Euthanasia for Alcoholics?

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Euthanasia for Alcoholics?

Post by asthmatic camel » Thu Dec 01, 2016 8:12 pm

Linky
A man in the Netherlands has been allowed to die because he could no longer carry on living as an alcoholic.

Mark Langedijk chose the day of his death and was telling jokes, drinking beer and eating ham sandwiches with his family hours before he passed away.

He was killed by lethal injection at his parents’ home on 14 July, according to an account of the ordeal written by his brother and published in the magazine Linda.

The Netherlands introduced a euthanasia law 16 years ago, which is available to people in “unbearable suffering” with no prospect of improvement.

Marcel Langedijk wrote his brother had a “happy childhood” and was loved by both his parents, and only found out he had an addiction eight years ago.

“I was particularly angry at Mark,” he said. “At first we did what most people do; help. My parents especially have done everything humanly possible to save Mark.”

His parents continued to believe in a “happy ending” despite eight years of help and 21 stints in rehab.

Eventually, Mr Langedijk told his family he wanted to die, but the family originally took the news with “a grain of salt”.

But his brother had no second thoughts. His application for euthanasia was approved by a doctor from the Support and Consultation on Euthanasia in the Netherlands.
It's no secret that I've had big problems with alcohol dependence over the years, so this story rather shook me. What do you chaps think? Should euthanasia be available for alcoholics who have repeatedly tried and failed to overcome their problem or not?
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Re: Euthanasia for Alcoholics?

Post by Doctor X » Thu Dec 01, 2016 8:57 pm

Wow.

Going to have to think about it.

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Re: Euthanasia for Alcoholics?

Post by Pyrrho » Thu Dec 01, 2016 11:52 pm

No, for the same reason it shouldn't be available for suicidal people.
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Re: Euthanasia for Alcoholics?

Post by gnome » Fri Dec 02, 2016 12:10 am

Technically speaking that could become a catch-22 as requesting assisted death might be considered suicidal by definition.

But, I do know what you're getting at and no, if someone was pathologically suicidal, as opposed to having a rational reason for assisted death such as a painful terminal disease, I would not want it available to them.
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Re: Euthanasia for Alcoholics?

Post by Anaxagoras » Fri Dec 02, 2016 4:11 am

Hmm, well. Generally I favor allowing people to decide for themselves, and a lethal injection is preferable to throwing yourself in front of a train or something, which is a big nuisance for others. But for old and sick people, not depressed teens. Extreme drug addiction is a tougher question. Article doesn't seem to mention how old he was.

Rehab didn't seem to be working after "21 stints". Would it be any better if he had simply drunk himself to death?

It is controversial but I would err on the side of individual autonomy. I assume they reviewed his case and didn't just rubber-stamp it.
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Re: Euthanasia for Alcoholics?

Post by Doctor X » Fri Dec 02, 2016 5:42 am

Who pays for rehabilitation in the Netherlands?

I fear a secondary gain to get rid of those who, to be fair, are a drain on society.

What I do not read in the article is any indication as to his medical complications secondary to alcohol--such as liver failure. It claims he treated his depression with alcohol, but I do not see that he had clinical depression. I am not denying it, but then his problem is that clinical problem.

I agree with Anax's general principle. Then why did he not administer it himself? No, a physician did it. What disease was the physician treating? What was he alleviating? You treat depression with . . . death?

I do not agree with that. If a patient of sound mind refuses treatment and wishes to commit suicide, that is one thing. Since he has the ability to do so, he should have done it himself. Physician/nurse-assisted suicide/euthanasia is for those who are unable to administer the lethal dosages.

My initial thoughts were I disagreed with it. I am not seeing anything to change that impression. Sadly, this will be used against allowing euthanasia for people who are suffering hopeless situations. I do not wish to diminish another's depression. I truly do not. However, it appears the man had both the ability and willingness to commit suicide.

He should have been allowed to do that.

I reserve the right to change my mind should more evidences--thanks--becomes available.

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Re: Euthanasia for Alcoholics?

Post by Anaxagoras » Fri Dec 02, 2016 8:00 am

So if he should be allowed to commit suicide, should he not also be allowed to enlist others, if they are willing, to assist him? Most of the obvious ways are going to be either messy or painful or both. He could probably inject himself I suppose. Intentional heroin overdose maybe? What do they give these people anyway?
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Re: Euthanasia for Alcoholics?

