January 14th, 2013

The assisted suicide slippery slope

Medical euthanasia is legal in Belgium “if those making the decision [to die] can make their wishes clear and are suffering unbearable pain, according to a doctor’s judgement.” It’s no surprise that those categories are starting to slip and blur, and evidence of this is the recent case of a pair of identical 45-year-old brothers from Antwerp, born deaf, who found out they would be going blind, who were euthanized according to their wishes by doctors at a Belgian hospital.

The twins had spent their entire lives together, and their unbearable pain consisted of the prospect that they would be unable to see each other. From the article, it seems that the blindness had not occurred yet, but it’s difficult to tell by the way it’s written. At any rate, the issue here is not the twins’ decision to commit suicide; they could have ended their lives by themselves and we would not be reading about them. It is the participation of the medical profession with the blessing of the state that is the subject. If that was possible in a case like this, it seems that the definition of “unbearable suffering” will end up being purely subjective and/or arbitrary and/or strategic (i.e. whatever the state thinks it should be).

Dangerous. And foreseeable.

There may be more to come in Belgium and Switzerland and elsewhere:

Just days after the twins were killed Belgium’s ruling Socialists tabled a legal amendment which would allow the euthanasia of children and Alzheimer’s sufferers.

The draft legislation calls for ‘the law to be extended to minors if they are capable of discernment or affected by an incurable illness or suffering that we cannot alleviate.’

The proposed changes are likely to be approved by other parties, although no date has yet been put forward for a parliamentary debate…

A bid to tighten legal controls on assisted deaths in Switzerland and ban suicide tourism was recently rejected by the country’s parliament.

“Suicide tourism.” Now, that’s a term I’d never heard before. But it makes perfect sense, doesn’t it?

Europe appears to be sliding down this particular slope, and I would not be at all surprised if the US follows. Oregon, Washington, and Montana have already set foot on it by allowing physician-assisted suicide under certain fairly strict guidelines.

There are big differences between suicide itself, physician-assisted suicide, euthanasia at the request of the patient (the Belgian situation), and euthanasia by the decision of another party, as well as differences when the person is unable to move or communicate and therefore cannot act him/herself. This post would be at least ten thousand words long if I were to tackle those issues and those differences today. Instead, I merely acknowledge them.

But I will say that the story of the Belgian twins is deeply disturbing. If the medical profession saw fit to be involved in this particular case, where would the limits be in the future? Will there be any?

28 Responses to “The assisted suicide slippery slope”

  1. holmes Says:

    Frustrated and despairing at the limits of this world, so many of postmodern mankind are coming to the conclusion that it was better had they not been born to begin with. There is a seeping nihilism creeping into so many aspects of Western Society, worse than a Gramascian march. It’s about meaningless and despair, where anything short of heavenly comfort is seen as suffering.

    That said, I can think of a few situations where, perhaps not assisted suicide, but rather easing a natural decline can be part ofa medical solution. I know my grandfather, suffering from lung and colon cancer, was basically given a very high dose of morphine before he passed. That lowered his breathing rate, and he went into decline very quickly. That does seem better than allowing technology to keep us in unnatural pain.

  2. I R A Darth Aggie Says:

    the definition of “unbearable suffering” will end up being purely subjective and/or arbitrary and/or strategic (i.e. whatever the state thinks it should be)

    Once you accept the socialist view that we are all wards of the state, to be used as seen fit, and discarded once we become a burden to the state, this is the sort of thing that happens.

    Forget the pain pills. Try a nice hemlock tea!

  3. LTEC Says:

    For many people, the only reason they need “physician-assisted suicide” is because the state allows them no other way of quickly, painlessly, and surely ending their lives. I think such methods should be available to all adults, with certain safeguards such as a waiting period.

    And no, I am not a socialist. What’s at stake here is the individual right to own one’s own life.

    Lastly, I acknowledge that there are some negative effects on society of giving people this right. But that’s true of most rights.

  4. Jim Nicholas Says:

    As his hearing and seeing diminished, my father found satisfaction in activities that demanded less of those senses. But a time came when his loss of memory kept him from finishing sentences because he could not remember how he had begun them. He had lost much of his ability to communicate with us. He decided that life was no longer worth living. However, it never occurred to him to ask a physician or anyone else to take any responsibility for a solution. He simply said goodbye and stopped eating and drinking. My mother and his physician were understanding enough to accept his decision and not initiate tube feeding. Had it been irremediable pain rather than memory loss that rendered further life meaningless for him, I think he would have solved his problem in the same way.

