Euthanasia for depression

[Os Cangaceiros]

This is a little bit old, but I've been meaning to post it. It's an excellent article about a subject I previously had very little knowledge of:

http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

I'm kind of two minds about it. On the one hand, I believe that everyone should have mastery over their own existence, and that includes being able to choose when to end it. But, on the other hand, I know that I'd be really upset if someone I knew who was depressed actually went ahead and did this.

[Luís Henrique]

This is a little bit old, but I've been meaning to post it. It's an excellent article about a subject I previously had very little knowledge of:

http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

I'm kind of two minds about it. On the one hand, I believe that everyone should have mastery over their own existence, and that includes being able to choose when to end it. But, on the other hand, I know that I'd be really upset if someone I knew who was depressed actually went ahead and did this.

Distelmans is basically a murderer that manages to convince his victims to pay for the "service" of killing them.

Luís Henrique

[Zoop]

Yes, I am in favour of euthanasia. People should be able to willingly end their life in a humane way.

That isn't to say their shouldn't be safety measures and certain rules surrounding it. I think there should be. Other than that though, yes people should be able to.

[BIXX]

That isn't to say their shouldn't be safety measures and certain rules surrounding it

Why do you think this? Do you mean rules and regulations to make sure they actually die, or rules and regulations to decide whether or not their desire to die is legitimate?


I'm of the opinion people who want to die can do so. I've had friends who I've prevented from committing suicide and I've at times wanted to commit suicide. Idk if I made the right decision to "save" someone from suicide, I kinda doubt I did. But honestly at the same time I don't think these issues can have a solutions that says "well if xyz conditions are met then suicide is OK but not if abc conditions are met" or whatever other ruberic is decided on. It has a lot more to do with interpersonal relations I think.

[Sharia Lawn]

Why do you think this? Do you mean rules and regulations to make sure they actually die, or rules and regulations to decide whether or not their desire to die is legitimate?


I'm of the opinion people who want to die can do so. I've had friends who I've prevented from committing suicide and I've at times wanted to commit suicide. Idk if I made the right decision to "save" someone from suicide, I kinda doubt I did. But honestly at the same time I don't think these issues can have a solutions that says "well if xyz conditions are met then suicide is OK but not if abc conditions are met" or whatever other ruberic is decided on. It has a lot more to do with interpersonal relations I think.

Rules like this are the product of civilization. Bad.

[BIXX]

Distelmans is basically a murderer that manages to convince his victims to pay for the "service" of killing them.

Luís Henrique

While I don't really care for the fact folks are paying for it, I don't see the issue with him killing them.

[Zoop]

Why do you think this? Do you mean rules and regulations to make sure they actually die, or rules and regulations to decide whether or not their desire to die is legitimate?


I'm of the opinion people who want to die can do so. I've had friends who I've prevented from committing suicide and I've at times wanted to commit suicide. Idk if I made the right decision to "save" someone from suicide, I kinda doubt I did. But honestly at the same time I don't think these issues can have a solutions that says "well if xyz conditions are met then suicide is OK but not if abc conditions are met" or whatever other ruberic is decided on. It has a lot more to do with interpersonal relations I think.

I just meant rules like age restrictions etc. I wouldn't know what other rules to put in place. I wouldn't want hardly any rules to exist to be fair, just reasonable ones, like age restrictions. Other than that, people can end their life if they wish to.

edit: I can see problems arising from adopting rules. There is the chance of them becoming too strict, which would essentially force people to attempt suicide some other way.

[Luís Henrique]

I just meant rules like age restrictions etc. I wouldn't know what other rules to put in place. I wouldn't want hardly any rules to exist to be fair, just reasonable ones, like age restrictions. Other than that, people can end their life if they wish to.

edit: I can see problems arising from adopting rules. There is the chance of them becoming too strict, which would essentially force people to attempt suicide some other way.

