The Euthanasia Slippery Slope: A Case Study

Dr. Kevorkian was happy to help you kill yourself…

As health care costs rise and the public as a whole becomes more financially responsible for the care of individuals; as the population ages and the massive increase in health care costs in the final years and months of life becomes an increasing burden on society, and as legal abortion stays front and center as the most brutal form of utilitarianism, where a weaker and “lesser” life is deemed expendable for the well-being of others, I expect the United States culture to be drawn closer and closer to the seductive policy of legal euthanasia.  It is now legal in Washington, D.C.,  California, Colorado, Oregon, Vermont, Maine (as of next year), New Jersey, Hawaii, and Washington. You may note what these states all have in common….not that there’s anything wrong with that.

I believe that permitting an individual to kill another with the victim’s consent is so ripe for abuse—Dr. Kevorkian comes to mind—that it crosses an ethical line that should be thick, black, and forbidding.  The alleged consent can too easily be coerced or manufactured for the convenience of others. A recent case in the Netherlands confirms my strong reservations.

The unidentified patient, 74, had asked in writing for doctors to end her life if she had to be admitted to a nursing home, and if she thought the time was right. When she entered a home in 2016, however, though incapacitated, she appeared to have changed her mind, and gave what prosecutors called “mixed signals” about her desire to die.

Nevertheless, a  doctor at the home, also unidentified, proceeded with the euthanasia, “in close consultation with the family.”

The London-based Journal of Medical Ethics published a paper reviewing  the case. It revealed that the doctor put a sedative in the patient’s coffee,  and the patient’s family members restrained her as she struggled to resist a lethal injection.

This does not sound like consent to me.

Still, the Dutch court cleared the doctor of any wrongdoing, writing, “The patient was heavily demented and deemed completely mentally incompetent.” Taking into account the patient’s state, the court ruled that the doctor did not have to verify her wishes at the time of administering euthanasia.

I don’t see how such reasoning couldn’t be used to justify killing any patient suffering from dementia, Altzheimer’s, or mental illness. In addition, such approval of legal euthanasia even in cases where the subject struggles with the death-dealing doctor to live, inevitably erodes society’s respect for life, and moves toward a culture that approves of  eliminating individuals whose existence it finds inconvenient or expensive.

Anyone who casually accepts this development as ethical is at least obligated to read the Nuremberg trial transcripts.

I wonder if anyone will ask the ten contenders for the Democratic nomination for President about their views on euthanasia. I suspect that the answers would be enlightening.

72 thoughts on “The Euthanasia Slippery Slope: A Case Study

  1. I mean, the practice of senicide is eons-old. That “modern” society is re-inventing it because taking care of people is expensive IS NOT A SURPRISE. And certain sections of society (who have opposed the collectivization of responsibility) warned us about this. The return to pagan practices (while being able to defend it as a “modern” development) will be inevitable as we abandon the ideals and values that either directly or indirectly evolved from a Christian ethos.

    Once a person is a financial burden on society instead of a financial benefit, the utilitarian balance makes sense to remove that person from society. Make no mistake, while we’ll talk a good game about valuing lives above our personal comfort – I think we practice that awhole lot less when the balance is our monthly budget versus a bunch of faceless people 1000 miles away that we don’t have to think about because a bureaucrat is doing it for us.

    As long as finances are what we care about, then the utilitarian balance is going to fall on the side of removing the “useless” from society.

    Good lord.

    But don’t say that modern society wasn’t warned. Modern society just didn’t like the deplorables who were warning it.

  2. This morning the DNC spokesperson (whose name I cannot spell) stated that the Democrats will choose a candidate who “WILL MAKE THEIR LIVES EASIER”. Nothing compares to being a full-time care giver for a parent or adult child who cannot care for themselves.

    So, if one’s political choice is based on who will make their lives easier the answer about euthanasia is clear; they will say life is important but quality of life should take precedence over quantity of life. The important thing to know is that the quality component refers to those burdened by the quantity of another’s life.

    I believe in death with dignity laws that allow the terminal patient to terminate all further treatments but facilitating early death, especially for economic reasons, is a bridge too far for me.

    • Addendum
      I was unaware we are to choose candidates based on who will make my life the easiest. When did that change from government’s role to that of providing a relatively stable and equitable playing field for people to pursue their own happiness.

