Assisted Dying
Mar. 21st, 2020 01:49 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
ysabetwordsmithWhat is unbearable suffering? The few places to allow assisted dying tend to restrict it to the terminally ill.
The following discussion is controversial.
In less political terms, unbearable suffering is when someone decides their body/mind/life/world hurts too much, they are done with this life, and choose to die. That's pretty common with terminally ill people who are in agony. But it's not limited to that. Other common cases:
* Nonfatal, degenerative diseases that destroy the quality of life -- a leading example is dementia. Current technology cannot cure a lot of things. Some people don't want to spend a decade or more suffering before achieving natural release.
* Incurable mental or physical conditions that aren't lethal but are miserable -- a leading example is depression. People are urged to "get help" but some sufferers have been doing that for decades when they reach the conclusion that the medical industry cannot, in fact, help them and they wish to stop suffering.
* Having make mistakes so horrendous that they are not willing and able to live with them -- a leading example is causing the death of other people, especially loved ones.
* When a thorough examination of the options available to them does not reveal one they are willing and able to live with -- a leading example is suicide among doctors, lawyers, and other people whose education runs up debt so high they can only pay it by working that career, but then they discover it is soul-destroying.
* When it is not possible for them to obtains the means of a livable life -- a leading example is farmers in India drinking agrochemicals due to monstrous debt and inability to grow enough to sustain themselves and their family.
* When they find the world around them so abhorrent that they cannot in good conscience participate in it -- a leading example is the highest form of protest permitted to Buddhist monks.
There are, of course, many people who have suicidal thoughts but do not really wish to die. They deserve as much help as they want. In America at least, very few of them get help, which is a blight upon society. Of those who do, sometimes it actually works, they stop thinking about it, and feel very glad to have their lives back. That's great. But not everyone has problems that medicine or society can or will fix. They are then left to their own devices.
Most societies treat people as livestock in this regard. No amount of suffering justifies choosing to die. Society demands the right to torture people for decades, simply by refusing to let them leave. Religions often explicitly deny humans freedom of will over their own lifespan, assigning responsibility to some other entity considered more important. (Conversely, some other religions encourage suicide in certain situations, which is a different problem.) This creates a lot of tension, especially where different societies or religions disagree with each other.
Consent and body autonomy, however, paint a different picture. If you can't say no, then yes is meaningless. It is your body and you decide what happens to it. The most fundamental right of life is actually the right of death: the right to say, "I am done now. I am leaving." In fact, when people have that right, they are less likely to use it; they want the choice, so they can escape if the suffering ever becomes too much. Just that freedom makes suffering more bearable for many people. (Consider a comparison: people in charge of their own pain medication take less on average than when someone else controls that.) Choice matters that much to people.
If society does not respect people's freedom to die, then some people will take it by force. This denies them the right to a reasonably painless death with dignity, having made what final arrangements they can, and having enjoyed a chance to say goodbye if they have friends or relatives. People who have benefited from assisted dying have expressed gratitude for these things, and people forced to flee their bodies in secrecy have condemned being cheated of them -- literally, treated as less than animals, which are granted a peaceful death if they cannot be healed.
And so, like sex, it's not a matter of whether this happens. It always happens. Some people will choose to die rather than suffer, regardless of the pressure applied to force them to remain. What we have left to decide is how comfortable and humane that passage will be.
The following discussion is controversial.
In less political terms, unbearable suffering is when someone decides their body/mind/life/world hurts too much, they are done with this life, and choose to die. That's pretty common with terminally ill people who are in agony. But it's not limited to that. Other common cases:
* Nonfatal, degenerative diseases that destroy the quality of life -- a leading example is dementia. Current technology cannot cure a lot of things. Some people don't want to spend a decade or more suffering before achieving natural release.
* Incurable mental or physical conditions that aren't lethal but are miserable -- a leading example is depression. People are urged to "get help" but some sufferers have been doing that for decades when they reach the conclusion that the medical industry cannot, in fact, help them and they wish to stop suffering.
* Having make mistakes so horrendous that they are not willing and able to live with them -- a leading example is causing the death of other people, especially loved ones.
* When a thorough examination of the options available to them does not reveal one they are willing and able to live with -- a leading example is suicide among doctors, lawyers, and other people whose education runs up debt so high they can only pay it by working that career, but then they discover it is soul-destroying.
* When it is not possible for them to obtains the means of a livable life -- a leading example is farmers in India drinking agrochemicals due to monstrous debt and inability to grow enough to sustain themselves and their family.
* When they find the world around them so abhorrent that they cannot in good conscience participate in it -- a leading example is the highest form of protest permitted to Buddhist monks.
There are, of course, many people who have suicidal thoughts but do not really wish to die. They deserve as much help as they want. In America at least, very few of them get help, which is a blight upon society. Of those who do, sometimes it actually works, they stop thinking about it, and feel very glad to have their lives back. That's great. But not everyone has problems that medicine or society can or will fix. They are then left to their own devices.
Most societies treat people as livestock in this regard. No amount of suffering justifies choosing to die. Society demands the right to torture people for decades, simply by refusing to let them leave. Religions often explicitly deny humans freedom of will over their own lifespan, assigning responsibility to some other entity considered more important. (Conversely, some other religions encourage suicide in certain situations, which is a different problem.) This creates a lot of tension, especially where different societies or religions disagree with each other.
