Should Euthanasia be legalised?

[Dak]

I'm for it. I believe in the right of the individual to choose the time and mode of their own death, but I'm talking from a clinical standpoint, which means I'm referring to patients in severe and intractable pain from terminal conditions and not advocating people throwing themselves under trains because they're depressed (depression is treatable).

 

is deperssion allways treatable?

 

Anyway, isn't it up to someone wether they want to live through the depression or just call it quits?

[john5746]

I completely agree with Glider on this one. When I visit a hospital or old folks home, I can see the need for euthanasia. I could even see extending it to depressed people, but that would need to be after much time and effort combating the condition. I know I would like to be able to take myself out under certain conditions, so I cannot deny that to others.

[Glider]

is deperssion allways treatable?

I should have been more clear here. Depression is always treatable yes (insofar as depression can always be treated), but that doesn't mean the treatment is always successful.

 

I was using the term 'treatment' in the sense of 'an intervention with a good probability of success'. In more severe depressive conditions, (e.g. bipolar disorders), the condition may not respond to treatment per se, but it is controllable, i.e. the intervention (e.g. lithium) does not 'cure' the underlying condition, but will control the symptoms.

 

So, whilst depression is always treatable, the treatment is not always fully effective, but under those circumstances, what's left is controllable.

 

Anyway, isn't it up to someone wether they want to live through the depression or just call it quits?

Arguably yes, but only if one is arguing for the right of suicide which, I think is qualitatively different from euthanasia.

 

Given that in so many cases, depression is temporary (it may be long-term, but that doesn't make it permanent), I think it would be a mistake to provide euthanasia for depressed individuals.

 

Revcovery rates in depression are usually good, but the problem is that due to the nature of the condition, insight and perspective are the first things a depressed person loses. This is evidenced by the fact that every week in the USA, a doctor commits suicide (not the same doctor), even though they are in a good position to know that the condition is potentially treatable or self-limiting.

 

I think to provide euthanasia to somebody who is known to have lost their insight and perspective would be wrong. As to whether they have the right to commit suicide nonetheless, that's a different discussion.

[Silverspeed]

What about Voluntary Euthanasia vs Involuntary? Surely theres more than just two kinds of Euthanasia.

 

Yes there probably is

But im listing the two main kinds of Euthanasia

[ydoaPs]

Yes there probably is

But im listing the two main kinds of Euthanasia

 

I suggest you read Rethinking Life and Death by Peter Singer.

[JHAQ]

Absolutely YES but only with proper constraints . It is therein where lies the difficulty--- the main one being how to do it without putting pressures on people deemed "imconvenient " for any reason . My many dogs have died far better deaths than many of my relatives .

[Dak]

I should have been more clear here. Depression is always treatable yes (insofar as depression can always be treated), but that doesn't mean the treatment is always successful.

 

I was using the term 'treatment' in the sense of 'an intervention with a good probability of success'. In more severe depressive conditions, (e.g. bipolar disorders), the condition may not respond to treatment per se, but it is controllable, i.e. the intervention (e.g. lithium) does not 'cure' the underlying condition, but will control the symptoms.

 

So, whilst depression is always treatable, the treatment is not always fully effective, but under those circumstances, what's left is controllable.

 

Ok. in that case, what would be your oppinion on euthanasia for people who have reached the point where it's probably not going to get any better under treatment (or do you not reach a point where you know that?)?

 

Arguably yes, but only if one is arguing for the right of suicide which, I think is qualitatively different from euthanasia.

 

well, i dunno. if we're going to accept suicide, i don't see the problem with helping suicidees, both to make sure they've explored all avenues of treatment and to help make it as painless as possible, for them and their friends/family.

 

Given that in so many cases, depression is temporary (it may be long-term, but that doesn't make it permanent), I think it would be a mistake to provide euthanasia for depressed individuals.

 

otoh, doesn't it again come back to being the patients choice as to wether they want to go through with the (potentially long) treatment regime in order to get their life back? espescially if they're old or depressed 'cos they have a terminal disease, and might not actually last through the treatment?

 

Revcovery rates in depression are usually good, but the problem is that due to the nature of the condition, insight and perspective are the first things a depressed person loses. This is evidenced by the fact that every week in the USA, a doctor commits suicide (not the same doctor), even though they are in a good position to know that the condition is potentially treatable or self-limiting.