    • Addendum 2
      My stepson was involved in an MVA in 1996. As a result his mother and I became his 24 hr care giver until he suffered some form of stroke 15 years later as a complication from the medication to treat recurring epileptic seizures. He lay in a coma for 6 days while we waited for him to wake. Ultimately, the doctors did an MRI which showed that his entire brain except for that portion that maintains pulmonary function was gone. The hardest decision I was ever involved in was to allow nature to take its course. I could not watch him struggle to breathe after the ventilator was removed. I had to leave the room while the nurses slowly increased the morphine drip to make him more comfortable while simultaneously suppressing his respiratory function. My wife was far stronger in this situation and never left his side.

      • Oh Chris! I am so very, very sorry that you two had to go through this! Something like this happening to my wife and children is my worst nightmare, and quite literally keeps me up at night.

      • This is similar to what Jack wrote here.

        https://ethicsalarms.com/2013/12/24/jahis-plight-why-death-panels-are-inevitable-and-necessary-if-we-are-going-to-pay-for-each-others-health-care/

        This is, undeniably, a tragic, heart-breaking situation. If the family wanted to keep Jahi on life support indefinitely and could pay all costs while also ensuring that her continuing care would not cause a shortage of space, facilities, equipment or personnel needed by other patients, then the handling of her maintenance would be the business of nobody else, certainly not the government. That is not the case, however, and virtually never is in such tragedies. Jahi’s care is expensive, and will soon create costs in the tens of thousands, and eventually hundreds of thousands. However the costs are divided among the hospital, insurers and the government, in the end, you and I will pay, either in taxes, insurance premiums, or higher prices for medical services. An ethical argument can be mounted for this when the health and life of a child is involved, but not when society is paying for futile hopes, denial, and the sentimental wishes of a family to pretend their dead daughter is spending Christmas with them. I don’t want to pay for it, and should not have to.

        In a shared system, there must be a mechanism to prevent people from wasting everyone else’s limited resources. That means death panels, either operated by private insurers, or the government. Unfortunately, most Americans, like Jahi’s family, will continue to behave as if they are paying for such extraordinary care and nobody but them has a stake in the treatment of their daughter, even when that is far from the case. There must be death panels, or we all have to pay for our own health care and insurance.

        This does beg two questions.

        What is 24 hour care like?

        And how did pre-industrial societies care for people similarly situated to your stepson?

  3. I think this is one of those things where the answer seems so clear cut until you come across a situation where you have to deal with it, and that experience opens you up to a mosaic made up of a million shades of grey.

    My own position has changed on this topic; 15 years ago I would have agreed and thrown my weight behind the argument with all the righteous certainty one can muster from the conviction that a stand is principled. Then I got to experience six family members dying from terminal cancer (lung, lung, lymphoma, leukemia, pancreatic, and lung). What I wouldn’t have given for a good old fashioned heart attack.

    I mean that, by the way. As nice as it was to have the opportunity to be able to say goodbye, parts of your soul flake off and die watching your family wither and die in an undignified hospital gown chained to a cold, blue bed.

    My grandmother; Matronly, God-fearing, a lifetime nurse, in the grip of stage four lung cancer, having lost half of her body weight, the ability to walk, and breathe without assistance, told (not asked, told, because she was still very much aware and still very much the battleaxe she always was) her doctor to administer a double dose of morpheme knowing full well that that dose would cause her death. The doctor, knowing full well what would happen “treated her pain” (which is such a clever euphemism for all the euthanasia currently happening that you don’t know about). And the family, fully half of which work in the medical profession, gathered to spend a couple last minutes, because we all knew what was going on too. And so ended the six year pain filled, embarrassing, degrading, dehumanizing, always known to be terminal struggle.

    Now, obviously, this is not the situation every time. Obviously, there are people looking to abuse the system. Obviously, thought would have to be put into how euthanasia would be administered. But anyone who think that forcing people into eking out years of pain filled with hopelessness is justified because they’re really worried about a couple of marginal horror stories… I understand them, but I think they couldn’t be more wrong.

    • See, I think if these types of decisions are to be made, they should be wholly personal, entirely the decision of the individual electing to die. But nothing makes those kinds of decisions less personal, more corporate, less informed, and much more casually, than the pooling of those decisions throughout society.

      Which is the inevitable outcome of socializing the costs of end of life care.

        • So what? It’s illegal. Do it anyway, if you’re so inclined. There are plenty of ways to do it that wouldn’t leave the “assistant” vulnerable to detection and prosecution, and of course the beneficiary isn’t concerned with such things. Like vigilanteism, however, I think it should remain illegal, and be prosecuted appropriately when discovered.
          For example; if someone hurt one of my children, I would administer the penalty for such a transgression. You can depend on that, as certainly as the sun rising in the morning. I think it’s an observation of natural law, like the desire to alleviate the torment and misery of a dearly-loved one in the throes of a painful terminal disease. Nonetheless, in the unlikely event I was discovered, I would not ask for, nor expect, any sort of clemency. I think a dangerous precedent would be set if the State ever tacitly or concretely gave its approval to euthanasia or vigilante justice.

