Terry Pratchett : Choosing to Die

[Graham Kennedy]

A rather harrowing documentary featuring Terry Pratchett investigating the world of assisted suicide. I don't know if non UKers will be able to view it, but if you do get a chance to see it have a hanky handy. Seeing this talented man casually mention how he's lost the ability to type and contemplate the fast-approaching day when "words will fail me", and whether he will really want to carry on living like that... it's heartwrenching.

He also accompanies a couple of people to a Swiss clinic where people end their lives. And be warned, the program shows one of these people actually going through the process. Bad as it is, the intrusion of legal oddities on it make the whole thing surreal - legally the clinic cannot be located in a residential area, so it's a little blue metal building in the middle of an industrial estate, surrounded by factories. And since the law it operates under allows "self determination", they can't actually end your life - instead, they have to hand you a glass of poison which you drink yourself. "You must drink it all in one go," says the doctor. "If you sip it you will fall asleep and it won't kill you."

And the nature of Pratchett's Alzheimers causes him to reflect that "by the time you are actually ready to ask for an assisted death, you may not be able to speak. And so the Alzheimers patient would have to choose to die earlier than might really be necessary."

Worst of all, of the two thousand or so assisted deaths that the clinic has handled, 21% of them are people with no medical problem at all who fell into the category of having a "weariness for life".

[Mikey]

I don't know if non UKers will be able to view it

"Not available in your area."

However, it's high time someone has addressed this topic from the inside, as it were. It's difficult for me to comment completely without having seen the program, but I'm highly bothered by this bit:

Worst of all, of the two thousand or so assisted deaths that the clinic has handled, 21% of them are people with no medical problem at all who fell into the category of having a "weariness for life".

Can this place which terms itself a medical institution really somehow justify aiding in the suicide of people without some sort of medical rationale for choosing euthanasia? This is completely separate from the case of someone with a terminal wasting disease which will end with the patient having such a hugely reduced quality of life a/o chronic pain that death could be considered preferable; this is the all-too-common case of someone choosing suicide. While I can intimately understand the people who do consider that, it's no place for a "clinic" of this nature in which to involve itself.

[Graham Kennedy]

The justification their guy cited legally is a right to self determination from Article 8 of the European convention on Human rights.

I have to say that statistic surprised the hell out of me and shook my attitude up somewhat. Do I have a right to just end my life because I feel like? My gut says no... but really, it's my life isn't it? If I really wanted to end it, who exactly has the moral imperative to tell me I may not?

No easy answers.

[Mikey]

I'm not talking about anyone's right to suicide. I'm talking about a "clinic" assisting people in committing suicide where there is no medical rationale. If you decide to commit suicide, that's your right as much as I'd rather you didn't. If you had a doctor help you do so when you don't have a condition justifying euthanasia, then I have a HUGE problem with him.

[Deepcrush]

I don't see the problem with this. If someone wants to die just let them die. Whats the point of forcing someone to stick around if they don't want to be here.

[Mikey]

I don't see the problem with this. If someone wants to die just let them die. Whats the point of forcing someone to stick around if they don't want to be here.

Nothing's wrong with it. But if you don't have a medical condition which makes life documentably worse than death, I have a very large problem with doctors getting involved.

[Tsukiyumi]

Yeah, they could always just buy a gun and do it themselv... oh, right... Europe.

[Graham Kennedy]

Nothing's wrong with it. But if you don't have a medical condition which makes life documentably worse than death, I have a very large problem with doctors getting involved.

Why?

I mean, if we do accept that people have a right to end their life, and we do accept that it's okay for them to do that even if it's not due to some medical problem, and we do accept that it's okay for a doctor to assist them in ending their life, why does it become wrong for that to happen in combination?

[Captain Seafort]

Why?

Because if someone decides to end their life because they are suffering from a terminal illness that will result in a slow, painful death, then assisting them in doing so can be treated as a preemptive form of pain relief. If they are otherwise healthy, then that argument is void. Moreover, if someone wishes to end their life for no other reason, effectively, than boredom, then it brings their mental health into serious question, and with it their competence to make such a decision.

[Graham Kennedy]

But that's an argument that we should restrict when people can end their own lives at all rather than that we shouldn't help them to. Mikey specifically said he had no problem with people killing themselves out of what you call boredom, but he did have a problem with doctors helping them to do so.

[Captain Seafort]

But that's an argument that we should restrict when people can end their own lives at all rather than that we shouldn't help them to.

It's both. However, short of sedating them and feeding them through a tube, society's options when it comes to stopping someone taking their own life are limited, and ultimately, as you said earlier, it's their body. Prohibiting medical professionals from assisting in such a suicide is another matter entirely, as they would not be acting as "preemptive pain relief", as in the other cases mentioned, but acting to terminate a life that would not otherwise end in the forseeable future.

[Graham Kennedy]

Maybe so, but it's the specific objection to one but not the other that I was questioning.

Here's one for you : do you think it's possible that a person can want to end their life whilst being completely sane?

[Lighthawk]

Nothing's wrong with it. But if you don't have a medical condition which makes life documentably worse than death, I have a very large problem with doctors getting involved.

I'm with Graham on this, why? Wouldn't allowing people to kill themselves in a clinical setting where their body can readily be properly handled by a means that gives the greatest likelihood of a clean and painless death be a preferable alternative to someone trying to off themselves in their own homes by means that might fail or be agonizing and even if successful leave a body for some unfortunate friend or love one to stumble across after a period of time that could allow all sorts of diseases or parasitic critters to grow?

[Mikey]

@ GK and Lighthawk - Why? Because, as Seafort said, in the case of medical euthanasia the termination of life is the last resort of palliative care. This is patently NOT the case for a medically-sound but suicidal individual. Therefore, the responsibility and sphere of influence of a physician is completely out of the picture in the latter case. You might as well say that construction workers have a similar responsibility to help suicidal individuals kill themselves.

In fact, a doctor's responsibility - by dint of his profession and his oath - in the case of a suicidal person would be to get them psychological care, not to help them commit suicide when such a desire could so easily be a symptom of mental disorder. A physician who helped someone kill themselves when no palliative medical reason was present would not only be outside of his sphere, but criminally derelict of the responsibilities of his profession.

do you think it's possible that a person can want to end their life whilst being completely sane?

Absolutely. There's a better-than-average chance that I will become blind, disabled of some motor function, a/o incur one or more amputations, so "what ifs" regarding medical situations are something I've spent dome time thinking about. In the case of unresponsive chronic pain (I should say, greater unresponsive chronic pain than what I have now) associated with a terminal condition, I'd certainly call suicide an extreme but sane consideration.

[Graham Kennedy]

And do you think that it's possible for a healthy person to end their life whilst being completely sane?