Euthanasia

[bekkiz]

Here in WA, it's called the Death with Dignity act:

"Patients must make two separate requests, orally and in writing, more than two weeks apart; must be of sound mind and not suffering from depression; and must have their request approved by two separate doctors. Doctors are not allowed to administer the lethal dose."

http://blogs.wsj.com/health/2008/11...e-1000-legalizing-physician-assisted-suicide/

 

[MM27]

This will be too long, but I so understand how you feel and I've not let myself actually talk or write about this yet, it's still so painful in my heart, so please forgive me. My 82-year old mother was diagnosed with vascular dementia less than a year and a half ago. During that time, she went from being a vital, highly intelligent woman who served on a multitude of non-profit and financial company boards, to an empty shell within a eight-month period. My mother was so smart, she honestly thought she had taken care of everything for her "old age" - she & my dad moved into an assisted living (AL) facility, had a long-term health care policy, signed legal medical POA & DNR forms, and for most of her life, she watched what she ate and walked 3 miles every day. Due to her financial planning skills, she had tons of retirement savings because she "knew" my dad, who always was in bad health, was going to go first and she didn't want to be a burden. Since no one in her family had ever had Alzheimer's or dementia, it was NEVER on her worry list, so she never wrote any provisions for that scenario. Now, she's had to be separated from my father in AL, her husband of 60 years whom she no longer recognizes, to stay in a medical facility where she's watched 24-7 because of rage issues and trying to leave and walk into traffic in the middle of the night. She does not recognize her children or her grandchildren. A woman who always prided herself on her clothes and appearance, now wears unmatching, stained clothes with soiled pants, and drools. She doesn't know what day it is or what time it is and is ready to go to bed as soon as the sun sets, even if it's only 4:30 pm. My mother would be horrifed if she saw herself this way, as all of us who love her are, yet, it angers me no end that the pharmaceutical companies are making a fortune out of the multitude of pills and drugs she (and others like her) is given every single day (about 20) for blood pressure, blood thinning, cholesterol, allergy, anxiety and psychotic medications...the list goes on. They should give an option - not just DNR, but "please don't continue to give me chronic condition medications to keep me alive even though I'm not really living." The doctors don't have the authority to simply stop these medications and so they say she may live another year or even up to three and my heart is breaking and my dad can't stop crying. The emotional toil on our family has been immense. My MIL, who is the same age as my mom and is battling breast cancer, after seeing the condition of my mom said to me - "there are things worst than cancer and people my age are living too long" (she is a both a brave & a wise woman). If I am ever given a diagnosis like this - I would want to do something while I was still mentally able, so that my loving family would NEVER have to go through this and see me this way and deal with these issues. But, most of all, I would never judge or make a decision for other families who haven't been through it.

And, Silent1CB - thoughts and prayers for your friend and his dad.

My dad died 13 years ago and I still have a hard time talking about it.

The worst part for me was that my dad had what they considered "early Alzheimer's" because he was under 60 years old when he was diagnosed. I was still in middle school when he was first diagnosed and what a confusing time for a teenager anyway. The things we lived through are things I would have never even imagined if I didn't experience them firsthand.
The worst part for me is that I don't even remember what it was like before the Alzheimers. My father was sick for almost 10 years and I try to remember the times before and I just can't.

 

[Disney Doll]

Obviously there have to be checks and balances in place to guard against going down that "slippery slope" that everyone worries about.

Having been a nurse for a number of years, and having provided comfort care to numerous patients including my own in-laws, I will say that allowing someone to die in comfort and with some dignity is the last loving thing we can do for them.

 

[wdwfan16]

I know that I could never administer it to a loved one. I also would never ask a loved on to do it to me.

I am on the fence leaning a little toward it being OK to be legal but I know it would be a law that I would not use.

 

[mhsjax]

I know that I could never administer it to a loved one. I also would never ask a loved on to do it to me.

I am on the fence leaning a little toward it being OK to be legal but I know it would be a law that I would not use.

I understand what you are saying, but I have to wonder, if it was legal, what would I do if I saw either my hubby or one of my kids dying from some incurable and extremely painful disease and begging to be put out of their misery, I think that may push me over the edge. So I can't say that it would be a law that I wouldn't use, however I am not sure that I could do anything myself either. This is a hard one.

