Just Hurry Up and Die, Will Ya?

[Don Corleone]

Not treating someone who will otherwise die is not euthenasia, it's treatment stoppage.

Is there anything in there about how it's ok to administer lethal morphine doses?

Do we really need to delove to semantics games? Would you really argue that a couple that refused to feed their 6 month-old child was "exercising their right to make a decision of quality of life for a loved one"?

[HoreTore]

But that's my entire point. I object not to the information, but the way it's framed as its presented. The booklet is an endless series of anecdotes and "questions", designed to lead you to understand euthanasia is okay in case A, in case B, in case C. But what about the guy who doesn't want to be euthanized in case A, B or C? There's nothing in the booklet that supports that point of view, though this is put forward as "an objective look at end of life issues", but it's not. It's a defense of euthanasia, and if anything, hints strongly that it's the preferable course of action.

See, this is where we disagree. First of all, all I see it saying, is that stopping treatment is an option. An option that needs to be considered. How is that wrong? For or against, that remains a fact.

Secondly, I do not see any problem for a guy who doesn't want his treatment ended. Actually, the way I read this pamphlet, is that prolonging life is seen as the default choice, and that this pamphlet is about making you think about whether that's what you want or not.

[Don Corleone]

See, this is where we disagree. First of all, all I see it saying, is that stopping treatment is an option. An option that needs to be considered. How is that wrong? For or against, that remains a fact.

Secondly, I do not see any problem for a guy who doesn't want his treatment ended. Actually, the way I read this pamphlet, is that prolonging life is seen as the default choice, and that this pamphlet is about making you think about whether that's what you want or not.

You say tomayto and I say tomahto? Fair enough.

Before I drop it completely though, one last time for those of you that are confused and I think I'm arguing against end-life-care decision counseling, I'm not. I personally am not afraid to die, though I am terrified immensely of unnecessary and prolonged agony, or loss of identity (Alzheimer's runs frighteningly high in my family). I'm not certain I won't even be a bit proactive, given a Kobyashi Maru scenario.

However, I have made these considerations and I have made that choice. Who the hell am I to tell anybody else "well, if you weren't so selfish, you'd see that you should kill yourself, or at least deny feeding/treatment and let yourself die, but hey... you do what you want...", which is exactly how this pamphlet reads to me.

[TinCow]

It's a defense of euthanasia, and if anything, hints strongly that it's the preferable course of action.

Do we really need to delove to semantics games? Would you really argue that a couple that refused to feed their 6 month-old child was "exercising their right to make a decision of quality of life for a loved one"?

It's not semantics, there are very significant legal differences between refusal of medical treatment and euthanasia. I believe part of your problem with this document comes from a confusion between those two separate issues.

[Don Corleone]

It's not semantics, there are very significant legal differences between refusal of medical treatment and euthanasia. I believe part of your problem with this document comes from a confusion between those two separate issues.

Alright, let me turn the question on you. You're saying that denial of feeding is a form of withholding of medical treatment. So, let me ask you.... if a young couple decides not to feed an infant, are they not simply making a "quality of life, end of life care" decision on behalf of a loved one?

[HoreTore]

Alright, let me turn the question on you. You're saying that denial of feeding is a form of withholding of medical treatment. So, let me ask you.... if a young couple decides not to feed an infant, are they not simply making a "quality of life, end of life care" decision on behalf of a loved one?

Let me help ya, Don:

It's not semantics, there are very significant legal differences between refusal of medical treatment and euthanasia. I believe part of your problem with this document comes from a confusion between those two separate issues.

And your example isn't sound, Don. The infant hasn't stated whether he wants to be fed or not(let's say it's a quiet baby for a second...). So, we must guess whether he would want food or not. I'd say it's fairly certain that it wants food... As for the person with dementia, you also have to guess whether he/she wants to be kept alive artificially. With a living will, there's no need to guess, the persons wishes are crystal clear.

Hence the reason why having a living will is important.

