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The Final Solution to Depression

Slippery Slope? What Slippery Slope?

Apparently some folks in the Netherlands are upset because not enough mental patients are being euthanized.

www.nrc.nl/international/Features/article2422766.ece/Euthanasia_still_a_taboo_for_mental_patients_-_even_in_the_Netherlands

The solution: require psychiatrists to justify =not= euthanizing the clinically depressed.

Comments

( 19 comments — Leave a comment )
marycatelli
Nov. 30th, 2009 06:24 pm (UTC)
Guilty consciences? It's hard to face someone who's willing to go to great efforts to preserve life when -- you haven't.
tualha
Nov. 30th, 2009 11:30 pm (UTC)
Apparently some patients with incurable conditions that cause them intolerable suffering are killing themselves (or getting it wrong and only maiming themselves) because their doctors aren't willing to help them do it. And you think this is a good thing? Why?
superversive
Dec. 1st, 2009 12:16 am (UTC)
I’m one of those patients with severe clinical depression, and I’ll thank you very much not to advocate that my doctors should be allowed to kill me. In one post you have proved that you are my mortal enemy, and I shall not forget it.
m_francis
Dec. 1st, 2009 01:14 am (UTC)
Because after one cites the extreme cases, there are all the others who are simply depressed and their suffering is that they are depressed. Instead of trying to talk them off the ledge as we used to do, we are now supposed to give them a push.

What did the Nazis call it? Lebensunwertes Leben, "a life unworthy of life." We say "quality of life," which sounds a lot better and pretends to a pseudo-scientific ability to measure the "quality" like we measure the qualities of length or weight or color, but it's the same old Final Solution. It's what you do when you throw up your hands and cry, I can't be bothered with this person any more. In this case: the final solution to mental illness and clinical depression.
jjbrannon
Dec. 1st, 2009 03:42 am (UTC)
What is this "intolerable"?
I suffer from migraines. They are incapacitatingly painful. I would not kill myself over them.

Hypothetically, let us presume I am afflicted with an incurable, untreatable, progressively crippling, non-fatal disease which will eventually render me functionally quadriplegic and intubated for sustenance. Why should I be put to death when I shall yet be able to read, converse, write with a voice-dictation program, enjoy the company of my friends and family, listen to music, and so forth?

Let us further presume that one has sat beside a friend or relative with a rapidly progressing cancer. Is that person's life less worthwhile because he or she wants to live to the last? Granted, I would say to withhold painkillers from that person is cruel, yet we cannot simply make the leap that to overdose the patient is just.


JJB

tualha
Dec. 1st, 2009 09:30 am (UTC)
Superversive, jjbrannon: fine, you would not kill yourselves. Therefore, under the Dutch law, no one would be allowed to kill you. You would have to ask for it. If you have evidence this is not the case, please produce it.

M_francis: where do you get that doctors are being asked to give them a push? My impression from the article is that doctors are simply being asked to cooperate with patients whose cases are severe and who have asked for help ending their lives. Do you know something about the Dutch euthanasia law that I don't? If you're arguing from facts other than those given in the article, please cite your sources.

If you want to make a slippery slope argument, I would point out that the slope in this case is pretty high-friction. These doctors clearly don't want to even discuss euthanasia with their patients.

Oh, and by the way, you've heard of Godwin's Law? I think you should not invoke the N word unless it's actually relevant.
m_francis
Dec. 1st, 2009 04:24 pm (UTC)
Oh, someone in a fit of depression may well want to jump off a bridge. There's your permission.

In re "slippery slope." It used to be that if someone felt suicidal, the psychiatrist was obliged to talk them "off the bridge." Now, a few feel that they should give the patient a shove off the bridge. The fact that it is not yet all of them doesn't change the direction of the shift. Many people now consider it normative to kill low-quality people. To "help" them now means to assist or enable their depression and despair rather than to help them get through it. The latter is too much work and takes time away from the pursuit of the wonderful me-ness of me. The former is much easier and much more final a solution.

Of course there is starting friction. Wait until it gets rolling.
jjbrannon
Dec. 1st, 2009 10:42 pm (UTC)
Bad assumptions
Superversive? Moi?

tualha, did you know that euthanasia is technically illegal in The Netherlands?