Here are some very basic rules that should be put in place:


It should not be a private business; the physicians conducting euthanasia should be civil servants (and should never be closely related to private physicians that have had the patient under their care). Maybe, indeed, the officers conducting euthanasia shouldn't even be physicians (who are infamous for covering each other's mistakes and crimes);
It should be strictly forbidden for anyone involved in the euthanasia process to inherit or receive donations from the patients;
Physicians who were dismissed by the patient on complaints about their professional skills should never be accepted as experts in the decision process;
Contact with close family - parents, children, siblings - should be mandatory, not optional.


What we have here is pure and simple murder. A patient with depression is convinced by an utterly dishonest physician that she should be offed; in the process, she makes donations to the foundation of the chief murderer, and pays him as if he was her physician. The obvious fact that she was a highly sugestionable person - who created strong ties of dependence with her psychiatrists - was completely ignored. Her familly was ignored. Several expert opinions were dismissed, to the point that they had to resort to her ex-psychiatrist - whose care she had abandoned, questioning his competence.

She was milked for her money, mislead on her prospectives regarding quality of life, and murdered.

And the chief murderer gives speeches at schools to peddle his murderous business, under the guise of "humanism".

Luís Henrique

[Redistribute the Rep]

I would do it if such services were available. I'm not really sure it's ethical though: a lot of my suicidal thoughts are based on irrational beliefs. And like LH said people who are in a desperate situation could be taken advantage of.

[Futility Personified]

It is a fundamental human right to decide when to end it, and if someone wants to go that route that should not be impeded, save for a select few criteria which determine if they can salvage their existence.

For this concept to be even remotely linked to profiteering however, is completely fucking perverse. We are anti-capitalists, but talking real politik, anyone without a pound coin rammed up their heiney, it should be bitterly obvious that convincing someone to die (save maybe Blair or Friedman) is not ethical or justifiable in any convoluted sense of decency.

[Luís Henrique]

The cynicism is utterly shocking:


[De Deyn] dismissed Kerstin’s account, telling me that she was a psychiatric patient—the same thing that Distelmans said about Tom when discounting his complaints.

So they dismiss the complaints of relatives of their victims, because such relatives are psychiatric patients - you know, psychiatric patients do not know what they do or say.

Except if what they do or say is to request for euthanasia, in which case the physicians should not question what they do or say, and instead move to off them as soon as possible.

What a couple of arseholes.

Coherence sends greetings.

Luís Henrique

[Hermes]

Contact with close family - parents, children, siblings - should be mandatory, not optional.

Sorry for not actually quoting you, quote button for you isn't working. What do you mean when you say contact?


It is a fundamental human right to decide when to end it, and if someone wants to go that route that should not be impeded, save for a select few criteria which determine if they can salvage their existence.

What do you mean when you say that you want 'a few select criteria which determine if they can salvage their existence'?


I don't know. I can see the argument for certain safeguards to be in place, so that someone isn't influenced into killing themselves, but how do you avoid creating a situation in which anyone who wants to kill themselves is prevented from doing so solely because by wanting to kill themselves, they're incapable of making that decision?

[Luís Henrique]

Sorry for not actually quoting you, quote button for you isn't working. What do you mean when you say contact?

Talking to.


I don't know. I can see the argument for certain safeguards to be in place, so that someone isn't influenced into killing themselves, but how do you avoid creating a situation in which anyone who wants to kill themselves is prevented from doing so solely because by wanting to kill themselves, they're incapable of making that decision?

Psychological suffering should not be a reason for "euthanasia", because arguably a person who is in psychological suffering does not fully control his or her own feelings and reasoning.

As in, the "they are a psychiatric patient, so what they have to say about their close relatives' deaths should be taken with a grain of salt" argument that those murderers use as an excuse to avoid being called upon their actions should apply, with more reason, to life-impacting decisions by psychiatric patients.