 

[wdwfan16]

I understand what you are saying, but I have to wonder, if it was legal, what would I do if I saw either my hubby or one of my kids dying from some incurable and extremely painful disease and begging to be put out of their misery, I think that may push me over the edge. So I can't say that it would be a law that I wouldn't use, however I am not sure that I could do anything myself either. This is a hard one.

We have living wills. When I went for my cancer surgery I talked to the Dr. and my DH about my wishes.

I have not problem with giving enough pain killers to make your loved one comfortable but I would not keep turning up the dosage just to end their life right now. I know that morphine can shorten a life but I would only increase it to the point they were no longer in pain. That could shorten their life but make the end comfortable.

I watched my Grandmother and Uncle die of cancer. My Uncle was stage 4 when then detected it, my cancer is a sister cancer to the one he died of and both tend to run in families. If I was my Uncle now I would not treat the cancer but I would not want anybody to end my life either.

 

[disfan07]

I have not problem with giving enough pain killers to make your loved one comfortable but I would not keep turning up the dosage just to end their life right now. I know that morphine can shorten a life but I would only increase it to the point they were no longer in pain. That could shorten their life but make the end comfortable.

But what about the people who can not be made comfortable with a dose of pain killers that wont kill them? If you give them teh max. dose that wont kill them but they are still in pain, whats the point? They are still in pain...thats what I'm saying. If the ONLY way that they can be comfortable and be out of pain is for them not to be living anymore, shouldnt we have that choice?

Again...I'm not saying that anyone HAS to do this. I just think that there is no reason why this should not be a CHOICE for everyone to have.

 

[Silent1CB]

We've been having this conversation just this weekend.

A friend's dad (89) was moved to hospice yesterday. He has made his own medical decisions since he's still alert. He cannot swallow. Throat muscles are not working. He has decided against a feeding tube via nose or throat. He's going downhill fast. So basically, he's going to starve to death in hospice.

If that were me, I would want to end my life now and not wait the number of days or weeks it would take to starve to death.

I'm thinking of my friend, his dad & family constantly.

And today he passed away.

 

[HannaBelle]

After watching my father suffer through his last years with Alzheimer's disease, not knowing anyone around him, not recognizing his own image in a mirror and being extremely violent to those that he was closest to because he didn't recognize them anymore, I can honestly say if that every happened to me, I would hope and pray that someone would end it for me.

In this country we end the lives of animals when we realize that they are suffering. While we have feelings about the death, we realize that it was in their best interest. I can't fathom why we don't do the same for humans.

I had the pleasure of getting to know my DH grandmother while we were still in "Junior High", we met when we were 12. She was a beautiful, graceful, intelligent, poised woman. We all watched helpless as Alzheimer's took away all of her grace and self control. She spewed hate and spoke words I would have never guessed she knew...it was heartbreaking. I know without a shadow of a doubt she would have been mortified if she knew what was happening.

My own grandfather lingered for months in the hospital, unable to speak after having a tracheotomy. He communicated with me via notes that if he had the courage and strength to stop eating he would...so that he could end his suffering. What do you say that?

I agree with the PP, I pray for someone to have to courage to offer me mercy if my death lingers.

 

[wdwfan16]

And today he passed away.

I am sorry.

 

[suzannen]

And today he passed away.

I'm so sorry - my sincere condolences to your friend and his family.

 

[Soldier's*Sweeties]

Who am I to tell someone that they need to continue living? That is an extremely personal decision.We are kinder to our pets at the end than we are to fellow humans.

This.........But I DO understand where it could be problematic in some cases.

 

[rotlex]

Beacuse of the flip side. I don't want anyone telling me I *have* to die.

The stories that have been in the news about patients in Oregon whose insurance won't pay for treatment but WILL pay for suicide pills are quite scary. That's the slippery slope we have to watch out for. What if you're of sound mind and normally in good health, but you develop an acute treatable condition, which you could recover from, but it would be expensive? What if your heirs just decide it's time they got their hands on the inheritance? There need to be very strict criteria for someone to be a candidate.

