I would say not (as one who is medically qualified and who can prescribe narcotics).
However I don’t have the skills of an anaesthetist.
I am also a daughter, grand-daughter and friend; been there/ done that/ got the T shirt.
I will say how much I hate the way that the word” euthanasia” is bandied around the Ship and other places.
Them as you who know some Greek will be aware that it is derived from eu and thanatos: in short “good death”. This does not equal the putting to death of man or beast by ( usually chemical) means.
If a life is shortened by adequate management of pain, inability to breathe or hunger and thirst then so be it. This is good palliative care. It might shave off a few hours or days, seldom weeks.
I’m not here to discuss this further but interested parties can PM me if they so choose.
Although there are questions at the end I ve been worrying about it and didn’t really know why
But
Think I do now
Considering something to be a sin is some great big huge statement.
I “think” I m ok with @Eliab saying that in relation to themselves. Only.
But sin is not a word to be used lightly.
Whilst also holding in tension the very real joy of your experience @Eliab . Wow , to have wife who fights for you like that.
So
As ever
I m sat on the ship asking myself difficult questions and having absolutely no answers!
But absolutely knowing Beyond Doubt ( earlier working life)
That palliative care doesn’t mean that someone is going to be shuffled off this planet, post -haste.
Proper palliative care just means that someone can be supported to do what they want without active and usually aggressive treatment.
I ve know folks live for a Long time with palliative care.
I share soujourner’s opinion of how the word euthanasia is bandied around. Everywhere. (And I have quite deliberately Not linked them, as they have indicated they are leaving this thread )
If you were to ask fifty people what that word meant, I don’t think we would have two answers the same.
Got a kinda idea that far more joined up thinking and talking needs to be done around this topic…. A topic that has many branches….
I will say how much I hate the way that the word” euthanasia” is bandied around the Ship and other places.
Them as you who know some Greek will be aware that it is derived from eu and thanatos: in short “good death”. This does not equal the putting to death of man or beast by ( usually chemical) means.
Most people's experience of what is called "euthanasia" is their household pet going on a one-way trip to the vet - and their thought is certainly that they are providing a "good death" for their beloved pet.
I'm not convinced by this argument by etymology. I think we have a fairly clear idea what we mean by Euthenasia, in general terms, and are not thinking (and need not be) of the derivation.
My immediate connotation to the word is someone who is dying being empowered and choosing their own exit. That isn't the denotation, and it isn't always how it works, but that's why the word sounds good to me. I think that in many western cultures those who are chronically ill or slowly dying* are made to feel inconvenient or expensive too often. And slow dying becomes more common with modern medicine. So the ill need to be empowered. Euthanasia is one way, and I don't think it has its place, but maybe we need to empower the dying, the chronically ill, and the very ill to live also.
*And be very clear that those are two separate groups.
Apparently the suicide rate in veterinarians (who only put down animals) is 4 times the general population's. So yeah, I think we should be concerned.
That article offers as a possibility the idea that vets (who habitually put down animals to ease their suffering) might as a consequence be more likely to think it reasonable to put down (at their request) humans to ease their suffering. That's a plausible speculation, but the article offers no evidence that it is actually true.
Just to clarify, this horrid idea is NOT my own, and in fact contrary to my personal opinion. I'd hate to have it associated with me. Please don't make it look that way, okay?
No, I brought up the article on the principle of "If it's hard to put animals down, even for their own good and with no moral sanctions against it, how much harder..." Were we ever to become a world where doctors routinely "put down" human beings, I suspect we'd see an astronomical suicide rate among them.
It's also the case that doctors and dentists (who don't usually euthanize either people or animals) have a significantly elevated suicide rate, which suggests that the elevated suicide rate is more likely to be associated with the commonalities between those professions rather than the exposure to euthanasia.
Having done a deeper dive into various statistical sources, there are conflicting reports on how being in medical fields affects suicide rates. UK data seems to be opposite to US date, for starters. So this is probably not going to get much further than speculation at this time.
Apparently the suicide rate in veterinarians (who only put down animals) is 4 times the general population's. So yeah, I think we should be concerned.
That article offers as a possibility the idea that vets (who habitually put down animals to ease their suffering) might as a consequence be more likely to think it reasonable to put down (at their request) humans to ease their suffering. That's a plausible speculation, but the article offers no evidence that it is actually true.
