering environmental conditions to be a factor in assisted suicide, which is generally based on the premise that even with the best possible care the patient is facing months or years of pain and disability beyond any reasonable quality of life. Assisted suicide shouldn't be a bandaid for suffering caused by the quality of prisons, economic class, or social stigma.

Psychiatrists are in agreement that he can't be cured, and I'm at a loss trying to understand why an incurable mental illness that causes distress should be treated any different than an incurable physical illness.

I think there's enough ambiguities regarding exactly how we diagnose mental illness in typical cases, much less highly atypical cases like Van Den Bleeken to raise some serious questions.

Yes, of course, one must be vigilant to ensure there's no coercion in the system. The Belgians seem to be doing that, and I'd be fairly surprised if his lawyer would be attached to this if he thought there was any coercion involved.

The article doesn't provide enough detail about how the Belgian government came to this decision. Perhaps they have a brilliant model for how to determine consent in coercive environments, maybe they don't. I can't really tell. My objection still remains that I don't see a fully explicated model for developing this kind of informed consent from inmates within inherently coercive situations. And without a lot more information about exactly how consent was obtained in this case and how it will be obtained in future cases involving incarcerated persons, I'm going to be skeptical.

I also should clarify that my primary response was to the "frame" described by Johan Georg Faust which described this case in terms of two different forms of retributive justice. I'm not thinking in that frame. For me the primary consideration is what are the necessary elements for affirmative consent to assisted suicide, and can they exist within a prison system?
posted by CBrachyrhynchos at 3:24 PM on September 17, 2014


Perhaps I should have said his choices are rot in prison with an incurable mental illness, or opt out.

Seems about as coercive as if he had incurable cancer, to me.
posted by feckless fecal fear mongering at 4:31 PM on September 17, 2014 [1 favorite]


This is Belgium we're talking about, not Mississippi or North Korea, you're projecting American problems onto a place where they're entirely irrelevant. As often hilariously incompetent as the Belgian governments may get, this kind of malfeasance is pretty inconceivable here.

It's true, Belgium and other European countries may currently be ahead of the US in criminal justice and prisoner treatment.

But these kinds of reforms and policies should be made looking at not just the present, but the future. Where there is space for abuse, regardless of where, abuse will fill it.

Let him decide after he is released.
posted by formless at 6:42 PM on September 17, 2014


Not when it's apparently totally voluntary, but once the system -- guards, other inmates, etc. -- start pressuring people to "volunteer" themselves for euthanasia (for whatever reason) and make life more difficult for them if they don't, that might become its own separate death penalty crisis.

The system already does this and people with no hope of ever getting out still want to live, even if they don't want *other* people to live. So many people on death row pretty much go kicking and screaming to the death chamber, and when they were free, they squandered their existence by being serial or mass murderers -- just don't take *their* life away!

And there are people who are very non-criminal who are saddled with terminal illness, who are in constant agony who have no chance of recovery -- or even walking or ever hoping to go home still want to live.

It is amazing when you stare death in the face, how it easy it is to still have the gumption to defiantly *spit* at it and keep on living in spite of it all as we get adjusted to the new norm of our lives...
posted by Alexandra Kitty at 7:09 PM on September 17, 2014


Let him decide after he is released.

He can't be released. That's kind of the point.

So many people on death row pretty much go kicking and screaming to the death chamber, and when they were free, they squandered their existence by being serial or mass murderers -- just don't take *their* life away!

Well, except for the innocent ones.
posted by feckless fecal fear mongering at 8:58 PM on September 17, 2014 [1 favorite]


Ain't an "opt-in death penalty" per se. He argued that his psychological condition was incurable and caused him excessive suffering.
posted by jeffburdges at 12:55 AM on September 18, 2014


This is interesting ethically, but it does sound like in this particular case the guys is trying to get onto this program he wants using threats/brinksmanship rather than a genuine desire for death. People who actually want to die don't usually qualify that with "unless I get my own way in this dispute". People who perceive they have no power in a situation often go for the nuclear option as there's no downside for them.
posted by tinkletown at 3:57 AM on September 18, 2014 [1 favorite]


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