Do I have a right to die?

[michel]

Well as an oncologist, I respectfully disagree. Cancer is maladaptive and there is no natural benefit nor is it something that should be in the body. I would say, philosophically, that the course nature takes is that the response the body gives from such a maladaptive disease. Giving treament, with proper caution isn't playing God, its being a physician. When referring to God I am talking about a physician serving as the sustainer of life and bringer of death. It is my job as a physician to provide the best medical therapy for the patient. Kavorkians thought on playing God when it comes to medicine just merely justifies his reasons for killing his patience.

Physicians shouldn't decide whether who lives and dies. I believe this will stigmatize our job. I believe in dealing with right to death issues there are gray areas as to who performs such procedures. Mentally I just couldn't bring myself to inject someone with sodium thiopental, Pavulon (also known as Pancuronium Bromide) and Potassium Chloride. Even though they were suffering to be the bringer of death is something that would psychologically effect me.

I can understand your stance, and it is of course the only one you can take.
My wife is in remission; she had oral cancer ( it started on the tongue - a bit rough on a non smoker, non drinker!), and although the cancerous mass was taken out, she the had problems with lymph nodes in the neck. After the second lot of surgery, she was given as much chemo and radio as she could take, and (touch wood) she seems O.K now even though the ravages of the therapies means that she is permanently in pain, feeling nastily remeniscent sensations regularly, which are frightening. She feels she can only live on a day to day basis; it isn't easy.

She has been working as a volunteer in the Cancer ward now - one day a week, which means that she sees many patients.

She often talks of elderly people who regularly return (after some time of remission), who are put through the system once again. A lot of those people tell my wife that they honestly don't know how they end up going through the interminable treatments - lots of them even say "Why on earth do they keep me alive ?- I have no quality of life."

The difficulty lies in that the cancer team will do anything to keep people alive - and those people are not quite certain why they go along with the treatment....it is almost as if they are unwillingly on some sort of treadmill of continuous sufferring. Ethically, of course, the hospitals are doing their job - trying to save people at all costs. In practice, this puts a tremendous financial strain on society, where money is already short, and society is doing all that it can to keep people alive for as long as they can - people who admit that, had someone asked them, they would have declined treatment. But that is contrary to human instinct, and there are all sorts of problems relating to familly (who don't want their loved ones to die), who put pressure on the patients to "carry on". I honestly don't know what the solution is..morally, ethically, and from a harsh logical and practical point of view..............

 

[Brendan ben David]

You are dead wrong. Show me in the Torah the solution to all quantum sciences to start with. You allow yourself to be disillusioned by thinking the Divine would only allow one avenue or resource to guid you. Has the the complexity of the Divine taught you nothing??

Torah is the blueprint of reality. It's depth is infinite, thus possessing all Truth within it. Yet I do not state that it is the only means to reach Truth.

Sounds to me like you choose to believe we are the Fallen Ones, good for you, I however do not nor will I ever agree. Reading a book shows nothing beyond the fact that you read it; how it is understood is much more important. Did you ever think for one moment that maybe existence is a melting pot of various different beliefs, all being True, could you handle it then, knowing you fed yourself half Truth?

Torah is both written and oral, something which may escape you. I realise and accept the melting pot of various different beliefs, but those which contradict cannot all be true.

 

[Father Heathen]

Torah is the blueprint of reality.

Then reality must be a poorly written cartoon.

 

[horizon_mj1]

Torah is the blueprint of reality. It's depth is infinite, thus possessing all Truth within it. Yet I do not state that it is the only means to reach Truth.



Torah is both written and oral, something which may escape you. I realise and accept the melting pot of various different beliefs, but those which contradict cannot all be true.

I did not state that they were all true, but hold truths. What works for some may not work for others; it is good you found something that works for you, but that does not make everyone else wrong for finding their own way, which may involve many more tools than just the Torah; to some it is nothing more than a small fragment of a much larger picture.

 

[McBell]

to some it is nothing more than a small fragment of a much larger picture.

And to some it is not even a fragment of the big picture.

 

[horizon_mj1]

And to some it is not even a fragment of the big picture.

Exactly! To some it is nothing more than a story written in the general interest of Judaism.