 

lol@'not the same doctor'

 

don't most depressed people know that they're depressed, and that the feelings will either go away or become lesser over time with proper treatment, even tho they don't neccesarily feel as if that's the truth?

 

if that's the case, then i'd argue that they're objectively sane, but (not to make light of their situation) suffering from a lack of enthusiasm to actually stick it out knowing that untill they get better they'll feel like they do. IF that's the case, and as long as they're aware that the feelings will probably go away after a while, i'd still be inclined to grant them euthanasia: it's their life, so it's theirs to choose wether to go through a bad patch to make it good again, or wether to just call it quits. maybe that US doctor understands his situation fully but still descides that he doesn't want to invest the suffering neccesary to get past the depression and back to having a good life?

[Mirabelle]

don't most depressed people know that they're depressed, and that the feelings will either go away or become lesser over time with proper treatment, even tho they don't neccesarily feel as if that's the truth?

Such clarity is not usually present in depression. Perhaps being in a foul mood you may realize that it will pass but in most cases of depression it's not a matter of "get over it" or "This too shall pass".

 

There is a very often an accompanying feeling of true hopelessness and sometimes self loathing that could be what is leading them to consider suicide.

[Glider]

Ok. in that case, what would be your oppinion on euthanasia for people who have reached the point where it's probably not going to get any better under treatment (or do you not reach a point where you know that?)?

In cases of depression, you never reach that point. There are many forms of depression and the majority have a high spontaneous remission rate.

 

well, i dunno. if we're going to accept suicide, i don't see the problem with helping suicidees, both to make sure they've explored all avenues of treatment and to help make it as painless as possible, for them and their friends/family.

Here I thihk we're confusing plain suicide with euthanasia. If you're talking about a situation in which all other avenues of treatment have been explored etc., then it sounds like you're talking about euthanasia. On the other hand, in cases of suicide the individual, if left untreated would not die without taking their own life.

 

otoh, doesn't it again come back to being the patients choice as to wether they want to go through with the (potentially long) treatment regime in order to get their life back? espescially if they're old or depressed 'cos they have a terminal disease, and might not actually last through the treatment?

If there's a life to get back, then one should try. However, in cases of terminal illness, there is nothing to get back. This is a difference between 'euthanasia' and 'suicide'.

 

lol@'not the same doctor'

 

don't most depressed people know that they're depressed, and that the feelings will either go away or become lesser over time with proper treatment, even tho they don't neccesarily feel as if that's the truth?

All depressed people know they are depressed, however none of them know these feeling will go away or lessen over time. It's that despair that is a major part of depression.

 

They can know it on an intellectual level, but that's a long way from believing it on an emotional level. The intellect in these cases provides no comfort. You can know the depression will get better, but that's of no comfort if you don't believe it. That's the thing about depression. The logical triad of 'knowing' does not apply.

 

Under normal circumstances, to know a thing, a) you must believe it b) it must be true and c) you must be justified in believing it (i.e. have some sound rationale for believing it). If these criteria are true then you can be said to know that thing.

 

However, in depression, a person can be justified in the belief that it will pass (i.e. have a sound rationale for the belief), and that fact is true, but they can't be said to know it's true because despair prevents them from believing it. In this, they can be said to be aware of the fact that these feeling will pass, but they cannot be said to know it.

 

if that's the case, then i'd argue that they're objectively sane, but (not to make light of their situation) suffering from a lack of enthusiasm to actually stick it out knowing that untill they get better they'll feel like they do. IF that's the case, and as long as they're aware that the feelings will probably go away after a while, i'd still be inclined to grant them euthanasia: it's their life, so it's theirs to choose wether to go through a bad patch to make it good again, or wether to just call it quits. maybe that US doctor understands his situation fully but still descides that he doesn't want to invest the suffering neccesary to get past the depression and back to having a good life?

Whilst depressed people are not insane, they have lost their perspective and are only 'seeing' half of reality (the negative half) and so cannot be considered to be of sound mind.

 

To accommodate their suicidal wishes is not helping them at all, it's buying into their belief that their despair and loss of perspective are permanent, which is not true. I don't think you can ethically provide euthenasia based on a false premise.

