Assisted Suicide and End of Life Care

Let's start with a warning.
I will not tolerate comments that are uncivil, off topic or unreasoned with this entry. Any such comments will be removed ASAP. Some commenters of the blogsphere have previously been completely unreasonable (not to mention illogical) and their comments will be eliminated, unheard, from any discussion.

This topic is hard enough to reason through without the tin-foilers throwing biblical verses about.

End of life care and it's relation to Assisted Suicide is a closely bound subject.

Today it doesn't command the same attention. Though opinions on the topic remain deeply divided, the debate has gradually shifted to a larger concern - the way America cares for people who are dying.

"The central issue, we all realize, is end-of-life care," said Dr. Ezekial Emanuel, chairman of the department of clinical bioethics at the National Institutes of Health. "Assisted suicide is really a sideshow."

For the vast majority of people who are terminally ill, the question is not whether they'll ask a doctor to help them end their life: It's whether anyone can relieve their depression and manage their pain, Emanuel said.

I've heard from many sources that pain management is too often the cause of the desire for assisted suicide. I've also heard that there are many reasonable ways to deal with pain at the level that is experienced by some terminally ill people. Personally, I have yet to see a terminally ill person who had reasonable pain therapy. I've seen four friends and relatives die from cancer and in the end stages they were so hopped up that they couldn't relate to anyone. Maybe they weren't getting the right therapy, but I find that to be unlikely.

The question I have is, how and who should be the ones to deal with pain therapy, and then assisted suicide if that is where the patient wants to take his last days? I have heard the ethical arguments of the physician not being part of assisted suicide. I can see that point of view. But if the doctor isn't going to be part of it, shouldn't there be an alternative? That person would be trained in the most advanced pain therapies, psychology and assisted suicide. This person would not be bound to saving life, but would be there to ease the transition at the end of life.

Personally, I see a viable case for having states license and regulate such a profession if their constituency should deem it desirable. In fact I would state that I see such a professional being in place to prevent the concerns of groups like this:

Critics see a much darker side to the issue. "Assisted suicide will discriminate against the old, the ill and the disabled," said Diane Coleman, president of Not Dead Yet, a Chicago-based disability rights group that filed an amicus brief supporting the government's effort to overturn Oregon's law. Vulnerable, expensive-to-treat patients will get medications to help them die because their lives won't be seen as worth living, she contends.

Depression, hopelessness and fear of becoming a burden are primary reasons why critically ill patients consider suicide, experts confirmed. Surprisingly, pain is a less important factor.

Horrible name for an organization by the way. It always makes me think of the dead cart scene in Monty Python and the Holy Grail.

They are likely quite correct about the emotional burdens for the end of life, but I've not seen that personally. Everyone I saw die of cancer were in extreme pain. I wouldn't have known their emotional standing due to being completely out of reality on pain killers. Wouldn't a professional who is specifically trained to deal with the dying function to help relieve the depression and fear as well as the pain?

Of course, it all will come down to politics. A place where it really shouldn't.

"I think several states will now look at this," said Myra Christopher, president of the Center for Practical Bioethics. "Even though this matter has been resolved from a legal perspective in Oregon, significant moral and ethical issues remain and deserve rigorous discussion."

At the federal level, legal experts say the Supreme Court's relatively narrow ruling left the door open for Congress to act. Congress already has restricted the use of federal funds for assisted suicide - a ban that President Bush's predecessor, Democrat Bill Clinton, supported.

In writing the court's majority opinion, Justice Anthony Kennedy noted that "the federal government can set uniform standards for regulating health and safety."

Personally, I hope the federal government stays out of the issue. Nothing like a politician to screw up what the citizen's want. Just look at the Schaivo case if you need an example. Control at the state level is more likely to give the regional differences an allowance for what each state's citizen's believe is right.

Finally, the whole topic of when to die must be left to the individual. They should be left in the position to decide when they want to check out. I don't agree with a sentiment that would force a person to live and suffer for the "good" of others. A person has self determination, and should be given the fullest allowances for control, when it's their life and the quality thereof that is being determined.

So there is a thought. Got something better? I don't want to hear "it's just wrong." Give me an alternative to dealing with the pain and emotional issues that are seen at the end of life.