          • I agree that having this practice remain illegal allows society the tools it needs to punish those who abuse the process. Otherwise, we arrive at faceless bureaucrats facilitating the decisions and specially trained ‘medical’ personnel who travel (or reside) hospitals looking for those who need ‘relief from pain.’

            Legality erodes society.

        • HT.

          I do not support euthanasia if euthanasia decisions fail to give the patient the choice to opt out at any time.

          I fully agree that palliative care is often a euphemism for euthanasia. I know the look that a patient in pain from either liver disease or colon cancer having watched my dad and uncle beseech you to end that pain. In those cases the patient should have the right to ask for it. At no time would I support euthanasia for merely economic reasons. Once third parties are given the right to establish the amount we will spend on any one life to keep it alive we are headed into an abyss.

          • “I fully agree that palliative care is often a euphemism for euthanasia”

            I didn’t say that, and I don’t agree. Palliative care is almost the polar opposite of euthanasia. Palliative care is care where the patient is sure to die, and they treat symptoms while waiting for death. Euthanasia is action taken to cause death.

            Other than that, I think we agree… I’m not waving a flag saying “kill all the old people” I’m waving a flag saying “Terminal patients should not be forced to suffer.”

            • We are in complete agreement.

              The palliative care I am speaking of is that which occurs when decisions are based on what reimburseable fees the doctor can expect short of self pay.

              A cogent terminally ill person in substantial unrelenting pain who makes decision to end the pain is the only time I can support euthanasia. Doctors have no role in the decision process except to render an opinion prognosis but doctors giving assistance based on a patient’s decision should be given as much deference as the law allows.

            • I misunderstood your comparison to “treating the pain” as a clever euphamism for euthanasia. My experiences reflect palliative treatment as treating the pain and at some point winds up being euthanasia which I define is the hastening of death through affirmative medical.processes. That is different than withholding treatment from a terminally ill patient who refuses such treatment.

      • Currently? Almost absolute certainty. The number of people being euthanized right this minute with you not knowing about it is significant. They’ll call it something different, like I said: “pain management” is very common…. But it is what it is, and it’s medically induced death.

        Particularly in Canada, because of the way our system works, there is no financial motivation for doctors or family members to euthanize patients: Doctors get paid one way or the other, and the family isn’t on the hook. Our horror stories tend to skew the other way: Elderly people, ignored in palliative care by their families, who despite their neglect still refuse to allow the life support to be turned off because they’re uncomfortable with the idea of killing baba. Anecdotally, my sister works as a health care aid, and she has related stories to me of having to force people to eat by injecting food down their throat because they are purposefully trying to starve themselves to death. It keeps her up at night.

    • My God fearing Catholic grandma had the opposite response to yours. She was 102 & 7mo. and after breaking her hip it was too late to even think of surgery. She continued to weaken & lose weight yet she fought by drinking milkshakes & trying to greet her many family/visitors.

      Before she got to this point a few years prior, her care coordinator somehow changed her directive to DNR, which as a Catholic she wouldn’t have agreed to, yet this person tried to convince the family my grandma said yes to the change. If my family hadn’t checked the paperwork, my grandma’s incorrect and unauthorized change would have remained however our family changed it back. My understanding is such acts are not uncommon in these facilities.

      Fast forward to her last days. She was increasingly given higher doses of morphine & we weren’t allowed to even give her sips of water, though she was clearly thirsty. Her last words ever spoken while she gripped onto me, and heard by everyone in the room were “I don’t want to die.” She didn’t want to go and the nursing home was killing her and she knew it. I still feel complicit in her death, as I tried to “go along” with staff who I assumed knew best.

      Yes it’s sad to see our loved ones suffer but it’s also wrong to kill them off so we can avoid the suffering of watching them suffer. Such a concept seems like the ultimate in dehumanizing our vulnerable citizens because suffering is part of being human. Denying that makes our society increasing prone to relying on “happiness indexes” to determine whether someone lives or dies. And in the hands of those who desire technocratic medical control over the rest of us (take a gander at Google’s medical device patents for a frightening example) it will only become easier to kill us in the name of comfort and convenience.

