Healthy 24-year-old granted right to die in Belgium

[garbon]

Incidentally, I find the reasoning which differentiates between physical pain and psychological pain to be quite outdated. The key questions should be whether the pain is preventable, what the downsides of the therapy are and whether the patient is willing to go through with it. Living in severe incurable physical pain is really no different from living in severe incurable mental anguish.

I feel like with something like mental illness the test might need to be more stringent. I've no idea if we can decided suicidal thoughts are incurable after 3 years.

[Valmy]

This is one of those things I would just assume they keep in Europe. Doctors should not be in the business of killing people. The unintended consequences of such a thing are just too extreme, especially when we get a situation where Marty is saying every emo teen and twenty something can get a doctors note for TEH LIBERTY. Just what we want our limited medical resources going towards.

If they want to off themselves then we have plenty of easily legally obtained fire arms and classes to teach them how to use them. No need to pull the poor doctors into doing something that is not their job.

[Valmy]

Mark my words, one day we will have someone sue the police when they prevent a person from jumping off a bridge.

Yep. If you want to commit suicide have the courage to do it yourself and not seek to make everybody else responsible for it.

[Martinus]

Valmy, would you be for it, though, if someone was not terminally ill and not in physical pain, but their condition made it impossible for them to commit suicide on their own without some severe pain (e.g. they are paralysed and the only way they could commit suicide unassisted was starving themselves to death)?

[Martinus]

This is one of those things I would just assume they keep in Europe. Doctors should not be in the business of killing people. The unintended consequences of such a thing are just too extreme, especially when we get a situation where Marty is saying every emo teen and twenty something can get a doctors note for TEH LIBERTY. Just what we want our limited medical resources going towards.

If they want to off themselves then we have plenty of easily legally obtained fire arms and classes to teach them how to use them. No need to pull the poor doctors into doing something that is not their job.

I agree with you but I think this is not the issue here - this is not about forcing a particular doctor to assist with suicide - more about not punishing doctors who do it out of their own volition.

[sbr]

I don't know how it works in Belgium, but here the doctor writes a fatal prescription and that is it; it's not like the doctor is injecting them with drugs or hitting them over the head with a shovel.  The person that wants to die still has to do the hard part themselves but it is less messy, guaranteed to work*, and can be done in the company of loved ones.

[Berkut]

That would seem to absolutely preclude anyone from choosing euthenasia while being physically healthy. Mental illness, almost by definition, precludes a sound mind in general, and a desire to destroy yourself is almost (to me) definitionally indicative of a significant impairment in an ability to think reasonably and rationally.

I disagree with your assessment that someone who wants to kill themselves but is physically healthy must be mentally ill.

I am surprised that you would consider someone in such extreme mental anguish that they feel their only recourse is suicide to be mentally healthy.

Isn't that the very definition of a mental illness?

[Ed Anger]

I know who I'd like to smother with a pillow.

*glances at Tim*

[Martinus]

That would seem to absolutely preclude anyone from choosing euthenasia while being physically healthy. Mental illness, almost by definition, precludes a sound mind in general, and a desire to destroy yourself is almost (to me) definitionally indicative of a significant impairment in an ability to think reasonably and rationally.

I disagree with your assessment that someone who wants to kill themselves but is physically healthy must be mentally ill.

I am surprised that you would consider someone in such extreme mental anguish that they feel their only recourse is suicide to be mentally healthy.

Isn't that the very definition of a mental illness?

Fine, let me rephrase - only the kind of mental illness that removes or significantly impedes cognitive capacity should preclude one from being eligible for assisted suicide.

[DontSayBanana]

I don't see the hubbub.  That kind of extreme depression tends to result in suicidal tendencies or attempts anyway.  Also, why should only people with a terminal physical condition have the right to end their own lives?

On the flip side of the coin, though, I could see an argument being made that the candidate should have to be of sound mental state to choose to terminate their own life, and this patient could be considered mentally unsound (dealing with depression myself, I'm very familiar with the fits of irrationality that go along with it).

[Josquius]

If you want to die you should be allowed to die.
If you can do this in a way that doesn't cause trauma for train drivers, your buildings caretaker, etc... Then so much the better.

