The Right to Die

callmeslick · Post by **callmeslick** » Tue Jun 30, 2015 10:16 am

.....I've always been ok with the concept of assisted suicide for provable, terminally ill patients, especially those with painful symptoms, but have always expressed my opinion that you head out there upon a very slippery slope. It would seem that Belgium's courts are willing to take a far greater step onto that slope than I'm comfortable with:

http://www.msn.com/en-us/news/world/hea ... ar-AAckxLg

comments?

Ferno · Post by **Ferno** » Tue Jun 30, 2015 11:14 am

just this.

http://www.theglobeandmail.com/news/nat ... e22828437/

Vander · Post by **Vander** » Tue Jun 30, 2015 11:38 am

I can kind of agree that assisting in such a circumstance might not be in societies best interest. (how's that for wishy washy) But how do you force someone to stay alive? Obviously, you should attempt to help, but what if it isn't working? Do you continue to lock them up to prevent them from killing themselves? Is that more humane? Do you set them free to commit suicide, allowing for the fact they may hurt others in the attempt?

Tunnelcat · Post by **Tunnelcat** » Tue Jun 30, 2015 12:56 pm

You know, people who are in pain and dying need a better out than living the last of their lives suffering and bedridden. Our system is shameful, cruel and costly when it comes to dying. A clean and painless death as a patient's choice would be the humane thing to bring to the medical table. Personal suicide is not a good or pleasant option for someone who's sick and in severe pain and the medical system has run out of options to help alleviate that pain. I know, because I've dealt with it in the past and I'm going to have to deal with it personally in the future a lot sooner than I'd like. I've already watched my mother die by starvation and lack of water, which was her final decision and choice by the way, because the pain her lung cancer caused her became intolerable and untreatable. She took that route because the medical system had done all it could to help her and offered her nothing more except hospice and a couple of last weeks of misery in her bed. No doctors were willing to help her die even after Oregon passed physician-assisted suicide in 1997 (she died in 2000). Once you've watched someone die that way, euthanasia looks pretty damn pleasant.

vision · Post by **vision** » Tue Jun 30, 2015 1:17 pm

callmeslick wrote:...especially those with painful symptoms...

So apparently, you aren't quite as familiar with depression as you might think. I have a friend whose life has been utterly ruined by severe depression, to the point where he is just "waiting to die" for the past several years. Would I help him die if given the opportunity? I honestly don't know how I would answer that. Would I miss him after he's gone? Maybe. I already do. The person he was, died many years ago and it doesn't look like he's "coming around" any time soon. This new person is a stranger that seems helpless to do anything but spread sadness. I don't talk to him much anymore, but when I do I keep thinking of my friend's father who blew his head off with a shotgun the day after Christmas. He was 54 and depressed for years. I'm almost certain one day I'll see a facebook post about how my friend committed suicide. Would be nice if he had options. The article you linked to is mistaken: This woman is not a "healthy 24-year-old." Depression is a terminal illness when it's bad enough.

Tunnelcat · Post by **Tunnelcat** » Tue Jun 30, 2015 1:26 pm

Trouble is, when a doctor or the medical system says someone is "healthy", it's unquestioned fact, even if they're 100% wrong.

Spidey · Post by **Spidey** » Tue Jun 30, 2015 2:03 pm

The idea that the state has the right to deny someone the right to die is based on ownership…plain and simple.

Where does the right to tell anybody they must live come from?

CDN_Merlin · Post by **CDN_Merlin** » Tue Jun 30, 2015 3:26 pm

Even with the huge strides we've done in the last decade alone about mental illness, people don't think it's sever enough to warrant someone wanting to commit suicide. Just because you don't look sick, doesn't mean you aren't. If someone has been battling depression for years and is tired and just wants it to end, they should have the right to assisted suicide.

Tunnelcat · Post by **Tunnelcat** » Tue Jun 30, 2015 4:29 pm

Spidey wrote:The idea that the state has the right to deny someone the right to die is based on ownership…plain and simple.

Where does the right to tell anybody they must live come from?

It's probably those religious taboos and morals that have been carried over into state and federal laws in this country.

CDN_Merlin · Post by **CDN_Merlin** » Tue Jun 30, 2015 5:44 pm

Religion needs to be taken out of our laws but sadly they are the basis of most laws.

callmeslick · Post by **callmeslick** » Tue Jun 30, 2015 7:28 pm

Both aware of the pain involved, and the rather high likelihood of suicide over the longer run. I just have an issue with a physician being granted the power to terminate the life of someone who(physiologically) could live quite a while. I do NOT subscribe, once again based on some family experience, to the idea that clinical depression is an untreatable illness, although aware that some cases are close to that. It is NOT the same as a stage-4 carcinoma of several varieties, for example. As I say,my issue isn't with the state mandating someone stay alive, or the concept of suicide per se, but in allowing physicians to terminate life, you move an inch or so closer to them being REQUIRED to terminate life.

