Auschwitz in America

[chequita guevara]

Originally posted by lord of the mark
I am very uncomfortable with legalizing euthanasia BEFORE 1. We have a just health care financing system 2. We take pain management, hospice care,etc seriously 3. Before we have a culture that values life to the point where we can be sure that NO ONE will feel pressured to choose euthanasia.

You make a very strong argument. Real dignity of life, v the sham that most pro-lifers spout. But this puts a positive obligation on the rest of society to make a better world, rather than just copping out and letting people die for whatever reason.

[Tripledoc]

Originally posted by notyoueither
Would it be different for a sick, underweight, weak adult with respiratory problems?

Morphine's lethal effects is directly connected to the knocking out of the respiratory system, so maybe people with respiratory problems are more vulnerable.

Sickness and weakness may not have that great effect.

[Berzerker]

Tripledoc -

I don't think it should be the responsibility of the murderer to judge whether his victim is worthy of life or not - that is actually what you are suggesting.

If a wife euthenises her husband because he's dying a slow death from a painful and incurable cancer, would you convict her of "murder"? I wouldn't...

I won't bother correcting your paganism, hedonism, sophistry, and excuses for racism, as I am sure no-one takes your crap seriously.

I never mentioned "hedonism" but your failure (which you blame me for) to refute what I said leaves no room for anyone to respond. I could easily dismiss everything you claim with "it's crap" but that would only show my inability to refute "crap". How impressive...

[Berzerker]

Btw, I didn't say the "responsibility" rests with the "murderer"...
thanks for responding with your "crap"...

[notyoueither]

Originally posted by Tripledoc
According to a Danish page on palliative treatment the usual dose is 10mg morphine per night (repeated until effect is reached, whatever that means), but may be more depending on how long the patient has been given the medicine. usually other drugs are given as well in combination with morphine, to stimulate appetite and combat nausea.

I kind of thought so. As some may know, my mother recently passed away after a lengthy struggle with ALS. The final stage of ALS for many (most?) is respiratory failure as the muscles that control breathing degenerate.

Her condition was complicated somewhat by an onset of emphysema, and then a bout of pneumonia. Long story short, she went into respiratory distress (not enough oxygen) and was off to the hospital from home. She rejected any invasive aid (no breathing tube/respirator) but accepted a 'bipap'(?) machine that forced oxygen in and drew breath out without a tube.

After a day and night on that, her doctor concluded that she was not going to recover in any meaningful way from the pneumonia/respiratory distress and communicated with her to decide what to do. By this time Mom was skin and bone. She could not be kept comfortable even if breathing were not an issue, as there was nothing but skin between her bones and whatever surface she was on, added to joint pain that many ALS sufferers experience. Even with individual care 24 hours a day, she was in misery. Mom decided that she wanted the bipap shut off and that would be done after I arrived back at the hospital. Her doctor called me and I got back to the hospital ASAP.

Cutting to the chase... they hooked up morphine by IV an hour before disconnecting the bipap. The order was she could have as much as she asked for. I am certain she asked for more than she could survive, and the nurses abided by her wishes. I am thankful they did. She was never going to get better. She was never going to be comfortable. She made her own mind up as to when to call it quits. It would have made a mockery of her life to have forced her to persist in a state of misery.

I don't think euthenasia is a bad thing, in and of itself. I think it has a place in medical practice when the patient decides that the time has come. I would not want anything other than the patient's wishes to be factored into it, but sometimes there is no tomorrow to look forward to for a person. At that point, forcing continued misery on them would be cruel. But then again, my experience with it has been in a case of palliative care.

[Spiffor]

Wow, this is a very sad story NYE

But your mother and her doctors did the right thing. It was the time to get her out of her misery

[MichaeltheGreat]

Originally posted by notyoueither


I ask, because I strongly suspect that euthanasia is being practiced right now in some cases. However, I would like some information confirmed before I am going to be certain about it.

To be more specific, how many units per hour would be considered safe for a healthy adult? Would it be different for a sick, underweight, weak adult with respiratory problems?

That's sort of a dangerous question to answer for a number of reasons.