[Berkut]

That would seem to absolutely preclude anyone from choosing euthenasia while being physically healthy. Mental illness, almost by definition, precludes a sound mind in general, and a desire to destroy yourself is almost (to me) definitionally indicative of a significant impairment in an ability to think reasonably and rationally.

I disagree with your assessment that someone who wants to kill themselves but is physically healthy must be mentally ill.

I am surprised that you would consider someone in such extreme mental anguish that they feel their only recourse is suicide to be mentally healthy.

Isn't that the very definition of a mental illness?

Fine, let me rephrase - only the kind of mental illness that removes or significantly impedes cognitive capacity should preclude one from being eligible for assisted suicide.

Then we are agreed.

How do you tell if a mental illness has significantly impeded cognitive capacity?

Would making clearly irrational choices be considered evidence that cognitive capacity has been impeded?

Should there not be some kind of assessment made by a competent healthcare professional (in this case a psychiatrist) to determine if there is significant cognitive impairment as a result of their illness?

I suspect that most psychiatrists would consider "I want to kill myself even though there is nothing physically wrong with me" to be evidence that a person is not thinking with complete clarity and soundness of mind.

Mental illness and physical illness are NOT the same thing.

[garbon]

I suspect that most psychiatrists would consider "I want to kill myself even though there is nothing physically wrong with me" to be evidence that a person is not thinking with complete clarity and soundness of mind.

Mental illness and physical illness are NOT the same thing.

But what if it isn't something curable. Like let's say bipolar disorder, crippling enough that said person needs to be in some sort of care for their entire lives (which was the case with my grandmother, though initially her care was handled by her husband).

While, certainly I wouldn't have wanted my grandmother to kill herself, if she felt that her life wasn't worth living because of her mental illness - is that anguish not enough? Must it be physical pain?

[Berkut]

I suspect that most psychiatrists would consider "I want to kill myself even though there is nothing physically wrong with me" to be evidence that a person is not thinking with complete clarity and soundness of mind.

Mental illness and physical illness are NOT the same thing.

But what if it isn't something curable. Like let's say bipolar disorder, crippling enough that said person needs to be in some sort of care for their entire lives (which was the case with my grandmother, though initially her care was handled by her husband).

While, certainly I wouldn't have wanted my grandmother to kill herself, if she felt that her life wasn't worth living because of her mental illness - is that anguish not enough? Must it be physical pain?

Those are good questions - I don't know the answer, but I would not assume it to be "Yeah, anyone who wants to kill themselves should be helped to do so regardless of a reasonable evaulation of their mental state".

I think I am ok with the idea that doctors be allowed to help people end their lives gracefully under a certain, narrow set of circumstances. I would rather we recognize that there will be sets of circumstances where people might want to end their lives that are justificable, yet still do not fall under the set of circumstances where we allow doctors to involve themselves, then expand the doctor assistance set much, if at all.

IMO, if the set of circumstances that lead to people wanting to kill themselves is 100 cases, previously we said there were zero cases where doctors should be involved. Now we pass some laws intended to address terminal, physical illness where someone is in gross pain, and we all agree that a death with dignity is appropriate. Lets say that is 3 out of those 100.

Now we are saying that maybe we should expand that to some cases where there is not such clear agreement? Say 10 out of 100? 20?

I don't think that going from 0 to 3 means we must go from 3 to 10 or 20 or even 4.

I think the set for doctors to involve themselves in the death of a human being should be limited to those clear cut, obvious cases where death is coming anyway, and the difference of suicide is simply to allow the person to die with some measure of dignity and comfort.

[Martinus]

garbon's example is a good one. Another could be someone suffering from severe violent sexual obsession or pedophilia that would be incurable.

Generally, I think we should err on the side of freedom and dignity - and this includes freedom to choose how to end one's life, unless there is a very strong reason why this right should be denied (so unlike you, Berkut, I think the narrow set of circumstances should apply to situations where euthanasia is not available).

To me the attitude of "we will not prevent you from killing yourself in some disruptive and gruesome way but we will not help you do it with dignity and in a respectful manner either" smacks of hypocrisy.