      When you have a society that deems it acceptable to abort a preborn because the child was a result of rape or may be potentially abused, then you have a society that believes they’re inherently less valuable. When you have a society that believes it’s acceptable that an 8 year old has the “right” to be permanently sterilized with hormones & at 12 years old is ready to have a double mastectomy, then you have a society where bodily dismemberment is tolerated & even celebrated. When you have a society that is ok with snuffing out the sick and elderly because it sucks to watch them in pain, then you have a culture that is pro-death and anti-human.

      A society of comfort nihilism is one that will eventually eat itself.

      My grandmother’s end of life wasn’t marginal. And taking away anyone right to life isn’t either.

      • I struggled with how to respond to this. I think my second choice would have been just to not, because dealing with death is an incredibly personal experience, and your mileage will vary.

        But I am going to say that I am not advocating for situations like what you went through. Allowing grace and dignity in death should not mean forcing someone metaphorically kicking and screaming for life to die. I understand that situations like that might become more common if euthanasia becomes more accepted, but I see that as a bug that needs to be controlled against as opposed to a feature.

        • I understand that situations like that might become more common if euthanasia becomes more accepted…

          Here we both agree. And I’m sorry for the suffering you and your loved ones experienced HT.

      • Great comment Mrs Q. You have given me much more to support my opinion that pushing euthanasia for the public good is outrageous.

        Decisions regarding death and dying must only be made by the person who will be the one who dies.

      • Powerful words, and so true! Nihilism is spot-on, and really the central theme, and pathology, behind those ushering in this Hell on Earth.
        Much of he staff at my Mother-In-Law’s nursing home hate me. They are sloppy, lazy, stupid, and often cruel people, and I don’t hesitate to give them Hell whenever I catch them delivering any sort of sub-standard care. I started out trying to be diplomatic, but quickly discovered that they only speak stick, not carrot. I wish you had had a chance to get hip to them in time. I’m very sorry you had to go through that.

    • “Then I got to experience six family members dying from terminal cancer (lung, lung, lymphoma, leukemia, pancreatic, and lung). What I wouldn’t have given for a good old fashioned heart attack.”

      So much cancerous deaths and all in one family, that’s got to be extremely hard to witness over and over again. My sincerest condolences Humble Talent for your family losses. Cancer is a terrible scourge. I understand your sentiment.

  4. Oregon’s system that basically lets you kill any seriously ill loved one you want. The safeguards of the law have not been followed. Drugs for suicide are allowed to be mailed to the patient’s address and can be requested by loved ones. They have been administered by others, physicians are not present. They have been administered without any physicians’ approval or even knowledge. There has been no prosecutions for any of the violations of the law, even when the drugs were obtained and administered without a physician’s knowledge. So, you can request assisted suicide for your ‘loved one’, have the drugs mailed to the house, administer them to the person, and call in the death. Physicians do not record sending assisted suicide drugs, autopsies are not performed, and the cause of death is listed as the underlying medical cause, not the suicide.

  5. I have no problem with individuals choosing to have a DNR or a person planning ahead that they will die naturally by refusing to have medical devices artificially extend their life indefinitely especially when they are brain dead, but I just don’t get the reasoning for any of the rest of it. These people are not simply pulling the plug and the patient dies naturally they are intentionally giving the person a substance that will end their life unnaturally – that’s an inhumane choice that I could never be part of no matter how it’s rationalized.

    In may ways we are seeing signs that segments of the human race is losing its humanity and when that kind of moral bankruptcy really sinks it tentacles into a society there is nothing that people won’t do to others.

    • In may ways we are seeing signs that segments of the human race is losing its humanity and when that kind of moral bankruptcy really sinks it tentacles into a society there is nothing that people won’t do to others.

      It’s what the parents are teaching the kids in the home. Then when they get to college it all gets super-charged by the Marxist professors. I am not saying that there should not be universities however.

        • Kudzu

          Kudzu is a perennial vine native to Asia, primarily subtropical and temperate regions of China, Japan, and Korea, with trifoliate leaves composed of three leaflets. Five species in the genus Pueraria (P. montana, P. lobata, P. edulis, P. phaseoloides and P. thomsoni) are closely related and kudzu populations in the United States seem to have ancestry from more than one of the species. Each leaflet is large and ovate with two to three lobes each and hair on the underside. The leaves have the ability to fix atmospheric nitrogen, which can supply up to 95% of leaf nitrogen to the plant in poor soils. Along the vines are nodes, points at which stems or tendrils can propagate to increase support and attach to structures. As a twining vine, kudzu uses stems or tendrils that can extend from any node on the vine to attach to and climb most surfaces. In addition, the nodes of the kudzu vine have the ability to root when exposed to soil, further anchoring the vine to the ground. The roots are tuberous and are high in starch and water content, and the twining of the plant allows for less carbon concentration in the construction of woody stems and greater concentration in roots, which aids root growth.The roots can account for up to 40% of total plant biomass.

