Assisted Suicide / End of life issues

[Cathleen]

Discussion and/or thoughts to share?


Group Plans to Help Healthy Woman Die


(April 3) - A healthy woman's desire to kill herself when her terminally ill husband dies -- a plan she intends to carry out with the help of a Swiss assisted suicide group -- has ignited a new right-to-die controversy.
Ludwig Minelli, the founder of the Swiss assisted suicide group, Dignitas, talked about the case in a recent interview with The Times of London. Assisted suicide is legal in Switzerland, and the group said it has helped more than 100 Britons die.

Minelli told BBC News his organization plans to test the limits of the Swiss law by helping a healthy person take her own life.

"There is a couple living in Canada, the husband is ill, his partner is not ill but she told us here in my living room that 'if my husband goes, I would go at the same time with him,' " he said Thursday. The couple in question is Betty and George Coumbias of Canada.

Minelli also acknowledged that his group helped some psychiatric patients commit suicide, BBC News said.

"I have a totally different attitude to suicide," Minelli said. "I say suicide is a marvelous possibility given to a human being."

A "suicide assistant" said she resigned from Dignitas because she was concerned about the way the organization dealt with couples and mentally ill people.

"I have no problem at all with assisted suicide, if somebody is terminally ill, my problem is with how Dignitas deals with it," Soroya Wernli told BBC News.
Patricia Hewitt, a former British health secretary, said Minelli's comments pointed to a need to tighten assisted suicide laws.

Dignitas came under fire last year for helping a 23-year-old Briton commit suicide. Daniel James was left paralyzed by a rugby injury but was not terminally ill.

In the United States, two states allow assisted suicide. Oregon sanctions physician-assisted suicide for terminally ill state residents. In Washington state, terminally ill patients with less than six months to live can ask their doctors to prescribe them lethal medication. Two doctors must certify that the patient has a terminal condition and six months or less to live.

In December, a Montana district judge ruled that doctor-assisted suicides are legal. That decision, which was based on an individual lawsuit, has gone to the state Supreme Court.

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[Bandit58]

This topic is a bit close to home for me. Sir has chronic health issues none of which are ever going to get any better (kidney failure, diabetes just two of a long list).

He has a DNR on his hospital records. This was put on before we met and we have discussed removing it now that we are married (I am listed as next of kin). He does not wish to be left as a vegetable attached to machines. He also would not want me following him into the never never by killing myself.

Yes, I would be incredibly sad. Yes, my heart would break, I would hurt so much. But He wouldn't want me to grieve forever. He'd want me to remember the happy times we shared together and not dwell on the bad ones (most of which if not all were out of our control).

He says he intends to be around for a long time yet though, if he has any say in it!

 

[SweetErika]

I don't get why these healthy people need assistance in committing suicide if that's what they really want to do. Well, I do understand that they probably want to be sure they get the job done quickly and painlessly, and the woman in the article wants to die at the same time as her husband, but I still question why they need help killing themselves.

And while I don't have a fundamental problem with suicide (people should be able to choose to live or die, provided they're not harming others, IMO)--and am ALL for assisted suicide for the terminally ill--I DO take issue with healthy people creating problems for systems that are for terminally ill people who may not have other options to end their lives. For instance, what if the story of this terminal/healthy couple results in stricter laws, a closure of the assisted suicide center, or something else that negatively impacts the terminally ill who want to die with dignity? Or what if a lot of caring assisted suicide providers feel an ethical obligation to quit their jobs because the centers have started helping healthy people kill themselves - should they be put out of work because the healthy people didn't want to commit suicide on their own?

I guess I just feel like it's an abuse of a system that was created for a very specific purpose, and if non-terminal people want assisted suicide, they should lobby for such a system for themselves, rather than using the one for those who might not have other options. And in the meantime, they can figure out how to kill themselves without assistance - logistically, it's not that hard to overdose effectively, put a gun in the mouth or make a cut from the inside of the wrist to the elbow.