Just to clarify, this horrid idea is NOT my own, and in fact contrary to my personal opinion. I'd hate to have it associated with me. Please don't make it look that way, okay?
No, I brought up the article on the principle of "If it's hard to put animals down, even for their own good and with no moral sanctions against it, how much harder..." Were we ever to become a world where doctors routinely "put down" human beings, I suspect we'd see an astronomical suicide rate among them.
It's also the case that doctors and dentists (who don't usually euthanize either people or animals) have a significantly elevated suicide rate, which suggests that the elevated suicide rate is more likely to be associated with the commonalities between those professions rather than the exposure to euthanasia.
Having done a deeper dive into various statistical sources, there are conflicting reports on how being in medical fields affects suicide rates. UK data seems to be opposite to US date, for starters. So this is probably not going to get much further than speculation at this time.
I would think the pressures in the two systems are very different - in the UK the biggest issues are likely to be overwork and stretches resources, while in the US the risk of malpractice suits and dealing with patients who can't afford treatment present different stressors.
@Eliab , did your wife just verbally argue , sorry Disagree Strongly , with the doctors or were there pieces of paper to hand - to aid her?
And
Looking back on this situation, would you suggest something written?
@Ethne Alba there were no written instructions, I (perhaps naively) imagined that a doctor would take as the default position that I wish would to live, and that they would do their best to achieve that.
In 1972, my 71 year old grandfather was terminally ill with cancer in one of Dudley's main hospitals. He was in a ward where there were no discharges. The last time I saw him he was a living skeleton. I had always regarded him as a strong man and if I had not followed the progress of his illness I would not have recognised him. When I visited the following day his bed was empty. I did not need to be told he had gone. If he was 'helped' to die I am grateful to whoever did it. I don't recall there being hospices at that time. He never had the choice to fight for life. He had a wife, my mom and my uncle as his nearest relatives. I felt helpless.
When my mom had cancer, I was scared it would be the same but she died peacefully at home.
Up until quite recently I (along with many others I guess) had bumbled my way through life , not really giving any thought to what might or might not happen to me.
Sure, I saw and engaged with people close and dear who were going through tough times. Made a will, so objectively glanced at eternity (whatever that is). Sat by bedsides in a professional capacity.
But until this past month….maybe upon sober reflection ….I have been guilty of a slight “head in the sand” approach.
Ten years ago when I was waiting for a diagnoses which might have been very bad news (but turned out not to be) a good friend counselled me that while I was waiting I should take some time to really think about what said bad news would mean. To think about it, pray about it, come to terms with it, at least a little. It was some of the best advice I have ever had, and though, thankfully, all I needed was a small op to set me right, the time I spent in deliberate contemplation has continued to shape how I live.
One of my Three Kind Friends, who helped me through the brain tumour thingy, asked me (after the event, obviously) how I felt as I was being wheeled to the operating theatre.
O (said I), I was philosophically thinking that, if I died, everything would be out of my hands, and, if I survived, I'd deal with it as it happened.
What I did not think of - as I've said previously - was how I would have reacted and/or coped if the operation had resulted in my surviving, but having had an incapacitating stroke.
It really does make sense to think about every option (as far as one can).
I am 83 years old, and if I am in such a state that I can express my wishes for treatment fine, If not please let me die at home in my own bed in peace, and not hooked up to stuff in a hospital. Yes, all paperwork is in order and my family knows my wishes.
I think whenever I consider possibly being in the position of making this kind of decision for someone who is incapacitated and has not left clear instructions, or where the situation itself is ambiguous enough to make it unclear how to carry their instructions out (and also when deciding what public policies to support in terms of the options individuals and families have at the end of life), I find it hard to come to terms with the fact that other people might have very different wants and needs than myself - and to come to terms with my own inability to imagine what kind of suffering a very ill person is in or what kind of mental state someone with impaired cognitive ability might be in. All of this leads me to want to lean on the side of preserving life and consider that a person who cannot communicate might have changed their mind since giving instructions on their treatment. I am terrified of being locked into a course of action and not having the communicative ability to stop it, or having all this play out while I am unconscious when I might come to a different conclusion than my family if I were awake. But other people are different than me and many of them have thought very long and carefully about precisely these possibilities. I still find the whole process very morally and emotionally troubling, and as someone with decision making ability for multiple considerably older loved ones, I dread what future decisions I might need to make.