[Philippus Flavius Homovallumus]

Do we really need to delove to semantics games? Would you really argue that a couple that refused to feed their 6 month-old child was "exercising their right to make a decision of quality of life for a loved one"?

There's difference between a helpless child and a terminally ill pensioner. The baby can take food itself, the woman requires an operation.

In fact, if you offer the baby food it will take it, the woman not. So the baby can, however primatively, express an opinion.

[TinCow]

Alright, let me turn the question on you. You're saying that denial of feeding is a form of withholding of medical treatment. So, let me ask you.... if a young couple decides not to feed an infant, are they not simply making a "quality of life, end of life care" decision on behalf of a loved one?

If we exclude juveniles from the equation, yes, refusal of feeding is a form of withholding medical treatment. The law in most states is pretty clear that no one can force another person to receive medical treatment, except in rare situations where they are found to be incompetent.

When minors are introduced to the equation, it's far more complex and there's no generally accepted rule on the situation (which, I suspect, is why you chose to focus on it). Current US state and federal law has not determined where the line is drawn on the issue of parental authority over medical decisions involving a minor. The law is clear that parents have the right to make medical decisions for their children in their role as guardian. However, child abuse is also illegal. Issues arise in borderline cases where the parents are making a medical decision that some people consider to be child abuse. I'm not going to pretend like I know what the right answer is to that hugely complex issue.

However, that's pretty much exclusively an issue involving minors. Since this pamphlet is specifically targeted at adults, the issues that are involved with the introduction of juveniles are irrelevant. So that I don't entirely dodge the question... in the example you give, it's a no-brainer. You're not talking about a medical situation, you're talking about starving a baby who is otherwise healthy. In that scenario, the parents go to jail and kid is put in a foster home, guaranteed. Give that kid terminal cancer and put them in a coma, and it's entirely different.

[Lemur]

The 800-pound gorilla in the room is simple enough: 90% of your healthcare expenses will likely be incurred in the last six months of your life. As one nurse posted on another forum, how many times do you want to be resuscitated when it's obvious you will never breathe, eat or move again without mechanical assistance?

In this respect, living wills are a boon. I never, ever want to wind up in a Terry Schiavo situation, with different relatives bickering and dickering over what my "real" intentions are. As several posters have pointed out, a living will spells out your intent and saves everyone involved a lot of guesswork and freaking out.

And that living will can say whatever you like. If you want every option for keeping you around to be used, you can spell it out. It's hardly a one-way ticket to euthanasia.

[Askthepizzaguy]

Alright, let me turn the question on you. You're saying that denial of feeding is a form of withholding of medical treatment. So, let me ask you.... if a young couple decides not to feed an infant, are they not simply making a "quality of life, end of life care" decision on behalf of a loved one?

Your example of the Democrats pushing an agenda of euthanasia was not euthanasia, and many disagreed with you that there was a bias towards choosing to allow someone to die naturally. The question is simply asked whether you know for sure whether or not the person in question wants extraordinary measures to stay alive, when a significant percentage of people would prefer not to have such measures if they were in a vegetable-like state or otherwise unable to speak for themselves.

The entire debate we're having here is that within a pamphlet asking serious questions that you agree need to be asked about living wills and end-of-life care, you consider the wording to be slightly biased, and based on that, Obama and the Democrats are trying to destroy veterans and the elderly to save a buck (yes, those same tax-and-spend Democrats who don't care about out of control spending ). I apologize, but this is all hype and no substance in my opinion, and distracting from the larger issue. Come to think of it, scratch that, it's distracting from the issue. There is no issue of euthanasia here that I can see.

I see no bias whatsoever towards choosing termination over life, just a bias towards making sure people know what a person's wishes are. But you know what? Even if this were a government-sponsored screed against choosing life, courtesy of the Democrats and stamped with their approval, it would still be a legal point of view (one I would disagree with). I could point out examples of bias and government-sponsored discrimination that I find wholly offensive, such as discharging someone from their lifelong career, who has earned medals for their valor in combat, merely for preferring persons of their own gender. That would be something which is part of the platform of a certain political party, and there's plenty of reading material out there endorsing that point of view, up to and including the actual regulations of the military itself, thus making it mandatory. Nothing the Democrats have proposed about end of life decisions or planning has been mandatory, to my knowledge.

