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Article #228

Re: A third death with dignity.

#228
From: Peter Merel
Date: Tue, 28 Jan 1997 00:00
151 lines
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d-moss@adfa.oz.au (David Moss) writes:

>[...]

First, my compliments David: in the last few posts you've really lifted
your game and the tone of the debate along with it. Good stuff.

>You obviously lack life experience Peter. Not everyone is "nice".
>Ask the RSPCA how many animals they "put down" at holiday time.

Indeed, but I think you miss my point - animals that are put down
because of neglect or inconvenience are not truly pets - they are not
loved. I stipulated that a great many animals are put down for such
reasons, but my point was that these reasons are quite different from
those of people who love the pets they put to sleep.

>"A middle-aged man requested euthanasia for his elderly, dying father
>so he could bury his dad before going on holiday. That kind of request
>is easily made, and granted, once a country opens the door to
>euthanasia, ... Dr. Karel Gunning ... said acolleague told him about
>receiving this request and trying to oblige the son by giving the
>father a huge dose of morphine. It failed to kill the sick man, who
>was found sitting up happily in bed that evening. Gunning said the
>episode "just shows you the mentality" in the Netherlands ....
>[Pitfalls of euthanasia cited, Ailing father death target, by Rebecca
>Wigod, Vancouver Sun, 4.10.94: B1.]"

This is another account of an abuse of the inadequate Netherlands
legislation, but we have already been through this - the NT legislation
is much more onerous and difficult to abuse than the Netherlands laws.
It's like comparing murder statistics in a place where automatic
handguns are permitted to murder statistics where gun regulations are
stricter - I imagine you'll agree such comparisons are unconvincing.

>If you are not convinced by now, Peter,  you are beyond the reach of
>reasonable persuasion. 

On the contrary, some of this debate has indeed moderated my views. I 
acknowledge that there are risks associated with VE legislation; I only
feel that the atrocious conditions that arise without it are much worse
than these risks.

>Although you will undoubtably "call foul" I evoke the T4 programme
>in Nazi Germany as a historical example of out of control euthanasia.
>(Even NAZI leaders tried unsuccessfully to stop it) To read a little
>of the horror of the T4 programme see:
>http://octarine.cc.adfa.oz.au/~dmoss/living/resource/nazit4.txt

This isn't VE leading to involuntary euthanasia - it's involuntary
euthanasia camouflaged by reference to the terms of VE. In the same way
the Nazi gas chambers were referred to as "showers", but you'd hardly
argue that showers lead inevitably to gas chambers.

>Elsewhere in this newsgroup I have indicated the first step on the
>slippery slope will be legalised euthanasia of mentally incompetent
>patients who indicate their wishes before mental deterioration takes
>place, perhaps even in writing. Find it, and refute it if you can.

Ah, I'd missed that, thanks for restating it. In the limited case of
prospective irreparable damage to the brain, there might indeed be a
case put for VE.  Such people might prefer, say, to avail themselves of
cryonic suspension before their brains became irreperably damaged; while
cryonics is an extremely risky and unproven technology, a slim chance of
revival and repair would, for some individuals, outweigh any pleasure
they might take in dementia.

Such cases are obviously not appropriate for euthanasia once
incompetence has set in. To continue in the vein of the NT laws, someone
who is in this kind of pickle should only be permitted to obtain VE/PAS
while still competent. I don't see this as a slippery slope, as all
the NT controls could still apply.

>Killing another person is not victimless on account of willingness by
>the victim, except in the NT when carried out in accordance with the
>RTI Act. 

By "victimless crime" I mean one that does not harm anyone but the
criminal. Since the definition of harm varies from person to person,
it is not sensible to expect society to "save" rational people from
themselves, or to punish them for enjoying their own free will, except
where others, by their own definition, are harmed.

>>Figures please, David - I recall your thinking that a few gun-nut emails
>>were statistically significant on that issue - let's have the results of
>>any formal poll that backs your contention here, not handwaving.

>From the talarian guide:
>"Clinicians in a pain clinic report seeing many patients who
>considered suicide who changed their minds once given adequate
>pain relief (Foley, 1991)." (Doctor Kathleen Foley is Chief of Pain
>Services at the Memorial Sloan-Kettering Cancer Center in New York)

Unfortunately, even with medical advances and excellent hospice research
in palliative care, severe indignity, pain and distress cannot always be
controlled. The hospices' most optimistic estimate for pain control is
95%, but in ordinary hospitals they admit it may be as low as 30%. Overall,
more than 40% of patients, according to the US study reported last week,
experience severe pain before they die.

In conditions such as cancer, strokes, acute arthritis and AIDS, to name
just a few, all the medical skills in the world may not permit death
with dignity. If a person, after undergoing all possible treatment,
still feels enough is enough, why shouldn't they have the right to be
helped to die?

Bob Dent said:

"[ After almost interminable medical indignities ] I have no wish for
further experimentation by the pallative care people in their efforts to
control my pain. [...] For months I have been on a roller-coaster of
pain made worse by the unwanted side effects of the drugs. Morphine
causes constipation - laxatives taken work erratically, often resulting
in loss of bowel control in the middle of the night. I have to have a
rubber sheet on my bed, like a child who is not yet toilet-trained.

[...] My own pain is made worse by watching my wife suffering as she
cares for me; cleaning up after my "accidents" in the middle of the
night, and watching my body fade away. If I were to keep a pet animal in
the same condition I am in, I would be prosecuted. I have always been an
active, outgoing person, and being unable to live a normal life causes
much mental and psychological pain, which can never be relieved by
medication."

Are you really suggesting that such an horrific experience of dying
should be prolonged against the will of the sufferer? Or that the method
of their suicide should not be as humane and risk-free as possible?

>Number one obvious answer: because both Dent and Mills were capable of
>ending their lives lawfully without using the RTI Act. 

We've already covered some ground concerning the risks associated with
having no legislation, and you have yet to answer my concerns about
these risks. Certainly Dent and Mills could have committed suicide
without assistance, but suicide is a messy business: their families
might have been suspected of murder or manslaughter. Why shouldn't they
have ended their lives peacefully and safely?

>Kevorkian in the USA ensured  good publicity for his "test pilot" as
>illustrated by the following quote from International Anti-Euthanasia
>Task Force's "The Real Jack Kevorkian" at
>http://www.iaetf.org/fctkev.htm :

I shall have to look into Kevorkian - I don't have any real idea about
his practices beyond what you've posted, and these quotes still seem
indirect. Kevorkian is not strictly relevant to the NT laws of course, but
certainly worth understanding.

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From: Peter Merel <pete@zip.com.au>
Subject: Re: A third death with dignity.
Date: 1997/01/28
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