 

[Eilan]

He has a DNR on his hospital records.

Being DNR did my grandma a lot of good. She ended up being put on a ventilator when she was transported to the ER during the final stages of her illness last year. Not that I'm bitter or anything. . .

And while I don't have a fundamental problem with suicide (people should be able to choose to live or die, provided they're not harming others, IMO)--and am ALL for assisted suicide for the terminally ill--I DO take issue with healthy people creating problems for systems that are for terminally ill people who may not have other options to end their lives.

This is pretty much what I was thinking when I read Cate's post, but you put it so much better than I would have.

 

[NaughtyLil1]

This is pretty much what I was thinking when I read Cate's post, but you put it so much better than I would have.

I second this.

I am all for the terminally ill having a way out. I just recently discussed this with my children. Although I can't say with 100% certainity, I am pretty sure I would seriously consider this option if need be.

On the other hand, I just don't grasp suicide in healthy individuals. Of course, I'm still reeling about yanking a garden hose off my neighbor's exhaust pipe last week.

 

[bailadora]

On the other hand, I just don't grasp suicide in healthy individuals.

I will fully admit this bothers me on a fundamental level and it's something I can't wrap my head around. I do understand sometimes people are depressed and grieving. I went through a three year period myself and there were days on end where I just wanted to pull the covers over my head and not wake up ever again. But the thing is, for as painful as those feelings were - at some level I also realized they weren't rational in the sense that they weren't enough to end my life over.

I guess deep down I feel that there is always hope and that life can get better if you just give it a chance. I also think a lot of how we view life and it's worth stems from how we choose to deal with things. I've had to learn the hard way that happiness is a choice.

 

[WriterDom]

It's humane to put animals down when they suffer. But go in a nursing home and you see many people with absolutely no quality of life left.

 

[bailadora]

It's humane to put animals down when they suffer. But go in a nursing home and you see many people with absolutely no quality of life left.

Maybe, maybe not. Again, I think it all depends upon your point of view and how you choose to deal with it. Ever read Tuesdays with Morrie by Mitch Albom? Morrie was Mitch's former college prof and the book details how Morrie dealt with end of life issues due to ALS. On the surface, one could say Morrie had no quality of life because he couldn't breathe on his own, someone had to wipe his ass, and feed him, etc. All things that we are accustomed to doing for ourselves as dignified adults. Morrie could have handled his situation in one of two ways: curl up and moan about how unfair it all is or learn to accept the situation and learn to let people do for him again and even find some enjoyment from it.

One passage that really stands out is as follows:

"Mitch, I don't allow myself any more self-pity than that. A little each morning, a few tears and that's all. "

I thought about all the people I knew who spend many of their waking hours feeling sorry for themselves. How useful would it be to put a daily limit on self-pity. Just a few tearful minutes, then on with the day. And if Morrie could do it with such a horrible disease....

"It's only horrible if you see it that way," Morrie said. "It's horrible to watch my body slowly wilt away to nothing. But it's also wonderful because of all the time I get to say good-bye." He smiled. "Not everyone is so lucky."

I studied him in his chair, unable to stand, to wash, to pull on his pants. Lucky? Did he really say lucky?


Again, I think that it's all in how you look at it. Happiness is a choice.

 

[WriterDom]

Maybe, maybe not. Again, I think it all depends upon your point of view and how you choose to deal with it. Ever read Tuesdays with Morrie by Mitch Albom? Morrie was Mitch's former college prof and the book details how Morrie dealt with end of life issues due to ALS. On the surface, one could say Morrie had no quality of life because he couldn't breathe on his own, someone had to wipe his ass, and feed him, etc. All things that we are accustomed to doing for ourselves as dignified adults. Morrie could have handled his situation in one of two ways: curl up and moan about how unfair it all is or learn to accept the situation and learn to let people do for him again and even find some enjoyment from it.

