Reviving the euthanasia debate

Quebec doctors will reportedly recommend its legalization


 

The euthanasia debate appears likely to undergo a revival in the next few months. A report by the Quebec College of Physicians, which should be ready for release this fall, may recommend it be legalized and a private member’s bill by a Bloc MP is aimed at doing just that. The college is reportedly going to recommend that drug-induced assisted suicide be authorized in cases involving terminally ill patients in severe pain. Under the current law, helping someone commit suicide is punishable by up to 14 years in prison. However, the last high-profile euthanasia case in the province resulted in the acquittal of Stephan Dufour. Dufour had been charged with helping his disabled uncle commit suicide.

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Reviving the euthanasia debate

  1. So much for "first, do no harm." I know, I know, euthanasia's adherents are adamant that it does no harm to kill these patients. They benefit tremendously from being annihilated.

  2. So much for "first, do no harm."

    I know, I know, euthanasia's adherents are adamant that it does no harm to kill these patients. They benefit tremendously from being annihilated. And we all know that no medical decision-maker would ever be motivated by cost-cutting to try and persuade someone, at their most vulnerable point in life, to take this option.

    • If only life were so simple and clear cut.

      I'll allow that despite safeguards, there might be the odd case (and I mean exceedingly rare) where assited suicide could be abused, and a terminally ill person could die before they really want to. Let's bear in mind that such a case would constitute murder, and in the same way that we trust our fellow citizens to go around not killing each other, so too can we extend trust to a situation where the legal and professional scrutiny would be intense. And we could punish anyone found guilty of this form of murder, like any other.

      But getting back to that part about life -and how it's never simple and clear cut – we remain with the numerous cases of individuals who are terminally ill, and wish to maintain the autonomy of their own lives (which includes ending them). What do you say to those people? "Sorry, but because a few folks might be coerced you can just lie there in pain and declining faculties until you die."

      .

    • Actually, in the Canadian system, there's no benefit to losing a patient whatsoever. In fact, there's tremendous benefit to keeping them alive and suffering so you can continue to dole out prescriptions for painkillers.

      • That's true if they're living at home, but not if they're living in a facility. Most terminally ill patients are in a facility.

  3. I've also got to wonder about the dim view you take of your fellow humans. I'm not saying some folks won't do evil things for their own self benefit, but it's almost as though you think most of us just can't wait to kill grandpa off to get the inheritance.

    I've been witness to the prolonged illness, pain, near-coma state from morphine, and eventual death of two close family members. That gives my posiiton no added weight, but it is an experience that has profoundly taught me about the limits of "life at all costs", and I wish both my loved ones had known there was an option to end the inevitable decline and suffering if they had wanted to

    • "I've also got to wonder about the dim view you take of your fellow humans. I'm not saying some folks won't do evil things for their own self benefit…"

      Thank the econos for pushing the everyone acts in their own self-interest to the point where it has largely become the core assumption underpinning our understanding human behaviour.

    • "I've also got to wonder about the dim view you take of your fellow humans. I'm not saying some folks won't do evil things for their own self benefit…"

      Thank the econos for pushing the everyone acts in their own self-interest to the point where it has largely become the core assumption underpinning our understanding human individual behaviour.

      • Actually you can thank Rousseau for that. It wasn't true when he wrote it but it became a self-fulfilling prophecy once people became convinced that looking out for Number 1 is right and good. Nowadays it's summed up with who-the-hell-cares-about-anyone-else phrases like "If it feels good do it" or "My body my choice".

        • I accept your point on the centrality of self-interest, largely, though not fully, expressed in terms of the need for self-preservation, to Rousseau's understanding of the world.

          But, I think there are ways to differentiate it (and others such as Darwin) from what I see as the more rampant form of the assumption as expressed by Olson (1965) that i think is indicative of the kind of claims that Sean is pointing to in your argument. Specifically claims of self-interest that preclude collective action: “rational, self-interested individuals will not act to achieve their common or group interests” except where “the number of individuals in a group is quite small, or unless there is coercion or some other special device to make individuals act in their common interest”. (Recognizing that SOME econos have climbed down from this since then).

    • I take a bright view of some humans, and a dim view of others. I do think that in Canada the selfishness quotient has gone up drastically in the last 50 years, to the point where a majority now would not make significant personal sacrifices to help others in need. If someone is dying and can save the system a lot of money by dying sooner, I guarantee you there will be people pushing to have that person terminated. There already are.

      But back to the main point, I think you could sum up my position like this: "Friends don't help friends kill themselves." Sounds crazy, I know, but there you have it.

      • I would still go back to Sean's point that the world is not that simple. If i was terminally ill and experiencing suffering on the magnitude that meant that i took no pleasure in being alive any longer, in my eyes a friend would help relieve me of my suffering.

        • In the eyes of someone in excruciating pain a lot of things look good that aren't. The question isn't what you (or I) would want in such a situation, but what it actually means to harm us.

          Don't help me harm myself even if, in the throes of misery, I go off my head and ask you to.