I think the key words are "dignity of risk." It's not my responsibility to enlist someone else into a battle they're fighting on behalf of my ethics. So if someone wants to struggle, they may struggle. And if someone wants to die, they may die.
All of this, of course, assuming that clear, straightforward communication of intent is achievable.
I think the key words are "dignity of risk." It's not my responsibility to enlist someone else into a battle they're fighting on behalf of my ethics. So if someone wants to struggle, they may struggle. And if someone wants to die, they may die.
All of this, of course, assuming that clear, straightforward communication of intent is achievable.
And of course, you will support the person no matter what their choice is. To do otherwise would deny them that dignity. Where that becomes hard is in the situation outlined by stonespring where you really have no idea of the wishes of the person concerned.
I think the key words are "dignity of risk." It's not my responsibility to enlist someone else into a battle they're fighting on behalf of my ethics. So if someone wants to struggle, they may struggle. And if someone wants to die, they may die.
All of this, of course, assuming that clear, straightforward communication of intent is achievable.
And of course, you will support the person no matter what their choice is. To do otherwise would deny them that dignity. Where that becomes hard is in the situation outlined by stonespring where you really have no idea of the wishes of the person concerned.
Yep, those are the dangerous cases, in which I think it would fall to next-of-kin (assuming a healthy relationship) or an appropriate authority figure. Might be a good case for a committee of concerned parties to make an informed decision.
We have these in my professional field for working out plans for adults who are not intellectually competent to make their own decisions, and they seem to work, admitting that it's hard work.
Something I've realized more as I get older is that in matters of life and death, mistakes are made and there are lots of people whose existence or lack thereof is, truthfully, arbitrary. At some point we have to make the best choice we can and hope for grace.
A fair bit of my work was in the area of what is called protective law - looking after both the property and the person of those who cannot care for themselves. A committee* - ie those to whom the functions of caring for an incapable person and/or their affairs are committed by the Court - has the power, but may get absolutely no training in what is involved nor how to set about doing it. If a trustee company is appointed to manage affairs, all is as safe as it can be, but in general there's no training for a committee of the person.
A fair bit of my work was in the area of what is called protective law - looking after both the property and the person of those who cannot care for themselves. A committee* - ie those to whom the functions of caring for an incapable person and/or their affairs are committed by the Court - has the power, but may get absolutely no training in what is involved nor how to set about doing it. If a trustee company is appointed to manage affairs, all is as safe as it can be, but in general there's no training for a committee of the person.
*A committee may be one or more persons.
I would completely agree that there should be training on the topic. I think, as in all things, there is a professional common sense, born of experience, that people deserve to learn from. I'd have some concerns about vetting the trainers, because the field is ideological fraught, but I agree. It's not a place for amateurs.
The Cdn Gov't is set to amend the MAID legislation to extend the ban on MAID eligibility solely for individuals who have a "mental illness". The changes have been made in the legislation following the Supreme Court ruling parts of the law unconstitutional a few years ago.
The Cdn Gov't is set to amend the MAID legislation to extend the ban on MAID eligibility solely for individuals who have a "mental illness". The changes have been made in the legislation following the Supreme Court ruling parts of the law unconstitutional a few years ago.
We've been having conversations in my church context about how this changes our pastoral approach to MAiD. I find this troubling in the extreme. I am disappointed beyond belief that the people who warned us of a slippery slope were right.
The issues with mental health and MAiD for me are that loss of hope and helplessness to improve life are directly associated with poverty and access to care. It's very poor and deteriorated in the 40 years I was involved in health care provision.
Waits for psychiatrist appointments which in Canada are mostly medication consultations only are 5-7 months where I live unless you've done a significant suicide attempt. Consults ate typically monthly until whatever seems stable enough to extend to 3-6 months or turn back to family doc, if the patient has one (there are thousands with no family physician, and there are no doctors accepting patients in my province for about 1 year, no end in sight). Most people never see a psychiatrist here. If hospital emergency sees a person, they'll stabilize in the ER and discharge if at all possible and not admit to psychiatry. People leave hospital and end their lives shortly thereafter. Some are reported in the media.