    I trust I have learned my lesson from a good teacher.

  5. neo-neocon Says:

    LTEC: Note that this post is not about physician-assisted suicide. It is about euthanasia by physician at patients’ request. Except for hearing loss, the men involved seem to have been otherwise able-bodied. So if they had wanted to get the means to kill themselves by themselves (“ordinary” suicide), it seems they could have done it.

    See the definitions.

  6. George Pal Says:

    The postmodern death cult continues its expansion and claims ever more imperfect lives as falling under its purview. In the beginning there was life, then there was quality of life, we are fast approaching self-sustaining life. Do the slopes seem steeper and slipperier or is it just my age?

  7. Ray Says:

    Eugene Rose pointed out that liberalism inevitably tend to nihilism. In the UK the NHS starves patients.
    http://www.lifesitenews.com/news/doctor-admits-starving-or-dehyrdrating-10-babies-in-uk-neonatal-unit-cancer

  8. RandomThoughts Says:

    Just another facet of the subjective value placed upon human life. Aborting inconveniently conceived babies, ending one’s own life if one is facing physical infirmities, it’s all part of the same thing. A human life only has value if someone else wants it, and if the person in question will have no disabling infirmities.

    Now what society really needs is a way to effectively utilize the unwanted…Soylent Green comes to mind.

  9. James Says:

    These are the people who want “common sense” control of our firearms.

  10. JuliB Says:

    While I know that the slippery slope is a logical fallacy, I am finding more and more that it is a reality in our world.

    In this area, and in others, we see that the boundaries keep getting pushed, and it happens across societies as well. It appears that there are no limits.

    Personally, as a Catholic Christian, I cannot help but object against the cheapening of human life. Do not those who advocate for such things as suicide look upon the world from a materialistic perspective?

    From an objective perspective, there are a lot of non-religious arguments that are against the acceptance of suicide. While I have lived many decades in the libertarian camp, it doesn’t serve me well in this case. Wesley Smith (NRO, First Things) has tried to address these issues from a balanced perspective rather than solely focusing on individual rights.

    “I know my grandfather, suffering from lung and colon cancer, was basically given a very high dose of morphine before he passed. That lowered his breathing rate, and he went into decline very quickly. That does seem better than allowing technology to keep us in unnatural pain.”

    Unfortunately, something similar happened to my grandmother 2 years ago. However, such an action is euthanasia in hiding. There’s a difference in keeping someone out of pain versus ‘putting them to sleep’. Just a couple of days ago Bloomberg said he wanted to limit pain prescriptions in emergency rooms and that the poor could suck it up:

    “Number two, supposing it is really true, so you didn’t get enough painkillers and you did have to suffer a little bit. The other side of the coin is people are dying and there’s nothing perfect …There’s nothing that you can possibly do where somebody isn’t going to suffer, and it’s always the same group (claiming), “Everybody is heartless.” Come on, this is a very big problem.’ ”

    I think there’s a big problem with the fear of getting in trouble at end of life with pain meds. There shouldn’t be such fears of prosecution, but on the flip side there also shouldn’t be people being sedated to death. I’m sure it looks like they’re using fewer of the addictive pain meds. Unintended consequences, I’m sure.

    And not to be snarky, but just what is unnatural pain?

  11. Molly NH Says:

    YUK ! Who wants to live in a country with such a poor value of human life. Shouldn’t counseling be done to determine if these people are depressed or other motivation is behind the suicide reasons ? Docs should refuse to be involved IMHO.

  12. Molly NH Says:

    Actually JuliB mayor Bloomberg is way, way out of line with his proposals (restricting Pain meds at city ERs) Pain is classified as the 5th vital sign, after BP, pulse, temperature & respirations.
    Also *it is totally subjective !!!!* Even what may seemingly be identical pain (like a broken leg) can be tolerable to one individual & excruciating to another. In addition inadequately treating pain can set up a *pain loop* in the individuals brain (because the pain receptors are constantly being triggered)
    where the sufferer develops unremitting pain.
    I am so shocked that no medical professional has *pushed back* on Bloomberg practicing medicine sans license. Sadly it seems this current climate of the sycophant media’s adulation of Obama has spilled over to all public figures never being challenged !

  13. Charles Says:

    In my opinion, anyone who is suffering “unbearable pain” is NOT in the right state of mind to make such a non-reversible decision.

    And how can those elites who think most of us cannot think for ourselves truly believe that folks in such a position are able to make this decision for themselves?

