FWIW, none of the friends I have who work or have worked for hospice would call themselves "medical professionals" . . . except, of course, for the ones who are doctors or nurses (and therefore bound by medical ethics).

It is, and maybe we're getting into areas of grey here. At least accoring to the Wiki (hey, why not), what you describe is called "passive euthanasia."

Euthanasia may be conducted passively, non-aggressively, and aggressively. Passive euthanasia entails the withholding of common treatments (such as antibiotics, pain medications, or surgery) or the distribution of a medication (such as morphine) to relieve pain, knowing that it may also result in death (principle of double effect). Passive euthanasia is the most accepted form, and it is a common practice in most hospitals. Non-aggressive euthanasia entails the withdrawing of life support and is more controversial. Aggressive euthanasia entails the use of lethal substances or forces to kill and is the most controversial means.

The Wiki on Physician Assisted Suicide.

I think that this is quite different from "aggressive euthanasia," which is what I, at least, think of when I hear "physician assisted suicide" -- a terminally ill patient, who by law usually must be of sound mind, makes a conscious decision to commit suicide before the illness puts them in what they consider an untenable quality of life situation and seeks out the help of a physician or medical professional to carry out the suicide painlessly and quickly. It's this later practice I have a problem with.

The Wiki also describes the Principle of double effect here; the description is quite in line with what AOII Angel said above.

Can it not be argued that by allowing a patient to live who suffers greatly every day and wishes to not live, the physician is assisting in the harm of that patient?

ETA: I see it was already answered - my bad!

I have it in my will that is binding that I will not be kept alive if there is no hope.

This releives the medical people of any recourse.

Why burden the family if any remaining with medical costs that they cannot afford or want?

I completely agree with you Tom. Our country goes soooo overboard on end of life care. No one knows how to say enough is enough, because so many decisions are made by people that feel too guilty for not doing enough for their parents and can't let go. Universal health care will never work here for this main reason...most medical costs are associated with the last two weeks of life.

Let me ask you all this question:

Have you EVER "euthanized" ANYTHING beyond a bug yourself? Particularly, a mammal?

If you have, then you should know with that comes responsibilities, that are sometimes difficult to swallow. You cannot do it with cruel intentions and malice and it must always be done with compassion...

Extending it to humans is difficult--especially if one has never seen another human die albeit slowly, painfully or quickly. Then, it is tough to imagine modern burial techniques--i.e. one must still prep the body even if it is to be cremated.

The best anyone can do is not only have a DNR, no code (because my grandmother's was ignored prolonging her painful existence), but also a Physician's Health Directive, POLST form and a living will and trust.

I personally do NOT want any healthcare worker injecting me with any lethal injections of anything even if I am from the Borg Collective... If I die naturally, with minimal pain because of the morphine drip, then hey, K.I.M.

But healthcare worker assisted suicide no matter what the cause--unrealistic in a "civilized society"... We know we can do better. There are some fine scientists working on the concepts of pain management, chronic diseases of the aging, and improvement of the quality of life. We MUST persuade people that we are better and we will improve health and wellness by all means necessary!

Dr. AKA_Monet
Ariafya LLC

Well said!

Tom, do you really mean your will, and did a lawyer draft the will? I ask only because in my experience (which I'll readily admit doesn't include Kansas), such a directive in your will, which by definition doesn't take effect until after your death, is meaningless. Most states provide for some version of an Advance Health Care Directive, Living Will or Health Care Proxy/Power of Attorney (or a combination of these) to cover these end of life issues.

Maybe I'm off base here, and sorry if I'm stirring things up unnecessarily; just don't want anyone to be relying on something if it won't be effective to carry out their intentions.

I know what you're saying, as I've sat by someone's side as they slipped away - and that's precisely why I really don't know how I feel on this topic anymore. I hate to say "you don't know it unless you've been through it," and I think people have been perfectly reasonable in this thread, but for me, the whole experience raised more personal questions that I haven't been able to answer.

Do you mind posting the journal to the bolded? Just asking? I had not heard that stat before. But it filters down to us minions over time... ;)

Not sure if it is in this article, but here's a NEJM article on physician-assisted suicide: http://content.nejm.org/cgi/content/full/339/3/167

I'm at work and won't have a chance to go through it right away, and it is kind of old (1998), but I figured it might be interesting reading for some of the posters.