There is almost no access to publicly funded psychological therapies and counselling. If you're not able to pay $200+ / hour, you're not getting it. Insurance plans if the low paid job provides it might cover 1-2 sessions. Even 'very good plans' typically max out at 6 hours.
Mental health problems are associated with not being employed and being on social assistance/ welfare. Which is just not enough for housing, food, utilities. Where I live, the government stopped coordinating rent and utility (water, electric, nat gas) with their reason being to build independence. Which doesn't work for many people with untreated MH issues. They get evicted. Some die from freezing to death. We're losing people every week. -23°C today (-10°F).
My conclusion- medical assistance in dying is wrong when the "psycho-social" diagnosis is poverty, homelessness, cold, hungry, lack of access to care, regardless of mental health diagnosis and mental state of the person.
We do have documented and undocumented situations of unasked for offers of death-as-treatment by health care workers and people authorising care. The ones that have come to national attention concern soldier veterans with diagnoses in the psychological trauma spectrum. It's wrong and should be prosecuted if the professional is licenced in my view.
Is this thread about Medical assistance in dying or is it about when to end life-maintaining treatment for a loved one? Or is it about both?
What are the kinds of mental health situations that advocates for MAiD argue should have MAiD as an option? Are they usually tied to a non-psychiatric physical health condition, injury, or disability?
Ten years ago when I was waiting for a diagnoses which might have been very bad news (but turned out not to be) a good friend counselled me that while I was waiting I should take some time to really think about what said bad news would mean. To think about it, pray about it, come to terms with it, at least a little. It was some of the best advice I have ever had, and though, thankfully, all I needed was a small op to set me right, the time I spent in deliberate contemplation has continued to shape how I live.
Almost twenty years ago I received what might be considered as a life threatening diagnosis which certainly caused me to re-evaluate my life and come to terms with how I might deal with the future. Three years later I received a second such diagnosis. Fortunately for me medical science and wonderful clinicians were able to deal with both diagnoses.
The two experiences have helped me greatly to be able to deal with any further such diagnoses.
I think the key words are "dignity of risk." It's not my responsibility to enlist someone else into a battle they're fighting on behalf of my ethics. So if someone wants to struggle, they may struggle. And if someone wants to die, they may die.
All of this, of course, assuming that clear, straightforward communication of intent is achievable.
And of course, you will support the person no matter what their choice is. To do otherwise would deny them that dignity. Where that becomes hard is in the situation outlined by stonespring where you really have no idea of the wishes of the person concerned.
Well, there is also the dynamic of the seriously ill person feeling - whether rightly or wrongly - that the 'right' thing for them is to seek an end to their life for the sake of their loved ones, despite their own personal desire to live. A person may wish to live, but conclude it is their duty to remove themselves - or have themselves removed - for the greater good. It's interesting how difficult 'clear, straightforward communication' between even capable and articulate people becomes, when one person is trying to second-guess what the others are 'really' thinking, or how they might suffer, or what relief it might be etc; and where pain, grief, guilt and fear kick in.
I don't think that I, as the lawyer, have the right or the skills to give that sort of advice. What I could have done was point the person in the direction of those skilled.
If there’s a chance of me recovering to an independent life, take it.
If I cannot possibly continue to exist without being plugged into machines in a hospital:
If I am able to communicate in any way, ask me.
If I’m long-term unable to communicate (eg comatose or locked-in), but with a reasonable possibility of regaining the ability to communicate (though not independence from the machines) one day, ask the kids what they want. They may want to keep me going until their wedding or something.
If I’m long-term unable to communicate with minimal or no hope of recovery, pull the plug. It would be a kindness. My greatest fear is being left fully conscious, but without any ability to sense or communicate with the rest of the world. Keeping me alive with machines in such a condition would be keeping me in hell.
Personally I think these decisions should be discussed in advance. I had some hospital time a couple of years ago with a colon problem that was both agonising and humiliating. For a couple of days I really didn't care whether I lived or died. That would not be the time to make that decision.
My wife and I have had "the conversation" and both know what the other wants. I can see no other way of handling it.
I've just re-read this thread because the brother to whom I have always felt closest is visiting next month. I hope I don't ruin his visit home, but he is the person that I have decided to open this conversation regarding end of life issues with. At present I don't think I'm about to die, right now, but who knows? I could be hit by a car while crossing the road to or from the bus stop - I swear some of those motorists are attempting the land speed record.