 

The difference here is what the patient has to lose. The terminally ill patient has nothing to lose. The depressed patient has the rest of their lives to lose. Their not wanting to live it is a temporary state and the best you can do is help them through it.

[Dak]

Here I thihk we're confusing plain suicide with euthanasia. If you're talking about a situation in which all other avenues of treatment have been explored etc., then it sounds like you're talking about euthanasia. On the other hand, in cases of suicide the individual, if left untreated would not die without taking their own life.

 

well, i was kinda taking 'euthanasia' to mean 'merciful death', i.e. any form of killing that was less painful than living.

 

I'm trying to think of it as simply as possible, and i think you can probably categorise 'suicide' into three classes:

 

1/ person will go through pain and then die, and wishes to cut out the 'going through pain' bit by dying earlyer

 

2/ person will go through pain and then live happily, but does not wish to go through the pain in order to get better

 

3/ person is not thinking clearly (ubiquitous 'other reason' someone might do something). if someone coincidenatally falls in another group, i'd treat them as in this one.

 

i think we're agreed that group 3 at the very least shouldn't be assisted in killing themselves, and that group 1 should. group 2 is where we disagree. which, yes, i would consider 'euthanasia' because i think it's merciful to help someone, both to make the descision and to kill themselves if they descide to (but i'll call it suicide from now on to avoid confusion).

 

If there's a life to get back, then one should try. However, in cases of terminal illness, there is nothing to get back. This is a difference between 'euthanasia' and 'suicide'.

 

In your (and tbh my) oppinion, yes. however, my point was that, as long as someone isn't having their thinking inpaired to the point where they can't make sane disisions, then shouldn't the choice as to wether to go through the pain in order to get ones life back be up to the person who's life it is?

 

btw, there's also an element of practicality guiding my oppinion: if someone's going to commit suicide, then they're going to commit suicide; by helping them, you could up the chances they'll go to a psychologist and have things explained to them (eg, treatments, the fact that it will get better eventually, etc) and, if they still want to, can be assisted in their suicide so that it's as painless as possible, both for them and their survivors. maybe just making it clear that it's an option would help (iirc, depressed people feel less hopelessly trapped in a shitty situation that they can't escape after they've made the desision to kill themselves?). iirc, this is the stance adopeted in holland, and the suicide rate fell after they adopted it.

 

All depressed people know they are depressed, however none of them know these feeling will go away or lessen over time. It's that despair that is a major part of depression.

 

They can know it on an intellectual level, but that's a long way from believing it on an emotional level. The intellect in these cases provides no comfort. You can know the depression will get better, but that's of no comfort if you don't believe it. That's the thing about depression. The logical triad of 'knowing' does not apply.

 

Under normal circumstances, to know a thing, a) you must believe it b) it must be true and c) you must be justified in believing it (i.e. have some sound rationale for believing it). If these criteria are true then you can be said to know that thing.

 

However, in depression, a person can be justified in the belief that it will pass (i.e. have a sound rationale for the belief), and that fact is true, but they can't be said to know it's true because despair prevents them from believing it. In this, they can be said to be aware of the fact that these feeling will pass, but they cannot be said to know it.

 

maybe i'm using 'depressed' differently than you. i'm just meaning someone who is unhappy to the point where 'unhappy' doesn't do their feelings justice. possibly with skewed perceptions, lack of perspective, and inability to believe they'll get better as a result of their depression.

 

are they neccesary results of depression? i.e., if you're depressed to the point where you'd consider killing yourself, would you also be depressed to the point where you'd be incapable of truly believing you'll recover? or, is it that to be classified as clinically depressed (which i'd guess is what you're talking about, you being a clinical psychologist 'n'all) you have to have skewed perception and an inability to believe that you'll recover, else you're just unhappy?

 

iow, if i keep talking about depressed people, are you going to keep on thinking about people who have skewed perceptions because that's part of the definition of being depressed, or because it's an unavoidable concequence?

 

Whilst depressed people are not insane, they have lost their perspective and are only 'seeing' half of reality (the negative half) and so cannot be considered to be of sound mind.

 

To accommodate their suicidal wishes is not helping them at all, it's buying into their belief that their despair and loss of perspective are permanent, which is not true. I don't think you can ethically provide euthenasia based on a false premise.

