Assisted DyingFollow

Sir Terry Pratchett gave a lecture tonight. It was broadcast on BBC TV and was a balance between laughter and tears. Google it, and you'll soon find a spoof or a transcript.

Diagnosed with a terminal illness that will leave him in a debilitated state, he wants to choose a dignified death. administered to his own wishes, by those he chooses, over a sterile technological so-called 'life-support'

I picked the ones with "checks" in it but I'd prefer checks of a different variety.


I think that anyone wanting to go through with assisted suicide should first be required to sit with psychologist/psychiatrist/whathaveyou. Not to determine whether or not they are "of the right mind" but more to just explore their options and reasons for wanting to end it. Sometimes talking about things changes your perspective.

I don't know of any good argument against assisted suicide.

It's called Love

I listened to what I could find. I really wasn't swayed by Baroness Finlay's counterarguments.

What about dementia? I don't know if people are clearly near death when dementia takes their minds, but in either case I'd like to have what Pratchett was talking about which is a tribunal before which the case could be laid out that a person has had enough - including that they are becoming senile - and have that considered and registered in a public place if indeed permission is given. I think any abuse will show up fairly clearly and that in the future most people will choose this over what will continue to become prolonged old age.

Yeah, I'm all for this.

I had to pull the plug on my brother a few years ago after he suffered a severe head injury that left him bed-ridden with a tube to drain the fluids that would otherwise have built up on his brain.

It was actually a very easy decision to reach. We were very close and had talked about this very situation several times (his health had never been good and he was worried about just such an event). Once the doctors confirmed that there was no realistic likelihood of recovery it was just a matter of signing all the right papers to free the hospital of liability.

Mercifully, once we halted the suction pump that was draining the fluids he died in less than a minute, with no apparent discomfort.

So, yeah.

Love goes both ways, doesn't it?

I'm not sure I could do that to Joph, leave him with that on his head.

I'll make up an advanced directive with instructions for DNR, but I couldn't ask him to take that sort of step. I imagine I would do so for him, should he ask.

Edited, Feb 1st 2010 8:14pm by Atomicflea

There should be a process, but yes. And I'd like to add that the process should be straightforward, even while putting in place checks and balances. Personally I wouldn't choose that route, but I would have a DNR order. I'd also make sure that my will specified that I wasn't to be kept alive in a vegetative state.

'Ere, that's real silver.

No. We must freeze his brain in a jar for future generations to cure his Alzheimers so we can get more Discworld.

I found a partial transcript of the thing - and while I got the impression that he picked his words with great care and was rather self-conscious (given the setting and subject matter, not surprising) - I felt he took a fairly reasonable tack.

From a legislative perspective this is difficult to bring about properly. Broadly the idea is to set up a tribunal with a mandate to give people what they want so long as they have made a serious approach towards considering all that would go into the decision. Fairly obvious to me is that it would be a opt-in only sort of deal - the default state is that people don't want to die unless they (or a relative if they cannot) explicitly indicate otherwise.

In my mind the situations would break out like this:

Self-applicant - Person who goes before the panel to define a set of circumstances where they would like to be killed - limits on reasonable expectation (so a 35 year old with no family history of ALS and who was undiagnosed wouldn't make it in the door if seeking assisted death in the case of ALS - that's just time wasting), the person's general psychological well being.

Application for relative - available in the absences of the self-application for sudden/unexpected/mis- or non-diagnosed disease or accident. Certainly would need a lot more checks than in the case of the self-application, lots of questions over who would have the proper standing in the case (see the Terry Schivo case, husband vs parents). This would just have gray areas, no real way around it.

State ward (who isn't going with self-application) - probably the most severe in terms of backlash (death gubberment death panels anyone?) - but fairly straightforward to legislate sensibly. A state ward gets triggered for review upon meeting certain clearly defined conditions - there's an advocate for and against who present to the panel, the panel decides.

Of course the cynic in me says that humans are never reasonable about death - and that anything that will initially come out will more resemble the current law he says would have "those wishing to assist a friend or relative to die would have to meet quite a large number of criteria in order to escape the chance of prosecution for murder" than anything sensible.

Me neither. I suppose the difficulty lies in finding the right checks and balances so that mistakes don't happen, but even that can't be that hard to do. This really is one of those topics that should've been settled ages ago.

It's true that it's selfish in some cases, but I've experienced about four family conferences in four years (the polite name we give to gathering the family to tell them there is no hope/this is as good as this person's gonna get/consider pulling the plug/can we have organs/this is going to get expensive for you if you want to keep him in your house) where the family struggles to come to a decision, reaches none and four days later the patient starts to move their eyes and fingers enough to answer simple questions, and they all want to live. They all want recovery to the extent that it's possible. We follow them all through therapy and recovery and they are all grateful, even though they're often left with permanent damage, both physical and mental.

I'm all behind making your own decision, but how can you be certain you would make the right one for another person?