One passage that really stands out is as follows:

"Mitch, I don't allow myself any more self-pity than that. A little each morning, a few tears and that's all. "

I thought about all the people I knew who spend many of their waking hours feeling sorry for themselves. How useful would it be to put a daily limit on self-pity. Just a few tearful minutes, then on with the day. And if Morrie could do it with such a horrible disease....

"It's only horrible if you see it that way," Morrie said. "It's horrible to watch my body slowly wilt away to nothing. But it's also wonderful because of all the time I get to say good-bye." He smiled. "Not everyone is so lucky."

I studied him in his chair, unable to stand, to wash, to pull on his pants. Lucky? Did he really say lucky?


Again, I think that it's all in how you look at it. Happiness is a choice.

Yeah I read that book. I'm talking about people who have lost all ability to communicate. They can't walk or rollover even.

 

[fire_breeze]

When I first read the article, I was reminded of Nero and his 'suicide'. He had to order a slave to make him fall upon his sword. The following conversations with others after reading this was interesting to say the least. But I digress.

I have no issue with suicide. In some cases, I will even understand the need to die (however, it should be pointed out that I come from a culture that regards certain types of suicide as honourable and acceptable). What I have an issue with is a healthy, capable individual who needs assistance to take her own life. Like many of the posters, I echo SweetErika's opinion and would even further it, saying that what the woman in question is doing is abusing a very specific system. She is able to take the proper dosage of pills, of putting a gun to her head, of ingesting poison, etc. Her husband, however, is not. I loathe to use this comparison, but it's like a personal who is well-off using the local community's goodwill pantry to feed oneself. There is a very wide line of being terminally ill and incapable of making that choice and of being utterly healthy and capable.

I would be interested in hearing whether or not the couple has a family and if they have spoken about it to them. Suicide is a shock, whether or not the causes are understandable. Unexpected death is grieving, even more so when a person takes his/her own life. The shock is astounding. I would be also interested in seeing what are her reasons for taking her life (presumably she doesn't want to live without her partner) and whether or not she has spoken to her husband about it.

 

[harrlequin]

Being DNR did my grandma a lot of good. She ended up being put on a ventilator when she was transported to the ER during the final stages of her illness last year. Not that I'm bitter or anything.

Not sure where you live, Eilan, but here's what I found out about DNR (I'm in Canada). Just went through this myself last year with my mom.

A DNR means nothing to an EMT (ambulance driver, etc.) The essence of their job is to prolong life until they get to the hospital. If an ambulance is called, they will do whatever they can to get that patient to the hospital alive, including "heroic measures". This is what they do, period.

The DNR does not take effect until they reach the hospital.

 

[Nightfreak]

Not sure where you live, Eilan, but here's what I found out about DNR (I'm in Canada). Just went through this myself last year with my mom.

A DNR means nothing to an EMT (ambulance driver, etc.) The essence of their job is to prolong life until they get to the hospital. If an ambulance is called, they will do whatever they can to get that patient to the hospital alive, including "heroic measures". This is what they do, period.

The DNR does not take effect until they reach the hospital.

Being a firefighter /emt a DNR order does have a lot of bearing in what care is given by the ambulance staff. In Maryland there is two types of DNR orders The most common one is for patients that have terminal illnesses like end stage cancer etc. The only care that a emt can give is comfort measures only O2 stuff like that. If they would happen to go into cardiac arrest in the ambulance we are not allowed to touch them. The only person that can break a DNR order at least in Maryland is a Doctor.
The second type of Dnr order in Maryland gives you full power to do everything you can with the exception of CPR and other advanced life support measures if the patient's is starting to die. I know different states have different protocols with DNR orders but I think there are standard across the board.

 

[SweetErika]

Being DNR did my grandma a lot of good. She ended up being put on a ventilator when she was transported to the ER during the final stages of her illness last year. Not that I'm bitter or anything. . .