 

[Brendan ben David]

I did not state that they were all true, but hold truths. What works for some may not work for others; it is good you found something that works for you, but that does not make everyone else wrong for finding their own way, which may involve many more tools than just the Torah; to some it is nothing more than a small fragment of a much larger picture.

Yes, I agree with you horizon.

 

[Poisonshady313]

I am not concerned with kavorkian he is the least ideal example

He got a bad rap. People were and are too quick to judge him without knowing his reasons or his methods.

 

[Barcode]

I can understand your stance, and it is of course the only one you can take.
My wife is in remission; she had oral cancer ( it started on the tongue - a bit rough on a non smoker, non drinker!), and although the cancerous mass was taken out, she the had problems with lymph nodes in the neck. After the second lot of surgery, she was given as much chemo and radio as she could take, and (touch wood) she seems O.K now even though the ravages of the therapies means that she is permanently in pain, feeling nastily remeniscent sensations regularly, which are frightening. She feels she can only live on a day to day basis; it isn't easy.

She has been working as a volunteer in the Cancer ward now - one day a week, which means that she sees many patients.

She often talks of elderly people who regularly return (after some time of remission), who are put through the system once again. A lot of those people tell my wife that they honestly don't know how they end up going through the interminable treatments - lots of them even say "Why on earth do they keep me alive ?- I have no quality of life."

The difficulty lies in that the cancer team will do anything to keep people alive - and those people are not quite certain why they go along with the treatment....it is almost as if they are unwillingly on some sort of treadmill of continuous sufferring. Ethically, of course, the hospitals are doing their job - trying to save people at all costs. In practice, this puts a tremendous financial strain on society, where money is already short, and society is doing all that it can to keep people alive for as long as they can - people who admit that, had someone asked them, they would have declined treatment. But that is contrary to human instinct, and there are all sorts of problems relating to familly (who don't want their loved ones to die), who put pressure on the patients to "carry on". I honestly don't know what the solution is..morally, ethically, and from a harsh logical and practical point of view..............

I am deeply sorry that your wife had to endure chemo and radiation. Tools that effective but aren't always effective depending on the type of cancer. I am not sure of the entire situation regarding your wife so I will respect your privacy by not inquiring any further on what happened. I understand the psychological effect it has on you and of course this is one of those gray areas for physicians I mentioned. If you have any questions I can forward you my email or you can PM me here.

 

[Poisonshady313]

Well as an oncologist, I respectfully disagree. Cancer is maladaptive and there is no natural benefit nor is it something that should be in the body. I would say, philosophically, that the course nature takes is that the response the body gives from such a maladaptive disease. Giving treament, with proper caution isn't playing God, its being a physician. When referring to God I am talking about a physician serving as the sustainer of life and bringer of death. It is my job as a physician to provide the best medical therapy for the patient. Kavorkians thought on playing God when it comes to medicine just merely justifies his reasons for killing his patience.

Not "just merely"... he has a point. If a disease afflicts a person in a fashion that you figure is untimely, who are you to suggest that a person's time isn't up yet? Who are you to prescribe a pill if God meant for an individual to have a headache? You figure God only pays attention to when a person dies? I think the "playing God" routine just merely justifies your reasons for prolonging the suffering of someone who has no hope of getting better and wants to be done with it.

Physicians shouldn't decide whether who lives and dies.

The decision should be made by the terminally ill patient with intractable suffering. For more on that, take a look at Kevorkian's interview with Barbara Walters (you can find it on youtube)

I believe this will stigmatize our job.

Physicians can authorize organ transplants, amputations, dangerous and potentially addictive drugs. Why not a merciful end to intolerable suffering with no hope of the condition improving?

I believe in dealing with right to death issues there are gray areas as to who performs such procedures. Mentally I just couldn't bring myself to inject someone with sodium thiopental, Pavulon (also known as Pancuronium Bromide) and Potassium Chloride. Even though they were suffering to be the bringer of death is something that would psychologically effect me.

So you'd have someone who specializes in such things. Or give doctors the choice to be able to apply to become certified/qualified to perform such a procedure.