One is a very real outrage and injustice, the other is a suggestion to plan ahead about a choice you would have to make anyway. One is the very definition of injustice and intolerance and double-standards, (especially since it apparently does not bar you from performing any other kind of team-oriented and highly dangerous work) the other is a suggestion to decide how you want to handle a difficult situation before you're placed in that situation, akin to asking people to keep emergency numbers near their telephone but not even making it mandatory.

It's an outrage based on nothing at all in my opinion, but we are free to disagree. I don't think either side is making headway convincing one another. However, I want you to know I examined your evidence with an open mind, and listened to every point you made very carefully to see if I could possibly understand your point of view, even if I disagreed with end of life planning as a concept... under the circumstances I still cannot, sorry.

This final, above example I quoted from you seals it in my mind that there is nothing to this matter, we aren't discussing starving an infant. We're discussing that it is possibly a good idea, but not mandatory, to plan ahead for the eventual and inevitable conditions immediately preceding one's own death or the death of a loved one, and what measures, extraordinary or not, should be made to keep someone alive, in essence determining where the "do not resuscitate" order takes effect, or what treatments are refused or accepted. And yes, there may be a bias in how it is phrased, because as it stands, the DEFAULT condition is to accept treatment. Doctors and nurses are required, in the absence of orders to the contrary, to keep you alive no matter how painful or terrible your life may become, to the point of absurdity in my mind, but hey... we want to save your life, don't we? And unless you tell us not to, that's what we are obligated and compelled to do out of human compassion and respect for your life, whether we would want to exist under such circumstances or not. The BIAS is already towards choosing life in all circumstances, to err on the side of caution.

The entire point here is because (I won't say most people) a significant percentage of people would consider it to be absolutely awful to have to endure certain conditions and have already opted-out of extraordinary measures to sustain their life under certain circumstances which they have predetermined, and given that is a legitimate point of view and it is a personal matter no matter which way you'd prefer it to go, and sometimes people disagree on what they would want to happen to them, it is best to determine ahead of time what you want to happen, because someone else may choose differently for you.

Don't put a feeding tube in me, don't shove a vent down my throat, don't shove all kinds of IVs and tubes and bags in here or there, don't continue this treatment if the doctor concludes the condition is very much terminal, don't try experimental drugs, etc ; if patient reaches condition X (and they can define condition X all for themselves) and can no longer speak for themselves, what would they want? And yes, at the end of the day, a feeding tube is an intervention, which may be unwanted or uncomfortable, and an extraordinary measure to keep you alive that is wholly different from feeding an infant from a spoon or a bottle. Just like a being put on a machine that breathes for you.

[Hosakawa Tito]

The 800-pound gorilla in the room is simple enough: 90% of your healthcare expenses will likely be incurred in the last six months of your life. As one nurse posted on another forum, how many times do you want to be resuscitated when it's obvious you will never breathe, eat or move again without mechanical assistance?

In this respect, living wills are a boon. I never, ever want to wind up in a Terry Schiavo situation, with different relatives bickering and dickering over what my "real" intentions are. As several posters have pointed out, a living will spells out your intent and saves everyone involved a lot of guesswork and freaking out.

And that living will can say whatever you like. If you want every option for keeping you around to be used, you can spell it out. It's hardly a one-way ticket to euthanasia.

From my experience the decision for extrordinary measures to prolong life is the default option when the patient's wishes are not known. Living wills put control of that decision in the hands of the patient, where it belongs. This "death panel" scare mongering is complete . Paying a doctor to explain/counsel/give guidance/information to help the patient decide what they feel is best for them and their loved ones. I see nothing wrong or unethical about that, and encourage everyone to talk with their loved ones about these issues and document them via a living will.