:(

I know someone quite well who has to make "life and death decisions" about GMO rodents...

For aggressive euthanasia, by exsanguination, she says her limit is ~10 mice. For "passive aggressive" euthanasia, by asphyxiation, she says her limit ~50 mice.

For rats, after 2, she cannot work anymore.

And after a whole process of euthanizing rodents, she cannot work anymore for ~2 days because she says the whole process is too much for her. Sometimes, she has nightmares. Especially if blood was involved or a full necropsy (an autopsy for animals).

And publish literature on the subject, especially with veterinarian care, says folks limits differ from one animal to another. Like for rodents, not too bad, but for non-human primates, euthanasia is painful to do and watch...

She says sometime you can see in their beady little eyes. And euthanasia is different for neonates mice... She does not like having to do that.

I'll have to do some searching about that, but it's a commonly held opinion taught at med schools throughout the country. I guess I shouldn't pass on info that I haven't seen myself, but I have a feeling that this is true since the most expensive part of medical care is ICU care. Add in all of the daily radiologic examinations, specialists charges and long length of stay, and the bills get astronomical. I'll post if I find anything definitive.

I have heard it directly from the Chief of ER at a large LA hospital that folks use ER care as routine healthcare... I guess if the pain is too much, folks feel better at the ER... IDK? But the ER care only stabilizes the patient until the "next step"...

The other issue is chronic diseases that most folks who are older get--heart attacks, strokes, etc... I've seen someone in his late 50's who needed a liver transplant, but the dobutamine echo showed his heart could not take the transplant due to the ath plaques. Now, if I can tell on an echo and I am not a sonographer, then this patient was far off...

Was he in pain, probably so. He needed a new liver--I think his was cirrhotic, but the fact remains, we aren't there yet with advances in technology--which means, that we have to take very good care with what we've got...

Part of the illness causes depression and several other mental health issues. Some alzheimer patients sometimes become psychotic with the drug treatments. Given the mental disorders that can occur with several illnesses, it would be inherently inhumane to allow this kind of practice in this country.

In a perfect system, euthanasia in NEVER humane. But given our system and how it's done with animals is to minimize pain and suffering. That gauge is set very high and is not allowed by several laws in place to protect people's human and civil rights.

Others are not allowed to terminate anyone's life. If you review Ms. Schiavo's case, they essentially unplugged her and she "expired". A husband has the right to make that call. However, if she had survived on her own--i.e. breathing and heart beat, they would have done nothing beyond what was allowable.

A DNR order is not going to protect your wishes. ONLY a living will and trust and a health directive will in a court of law.

Think of it this way, you come in from a very bad car accident, you are mangled. Then you cough up blood and you go into cardiac arrest. Would you NOT want the team to put the AED on you because of a DNR order?

What about a routine simple outpatient surgery? For some reason you OD'ed on the Servoquel mix. Do you want them to NOT do all that is in their pharmacopoeia power to revive you--even if it is just enough smelling salts?

I think it will make things worse for some people. We have a problem with health disparities in this country. And childhood healthcare for ALL children is foul. Mothers are NOT allowed to be with their children 6 weeks after birth, whereas other advanced countries allow upto 2 years of PAID mother leave to care for infants.

Moreover, disabled people get jacked constantly. Let's not even go there with what happens to their insurance and job placement.

And if freedom to die is passed, do not be mentally retarded in this country. You can forget it.

I think our healthcare crises should be fixed first before we start culling our colonies down with people. Yes, there will be exorbitant costs, but I think that will be up front money that will pay off in the future. And to fix healthcare costs will be a dynamic process that will need constant review every 2,3,5,10+ years. I'd rather have a fair and equitable system that what we have now with a bunch of hypochondriacs.

If folks feel the need to kill themselves, then there are plenty of illegal actions that one can do to make that happen.

But, I would not allow any healthcare worker with that kind of power to do it. What would that person LOOK like? The "Angel of Death"?

I think is how one lives his or her life that makes all the difference...

Wasn't Terri Shchiavo basically denied nutrition and hydration? I believe she was still breathing on her own - she was essentially starved to death.
The husband argued that she was brain dead.That is totally different than not being able to function at all without machines. I think it is barbaric to allow someone to die that way.