Remember... Kevorkian said no to 98% of the people who asked him to help them end their lives. He would plead with people to go on living, to get more treatments, to change their mind about wanting to end their lives. He thought that patients should be able to get not just second opinions... but third and fourth opinions, to make sure there was some sort of alternative that might improve a patient's quality of life.

But his position was that exhausting all alternative treatments, a patient has the right to decide to be put to sleep forever. To end their suffering.

 

[Barcode]

Which oath?

I Googled "hippocratic oath" for the exact text, and there's nothing in this version I found that necessarily precludes euthanasia when it's done responsibly: Hippocratic Oath - Wikipedia, the free encyclopedia

Did you mean some other oath?


If we're talking about people with terminal illness, then the physician isn't deciding whether the patient should live and die; that's already a foregone conclusion. The decision is only about when and under what circumstances that inevitable death should occur.


Could you bring yourself to subject a person to months or years of pain before the death that they know is coming? Because in many cases, the choice not to pursue euthanasia is a

I am pretty sure medical ethics or whatever isbconsidered professional and medically ethical covers the ramifications of Euthenasia.

 

[waitasec]

I think we he is saying is physicians assisting in euthenasia. What you're talking about is pain management

i see, but is permanently ending pain for a terminally ill person, pain management or euthanasia?
drugging someone with morphine isn't the way i'd like to go..if i could choose, i'd rather be lucid, and i believe i have all the right to choose that for myself

 

[Barcode]

I think most people don't realize here is that the position of each and every physician is complex when it comes to patient care and end-of-life. I have treated terminally ill patients for over 20 years and although I sympathize (sometimes overtly) with each and every one of my patients I too, have to remain objective. If I cried for each and every one of my patients regarding their suffering I couldn't effectively treat them. Of course I will do my best to sustain their life and increase the amount of care I can provide.

 

[Poisonshady313]

I think most people don't realize here is that the position of each and every physician is complex when it comes to patient care and end-of-life. I have treated terminally ill patients for over 20 years and although I sympathize (sometimes overtly) with each and every one of my patients I too, have to remain objective. If I cried for each and every one of my patients regarding their suffering I couldn't effectively treat them. Of course I will do my best to sustain their life and increase the amount of care I can provide.

Nobody's asking you to cry for anyone, let alone everyone. But haven't you ever found yourself in a situation in which sustaining a particular patient's life IS doing harm?

Maybe you have been fortunate enough not to.

Jack Kevorkian found himself in that situation 130 times.

 

[Pegg]

Very simple what the ethical ramifications regarding Euthenasia? Although in hospitals patients have many rights, they don't have a right to die. However what about suffering should we consider this practice if a patient is in tremendous amount of agony even if they consent to it? What are some of your thoughts?

i work in a nursing home and I can tell you that it makes you stop and wonder if euthenasia should be made legitimate for some terminally ill patients

but the problem is that people WILL abuse it. There are many elderly people in our home who's family dont come to see them and couldnt give a hoot that they were there. They only come after the person has died and there is money to collect. I know that if euthenasia was available, then those sorts of people would see to it that their parents/grandparents were 'put down' just to make things easier for themselves.

But in australia, they do allow a person to choose to die if they want to. We have one old lady who wants to die and she has simply stopped eating and drinking. The family have the right to decide not to feed her, and they have instructed us not to feed her. So in some ways, it is there, but its without intervention that it occurs. So she'll die of 'natural causes'... but its not really natural causes. Its starvation in her case.

and then for those in palliative care, the high doses of pain killer does actually kill them.... at lease they die pain free

horrible horrible subject.

 

[Barcode]

Nobody's asking you to cry for anyone, let alone everyone. But haven't you ever found yourself in a situation in which sustaining a particular patient's life IS doing harm?

Maybe you have been fortunate enough not to.

Jack Kevorkian found himself in that situation 130 times.

The patient has every right to refuse medical treatment. Nobody is forcing a patient to take medication nor is anyone forcing a patient to take pain management. To say "keeping a patient alive" in the way you word it is almost saying we are forcing a patient to stay alive. Patients have the right to refuse medical advice (Known as A.M.A), have the right to refuse treatment, or anything else. A lot of times patients staying alive is normally a family legal issue than a medical one. Some family members are Executors over patients when they are incapable of making decisions for their care. Hospitals can only be suggestive but we don't force anyone to stay alive.

