Right to die

[Ghoulish Delight]

I'm surprised no one's talked about this.

As much as I support the right, and the right of states to make the decission, I fear the feds might have a good case. As long as the blasted Controled Substances Act exists, this probably falls under federal jurisdiction.

And I don't think the scope of the case is broad enough to say either of the 2 things I'd really like to see said. The first is, "Controlled Substances Act be damned, this is clearly not under the purvey of Constitutionally granted federal powers and therefore is the state's choice." The other is, "Screw the CSA, we're calling it invalid here and now."

The second is clearly not an option, that's not the question before the court. I have a dim hope that the first might happen. But, sadly, if they rule it as, "Based on the existence of the CSA, the federal government has a right to enforce restrictions," I can't really say I can argue with that.

The best I hope for right now is an opinion, like the recent marijuana opinon, that says, "Based on existing law, we have to side with the feds...BUT, we really think someone needs to get to repealing that stupid CSA." Unsatisfying, but it'd be something.

Of course my other pie-in-the-sky hope is that the Court does shoot down the Oregon right to die act based on the Controlled Substances Act, sparking action to either legislatively repeal the CSA, or get a case before the court that would put the Constitutional validity of the CSA into the scope. It's so entrenched that I doubt it'll happen, but it'd be nice.

[scaeagles]

I have read about this, and have tried to come to some sort of coherent or relevant expression, but find I am struggling to do so.

I find it sad that legal wranglings over the CSA should come into play over this. What if the law in Oregon was legalized and consensual beheading? Would that be acceptable? I doubt such a law would be passed, as it isn't clean enough. Has to be clean.

Surely if Terri Schiavo can be put to death by dehydration and starvation (I had no problem with her life being ended only the way in which it was done), surely there is a way in which people can legally end their lives in a more humane fashion. However, I digress - this really isn't about Schiavo.

I struggle with this issue like no other. My mom died of lupus in Sept. 1984 when I was 15. She had been suffering for 13 years after the first signs of the disease surfaced - specifically a brain tumor. I came close to killing her myself at her request one summer day in 1984, but was removed from the situation by a knock at the door by a lady from our church that had come to offer assistance that day. My mother never made the request of me again.

While lawyers present arguments and judges rule from on high, the very real situation faced daily by Americans is not dealt with. My family and I were ripped apart by this. While I email my dad a couple times a year, I literally have not spoken to him in.....10 years? The roots of that go back to the complexities of my mom's situation, and should she have simply been permitted to die - without medication she would have a couple years into it, and without brain surgery she would have died before I had any memories of her - it would not be so. Surely in a world where medical advances can assist so many to lead quality lives when they would be dead otherwise it should be possible for those who are terminal and in pain to end them.

So.....I will read about the CSA and the constitutionality and morality thereof, and perhaps see an attempt by Oregon to rewrite their law to circumvent it, and I will sit and sadly shake my head because the legality of this case has nothing to do with the issue itself, and people go on terminally ill and in pain while their families go through the grieving process in front of them on a daily basis.

[Prudence]

I'm fortunate to not have had any personal experiences with this subject.

However, I work with faculty who are involved with end-of-life care and research. At the moment, my biggest concern is the impact the SC ruling will have on EOL care of people NOT actively seeking to end their lives.

Pain management is a big issue. Many care providers are afraid and/or unwilling to provide the full measure of pain relief dying patients need, for fear that the care providers will be accused of hastening death. What is a care provider to do when, for example, the appropriate dose of pain medication needed to relieve the patient's pain also further decreases the patient's respiratory function and thus may hasten death? What happens when death is not the goal, but the unavoidable side effect of pain relief?

When an administration, such as this one, goes to such lengths to assert its position on physician-assisted suicide, even care providers NOT involved in suicides have to be extra careful, lest someone disapprove of the care provided. Result? Patients suffer.

