Osler's Razor

I can't speak on the issue of what the law should read. I do know that I feel the same way about assisted suicide as I do about abortion. As a Christian, I believe they are wrong. At the same time, I think they should both be legal. It is very easy to condemn either - as long as you are not the one who is involved. Palliative medicine has come a long way and I firmly believe in the ability of hospice care to relieve suffering as a patient reaches the end-of-life stage. But, should laws dictate when and how someone dies? I look forward to reading the comments on this as it is clear I don't have a position that is clear in any way.
 

I recommend watching this Frontline documentary on the issue:
 

http://www.pbs.org/wgbh/pages/frontline/suicidetourist/
 

I believe it is none of the government's business when I or anyone else chooses to end their life. I think that, like other unpleasant-yet-necessary things such as abortion, there should be a medically safe way to go about it to prevent the harm from pushing it underground.
 

Anon @ 12:30..Just because one morally disagrees with an activity, doesn't mean that one also has to use the coercive power of the state to prohibit that activity. For example, I think (or I hope) most people morally disagree with committing adultery; however, most people don't seem to think it should be a crime. Your position isn't necessarily contradictory.
 

I don't want someone to voluntarily choose to end their life before they otherwise would because the cost of medical care is too high.

Still, euthanasia is good enough to keep animals from suffering. I'm not sure it's a call we should let someone make without the advice of a professional, though.

Anyway, what's up with not discussing the the biggest bit of law school gossip to hit the blogosphere in a while? I mean, not that I think we ought to give two whits about the catfight between two privileged Harvard numbskulls (and this is a Yalie blog so I can say that) that resulted in a spectacularly stupid thing being said in a private e-mail.

I really don't care that Ms. Grace is apparently clueless about biology, statistics, and race. That's par for the whitebread course. What really irks me is that Harvard is held in such prestige, and yet their 3Ls get into this kind of nonsense. At Baylor, we worked hard in our third year to be professional and not say the kinds of things that make the national media... you know, being lawyerly. Yet she'll be the one who goes out to be the leader, the politician, the public figure of tomorrow, while we'll get regional notoriety, if that.

I'd say we worked too hard for too little in return, but every day I don't screw up at my job because of the training I received, I'm reminded again why I wanted to be a lawyer: to help others. And I'm glad I went to Baylor.
 

Assisted suicide should be legal, but only for scary clowns.
 

I'll leave it to others to say what the law should say, but it seems like there's a range of precedents, from the Netherlands to Oregon. From the little that I know, the Dutch law may be a bit too soft, but the law in Oregon seems appropriate.

Given the crazy costs in health care associated with the last years of life, if an individual chooses with their family to end their life peacefully, I don't see why this should be disallowed. I'm sure we've all seen a grand/parent or relative slip painfully into eventual death, and making a decision seems so much more empowered to me.

Perhaps the law should have some sort of mandatory counseling session (funny, though, that I would see that as intrusive in the case of abortion -- Anon 12:30 is making me think in juxtaposing these two) so we don't get all the depressed people just killing themselves, but the question was "assisted" suicide, so maybe part of the assistance would be counseling?

While the right to assisted suicide seems certain to me, the particulars of the law are debatable. I'll be curious what others have to say.
 

Would it really be so bad if all the depressed people killed themselves already?
 

My aunt's mother in law died of breast cancer. She was a very devout Christian Scientist, and did not believe in accepting any medical care nor pain relief. In the end, however, even she broke down and asked for some morphine. The cancer literally ate her breast from the inside out, and she died in terrible agony. She died fighting it, and I stand in awe of that type of resolve. I've often wondered, however, if I was in that position, would I have done the same? Or would I have asked--begged--someone to end the pain, choosing a peaceful death over a miserable one when it was clear death was inevitable? I don't know, and I don't think any of us knows what the dying and their families are experiencing until we are (God forbid) in that position.

Could I as the doctor be the one to assist in the suicide? No, just like I couldn't be the doctor performing the abortion. Does that mean I think it should be illegal? Not necessarily.
 

Having majored in science and minored in Religion and Philosophy, and worked as a paramedic, I have pondered this in depth. I'm certain as to my own beliefs (atheist) and and final wishes.

I do not want to continue to live if I am losing my mind from Alzheimer's, or locked into a useless body from stroke or injury, unable to communicate or interact in any meaningful way. I have all the current relevant legal documents, and have made my wishes crystal clear to all my relatives - and they have sworn to honor them. I have participated in the last of many lives, and assisted those who wanted to depart with dignity and comfort.

Unfortunately, the ridiculous, hysterical war on drugs has made in impossible for doctors to prescribe the proper drugs in amounts needed to treat chronic pain without being prosecuted. This has affected greatly the hospice services.

At the same time, I have heard and agree with the argument that this can be a slippery slope, and should only considered in extremis and with medical verification of the seriousness of the individual's illness or mental deterioration. If the individual can take care of it himself, that is best, but it should be legal for others to help if he is past the point of physically doing the deed.