As for evidence:

http://news.bbc.co.uk/2/hi/health/background_briefings/euthanasia/331270.stm

I'm also trying to track the Dutch citizen's testimony to Congress this past year about how a Dutch physician elicited permission to euthanize an elderly woman while she was under the influence of painkillers. He was in the process of administering the dose when the woman's family happened to visit and intervene. The woman recovered after changing her course of treatment and, I believe, was still alive more than a year later at home when her daughter testified.

Also, a Dutch study in 1992 showed that no one requested euthanasia from intolerable pain; rather, depression and loss of dignity were the main reasons offered. This was supported by a later study conducted in Washington State, where less than a third of person indicated pain as a reason for considering euthanasia as an option.

Finally, Godwin's Law is irrelevant when discussing euthanasia. The Nazi practiced killing people under their control. The subject of euthanasia pertains to people being killed while under the medical control of others.

JJB
tualha
Dec. 2nd, 2009 12:19 am (UTC)
Re: Bad assumptions
"Superversive" was not a modifier applied to your name, but another name: I was addressing both of you.

The BBC article you cite was published in 2000, and the law has changed since then, but you're right: it's still illegal, just decriminalized if the guidelines are followed. To the extent that the distinction matters, it supports my position: at least in theory, doctors can be prosecuted if they don't follow the guidelines.

It seems to me that if the guidelines were always followed there would be nothing objectionable about physician-assisted suicide as practiced in the Netherlands. Unfortunately, having spent some time this evening researching it, I can't reliably tell to what extent the guidelines are being followed. I can't find anything both unbiased and informative. All the pro-euthanasia people just talk about what the law says, not how it's working out in practice; and all the anti-euthanasia people talk about cases where the guidelines weren't followed, mental patients are helped to suicide for mere temporary mental anguish, patients are "euthanised" without their having brought up the subject, etc. — almost entirely without sources or evidence, and what reliable evidence there is, is merely anecdotal; there are no statistics. Rare? Common? Who knows?

And this is precisely what I'm objecting to in Mr. Flynn's postings. It's possible he's right; but he offers no evidence to back up his statements. I find it difficult to believe this is the same man who wrote the introduction to The Forest of Time and Other Stories 12 years ago. That man had respect for facts and for backing up one's statements. What happened to him?
martinjt
Dec. 2nd, 2009 12:41 am (UTC)
Re: Bad assumptions
It seems to me that if the guidelines were always followed there would be nothing objectionable about physician-assisted suicide as practiced in the Netherlands

As James Chastek put it: If murder is killing an innocent person then how do you justify suicide (and more so, assisted suicide).

Also the arguments for A.S. assume the person is in his right mind. If you are suffering from chronic depression you are not in your right mind.
m_francis
Dec. 2nd, 2009 01:01 am (UTC)
Re: Bad assumptions
Notice too that what often seems to matter is what a law says, and not how people naturally behave in the face of that law. That is, if I draw the line here and people step over it from time to time, that may be very different from drawing the line over there so people can step over that. Or as a girl I knew in college put it: "If there are no boundaries, what can we rebel against?"

We see the same thing in the statements by the head AIDS researcher at Harvard. The technological merits and failure rates of condoms [4% when last I saw hard data] are one thing; but what matters is the behavior of people. Those enamored of tech fail to comprehend. They say, but if people use them correctly and consistently, there will be no problems. Which may be true, at least among groups engaging in risky behavior, like prostitutes and male homosexuals; but the real problem is that people do =not= use them correctly or consistently, and all the banana classes in the world won't change that. If at the same time, one encourages an increase in risky behavior, some very bad results may obtain.

Compare this to seat belts in automobiles. Because the safeguard was driver-evident, drivers felt safer belted in and therefore drove faster and more recklessly. This increased the accident rates and, among the people broadsided and T-boned at intersections, may have also increased auto fatalities. The driver, belted in, was less often affected.

At the same time, the collapsible steering column and crumple zones were introduced. These were opaque to the driver and so did not affect his driving behavior. (And the introduction of better EMS procedures during the same time frame further reduced fatalities.)

