Deaf Twins Euthanised In Belgium

[Howdyphillip]

It is a choice I support as I support a persons rights to their own life...that means they also have the right to end it; it is theirs.

There are a lot of good points to your last post. I firmly believe in the statement that I highlighted up there as well. Of course people have the right to end their own life. My argument is that these people didn't have the right to assist them in doing so. Euthanasia by very definition should be done for humane reasons, and this case didn't contain that.

I personally wouldn't put a dog down if the only issues it had was being deaf and blind.

[Seli]

...

I can completely understand and support euthanasia in cases where the person is in pain and there is no hope of that subsiding. This decision was not about that.

And by the definitions used in Belgium, and in the professional opinion of at least 3 doctors, it was exactly about that.

[NestorMakhnosLovechild]

There are a lot of good points to your last post. I firmly believe in the statement that I highlighted up there as well. Of course people have the right to end their own life. My argument is that these people didn't have the right to assist them in doing so. Euthanasia by very definition should be done for humane reasons, and this case didn't contain that.

I personally wouldn't put a dog down if the only issues it had was being deaf and blind.

People are obviously different than dogs - in relevant part because for people, "suffering" doesn't just mean immediate physical pain like it means for a dog. People are capable of existential anguish; despair, hopelessness, a sense of meaninglessness or profound loneliness - which can all strike at the core of our humanity. Some of this might be treatable; some of it might be situational. But I absolutely dispute that the only type of suffering worthy of euthanasia is physical since it ignores completely what it is that distinguishes us from other animals. Maybe you think you could be happy again after having sight and sound stripped from you. Great. But people should be allowed to make, for themselves, the decision that some losses are too profound to bear. And they should be entitled to the simple, basic humanity of assistance to make sure that their passing is not unnecessarily painful or prolonged.

[Sci-2]

Yeah, seems unfair to discount the mental anguish of the twins or to limit "pain" to the physical. I recognize this takes us into dicey territory, but that's always going to be the case when dealing with euthanasia.

As for no one assisting them...I don't know about that either. Are they supposed to just find some way of off themselves on their own?

[Howdyphillip]

As for no one assisting them...I don't know about that either. Are they supposed to just find some way of off themselves on their own?

In a just world, they would be talked out of this nonsense, and could find support with people willing to walk them through a living process rather than one of death.

If they make the decision to take their own life anyways, the manner is inconsequential in the scheme of things.

I am drawing a line with physical pain being the only case where euthanasia is justified. If you want to get into psychological torment, anyone can be "euthanized" for any reason. In the grand scheme of things this falls far closer to assisting a sixteen year old girl to do it because her boyfriend broke up with her than it does to helping a cancer patient that only has misery to look forward to.

And by the definitions used in Belgium, and in the professional opinion of at least 3 doctors, it was exactly about that.

This reeks of a political decision to emphasize the fact that euthanasia should be available rather than anything truly medical. They are partially right. It should be available. Just not in this case.

[Castel]

What about mental anguish caused by incurable physical symptoms being the line? Though you'd then have to deal with all manner of people from amputees to people who think that they're a wolf trapped in the body of a man.

[Howdyphillip]

What about mental anguish caused by incurable physical symptoms being the line? Though you'd then have to deal with all manner of people from amputees to people who think that they're a wolf trapped in the body of a man.

How about if it is a permanent physical problem, then we allow for it to be remedied with a permanent physical solution, and if it is a mental issue, then the course of treatment be mental in nature?

[Castel]

How about if it is a permanent physical problem, then we allow for it to be remedied with a permanent physical solution, and if it is a mental issue, then the course of treatment be mental in nature?

How bout if people don't want to have treatment for a problem with no cure?

[Ormond]

People are capable of existential anguish; despair, hopelessness, a sense of meaninglessness or profound loneliness - which can all strike at the core of our humanity. Some of this might be treatable; some of it might be situational. But I absolutely dispute that the only type of suffering worthy of euthanasia is physical since it ignores completely what it is that distinguishes us from other animals. Maybe you think you could be happy again after having sight and sound stripped from you. Great. But people should be allowed to make, for themselves, the decision that some losses are too profound to bear. And they should be entitled to the simple, basic humanity of assistance to make sure that their passing is not unnecessarily painful or prolonged.

I'm sorry, I profoundly disagree. Of course human beings are capable of "existential anguish, despair, hopelessness, a sense of meaningless or profound loneliness"-- this is called major clinical depression. These are exactly the emotions that are used to diagnose depression. Anyone who has those symptoms needs to be treated for depression, not euthanized. This really sounds like giving a death sentence to anyone who is in the depths of a depressive episode to me, and I find it immoral and despicable.

[Castel]

Now we're back to whether or not depression skews your mind. I think it's perfectly rational to be depressed in certain cases and if it does skew your thought process is doesn't prevent you from absorbing information and making decisions. Whether or not you would get out of it is irrelevant to the fact that you, at the time, made a reasoned decision.

[Seli]

...

This reeks of a political decision to emphasize the fact that euthanasia should be available rather than anything truly medical. They are partially right. It should be available. Just not in this case.