          Kudzu’s primary method of reproduction is asexual vegetative spread (cloning) which is aided by the ability to root wherever a stem is exposed to soil. For sexual reproduction, kudzu is entirely dependent on pollinators.

          Child of Marxist Professor

          We are in a social, political and economic war with the most malign internal forces the nation has had to deal with in my lifetime. Continual exposure of the Trump regime’s crimes, and those of his major backers and supporters, needs to persist all the way up to the election, and beyond. The Trump influence is a mortal infection of evil in our country, and we need to fight it in every way we can, every day. We should give our thanks to California for lighting the way out of our national crisis.

          <b<Solution: Close the Universities and send the kids on Kudzu-destroy missions.

    • Remember, these aren’t just terminally ill people, either. Mental suffering alone is enough for euthanasia in Belgium, even the Catholic Church has caved to this. The Brother’s of Charity, an order who serves the mentally ill, allows physicians to euthanize their patients in all their facilities in Belgium. They are the largest provider of psychiatric care in Belgium. Their board argued that believing that life is sacred is un-Chrisitan and idolatry. Although many psychiatrists seem to feel uneasy about the practice, it is widely supported in the press and anyone who speaks out will be attacked by the media.

      • Their board argued that believing that life is sacred is un-Christian and idolatry. Although many psychiatrists seem to feel uneasy about the practice, it is widely supported in the press and anyone who speaks out will be attacked by the media.

        It seems to me this is not the first time a society has faced this perversion, rationalizing and justifying the unthinkable.

        Woe to those who call evil good and good evil,
        who replace darkness with light and light with darkness,
        who replace bitter with sweet and sweet with bitter.

        This is what we are faced with, as elements in our society (western culture, not just the USA) have decided that ‘anything goes’ despite assurances from these same people that the slippery slope would never end up at the bottom. These elements thus cannot be trusted, as we have seen their track record:

        – “Abortion will never be used for birth control; It should be rare and a last resort…” Note we are now openly discussing post-birth negligent homicide while the doctors and family have a nice chat, perhaps over tea.

        -“Holding the mentally ill in facilities to protect society and they themselves violates their rights, so we will release them upon society” Notice the multiple problems this has caused society as neglected these people, like third world diseases returning to in US cities.

        -“You cannot kill a criminal as punishment for serious crimes. This is not a deterrent, violates their rights, and society is not protected by this practice.” Note how many murders are released, and how many kill again. Note that in places that still practice the death penalty, surveys of prisoners indicate that this is indeed a deterrent in those jurisdictions.

        -“Open borders would never result from our stance of not enforcing immigration laws.” Note the stance of these elements today.

        -“Illegal immigrants just want a better life, and would never come here to game the system.” Note that they ARE gaming the system today, even voting in states where ID has been opened to anyone, no questions asked.

        -“Title IX would never cause unjust prosecution of men. Nor would a man ever be allowed to dominate a women’s sport using the law.” Note current headlines for the latter, and college kangaroo courts the past decade for the former.

        -“Gay marriage would never lead to further demands for other ostracized groups to be legitimized.” Once homosexuality won their ‘battle for equality,’ they suddenly lost much of their protected class status. Now we must endorse rights for non transitioned, fully functional men (who feel they are women) to use women’s locker rooms, bathrooms, and lesbian’s vaginas, all in the name of ‘being woke.’ Note the destruction of women’s rights (and accomplishments) in sports, as the new protected class is allowed to compete.

        (Human nature would predict that soon pedofilia and beastality will become the new ’cause’ we must accept. The rumblings are already being heard.)

        -“Undocumented people do not commit crimes more than Americans.” Other than the crime of jumping the border, right? Tell that to the 25,000 odd killed in America by illegal immigrants from 2003 through 2009, according to the FBI. The rate at which illegals murder compared to citizens is irrelevant: those aliens should not have been here to kill Americans.*

        -“Illegal immigrants are a net benefit to our economy.” To quote: “According to research and statistics by the U.S. Departments of Justice and Homeland Security, U.S. taxpayers are footing an annual bill of nearly $19 million a day to house and care for an estimated 300,000 to 450,000 convicted criminal immigrants who are eligible for deportation and are currently residing in local jails and state and federal prisons across the country. * These expenses alone, disregarding the welfare, free school through college, and lost American jobs, give the lie to that assertion.