I do not believe that it is right for government to interfere in such a personal, private matter except to insure that the individual truly wishes to leave this life and that he has expressed this desire before being rendered incapable and needing assistance.

Lee
 

WOW, talk about a slippery slope.

There are many doctors who do, in fact, prescribe drugs to alleviate pain in such high dosages that they know any extended exposure will accelerate/cause death for patients who are suffering a great deal.
But then there is this, directly from the Hippocratic Oath, which some might call the original constitution of medicine: "I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect."

Way to be all thought provoke-y, Osler. It's a question with moral, ethical, legal, animal, vegetable and mineral implications.
I know I don't have the answer, but I do know that it looks like a great, big slippery slope to me.
For more on this, see: http://www.youtube.com/watch?v=3caoy4cIXac
 

Lane,

I tried to read that thing, but man, what a waste of time and energy. Everyone, including the writer, the insulter and anyone who reads that stuff for more than mere entertainment should be forced to go volunteer at a local soup kitchen, homeless shelter or legal aid society for 100 hours and stop wasting society's time with such sophistry.
 

Oh, and on assisted suicide, I come down on the "no" side. The law has to draw lines. Sometimes the boundaries are clear and understandable: "don't steal." Other times they are arbitrary and based upon the notion that we have to put a line somewhere, like "65 MPH Speed Limit."

Here, trying to allow killing in some cases, but not in others, looks like saying 65 MPH most of the time, but 55 MPH if you're old and have slow reflexes, or if you're young and foolish. 75 MPH is OK if you've got perfect vision and athletic reflexes.
 

Very well said, IPLawguy. I agree with your black and white stance on this.
To allow physicians and patients a grey area on this could be catastrophic.

Doctor: "I'm going home, Nurse Bennett. Just finished euthanizing room 313."

Nurse Bennett: "Ummmm, Dr. Jeckyl, the euthanasia was room 314. Room 313 is here for allergy testing."
 

One of these topics with no clear answer and so very personal. The thought of legalizing assisted suicide just screams government intervention and continued fighting in our very polarized society. Could 'we the people' ever agree upon what this really means? I dare say - NO! This being said, I am a strong supporter of hospice and the use of pallative care during end of life.

I think each persons end of life decisions belong to them and in some cases their families. Leaving very clear instructions if one becomes incapacitated is a start. But one can have a DNR yet when taken to the hospital have the order ignored. If I were to start somewhere it would be ensuring that people who have clear written directives can have them followed.

Until one is faced with such a decision in their family due to a cancer, ALS, MS, Alzheimers, etc.. and surely in most of these cases the patient/family had the ability to discuss the treatment options available to them or not prior to the disease taking one past a point of treatment or meaningful survival.

ps. Jessica, your aunts M-i-L was very brave to hold tight to her beliefs. Perhaps harder to watch by those around her knowing that breast cancer does not have to be a death sentence (depending on the variation).
 

This begs the question: can a death row inmate ever forego his appeals and choose to be executed? If we as a society do not allow terminally ill patients to voluntarily choose to end their lives, can we allow a death row inmate to refuse to pursue his appeals, knowing the end result will be death? If we can, why is a death row inmate allowed to make that choice but not a terminally ill patient? If we can't, isn't that an end-run around the death penalty, thus rendering it ineffective?
 

Justin - we are a society of contradictions.
 

Good point, Justin . . .

And I can understand the arguments on both sides. I would think that, in this case, the government intervention that you speak of, Ginger, is the government prosecuting doctors for assisting in suicide, rather than the government allowing a patient to seek it out (which doesn't seem like intervention to me).

I suppose I lean toward to side of yes, the law should allow ASSISTED suicide (I agree about the necessity of some kind of medical verification), because I believe a person should be able to do what she wants with her own body, or his own body, even if it's potentially harmful. But, it's a big slippery slope, for sure.

Really what we're talking about is whether doctors should be prosecuted and put in jail for having assisted with someone's death. The patient isn't going to be prosecuted! I'd imagine it could be difficult to prove in what way a doctor assists with suicide. Kevorkian was very public about it on purpose, but most of the time it's not so obvious, is it?

I wonder what doctors favor on this issue?
 

Last year, my dad's first cousin shot his wife to death on their living room couch, then went into their attic and shot himself... both after having sent their daughter a letter wherein he said he "didn't want to be a bother."

The wife had severe dementia and was "gone" in every meaningful sense. He was exhausted from having been her sole care-giver, and had begun to recognize symptoms of his own dementia.

Contrast this to the British conductor Edward Downes, who (with similar health circumstances for himself and his wife), decided - with their children's input and consent - to take his wife to Switzerland, to a place called Dignitas. There the doctors and nurses there helped them end their lives, together and (by all news accounts I've read) peacefully.

While I wish above all that my father's cousin had felt he could reach out to someone, anyone, in his emotional pain, I grieve for my other cousins - his kids and grandkids - who are still reeling.

I thought Kevorkian was a horrible person, back in the day. I no longer do.