Anyone can kill themselves without the need of the rubberstamping of the iatrocracy; what is absurd is to take people into counseling, and then direct them, via medical authority, into perfectly avoidable deaths. Euthanasia should be strictly reserved to terminal patients who would off themselves if they could physically do it, but are too debilitated for the task.

Luís Henrique

[Hatshepsut]

I believe that everyone should have mastery over their own existence...

Perhaps we should have such mastery. Or we wish we had it. But we don't. At the beginning, when we're born without having asked for this to happen. In most cases, at the end, when we depart under circumstances we would never choose freely. There's a lot of stuff we don't control.

Also with doctor-assisted deaths, where such laws permit. Only a minority with money and enough remaining health to doctor-shop aggressively, or have longstanding relationships with personal physicians, are likely to be offered this option. For the poorer folk, if one must end it and can still walk, there are the tracks where the freight trains run.

For a change I can even see a problem with all the rules that are made about it. No matter how expert a doctor is, it remains impossible to read someone's mind and determine "legitimacy" of any request to die. Sartre and Dostoyevsky aside, death is not a philosophical exercise nor a situation ethics has effective tools to analyze. It's a totally alien experience we know nothing about the whole time we're here on earth, beyond the fact that it's the outcome of life. Death is the only thing we do utterly alone; no one goes there with us when it is time.


A patient with depression is convinced by an utterly dishonest physician that she should be offed; in the process, she makes donations to the foundation of the chief murderer, and pays him as if he was her physician.

I didn't see this in the New Yorker article. Was there a related story elsewhere that has this money donation? In the New Yorker, Dr. Wim Distelmans deals with the depressed lady; another physician, Dr. Peter De Deyn, accepts the brain of an Alzheimer's patient he has euthanized. The latter scenario is obviously bad without the money.

But we can't say that to kill a patient in great pain with narcotics instead is the same thing as murder. It may be an act of mercy. Whether "purely" psychiatric ailments qualify as being "painful enough" is something I don't know; I've never had the condition in question—and neither has the doctor, which complicates making such judgments. No one can feel another's pain. Consulting family is problematic as well. Does it become the decision of kin, who might want to inherit, who might be exhausted by home caregiving, or on the flip side, be too sentimental to let their loved one go?

There's really no good way to die, nor any easy way to help someone else do so. Death sucks.

[Palmares]

I'm unsure if anyone here is familiar with Dr Philip Nitschke, but he has been quite prominent in both Australia and abroad in the euthanasia debate.

https://en.wikipedia.org/wiki/Philip_Nitschke

He has even written a book about how someone can end their own lives themselves, and even helped invent devices to assist with thus. Not to mention, when he has had legal opportunity, he has assisted a few people in ending their lives.

From what I remember, in a legal sense, he is for only assisted-suicide for those with extreme-illnesses. But in general, he believes if someone wants to end their own life, irrespective of circumstance, it's their own prerogative.

[Luís Henrique]

I didn't see this in the New Yorker article. Was there a related story elsewhere that has this money donation? In the New Yorker, Dr. Wim Distelmans deals with the depressed lady; another physician, Dr. Peter De Deyn, accepts the brain of an Alzheimer's patient he has euthanized. The latter scenario is obviously bad without the money.

There is also this:


When Tom read his mother’s daily planner, he saw that she had met with Distelmans at least six times in the past eight months. Seven weeks before her death, she donated twenty-five hundred euros to LEIF, the organization that Distelmans had founded. On the bank-transfer form she had written, “Thanks to the staff at LEIF.”

In other words, she was swindled and murdered. As the whole fiasco is based on the idea of "dying with dignity", I must say that I don't see anything particularly "deign" in being swindled and murdered.


Whether "purely" psychiatric ailments qualify as being "painful enough" is something I don't know; I've never had the condition in question—and neither has the doctor, which complicates making such judgments.

