How can you deny euthanasia?

[cobl04]

It's extremely easy for you to say he should fight on. That's cold comfort to him.

I'm not suggesting doctors be forced into doing it, but I'm sure there are people out there who could end this man's life because he doesn't want to live in hell any more.

[Kieran McConville]

Stephen Hawking may not be the best example. He's a major physicist with a global reputation and I would imagine considerable means at his disposal. There must be compensations there for his physical condition. I mean there must be, because he is still around. That is not necessarily a typical situation (incidentally his condition typically is terminal, and within quite a short time).

[Irvine511]

This condition is very, very different from Terri Schiavo.

[anitram]

Euthanasia is something that the individual would have to elect after having undergone extensive psychiatric evaluation to determine that he or she is not depressed, coerced, etc. What does this have to do with Stephen Hawking? I don't think that he's calling for assisted suicide.

It's also very patronizing IMO to tell people that they need to fight on. Why not all those kids dying of cancer whose parents make the decision to stop treatment? Should those kids suck it up and continue because it ain't over until you're actually dead?

[Galeongirl]

If a physically healthy person wants to get out of this world, they commit suicide.

If someone isn't able to do that, but still has very rational reasons for wanting to be dead, who are we to deny them that? Why should we force them to live the shitty life they don't want to live anymore?

[Pearl]

Originally Posted by AchtungBono

What would have happened if Stephen Hawking had been euthanized years ago? His is almost the same thing - he has ALS and is also paralyzed with no means of communication other than his voice box. What would have happened if Christopher Reeve had been euthanized after his accident? He was also paralyzed from the neck down with no hope of survival....

I am so very very sorry for this poor man's condition but I believe that, instead of wanting to end his life, perhaps he could use his circumstances to help other people in his condition - like Christopher Reeve did.
The article said that his mind isn't affected and his condition isn't terminal so I believe that he should fight on.

The murder (in my opinion) of Terry Shiavo was an absolutely horrible story. She was alive, she responded to the outside (we all saw her eyes following the balloon over her head) and in the end she was selfishly and cruelly starved to death. You can look at all my posts in the Shiavo thread from a few years ago and you can see how critical I am of euthanasia(sp?) which, in my opinion, is a fancy term for murder.

All that being said......if he wants to end his life then he should just do it himself and not involve anyone else who might get prosecuted because of him.
However, I really don't want him to die - I hope he lives long enough to be treated and eventually cured.

Niklinson can't help others. His only way of communication is to blink and that doesn't help much. He is a prisoner of his own body.

I'd like to see this man be cured too, but when will that happen? Are doctors and scientists any where close to curing his disease or paralysis? I haven't seen any reports indicating that they are. So, how long do we have to wait? 10 years? 20 or 30? Let's say Niklinson dies naturally along the way - it would be like all the waiting for nothing.

ETA: I just want to say that I think modern medicine seems like a double edged sword. There are ways to keep people alive after paralysis, major brain damage, etc., yet they are trapped in their bodies. 50 years ago, they would've died. Seriously, science has to get moving with stem cell research and the like to get people like Niklinson out of their hellish existence.

[lemonfly]

Locked in syndrome is perhaps the worst thing that could happen to a person. Out of all the heinous afflictions - cancer, AIDS, MND, Parkinsons, Alzheimers etc - locked in is probably the worst because it's usually sudden so there is no time to prepare/adjust. My deepest sympathies go out to this man. I don't think he can be asked to "tough it out" because how could any able bodied person have the slightest comprehension of what he's going through? Also the poster who said he should take his own life - how exactly? Refuse food? The doctors would only feed him intravenously. For extreme (and thankfully very rare) cases such as this, the laws on assisted suicide should be ammended. It is devastating not only for the victim but also their family.

[yolland]

Originally Posted by Liesje

I suppose you could just not care for a locked in patient, it would just take a lot longer for him to die.

It sounds like that's exactly what the other patient who was petitioning the Court alongside Nicklinson was seeking. But apparently that's not legal either, I guess because the condition necessitating the feeding tube/IVs wouldn't in itself be terminal or life-threatening.

From cobl's article:

Martin, 47, also has locked-in syndrome and asked for the court to allow professionals to help him die either by withholding food and water or by helping him go to a clinic in Switzerland to die. His wife said she respects his wishes, but does not want to help kill him.