I will get a copy of the end of life stuff from my G.P, discuss it with my brother, discuss it with my lawyer and make a will and register the end of life decisions with my GP or whatever authority necessary. (NZ used to have District Health Boards, but this has changed recently, so I'm a bit hazy on it, but my GP will know.)
Thanks questioning, I ducked out of doing this on his last visit which was before the pandemic, but as someone once said, " The thought of sudden death concentrates the mind". Also his partner has to return home earlier. It's not that I mind her knowing the details, and he is free to tell her everything we discuss, it just that it will be easier to talk to him by himself.
I have more thoughts than I probably can share right now, but I can't help bring in my bipolar illness. I've dealt with suicidality quite a lot in my life, and am maybe still alive just out of fear of botching it up.
That said, I can still see myself (sorry to sound this crass) pulling a Robin Williams if/when I get my Alzheimer's diagnosis (what my dad died of) - not just because I don't want to live and die that way, but because I don't have resources, and I will have no one to take care of me. There may be other conditions that would send me in that direction, too, but as long as I had my mind, I suspect I'd find it worth fighting.
Like many here, I also don't think we're meant to fight against the inevitable. Medical science has gotten us to where we can prolong life a lot longer, and at great cost (not just financial) and with greater suffering, than was ever possible. This causes a lot of undue suffering but people still think they need to cling to every fragment of hope, real or imagined. I remember one of Jack Kervorkian's paintings (displayed years ago in a gallery in Royal Oak, MI, as he was local here) called "Nearer My God to Thee" that depicted someone trying to stop falling into a long bottomless hole to the point their fingers were worn to the bone. It was, he had commented, about the pointless efforts he in his medical practice would see people make just to stay alive for one more breath - people who also had strong faith in God and claimed they were ready to meet God.
I did some theological work some decades ago, researching ethics around suicide, and satisfied myself that, should I die from it, I would find myself in God's embrace - not in hell, as I was taught growing up. (Now I don't even believe in hell, but that's another matter.) It made me want to live, actually. I'd been feeling like God had a gun to my head ordering me to keep my heart beating at all costs, and that went away once I realized God's love was so profound and gracious.
We're going to mess things up, and I don't personally view sin as ponderously as some do - I believe it's been taken care of by God, and God's desire for us to have union with God is so much more intense than anything sin could bring up. So I think whatever decision we make, as we make it carefully, prayerfully, and with as much information as we can gather, is a decision we needn't worry too much about.
“as long as I have my mind I suspect I’d find it worth fighting”
A close friend of mine eventually succumbed to motor neurone disease almost 5 years after diagnosis, after being given 1-2 years to live. For her last year she was paralysed ( just able to grip a pen) speechless, and swallowing was impaired. Her mind was intact until the end when ( thank God) pneumonia set in and put an end to her suffering. At least the agony was not prolonged with a gastric feeding tube or a tracheotomy and ventilatory support.
My point is that she was mentally intact when physically she was beyond putting up any sort of a fight.
Her palliative care could have been better if her medical attendants had cranked up the morphine and midazolam. I guess they did not want to be seen to be hastening her demise.
“as long as I have my mind I suspect I’d find it worth fighting”
A close friend of mine eventually succumbed to motor neurone disease almost 5 years after diagnosis, after being given 1-2 years to live. For her last year she was paralysed ( just able to grip a pen) speechless, and swallowing was impaired. Her mind was intact until the end when ( thank God) pneumonia set in and put an end to her suffering. At least the agony was not prolonged with a gastric feeding tube or a tracheotomy and ventilatory support.
My point is that she was mentally intact when physically she was beyond putting up any sort of a fight.
Her palliative care could have been better if her medical attendants had cranked up the morphine and midazolam. I guess they did not want to be seen to be hastening her demise.
A terrible end, one that none of us wants. A lot of truth in your last sentence - I can see the newspaper headlines.
Some months ago I read a newspaper story about a terminally ill man here in Aotearoa/NZ who chose to have the lethal cocktail of drugs administered to him while sitting in his ute, on his favourite beach looking out to sea.
When I read Sojouner's post about her friend I was reminded of that man and his story. I know which I would prefer.
