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Should assisted suicide be expanded?


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Although the issue has recently slipped off the radar, perhaps this is the time we should be examining our assisted suicide regime and specifically whether it should be expanded to include 'advance directives', particularly for those who are starting to experience dementia, as well as opening it up to cover other issues like severe depression. A friend of mine who had final stage cancer chose assisted suicide last year rather than languish in a hospital or hospice for weeks or months. As our gawdawful health care system (at least in Ontario) continues to slide into oblivion, shouldn't we offer the sick a broader range of options to deal with their illnesses rather than hold them hostage in a system we clearly don't want to pay higher taxes to improve? And while we're at it, maybe we should just acknowledge that some people with depression, addictions and other intractable problems might find it easier to move on rather than endure the indignities to which we insist they be subjected. Increasingly, we live in a 'survival of the fittest' social and economic model, so why shouldn't those who want to opt out have the right to make the ultimate choice to do so?

Edited by turningrite
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A friend and I were discussing this recently.  A friend of her family decided on assisted suicide due to incurable cancer but she did not discuss nor advise her family and friends about her decision.  She did call friends on Monday to ask them to sing at her memorial on Friday, announcing only that she would be passing on Tuesday.  Friends and family were shocked and devastated, but I do understand why she may have decided to avoid pleas and bargaining from others to wait.  On the other hand, this woman had also lost her husband and mother to cancer within the previous two years, so was her decision entirely untainted by her recent losses?

I think this is a decision that needs to be thought out and discussed well in advance, not left to the last minute, perhaps made under emotional duress and/or sprung on family and friends.  I have already let my kids know that assisted suicide is definitely an option for me under some circumstances and at some point I plan on written directives to support them and myself as needed.

If one is suffering a terminal disease, it can be relatively straightforward to decide when to pull the plug.  But dementia is much trickier, since quality of life is determined subjectively and for a time dementia allows some quality of life interspersed with nothingness.  Does one decide that being aware and responsive 20% or 10% or 1% of the time is worth the time spent otherwise?   If one ultimately decides to leave the decision in someone else's hands is that fair to them?  

So much of this is based on one's personal beliefs and their relationships that making a law that will effectively address all scenarios seems very difficult.  I think the widest latitude combined with the best safeguards is needed.  One safeguard could be that the individual has to choose, well ahead of time, who should make the decision, that it should be a minimum of three people and that at least one should have nothing to gain through the death of the individual.  Another could be a significant waiting period for a person that is not suffering from dementia, so that a temporary sense of hopelessness does not lead to a hasty and permanent decision.

I don't think addictions or depression should be included under the "assisted suicide" banner.   I spent much of my adult life wishing for a way to end the pain I felt, but now I am glad my attempts failed.  I also know of people who spent decades addicted and/or in jail but are now functioning, productive and happy members of our society.  In my opinion, assisted suicide should only be for physical ailments that are terminal according to our best medical knowledge today.

Edited by dialamah
So many typos ...
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6 hours ago, dialamah said:

A friend and I were discussing this recently.  A friend of her family decided on assisted suicide due to incurable cancer but she did not discuss nor advise her family and friends...

I don't think addictions or depression should be included under the "assisted suicide" banner.   I spent much of my adult life wishing for a way to end the pain I felt, but now I am glad my attempts failed.  I also know of people who spent decades addicted and/or in jail but are now functioning, productive and happy members of our society.  In my opinion, assisted suicide should only be for physical ailments that are terminal according to our best medical knowledge today.

I'm not sure what ethical obligation anybody has to inform anybody else of their intent to end their life, except perhaps for a spouse. My friend who chose assisted suicide was utterly transparent with everybody close to him about his choice and as far as I'm aware they/we all accepted it.

I used to have qualms on the latter issue concerning depression and addictions, but I've changed my view on this. I believe that suicide is quite often a rational choice and I think having a humane and reliable way of so doing would be beneficial to those who are really serious about it. Our health system offers very little psychological support and as survival becomes more difficult for ordinary people in our economy I think we have to acknowledge that suicide is actually a practical and morally valid choice. I thought a lot about this after an acquaintance lost his job in his late 50s, could never find another one, spent down his savings and was eventually served an eviction order due to non-payment of rent. There were no options other than becoming homeless because social assistance wasn't sufficient to cover his rent and the waiting period for social housing is several years. On his eviction date he was found dead in his apartment, an overdose suicide I believe although I'm not sure as cause of such deaths is seldom if ever publicized. I suspect it would have comforted him to know his suicide would not be a matter of chance. I think his choice was rational, eloquent and indicative of what this society's values really rest at this point in history. I think it's what I would do were I in the same situation. We should be honest about these things.