ETA -- According to this textbook (Ethical Issues in Neurology), US courts have in some cases permitted this:

Two locked-in patients were similarly permitted to die when they refused life-sustaining therapy. Hector Rodas was a young man who was chronically locked-in following a brain stem stroke. A Colorado district court found [1987] that he had the right to refuse hydration and nutrition because he was "mentally capable of refusing treatment." Under the circumstances, his decision was "rational and reasonable." Murray Putzer also was in a locked-in state and refused hydration and nutrition for the same reason. The New Jersey Supreme Court [1987] upheld his right to refuse treatment because it was a rational choice not to want to live in a chronic locked-in state and because refusing therapy in this context did not count as suicide.

However the text also notes that in other, similar cases, such as that of Elizabeth Bouvia, a court did not uphold the patient's right to refuse hydration and nutrition:

On September 3, 1983, Bouvia, at the age of 26, admitted herself into the psychiatric ward of Riverside General Hospital in Riverside, California. She was almost totally paralysed by cerebral palsy and had severe degenerative arthritis, which caused her great pain. Bouvia was alienated from her family and husband, and had been entertaining thoughts of suicide. She requested hospital authorities to allow her to starve to death. When they refused and ordered her to be force-fed, Bouvia contacted the American Civil Liberties Union, which assigned her a lawyer. In the subsequent lawsuit, the court upheld the hospital's decision and ordered force-feeding to continue. Following the court case, a bitter dispute broke out among physicians regarding the Bouvia case. Bouvia tried to resist the force-feeding by biting through the feeding tube. Four attendants would then hold her down while the tubing was inserted into her nose and liquids pumped into her stomach. Some physicians called this battery and torture, while others claimed that the hospital was right to err on the side of continued life. Bouvia appealed the lower court ruling and lost. Now, in addition to the force-feeding, she was hooked up to a morphine drip to ease the pain of her arthritis.

Eventually, she appealed again and this time the court ruled in her favour that the force-feeding constituted battery [1986]. After the court case, Bouvia decided that she would live. [Specifically, she stated that she found the resulting process of starvation, in tandem with the morphine side effects, too painful to bear. ~y.] In 1998, she appeared on 60 Minutes, saying that she was still in pain and had felt great pressure to continue living; she expressed the hope that she would soon die of natural causes. She was still living in 2002. In its obituary for USC professor Harlan Hahn, the Los Angeles Times on May 11, 2008, reported that Bouvia was still alive.

[LJT]

Life in itself, not quality of life seems to be held above everything else. I often struggle with this in my area of work being a nurse on a respiratory ward. There is very little acceptance of death among the consultants, and a lot of the treatment given to some of our patients who have terminal illnesses and are at the end stage of the illness are very unnecessary, IV medications given 10 times a day, NG tubes inserted, non-invasive ventilation masks that will be required to be worn 18 hours a day that leave sores on your face, unable to communicate properly, and entirely dependent on the mask for breathing. We'll drag people's lives out for another couple of weeks in a barely coherent state with no real plan for attaining a certain standard of life.

I've watched Motor Neurone's disease patients nearly choke to death on a small bit of phlegm. With all our medical advances we have merely sought to extend life into a state of limbo, a half life and we watch the slow torturous degradation of people all the time, repeat admissions getting worse all the time.

Before the medical profession even thinks about implementing euthanasia, it needs to look hard at how we actually manage the majority of end of life patients and how to let go better. That said the junior doctors I work with seem more open to idea of less intensive and invasive treatments towards the end of life.

I also find DNR orders less than useful, as they may stop a resus attempt being made but up til then it still allows for some pretty invasive and extensive treatment to take place that often borders on the cruel. There has to be more value in a good death well prepared death than a pain filled or vacant life.

[anitram]

Originally Posted by LJT

I also find DNR orders less than useful, as they may stop a resus attempt being made but up til then it still allows for some pretty invasive and extensive treatment to take place that often borders on the cruel. There has to be more value in a good death well prepared death than a pain filled or vacant life.

As a lawyer I am well aware of this and also of my rights. If I were diagnosed with a terminal illness, one of the first things I would take care of is to ensure that I had a legally binding document that clearly outlined which procedures are not to be done on me.

It is astounding to me that we keep people alive at all costs when their quality of life is nonexistent and their prognosis is death. Dying with dignity and on my own terms is of paramount importance to me.

I remember the last weeks and days of my grandmother's life and I hold the medical profession, at least the doctors involved in her care in great contempt for the suffering and needless procedures she endured to get a few more weeks of agony. My other grandmother, who had very clear directives and who had the luck of living in a country where patients' rights are respected, died very peacefully, when her time came.

[bono_212]

I have mixed feelings about Euthanasia, but I came here to say that DNRs confuse the hell out of me.