        -“No one is going to take your guns away.” Note that this is indeed a part of mainstream discourse today, as candidates for President adopt this stance.

        I could go on, but the trend is clear: the moral rot has caused the exact issues predicted in the verse above. Not only must we accept these things, but now we must endorse them or face the angry mob. Increasingly, having an opinion that contradicts the narrative of the day (even one that WAS the narrative the day before) can have one scourged socially, fired from one’s job, and even imprisoned. Calls for your death are not uncommon is such circumstances. The very pronouns we use are now subject to litigation and imprisonment.

        This, too, was discussed in the society that produced the verse above. From the translator’s notes:

        Isaiah 5:20- Their moral code is reversed as sin is accepted as something good. Not content to abandon what is good, they must label it as evil. Those who abandon the absolute standards of God’s Word will find a reversal of every true virtue. Good is mocked and evil is embraced. Light is ridiculed and darkness is worn like a cloak. The sweetness of God is called bitter; the bitterness of sin is called sweet.

        Good is being mocked and evil is being embraced. In every example described here, those who object are labeled undesirable, fungible, and subhuman. You will celebrate lawlessness and depravity, or be destroyed.

        There really is ‘nothing new under the sun.’

        *https://thehill.com/blogs/pundits-blog/crime/329589-the-truth-about-crime-illegal-immigrants-and-sanctuary-cities

  6. Well that deliberately misrepresents the issue doesn’t it. Weak sauce Jack, weak.

    If in my lucid state I sign a form saying I want X, then my wants in a non-lucid state are irrelevant. Accepting consent form a sane person is ethically valid, accepting consent from an insane one is not ethically valid. They didn’t kill the resisting patient because she had dementia or out of convenience. They rightly concluded that the patient’s dementia prevented them from making a reasonable and ethically valid expression of intent and went with the that last known ethically valid expression of intent. They even consulted with those who knew the patient best in order to double check. They were all on the same page and made the patients wishes happen.

    I hope I have doctors and loved ones with the same fortitude. If I end up in a vegetative state and two or more doctors say that I have a greater than, say, 80% chance of being in that state permanently, put me down. I don’t care what vegetative me says or does while you’re doing it. The care giver I’m paying and the family I contribute to damn well better respect my lucid wishes over some brain dead thrashing and moaning.

    The doctors and the family were spot on, the judge got it right, and the only ethically interesting thing here is a well trodden discussion about who can give ethically valid consent and, maybe some ethics hero status for the family and doctor who went above and beyond to make sure that the patient’s wishes were respected.

    • When it’s life and death we are talking about, the fact that the patient no longer wants to die should be dispositive, no matter how demented or crazy he or she is. She wasn’t vegetative. She changed her mind, what she had left of it. If she were a chimp or a dog, I’d agree with you. Human life should be harder to write off.

      • Wrong. She didn’t change her mind Jack – her mind was gone. The sane version of the patient wanted to die and the insane version doesn’t have ethical standing to override that. The patients affirmed their wish to die by signing the forms before hand, her family re-validated it, and the courts agreed. You’re fundamentally misrepresenting the patient as being of sound enough mind to revoke consent. They weren’t.

        • “The sane version of the patient wanted to die and the insane version doesn’t have ethical standing to override that.”

          That’s essentially saying that an “insane” person, however someone chooses to define that, doesn’t have the same right to life that a sane person does. Pardon me for saying this, but that seems to be morally bankrupt. A person is not less of a human being with choices because they are deemed “insane”.

        • Furthermore; if her mind is gone then isn’t her essence basically gone too and what’s left behind is the mind of the insane person, why should the new mind, insane or not, have a the same choices?

          How’d you like how I twisted that one? 😉

    • Addendum: since the Journal of Medical Ethics that reviewed the case said the case demonstrated the “myriad ethical concerns” raised by advance euthanasia directives, I think your claim that there are no ethical issues here is myopic. My position, if you read the article, is essentially the same as that of Dr. Scott Y.H. Kim, a psychiatrist and bioethicist at the National Institutes of Health in the United States, who said that “When a human being is resisting — regardless of how ‘meaningless’ the action is in terms of intentions and understanding — and what she is resisting is an act to end her life,” then it could be “pretty difficult to take in.”

      You’re arguing that the demented should be treated like animals. OK. But that’s hardly beyond debate.

