Dementia suicide ethics - discussion from the NYT (long-term, spouse, 2014)

[kavm]

@katharsis - May I please request that we keep from the characterization of assisted suicide as murder? Without arguing with your well considered rationale, I fear that these discussions can easily get inflamed and attract completely unproductive attention preventing any useful discourse. And, insisting on calling what is a person exercising their own free choice to end their own life with assistance of others as murder might well achieve that - irrespective of your intentions.

We can all call it what we like - but I see it as an individual exercising the ultimate right over their own body and life. I am sorry that there is not better legal support for this basic right.

-----------

Back on topic, the limitation of the assisted suicide laws on books in a limited number of states in the US is that they require a terminal diagnosis. And, diagnoses such as dementia or Alzheimer's are not terminal and, therefore, do not qualify. And, it is not a decision one can make through a advance directive. Those with means can go to Switzerland and/or Belgium (not sure but someone mentioned) to exercise their choice without a terminal diagnosis, but that's not an option available to a lot of people. And, it should not be so complicated.

[leastprime]

Originally Posted by kavm

For those interested in this topic, there is a book - In Love: A Memoir of Love and Loss by Amy Bloom. It’s a similar story (very well written) of her husband getting an Alzheimer’s diagnosis and getting an assisted suicide, I think, in Switzerland. A friend, a neurologist himself, is facing a similar situation with his mother and mentioned it to me this morning.

As you wrote, we were listening in the car….
On our way home from day trip to witness the fall colors in the Northern Cascades (US 2) and Leavenworth’s Oktoberfest, we Listened to the Podcast version, on “ThisAmericanLife.org“ , #779, Ends of the Earth. Sept 16, 2022. Amy Bloom.
YLMV

[StealthRabbit]

Originally Posted by Teacher Terry

I learned through my dad’s and friend’s illnesses that there are worse things than dying. I never pray for someone to live but rather for their best and highest good. I realize that I don’t know what that should be.

Same here by investing 32 yrs of my prime life doing very thankless eldercare for a combative parent.

I'm not the ultimate judge / controller of my own life, much less the life of others. I don't have that right, or responsibility. Whether an innocent infant, or a mindless or vegetative adult.

I have my preference, but I'm not the one in charge.
Had many 'pull-the-plug' decisions to make during my many caregiving years. A lot to burden an 18 yo with. But we issue them rifles and instruct them to kill humans, so they're all grown up to handle that choice.

[katharsis]

Originally Posted by kavm

@katharsis - May I please request that we keep from the characterization of assisted suicide as murder? Without arguing with your well considered rationale, I fear that these discussions can easily get inflamed and attract completely unproductive attention preventing any useful discourse. And, insisting on calling what is a person exercising their own free choice to end their own life with assistance of others as murder might well achieve that - irrespective of your intentions.

We can all call it what we like - but I see it as an individual exercising the ultimate right over their own body and life. I am sorry that there is not better legal support for this basic right.
.

Point taken, and I have no problem with that. As you probably know, judging from your reply above, many people who are against euthanasia and assisted suicide will often hurl the term "murder" at those of us who are in favor of it in very specific situations and with the safeguards that I listed, in an attempt to try to "cow" us and put us on the defensive -- but obviously, such tactics do not work with me.

But, again, I will refrain from using that term in the future unless it is to reply to someone who used that term first.

[CalWorth]

I was only 25 when I helped my much-older sister with our father who had dementia. He was a horrible father & I did it for my sister. He was very violent toward me & the whole process was very traumatic. I knew that his mother & most of his siblings also had dementia so this has haunted me for most of my life.

I’m not going to live like that, absolutely not.

[webster]

It's easy to say suicide assisted or not is wrong, but those who are against it...well, are they willing to provide the resources 24/7 so the ill person can live in dignity?

[elnrgby]

I think an option of assisted suicide should exist, and I think anyone who can demonstrate that he/she understands the meaning of the word "suicide" but is not physically capable of taking the necessary steps to commit suicide, should be able to use this assistance from people willing to provide it. I personally don't think I could provide it because the need I feel to fight for preservation of other people's lives is just too strong; it had been drilled into me professionally (in the summer of 2018, I was walking down the street, and saw a bird on the sidewalk that might have been hit by a car, and was having violent seizures. It would have been probably the best for the bird if someone would just stomp it to death or smash it with a stone. But I couldn't do it, I just pushed the bird from blazing sun to a shade. When I walked by a short time later, the bird was no longer there, so somebody did the deed after all, or at least some prowling cat had a good lunch).

Nobody in my family, on either side, had dementia. My father's two aunts who lived over 100 years were lucid until the end. The one who lived to 108 just slept a lot, but when she was awake, she was conversational. She could feed and toilet herself normally, and her main psychologic complaint (same as that of my grandfather who lived to 99) was that all the interesting people had died, and the modern life was very boring. But I was told she would really perk up and become quite animated when something from the 1920s was mentioned.

I saw patients with dementia of course, but I had to deal with them only for limited times, and in situations in which normal people often can act disoriented too. But I am sure those who have seen dementia 24/7 for extended time with a beloved (or not beloved) relative must have a different perspective.

If I were to start developing dementia and had insight in it like the man in the letter to the NYT, it certainly would not give me suicidal thoughts; it would give me thoughts of that nursing home in Bangkok :-). It is a part of my advanced directive that I request sedation and pain treatment in the doses sufficient to make me comfortable even if such doses could potentially hasten death. That request is perfectly legal in the US, and I think it tends to be honored ("Steven P. Jobs died at home in Palo Alto, Calif., of respiratory arrest caused by a pancreatic tumor at about 3 p.m. on Wednesday, according to his death certificate. The Santa Clara County Public Health Department in San Jose, Calif., issued the death certificate on Monday"........ Well, by what physiologic mechanism do you think pancreatic cancer causes respiratory arrest?)

[TheShadow]

Originally Posted by Crazee Cat Lady

I subscribe to the NYTimes, here is a share- or gifted link to get you beyond the paywall.


https://www.nytimes.com/2023/10/06/m...smid=url-share

Thank you for that.

[kavm]

I suppose the point is that a person should have the right to make their own choice. It is not what you or I might do but whether the person facing the situation has the right to decide what they would like done. And, to me that should be an inalienable right.

Also, the riders such as ‘as long as they demonstrate…’ are kind of impossible for a person who already has the diagnosis. So, there needs to make such a decision in an advanced directive where the person can jump through whatever hoops the society / law wants them to jump through in advance.

[kavm]

Originally Posted by webster

It's easy to say suicide assisted or not is wrong, but those who are against it...well, are they willing to provide the resources 24/7 so the ill person can live in dignity?

I know resources can be a factor. But, ultimately it is a matter of suffering of the person inflicted with the disease. So, I don’t care whether someone is willing to provide resources or not. In any case, the insistent opposition based upon personal / religious beliefs is hardly ever matched by commitment of resources for support. Resources and energies go into fighting other people’s rights. This is seen in the most contentious division of our times (without using the word that’s would bring the wrath of the lobby on me) and will remain true here. People wish to impose their personal positions on others through laws and not provide support.