Edited by turningrite
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15 hours ago, turningrite said:

Although the issue has recently slipped off the radar, perhaps this is the time we should be examining our assisted suicide regime and specifically whether it should be expanded to include 'advance directives', particularly for those who are starting to experience dementia, as well as opening it up to cover other issues like severe depression. A friend of mine who had final stage cancer chose assisted suicide last year rather than languish in a hospital or hospice for weeks or months. As our gawdawful health care system (at least in Ontario) continues to slide into oblivion, shouldn't we offer the sick a broader range of options to deal with their illnesses rather than hold them hostage in a system we clearly don't want to pay higher taxes to improve? And while we're at it, maybe we should just acknowledge that some people with depression, addictions and other intractable problems might find it easier to move on rather than endure the indignities to which we insist they be subjected. Increasingly, we live in a 'survival of the fittest' social and economic model, so why shouldn't those who want to opt out have the right to make the ultimate choice to do so?

Don't people who are determined to die commit suicide?   If one is determined to end his life, no one can stop him.  He doesn't need to drag people into assisting him!  This is such a self-centered world now....that we forced people to be party to whatever we want to do!

Legalization puts the vulnerable at such high risk.  Who can really say that the quadruplegic wanted to die - or that he was talked into wanting to die?   Depressed people can easily get manipulated to end it.   Who benefit to his death?   Him.....or the people taking care of him?   Or, his heirs to his estate?

Edited by betsy
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4 hours ago, betsy said:

Don't people who are determined to die commit suicide?   If one is determined to end his life, no one can stop him.  He doesn't need to drag people into assisting him!  This is such a self-centered world now....that we forced people to be party to whatever we want to do!

Legalization puts the vulnerable at such high risk.  Who can really say that the quadruplegic wanted to die - or that he was talked into wanting to die?   Depressed people can easily get manipulated to end it.   Who benefit to his death?   Him.....or the people taking care of him?   Or, his heirs to his estate?

And your point is? People unfortunately often botch suicide attempts. Or they do so in ways, like jumping in front of subway trains, that massively inconvenience others. We need to provide people with more humane options. Sure, people can be urged into committing suicide by others but do you not think this is happening today? Perhaps those who feel vulnerable would be able to register their unease in a system in which people have to request an assisted suicide and an objective counselors or administrators could then intervene in cases where abuse or intimidation are apparent. There are pros and cons for every idea and there is no absolutely perfect model. But I prefer to allow individuals to choose their own fate rather than having others do so for the sake of feeling better or even morally superior about it.

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4 hours ago, turningrite said:

And your point is? People unfortunately often botch suicide attempts. Or they do so in ways, like jumping in front of subway trains, that massively inconvenience others. We need to provide people with more humane options. Sure, people can be urged into committing suicide by others but do you not think this is happening today? Perhaps those who feel vulnerable would be able to register their unease in a system in which people have to request an assisted suicide and an objective counselors or administrators could then intervene in cases where abuse or intimidation are apparent. There are pros and cons for every idea and there is no absolutely perfect model. But I prefer to allow individuals to choose their own fate rather than having others do so for the sake of feeling better or even morally superior about it.

 So it get botched.   That's the risk you take.   The possibility of it getting botched could be a deterrant for those who fear they might botch it!  Don't they have pills suicides?   Don't some use overdose of pills?   Maybe, that's what they should have available - suicide pills that you can take without needing the help of anyone.

Like, as if there will be no botched assisted suicides the first time around.   All these created options - that's how we get mired in bureaucracy.

 

Anyway, people who are suffering from depression aren't thinking properly, so how can we give them the death that they ask for?

Another  thing.....

Physicians or anyone needed for assisted suicides, are going to be forced to go against their conscience - especially in a system like ours!  If they don't play the game they lose their jobs or their income.

 

For a country that's supposed to pride itself by staying out people's bedroom - why are we so involved in this?

Edited by betsy
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4 hours ago, CITIZEN_2015 said:

Assisted suicide is a personal choice it is none of the business of the government to regulate my life or death. Simply my opinion.

Agreed.  If a person wishes to end their life and a medically trained person is willing to assist, that should be all there is to it.  No-one has the right to force someone to live when they don't want to.