The 3 doctors bit is a political solution to make sure that no single doctor has to carry the burden of the decision, and that the patient is persistent and fits the criteria.

The suffering criteria follows from the fact there is no objective measurement for pain (which can be treated in most cases anyway).

Euthanasia is not a procedure to end pain, but to end the suffering caused by (an often painful) loss of dignity and irreversible loss of quality of life. It is never narrowly medical in the technical sense, but broadly medical in the act for the good of the patient way. And mental anguish, as scary as the idea is, is something that deserves proper consideration.

[Seli]

I'm sorry, I profoundly disagree. Of course human beings are capable of "existential anguish, despair, hopelessness, a sense of meaningless or profound loneliness"-- this is called major clinical depression. These are exactly the emotions that are used to diagnose depression. Anyone who has those symptoms needs to be treated for depression, not euthanized. This really sounds like giving a death sentence to anyone who is in the depths of a depressive episode to me, and I find it immoral and despicable.

And that is why (if everything works properly) the procedures are in place to prevent that from happening.

But at one point (perhaps after decades), when medication and protocol and treatment and whatever else does not help anymore, who are we to deny some-one the right to self-determination. And why should a society, and the medical community, condemn them to whatever crude methods anyone has access to when other more humane options exist?

ETA: Take Terry Pratchett. Why should he, deciding now when he is still sound of mind, and knowing full well that he (probably) would not be aware of his condition at the end of his disease, have to go through years of knowing what is happening in lucid periods? He won't suffer physical pain (as far as I am aware), but he will suffer mentally, since his outlook is hopeless and his life will (most likely) be meaningless to him.

That does not mean anyone will force him, and no-one but him can make the decision, but it would seem humane for him to have the option to refuse that future.

[TrueMetis]

Quick question, we've got a whole bunch of people who are assuming that these twins were depressed. Do we have any actual evidence of that?

[Howdyphillip]

Quick question, we've got a whole bunch of people who are assuming that these twins were depressed. Do we have any actual evidence of that?

They killed themselves...

[NestorMakhnosLovechild]

They killed themselves...

This is, of course, completely circular logic.

[Res ipsa loquitur]

Quick question, we've got a whole bunch of people who are assuming that these twins were depressed. Do we have any actual evidence of that?

Depression in the face of their diagnosis and prognosis is entirely rational and understandable. So is their wish to end their lives rather than live such lives. I am in full agreement with Seli regardjng Terry Pratchett and his situation; if Mr Pratchett wished to end his life before the horrid effects of his illness came fully to bear, I would not blame him, and I would feel his depression regarding his situation logical as well.

[NestorMakhnosLovechild]

I'm sorry, I profoundly disagree. Of course human beings are capable of "existential anguish, despair, hopelessness, a sense of meaningless or profound loneliness"-- this is called major clinical depression. These are exactly the emotions that are used to diagnose depression. Anyone who has those symptoms needs to be treated for depression, not euthanized. This really sounds like giving a death sentence to anyone who is in the depths of a depressive episode to me, and I find it immoral and despicable.

This is a sensitive topic because of the stigma of mental 'illness' or the need for mental health treatment so please, take it on my word that: I have no issue with people suffering from depression seeing professionals, from taking medication, etc. and so on. I think people should actively take steps to make their lives better, and for a depressed person, if that means talk therapy - do it. If that means medication - do it. If that means changing the situation in your life that's making you depressed - do it. At various stages in my life I've had situational depression. I sought professional help for it. I made changes in my life to help myself get past it. I think that the depressed owe it to themselves to explore opportunities for living happy lives.

That being said - I'm not kidding myself. I don't think that "existential joy of life" is the "correct" or default state of humanity. There are different causes of "depression" - sometimes I don't think those causes are fixable or even incorrect. And I don't think everyone is obligated to respond (or capable of responding) in the same manner to everything life throws at them. I think there are circumstances that can happen to people in life that just render their quality of life so low that it's a perfectly reasonable proposition to end it because life isn't everything. The mere act of existence isn't necessarily praiseworthy or a good thing - it just it. It's a state of being like many others.

Right now - I'm a very happy person. I feel like I have a lot to live for. I have a family that I love and friends that help round out the experience. I can easily imagine circumstances that, if they confronted me now, would render my quality of life so low that I would seriously consider ending my life. I'm not saying that as a depressed person. I'm saying that as a very happy person who can contemplate terrible circumstances. If I lost my entire family - wife, step-daughter, parents and all in a terrible accident, I think it's fair to contemplate ending my own life after that. Could I persevere through the total destruction of everything I hold dear and come out on the other end? Maybe. But I don't fucking owe it to you or anyone else to scale that mountain.If I were to lose my motor skills and end up say, like Richard Hawking - I would consider ending my own life. Might I eke out some small happiness being taken care of 24/7? Maybe. But you know, I'm not a genius, and from my vantage point now - that of a happy person - that would entail the near-total destruction of my ability to do the things I love.

Nobody owes it to me or to you to stick it out in truly terrible situations. Sometimes people have a damn good reason to be down. Sometimes "depression" is a perfectly reasonable outlook to have. And if someone feels like that's their situation, and they really want to get off this ride - then they should absolutely be given the minimum of human decency, which is the help they need to make sure their exit is as peaceful and painless as possible.