Top Gun · Post by **Top Gun** » Tue Jun 30, 2015 9:43 pm

As someone who has suffered from depression in the past, this utterly disgusts me. You're taking someone with a disease that creates the horribly-wrong impression that death is the only way out...and telling them that, yes, death is the only way out. This isn't a "mercy killing," it's ★■◆●ing murder, and the ★■◆● quack responsible for approving it should be tried for as much if they proceed.

Sergeant Thorne · Post by **Sergeant Thorne** » Tue Jun 30, 2015 10:21 pm

Doctors and such exist, ostensibly, to do what is in their ability to heal those who are injured or diseased. It's not their place to assist in ending someone's life. That's a very screwed-up notion, IMO.

I would argue there is no "right to die". It's an insane notion.

vision · Post by **vision** » Wed Jul 01, 2015 1:56 am

callmeslick wrote:I do NOT subscribe, once again based on some family experience, to the idea that clinical depression is an untreatable illness, although aware that some cases are close to that.

Top Gun wrote:You're taking someone with a disease that creates the horribly-wrong impression that death is the only way out...and telling them that, yes, death is the only way out.

I politely disagree. First, you must acknowledge that some cases of depression are both exceptionally severe and untreatable. Second, you must also acknowledge that this sort of decision, by either doctor or patient, is not something that happens without an exhaustive, clear-headed analysis and deliberation of the pros and cons of prolonged suffering under depressive conditions. How long is too long? Third, not everything is a slippery slope, and even when things start to slide in one direction or another, they slide slowly, following public approval. I see this as a positive milestone for civilization if only to have open discussion about something that has been under silly religious taboo for too long.

Also, I whole-heartedly disagree with the myth that depressed people are "not thinking correctly." Depressed people are sad, not stupid. My friend with severe depression is one of the brightest people I've ever met and that's part of why his condition is so tragic. Another friend even suggested that he's depressed because he's too smart and rational. I'm sure that's not it, but he's always been this kind of borderline autistic, savant-ish guy and people like that seem to be a magnet for mental illness.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 6:02 am

vision wrote:I politely disagree. First, you must acknowledge that some cases of depression are both exceptionally severe and untreatable.

no, I don't have to acknnowledge such, as I don't believe in the 'untreatable' part.

Second, you must also acknowledge that this sort of decision, by either doctor or patient, is not something that happens without an exhaustive, clear-headed analysis and deliberation of the pros and cons of prolonged suffering under depressive conditions. How long is too long? Third, not everything is a slippery slope, and even when things start to slide in one direction or another, they slide slowly, following public approval. I see this as a positive milestone for civilization if only to have open discussion about something that has been under silly religious taboo for too long.

here, we will indeed agree to disagree.

Also, I whole-heartedly disagree with the myth that depressed people are "not thinking correctly." Depressed people are sad, not stupid. My friend with severe depression is one of the brightest people I've ever met and that's part of why his condition is so tragic. Another friend even suggested that he's depressed because he's too smart and rational. I'm sure that's not it, but he's always been this kind of borderline autistic, savant-ish guy and people like that seem to be a magnet for mental illness.

a lot of folks with clinical depression ARE intelligent individuals, and, as suggested by another, to start planting the idea that giving up on treatment options at age 24 is ludicrous.

vision · Post by **vision** » Wed Jul 01, 2015 1:13 pm

callmeslick wrote:I don't believe in the 'untreatable' part.

Time for a little education on refractory depression from WebMD.

callmeslick wrote:
Second, you must also acknowledge that this sort of decision, by either doctor or patient, is not something that happens without an exhaustive, clear-headed analysis and deliberation of the pros and cons of prolonged suffering under depressive conditions.
here, we will indeed agree to disagree.

Ok, but I think your lack of experience with someone who has refractory depression is a factor here. Depression isn't just one thing, it's a complicated illness with a large gradient. Some people have never felt like ending their life and can't relate to someone who does. Others might go through a rough period where they feel suicidal, but then come out of it with all sorts of confidence as if to say "hey if I did it, anyone can!" But that's not true. My friend is a perfect example of this.

It's been a decade of failed treatments and misery, and from what he says (I can only take his word) exactly nothing has changed. The guy's depression makes him completely incapable of normal interaction with the rest of the world. He lives alone on disability in a tiny apartment. He told me something along the lines of "existence is a torturous prison. I don't want to kill myself, I simply don't want to exist anymore." I don't know what that means, but he also told me one time he would rather have cancer than depression, which sounds outrageous, but then again, pain and suffering are subjective (and I have another friend who is beating cancer just fine right now and is considerably more healthy mentally and physically than my depressed friend).