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9 hours ago, betsy said:

For a country that's supposed to pride itself by staying out people's bedroom - why are we so involved in this?

Figures you'd ridicule having the freedom to end one's life by comparing it to sexual freedom but of course its actually the freedom you religious social conservatives really don't like.  Which explains why we need to be so involved in it.

As for forcing doctors to carry out an assisted suicide, that would be against the law.

Quote

 

Protecting the right of providers to act according to their beliefs and values
Not all health care providers will be comfortable with medical assistance in dying. The practice may not be consistent with a provider's beliefs and values.The legislation does not force any person to provide or help to provide medical assistance in dying.

Provincial and territorial governments have the responsibility for determining how and where health care services are provided. They may also make policies around where medical assistance in dying can take place as long as they do not conflict with the Criminal Code.

https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

 

 

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On 7/24/2018 at 10:20 PM, bcsapper said:

Agreed.  If a person wishes to end their life and a medically trained person is willing to assist, that should be all there is to it.  No-one has the right to force someone to live when they don't want to.

I completely agree, though I would add that some paperwork needs to be in place to ensure living relatives and insurance companies can't fight over the decision, assets, etc. 

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This case is shocking and sure to make your blood boil.

Quote

An Ontario man suffering from an incurable neurological disease has provided CTV News with audio recordings that he says are proof that hospital staff offered him medically assisted death, despite his repeated requests to live at home.

Roger Foley, 42, who earlier this year launched a landmark lawsuit against a London hospital, several health agencies, the Ontario government and the federal government, alleges that health officials will not provide him with an assisted home care team of his choosing, instead offering, among other things, medically assisted death.

https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841

I'm so upset over this, I'll you read the rest yourself as my heart is in my throat.

Is this the future of our health care? Scary stuff. :wacko:

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1 hour ago, capricorn said:

This case is shocking and sure to make your blood boil.

I'm so upset over this, I'll you read the rest yourself as my heart is in my throat.

Is this the future of our health care? Scary stuff. :wacko:

I've read and seen television reports about Mr. Foley's case, which for personal reasons I've followed with great interest. It's problematic, to be sure, but it does raise some vital questions about what we expect our public health care system to do. Many who've had extensive contact with the health care system, as I have, come to realize how limited the available resources actually are. I believe that Mr. Foley had access to publicly-funded chronic care but was unhappy with the quality of that care. Now he's lying in a hospital bed for which administrators argue he should be paying more than $1K a day as he doesn't require acute care and has apparently rejected other options.But do we get a say on our quality of care, particularly where chronic illness is concerned? In an ideal world, one would think we should but in a system paid for by others (i.e. taxpayers), where resources are essentially rationed, is it realistic to allow patients who can't pay for their own care to be able to get from the system (and taxpayers) exactly the quality of care they demand? 

As a person living with a serious chronic illness myself, I've thought about this problem a lot. As I too live with a degenerative illness, I'm aware that when I can no longer live independently I can afford to direct and pay for my own care only to a certain extent - perhaps a couple or three years, after which I too will either have to accept what I believe to be the generally mediocre care  offered by our public system or make other arrangements. I tend to look at the situation from a "quality of life" perspective. When that quality of life becomes insufficient to justify remaining alive mainly for the sake of so doing, I've resigned myself to making a choice that will definitively put an end to the situation. It will be interesting to see whether Mr. Foley can succeed in his battle. I wish him luck but am not optimistic at this point that he will be successful. He might be offered a resolution that addresses his individual concerns, but I suspect he won't be able to achieve systemic change. And given an aging population, the situation is likely to get worse, and likely much worse, which is why I believe assisted death should be an option that's easily accessible for a broad range of patients. The potential for abuse exists, of course, but that shouldn't serve to negate the ability of seriously ill patients to rationally decide to end their own suffering.

Edited by turningrite
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Thank you so much turningrite for sharing your personal experience. You provide much food for thought. I wish you well as you face your very serious challenges.

What I find most objectionable about this case is that it appears some health care workers at that London hospital went outside the bounds of the assisted death law by offering it to him. This is against the law. And this under the guise that Mr. Foley can't afford the care he needs.

Re resources yes it's a big problem and I really don't know how this can be resolved other that the government reassigning money from other programs.  The funds spent on accommodating illegal migrants for one comes to mind.