  14. Alix Says:

    I think one of the most insidious dangers is that family members might nudge older, frail relatives to take advantage of the euthanasia ‘service’ for the good of ‘all’.

  15. J.J. formerly Jimmy J. Says:

    Two close relatives have suffered excruciating pain from cancer as they died, inch by inch. The dotors did not provide enough pain relief drugs because they didn’t want them to become addicts. What? They were dying and the doctors admitted they had no more than six months to live, yet they did not want them to be addicted to pain killers? That was sadism, and tyranny. The very least we can do for the dying is keep them comfortable. I pray that I don’t end with excruciating pain for which some sadistic doctor will withhold pain killers because he doesn’t want me to become addicted.

    Assisted suicide is at least a way for some one who is in awful pain to put an end to it. It’s a personal decision. Probably one of the most personal there is. As long as there are safeguards in place, I’m for it. But, as with any other laws, it should be evaluated periodically to see if it is actually working properly. It certainly can be abused, but so can any other law affecting one’s rights.

  16. IGotBupkis, Legally Defined Cyberbully in All 57 States and Some Canadian Provinces Says:

    Soory — As a strong libertarian, I find the entire notion that the State has ANY say in my own decision to quietly and peacefully end a life I consider intolerable — FOR ANY REASON WHATSOEVER — both reprehensible and despicable.

    It is PRECISELY the kind of evil that governments are prone to, to dictate behavior over things which the State has not the slightest arguable vested interest in.

    This is MY business, and MY business alone.

    You are free to be certain someone is of sound mind, and has properly considered all the ramifications, and dealt with problems ahead of time that may result from it, as much as possible.

    But, in the end, the decision is between that person and whatever God they may believe in, if it is made in sound mind and with reasonable forethought.

    No, I don’t give a rat’s ASS how much it bothers YOU that someone makes that decision.

    None of you, nor the government, has any business butting your noses into it.

    >:-/

    .

    Whose Life Is It Anyway?

    .

  17. IGotBupkis, Legally Defined Cyberbully in All 57 States and Some Canadian Provinces Says:

    }}}}In my opinion, anyone who is suffering “unbearable pain” is NOT in the right state of mind to make such a non-reversible decision.

    Charles, your claim is ridiculous. And that of a busybody. YOU have no business telling someone what is right or wrong when it comes to their life alone, having no direct effect on anyone else. No, not even family when it comes to THAT.

  18. IGotBupkis, Legally Defined Cyberbully in All 57 States and Some Canadian Provinces Says:

    Does it occur to any of you that our capacity to keep people alive under circumstances which Nature has no provision for might, at least in some cases, do the Devil’s, and not God’s work? That, as a result, you might be interfering with God’s will by preventing someone from doing something they wish to do which causes no harm to anyone else? Or by keeping someone alive past their natural end?

    Suppose someone in an “unrecoverable” coma (yes, the term is quite slippery and has known exceptions counter to expectation) is fully aware, but totally unable to interact with anyone around them. They itch, they hurt, they feel hungry or miserable — and they can do NOTHING about it — just lie there, SUFFER, and ENDURE. Keeping someone’s “body” alive in this circumstance is not God’s work. It’s the Devil’s. You are torturing someone, not saving them. I can see a future time when this can be done indefinitely.

    I, personally, have Faith in God. If it is deemed, to the best of physician knowledge, that someone will not recover, then let GOD make the decision to keep them alive, and not use MACHINERY to force the issue. If He doesn’t want them dead, then something will happen to prevent it…

    He does that kind of thing.

    And if someone chooses, whether you agree with their reasoning or not, to self-terminate, then it’s their decision to make — not yours.

    Again, I have Faith in God — if He doesn’t want someone dead, they won’t be that way, under those circumstances. He will find an inspiration, a moment’s prevention that changes the intent of the person. Because…

    He does that kind of thing.

    Amazing how little Real Faith most people have when it comes to brass tacks.

  19. neo-neocon Says:

    IGotBupkis: not sure what your point is here. I read the other people’s comments quickly, so I might have missed something, but I don’t think most of the commenters are talking about limiting a person’s decision to commit suicide. People are talking (or, at least, I was talking) about the state’s being part of the decision by allowing doctors to administer lethal drugs, which is not suicide but is euthanasia. There is a difference between that and suicide, and even a difference between that and assisted suicide.

    In the example you give above—the person in what you call an “unrecoverable coma”—you are not describing a coma if you are describing a situation where a person is “fully aware.” You are describing a different (and very very terrible) condition known as “locked-in syndrome.” Read about it at the link. There are certain ways that some sufferers can communicate, and scientists are working on more. Till then, though, how can people in this horrible state make their feelings known about whether they want to commit suicide or not? The situation is very complex, too much to go into here.