[Ghoulish Delight]

So.....I will read about the CSA and the constitutionality and morality thereof, and perhaps see an attempt by Oregon to rewrite their law to circumvent it, and I will sit and sadly shake my head because the legality of this case has nothing to do with the issue itself, and people go on terminally ill and in pain while their families go through the grieving process in front of them on a daily basis.Exactly what's bothering me. Legally, I will understand if the court's hands are tied by what's on the books. But I hate that that's the case. I wouldn't want the court to go beyond its powers if indeed the CSA is deemed to cover this, but the end result will be a continued restriction on individual freedom that I believe shouldn't be there. And the only possible solution is the hurculean task of dismantling the CSA. Bloody CSA.

[Name]

The right to die clearly falls under the lines of interstate commerce.....

rationale: if people are allowed to off themselves, then they will be removing themselves as a consumer of interstate trade and commerce, which would fall under federal jurisdiction.

[/sarcasm]

completely tongue in cheek, but based on other scary decisions, can see that being used......

(I hope the feds don't read this and use this argument(if they do, they better f'in pay me, or something))

[Alex]

The entire constitutionality of the Constolled Substance Act relies on a broad definition of the Commerce Clause.

I'm in favor of freely available drugs of all types and people can kill themselves if they want. Doctors shouldn't be involved. If you want to die, it should be a personal decision acted up by yourself. Involve who you want and how you want them involved. The only reason we've created a need for allowing physician assisted suicide (which is a horrible misnomer) is that we've made the means of actual peaceful painless suicide illegal for no good reason.

[alphabassettgrrl]

The right-to-die is as hotly contested as the right-to-life, though with the added benefit that the person facing death can chime in with an opinion.

I can't see how it's a Federal issue. The administration just wants to butt its nose in where it doesn't belong, and make a stand that they have no ground to make. Ok, the drugs used are sold across state lines, but so what? Many things are purchased across state lines but this is the only one they're making a stink about.

Death is a choice every person should be able to make. I'm sure people make that choice every day, holding off that dose of pain pills, and stockpiling the "extras". When they have enough, they say goodbye. Nobody knows the difference, except possibly the family.

I understand that we as a culture should value life. This is a good thing. We also need to understand that sometimes it's time to die. Quality must win over sheer quantity, at least in some cases. I only worry that the right-to-die will become a requirement, or a source of pressure. "Y'know, grandma, if you choose to die early, you'll be able to leave more money to your family."

I've seen people hang on who only want peace. I've seen people struggle for just one more day. My dad chose suicide for no reason we've been able to ascertain. It's not like I'm standing outside the issue. It's a choice only the person involved can make. Yes, there is pain, but there is also pain in watching someone you love suffer. It's a hard choice either way.

[€uroMeinke]

I believe Oregon must use the 2nd Amendment right to bare arms and create a "Militia Assisted Suicide Initiative" whereby a phonecall to the state militia provides you with a gun and bullet to off yourself with. The militia will also be allowed to counsel the suicide as to the best place to aim the gun to ensure fatality. At least this way the right to die will be protected by the constitution.

[sleepyjeff]

I voted against this law(twice) but since it did pass a vote of the people of my State I will be a little un-happy if it is lawyered out of exsistence.

[PanTheMan]

Before Abortion was legal, doctors got around the law with various procedures, and today there are many doctors who will skirt around the Euthenasia issue by offering the 'Service' Quietly.

It would be far better to make it Legal and regulated, (2 doctors, 4 evaluations, no less than 15 days apart, etc....) than the way it IS NOW, one doctor writing a prescription. And it IS going on now, and has been quietly for quite some time.

[Alex]

Best would be to just remove doctors from the decision. If someone wants to die, that is not a medical treatment and need not involve doctors.

Then you don't need to build in 400 safeguards to make sure doctors aren't killing people who never wanted to die or at the last moment changed their mind.

[€uroMeinke]

Best would be to just remove doctors from the decision. If someone wants to die, that is not a medical treatment and need not involve doctors.

