In Tony Nicklinson's heroic suffering, I can't help but see the case for life

[ljtaylor]

It is harrowing to watch the anguish of a man who wants to end his life but cannot - yet his message somehow backfires

Comments

[herongale]

physician-assisted suicide is already practised quietly and routinely, with the help of a famous loophole (principle of double effect). This is working fine, so we don't need to legalize euthanasia.

What that's referring to is the fact that if you're treating someone with intense, terminal pain, the very medications that are used to treat the pain can also help usher in death.

But the man in this story is not someone with terminal cancer. He has locked-in syndrome, and I would bet that his physical pain is never to the degree where he needs heavy pain medications which could mercifully help end his life. This "option" isn't really an option at all, it only works in select cases... usually the sort of select cases where even if you do nothing, and let someone writhe in their moving, transcendent pain (/rolling my eyes here), they'll probably die sooner rather than later anyway, because the illness that is paining them is also the illness that will kill them.

Locked-in syndrome is often a non-progressive illness, meaning that the event that causes it could be something like trauma, or a stroke... once the original inciting event is over, it's not going to automatically get worse, nor is it going to bring on death on its own.

The issues that you raise are all important, but that doesn't mean they necessarily should be a bar to assisted suicide as an option... all it means is that it's a really difficult medical decision that should require the input of several different types of doctors, to make sure that depression or coercion are not factors, to make sure that the patient is in a proper mental state to be making such a decision. Where assisted-assisted suicide is legal, there are usually very stringent criteria in place to screen for these factors before it would even be considered: so, for instance, a patient with depression would need to be treated for their depression first, and then see if the will to die still holds true. The patient in the story cited above doesn't sound depressed to me: the very passion with which he argues for his right to die seems to counter that possibility quite nicely. And it really doesn't look like a case of coercion either. So although the cautions you raise are important, they don't really seem to apply in this case. There is no reason to argue in generalities about a specific case.

[metatrix]

First, I want to re-iterate that I wasn't actually stating my own opinion on euthanasia. I was just summarizing the main points that were brought up in an article that I read on euthanasia a long time ago. Personally, I'm undecided on the subject of euthanasia.

One thing my prof said in my medical ethics class which I think I agree with is that you can argue for legalizing physician-assisted suicide, but legalizing euthanasia is a wholly unnecessary legal risk, and going too far. If you legalize physician-assisted suicide, patients are still able to end their own life in a safe and dignified manner with medical help. But you have the added precaution of the patient being the one to 'pull the trigger'. This precaution is may seem insignificant on the surface, but it's actual hugely significant because:

- it avoids lawsuits from family members who will sue the doctor for wrongful death, saying the patient didn't really want to die
- it avoids the mental distress of the doctor needing to end the life
- it protects the doctor from criminal prosecution
- extra insurance that the patient really wants to die

In almost any circumstance, some kind of system can be rigged whereby the patient, no matter how disabled, can perform the final action that ends their life. Even if the patient is locked in and can't move, a system can be set-up whereby a morphine drip hooked up to a computer will be activated by the patient blinking his eyes in a specific pattern.

So, in that sense, I believe that between physician-assisted suicide and euthanasia, it is physician-assisted suicide that ultimately retains patient autonomy best (all the way until the very end), whereas euthanasia follows more in the old tradition of paternalism/beneficience ('it's too emotionally painful for the patient to pull the trigger, so as physicians we will take on the burden instead')

IDK if that made sense.

[wrestlingdog]

Thank you for this.