The point of this rant is, people with depression this severe don't flippantly decide they want to die. They come to that conclusion after years of suffering. There needs to be a humane option here. Some people don't get better.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 1:17 pm

vision wrote:
callmeslick wrote:I don't believe in the 'untreatable' part.
Time for a little education on refractory depression from WebMD.

I have advanced degrees and active contacts in the world of neurochemistry, so am not basing my opinions on WebMD, thanks.

Ok, but I think your lack of experience with someone who has refractory depression is a factor here. Depression isn't just one thing, it's a complicated illness with a large gradient. Some people have never felt like ending their life and can't relate to someone who does. Others might go through a rough period where they feel suicidal, but then come out of it with all sorts of confidence as if to say "hey if I did it, anyone can!" But that's not true. My friend is a perfect example of this.

It's been a decade of failed treatments and misery, and from what he says (I can only take his word) exactly nothing has changed. The guy's depression makes him completely incapable of normal interaction with the rest of the world. He lives alone on disability in a tiny apartment. He told me something along the lines of "existence is a torturous prison. I don't want to kill myself, I simply don't want to exist anymore." I don't know what that means, but he also told me one time he would rather have cancer than depression, which sounds outrageous, but then again, pain and suffering are subjective (and I have another friend who is beating cancer just fine right now and is considerably more healthy mentally and physically than my depressed friend).

The point of this rant is, people with depression this severe don't flippantly decide they want to die. They come to that conclusion after years of suffering. There needs to be a humane option here. Some people don't get better.

no one is suggesting that they do. What I am suggesting is that a physician has or ought have NO ROLE in ending a physiologically healthy life.

Spidey · Post by **Spidey** » Wed Jul 01, 2015 1:48 pm

Ok, but some have no problem with letting a physician kill a perfectly healthy unborn blob.

We call that a “medical procedure” but doctors take an oath “do no harm”.

And before you start going into the entire abortion debate thing again…you did say… physiologically healthy life…(that includes blobs)

So if you can make an exception for one, why not the other…(rhetorical, because I have no intention to do the abortion debate) And please don’t start one.

Tunnelcat · Post by **Tunnelcat** » Wed Jul 01, 2015 1:55 pm

Sergeant Thorne wrote:Doctors and such exist, ostensibly, to do what is in their ability to heal those who are injured or diseased. It's not their place to assist in ending someone's life. That's a very screwed-up notion, IMO.

I would argue there is no "right to die". It's an insane notion.

That's a screwed up assumption on your part. Sure, a doctor's purpose is to heal and sometimes give palliative care when they can't heal. But why is helping to end the suffering of an already dying patient, if they make that request, out of the purview of a doctor? They're medical specialists that deal with the human body, so they should be experts. Hell, even vets take care of our terminally sick and dying pets by euthanizing them to alleviate their pain. Since doctors can't cure everything, even though they have the arrogance to think they can, helping a person to die who's dealing with the pain and misery of an incurable disease is should be considered being compassionate for once. In fact, I think these bastards keep people alive in hospitals just to take as much money off them as possible. That may be cynical, but you know it's true, at least in our system. As Spidey noted, doctors routinely kill viable fetuses during abortions all the time, AND they make money off of the procedure like any other medical procedure. So much for the Hippocratic oath getting in the way of that practice.

Which leads me to the next question, why shouldn't I have the right to choose death and have a medical professional help me if I'm terminally ill or in incurable pain? Who says so? You? Your religion ST? In fact, that's why I think medicine is so screwed up now. It used to be something the church did back before science came figured out the human body and religion's influence is still intertwined in medicine today. Catholics even ran our hospitals back before the 1960's. The medical system needs a final divorce from it's religious roots.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 2:25 pm

Spidey wrote:Ok, but some have no problem with letting a physician kill a perfectly healthy unborn blob.

We call that a “medical procedure” but doctors take an oath “do no harm”.

And before you start going into the entire abortion debate thing again…you did say… physiologically healthy life…(that includes blobs)

So if you can make an exception for one, why not the other…(rhetorical, because I have no intention to do the abortion debate) And please don’t start one.

not going to beat the abortion, or independant viability thing to death, but thanks for reviving the dead horse for the umpteenth time.

vision · Post by **vision** » Wed Jul 01, 2015 3:32 pm

callmeslick wrote:What I am suggesting is that a physician has or ought have NO ROLE in ending a physiologically healthy life.

I have a hard time believing you have an advanced degree in neurochemistry, yet claim that a person with severe mental illness has a "a physiologically healthy life." It doesn't add up and I'm calling bull★■◆● on your imaginary degree. Do you live in a magic world where feelings are disjointed from chemical states? How is someone whose neurology is causing them extreme suffering considered "healthy" to you? Please explain your position, which appears to contradict what we actually know about neurochemistry.