[ShowOverBooks]

Bravo, Belgium (though I would remove the requirement of pain), and Kevorkian was a hero.

No... I am not advocating that these people be restrained and forced to live, but I am saying that their reasons for suicide would make it impossible for me to assist them. I also find it morally reprehensible that someone actually did.

I can completely understand and support euthanasia in cases where the person is in pain and there is no hope of that subsiding. This decision was not about that.

It was about two people in emotional pain.

[Relic]

I ran into an article while reading the newspaper in India a year or so ago that blew my mind. I took a (blurry) picture.

http://images2.travb...82779248881.jpg

An entire family of 18 asking for permission to die.

[Sixshells]

Unfortunately, Relic, the article is unreadable for me. Edit: but them killing themselves because they are destitute, according to the title, seems to me a terrible failure of society as a whole. How is it not pushing people to die?

Anyway, we are indeed talking past each other.

This story shows how euthanasia has grown rom being the ultimate recourse for dying patients to die in a more peaceful and dignified way to to assisted suicide, which is significantly more sketchy grounds.

I hear those defending people's right toask help in killing themselves, in cases like the one of those deaf and soon to be blind brothers. As well as respecting a preson's ability to end their own life. But.

A. If have to choose between forcing people suffering a lasting anguish and distress because of the impact a handicap or a chronic illness on their quality of life, and preventing people to be abusively pushed to death, sorry, but I choose the latter. When kept alive aginst your will, you have the ability to protest against that and make your case. A person who was wrongfully euthanised doesn't have that kind of luxury.

B. On suicide, some of you people seem to act like people weren't pushed to a place where the only escape they are able to get is through killing themselves. I have news for you: it happens all the time. I am all for respecting people's ability to choose to end their lives, but each time someone chooses so when they could have been helped, it's wrong, plain and simple.

There are a lot of circumstances that can push someone to kill themselves when it doesn't need to and where it should be helped. Financial distress for example. How about the reason a person chooses euthanasia is because the procedure that could help her with her handicap (and that she would agree to) was beyond her means? Peer pressure and more or less subtle forms of abuse and harrassement. What if an elderly person chooses euthanasia because of how, under the apparent sollicitude of her family and caretakers she feels she is being an imposition on them or that "others wouldn't bear to go on living in her state"? Or a person choosing to kill herself before her health degrades enough to need elderly care, partly out of fear of being dependent and badly treated?

RiL, I'm glad you are able to not suffer from those kinds of pressure, but that doesn't mean those who can't are less deserving of being given a chance to keep living under the pretense of accepting their choice to die. Bearing in mind the pressure to off yourself will be far greater if your are "non-functional" in your handicap or illness than if your are "functional".

And yes, how about depression? If a depressed person decides to kill herself, should we just sit idle by or even help her do it? Even though depression is manageable? Even though the person may simply need help to see other ways out of the situation that drove her there?

C.

As for organ donation/ harvesting....I do not see the concerns you have. Suicide is by default pretty selfish, so I hardly think they will care if someone thinks they are a bit more. Not all selfishness is wrong or bad, though, and I do not at all believe a persons selfish choice to commit suicide rather than live in agony or suffering is a bad or wrong choice in the slightest. It is a choice I support as I support a persons rights to their own life...that means they also have the right to end it; it is theirs.

The concern with the organ donation bit is the tying together of two very different major and ethically difficult decisions. Particularly asking organ donation at a point where the person is most likely vulnerable and not thinking very highly of herself.

It confuses thing and thus is not very ethically clean. There is also damage to trust in medical professions if they are percieved as pushing euthanasia to be able to harvest organs, even if they don't do so in practive.

D. Ultimately my concern isn't that terminally ill patients choose euthanasia because they feel it's a better option than the others available to them at this point. What makes me more uncomfortable is that making resorting to it more trivial, and covering more cases and more situations, it may become an easier way to deal with these situations rather than actually trying to make them better, or to provide proper end of life care.

Some food for thought (in french, with Google translate links):

- An interview with a person from the Belgian Federal Commission of Evaluation on Euthanasia explaining how the case of those two brothers was nothing new and corresponded to the conditions recognised to get euthanasia (translate).

- An op ed from a collective of Belgian medical doctors criticising the widening use of euthanasia, particularly instead of palliative care (translate). They also criticise the lack of control on the practice, it being done after the fact and depending on doctors reporting it; they claim the Commission itself is warning of its lack of ability to exert proper oversight. There are also interesting considerations about the attitude towards the end of life. You may agree or not with them.

- The reports of the Federal Commission of Evaluation on Euthanasia for the last years (pdf for the last year, in french, no version in english). What's interesting to see is there are strong differences between the regions on the matter as far more reports of euthanasia were made in dutch than in french. They are explained by the Commission as being caused by differences in information, and in sociocultural attitudes and end of life care between regions. They also point out the Commission is unable to determine the extent to which unreported euthanasias are practiced. (p. 14 in the 2012 report)