There are a lot of subjective and objective considerations - one is that the body desensitizes, and you will eventually (given enough time and assuming the patient doesn't die of something else) reach a crossover point where the analgesic effect declines with a specific hourly dosage, and you either accept that to avoid potential overdose, or you increase the dose to try to maintain the analgesic effect.

With most potentially lethal agents, body mass is a factor in LD₅₀ dosage calculations. Particularly when you consider a slow continous dose a la an IV drip, you're concerned with whether the concentration in the bloodstream is increasing over time, or decreasing. Liver and kidney function are important factors as well, as well as built up tolerance.

I know that my brother (who was significantly smaller than me, even when bloated due to post-chemo fluid retention) was taking morphine for several weeks at a time on several occasions at a dosage that would likely have dropped me in my tracks. And he was suffering from the effects of chemo, ****ed up blood transfusions, multiple surgeries, etc.

[MichaeltheGreat]

Originally posted by Ben Kenobi


So everyone gets a say but the victim. Very individualistic.

Well, if the victim is at a state of development where he/she could come out and go "waaaah" the state intervenes and says that therapeutic abortion at that point is illegal. Or at least the state has the recognized right to do so.

If the victim is still an incompletely formed organism incapable of survival in any way by any means without the biological attachments to the mother's body, then the victim is not deemed to be capable of expressing an opinion on the matter, and it's left to the conscience of the woman who bears the "victim."

[Tripledoc]

There is a distinct difference between paliative care and euthanasia I think.

Palliative treatment is given to socalled terminal patients. That is patinets who are in the last stages of an incurable sickness. As a result of that treatment death might arive earlier, than it would otherwise have had had there been no alleviating the pain. There is nothing unethical about this since the medical profession has the responsibilty of alleviating the consequences of sickness, if no cure is feasable.

Euthanasia quite often takes place before the terminal stage has been reached.

I would say to notyoueither that your mother was given palliative treatment and it was not a case of euthanasia.

[NeOmega]

The highest incidence of suicide in the United States is amongst males aged 65+
The preferred method is firearm.

Why can't it be lethal injection. Plus, imagine an old man, depressed and lonely going to a hospital for lethal injection....
Do you think he would go through with it?

Also, my girlfriend and I had to discuss "euthenasia" after the 13 year vegetable's feeding tube was shoved back down her throat. We both agreed, 1 year vegetative state, if we don't come out of it, pull the plug.

Also, pro-longers want to either a)keep a person doped up on painkillers for years, and suffer a panople of side effects or b) get off medication and suffer an excruciating death.

Why can't they have a humane option. I want one when I am in that position, people were not meant to live so long anyway. It is my own personal belief is that alzheimers comes into existance because the DNA in people brains becomes deteriorated, as it cannot match the DNA of "revived via drugs" failed organs. In other words, the body is kept alive by drugs, as the brain turns to swiss cheese.

[Berzerker]

Tripledoc -

There is nothing unethical about this since the medical profession has the responsibilty of alleviating the consequences of sickness, if no cure is feasable.

So the "murderers" have the responsibility of deciding?

[monkspider]

Most of these conservative bullies who want to keep vegetables alive are just trying to help their buddies in the pharmaceutical industries get a few more dollars in their pocket. Typical righties.

[Tripledoc]

Originally posted by Berzerker
Tripledoc -

So the "murderers" have the responsibility of deciding?

Sorry for my former ranting.

What I tried to say was that there is a distintion to be made between what you would consider 'terminal patients' and patients, or non-patients for that matter, who are merely suffering from a loss in 'qualty of life' however that quality is decided upon.

[MichaeltheGreat]

Originally posted by Ben Kenobi


We already have this, one can ask not to be put on life support in a living will, or not to have extraordinary measures of resuscitation.

That's why I don't see the need for euthanasia, and I fear the consequences of abuse since it will always be the weak and helpless most targeted.

Actually, we don't have that. I've dealt with this general subject twice in a very up close and personal way.