      • “When a human being is resisting — regardless of how ‘meaningless’ the action is in terms of intentions and understanding — and what she is resisting is an act to end her life,” then it could be “pretty difficult to take in.” Reads as nothing more than ‘I feel about this’. Sure you can feel bad about it, that’s hardly a controversial ethical analysis.

        More importantly, I’m arguing the nature of consent. Crazy people don’t get to give or revoke consent that they wouldn’t have given in their sane state of mind. We use statements of will and the opinion of the family to determine the most ethical course of action here. This is beyond doubt. In this case the known statements of will and the opinion of those who knew the patient best line up. The effect of what you’re very literally arguing is that we should ignore the wishes of sane people and their families and instead let the crazies call the shots in serious matter of consent.

            • Crazy people still have civil rights. There may be things they can’t do, just like blind people can’t drive cars. that doesn’t mean they don’t have exactly the same rights as everyone else. There is no right to execute a legal document if long-standing common law and current legal requirements can’t be met, particularly when the document requires the law to enforce distribution of property affecting others.

              • That’s not quite right either… For instance, states have the authority to establish voting qualifications, and those qualifications can be related to things like residency, citizenship, criminal record, or, more relevant to this conversation: mental capacity. Mentally inform people *do not* have *exactly* the same civil rights as everyone else, particularly if you have taken certain actions to give some of them up. Relevant: If you commit yourself to a mental institution, depending on where you are and the facts of the case, your mileage may vary, but you almost certainly give up *some* of your civil rights.

                What I find interesting is that if I’m reading this correctly, you seem to be saying that you think that euthanasia requests in the case of dementia in particular, but probably also other types of mental infirmity, is basically null and void the moment it would apply. If someone wants to euthanize in the event that they can’t remember anyone, or anything, and then in the grips of dementia, where they can’t remember anyone or anything, they can nolonger remember the request or grasp why it was made, the previous request becomes void even though the request was made cognizant that for the request to apply they probably wouldn’t understand the request when it came time to act on it.

                I think that if that was spelled out to someone, they might make different choices in the disposition of their death. To use your hypothetical, if Tess knew that in the grips of her dementia, she would resist the lethal injection, and that demented resistance would mean that her wishes were not followed, she might opt in one of her lucid periods to take the injection.

                • Right. I have sometime said to my wife, referencing an individual or character I see on TV, “If I ever get like that, just hit me from behind with a brick.” But that statement should not be governing if I do get like that, and decide that I don’t want the brick.

                  The core American rights are life, liberty, and the pursuit of happiness. The rest are all secondary, and have legally sanctioned qualifications. Life is number #1 for a reason.

                  • I think that’s a particularly weak comparison, but it’s irrelevant, because the answer to “Do you these requests basically unenforceable?” if I’m reading this correctly was “Right”.

                    In that case, let’s go back to your hypothetical… Do you think Tess knew that? Because I think she used the request as peace of mind assuming it *was* enforceable, and that if she knew it wasn’t she would have made other plans.

                    Does the situation in essence trick people out of their own self-determination?

                    • Do I think past requests to be killed when the present individual recants them, regardless of that individual’s metal state, are unenforceable? Yes. I would also add: of course.

                      Can you bind yourself in slavery? No.

                    • Right, but we’re talking about suicide. Suicide is permanent. If someone wants to die before or shortly after losing their mind, lying to them in order to string them on to a point where they’re too mentally infirm to follow through with what they want can’t possibly be ethical,

        • The effect of what you’re very literally arguing is that we should ignore the wishes of sane people and their families and instead let the crazies call the shots in serious matter of consent.

          Well, yes. Life and death is a different matter than distribution of property. Given the propensity for progressives (and others through history: this is not merely a progressive form of deception) to define their way around the law, how long until this assertion is not extended to political enemies?

          ‘Climate deniers’ have been defined as insane. Second Amendment advocates have been defined as insane. Pro life advocates have been defined as insane. Courts have taken the rights of entire minorities and in short order they were legally murdered en mass. Now Republicans have been defined as evil, and therefor insane.

          You trust too much in those who will adjudicate death. I trust in the history of mankind, to human nature, and to an understanding of how such good intentions have panned out in the past, especially when the left has been the advocates looking for power.

    • RPE
      I suggest you consider type 1 and type 2 errors.

      If you force the issue and the person fights you as you attempt to administer the lethal injection and you are wrong that is a type 2 error from which there is no recovery for the patient.