          • I guess this is where we honourably disagree Gaunilon. If the "question isn't what you (or I) would want in such a situation, but what it actually means to harm us", to me the answer is that it means that as an adult with a minimum standard of faculties intact and presented with a range of information (including prognosis; my own sensations; etc etc) I would be able to assume, with assistance, the autonomy to govern my own life, without causing undue harm to others. I suspect you see it another way.

          • Well let us take a less palatable example. Suppose a terminally ill patient in extreme pain and sound mind decides, for whatever reason, that they want to have their eyes gouged out. The doctor explains that this is not going to help anything but they are determined: they're in pain and they believe that removing their eyes will benefit them.

            Should the doctor assist them in this harmful act, saying "well, they're an adult who has been presented a range of information, and they have the autonomy to govern their own life without causing undue harm to others, so I'll help them gouge their eyes out."?

            Of course not. Freedom means you are free to make mistakes, true, but it does not mean that anyone else should help you.

          • uhmmm, your example is srsly deficient. in the scenario you are trying to set up – asking for something that actually would not relieve any problem – the doctor would refuse based on his expert knowledge that the procedure would not relieve suffering. euthanasia does for some, relieve tremendous suffering.

            and, if your example was not as flawed i would remind you that often in cases where it might possibly help to relieve a problem patients are given the option of choosing amputation even where other forms of treatment are on the table (e.g., cancer).

          • Ah, well then you have conceded that the criterion here is whether the patient's request is actually harmful to them. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they want done to themselves.

            So back to the original point (and this is where we may have to agree to disagree), I am of the bold opinion that killing someone is not good for them (medically speaking). Therefore no one, particularly doctors, should participate in such harmful behaviour.

          • Ah, well then you've conceded that the criterion here is whether the patient's request is actually harmful. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they choose for themselves.

            So back to the original point (and this is where we may have to agree to disagree), I am of the bold opinion that killing someone is bad for them (medically speaking). Therefore no one, particularly doctors, should participate in such harmful behaviour.

          • Ah, well then you've conceded that the criterion here is whether the patient's request is actually harmful. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they choose for themselves.

            So back to the original point (and this is where we may honourably have to agree to disagree), I am of the bold opinion that killing someone is bad for them (medically speaking). Therefore no one, particularly doctors, should participate in such harmful behaviour.

          • Ah, well then you've conceded that the criterion here is whether the patient's request is actually harmful. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they choose for themselves.

            So back to the original point (and this is where we may honourably have to agree to disagree), I am of the bold opinion that killing someone is bad for them (medically speaking). Therefore no one, particularly a doctor sworn not to harm people, should participate in such harmful behaviour.

          • Ah, well then you've conceded that the criterion is whether the patient's request is actually harmful. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they choose for themselves.

            So back to the original point (and this is where we may honourably have to agree to disagree), I am of the bold opinion that killing someone is bad for them (medically speaking). Therefore no one, particularly a doctor sworn not to harm people, should participate in such harmful behaviour.

          • Ah, well then you've conceded that the criterion is whether the patient's request is actually harmful. This is different from your prior position, that an adult has the autonomy to govern their own life and should be helped regardless of what they choose for themselves.

            So back to the original point (and this is where we may honourably have to agree to disagree), I am of the bold opinion that killing someone is bad for them (medically speaking). Therefore no one, particularly a doctor sworn not to harm people, should participate in such harmful behaviour under the guise of medical care.

          • "This is different from your prior position"

            Uhmm, not quite. the distinction is what a doctor is your avg doctor is REQUIRED to do. again. your comparison is flawed. when talking euthenasia there would no doubt be parameters, protocols and structures (including physical spaces) put in place to deal with theses cases where there is no disagreement over diagnosis or prognosis. that is different from patients self-prescribing surgical procedures based on their assessments of their problems. your comparison does not work.

            And I agree, we will have to disagree. while i understand your position i am just not convinced. I don't believe that relieving someone of their suffering when the diagnosis, prognosis and individual will is not in question is causing harm indeed not doing so may well be a worse form of harm).

          • Well let us take a less propagandized example for greater clarity. Suppose a terminally ill patient in extreme pain and sound mind decides, for whatever reason, that they want to have their eyes gouged out. The doctor explains that this is not going to help anything but they are determined: they're in pain and they believe that removing their eyes will benefit them.

            Should the doctor assist them in this harmful act, saying "well, they're an adult who has been presented a range of information, and they have the autonomy to govern their own life without causing undue harm to others, so I'll help them gouge their eyes out."?

            Of course not. Freedom means you are free to make mistakes, true, but it does not mean that anyone else should help you.

          • "Don't help me harm myself even if, in the throes of misery, I go off my head and ask you to."

            When your body is ravaged by cancer that makes every waking moment agony, and when there is nothing that can be medically done but wait until the disease finally breaks down your systems enough to kill you, as you become unable to properly feed yourself, control your functions, speak or swallow, and as the alternative to consciousness becomes a morphine-induced stupor, "throes of misery" is a bit too poetic and abstract a description.

