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Thanks, Mitzi, and everyone else, for the comments so far. This is turning out
to be a good discussion.

Mitzi, I have problems with the idea that, once suicide is on the agenda,
people
will start killing themselves wily-nilly. I admit that I have not come across
the idea of familial tendency to suicide, even when I was a psychiatric nurse,
so I'd appreciate any references you have for that. However, it may not be that
suicide is "contagious" - it might be linked to shared views within the family.
I come from an immediate family of public servants (nursing and fire service),
and both my parents would rather die than be looked after - in fact, my dad
did, though through refusal of treatment rather than active means. Which raises
the point that there is no effective difference in some cases between killing
oneself and allowing oneself to die. This particularly useless legal doctrine
only clouds the issue. Remember that in England we have allowed people to
refuse life-saving or life sustaining treatment, such as remaining on a
ventilator (for instance, Ms B, case at
http://www.hmcourts-service.gov.uk/judgmentsfiles/j1075/B_v_NHS.htm), which is
effectively suicide, and in a spectacularly wrong case, allowed a person in a
persistent vegetative case to die of dehydration (Tony Bland - for similar in
the USA, see the Terry Schiavo case). I am not saying the results were wrong,
but, as Dawna has pointed out, that is a really inhumane way to kill someone,
and the judgments (or justifications) the judges in each case do the legal
system little credit.

The Oregon legislation has raised many interesting points. One that fascinated
me was the number of people who got the prescription of lethal drugs, but did
not use them, ultimately dying of the condition they were diagnosed with. It
seems that having the ability to control things made life more bearable. I
accept that there may be a problem with offering palliative care, but, speaking
for myself at this time in my life, no matter how good the palliation, I would
still tend towards ending it all at a time of my choosing. It is the necessity
to be cared for that constitutes the problem. That applies to the truly
wonderful stories, such as you report, of people who just get on with it and
carry on with a life dramatically different from that they had. My favourite is
Frank Williams, owner of the Williams Formula 1 racing team. I'm not sure I see
the relevance of the difference in sexes in the Oregon figures, though - it is
no secret that there are a lot of people with inadequate health care in the USA
as a whole, and that women are badly served in general by the system. I don't
think it is unusual that people who cannot afford expensive health care are
going to consider the cheaper options that will not put financial strain on
their families. Also, at the risk of sounding sexist, I would expect more women
to have their identity rooted in what they do for others, and to feel "wrong"
if they are having they are ahving things done for them.

It keeps coming back, for me, to the individual. Every individual decides for
themselves which battles to fight, which to watch, and which to leave alone.
Whether the decision to live or to die hinges on moral, economic, social, and
historical factors. Of course living should be the default option, but for
able-bodied people with sufficient competence to make the decision (I'm not
going into competence here - this is turning into an essay again anyway!),
suicide is always an option. I cannot see why that option should be taken away
because the person is no longer able bodied, yet still has the same level of
competence. Surely it is the competence, not the physical state, that should be
the determinant.

Yours,

Jeremy.

-- 
Jeremy Wickins,
PhD Researcher, 
School of Law,
University of Sheffield,
Bartolome House,
Sheffield. S3 7ND
UK.


Quoting Mitzi Waltz <[log in to unmask]>:

> I object completely to state-sanctioned assisted suicide, and feel extremely
> uncomfortable with it in any other form as well.
> For one thing, it sanctions the idea of suicide, full stop. And suicide is
> contagious--if one person in a family commits suicide, others in the family
> are more likely to do so as well. I have not seen any evidence that this
> well-known fact is any different in situations where health is cited as a
> reason. It could be the case, but as I haven't seen any contradictory
> evidence, I have to assume that it is so.
> Second, once the state or the medical establishment gets involved, you get
> official criteria for what kind of life is worth living. The pressure, subtle
> and otherwise, to make the "right" choice is definitely there. The current
> media campaign, which is quite concerted (for example, there have been funded
> seminar series in the US to convince film and TV writers to work "end of life
> issues"--usually around assisted suicide--into their scripts), is part of
> that pressure. It works best i it is internalised. It also obscures the fact
> that what people are usually reacting to is poor provision of social care
> (i.e., the services people need when they become disabled) and palliative
> care for those who have painful and/r terminal conditions. Until we get that
> stuff right, I think assisted suicide ought to be off the menu altogether, as
> how can one make an informed and logical choice under such circumstances?
> It's simply much cheaper to convince people to kill themselves off than to
> fund a health and social care system that allows them to live with dignity.
> BTW, I used to live in Oregon, one of the US states where physician-assisted
> suicide is legal. One of the interesting findings there is that palliative
> care was NOT offered as an option to most patients who approached doctors,
> nor were their psychiatric difficulties addressed. There is an excellent
> article by Herbert Hendin and Kathleen Foley, published in teh Michigan Law
> Review, that looks at the Oregon programme in detail--well worth reading (see
> www.spiorg.org/publications/HendinFoley_MichiganLawReview.pdf ). They have
> also written a book, published by Johns Hopkins Press, but I haven't read
> that. If memory serves, it was also notable that in Oregon women were more
> likely to approach doctors about assisted suicide, because women are rather
> less likely than men to have a full-time carer (otherwise known as a "wife")
> handy when they fall ill. Of course women also have lower incomes, fewer
> savings or assets to pay for carers with, and in the US system are less
> likely to have health insurance. And women are more likely to suffer from
> depression, which is usually a factor in assisted suicide. 
> I am particularly distressed about the case of the young man who became
> disabled following an accident, and chose assisted suicide rather than life
> as a wheelchair user. Such things must be especially difficult for someone
> who was an athlete but with help and support people do adjust. I think in
> particular of a "murderball" player that my husband did a documentary on at
> Uni, a young athletic guy who worked through becoming quadriplegic following
> a football injury and is now an athlete again, and teaching part-time. What a
> contrast.
> Mitzi
> 
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