Yes. It is 4 weeks today since the death of another old friend ( younger than me at 62) from relapsed oesophageal cancer. He had suffered 3 different cancers in the 4 previous years besides chronic HIV ( well managed) for 15 years. The last few months were tough after his final cancer recurred 18 months after heroic surgery/ radiotherapy/ chemotherapy and it was a profound relief when he was admitted to hospital and the oncologist pulled the pin on palliative chemotherapy. I could not have faulted any of his care and it was a great comfort to me that all his anxieties dissipated and he was able to go in peace with good control of symptoms and loving care by nurses and medicos ( who allowed me to wander in and out of the ward at all times).
Yes. It is 4 weeks today since the death of another old friend ( younger than me at 62) from relapsed oesophageal cancer. He had suffered 3 different cancers in the 4 previous years besides chronic HIV ( well managed) for 15 years. The last few months were tough after his final cancer recurred 18 months after heroic surgery/ radiotherapy/ chemotherapy and it was a profound relief when he was admitted to hospital and the oncologist pulled the pin on palliative chemotherapy. I could not have faulted any of his care and it was a great comfort to me that all his anxieties dissipated and he was able to go in peace with good control of symptoms and loving care by nurses and medicos ( who allowed me to wander in and out of the ward at all times).
Much sympathy for the loss of your friend.
The name of the thread has bothered me. What is the duty to fight for life, and where is that duty set out?
Mind you I was brought up as an old fashioned RC fatalist,with the view that life on earth is a vale of tears and death a merciful release.
My 2 unbelieving siblings take the same view and it was surprising to all of us 24 years ago when our mother died the negative comments which came our way at our (apparent) lack of seemly public grief.
Our late father ( died 1987) took the same view. I recall that after his death that his parish priest who saw him almost daily during his (brief) final illness commented that he took great consolation at Dad’s death. So did I.
Comments
However I don’t have the skills of an anaesthetist.
I am also a daughter, grand-daughter and friend; been there/ done that/ got the T shirt.
I will say how much I hate the way that the word” euthanasia” is bandied around the Ship and other places.
Them as you who know some Greek will be aware that it is derived from eu and thanatos: in short “good death”. This does not equal the putting to death of man or beast by ( usually chemical) means.
If a life is shortened by adequate management of pain, inability to breathe or hunger and thirst then so be it. This is good palliative care. It might shave off a few hours or days, seldom weeks.
I’m not here to discuss this further but interested parties can PM me if they so choose.
Although there are questions at the end I ve been worrying about it and didn’t really know why
But
Think I do now
Considering something to be a sin is some great big huge statement.
I “think” I m ok with @Eliab saying that in relation to themselves. Only.
But sin is not a word to be used lightly.
Whilst also holding in tension the very real joy of your experience @Eliab . Wow , to have wife who fights for you like that.
So
As ever
I m sat on the ship asking myself difficult questions and having absolutely no answers!
That palliative care doesn’t mean that someone is going to be shuffled off this planet, post -haste.
Proper palliative care just means that someone can be supported to do what they want without active and usually aggressive treatment.
I ve know folks live for a Long time with palliative care.
I share soujourner’s opinion of how the word euthanasia is bandied around. Everywhere. (And I have quite deliberately Not linked them, as they have indicated they are leaving this thread )
If you were to ask fifty people what that word meant, I don’t think we would have two answers the same.
Got a kinda idea that far more joined up thinking and talking needs to be done around this topic…. A topic that has many branches….
Most people's experience of what is called "euthanasia" is their household pet going on a one-way trip to the vet - and their thought is certainly that they are providing a "good death" for their beloved pet.
*And be very clear that those are two separate groups.
Just to clarify, this horrid idea is NOT my own, and in fact contrary to my personal opinion. I'd hate to have it associated with me. Please don't make it look that way, okay?
No, I brought up the article on the principle of "If it's hard to put animals down, even for their own good and with no moral sanctions against it, how much harder..." Were we ever to become a world where doctors routinely "put down" human beings, I suspect we'd see an astronomical suicide rate among them.
Having done a deeper dive into various statistical sources, there are conflicting reports on how being in medical fields affects suicide rates. UK data seems to be opposite to US date, for starters. So this is probably not going to get much further than speculation at this time.