Indeed, he is an oncologist. But he pretty well knows what he is doing. When the son of his victim complains about the way things were handled, he dismisses him, commenting that he is "a psychiatric patient". So why did he not dismiss his victim's demands, since she "was a psychiatric patient"? My answer is brutal, but I very much doubt it isn't spot on: because the son's complaints are a source of trouble, while the patient's demand were a source of profit - of 2,500 euros, to be precise.


No one can feel another's pain. Consulting family is problematic as well. Does it become the decision of kin, who might want to inherit, who might be exs hausted by home caregiving, or on the flip side, be too sentimental to let their loved one go?

Ah, but we read from the patient's former therapist that


“after recent rejection by her latest partner and by her children, her psychiatric issues will not improve.”

And so the obvious step is to check whether such rejection is real or definitive. Which means something very simple: "I'm sorry, Ms. De Troyer, but I won't rubberstamp this procedure unless you agree to meet your children" (which, incidentally, is what was told to the victim's son when he queried about the issue).

It shouldn't become the decision of kin, for the reasons you point, but the decision of the patient should be informed by an actual grasp of what the dispositions of kin are, instead of unchecked fantasies (proper of a psychiatric patient, let's remember).


There's really no good way to die, nor any easy way to help someone else do so. Death sucks.

Which is perhaps the reason why this whole thing is so awful - because the idea of "deat with dignity" is being promised, but not actually delivered.

Luís Henrique

[Anglo-Saxon Philistine]

It should not be a private business; the physicians conducting euthanasia should be civil servants (and should never be closely related to private physicians that have had the patient under their care). Maybe, indeed, the officers conducting euthanasia shouldn't even be physicians (who are infamous for covering each other's mistakes and crimes);

Civil servants serve, not civil society but the bourgeois state. Now the bourgeois state has proven itself to be anything but impartial when administering death (only to persons who don't want to die, as of the time of writing). If you're worried about abuses, it makes much less sense to trust the bourgeois state than individual physicians.


Contact with close family - parents, children, siblings - should be mandatory, not optional.

And here I can only echo other posters: why? This does nothing but bolster the family unit, something socialists should surely see as problematic. The reason you give in your reply to Hatshepsut applies, at best, to this one case. Why make that a requirement for every procedure? Why even write these requirements as if the situation can be resolved with some sort of reform?

This is an awful situation but we live in an awful world and sometimes, the world can't be made less awful in any meaningful sense without the sort of fundamental change we call for (or should call for). In the meantime socialists can only oppose the bourgeois state when it prosecutes doctors who euthanise patients. We won't solve this short of the revolution, however.

[Hatshepsut]

In other words, she was swindled and murdered.

Duly noted & thanks. So we got two crooks here. Is that typical of bourgeois doctoring? The siren songs of Mammon are hardly rare in capitalist countries, yet Rachel Aviv has to hunt for those two examples to support her selective position on the overall issue. I suspect she has religious objections to assisted death although without proof; her writing style suggests it may be so although she doesn't editorialize. See

Aviv. "Like I Was Jesus," Harper's, Aug. 2009
http://harpers.org/archive/2009/08/like-i-was-jesus/

The only thing getting older has done for me is to demonstrate the futility of mollycoddling and idiot-proofing our world. In youth of course I dropped for that fallacy; to be young is to be idealistic, and in general that's a good thing. But no post-capitalist political economy is going to bring us a trouble-free existence. Health care is demanding by nature, especially when complex psychiatric problems are involved; resource limitations apply whether we like it or not, meaning this good will be rationed in some way. As a communist, I prefer it be rationed by having people wait their turn than by the current system of treating those who can pay.

Rejecting paternalism in favor of self-determination while protecting people from themselves is mutually contradictory as well. One can only balance between these two diametrically opposed goals.