            Many people want to soldier on through such things, as did one of my family until his body couldn't take the cancer any more and he had a heart attack. Some may wish to choose the moment of a death that is unavoidable, as another loved one of mine wanted weeks before her body finally let go.

            Having witnessed both those horrible declines up close, I can only say that I wouldn't wish that kind of suffering on my worst enemy. And that the sanctity of life surely demands we extend people in such circumstances the right to make whatever decision they want.

          • You are confusing "sanctity of life" with "sanctity of choice". The two are neither identical nor entirely compatible.

          • Poor phrase to use, I agree. I should have said respect for life demands we extend individuals the autonomy of deciding when to end their suffering – particularly when they are simply choosing the timing of a looming and unavoidable death, and avoiding horrors in the process.

          • sorry to jump in at the end of this, but wasn't it Hobbes who first posited the self-interested point; a short nasty and brutish war of all against all?

          • You are confusing "sanctity of life" with "sanctity of choice". The two are not neither identical nor entirely compatible.

        • In the eyes of someone in excruciating pain a lot of things look good that aren't. The question isn't what you (or I) would want in such a situation, but what it actually means to help us.

          Don't help me harm myself even if, in the throes of misery, I go off my head and ask you to.

  4. I used to be on the fence about euthanasia, because like we all say, it is a difficult issue.

    Then I worked as an security/guard orderly at a public hospital. I saw family members lied to, patients drugged without their knowledge, and various other violations of human dignity in order to make easier for the nurses and other health professionals to get through the day. I don't think my hospital was a particularly bad hospital, but a normal one dealing with difficult circumstances.

    In other words I've seen how flexible the notion of consent can be in a hospital situation where someone may be mentally or physically unable to defend their own interests. So I have become very opposed to euthanasia as a result of that experience. If you think I am going to allow someone the legal right to end my life (as opposed to ending my care, which they can already do) you got another thing coming. If Canada recommends moving in this policy direction, Canada will no longer be my country. I do not want to be in the thrall of an institution that can end my life in the case of my eventual infirmity.

    • i don;t think anyone is aruing to hand over th right to an arm of the state to decide when to terminate your life.

  5. No, I realize that. But like I said, my experiences working in, a palliative care ward have shown me how flexible the notion of consent is.

    Mark my words, the problem patients will have pressure put to bear on them by the hospital staff to end their life. As well, sick and suffering patients may not be able to hold to their ideals to work through their situation when isolated and everyone around them encouraging them to consider taking a way out. The prospect of losing your mind to dementia, being infirm to the point of losing your personal liberty, or having a constant level of pain that has to be managed for months or years till the end is very terrifying. I am not sure if I am up to it, and I am sure that I''m probably not up to it without the support of the people around me.

    I'm not even sure that having institutions that forswear offering the service of euthanasia (such as a Catholic hospital) would be enough of a protection, because the people there would be human too, and you might find health care professionals pressuring a transfer to the public hospital to be jabbed with a needle.

    We also don't need to guess how the system will be used and abused. We have the Netherlands which legalized assisted suicide, and pretty much all the problems I allude to in this post happened there far more often than expected. They are trying to tighten it up, but I am not confident that you can. Health professionals are human, and while they want to help people they also want to get through the day like everyone else. Different people also have different levels of belief as to what amount of human suffering is acceptable, and some health professionals will be less tolerant of a patients willingness to endure pain than others.

    So these reasons are the reasons I have no confidence in a health care system that allows for the option of euthanasia, and they are not unrelated to the fears I have for a justice system that includes capital punishment.

  6. In other words I've seen how flexible the notion of consent can be in a hospital situation where someone may be mentally or physically unable to defend their own interests. So I have become very opposed to euthanasia as a result of that experience.
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  7. Surely any institutionalized problems can be solved by having the decision rest only with the patient or their designated caregiver, not the institution.

  8. With Quebec's birth rate being one of th lowest on the continent, killing off the elder folk will help hasten their demographic demise.

    The national question, that is to say sovereignty or no sovereignty, pales in comparaison to the demographic question, which Quebec has answered in the negative, thereby resulting in a collective suicide.

    Think about it, they are dying out demographically, does that look like a society that's ready to strike out on its own? Nope. They don't have the will to do that. They're barely existing as it is. A sad bunch when you think about it. Whatever happened to their "joie de vivre."?

  9. death is the final outcome of life, therefore it is as diverse as humanity and euthanasia is one way to counteract the business and costly often times unbearable life for those who chose this style of life ending process… it will continue to be a barb in the government chambers for it is an ethical and moral issue sometimes religious issue

  10. We often treat our pets better than we do our friends and family… if a dog is in incredible pain and there is no viable way to relieve it, we put the animal down so it doesn't have to live in a constant state of suffering.

    If someone is in pain, has no hope of recovery or rehabillitation and is still in their right mind, I see no reason not to let them die as they see fit, under the supervision of a medical professional. Death is a part of life – someone who's already staring at death's door should not be forced through potentially years of substandard living if they don't wish to go that route.