So, there is the techy side of any change; and there is the people side. It is the people side that we find so frustrating. "But they should not be doing THAT!"
pumprat
Dec. 2nd, 2009 04:21 am (UTC)
Re: Bad assumptions
Spent about 7 years on our city's rescue squad. Most of the suicide attempts I saw were folks who'd imbibed a little more than they should've and didn't get lucky by the time the bar closed, found the bridge and after some equivicating,(giving us time to arrive and lauch the boat, whilst the donophages did their best street councilling on the bridge), useually jumped, changed their minds somewhere between the bridge and the water and were hollaring for help by the time we boated up to them. Of course a few were gone by the time we got to them and I know nothing about their state of mind.Nothing scientific,just personal observation over time, but most of the people I saw seemed to need just a little push to decide not to. In such cases, I would append to the Physician's Creed of "Do no harm", to that of the archivist, "Do nothing irreversable".

First time I saw crumple zones in action (or after action to be precise) was car vs. bridge abutment and Detroit 70s steel. The crumple zones had worked. the engine had dropped, the front of the car was totalled but once the driver unfastened his seat belt, he opened the door and staggered out, hurt but concious and greeting the ERs as we showed up.On other side the passenger had not fastened the seat belts, was flung against the unlocked door that popped, sent the passenger into the abutment to bounce off and under the still moving car. When we got there, the passenger was pinned under the back of the car and once we did the extrication and helped make the move to the ambulance,it was plain that it was going to be touch and go, with 'go' currently in the lead. An atypical incdident to be sure, but it impressed me that ALL parts of the system (people and tech)have to be working right for best performance. The longer I was on the squad, the more obbessive I got about seat belts. If you wuz to call me a seat belt El Duce by now, you'd be right. I like it when my passengers leave of their own volition.
m_francis
Dec. 2nd, 2009 05:01 am (UTC)
Re: Bad assumptions
Oh, certainly. The seat belt does not make the passenger more reckless. Bouncing around after a sudden deceleration cannot be a good thing. But neither is being on the receiving end of a T-bone. A seat belt can keep you from flying out of the car, and this is a good thing. It cannot keep another car, driven by a driver securely belted and therefore feeling a bit more frisky, from flying into you.

A guy I know once suggested that if we really wanted to cut traffic accidents we would equip every steering wheel with a spike aimed right at the driver's eyes. No one would drive too fast or too carelessly. He was joking. I think.

marycatelli
Dec. 3rd, 2009 02:49 am (UTC)

fine, you would not kill yourselves


You know very little about depression, apparently.
the_deuce
Dec. 1st, 2009 03:58 pm (UTC)
Um, why exactly is it better for a physician to compromise himself and kill a patient than for the patient to kill themselves? If someone wants to kill themselves, they should take their blood on their own hands rather than implicating someone else. The physician's job is to cure disorders, and a suicidal person's disorder is that they're suicidal, not that they're alive.
martinjt
Dec. 2nd, 2009 12:43 am (UTC)
My first thought was "Hire a professional" Maybe we should decriminalize the Mafia.
howling_wolf
Dec. 2nd, 2009 03:39 am (UTC)
A bullet to the head seems quicker and less expensive than wasting morphine.
howling_wolf
Dec. 2nd, 2009 03:43 am (UTC)
"Apparently some patients with incurable conditions that cause them intolerable suffering are killing themselves (or getting it wrong and only maiming themselves) because their doctors aren't willing to help them do it."

Dividing your sentence into two different statements will answer your question.

Some patients with "incurable" conditions that cause them "intolerable" suffering are killing or maiming themselves. This is bad.

Doctors refuse to participate in the act of annihilation or mutilation. That is the good thing.

You really want to off yourself, stain your own hands or hire an assassin. Don't go about turning doctors into monsters.
(Anonymous)
Dec. 2nd, 2009 06:56 am (UTC)
I wonder if the depressed patients feel happier when they take poison. Probably hard to quantify since a person can only kill himself once. Now if there were a placebo group we might get somewhere. Call it the "MASH protocol."
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