In short, I think the lethal narcotic and a nurse's attendance should be given to those who express a wish to die, provided they are of age and express that wish clearly, say by repeating it several times over a period of weeks or months in an environment where family or friends who might be pressuring them are absent. Then the patients can activate the dose themselves, making it clear that's what they really want to do. I'm willing to bet not too many folks will actually take this offer even if they are psychiatric. You have to get pretty hard up to choose death. Whether the family is informed beforehand or visits at the time of death should be as the patient desires. Patients who can't express a wish or are underage will be given enough narcotics to sedate or make comfortable and allowed to die naturally. Because of our drug-warrior mentality we don't even do that in the USA, where dying in pain is a normal outcome of fatal diseases.

[Luís Henrique]

Civil servants serve, not civil society but the bourgeois state.

Well, if we are going to be precise, then civil servants serve the bourgeois State, and the bourgeois State serves "civil society", which is society as organised by capital, not society in abstract.


Now the bourgeois state has proven itself to be anything but impartial when administering death (only to persons who don't want to die, as of the time of writing).

That being the main reason why we oppose the death penalty. But that is altogether a different issue; the point in death penalty is that is politically motivated; the State offs people whom it perceives, rightly or wrongly, as its enemies, ie, as enemies of the bourgeois rule. Offing people who aren't perceived as State enemies isn't in the direct interest of the State.


If you're worried about abuses, it makes much less sense to trust the bourgeois state than individual physicians.

Well, we will have to trust the State at some level anyway: either as the direct executioner of people (and it would be better, as it would introduce a separation between decision and execution, instead of allowing private physicians to play god, deciding and then executing), or as the regulator of the whole process.


And here I can only echo other posters: why? This does nothing but bolster the family unit, something socialists should surely see as problematic. The reason you give in your reply to Hatshepsut applies, at best, to this one case. Why make that a requirement for every procedure? Why even write these requirements as if the situation can be resolved with some sort of reform?

Because we are social animals, not Lockean fantasies lost in a desert island. And the precise forms of our society, albeit not being what we want, are the actual forms of our socialisation. Whether we like it or not, close relatives are the people most likely to care for us, because this is the way we are socialised.


This is an awful situation but we live in an awful world and sometimes, the world can't be made less awful in any meaningful sense without the sort of fundamental change we call for (or should call for). In the meantime socialists can only oppose the bourgeois state when it prosecutes doctors who euthanise patients. We won't solve this short of the revolution, however.

I am sorry, but nothing of this follows. If we should oppose the State when it persecute private physicians that carry on illegal euthanasia, why should we support the State when it upholds physicians who carry on legal assessinations, even making procedures against their malpractice secret, in order to hinder complainants?

And yes, the solution for this kind of problems is a socialist revolution, but in order to make a socialist revolution, the working class must take power and become the ruling class. And in order to become the ruling class, the working class must state its will to rule. If we are going to say that anything goes, because short of socialist revolution nothing satisfies us, then we are simply stating our willingness to rule. The ruling class must make its points clear, in all subjects of public discussion, or it is unfit for rule.

Luís Henrique

[Sasha]

The average traindriver is forced to dismember at least 3 people over the course of their career...

Let that sink in for an moment.

an absolute right to medical assisted suicide is not only better for those left behind and those dragged in involuntary, its better for the suicidal too as you can first see if you can help them in a less drastic way.
Suicide is not unlike drug use or abortion, you dont have to aprove of the act to know the alternative to legalization is worse, both in a brutally practical way as in a moral principal sense.
Nor does this mean, like with drugs and abortion, that we shouldn't put extreme efforts in removing the societal conditions that lead to them in the first place.

[Anglo-Saxon Philistine]

Well, if we are going to be precise, then civil servants serve the bourgeois State, and the bourgeois State serves "civil society", which is society as organised by capital, not society in abstract.

But this was notably not Marx's (and Lenin's and so on) view of the state - that it "serves civil society" (it goes without saying that the present society is the capitalist society). In fact Marx famously called it a "parasitic excrescence" from society, the "state parasite" feeding upon and restricting society.


That being the main reason why we oppose the death penalty. But that is altogether a different issue; the point in death penalty is that is politically motivated; the State offs people whom it perceives, rightly or wrongly, as its enemies, ie, as enemies of the bourgeois rule. Offing people who aren't perceived as State enemies isn't in the direct interest of the State.