I don't know if you want to elaborate, but I'd be interested in hearing how that happened. I know sometimes mistakes like DNRs not being found in time are made, but was that the case here, or was it a clear decision by someone to ignore the DNR?

Not sure where you live, Eilan, but here's what I found out about DNR (I'm in Canada). Just went through this myself last year with my mom.

A DNR means nothing to an EMT (ambulance driver, etc.) The essence of their job is to prolong life until they get to the hospital. If an ambulance is called, they will do whatever they can to get that patient to the hospital alive, including "heroic measures". This is what they do, period.

The DNR does not take effect until they reach the hospital.

Here (at least in my state), hospices and such advise patients to put a DNR and statement of wishes on (or maybe it's in) the fridge door along with other important medical info and tell all family members and friends about it. Paramedics are trained to look at the fridge for such info, especially in the case of chronically or terminally ill patients.

This way, if someone does panic and call 911 (I guess this happens quite often when people are in the midst of pain or grief), the patient's wishes can more easily be honored by the paramedics and hospital (if they are taken). Of course the patient can override the DNR or ask to be treated in certain ways, but snafus like having the EMTs give CPR when a family member asks them save the terminal patient are more easily avoided.

It seems like a pretty good system to me.

 

[bailadora]

I'm talking about people who have lost all ability to communicate. They can't walk or rollover even.

Perhaps like in the Terry Schiavo situation? In that case, I agree that I wouldn't want to be kept in a vegetative state. But the article refers to a healthy person who has no such issues.

In some cases, I will even understand the need to die (however, it should be pointed out that I come from a culture that regards certain types of suicide as honourable and acceptable).

FB, if it isn't too intrusive, would you elaborate?

 

[WriterDom]

Perhaps like in the Terry Schiavo situation? In that case, I agree that I wouldn't want to be kept in a vegetative state. But the article refers to a healthy person who has no such issues.



FB, if it isn't too intrusive, would you elaborate?

No, more like old people with really advanced dementia. It's like all the circuits in their brain are shutting down. Nursing homes are filled with people like that. Some of them can sit up but they just stare into space.

 

[Eilan]

The DNR does not take effect until they reach the hospital.

Oh, this happened in the hospital.

I don't know if you want to elaborate, but I'd be interested in hearing how that happened. I know sometimes mistakes like DNRs not being found in time are made, but was that the case here, or was it a clear decision by someone to ignore the DNR?

My grandma was transported to the nursing home to the hospital via ambulance. It's probably a five-minute trip, so I'm not sure what was done to stabilize her en route. She was incoherent and in respiratory distress due to pneumonia and congestive heart failure and she was dehydrated (thanks to the stomach bug she caught after only a week at the nursing home) and septic.

We weren't able to see her until she had been stabilized, and it was then that we'd been told what had happened. The ER staff had her records and knew about the DNR; according to the nurse who came to talk to us, the doc asked my grandma if she wanted to be put on a ventilator, and she said yes. Because of the condition that she was in when she arrived at the ER, we found it difficult to believe that she was able to communicate.

When my grandma stabilized in the CCU, she was, BTW, furious about being put on the ventilator.

 

[fire_breeze]

Perhaps like in the Terry Schiavo situation? In that case, I agree that I wouldn't want to be kept in a vegetative state. But the article refers to a healthy person who has no such issues.



FB, if it isn't too intrusive, would you elaborate?

Not at all. Like many Eastern cultures (Japanese comes to mind), Hungarian culture 'dictates', for the lack of a better word, the value of honour above life. When honour is somehow irrevocably damaged, suicide is then an acceptable way of saving face. It's not pushed on the person, because it is a personal and individual decision. However, it should be noted that suicide is also thought of as not the answer to everything, and at times considered to be the 'easy way' out of the situation (which in turns causes dishonour in death).

When it comes to terminally ill, if the individual feels that by existing will somehow make him/her lose face, and could cause familial dishonour (making the family go into debt for example), then suicide would be an acceptable and honourable choice. However, assisted suicide is one of those issues that is surrounded by controversy.