Then you don't need to build in 400 safeguards to make sure doctors aren't killing people who never wanted to die or at the last moment changed their mind.

I take this as an endoresement for my Militia Assisted Suicide Initiative

[wendybeth]

Alex is right. Since when do you need to have all those formalities in place to off yourself? I suspect that perhaps it's a way of expiating self-guilt, and turn the act into a medical procedure. Doctors have been 'helping' terminal patients along for many, many years, without the benefit of legislation.

I had a dear friend who was dying of cancer, and it was everywhere- her hips, her spine, her brain. She had excruciating pain that nothing would touch, yet could not commit suicide due to her devout Catholic beliefs. Her docs put her on very aggressive chemo, which outraged me, as we all knew she would never get better and the chemo made her so sick. She died two weeks later of renal failure. A friend in the medical community told me that if they hadn't done the chemo, she could have lingered for months like that. The chemo shut her system down, and in the end she drifted peacefully away. This was done in a Catholic hospital, btw.

[Nephythys]

Is the implication that they knew the chemo would kill her, or speed the process?

[Alex]

Suicide was medicalized as an avoidance rationale, and physician-assisted suicide is just a continuation of that avoidance.

It used to be that suicide was criminalized. The person was either viewed as a possession of God or a possession of the state and suicide was either a crime against god (and therefore punishment included spiritual exclusion) or a crime against the state (an therefore punishment included bodily mutilation or material confiscation). It was by this logic that attempted suicide was viewed as a crime punishable by death.

In the late-1700s, English coronor juries began to rebel against the idea that in determining a death a suicide that it would result in the confiscation of the surviving family's property in many cases. By the early 1800s the medical community started to provide a way out that allowed them to no longer punish suicide without having to say that suicide was a personal choice. The doctors and burgeoning field of psychiatry simply declared that suicide was, by definition, an act of insanity. Therefore the a suicide could be declared, post facto, to have been non compos mentis, or not in their right mind.

Having provided a route to determine a suicide without having to punish the survivors (or the spirit and body of the dead) it quickly became the rubber stamp determination that a suicide was insane and therefore could not be held responsible for their actions.

This means that wanting to commit suicide is an irrational state as well, and the criminalization was turned into medicalization. Involuntary incarceration in a prison for attempted suicide was replaced with involuntary incarceration in a mental hospital. Interestingly, there is evidence that suicide-prevention programs may increase the rate of suicide since people are unwilling to seek assistance fearing involuntary incarceration.

Unfortunately, this entrenched notion that suicide can not be a rational act has put society in the bind of treating it as an act of insanity even when it is obviously most rational, and therefore requiring the intervention of a doctor to say it is not insane in this instance. The reason I oppose bureaucratized physician assisted suicide is because the next logical step (and one already reached in the Netherlands where more than a thousand euthanizations each year under their physician-assisted suicide laws are without the active consent of the patient) is that if doctor's can decide that encouraging death is an acceptable option, it isn't a big step to doctor's being able to decide that death is the preferable option.

Wendy, the Catholic Church has long quietly accepted such practices under the Principle of Double Effect, which goes back at least as far as Aquinas (essentially, as long as the primary intent of an act, in this case treatment of the cancer, is positive it isn't bad if secondary results, in this case death of the patient, is negative; similarly you can't take birth control with the intent to prevent conception but you can take it to control the pain and wellbeing of the woman even if it results in preventing conception.)

(Yes, it just so happens that I am reading Fatal Freedom: The Ethics and Politics of Suicide at the moment. I've always believed that suicide is a personal liberty and while the author of this book is way out there on many issues, he's helped me establish why I think that.)

[wendybeth]

Is the implication that they knew the chemo would kill her, or speed the process?`

She was already dying, so I suppose it would be that it sped the process. There was absolutely no hope- she was in the last stages of a very aggressive cancer, so we were (most of us, anyway) very surprised by the decision to do chemo.