If we can terminate the life of someone in a vegetative state per their wishes, then why not someone whose mind has failed due to Alzheimer's or depression?

Spidey · Post by **Spidey** » Wed Jul 01, 2015 3:38 pm

He actually said “degrees” as in plural.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 4:17 pm

vision wrote:
callmeslick wrote:What I am suggesting is that a physician has or ought have NO ROLE in ending a physiologically healthy life.
I have a hard time believing you have an advanced degree in neurochemistry, yet claim that a person with severe mental illness has a "a physiologically healthy life." It doesn't add up and I'm calling **** on your imaginary degree. Do you live in a magic world where feelings are disjointed from chemical states? How is someone whose neurology is causing them extreme suffering considered "healthy" to you? Please explain your position, which appears to contradict what we actually know about neurochemistry.

If we can terminate the life of someone in a vegetative state per their wishes, then why not someone whose mind has failed due to Alzheimer's or depression?

there are psychosomatic effects, and yes, the neruochemistry can in some cases affect physiology profoundly, but the patient in question DID NOT HAVE ANY of those, vision. All physical reports showed her to have perfectly normal functionality beyond the symptoms of depression, which are profound in their own way. You bring up Alzheimers....there is a case where brain chemistry DOES affect physical functionality.
Once again, I'm not denying the suffering, yet suffering(even long term suffering) does not translate to 'incurable'. You wish to savage me, and lord knows it's easy, but just because you don't wish to accept what I'm saying(which is pretty much the view of the entirety of Biochemical/Physiological journals) you have no real grounds for the argument. All you've come up with is 'my friend suffers'. I feel for your friend....hell, I feel for you as an empathetic friend. I still don't feel that putting 24 year olds to death, given the nature and pace of medical advances, for a disease which the overwhelming majority of patients has proven treatable(albeit difficult path to treatment, much of it reliant on patient cooperation). Giving the range of patients with depression are their diagnosis the idea that suicide is an acceptable course is simply dreadful, and rather ignorant.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 4:21 pm

Spidey wrote:He actually said “degrees” as in plural.

no, he has it right.....I have a BS in Biochemistry and an MS in Biological sciences(emphasis Neurochemistry, Physiology and Molecular Genetics).
So, only one of the two is 'advanced', but I took graduate level Neurochem and Physiology coursework as an undergrad. My only point in bringing it up was that he keeps acting as if I'm just commenting as a layperson, despite studying the stuff, spending nearly 30 years in clinical chemistry after. I'm basing my opinion on what I know, and what I've learned, not merely on empathy and gut feelings.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 4:32 pm

I would urge vision(or anyone else similarly confused) to read the specifics of what I've written from the outset. If you wish to quibble over MY definition of physiological functionality, use whatever words you wish. The patient in the article, as best as I was able to determine, was able to maintain a normal diet, communicate, all vitals were in normal range. Yes, she reports near constant torment from the unbalanced brain chemistry. Yes, many such people both resist treatment options and seek either self-medication(drug abuse) or suicide. My awareness of these facts is NEVER going to translate into feeling sanguine about suggesting someone at SUCH A YOUNG AGE be allowed to be put to death at the hands of a physician. In fact, I am aware of very few cases where a clearcut psychological diagnosis has been uniformly concurred upon by trained professionals by age 24. Still, go back and read my words, I am not denying the right to suicide, I am wondering if the medical community should tacitly imply it to be acceptable in this case, given the age and diagnosis of the patient.

vision · Post by **vision** » Wed Jul 01, 2015 5:21 pm

callmeslick wrote:there are psychosomatic effects, and yes, the neruochemistry can in some cases affect physiology profoundly, but the patient in question DID NOT HAVE ANY of those, vision. All physical reports showed her to have perfectly normal functionality beyond the symptoms of depression, which are profound in their own way. You bring up Alzheimers....there is a case where brain chemistry DOES affect physical functionality.

Ok, now I know for a fact you are full of ★■◆●. Depression does affect you physiologically by increasing stress on the body, keeping people in a perpetual state of "fight or flight" and leads to cardiac and metabolism problems. It also causes adverse sensitivity to normal stimuli (in essence, the world becomes physically more painful). Go ahead an look it up, though you should already know this with your cool medical background. Maybe you've been out of school too long?

And what is this bull★■◆● "beyond the symptoms of depression" like it's something minor? All in her head right? Not really a problem, right? Sickening and insensitive.

callmeslick wrote:...which is pretty much the view of the entirety of Biochemical/Physiological journals...