First time was with my ex-father-in-law and his wife who came out from Japan to visit his my ex and our daughter. Living wills, assuming they existed in Japanese law, would have no force and effect in the US. He was 83 at the time, had some coronary problems, and had a heart attack when they were all visiting New York. After he was well enough to travel, several weeks later, they came back to San Diego, and he had some follow up exams done. It was determined he should have an emergency triple bypass, he consented to the procedure, and at the end, a piece of sclerotic plaque broke off, followed the aorta up instead of down, and obstructed a mid-size artery near the base of his brain, and a smaller piece blocked a small artery near the right temporal lobe.

By definition, you have to be on "life support" during an open heart procedure, and you remain on life support for a while, until it's determined that everything's working and they can close you back up. Meanwhile, you're in CICU split open from stem to stern with a translucent membrance covering the opening.

So the question came down to him having minimal brain function, almost no oxygen uptake from his blood - some cells were oxygenating, but nowhere near enough to prevent death. It came down to me because his immediate family member available spoke no English, his daughter (my ex) didn't want to be responsible for making that decision, and I was who was available. If I'd insisted, they would be liable under law to keep him on the heart-lung device until all brain function stopped. That could have been minutes, or hours, or at most a day or two, but the simple fact was he had no chance of any recovery. Forcing him to remain on life support would have meant no difference in outcome, except keeping equipment and personnel and CICU space from people who had a chance to recover. There was nothing to debate, no tradeoffs between this possibility and that, nothing but a decision to make that technically ended a life that had already ended in a practical physiological sense.

The next time I dealt with it was a couple of years later, with my brother's Agent Orange caused cancers. In that situation, we did discuss various options for suicide or fratricide, depending on how bad things got, and what he felt he might need to do, or have done for him. It's a lot different when you're there facing it in person, than when it's an abstract principle. We'd talk about ideas, and I'd look up the legal consequences. He lost a lot of strength, so he was concerned that if he tried to shoot himself, he might not have the strength to manage the trigger pull with the pistol in the right position. Even if I'd altered the trigger pull on a pistol I provided him for him to do the deed, I'd be liable for conspiracy and homicide charges. Whether I got prosecuted or not might depend on whether I got a zealous "born again" type of DA or state's attorney, or (because it might have occurred in a VA facility) US Attorney.

We also talked about illicit OD's, if I could get ahold of the right stuff, etc. Fun stuff. And all because in the US, we don't have any comprehensive legal recognition of individual's rights to control the means of ending their lives. Unless they choose to act early, when they have the capability of taking their own lives without any possible action that could be interpreted as assistance.

The VA's botched medical care and final treatment hastened my brother's death, so we never got to the end point of those discussions, but we very well could have. Ultimately, if it came down to it, and he finally asked me for help out, I would have done what he asked, and the state and the law (and the damned VA) could all go to hell.

Well, it seems then the issue then is not should we go for euthanasia, but how can we develop better pain medications?

Medication is a choice, it should not be the state mandated solution. In my brother's case, increased tolerance for the drugs he was taking lead to decreased analgesic effect, while still stoning him out of his gourd and rendering him completely incoherent and hallucinatory. Things that he wanted to do, like have some final "clear" time with his wife and two small kids, could only be done under much lower doses of painkillers that only had a minimal effect. He had multiple cancers that metastasized up his spinal column and spread all throughout his body, and due to the close involvement of the cancers with his nerves and muscles, he had a very hard time moving in the later stages, and was in excruciating pain many times.

What's my cut off point where I decide I will not endure more for the sake of "living?" I'm not sure. It depends a lot on the circumstances, and I doubt I'd know until I'm right there faced with it. For a lot of people, I expect it's the same - what you can bear when the time comes may be more or less than you think now when it's abstract. But whatever a patient decides about dealing with their situation, if they're competent to make that decision, and do so without external duress, we should support it, even if it means assisting them in ending their suffering.

[MichaeltheGreat]

Originally posted by monkspider
Most of these conservative bullies who want to keep vegetables alive are just trying to help their buddies in the pharmaceutical industries get a few more dollars in their pocket. Typical righties.

Sorry Monky, I think you're losing it. That is one of the most absurd assertions I've heard yet on either side of this issue.