Consent and body autonomy, however, paint a different picture. If you can't say no, then yes is meaningless. It is your body and you decide what happens to it. The most fundamental right of life is actually the right of death: the right to say, "I am done now. I am leaving." In fact, when people have that right, they are less likely to use it; they want the choice, so they can escape if the suffering ever becomes too much. Just that freedom makes suffering more bearable for many people. (Consider a comparison: people in charge of their own pain medication take less on average than when someone else controls that.) Choice matters that much to people.
If society does not respect people's freedom to die, then some people will take it by force. This denies them the right to a reasonably painless death with dignity, having made what final arrangements they can, and having enjoyed a chance to say goodbye if they have friends or relatives. People who have benefited from assisted dying have expressed gratitude for these things, and people forced to flee their bodies in secrecy have condemned being cheated of them -- literally, treated as less than animals, which are granted a peaceful death if they cannot be healed.
And so, like sex, it's not a matter of whether this happens. It always happens. Some people will choose to die rather than suffer, regardless of the pressure applied to force them to remain. What we have left to decide is how comfortable and humane that passage will be.
Re: Thoughts
Date: 2020-03-22 12:03 pm (UTC)And it breaks my heart that we can show more mercy and compassion to our animal friends than our own family. That we (and the doctors) think it’s more noble to lie in bed in pain, confused, scared, and helpless. That it makes us better humans when we say we can’t kill people just because it’s convenient.
It breaks my heat and makes me unreasonably angry and frustrated that people can’t seem to understand the difference between killing and letting a loved one go.
Re: Thoughts
Date: 2020-03-23 02:24 am (UTC)Exactly. I just don't think it's okay to torture people, and the way most people die nowadays is torture. >_<
>> That it makes us better humans when we say we can’t kill people just because it’s convenient.<<
Well, there is a very credible threat of murdering people because they aren't wanted. Once euthanasia becomes legal, some people will pressure the old, sick, and especially disabled to "choose" it when they don't want to -- or simply murder them and lie that they wanted to die. So any program for the right to die has to account for that, because murder is not okay.
My best thought would be to distinguish facilities based on whether or not they offer that service, because lots of people have really strong feelings about it and wouldn't want to work in the other kind of place. But that would require having enough facilities to meet everyone's preference and the money to fund both well enough to ensure a FREE choice.
I haven't really figured out a solution for the dilemma that everyone has free will, but some people want to die for mistaken reasons, so if it's too readily available that would run up the suicide rate undesirably; whereas gatekeepers could easily prevent people from dying, thus denying an important right and prolonging the suffering.
I'm curious about your thoughts on these dilemmas, from your clinical perspective.
>> It breaks my heat and makes me unreasonably angry and frustrated that people can’t seem to understand the difference between killing and letting a loved one go. <<
That's because most Americans don't have the skills to make a difference. They don't know how to kick off their body without destroying it by force. That's distressing for everyone.
But it's not the only way. Native American practices entail the kind of spiritual experience that facilitates a deliberate departure, phrased as "dropping their robes." Tolkien wrote about it as the gift of Numenor. In Amish culture, someone actually had to make up a medical code for "took to his bed" -- when an old or sick person decides it's time to die, they lie down, and their family takes care of them while everyone visits. It usually takes a couple of weeks and then they die.
Compare birth and death. Both are natural processes that are essential for the species. If you know how they work, they may be uncomfortable but not too scary, and sometimes really fantastic experiences. If you don't know what you're doing and/or the people around you screw up the process, it's absolutely miserable and people can get really hurt.
America doesn't know enough about death to keep people from getting brutalized. It's awful. And that runs up the suicide rate among people determined to get while the getting's good, because they don't want to risk getting trapped and tortured to death.
Re: Thoughts
Date: 2020-04-06 01:07 pm (UTC)I do understand the complex thoughts about euthanasia and groups it will be pressured on. And it will be. Humanity has a long, long history of getting rid of people or groups of people that are inconvenient and don't fall into line with others. The ones who believe differently, who look different, who act different. The ones who are considered a burden and baggage. The ones who aren't productive and useful. Sure, the first in line would be chronically ill or otherwise disabled people and the elderly, but at some point it would expand to include people who are in some way or another considered freeloaders. But if this current pandemic has taught us anything, it's that we need people who aren't productive in the capitalistic sense. We need people who aren't corporate and who have minds of their own, the kind who give us art, music, literature... all we're so desperately consuming now in isolation.
Sorry. That got away from me.
I guess the only viable way of ensuring that people have the freedom to choose their last days is to talk about it. A lot. Just like we talk about pap smear tests and prostate screening, of breast cancer screening and annual dental check-ups. It should be just as an everyday topic as buying a house or choosing a bed. It shouldn't be covered in mysticism and fear, it should be... just talked about. I don't mean that death should be trivialized and reduced to clinical facts but it shouldn't be a taboo. For fuck's sake, we have birthing plans, we should have death plans as well! And considering that a human individual isn't as close to death as they are at the moment of birth, it's a valid comparison.
...What I mostly mean is that we should talk more about death and dying to remove the fear surrounding it so that we could fully concentrate on grieving the loved ones we're losing. It's all the extra stuff that makes it so hard and, frankly, stupid to deal with.