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11 hours ago, capricorn said:

Thank you so much turningrite for sharing your personal experience. You provide much food for thought. I wish you well as you face your very serious challenges.

What I find most objectionable about this case is that it appears some health care workers at that London hospital went outside the bounds of the assisted death law by offering it to him. This is against the law. And this under the guise that Mr. Foley can't afford the care he needs.

Re resources yes it's a big problem and I really don't know how this can be resolved other that the government reassigning money from other programs.  The funds spent on accommodating illegal migrants for one comes to mind.

Thanks for this. Until I became seriously disabled I had no idea how threadbare our health care and support systems really are. It's actually made me question the value of publicly subsidized services, which simply aren't accessible to most people, including those with relatively modest incomes and resources. Most of us are or will be on our own in the event of serious disability. I now tend to think we'd be better paying lower taxes and funding our own future medical care needs by directing our tax savings to dedicated tax sheltered products or good insurance. Public funding doesn't work, particularly where complex and chronic diseases are concerned. We might as well admit this and limit the public health system to basic medical services and work toward a system that lets people save enough or buy sufficient insurance to make their own decisions and fund their own treatment.

Although the situation faced by Mr. Foley is stark and morally unacceptable, we all bear some responsibility for this. I have some sympathy for the staff at the London hospital. I listened to the recordings on a news program this weekend. Their job is to manage hospital funding in an environment of scarcity where increasing demand makes it impossible to meet the needs and expectations of all patients. This is where we are right now, sad to say. We need to take a long, hard look at the whole system, which simply isn't designed to cope with an ageing population.

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14 hours ago, capricorn said:

Re resources yes it's a big problem and I really don't know how this can be resolved other that the government reassigning money from other programs.  The funds spent on accommodating illegal migrants for one comes to mind.

Spending on military alliances and adventures that help create refugees come to my mind.

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15 hours ago, capricorn said:

Is this the future of our health care? Scary stuff. :wacko:

Its a reflection of the increasingly sociopathic nature of our economy right now.  This has nothing to do with the right Canadians have to assisted suicide. Taking that right away won't do a thing to prevent the economy from becoming ever more sociopathic in the future.

I'd be more inclined to worry that budget conscious care providers will just outright take it on themselves to euthanize the costliest terminal patients.

One definite take away from this case is that having a camera to record everything that happens to you while in a hospital might be a good idea.

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On 8/4/2018 at 2:36 AM, eyeball said:

Its a reflection of the increasingly sociopathic nature of our economy right now.  This has nothing to do with the right Canadians have to assisted suicide. Taking that right away won't do a thing to prevent the economy from becoming ever more sociopathic in the future.

 

Based on personal experience, I've come to the conclusion that many of these problems are related to conditions progressives have imposed on the system. The notion that we enjoy "universal" healthcare coverage is laughable. I was approved by the provincial health ministry to obtain health services in the U.S. due to suffering a rare illness for which there's no specialized expertise in Canada. But when I contacted the U.S. institution to which I was being referred I was informed that even with provincial funding approval the coverage is so minimal that in the U.S. system I'm considered an uninsured patient and have to assume full responsibility for all costs above the provincial coverage with no cap on my personal liability, which could amount to tens of thousands of (U.S.) dollars. So I called the company that administers my work benefits and asked whether my plan offers any coverage for out-of-country medical services under its "extended benefits" program. The administrator was very nice and clearly sympathetic but told me that insurance coverage in Canada cannot be sold or obtained for medical services, whether provided inside or outside of Canada, that are theoretically covered under provincial health programs, except for temporary travel coverage, which doesn't generally cover preexisting conditions. So, if you've got a condition that can't be treated in Canada, you're effectively both uninsured and uninsurable. You're up a creek without a paddle. That's where decades of progressive health care policy premised on a false and misleading ideology of single-payer universal coverage has landed us.

Edited by turningrite
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11 minutes ago, turningrite said:

Interestingly, I've come to the conclusion that many of these problems are related to conditions progressives have imposed on the system. 

Of course you have, so has virtually every other right wing conservative. Hence all the lol's and brainless references to Pol Pot, Stalin and Hollywood et al that conservatives like to pepper their stupid political observations with.

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24 minutes ago, eyeball said:

Of course you have, so has virtually every other right wing conservative. Hence all the lol's and brainless references to Pol Pot, Stalin and Hollywood et al that conservatives like to pepper their stupid political observations with.