Many of us who grew up outside of Hungary calls this 'the Klingon mentality' and choses a less extreme way of honour reparation.

I don't know how much this answered your question.

 

[MisterSir]

I could not even give a fraction of a shit about the moral ramifications - if somebody wants to die, they should be allowed to go ahead and do it painlessly because it's their fucking life. Who the fuck am I or Gordon Brown or Barack Obama or whichever prick is in charge of the EU Parliament to decree "No! No, you can't end your life like this! I won't allow it"?

Also, let's face it, if someone's suicidal, they're going to die anyway. May as well make it easier on them.

 

[Cathleen]

Bandit, I respect and appreciate your reply since I know you and Gil face his very real difficulties each day. Your acknowledgment that losing him will be beyond hard, filled with pain and sadness but that you will go thru that and come out the other side is the healthy truth, IMHO.

Naughty1, what an experience had with your neighbor's attempt at suicide.

I don't know how I feel about Betty Coumbias, choosing to kill herself when her husband dies. I question it from a stance of "Hey, life isn't all roses and butterflies but you take what's dealt." I know that may come across as harsh but --- I don't know how to express my thoughts but I'll give it a shot.

Just because something difficult lands in my lap doesn't mean I need to kill myself. I have fortitude, I've been faced with difficult circumstances and the idea of suicide isn't too far away when things get really tough, but even having that as a choice can actually make me push on and fight harder thru the crap. It becomes a sort of therapeutic tool, just knowing it's an option can help the spirit survive. For me anyway.

Being totally honest I guess my beef is 'hey lady who says you get a pass on this?' I don't know if they have kids or grandkids but she will have worth after the death of her husband. Sure it'll be tough to go on without him but it doesn't kill you -- no pun on the topic -- it'll test you in many ways but it doesn't mean you can't do it.

Is she quitting? Taking the easy way out?

I agree with the idea mentioned by many of you about a healthy person using the organization isn't fair to the people it truly seeks to help.


I have had a personal experience with a loved one ready and wanting life's end. My mother suffered years with cancer and during her active dying stage she truly was ready, she stated it. At the early part of that stage a hospice nurse gathered my father, my sister and I to express some thoughts and share information with us. Cutting to the chase she said we could withhold a certain medication and it would probably hasten her death and a it'd be a peaceful death. To say I was caught off guard was an understatement, hell I had just arrived from my office to spend time with her, I didn't come to decide if I should kill her. I don't mean those words in fact, I mean those words as my emotion and reaction.

My mother wanted to die, I didn't want it and I didn't want anything to do with helping to accomplish that. I talked privately with my mom and told her I will do everything I can to make things easier for her but I was limited, but the one thing I could do was to be the very best daughter I could be.

Even to this day I doubt I'd chose differently now.


(It turned out that that certain medication was NOT given to my mother and my mother lived six weeks more, far beyond the five days the nurse had thought. It's my believe there was a reason or reasons for her to stay, I don't know.)

 

[throbbingclit69]

Ok, this is obviously a very passionate topic, with deep feelings and beliefs involved. But if I can ask this. If you exist and live on the earth, was it you yourself who brought you into existence? Of course not. Is life difficult? Of course it is. Should we be kept alive by artificial means? That's an individual and philosophical choice. Should we decide to opt out of a healthy, yet unhappy life? Hopefully not. Should we destroy what we were not able to create in the first place? How could we? Is that our right? Are our problems, no matter how seemingly deep, that significant in the context of all the lives that have gone before us? Has there been no one else in history who has experienced at least as much pain as we are right now? Of course there has been. The world has been full of human suffering since it was created. No one knows why. Often we get caught up in our own pain and cannot see the way out. Yet, it is such a very common human experience. One that patience and perseverance can prevail over.