DH and I had some very serious discussions about this type thing when the Terri Schiavo case was in the news, and we both have living wills. There is a difference between not keeping someone alive, and actively causing their death. It is a VERY thin line sometimes, though.

This is very well said. For the record, and I have lived through some horrible experiences within my own close family, I am 100% against assisted suicide\euthanasia, for a number of personal reasons. What the poster above states is definitely one of them. Too many people do not realize just how quickly things like this can go the absolute opposite direction of what you ever expected them to do.

Life is precious, and human life, FAR more precious than that of the animals some speak of us being "kind" to by ending their lives. The bottom line is, the thought of this stuff scares me to death. With that said, I AM for allowing someone to die by say, natural means. If a person wishes to NOT have life support systems to keep them going, yes, that is their choice, and would be mine. But to purposefully kill someone and think you are doing them a favor, is just plain wrong. In my opinion\belief.

Not looking for arguments for or against my view, just simply stating it.

 

[Pea-n-Me]

I have not problem with giving enough pain killers to make your loved one comfortable but I would not keep turning up the dosage just to end their life right now. I know that morphine can shorten a life but I would only increase it to the point they were no longer in pain. That could shorten their life but make the end comfortable.

You've hit on the crux of end of life care using morphine.

Morphine doesn't just help pain, it eases breathing. People in respiratory distress who aren't dying often receive it to make their breathing easier.

Someone who is dying often has both pain and respiratory distress. Fluids often build up in the lungs during the dying process so in effect, they feel like they're drowning. This is both uncomfortable and terrifying to the dying person.

There really is no "top dose" of morphine. I've seen people on astronomical doses who were still uncomfortable. In that situation, there is no choice but to go up to help them become more comfortable.

Both the AMA and the ANA support the use of morphine to make a dying patient comfortable, even if it hastens death. http://www.mcw.edu/fastFact/ff_08.htm

Realistically, if symptom management is achieved successfully, the need for euthanasia at the end of life may not be necessary. Here's how one NP sees it.

In all of my years in end-of-life care and now practicing as a palliative care nurse practitioner, I have never had one of my patients request to die. I believe that because I have worked with very strong interdisciplinary teams and have learned to treat depression early on and know how to properly manage pain and symptoms, my patients die "healthy" deaths. I have witnessed horrible symptom management and have seen how pain, dyspnea, and unrelieved depression can promote suicidal ideation. Once symptoms become relieved, these thoughts become distant.

Others have different opinions: http://www.medscape.com/viewarticle/462828_4 Obviously there are lots of opinions on the matter and no two situations are ever exactly alike. I'll add (in part from personal experience) that I think that not all care teams are great at symptom management, unfortunately, so there's lots of room for improvement here.

Besides actual end of life, it seems like there are some people here who advocate suicide/euthanasia at a point earlier than near the actual end. I guess I don't have an opinion about that one way or another but understand points on both sides of the argument. I do think you have to separate one making that decision for him or herself vs someone else making it for you, which is when you enter that slippery slope category.

I had a patient this week who was elderly and very sick, though functional, still married, etc. His prognosis was poor, and outlook bleak. His doctors were honest with him about it, and he just knew as well, as it was quite evident from his physical self. I was very impressed with the way it was handled on both sides, ie medical team and patient/family. A decision was made to try to alleviate symptoms without heroics. The patient stated he was "ready to go when God takes me". My heart went out to him, as it's always sad to see a life come to an end, but I think all around it was handled well. I have no doubt that if and when he becomes uncomfortable, his symptoms will be very well managed.