More bull★■◆●. I read medical journals and I study depression because it's not just one friend that suffers.* I have another friend who has chronic depression, though manageable enough that she's able to hold down a job as a biologist. She's been helping me get educated. I've read the papers and the stats. Modern "treatment" for depression is more or lees like voodoo. There are a few things have some success for some people some of the time (CBT, SSRIs, etc...), but as much as 70% of people with depression have continually reoccurring of symptoms over their life. There is no cure, and treatment is sketchy at best, even though it somewhat successful for lighter forms of depression. This still leaves a sizable subset of severely depressed persons where no treatment works at all. Even promising experimental treatments like VNS which had high initial results have seen success slide back down to the 30%-40% range with further studies.

callmeslick wrote:I still don't feel that putting 24 year olds to death, given the nature and pace of medical advances, for a disease which the overwhelming majority of patients has proven treatable(albeit difficult path to treatment, much of it reliant on patient cooperation).

You still don't get it. I've looked into this story. This girl has been depressed her entire life, has tried to kill herself a few times, and has been living in a psych ward for three years. Her case is exceptional and reinforces my point that some depression is untreatable. Those people need options, now.

Will we cure depression? Maybe one day, when we cure Alzheimer's and other brain diseases, but that doesn't change the fact that people are suffering today and the law needs to change immediately. When we can reliably cure this stuff, we simply won't need the law anymore.

* Note: I don't have time to cite 100's of studies for someone who should know better.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 6:09 pm

vision wrote:
callmeslick wrote:there are psychosomatic effects, and yes, the neruochemistry can in some cases affect physiology profoundly, but the patient in question DID NOT HAVE ANY of those, vision. All physical reports showed her to have perfectly normal functionality beyond the symptoms of depression, which are profound in their own way. You bring up Alzheimers....there is a case where brain chemistry DOES affect physical functionality.
Ok, now I know for a fact you are full of ****. Depression does affect you physiologically by increasing stress on the body, keeping people in a perpetual state of "fight or flight" and leads to cardiac and metabolism problems. It also causes adverse sensitivity to normal stimuli (in essence, the world becomes physically more painful). Go ahead an look it up, though you should already know this with your cool medical background. Maybe you've been out of school too long?

geezus, simmer down. Fight or flight response is NORMAL. Obviously, constantly heightened fight or flight is stressful, but you are generalizing for all cases of clinical depression and are simply WRONG.

And what is this **** "beyond the symptoms of depression" like it's something minor? All in her head right? Not really a problem, right? Sickening and insensitive.

did I say that? No, Did I even so much as IMPLY that? No. As I said before simmer down and read my words, without reading your own prejudices into them.

More ****. I read medical journals and I study depression because it's not just one friend that suffers.* I have another friend who has chronic depression, though manageable enough that she's able to hold down a job as a biologist. She's been helping me get educated. I've read the papers and the stats. Modern "treatment" for depression is more or lees like voodoo. There are a few things have some success for some people some of the time (CBT, SSRIs, etc...), but as much as 70% of people with depression have continually reoccurring of symptoms over their life. There is no cure, and treatment is sketchy at best, even though it somewhat successful for lighter forms of depression. This still leaves a sizable subset of severely depressed persons where no treatment works at all. Even promising experimental treatments like VNS which had high initial results have seen success slide back down to the 30%-40% range with further studies.

so, let's give up and just let them all kill themselves? Moreover, let's have the weight of medical professionals and society sanction it, as if they're making a fine and noble choice.That is your solution? Get a grip, please. Some major talents and contributors to society have lived for up to 9 decades with that 'recurrant' depression, managed 'more or less'. Please, feel free to find me statistics where 30% of depression patients are functionally non-functional and untreatable(limit to peer reviewed literature, of course).That you claim not to have the time, yet have the time to scream this nonsense at me is sort of divergent, wouldn't you say?

You still don't get it. I've looked into this story. This girl has been depressed her entire life, has tried to kill herself a few times, and has been living in a psych ward for three years. Her case is exceptional and reinforces my point that some depression is untreatable. Those people need options, now.

death is now an 'option'? Sort of a rather final option for a 24 year old, huh? Sorry, that isn't compatable with my view of medicine in practice. Maybe from your perspective, 24 years of life is enough, but those of us who are a bit older might find that there is enough time to look into other options. I note that you chose not to address my observation that VERY FEW people ever even have a firm diagnosis of ANY mental illness by age 24, partly due to the development arc of the nervous system. Yet, you'll declare them ready for the grave? Sorry, I may be full of ★■◆●, heartless and clueless, but I have a bit more hope for humanity and medical knowledge than that.

Ferno · Post by **Ferno** » Wed Jul 01, 2015 6:18 pm

We've settled this question about a year ago in Canada. It became a situation where only the doctor and the affected patient have a say, and no one else has a right to even talk to them about it.