Post by sparks » Fri Dec 02, 2016 8:29 am

Too much booze affects the mind. Therefore, not being in his right mind, he shouldn't have been allowed to make this 'decision'.

His pain is real, yes, and I sympathize with that. But, dayum!! Lock him up for a year (humanely of course), just to make sure he's really dry and then ask him again if he wants to die.

I would hope the answer would be different than the one he chose.

Oh, and fuck.
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Re: Euthanasia for Alcoholics?

Post by Doctor X » Fri Dec 02, 2016 8:52 am

Anaxagoras wrote:So if he should be allowed to commit suicide, should he not also be allowed to enlist others, if they are willing, to assist him?
No. Not physicians. Not representatives of "the state." Given the details of the article, he required no such assistance. Hell, back when you were still [CENSORED--Ed.] to magazines on some base somewhere, Dr. Kevorkian provided the means for people to do this themselves.
Most of the obvious ways are going to be either messy or painful or both. He could probably inject himself I suppose. Intentional heroin overdose maybe? What do they give these people anyway?
Understood. Painless suicide is not that difficult if someone takes a few moments to do the research. This gets into the whole matter of the mind of the suicide. It appears that [A percentage he pulls from his fundament.--Ed.] have a bit of a "spur" to it. So they do it in such a manner they cannot back out--jump in front of a train, "suicide by cop," listen to Green Day, et cetera.

Make no mistake: physicians have traditionally assisted the terminal across the River of Styx even if they will not admit to it. Up the morphine dose, "slow codes," all the way to the simply withdrawing support. Terri Schiavo was such a situation. Briefly, a physician asked her husband why they bothered to treat yet another urinary tract infection. Her husband was under the delusion that "one day" she would get better: regain consciousness. The fault in that case lay with the medical community unable to "give the bad news" honestly to families. That is another subject entirely.

You may find the infamous "Dax" case enlightening. Briefly, a guy got burned "over a hundred percent of his body" blah . . . blah . . . you can imagine. He gave Power of Attorney to Your His Mom. Then he wanted to die. His Mom, a "good Christian" refused.

What followed was too many years and far too much case law that could have been solved if the dumb fuck simply removed Power of Attorney from his mother. To this day, seriously, he refuses to explain "why." He eventually recovered and all of that and lectured everyone on how "T3h 3v1l" the medical community is. Neat.

He could have refused treatment, but he gave away his rights, then never reclaimed them.

So you have stories and movies with T3h 3v1l doctors and nurses "torturing him against his will!11!!" but what choice did they have?

You may guess the answer: he did not want to die. He wanted--and this is not a criticism since it is a "human thing"--someone to blame for his condition.

This man had far more power to end it himself.

It is a bit of an odd contradiction. Physicians and medical ethicists will quote the Hippocratic Oath with "first, do no harm"--usually quoting it in Latin!--not realizing that that is not actually in the Hippocratic Oath. However, said Oath forbids giving a deadly poison . . . as well as an abortifacient . . . and performing surgery! And accepting payment from students! Funny that! Be that as it may, the reason that proscription is contained in the Oath was to counter the fear that a physician would kick your ass into the grave if Your Loving Family paid him enough!

Move through the centuries of paternalism--"doctor knows best!"--and various cases of abuse of patients, Holocaust, Tuskeegee, Obama Care and, frankly, there should be a reticence concerning those charged with curing you/alleviating suffering killing you. This is why it remains a major problem concerning nurses/physicians who start the IV lines for a lethal injection.

You seek an attorney you hope will do whatever he can to keep your rancid ass out of the stripey hole. He may not be able to do this--next time, Anax, do not post what you did to that salariman with that fish on your company's webpage--but you hope he will do his best. He knows the law, you do not, so you trust him.

Same with physicians.

From a utilitarian/cold equation, perspective there are a lot of people who should not be on this planet. We can argue about this until we get drunk to sooth our anger. Do you want your defense attorney to have a stake in having your ass convicted?

What Follows is Distasteful but Unfortunately Real:

Forgive me for making this personal: imagine you have Another Wee Spud. Fortunately, for her sake, she takes after お母さん rather than your rancid ass. We will let her grow up a bit. Junior high equivalent. Just old enough that the idea of becoming an adult starts to form in her head--just enough so ワイフさん starts muttering to you--she starts becoming independent. ワイフさん narrows her eyes and mentions she has spent some time with "That Toshi!"