My grandmother has horribly bad emphysema and is in and out of the hospital on a fairly regular basis. She has been placed on a respirator multiple times, in spite of her DNR. I thought they weren't allowed to do that?

The fact is, I'm glad for it, because she has come back every time and every time has recovered to the point of being able to go home.

I hate living in this constant loop of her getting sick/being on the respirator/recovering, but she wants to live and it means I get more time with her, but it get so scared and confused because of the DNR.

[LJT]

A DNR at least in the UK basically means you will not carry out CPR on a person who has sustained cardiac or respiratory arrest (Though if I remember correctly our policy on it is based off a US one). It only really concerns the moment of death and that you will not attempt to get them back.

So in the case of your grandmother the exacerbation of her emphysema is something that is short term wise easily treatable and she can be returned to her baseline of fitness before the exacerbation occurred, so very aggressive, active treatment will be given.

What DNRs generally stop at least here is people being escalated to intensive care. What usually happens on my ward is that they may be DNR but we will escalate the care to ICU levels without actually sending them to ICU, so there will be multiple drips, respirators, strong and horrible medications etc (from my own personal perspective it makes life hell on the ward as I am generally looking after 8 patients and if one requires almost ICU levels of care, the rest tend to get neglected).

The worst thing is seeing families come in with loved ones multiple times to the hospital towards the end of life, with the expectation 'is it going to be this time'. Then get sent home again only to repeat it a few weeks later. It is a kind of mental torture, anyway you have my best wishes for your gran.

Just in reference to Anitram, we do have the ability to create Advanced Care Plans where a patient can specify what sort of treatment can be given when they reach the end of life, but most do not know their rights regarding this and are generally completely unaware. Doctors never ever raise this with the patient and I have only ever seen one in effect once in 4 years throughout my training and now as a qualified nurse and even then it was disregarded due to some missing documentation.

[Jive Turkey]

Originally Posted by AchtungBono

I am so very very sorry for this poor man's condition but I believe that, instead of wanting to end his life, perhaps he could use his circumstances to help other people in his condition - like Christopher Reeve did.
The article said that his mind isn't affected and his condition isn't terminal so I believe that he should fight on.

.

It's none of your business, so it doesn't matter what you think he should do with his life

[Jive Turkey]

Originally Posted by AchtungBono

.

All that being said......if he wants to end his life then he should just do it himself

He can't. That's the whole point

[Liesje]

I believe a DNR means they won't use CPR or AED to bring someone back. If she goes in sick and they put her on a respirator, that's different. I suppose she could refuse treatment but that would be different than the DNR. If she went in not breathing and her heart had stopped, *then* the DNR applies.

[bono_212]

Thanks LJT and Lies. That makes a lot of sense and is what my brain was vaguely assigning was the vcr, so I thank you for the knowledge. It actually helps a lot.

[AchtungBono]

Originally Posted by Jive Turkey

It's none of your business, so it doesn't matter what you think he should do with his life

Hi Jive Turkey,

You're right - it ISN'T my business thank G-d almighty.....

We're just having a discussion and I'm voicing my opinion - and that DOES matter on a message board, just like yours does,

[Jive Turkey]

Hi AchtungBono. Always so polite!

I guess my point is just that it's very patronizing to say to someone so desperate to be relieved of their suffering "no, I think you should do this with your life". Your opinion does matter here. But in the real life situation, no one's should matter but the person suffering

[AchtungBono]

Originally Posted by Jive Turkey

Hi AchtungBono. Always so polite!

I guess my point is just that it's very patronizing to say to someone so desperate to be relieved of their suffering "no, I think you should do this with your life". Your opinion does matter here. But in the real life situation, no one's should matter but the person suffering

Gee...thanks....

Again, you're right - ultimately it is no one's concern what he does.
In any case, I don't mean to be patronizing - I do deeply sympathize with him and hope that somehow his suffering will end - hopefully by treatment.

[Saracene]

Originally Posted by anitram

It is curious that we are all in favour of allowing our pets a dignified death when they are suffering beyond comprehension and without any chance for improvement, but when it comes to humans, many of us totally lose all rationality with respect to this debate.

Well, I guess there's the fact that ending an animal's life, for a wide variety of reasons - food, population control, because the pet has become dangerous etc. - is a whole lot more easily accepted in our society.

Euthanasia for me is one of those impossible issues; when I read about the individual cases and people's suffering it just kills your heart, but at the same time the idea of it actually being legalised creeps the hell out of me.