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

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.

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

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.)

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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.

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.

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.

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.