Spidey · Post by **Spidey** » Wed Jul 01, 2015 6:25 pm

And just out of curiosity, how long should someone wait for a cure?

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 6:25 pm

Ferno wrote:We've settled this question about a year ago in Canada. It became a situation where only the doctor and the affected patient have a say, and no one else has a right to even talk to them about it.

if it didn't become a matter of public discourse, that would seem fair enough. Are there limitations on conditions, prognoses, etc?

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 6:27 pm

Spidey wrote:And just out of curiosity, how long should someone wait for a cure?

cure or effective treatment? One could be generations off, the other could be next week. As is the case with many disease states. Think where AIDS stood a few short years ago. There is no cure for a lot of diseases, but many(if not most) can be managed.

Aside to vision, I realize the case in question here is an extreme one, assuming the inpatient care for 6 years was completely warranted. However, see my response to Ferno.....part of my ire is the very public nature of this case, sending a dreadful message to ALL depression patients, IMHO.

callmeslick · Post by **callmeslick** » Wed Jul 01, 2015 7:15 pm

vision---and all, for that matter. This is a nice overview of treatment-resistance in Clinical depression, looking somewhat outward
at alternative or supplemental treatment options as the field progresses.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/

note, that 30% figure is the top end of range in all patients(10-30 is the range) with the statistics stating that treatment ineffectiveness seems to
elevate with age of patient. It seems that 5 issues are in play in many these cases(not all 5 in every case, mind you)--1.Misdiagnosis of proper subtype(prevents proper pharm treatment mix) 2.Patient resistance or noncompliance 3.Depression can be accompanied by other psychological disorders which counteract pharmacology 4.Excessive external stressors and 5.prior temporary successes followed by sharp crashes. These causations being eliminated, that leaves very few truly resistant cases that can't POTENTIALLY be treated effectively.
Just ran it by my daughter(no training, 26 year old layperson), and she got caught on the same point I did. Now,by way of background, the one thing my daughter DOES have experience with is psychiatric treatment, having been through eating disorder and far milder depression....it's the age, for both of us, of this patient. Given the rapidity of the development of treatment for most diseases, expectation of more effective therapy is not so far fetched as to be a REASONABLE expectation for a 24 year old by mid-life, likely far sooner, at least to some degree. Just for contrast, I looked at a 1989 overview in a different journal on the subject of effective treatment of depression. The increase both in effectiveness and accurate diagnoses in the 23 years between that and the article above were marked. It's the age of the patient, and the message sent to ALL depression sufferers out there. My daughter was flat out appalled, where, as one can see in my original post, am quite uneasy over this case, but wouldn't go farther.

vision · Post by **vision** » Wed Jul 01, 2015 7:55 pm

callmeslick wrote:1.Misdiagnosis of proper subtype(prevents proper pharm treatment mix) 2.Patient resistance or noncompliance 3.Depression can be accompanied by other psychological disorders which counteract pharmacology 4.Excessive external stressors and 5.prior temporary successes followed by sharp crashes. These causations being eliminated, that leaves very few truly resistant cases that can't POTENTIALLY be treated effectively.

Oh good, in a magical scenario perfectly aligning these five factors we are still left with a few truly resistant cases. Well, ★■◆● those guys. Bad luck for them!

You keep bringing up this girl's age like that means ★■◆●. She has been under supervision in a psych ward for years. Why are you focusing on age instead of the length of suffering? Imagine if you were stuck in the hospital with constant pain doctors could not alleviate – for years. She's not going to "grow out of it." She's an adult with a unbearable, debilitating medical condition, not a kid who doesn't know better. And for the record, neither am I. My friend with severe depression was full of enthusiasm and energy until sometime in his 30's when he slowly slipped into darker and darker moods over the years until his personality disappeared. That guy we knew has been gone for a decade and we're all pretty sure he's not coming back. We all know how this is going to end. It's just a matter of time, and his suffering will increase right up to his last day.

And since you know so much, you already know that depressive risk factors go up later in life, so we've all got that going for us too.

callmeslick wrote:Given the rapidity of the development of treatment for most diseases, expectation of more effective therapy is not so far fetched as to be a REASONABLE expectation for a 24 year old by mid-life, likely far sooner, at least to some degree.

Cool. There might be help for her in the 15-20 years, so ★■◆● off is basically what you are saying. How terribly insensitive. Seriously, do you think a person like her with multiple suicide attempts would survive that long? I mean, she's already been in State care for years. Should she be locked up indefinitely? Hey, now that I'm thinking of it we're doing pretty good on Alzheimer's research so ★■◆● them too. Just keep suffering until we figure it out, right?