 

The difference here is what the patient has to lose. The terminally ill patient has nothing to lose. The depressed patient has the rest of their lives to lose. Their not wanting to live it is a temporary state and the best you can do is help them through it.

 

otoh, can they understand 'you'll get better, but it will probably take a while, possibly up to x-years' and make a rational descision based on that?

 

again, as a practicle element: wouldn't they be more likely to overcome their depression and actually make a rational descision if they have a psychologist helping them? i'd not neccesarily advocate automatically assisting suicide, maybe only if/when they've gone through a period of treatment and established that they can understand their situation and overcome their skewed perspective as much as can be expected of a human.

 

btw, isn't 'feelings of everlastingness' common to any affliction? this is just anecdotal, but it seems that everyone i know who has had any condition (espescially bad, but also good) seems to have trouble actually believing that it's going to change. e.g., it certainly doesn't feel like my guts are going to ever get better (IBS for 3ish years now), but i acknowledge that they will, and am planning to do an MSc in gene manipulation techniques when i get better, so even tho i don't actually believe that i will recover as far as my feelings are concerned, i'm still planning as if I will -- i'm assuming that depressed people could take a similar approach? act as if they believe, even tho they don't?

[ParanoiA]

Such clarity is not usually present in depression. Perhaps being in a foul mood you may realize that it will pass but in most cases of depression it's not a matter of "get over it" or "This too shall pass".

 

There is a very often an accompanying feeling of true hopelessness and sometimes self loathing that could be what is leading them to consider suicide.

 

But Dak's got a point. I've known many people suffering from depression, and while they do feel hopeless as you say, if they didn't think someday they'd feel better then I'm convinced all of them would commit suicide - it's debilitating and the self loathing becomes a futile feedback loop. It's grim, and it's not clear to them, but it's in them and is the only reason they try. Obviously this doesn't apply to everyone, but I do believe it does most.

[iNow]

You seem to be confusing depression with lasting sadness. Depression is a different monkey all together.

[ParanoiA]

You seem to be confusing depression with lasting sadness. Depression is a different monkey all together.

 

On the contrary, it's precisely the grim nature of depression that leads me to my conclusion. Why wouldn't you kill yourself?

[iNow]

On the contrary, it's precisely the grim nature of depression that leads me to my conclusion. Why wouldn't you kill yourself?

 

I dunno. Perhaps the depression gets balanced by masochism?

[Mirabelle]

But Dak's got a point. I've known many people suffering from depression, and while they do feel hopeless as you say, if they didn't think someday they'd feel better then I'm convinced all of them would commit suicide - it's debilitating and the self loathing becomes a futile feedback loop. It's grim, and it's not clear to them, but it's in them and is the only reason they try. Obviously this doesn't apply to everyone, but I do believe it does most.

 

I agree. Simply by seeking help for their depression shows they know somehow this can be better or they still have hope that it can.

 

However, I do not feel that a person suffering through "clinical" depression has the clarity to request and be granted euthanasia.

 

How many people who have been through depression have seriously thought about suicide and then after they recovered regretted even thinking it?

 

I can not to see the choice of euthanasia as a "yes or no" for all persons in all situations.

[Rhino]

Euthanasia, or mercy killing should be legal as long as it is voluntary IMO. It's really not connected to other suicides that stem from mental issues such as depression. Euthanasia is simply the act of ending the life of an individual suffering from an incurable illness or condition such as inoperable cancer. I've had a few relatives die painfully and suffer a great deal. I think it should have been an option open to them to preserve their dignity if they wished to do so.

 

It primarily faces opposition from religions that suggest "god" has control of life and death, and to take those matters into your own hands is to oppose god's will.

[Neopluto]

Completely agree with Rhino.

 

Of course we can get back to the sticky subject of those with an altered state of mind having control of someone's life...but for the sake me not posting something really lost, let's not (for now).

 

However, I do have a question. DNRs are just too narrow for me, I don't think I'd ever sign one. However, if in a will you state that you don't want to be kept on life support in such and such situations, or if you tell a close family member, how does that play out? I would assume it's still under jurisdiction of state law (in which case I've move to Oregon). Should it be? I think it's apparent that I think not. Then again, we get into more hazy lines and such with being able to verify that said person was okay with whatever they chose.