By the way I have found myself dealing with lsuffering patients well over 120 times.

 

[Barcode]

i work in a nursing home and I can tell you that it makes you stop and wonder if euthenasia should be made legitimate for some terminally ill patients

but the problem is that people WILL abuse it. There are many elderly people in our home who's family dont come to see them and couldnt give a hoot that they were there. They only come after the person has died and there is money to collect. I know that if euthenasia was available, then those sorts of people would see to it that their parents/grandparents were 'put down' just to make things easier for themselves.

But in australia, they do allow a person to choose to die if they want to. We have one old lady who wants to die and she has simply stopped eating and drinking. The family have the right to decide not to feed her, and they have instructed us not to feed her. So in some ways, it is there, but its without intervention that it occurs. So she'll die of 'natural causes'... but its not really natural causes. Its starvation in her case.

and then for those in palliative care, the high doses of pain killer does actually kill them.... at lease they die pain free

horrible horrible subject.

Yes. High enough morphine can create respiratory failure. Patients with advance stages of cancer who have erratic breathing normally are given this to call their breathig down but sometimes they and up passing away from this eventually.

 

[Poisonshady313]

i work in a nursing home and I can tell you that it makes you stop and wonder if euthenasia should be made legitimate for some terminally ill patients

but the problem is that people WILL abuse it. There are many elderly people in our home who's family dont come to see them and couldnt give a hoot that they were there. They only come after the person has died and there is money to collect. I know that if euthenasia was available, then those sorts of people would see to it that their parents/grandparents were 'put down' just to make things easier for themselves.

But in australia, they do allow a person to choose to die if they want to. We have one old lady who wants to die and she has simply stopped eating and drinking. The family have the right to decide not to feed her, and they have instructed us not to feed her. So in some ways, it is there, but its without intervention that it occurs. So she'll die of 'natural causes'... but its not really natural causes. Its starvation in her case.

and then for those in palliative care, the high doses of pain killer does actually kill them.... at lease they die pain free

horrible horrible subject.

Having the right to make that decision doesn't mean it's elective. There would have to be a real medical justification for a doctor to go through with such a procedure.

Is it 100% fool proof? No. Nothing in this world is. But if there are going to be far more pros than cons, it's hard to say no.

If a person wants to put an end to a suffering there is no hope of alleviating except by death, and can say so as a competent adult (and Kevorkian was onto something with the whole video taping every patient consultation), I don't see why not.

 

[Barcode]

Having the right to make that decision doesn't mean it's elective. There would have to be a real medical justification for a doctor to go through with such a procedure.

Is it 100% fool proof? No. Nothing in this world is. But if there are going to be far more pros than cons, it's hard to say no.

If a person wants to put an end to a suffering there is no hope of alleviating except by death, and can say so as a competent adult (and Kevorkian was onto something with the whole video taping every patient consultation), I don't see why not.

Well again the medical board is pretty clear and most hospitals are pretty good at decisions regarding the patients care, maybe not 100% but pretty close.

 

[Poisonshady313]

The patient has every right to refuse medical treatment. Nobody is forcing a patient to take medication nor is anyone forcing a patient to take pain management. To say "keeping a patient alive" in the way you word it is almost saying we are forcing a patient to stay alive. Patients have the right to refuse medical advice (Known as A.M.A), have the right to refuse treatment, or anything else. A lot of times patients staying alive is normally a family legal issue than a medical one. Some family members are Executors over patients when they are incapable of making decisions for their care. Hospitals can only be suggestive but we don't force anyone to stay alive.

By the way I have found myself dealing with lsuffering patients well over 120 times.

I'm not talking about suffering in general, but the sort of suffering that might make a patient insist on ending their life immediately so as to end it. I understood from earlier posts that you deal with suffering patients on a regular basis. The question was specific. Ever find yourself in a situation where sustaining a particular patient's life would have been considered doing harm?

As far as refusing treatment... do you really feel better about patients slowly and painfully wasting away and/or starving to death than patients in that same situation that simply want to get it over with?

If patients have the right to refuse treatment, why not have the right to refuse living any longer?