I would think the pressures in the two systems are very different - in the UK the biggest issues are likely to be overwork and stretches resources, while in the US the risk of malpractice suits and dealing with patients who can't afford treatment present different stressors.
And
Looking back on this situation, would you suggest something written?
When my mom had cancer, I was scared it would be the same but she died peacefully at home.
I'd say your post was in an unexpected order rather that wrong - it is grammatically correct and makes proper sense.
Sure, I saw and engaged with people close and dear who were going through tough times. Made a will, so objectively glanced at eternity (whatever that is). Sat by bedsides in a professional capacity.
But until this past month….maybe upon sober reflection ….I have been guilty of a slight “head in the sand” approach.
Much to think about here.
One of my Three Kind Friends, who helped me through the brain tumour thingy, asked me (after the event, obviously) how I felt as I was being wheeled to the operating theatre.
O (said I), I was philosophically thinking that, if I died, everything would be out of my hands, and, if I survived, I'd deal with it as it happened.
What I did not think of - as I've said previously - was how I would have reacted and/or coped if the operation had resulted in my surviving, but having had an incapacitating stroke.
It really does make sense to think about every option (as far as one can).
All of this, of course, assuming that clear, straightforward communication of intent is achievable.
And of course, you will support the person no matter what their choice is. To do otherwise would deny them that dignity. Where that becomes hard is in the situation outlined by stonespring where you really have no idea of the wishes of the person concerned.
Yep, those are the dangerous cases, in which I think it would fall to next-of-kin (assuming a healthy relationship) or an appropriate authority figure. Might be a good case for a committee of concerned parties to make an informed decision.
We have these in my professional field for working out plans for adults who are not intellectually competent to make their own decisions, and they seem to work, admitting that it's hard work.
Something I've realized more as I get older is that in matters of life and death, mistakes are made and there are lots of people whose existence or lack thereof is, truthfully, arbitrary. At some point we have to make the best choice we can and hope for grace.
*A committee may be one or more persons.
I would completely agree that there should be training on the topic. I think, as in all things, there is a professional common sense, born of experience, that people deserve to learn from. I'd have some concerns about vetting the trainers, because the field is ideological fraught, but I agree. It's not a place for amateurs.
https://www.cbc.ca/news/politics/maid-deadline-extension-mental-illness-1.6687429
We've been having conversations in my church context about how this changes our pastoral approach to MAiD. I find this troubling in the extreme. I am disappointed beyond belief that the people who warned us of a slippery slope were right.
Waits for psychiatrist appointments which in Canada are mostly medication consultations only are 5-7 months where I live unless you've done a significant suicide attempt. Consults ate typically monthly until whatever seems stable enough to extend to 3-6 months or turn back to family doc, if the patient has one (there are thousands with no family physician, and there are no doctors accepting patients in my province for about 1 year, no end in sight). Most people never see a psychiatrist here. If hospital emergency sees a person, they'll stabilize in the ER and discharge if at all possible and not admit to psychiatry. People leave hospital and end their lives shortly thereafter. Some are reported in the media.
There is almost no access to publicly funded psychological therapies and counselling. If you're not able to pay $200+ / hour, you're not getting it. Insurance plans if the low paid job provides it might cover 1-2 sessions. Even 'very good plans' typically max out at 6 hours.
Mental health problems are associated with not being employed and being on social assistance/ welfare. Which is just not enough for housing, food, utilities. Where I live, the government stopped coordinating rent and utility (water, electric, nat gas) with their reason being to build independence. Which doesn't work for many people with untreated MH issues. They get evicted. Some die from freezing to death. We're losing people every week. -23°C today (-10°F).
My conclusion- medical assistance in dying is wrong when the "psycho-social" diagnosis is poverty, homelessness, cold, hungry, lack of access to care, regardless of mental health diagnosis and mental state of the person.
We do have documented and undocumented situations of unasked for offers of death-as-treatment by health care workers and people authorising care. The ones that have come to national attention concern soldier veterans with diagnoses in the psychological trauma spectrum. It's wrong and should be prosecuted if the professional is licenced in my view.
https://www.cbc.ca/news/politics/veterans-maid-rcmp-investigation-1.6663885
What are the kinds of mental health situations that advocates for MAiD argue should have MAiD as an option? Are they usually tied to a non-psychiatric physical health condition, injury, or disability?