That's an idiotic comment. Did you even read my post? If you had, maybe you'd have come up with a more thoughtful and/or respectful response. My comment is based on my own experience, plain and simple. If you can refute it with a rational argument, you're free to do so. Otherwise, direct your frustrations with those who don't comply with your world view elsewhere. I started this topic hoping for serious and respectful discussion.

Edited by turningrite
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3 hours ago, turningrite said:

That's an idiotic comment. Did you even read my post? If you had, maybe you'd have come up with a more thoughtful and/or respectful response. My comment is based on my own experience, plain and simple. If you can refute it with a rational argument, you're free to do so. Otherwise, direct your frustrations with those who don't comply with your world view elsewhere. I started this topic hoping for serious and respectful discussion.

Well sure you did but then you cocked it up by steering it in the direction you people usually go. I guess you just can't help yourselves.

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5 hours ago, eyeball said:

Well sure you did but then you cocked it up by steering it in the direction you people usually go. I guess you just can't help yourselves.

I think you're making a fool of yourself and apparently trying to dig even deeper. Maybe you should quit while you're falling even further behind.

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11 hours ago, turningrite said:

I think you're making a fool of yourself and apparently trying to dig even deeper. Maybe you should quit while you're falling even further behind.

Whatever, just get used to it. You keep dragging your knee jerk disdain for progressiveness around and I'm going to rub your snooty little nose in it.

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21 hours ago, turningrite said:

That's an idiotic comment. Did you even read my post? If you had, maybe you'd have come up with a more thoughtful and/or respectful response. My comment is based on my own experience, plain and simple. If you can refute it with a rational argument, you're free to do so. Otherwise, direct your frustrations with those who don't comply with your world view elsewhere. I started this topic hoping for serious and respectful discussion.

Your situation sucks, and my heart goes out to you really. 

We had a friend who suffered several strokes, along with liver failure during the last few months of his life.  He was on a fixed income, imposed by heartless conservative policies; it was clear, and confirmed by a health care worker, that such patients are considered essentially ignorable.  He was sent home repeatedly, though he was clearly unable to care for himself adequately and presented a danger to others as well as himself. 

The lack of adequate resources isn't the fault of frontline health care workers; they must practice triage as best they can.  Conservatives scream bloody murder whenever the idea of increasing funding for health care is raised; their own personal bottom line is their only concern when it comes to government policies; they could care less about how such policies affect others.  So, governments pander to Conservatives through policies that reward them with lower taxes and leave people who are poor and/or sick at a distinct disadvantage.   Canadians pay among the lowest tax rates in the world, but that doesn't matter to Conservatives: any amount of taxation is too much and so what if our health care, education system, social infrastructure falls apart?  As long as they get theirs, everybody else can go hang. 

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On 8/6/2018 at 12:33 PM, dialamah said:

The lack of adequate resources isn't the fault of frontline health care workers; they must practice triage as best they can.  Conservatives scream bloody murder whenever the idea of increasing funding for health care is raised; their own personal bottom line is their only concern when it comes to government policies; they could care less about how such policies affect others.  So, governments pander to Conservatives through policies that reward them with lower taxes and leave people who are poor and/or sick at a distinct disadvantage.   Canadians pay among the lowest tax rates in the world, but that doesn't matter to Conservatives: any amount of taxation is too much and so what if our health care, education system, social infrastructure falls apart?  As long as they get theirs, everybody else can go hang. 

The system is so broken and inadequate that I believe higher taxes and greater public support can't and won't fix it. I think we should simply permit private insurance to be sold in this country and otherwise permit people to save in tax protected plans for their own future health care needs. Many will argue this will lead to two-tier health care. But that's what we have now. Those who have the cash can pay for private chronic care (and many who don't have the cash are forced to do so anyway) and those who need access to specialized and/or expedited care outside the country can access it if they can afford to. Those who are forced to deal entirely with the Canadian system must in many cases simply accept inferior care, long wait lists and sometimes, as I experienced, literally no access to necessary care and/or treatment at all. I sympathize with Mr. Foley's plight, as it appears he's being afforded a stark and unacceptable choice between mediocre care or death, but in actuality his situation is indicative of a much broader reality applicable to the current system. "One size fits all" health care, which is the premise of the Canadian system, translates into mediocre care for most and no care for some. My plan is to make the ultimate choice, assisted death, when my quality of life is sufficiently compromised as to render any other option unacceptable to me. I think assisted death should be seen as the last, logical, stage in the Canadian health care model.

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