      If you stop trying because the patient fights you but had he or she been cogent the patient would have allowed you to proceed that is a type one error which can be corrected later if needed.

      When the patient fights the injection, that suggests enough competence to know what is happening and is attempting to communicate the change of mind.

      This should be obvious. Hey if consensual sex can be called rape the next day because he did not call then withdrawl of consent to euthanasia should be treated with greater deference.

      • Psshh simply recognizing a threat is in no way shape or form the equivalent of being competent. In fact the patient was deemed mentally unfit for purposes of serious choice by the court. When you sign the form as a competent sane person you are literally voiding your type one type two concerns – they are addressed preemptively by the damn form. No one signs a form telling doctors to kill them under certain conditions with the expectation that their insane dementia riddled reaction will invalidate their sane thinking will. What a silly position.

        • When the patient signed off on euthanasia, it was because at the time she didn’t expect to desire life under the specified conditions. Yet when the time came, she DID desire life. We’re not talking about her state of mind in dividing her estate, we’re talking about whether or not she was willing to die, and for whatever her reasons, she didn’t wanna die! Was she insane to decide life was worth living?

          Also, even with the family and doctors in agreement, I still fear there is potential for abuse. What if the family was just in a hurry to get their inheritance? What if the hospital was on a tight budget?

        • Any Advance Directive can be withdrawn by the patient at any time.

          If a court can order a patient to be euthanized by virtue of an advance directive simply because the court rules them incompetent and unable to withdraw such directives we are all in trouble.

          I understand that if a family member did not want the directive followed and the patient is unresponsive I can see a court stepping in to ensure the advance directive was enforced but I cannot see a court enforce an advance directive that was countermanded by the patient in question.

  7. I am healthcare POA for both of my parents. 5 years ago, my mother was unexpectedly gravely ill. Her wishes were made clear to me in advance, no unusual measures were to be used to prolong her life. She has a DNR on file.
    When she was admitted to the hospital, her treating physician explained to me that her condition would get worse, and may or may not get better. He recommended intubating her in advance, because he was certain she would get worse. I consented, although one could argue she wouldn’t have wanted that.
    The doctor was right, and she did get worse. I was called back to the ICU at 1 a.m. to make decisions. As I sat with my mom, holding her hand and watching a machine breath for her, I wondered if I was doing the right thing. She woke up 2 days later, had the tube removed, and although she had to fight to get better, has good quality of life. I sometimes have nightmares thinking about what other choices I could have made, or would have been allowed to make, which would have lead to my mom not being with us for the last 5 years.

  8. I don’t like that changing your mind about assisted suicide is deemed ‘not in their right mind.’ I’m big on quality of life as well, but you do get used to your limitations and may still find joy within your limitations, DNRs and other end of life decisions should always be subject to change of mind. Being in your right mind should not be governed by people with ethics conflicts.

    I do not want extreme measures to keep me alive when I’m not alert and engaged to some degree. Wanting to live should have trumped any previously expressed fear of assisted living. That should have been a no-brainer, and forcing it was plain and simple murder. I would rather ban assistance, as much as I might be open to suicide in restricted conditions than enable murder like that. Changing your mind is not being out of your mind.(I like Chris M’s parallel about withdrawing sexual consent, it reall should be more important.

    But how can we draw a fair line?

    • In the court of law, it’s my understanding that no matter how heinous a crime is, an insane person or mentally deficient person can’t be put to death. I’d simply suggest that the same rule apply to our elderly patients- if your mind is slipping, you don’t get to decide to pull the plug. It may be a challenge, but the safest thing to do would be to wait for them to become lucid again, and then you can simply administer the “care” without conflict. They’ll push the plunger themselves, if it’s still what they want.

      It lets people decide for themselves in the moment, and protects all involved from the horrific chance of making a mistake. And if they dont have any more opportunities of lucidity to make the choice, we as a culture can still say that we don’t simply kill off our old, infirm, and inconvenient. Which we shouldnt do, right?

      • I’ve been in the throes of a long-term sickness that was so indescribably miserable that I tried several times to kill myself. There was also one time when I was in a depressive psychosis so deep that I thought I was the subject of a medical experiment, and everyone at Camp Lejeune was involved. I tried injecting a gram of potassium cyanide, and was fortunately caught. Not too much later, they finally diagnosed me with bipolar disorder type I and C-PTSD, and it never got to that point again, thank God.
        I’m extremely grateful that I never succeeded, but if you had asked me at these times, I would have told you with absolute sincerity that my quality of life had completely deteriorated, and was unlikely to return, or to return quickly enough.

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