    I’ve known quite a few people who have been in actual comas that are considered unrecoverable, and life support has been disconnected at the request of the family, and especially in accordance with a living will if the person has one. This is quite standard today, as far as I know.

  20. Jim Nicholas Says:

    IGotBiupkis . . .,

    To quote you, “Charles, your claim is ridiculous. And that of a busybody.”

    When I agree with a person’s position, as I do on the whole with yours, I particularly wish he would be moderate in how he expresses it, because I would like others to adopt that position. Being insulting is unlikely to be persuasive.

  21. neo-neocon Says:

    JuliB: doctors are not supposed to give enough morphine to kill. The problem is that when a patient is frail and near death, how much is enough to reduce pain sufficiently to relieve their intense suffering, and how much is too much and lethal? It’s not easy to tell. My understanding of what medical practice is these days is to give enough to relieve pain. If that ends up being a factor that might arguably be nudging the person closer to death, that is a possibility but not something that can be known, and the intent was to relieve pain without killing, and the dose was calibrated for that. I would imagine this guideline is probably violated at times, but that is my understanding of the guideline: to relieve pain. “Pain” can also include the struggle to breath when there is lung disease. Morphine not only relieves pain, but it eases that struggle–not by killing (although it does sometimes kill) but in this manner.

  22. Jim Nicholas Says:

    The concern by doctors that their attempts to alleviate suffering at the end of life led to studies about the effects of pain-relieving medications on hastening death. The outcome of a number of studies is that the reduction in the struggle and agitation caused by reduction of pain results in a more peaceful and a bit longer survival. This article references several such studies.
    http://www.capc.org/news-and-events/releases/01-06-10

  23. MollyNH Says:

    As an RN I have dealt with people at the end of life (one in particular was a retired nurse who had served as an Episcopal missionary in prestatehood Alaska above the Arctic Circle)
    Morphine can deliver a “wondeful serenity” to a terminally ill person, the wonderful serenity allows Nature to take its course! The before & after demeanor of the patient leaves no wonder why the ancients, (or whomever) chose to name the medication after a god !

  24. Sharon W Says:

    Molly is right about the “wonderful serenity”. I found my 84 year old MIL ailing with sepsis in the ICU, strapped down and not allowed to receive fluids in anticipation of further medical care. This after several strokes, surgery for a broken hip and transfusions due to low blood iron. She moaned when she spotted me outside the room where 2 nurses were speaking. When I ran to her, she told me she needed water. The nurses explained and I insisted that they remove all medical means except that necessary to deal with her pain. For the next hour I massaged her wherever she directed me while we awaited the shots. She received 3 as we waited for the doctor to approve my directives. She was still in pain. Fully coherent (even able to spell words for our understanding), she told me she was so happy my mother never had to go through this (my mother having died suddenly at 66). 2 more shots and she began to have relief. After the doctor came, an IV for a morphine drip was ordered, and at my request, the IV for fluids removed. She was in blessed peace until she died that evening. Her last months of her life were nothing more than sustained existence with plenty of suffering (mental, emotional & physical) to go around. Oh, and the taxpayer paid the $800,000 bill to boot. All because my SIL (the executor) couldn’t honor her written request in her will for no extraordinary means. Best intentions again paving the road to hell.

  25. JuliB Says:

    @JJ:

    “They were dying and the doctors admitted they had no more than six months to live, yet they did not want them to be addicted to pain killers? That was sadism, and tyranny.”

    From what I’ve read, it’s not done out of personal feelings, but fear… even terror.. at criminal charges and loss of their life’s work by the DEA/FDA/?…

    I’m not sure who is responsible for the enforcement of the drug laws regarding addiction and doctors, but the gov’t is dealing with the issues with a very heavy hand. It is horrific.

    @neo:

    ” My understanding of what medical practice is these days is to give enough to relieve pain. If that ends up being a factor that might arguably be nudging the person closer to death, that is a possibility but not something that can be known, and the intent was to relieve pain without killing, and the dose was calibrated for that”

    Indeed, I can accept the possibility of double effect, and have no problem with that. However, doctors are people too, and have their own ideas about relieving suffering. There are probably a lot who overdue it at times based on their own judgments. It’s probably a lot more common than we think.