 

[VelvetDarkness]

I think that referring to a physically healthy person who wants to commit suicide when her husband dies as generally 'healthy' is questionable. We do not normally think of suicidal individuals as healthy. There must be some serious issues going on with this woman and they may or may not add up to a compos mentis person capable of making an informed choice. Who's to say that the minute her husband's dead and buried she won't turn around screaming 'fucked if I'm topping myself for that domineering, abusive asshole!' This may in part be an attempt to 'prove her love' in the eyes of her currently live and kicking hubby and it's impossible to say whether she would feel exactly the same if his influence was not a factor. To want to end one's life because a loved one has passed is an extreme response to grief and it seems over-theatrical to me that this woman is making a public and legal issue out of what should be a very personal and private decision.

In the case of Daniel James, although he was not terminally ill, he faced a lifetime of total incapacitation and dependence on round the clock care. I think that many people would want to opt out of that and his parents went through every appropriate channel to ensure that they were doing what was best for their son rather than giving a traumatized youngster an easy out. I have every respect for the decision they made to assist his suicide even though it was heartbreaking for them.

In a case particularly close to myself, a woman with a degenerative brain disease found that the nature of her illness was such that it would not be possible for medical professionals to assert that she could give an informed consent to assisted suicide. She took matters into her own hands and ended her own life. She did this while alone so that no relative could be implicated and she died without the love and support around her that she deserved. There will always be determined individuals who do not fall within the parameters set by organisations like Dignitas.

So to go back to the case of the woman who wants to die when her husband does. I think it's unnecessary for her to seek this through an organisation set up to assist terminally ill people who in many cases could not access the ability to end their lives without the agreement and assistance of others. This woman is not in that position. If she is determined to end her life she can do that unaided and that is why I think this is a case that Dignitas should not become involved with because it will jeopardise the facilities in place for those who need assistance in order to end their lives. Their potential for quality of life is almost negligible when placed beside that of a woman of sound body and sound-ish mind who wants to make a song and dance about euthanasia for the sake of kicking up a controversy and martyring herself to her husband.

 

[breezyblue]

I agree that seeking Dignitas's services in this situation is an abuse of the system in place to protect people from suffering through slow painful deaths. I do not see why, in a country which allows assisted suicide for non terminal patients, this woman cannot simply go to her physician and be prescribed lethal medication. I understand this woman's position to a point - if i had chosen to end my life it would be much less painful to do it via medication designed for that specific purpose rather than blowing my brains out or taking a knife to my wrists. However, on the other hand I don't believe that it should be made easier for her. Suicide is something ment only for those with no other choice and no possibility for a happy/fulfilling life in my opinion. Therefore those individuals who feel they have no such chance of a future will feel the necessary drive to take their own life because the alternative to death is unbearable for them. It is certainly a different situation if one is unable to do this themselves which is where organizations such as Dignitas come in but their services should only be used when absolutely necessary - I guess i sort of see the actual act of taking ones own life is a test as to whether things are really bad enough to warrant death.

 

[VelvetDarkness]

I do not see why, in a country which allows assisted suicide for non terminal patients, this woman cannot simply go to her physician and be prescribed lethal medication.

Agreed.

If a person is resolved on suicide a quick google search will tell them what dosage they require of any number of over-the-counter drugs. If they choose to end their life by hanging themselves, google will teach them how to tie a noose. If they plan on jumping from a tall building, google maps will direct them. In our modern society where the internet hyper-informs the masses on everything from paedophilia to bomb manufacture, effective suicide options are only ever a click away. This woman does not need the services of an organisation like Dignitas because she can procure and utilise whatever she needs in order to kill herself without assistance of any kind. Severely disabled and/or sick people simply do not have that option and that should be the salient point here. If the great scientist and Amyotrophic Lateral Sclerosis sufferer, Stephen Hawking, decides one day that enough is enough it will not be within his power to obtain and administer a lethal cocktail of drugs and it was to empower people such as him that Dignitas was founded.