Look, I don't know what your major brain-fart is on this topic. With a law in place that let's severely depressed people have access to euthanasia there isn't going to be a rush of people taking them up on the offer. I know people with serious depression. They want cures, not death. But since there is no end to their suffering, they have only one choice choice, and it's a scary, painful one. Besides, if you have so much faith in the potential cure, then a law like this will fall quickly into obsolescence.

vision · Post by **vision** » Wed Jul 01, 2015 9:20 pm

Oh, and I forgot to mention that having laws that allows doctor assisted suicide and euthanasia would likely reduce the number of suicides in the world. Many people who suffer from depression don't seek treatment and some people hide their feeling and end commit suicide without ever showing signs of trouble. Those pursuing this option of death would necessarily be subject to clinical evaluation before being eligible and would automatically be exposed to more/different types of treatment. If you believe treatment works, this is a win. Even an initial uptick in assisted deaths would ultimately change the discourse and perception of depressive mental illness in the world, and the result of that would be a drop in suicides. It's worked this way with everything else that carries a social stigma, depression would be no different. And there aren't going to be "death panels" with doctors killing teenagers who feel sad because they got dumped by a gf/bf.

Ferno · Post by **Ferno** » Wed Jul 01, 2015 10:00 pm

callmeslick wrote:
Ferno wrote:We've settled this question about a year ago in Canada. It became a situation where only the doctor and the affected patient have a say, and no one else has a right to even talk to them about it.
if it didn't become a matter of public discourse, that would seem fair enough. Are there limitations on conditions, prognoses, etc?

http://www.dyingwithdignity.ca/learn/th ... -arguments

I'd answer your question more thoroughly Slick, but I'm having trouble putting together an answer due to this monstrous heat.

But I think you can find what you seek in that link.

Top Gun · Post by **Top Gun** » Wed Jul 01, 2015 10:47 pm

Also, I whole-heartedly disagree with the myth that depressed people are "not thinking correctly." Depressed people are sad, not stupid. My friend with severe depression is one of the brightest people I've ever met and that's part of why his condition is so tragic. Another friend even suggested that he's depressed because he's too smart and rational. I'm sure that's not it, but he's always been this kind of borderline autistic, savant-ish guy and people like that seem to be a magnet for mental illness.

That's just nonsensical. By its very definition, depression involves "not thinking correctly." It's a physical imbalance in the brain's neurotransmitter pathways, a literal rewiring of cognitive processes. It wrenches your mind out of a logical, rational state. Quite frankly, it's completely impossible for someone suffering from severe depression to make an informed judgement call about their own quality of life. Their own brain won't let them. It has nothing to do with stupidity, just biology.

And your WebMD link neatly undermines your own point, as it's entirely focused on how severe depression can take years and all sorts of combinations of medication and therapy to control. I am indeed sorry for your friend, and I hope that he finds something that works for him, but nothing in that article suggests that he should be told, "Sorry, you're SOL!"

Look, if you want to go back and forth over whether it's ethical to let someone with terminal cancer choose to die, let's do that. There's a big healthy debate to be had there. But if you can't see the massive difference from a disease which irrevocably destroys one's physiological processes, and one which (almost entirely) has no effect on them, then I don't know what to tell you.

Sergeant Thorne · Post by **Sergeant Thorne** » Wed Jul 01, 2015 11:04 pm

tunnelcat wrote:
Sergeant Thorne wrote:Doctors and such exist, ostensibly, to do what is in their ability to heal those who are injured or diseased. It's not their place to assist in ending someone's life. That's a very screwed-up notion, IMO.

I would argue there is no "right to die". It's an insane notion.
That's a screwed up assumption on your part. Sure, a doctor's purpose is to heal and sometimes give palliative care when they can't heal. But why is helping to end the suffering of an already dying patient, if they make that request, out of the purview of a doctor? They're medical specialists that deal with the human body, so they should be experts. Hell, even vets take care of our terminally sick and dying pets by euthanizing them to alleviate their pain. Since doctors can't cure everything, even though they have the arrogance to think they can, helping a person to die who's dealing with the pain and misery of an incurable disease is should be considered being compassionate for once. In fact, I think these bastards keep people alive in hospitals just to take as much money off them as possible. That may be cynical, but you know it's true, at least in our system. As Spidey noted, doctors routinely kill viable fetuses during abortions all the time, AND they make money off of the procedure like any other medical procedure. So much for the Hippocratic oath getting in the way of that practice.

Which leads me to the next question, why shouldn't I have the right to choose death and have a medical professional help me if I'm terminally ill or in incurable pain? Who says so? You? Your religion ST? In fact, that's why I think medicine is so screwed up now. It used to be something the church did back before science came figured out the human body and religion's influence is still intertwined in medicine today. Catholics even ran our hospitals back before the 1960's. The medical system needs a final divorce from it's religious roots.