So in my perfect world, (unless this already exists) there should be a legal document that people must make after the age of 18 specifying terms of their death in extraordinary conditions. Yes, I realize the age can be debated on, but it would land basically where a person is capable of making their own decisions knowing that they will actually impact their life. I would say earlier rather than later because then the document would be pointless to have. And of course, you may edit it anytime you wish. You should also have some very close family member with you so that it's not just on paper, but spoken aloud as well.

[Lilian]

I believe if someone is in a lot of pain, has no prospect of ever leading a "normal", fulfilling life (ie. a low quality of life) or even survival, then Euthanasia is okay.

 

Some people with terminal illnesses may decide to "die with dignity" before the disease leaves them completely dependent on someone and incapacitated. Any opinions?

[Zaire]

im surprised no one has invoked Hippocrates' law for this

[Cap'n Refsmmat]

That's because they don't want to defer to an arbitrary law, they want to discuss the actual morality of the issue.

[Mr.Chockuls]

i think that actived Euthanasia should be legalised, because if you are suffering too much and you dont have any cure, you could choose if live or die.

[Zaire]

arbitrary law? its an oath taken by doctors and is vitally important to this issue...

[Cap'n Refsmmat]

arbitrary law? its an oath taken by doctors and is vitally important to this issue...

 

But it's not the definition of morality, and we're talking about the morality of an issue here.

[DrDNA]

Hmmmmm.....

Quote:

"THE OATH OF HIPPOCRATES

I SWEAR by Apollo the physician and AEsculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgement, I will keep this Oath and this stipulation-- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men,in all times. But should I trespass and violate this Oath, may the reverse be my lot.

 

THE LAW OF HIPPOCRATES

Medicine is of all the arts the most noble; but, owing to the ignorance of those who practice it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. Their mistake appears to me to arise principally from this, that in the cities there is no punishment connected with the practice of medicine (and with it alone) except disgrace, and that does not hurt those who are familiar with it. Such persons are the figures which are introduced in tragedies, for as they have the shape, and dress, and personal appearance of an actor, but are not actors, so also physicians are many in title but very few in reality. Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; instruction; a favorable position for the study; early tuition; love of labour; leisure. First of all, a natural talent is required; for, when Nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. He must also bring to the task a love of labour and perseverance, so that the instruction taking root may bring forth proper and abundant fruits. Instruction in medicine is like the culture of the productions of the earth. For our natural disposition, is, as it were, the soil; the tenets of our teacher are, as it were, the seed; instruction in youth is like the planting of the seed in the ground at the properseason; the place where the instruction is communicated is like the food imparted to vegetables by the atmosphere; diligent study is like the cultivation of the fields; and it is time which imparts strength to all things and brings them to maturity. Having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall thus, in travelling through the cities, be esteemed physicians not only in name but in reality. But inexperience is a bad treasure, and a bad fund to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity. For timidity betrays a want of powers, and audacity a lack of skill. They are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant. Those things which are sacred, are to be imparted only to sacred persons; and it is not lawful to impart them to the profane until they have been initiated into the mysteries of the science.

 

THE MODERN OATH OF HIPPOCRATES

(Please read the "Physicians' Charter," a new Charter on medical professionalism)

 

One version, approved by the American Medical Association, is as follows:

 

You do solemnly swear, each by whatever he or she holds most sacred:

 

That you will be loyal to the Profession of Medicine and just and generous to its members.

That you will lead your lives and practice your art in uprightness and honor.

That into whatsoever house you shall enter, it shall be for the good of the sick to the utmost of your power, your holding yourselves far aloof from wrong, from corruption, from the tempting of others to vice.

That you will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it.

That whatsoever you shall see or hear of the lives of men or women which is not fitting to be spoken, you will keep inviolably secret.

These things do you swear. Let each bow the head in sign of acquiescence. And now, if you will be true to this, your oath, may prosperity and good repute be ever yours; the opposite, if you shall prove yourselves forsworn.

From "Harvard Classics Volume 38"

Copyright 1910 by P.F. Collier and Son.

This text is placed in the Public Domain, June 1993."

End Quote.

[Zaire]

your point?

i know what it is, and i'm just saying that doctors hold it in the highest esteem and euthanasia would profoundly go against it.