"Who?"

She narrows her eyes further which can only mean you have, once again, failed as 父 which means yet another night of cold ramen.

She suffers a C2-3 level incomplete spinal cord injury.

Forgive me for writing that, it is unfair, but unfortunately it is a reality.

Oh there is surgery which will stabilize the spine and all of that. Bottom line is ventilator dependency with loss of use of arms and legs. Modern Medicine [Tm.--Ed.] can make it so she can live a long life . . . trapped in her body. Feeding tube. If the injury is incomplete, she can feel every pain. Multiple surgeries will follow to deal with decubitus ulcers, urinary tract infections, spasticity, et cetera.

She wants to die.

Now, as a parent, as an actual parent as you have children--apologies, again, for seemingly making this personal--this is one of the Worst Nightmares you can have. There is no end to this condition. Cancer? It will end. Permanent vegetative state? Well, it sort of "ended" long ago.

Here you have a conscious near-adult who simply does not want to live a life in that state. Oh, particularly in America where Jesus Is There For You, we can parade a crap-load of people in similar conditions who are "so happy" to be in that condition.

Actually, no. Not many are. But we have people who like to speak for them.

As a parent, what do you do?

You would, I imagine, like some advice, some objective advice. Someone to tell you not only what the prognosis is but how people have--and have not--dealt with the condition. Generally, avoidance of decisions is the "default" position. Keep telling a person "life is worth living!" and then ship them off to someone else. It is a human thing.

But it is not for everyone. Some, in that state, do live. Do find a meaningful existence. To that, I recommend the self-confessed sick cartoonist Callaghan:

Image
Image

who draws these with his teeth.

Is that the existence for your daughter? Who the fuck has the right to make that decision.

So . . . with all apologies . . . do you want a physician to advise you who also is allowed by the government to kill her? Make no mistake: that is what it is. The physician in the article murdered the man.

Was it "justifiable homicide?"

Whom do you ask? Whom is objective?

This is my issue.

In the distasteful example I gave, the victim is unable to act to end her suffering. Medicine can simply withdraw support and give palliative care which is what happens, in reality, in these cases where the victim chooses not to continue. You have met no greater tragedy than the one I described: where a child wants to die but the parent has to give permission.

This guy?

Who could walk, talk, eat a fucking sandwich? Drink beers!

Do you want the physician who decided his life was not worth living to advise you?

Can you trust him?

That is my issue Anax. The "right answer" may be to let your hypothetical daughter go . . . but do you want to hear that from me? Some asshole on an internet board?

Some doctor who makes as part of his career killing patients?

--J.D.
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Re: Euthanasia for Alcoholics?

Post by Anaxagoras » Fri Dec 02, 2016 10:22 am

Well, when you put it that way, being an alcoholic by itself doesn't seem like a good enough reason.

The person who is paralyzed would necessarily need somebody's assistance.

I assume that no physician tried to talk this man into ending his own life. Did he not try hard enough to talk him out of it though? I don't know their system. Maybe there should be a mandatory waiting period and mandatory counseling, where the person doing the counseling has no incentive to talk the person into dying, they get paid the same either way. And they actually try to see if there is a way for the person to find some reason to live.

It all depends on the situation though. If it is someone rapidly approaching the last stages of a terminal disease, a mandatory waiting period would seem to defeat the purpose.
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Re: Euthanasia for Alcoholics?

Post by Abdul Alhazred » Fri Dec 02, 2016 10:36 am

These issues are why I am opposed to the medical profession being officially involved in assisted suicide.

It will always tend toward more and more suicide for lesser and lesser reasons.

"Guidelines" are just hypocritical public positions, even if written into law.
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Re: Euthanasia for Alcoholics?

Post by Doctor X » Fri Dec 02, 2016 10:39 am

At least according to the article linked, he spend about a year and a half in evaluation before he obtained approval. No other details on what the vetting was. Still, as you put it, that leaves a lot of questions.

Given that the default position of a bureaucracy is to limit if not quash anything that would cost money and/or man-power, I distrust a bureaucracy making this decision. To put it more succinctly, I can definitely see a very human physician, charged with making these decisions, decided there is no reason to keep a pain in the ass alive. Fine if the pain in the ass wishes to leave. Not so fine that an official government operative could decide based on what gets him back to his television programs the fastest.