We're just going to have to agree to disagree exterminate one another from the issue, heir TC, because bull★■◆● and lack of perspective is intertwined with your rant, and the only answer good enough for you is the one that lets you get out of jail free and avenge your mother's suffering on Christianity, because its everyone's right to escape the end-result of their path in life with a little help from the MD.

vision · Post by **vision** » Thu Jul 02, 2015 3:25 am

Top Gun wrote:
Also, I whole-heartedly disagree with the myth that depressed people are "not thinking correctly." Depressed people are sad, not stupid.
That's just nonsensical. By its very definition, depression involves "not thinking correctly." It's a physical imbalance in the brain's neurotransmitter pathways, a literal rewiring of cognitive processes. It wrenches your mind out of a logical, rational state. Quite frankly, it's completely impossible for someone suffering from severe depression to make an informed judgement call about their own quality of life.

I'm sorry, you are 100% wrong on this point and you will find no scientific evidence to support the view that depressed people are illogical, while there is at least some contested evidence to the contrary. You are also guilty of the naturalistic fallacy in assigning a value judgment to what you imagine is "correct thinking" and the idea of "physical imbalance." When is the last time you heard of a depressed person having the chemicals in their body checked for "balance" before receiving an anti-depressant? Never, because it doesn't happen. And how would you know what the correct balance is? This "imbalance" thing is partly pharmaceutical marketing and partly an outdated and stubbornly persistent way of thinking about depression.

The latest research shows that mental states are not simply a matter of dopamine, serotonin, cortisol, and the countless other chemicals in the brain, and some depressive identifiers are localized to regions, though the connections are unclear. This is why the effects of anti-depressants are so irregular and why seriously depressed people have to continually try different drugs and treatments. You're just washing the entire system in a bunch of chemicals and seeing what comes out.

Don't get me wrong, anti-depressants are great for lots of people. Some of my friends have been on them for decades (though one was taking so many he was at serious risk of liver damage). But these drugs are still part of this "voodoo" depression treatment that doesn't and can't address the currently unknown root causes. It also fails miserably for countless people. For the record, my depressed friend has tried every known treatment. He's even tried to get experimental treatments like TCMS and VNS but apparently that's not something that's realistically available to anyone other than the lucky few who get selected for research (or if they are rich).

Top Gun wrote:But if you can't see the massive difference from a disease which irrevocably destroys one's physiological processes, and one which (almost entirely) has no effect on them, then I don't know what to tell you.

There you go making Slick's physiology mistake. Can either of you explain how a person in great suffering is physically healthy? "Oh, that person would be in great shape if it weren't for their head-organ causing them constant pain!" Are you guys idiots? How are you decoupling the physical processes of the brain and "neurotransmitter pathways" as TG said with the rest of the body? You realize that a lot of depression treatments are there to try and spur the brain into fixing itself, right? That doesn't always work. We don't know how to fix brains yet. And why are you framing this in the context of imminent death from degenerative disease when the motivation for euthanasia laws reside in removal of suffering. How much is too much?

Everything about life with regard to suffering is subjective and if a person decides that their life is not worth living, then simply put, their life is not worth living. They are ultimately the only person who can decide based on the knowledge and experiences they have.

I'll make this point one last time: There ARE people out there who suffer immensely from untreatable depression and those people need options just as much as anyone else with a terminal illness.

woodchip · Post by **woodchip** » Thu Jul 02, 2015 5:13 am

For my 2 cents, I think the only people that should write the laws for assisted suicide are those with the unmanageable pain...not healthy people who have no clue.

callmeslick · Post by **callmeslick** » Thu Jul 02, 2015 6:10 am

vision wrote:There you go making Slick's physiology mistake. Can either of you explain how a person in great suffering is physically healthy? "Oh, that person would be in great shape if it weren't for their head-organ causing them constant pain!" Are you guys idiots? How are you decoupling the physical processes of the brain and "neurotransmitter pathways" as TG said with the rest of the body? You realize that a lot of depression treatments are there to try and spur the brain into fixing itself, right? That doesn't always work. We don't know how to fix brains yet. And why are you framing this in the context of imminent death from degenerative disease when the motivation for euthanasia laws reside in removal of suffering. How much is too much?

Everything about life with regard to suffering is subjective and if a person decides that their life is not worth living, then simply put, their life is not worth living. They are ultimately the only person who can decide based on the knowledge and experiences they have.

I'll make this point one last time: There ARE people out there who suffer immensely from untreatable depression and those people need options just as much as anyone else with a terminal illness.

and attampting to make suicide for young patients an option is an unacceptable idea to foist on folks who aren't thinking properly, by definition.