[Alex]

While your information is hearsay (I'm assuming you're friend wasn't involved in the case but rather providing more general information), if we assume that the doctors made this choice of treatment knowing it would hasten her inevitable death, I wonder if they explained this result to her.

[wendybeth]

While your information is hearsay (I'm assuming you're friend wasn't involved in the case but rather providing more general information), if we assume that the doctors made this choice of treatment knowing it would hasten her inevitable death, I wonder if they explained this result to her.

The person who provided the information was a medical doctor who was friends with Betty, but wasn't involved in her treatment. I doubt they discussed it with her, as she wasn't really in the frame of mind to make any such decisions. Her children were consulted. The main things causing the severe pain were inoperable tumors on her spine and hips, which were destroying the bone. (Her liver was also involved, which is why pain meds were ineffective). An arguement could be made that they did the chemo in an attempt to retard the growth of the tumors, but it also made her very sick to her stomach, and that (for a short period of time, until she slipped into a coma) was not good, as any movement caused horrible pain. I was angry about this, but it really was a bad situation all the way around, and in the end we were just very relieved for her, in that her pain had ended.

[PanTheMan]

Best would be to just remove doctors from the decision. If someone wants to die, that is not a medical treatment and need not involve doctors.

Then you don't need to build in 400 safeguards to make sure doctors aren't killing people who never wanted to die or at the last moment changed their mind.

If you remove the Doctors, you will get cases of botched attempts. It is a very tricky subject.

If Nothing Else Everyone reading this thread should get what is called an "Advance Directive" every Hospital should have them. That way when the time comes there will be no Question as to your wishes.

[Prudence]

You have to couple the advance directive with making sure your next of kin know of and will abide by your wishes. Once you're out of commission you're unable to stand up for yourself should your next of kin contest the advance directive.

[Alex]

An Advance Directive is the complete opposite of suicide, so it isn't really relevant.

An advance directive says that if you're going to die anyway to let you die. Assisted suicide say that if you're going to live anyway (at least for now) to let you die.

As for botched attempts, yes, if you are allowed personal freedom of choice that means taking on the risk that you'll not be very good at it. It makes no sense though, that you are not allowed to decide that it is better to be dead than alive. At best you are given a chance to convince a doctor that it is better for you to be dead than alive. Nor does it make sense that we are allowed to passively commit suicide (by refusing chemotherapy, for example) but not actively commit suicide (by cutting our veins open while taking a pleasant bath).

[Claire]

I voted for and support Oregon's Death with Dignity Act and I'm annoyed that there is so much effort being put forth to get rid of it. I remember when John Ashcroft was appointed Attorney General and the first thing he said was on his agenda was to get Oregon's law blocked.....I thought to myself....wow, that's the first thing on your agenda, big guy? :rolleyes: Ugh.

The law has a lot of support in our state....I can't believe other states haven't passed similar laws....not that it'll matter, because apparently states' rights no longer count. ;)

[Alex]

I'm curious, since boths sides tend to only believe in federalism when the federal government is trying to block a state law they personally like (it is a state issue to decide when doctors can kill patients, but it is a federal/constitutional issue to decide when mothers can kill fetuses, or vice versa depending on party; it is a federal issue that pharmacists be required to sell birth control but a state issue that pharmacists be able to sell marijuana, or vice versa depending on party).

States rights do mean something, but it is just something more than "states rights are paramount when I like the law and hick provincialism when I don't." Since I've never seen anybody here give enough examples on when they think states' rights are paramount I am not speaking of anybody specific, just in generalities about when I see "states' rights" generally invoked.

To me, this one isn't a federalism question at all. The Oregon law is a travesty against personal freedom (wrapped up to pretend that it is an extenion of personal freedom). It isn't an issue on which either the federal government or state governments should be making laws, the right to termination resides with the individual, not the medical-bureaucratic complex. We've foolishly medicalized a non-medical action.