I would venture a guess that even the most paranoid official of the US state does not think that most black workers executed by the US are "enemies of the state", and the same goes for their Iranian counterparts with regards to Kurds, and so on. Sure, the death penalty is useful for the bourgeois state when dealing with political enemies. It is also useful in other ways. It keeps the lowest strata of the proletariat - and in the US an entire colour-caste - down, along other things of course. It also exterminates those, like homosexual workers, who do not conform to the family as the manner in which the proletariat is reproduced as a class of dispossessed producers. To believe that the bourgeois state would not use euthanasia for these other purposes is staggeringly naive - and indeed flies in the face of historical experience.


Well, we will have to trust the State at some level anyway: either as the direct executioner of people (and it would be better, as it would introduce a separation between decision and execution, instead of allowing private physicians to play god, deciding and then executing), or as the regulator of the whole process.

Must we, now? We aren't trying to set up the perfect laws in accordance with some "principle of universal justice". To do so would be sub-reformism. We are merely opposed to the bourgeois state prosecuting doctors who preform euthanasia. To extend our support to acts of the bourgeois state would be worse than stupidity, it would be political suicide.

Back in the real world anyway. Here on RevLeft, the funerary home of the revolutionary left, the bourgeois state probably ranks in popularity just after Kautsky.


Because we are social animals, not Lockean fantasies lost in a desert island. And the precise forms of our society, albeit not being what we want, are the actual forms of our socialisation. Whether we like it or not, close relatives are the people most likely to care for us, because this is the way we are socialised.

This has to be the world's most generic answer. It can be offered as an "explanation" for anything. Why should someone's family decide who they can fuck? "Because we are social animals, not Lockean fantasies lost in a desert island." Why should someone's family decide what profession they take up? "Because we are social animals, not Lockean fantasies lost in a desert island." It doesn't mean anything. The supposed intention is to oppose individualism, the ridiculous, one-sided, metaphysical view, but what the answer really does is impugn individual choice, substituting for one one-sided metaphysical view another.

I don't know how one would quantify what group of people is "the most likely to care for us". It sounds quite silly to me. But this is beside the point. "Care" is such a nice word, but it's not all sunshine and rainbows. The honest Christian fanatic genuinely cares for their victims - and this does not make them any more damaging. Even if the family (ugh) was "the most likely to care for us", why should we fight for their "right" to make decisions for us? It's absurd.


I am sorry, but nothing of this follows. If we should oppose the State when it persecute private physicians that carry on illegal euthanasia, why should we support the State when it upholds physicians who carry on legal assessinations, even making procedures against their malpractice secret, in order to hinder complainants?

And this is equally absurd. We are talking about the state not prosecuting doctors. That is what "upholding them" means. There is no symmetry between the state prosecuting and not prosecuting someone.


And yes, the solution for this kind of problems is a socialist revolution, but in order to make a socialist revolution, the working class must take power and become the ruling class. And in order to become the ruling class, the working class must state its will to rule. If we are going to say that anything goes, because short of socialist revolution nothing satisfies us, then we are simply stating our willingness to rule. The ruling class must make its points clear, in all subjects of public discussion, or it is unfit for rule.

The proletariat does not have a "will". The various strata of the proletariat all have various political positions, and the thing is not to sit on our hands waiting for the social-democratic "party of the entire class" to "state" its "will to rule", but for the advanced layers of the proletariat to lead the rest of the class in smashing bourgeois rule, kicking and screaming if that is necessary. And the transitional society that the proletariat will establish is not a long-term state of the possessing classes, but a semi-state presiding over the dismantling of class society. As such it is not necessary for the proletariat, or those who claim to represent the proletariat, to find the perfect solution to any problem in the confines of capitalist society. Quite the contrary, the members of the advanced layers of the proletariat should not do that.