    On the other hand, this article suggests that it isn’t the case:
    http://www.chninternational.com/when_morphine_fails_to_kill.htm . There are several articles out there about Dr. Luce.

  26. IGotBupkis, Legally Defined Cyberbully in All 57 States and Climate Change Skeptic Extraordinaire Says:

    }}} about the state’s being part of the decision by allowing doctors to administer lethal drugs, which is not suicide but is euthanasia.

    Neo, the State IS a part of it either way by your usage. If the State has ANY say in what the DOCTOR can do if a patient asks for help, it is interfering with that person’s decision by making it more difficult and/or painful. Because, frankly, it’s the doctor’s decision to help, too. NOT the State’s. The State has no more place mandating the doctor NOT assist than it has mandating that the doctor MUST assist. Both are outside the proper bounds of The State’s authority, as well as its arena of responsibility, beyond the “sound mind, well-considered action/result” element of the argument.

    Moreover, if someone is a quadraplegic, they clearly can’t really STOP a doctor from preventing them from dying. If they refuse food and water, they can be given it IV without their consent by your reasoning, and the doctor would most likely be REQUIRED to do so by the State.

    The most obvious case is the movie I linked to, but the principle is valid even without the extreme case the movie offers.

    }}} Being insulting is unlikely to be persuasive.

    LOL, calling a busybody a busybody is insulting? Or is calling a ridiculously “busybodyish” position ‘ridiculous’ insulting?

    Sorry, that’s not a position agree with. The Truth doesn’t insult. It can annoy, it can be abrasive, it can be confrontational. It can’t insult. ;D

  27. IGotBupkis, Legally Defined Cyberbully in All 57 States and Climate Change Skeptic Extraordinaire Says:

    }}} you are not describing a coma if you are describing a situation where a person is “fully aware.”

    No, that’s not what I’m talking about. I’m saying we have NO IDEA what actually happens to… call it one’s “soul”… in that circumstance where the brain is “dead” but the body is still functional…

    Whatever true consciousness lies at the heart of us all still remains, or there should be no issue with terminating the body.

    Even if there is no pain, no discomfort, it’s still a state of being alone and utterly unable to communicate with those around you, possibly devoid of any stimulus of any kind at all. For all anyone knows, you may be drifting with no sensations in a dull grey void.

    That is an abnormal, torturous condition for the mind/psyche/soul, which craves stimulus at all times.

    That someone coming out of a coma might not recall such is irrelevant, it might be so traumatic it is automatically blocked.

    The point is, WE DON’T KNOW, not that it IS that way. The point is, we ARE fighting against the natural condition God created. And that’s not a problem in itself, but slavish presumption that it can’t be anything but Right to keep someone alive in that situation is an abrogation of your moral responsibility to consider that fact. As I say — for all you know, you’re doing the Devil’s work, not God’s.

    And the decision needs to be made by people on the scene, not by some #$#%% bureaucrats in DC or even the State capital. Yes, there may well be people — family members — drooling over the estate ready to kick ‘em off at the drop of a hat — but that’s where God steps in. If He doesn’t want that person to pass, then He WILL step in and act. Perhaps so subtly that it’s not even obvious He has… the person just doesn’t “die” even when there’s no reason for them to keep going (you know THAT happens, too). And maybe that causes one or more of the family members to feel guilt, and remorse, and find God — who knows? This is an arena where the big picture is well beyond your, my, anyone’s pay grade. You gotta have Faith and que sera, sera… Kyrie Elaison.

    These decisions need to be made at the personal level, not by The All Powerful State.

    Even if Oz is wise, he’s still just a man. And all too often, Oz is a committee, “the only known form of life with six or more legs and no brain”. Is that REALLY who you imagine should be making decisions about someone’s life?

  28. Uncle Bill Says:

    I suffer from a rare autoimmune disease, somewhat akin to MS. Mine is reasonably well controlled, but I am fairly weak, and get fatigued very quickly. I usually sleep 9-10 hours a night, and then often nap in the afternoon.

    I recently met another fellow who has the same condition. He said that when he was first diagnosed, he looked into assisted suicide, and determined that Switzerland was the place to go. He had about decided to book a first class ticket to Switzerland, spend a few days sightseeing, then end his life. Fortunately, he changed his mind, and is now able to lead a relatively normal life.

    I was troubled by the whole discussion. My life is not what it once was, but I am certainly not in unbearable pain, and I can still get a lot of pleasure out of life.

    BUT: if I had something like ALS, instead of what I do have, would I still be able to keep the same attitude? I’m afraid I would start thinking about that ticket to Switzerland.

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