Love this post. Thanks @Cathscats
The two experiences have helped me greatly to be able to deal with any further such diagnoses.
Well, there is also the dynamic of the seriously ill person feeling - whether rightly or wrongly - that the 'right' thing for them is to seek an end to their life for the sake of their loved ones, despite their own personal desire to live. A person may wish to live, but conclude it is their duty to remove themselves - or have themselves removed - for the greater good. It's interesting how difficult 'clear, straightforward communication' between even capable and articulate people becomes, when one person is trying to second-guess what the others are 'really' thinking, or how they might suffer, or what relief it might be etc; and where pain, grief, guilt and fear kick in.
My wife and I have had "the conversation" and both know what the other wants. I can see no other way of handling it.
I will get a copy of the end of life stuff from my G.P, discuss it with my brother, discuss it with my lawyer and make a will and register the end of life decisions with my GP or whatever authority necessary. (NZ used to have District Health Boards, but this has changed recently, so I'm a bit hazy on it, but my GP will know.)
I have more thoughts than I probably can share right now, but I can't help bring in my bipolar illness. I've dealt with suicidality quite a lot in my life, and am maybe still alive just out of fear of botching it up.
That said, I can still see myself (sorry to sound this crass) pulling a Robin Williams if/when I get my Alzheimer's diagnosis (what my dad died of) - not just because I don't want to live and die that way, but because I don't have resources, and I will have no one to take care of me. There may be other conditions that would send me in that direction, too, but as long as I had my mind, I suspect I'd find it worth fighting.
Like many here, I also don't think we're meant to fight against the inevitable. Medical science has gotten us to where we can prolong life a lot longer, and at great cost (not just financial) and with greater suffering, than was ever possible. This causes a lot of undue suffering but people still think they need to cling to every fragment of hope, real or imagined. I remember one of Jack Kervorkian's paintings (displayed years ago in a gallery in Royal Oak, MI, as he was local here) called "Nearer My God to Thee" that depicted someone trying to stop falling into a long bottomless hole to the point their fingers were worn to the bone. It was, he had commented, about the pointless efforts he in his medical practice would see people make just to stay alive for one more breath - people who also had strong faith in God and claimed they were ready to meet God.
I did some theological work some decades ago, researching ethics around suicide, and satisfied myself that, should I die from it, I would find myself in God's embrace - not in hell, as I was taught growing up. (Now I don't even believe in hell, but that's another matter.) It made me want to live, actually. I'd been feeling like God had a gun to my head ordering me to keep my heart beating at all costs, and that went away once I realized God's love was so profound and gracious.
We're going to mess things up, and I don't personally view sin as ponderously as some do - I believe it's been taken care of by God, and God's desire for us to have union with God is so much more intense than anything sin could bring up. So I think whatever decision we make, as we make it carefully, prayerfully, and with as much information as we can gather, is a decision we needn't worry too much about.
Will say more later - I have to go.
“as long as I have my mind I suspect I’d find it worth fighting”
A close friend of mine eventually succumbed to motor neurone disease almost 5 years after diagnosis, after being given 1-2 years to live. For her last year she was paralysed ( just able to grip a pen) speechless, and swallowing was impaired. Her mind was intact until the end when ( thank God) pneumonia set in and put an end to her suffering. At least the agony was not prolonged with a gastric feeding tube or a tracheotomy and ventilatory support.
My point is that she was mentally intact when physically she was beyond putting up any sort of a fight.
Her palliative care could have been better if her medical attendants had cranked up the morphine and midazolam. I guess they did not want to be seen to be hastening her demise.
A terrible end, one that none of us wants. A lot of truth in your last sentence - I can see the newspaper headlines.
When I read Sojouner's post about her friend I was reminded of that man and his story. I know which I would prefer.
Much sympathy for the loss of your friend.
The name of the thread has bothered me. What is the duty to fight for life, and where is that duty set out?
Mind you I was brought up as an old fashioned RC fatalist,with the view that life on earth is a vale of tears and death a merciful release.
My 2 unbelieving siblings take the same view and it was surprising to all of us 24 years ago when our mother died the negative comments which came our way at our (apparent) lack of seemly public grief.
Our late father ( died 1987) took the same view. I recall that after his death that his parish priest who saw him almost daily during his (brief) final illness commented that he took great consolation at Dad’s death. So did I.