This is my mistrust, Anax. As I indicated in my "nasty" example: the correct decision may be to let a teen in that horrible condition "go." It is very easy for the healthy to decide that someone else should suffer to keep their ethics pure. I get that.

But.

A person charged by said bureaucracy will feel the pressure, even from just the hospital, to lessen its burden--and the "daughter" in my example is a burden in strict monetary and human effort sense. The "Right Answer" may be arrived at from the wrong reasoning which makes the "Wrong Answer" all too possible.

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Re: Euthanasia for Alcoholics?

Post by Pyrrho » Fri Dec 02, 2016 12:01 pm

There is a writer "out there" who suffers from bipolar disorder. This writer is against the availability of euthanasia described in the OP, because it would be that much easier for a mentally ill person to decide to end it all and to carry through on it. The point is that the bipolar sufferer is not always in a suicidal state. The writer does not want to commit suicide and does not want to be able to make such a decision during a period when the writer is "unwell."
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Re: Euthanasia for Alcoholics?

Post by Rob Lister » Fri Dec 02, 2016 1:01 pm

This is a hard one.

In the midst of his disease, the chronic alcoholic will idealize suicide 16 hours of every day and sleep fitfully the other 8.

In the rooms you will hear words to the effect, 'Suicide is a permanent solution to this temporary problem. Treatment is the only sane option.'

But ...

Point in fact: treatment is not always successful. 21 rehabs over 8 years is not evidence of success.

Point in fact: without successful treatment, the alcohol will kill him anyway, usually in a matter of a few agonizing years.

It is a very painful and lonely death.

I won't take a position because I do not know his circumstances.

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Re: Euthanasia for Alcoholics?

Post by Abdul Alhazred » Fri Dec 02, 2016 2:09 pm

It's only a hard one if you favor "euthanasia" as an institution at all.

Yes sometimes suicide can be a rational decision. That's not the point.
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Re: Euthanasia for Alcoholics?

Post by gnome » Fri Dec 02, 2016 3:15 pm

Kind of agree. I'm one to take a hard line that the medical industry or government should only be allowed an assistance role if the person is convincingly of sound mind.
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Re: Euthanasia for Alcoholics?

Post by Rob Lister » Fri Dec 02, 2016 3:27 pm

gnome wrote:Kind of agree. I'm one to take a hard line that the medical industry or government should only be allowed an assistance role if the person is convincingly of sound mind.
And if 'a sound mind' is not possible?

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Re: Euthanasia for Alcoholics?

Post by asthmatic camel » Fri Dec 02, 2016 4:04 pm

Rob Lister wrote:This is a hard one.

In the midst of his disease, the chronic alcoholic will idealize suicide 16 hours of every day and sleep fitfully the other 8.

In the rooms you will hear words to the effect, 'Suicide is a permanent solution to this temporary problem. Treatment is the only sane option.'

But ...

Point in fact: treatment is not always successful. 21 rehabs over 8 years is not evidence of success.

Point in fact: without successful treatment, the alcohol will kill him anyway, usually in a matter of a few agonizing years.

It is a very painful and lonely death.

I won't take a position because I do not know his circumstances.
Nearly 4 rehabs a year. That's what really struck me about this case. I really wonder whether the guy has ever managed to remain sober for long enough to see any benefit from doing so. A medically supervised detox usually takes around seven days but that's only the start of recovery. While the physical symptoms of withdrawal disappear quite quickly, learning to live without alcohol takes a long time, many years for some, and relapse is a high risk for life.

From what I've read over the years, the success rate of treatment for alcoholics who seek it is only around 50% and the prognosis for those who fail is grim, as Listy points out; death from accident, disease or suicide the likeliest outcome.
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Re: Euthanasia for Alcoholics?

Post by gnome » Fri Dec 02, 2016 6:00 pm

Rob Lister wrote:
gnome wrote:Kind of agree. I'm one to take a hard line that the medical industry or government should only be allowed an assistance role if the person is convincingly of sound mind.
And if 'a sound mind' is not possible?
I would be against it. Voluntary assisted suicide is not voluntary if the person does not have the capacity to make decisions about their own well being.
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Re: Euthanasia for Alcoholics?

Post by Rob Lister » Fri Dec 02, 2016 6:28 pm

So a man of non-sound mind may not elect euthanasia regardless of his pain? What if the pain causes the non-sound mind?