 

[tinkntraining]

This will be too long, but I so understand how you feel and I've not let myself actually talk or write about this yet, it's still so painful in my heart, so please forgive me. My 82-year old mother was diagnosed with vascular dementia less than a year and a half ago. During that time, she went from being a vital, highly intelligent woman who served on a multitude of non-profit and financial company boards, to an empty shell within a eight-month period. My mother was so smart, she honestly thought she had taken care of everything for her "old age" - she & my dad moved into an assisted living (AL) facility, had a long-term health care policy, signed legal medical POA & DNR forms, and for most of her life, she watched what she ate and walked 3 miles every day. Due to her financial planning skills, she had tons of retirement savings because she "knew" my dad, who always was in bad health, was going to go first and she didn't want to be a burden. Since no one in her family had ever had Alzheimer's or dementia, it was NEVER on her worry list, so she never wrote any provisions for that scenario. Now, she's had to be separated from my father in AL, her husband of 60 years whom she no longer recognizes, to stay in a medical facility where she's watched 24-7 because of rage issues and trying to leave and walk into traffic in the middle of the night. She does not recognize her children or her grandchildren. A woman who always prided herself on her clothes and appearance, now wears unmatching, stained clothes with soiled pants, and drools. She doesn't know what day it is or what time it is and is ready to go to bed as soon as the sun sets, even if it's only 4:30 pm. My mother would be horrifed if she saw herself this way, as all of us who love her are, yet, it angers me no end that the pharmaceutical companies are making a fortune out of the multitude of pills and drugs she (and others like her) is given every single day (about 20) for blood pressure, blood thinning, cholesterol, allergy, anxiety and psychotic medications...the list goes on. They should give an option - not just DNR, but "please don't continue to give me chronic condition medications to keep me alive even though I'm not really living." The doctors don't have the authority to simply stop these medications and so they say she may live another year or even up to three and my heart is breaking and my dad can't stop crying. The emotional toil on our family has been immense. My MIL, who is the same age as my mom and is battling breast cancer, after seeing the condition of my mom said to me - "there are things worst than cancer and people my age are living too long" (she is a both a brave & a wise woman). If I am ever given a diagnosis like this - I would want to do something while I was still mentally able, so that my loving family would NEVER have to go through this and see me this way and deal with these issues. But, most of all, I would never judge or make a decision for other families who haven't been through it.

And, Silent1CB - thoughts and prayers for your friend and his dad.

As a caregiver for my mom with dementia -- I couldn't have said it better. And thank you for being so brave to post your feelings.

Hugs to Silent1CB, too. It's so difficult to watch. My heart goes out to you and your friend's family.

 

[Judy from Boise]

almost all freedoms have the potential to be used for evil, I cannot understand so simplistic thinking that because something could be used for evil instead of good, we will deny the large majority the personal freedom to legal chose when and how they die? I happen to have more faith in our society that we could have reasonable safeguards and laws, that prevent most abuses. In some cases the benefit of the majority really should trump the failure of the minority.

 

[PaulaSB12]

almost all freedoms have the potential to be used for evil, I cannot understand so simplistic thinking that because something could be used for evil instead of good, we will deny the large majority the personal freedom to legal chose when and how they die? I happen to have more faith in our society that we could have reasonable safeguards and laws, that prevent most abuses. In some cases the benefit of the majority really should trump the failure of the minority.

Anything that leaves people too scared to go to hosipital because they fear being put down is a big problem. Also if you haven't noticed doctors in Holland are now going after babies they don't think are worth while how many of you parents of disabled children think they would be better off dead?

 

[eliza61]

Anything that leaves people too scared to go to hosipital because they fear being put down is a big problem. Also if you haven't noticed doctors in Holland are now going after babies they don't think are worth while how many of you parents of disabled children think they would be better off dead?

So why hasn't anyone reported this or protested. I mean all of Holland is simply allowing these doctors to kill all the disabled children? Why has no one seemed to have heard of this? I do have a son who is special needs, there are so many advocacy agencies, special ed teachers etc etc who I come in contact with. I find it hard to believe that Holland has all these doctors supposedly murdering disabled children and the Parents are quietly going along with the program?

sorry, I see you feel very strongly about this and that's good, I'm just having a hard time picturing Holland's medical community all blinding going along with this modern day extermination scenero you've painted.

 

[Pigeon]

Anything that leaves people too scared to go to hosipital because they fear being put down is a big problem. Also if you haven't noticed doctors in Holland are now going after babies they don't think are worth while how many of you parents of disabled children think they would be better off dead?

Do you have a legitimate unbiased source for this?

 

[fortheluvofpooh]

If we can be humane to animals, why not to people. If they are coherent and can make a "will" of sorts ahead of time stating their wishes then why not.