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euthanasia:start [2022/05/17 03:31] – old revision restored (2022/04/17 19:38) 216.244.66.245euthanasia:start [2022/05/17 14:50] (current) – old revision restored (2022/04/17 19:39) 216.244.66.245
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 ==== Social Science: Being suicidal is always a symptom of some other unmet need ==== ==== Social Science: Being suicidal is always a symptom of some other unmet need ====
  
-  - Among the terminally ill, we can see that a will to live changes frequently +FIXME transient will to live 
-    * According to the studies undertaken by professor Chochinov of Winnipeg, 80% of people who ask for death have bad pain relief and 60% are gravely depressed (Harvey M. Chochinov (dir.), Handbook of Psychiatry in Palliative Medicine, Oxford University Press, 2012).((http://alexschadenberg.blogspot.ca/2013/09/brief-presented-by-physicians-alliance.html)) + 
-    * [[http://www.economist.com/node/346303|The Economist]] +FIXME Oregon data and disability issues
-      * "The current medical model of suicide, which has spawned such a great increase in suicide-prevention and intervention efforts, denies absolutely that suicide, except for the terminally ill, can ever be a rational choice, and claims that society has an obligation to stop someone with an unbalanced mind from destroying themselves just as it would try to stop them from doing other harmful acts. The fact that suicide is utterly irrevocable just adds to the obligation to intervene." +
-      * "There is a great deal of evidence for this view. <del>Most people who fail at suicide, or who are rescued after an attempt, do not try to kill themselves again.</del>((Diane said there are other studies that take past suicide attempts as predictors for future attempts, increasing effectiveness too, so this may not be true or may at least be contested.)) Anti-depressant medication and counselling have helped many people banish suicidal thoughts. And yet the terminally ill also often have great difficulty in coming to a rational decision about whether they want to live or die. A study of 168 terminal-cancer sufferers published last month in the Lancet by researchers at the University of Manitoba in Canada found that their desire to go on living fluctuated greatly, depending largely on their experience of distressing symptoms. Given this, should not society reinforce the taboo against suicide and resist even a relaxation of laws against euthanasia?" +
-    * FIXME The Lancet, Harvey Max Chochinov, Douglas Tataryn, Jennifer J Clinch, Deborah Dudgeon, September 1999, Volume 354 (Issue 9181), p.816-819 +
-    * [[http://www.nytimes.com/1999/09/04/us/terminal-cancer-patients-will-to-live-is-found-to-fluctuate.html|NYTimes]] +
-       * "study by Canadian researchers suggests that in the weeks before death, cancer patients show substantial fluctuations in their will to live. And the factors that contribute to a loss of that will shift over time, the researchers found, and often involve suffering that can be alleviated through treatment." +
-       * "Dr. Chochinov and his colleagues studied 168 cancer patients admitted to the hospital for end-of-life care. The patients were screened to make sure that they had the mental competence and the physical strength to participate in the study, which involved filling out a questionnaire twice a day -- a process that Dr. Chochinov said took about a minute -- and continued until shortly before death. The participants were asked to rate themselves on 100-point scales measuring pain, nausea, appetite, activity, drowsiness, sense of well-being, depression, anxiety and shortness of breath. They also rated the strength of their will to live." +
-       * "Most of the patients in the study were elderly, although the youngest was 31 (and the oldest 89). On average, the participants survived for 18 days after entering the hospital. One woman, however, survived for more than 150 days." +
-       * **"Over a 12-hour period, Dr. Chochinov said, the patients' will to live could fluctuate by 30 percent or more. Over a 30-day period, the shifts were even larger, on average up to 60 percent or 70 percent."** "These large fluctuations suggest that will to live is highly unstable," the researchers wrote. +
-       * :!: "In the period just after a patient entered the hospital, a decrease in the will to live was most strongly associated with anxiety, perhaps as a result of the psychological shift required in moving from out-of-hospital care, Dr. Chochinov said. One to two weeks afterward, the researchers found, depression was the symptom most strongly associated with decreased will to live." +
-       * "But in the final days of life, physical distress -- specifically pain and shortness of breath -- repressed patients' will to live more strongly than psychological suffering." +
-  - We need to look at the real reasons that people take assisted suicide +
-    * people think that pain is the #1 reason, but it's not in Oregon((http://time.com/4068423/physician-assisted-suicide/)), for example, [[https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year18.pdf|1998-2014 data, published 2015]]: +
-      * 92% losing autonomy +
-      * 89% less able to engage in activities making life enjoyable +
-      * 79% loss of dignity +
-      * 50% losing control of bodily functions +
-      * 40% burden on family, friends/caregivers +
-      * 25% inadequate pain control or concern about it +
-      * 3% financial implications about treatment +
-    * :!: physical pain (or fear of) is not the main concern +
-    *  **"These are disability issues"**((http://notdeadyet.org/assisted-suicide-talking-points)) +
-      * FIXME graphic of person in wheelchair with ramp to assisted suicide and stairs to suicide prevention program+
  
 ==== QUIT Ablism ==== ==== QUIT Ablism ====
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     * Peter Singer: love > his philosophy     * Peter Singer: love > his philosophy
  
-===== Position 3: Pro-Life Alternatives ===== 
- 
-  * The pro-life position is not vitalism, getting every last beat out of that heart 
-    * FIXME extraordinary vs ordinary care, refusal of treatment 
-  * The pro-life position isn't just saying no to suicide, but it's offering positive forms of care instead 
-    * FIXME Dignity Therapy