euthanasia, health-system reform?your thoughts pls.

Discussion in 'Pre-Medical - MD' started by Amiroz, Dec 7, 2002.

  1. Amiroz

    Amiroz Member

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    Hey yall

    Interviewers ask questions like:

    - What do you think about euthanasia and doctor assisted suicide?
    -if you could change the healthcare system in AMerica and worlwide, whats the one thing you'd want to change?
    -If you had one patient to treat, an illegal immigrant and a non-insured citizen, which one will it be and why?

    Can you please voice your opinions on these question so i kinda know the main two debating positions in each one of these issues and not put my foot in my mouth.

    Thank you much
     
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  3. UCLAMAN

    UCLAMAN Air Jordan Collector

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    for euthanasia - go to google and type "euthanasia" in and you'll get tons of websites debating

    for healthcare reform go read David Lawrence, MD's book "From Chaos to Care" found at your local Barnes and Noble.

    and for the last one...i would treat the one most in need of my services as a physician.
     
  4. Saluki

    Saluki 1K Member

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    Euthanasia or doctor assisted suicide is incredibly wrong, but in addition it can get out of control scarily fast. Look at the Christian Medical and Dental Society website and you'll see some stuff that will send a shiver down your spine. In countries where assisted suicide has been accepted there has a rise in depression and feelings of guilt among elderly people, and there have been several cases where the elderly were killed without their permission, in one case because the hospital needed another open bed! The minute we start saying that the life of anyone, even someone incredibly sick or old is not worth living anymore, that their life is not valuable we're in big trouble.... Can we say Hitler and the Nazis.... Disrespect for the elderly and the mentally handicapped and then the killing of many of the mentally handicapped marked the beginning of Hitler's rule in Germany...
     
  5. badgergirl

    badgergirl look! i have no avatar...

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    For the healthcare reform (I've been asked this question at all 3 of the interviews I've had so far), the AMA has a really good proposal for expanding health insurance coverage. There are 41 million people uninsured in this country, and when they get sick they go to teaching hospitals that have to absorb the costs because they can't refuse patients. I know this is rather simplistic, but look at www.ama-assn.org and just browse their articles -- they have a lot of healthcare reform information!
     
  6. Indy

    Indy Member

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    The last question is pretty interesting - usually they ask about insured versus non-insured patient, but this is a nice variation. I love a friendly debate so c'mon people, post!

    UCLAMAN, i have to disagree with your response...the question asks you to pick one, and saying you'd treat the one most in need of your services doesn't answer the question, since you're assuming more information than was provided. Also, let's assume both patients arrived at the same time, have the same injuries/diseases, and both are equally in need of your services. They're both in critical condition and their stats are dropping, so you don't have time to wait more for information. In theory it's fine to say you'd treat the one most in need, but it's not practical.

    I would treat the non-insured citizen. The citizen supported my medical education through state and federal taxes. Even if I went to a private medical school that didn't receive state funds, federal funding supported my education. As a side note, the citizen also supported my K-12 education. Because of paying into the system for years, the citizen should expect to receive care before someone who did not pay into the system. Illegal immigrants are in a dire health care situation to be sure, and the US needs to do a lot more to provide health care for them, but that doesn't mean an illegal immigrant should receive care before a non-insured citizen when both are equally in need of care.

    In a related issue, for one of my health policy classes we analyzed the issue of whether illegal immigrants should be covered by Medicaid. Our report analyzing the issues (admittedly not expert) is online, if you'd like to take a look. http://www.pubpol.duke.edu/courses/pps255s/2002/t-team-b/

    Amiroz thanks for posting this!
     
  7. Tweetie_bird

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    wow. very harsh words, some of which is anecdotal. I am not going to try and prove Mashce wrong (my opinion is quite different) but all I want to say to those of you reading this is PLEASE do your own research and don't feel like you have to go with the general consensus.

    There is nothing inherently evil in physician assisted suicide. In fact, most physicians will not confess to this but it IS done in hospitals around the country in "secrecy." I don't mean to say that doctors out there actually practise PAS, but don't fool yourself when you believe that a doctor doesn't know the therapeutic index value being reached of a medication that is being prescribed in increasing doses. Sure, it can be blamed on an "accident" or you can say the doc was only trying to relieve pain and did not know that death could have been caused with such increasing (and sometimes lethal) doses...but who would be there to prove it???


    Again, I urge everybody to do their own research and decide. If you actually look at the statistics from after 1997 after Oregon made it legal you'd see that there has been no exploitation going on. The cases you hear about where a patient was euthanized because of the need of a hospital is only anecdotal. Let's not make rules from these stories!! The Dutch had formed a commission that actually measured the effects of legalizing euthanasia longitudinallya nd have demonstrated that there has been no significant increases in the number of deaths resulting from PAS over time. Even the number of deaths tallied by the Oregon Health Division has not increased significantly over the last 3-4 years since they made it legal. Furthermore, if you look at societies that have legalized euthanasia, you'd learn about the strict regulations they have to make sure that our patients do not get exploited. Please don't be mistaken that doctors in these societies are not advocates for their patients. Most of them (like in any other medical society all over the world) do care for their patients very well and do provide palliative care before their patients are euthanized.

    Also, there was a comment about depression among these patients. I don't have the values on this but let me tell you that depression goes hand in hand with having a terminal illness. How can one prove for sure that the terminal illness is not the confounding factor between your correlation between depression and use of PAS in a society? About 10 percent of depressed patients never get cured, and one would think that these physicians are having their patients evaluated professionally for competency to make sure that depression is not causing suicidal ideations in these patients.

    You would be surprized to hear that a majority of doctors have actually HAD requests for PAS (this is before Oregon made it legal so the numbers may be even higher in the last few years); over 3/4 of those doctors said that these patients should have had the option of PAS and over half of them actually said that they would practise euthanasia if it were legal. So what is stopping docs from practising it? It is the law. Unfortunately, morality and legality do not always go hand in hand, and here is a case where you see that although patients and doctors DO think it is a workable option, it is not enforced (and rightfully so, because I do acknowledge the need to have strict regulation if it were legalized).

    Anyway, I am getting close to trying to prove my point over mashce, and I don't intend to do that. All I'm saying is keep your ears and eyes open to learn about these issues. In societies where PAS is legal, patients ARE being served. Who are we as physicians to decide the time and manner of the patient's death? Let our patients do the talking, and as polls have demonstrated, we may be causing a shift in opinion toward promoting PAS in some societies. No offense Mashce, but I was genuinely hurt by your point about comparing docs that support PAS with Hitler and Nazis. Those people killed WITHOUT CONSENT. These two words in medicine make all the difference.

    In an ideal world, we would know about consent for any and every patient that walks through our clinic. But we don't. So we try and make do best with what we have. In such situations, they use healthcare proxies (which may/may not work). But by no means would a doctor say, "hmmm, whom am I going to kill today." Medicine is still a profession of compassion and dignity. It's just that some doctors view giving a person the right to live and die in a time and manner they choose, as compassionate care also. You are not choosing to end their lives. We are simply the tools patients may use to achieve the goal of passing on in a manner they want. Whew. :) Thank you for putting up with my [email protected]@ post and please, no flames. We are only posting opinions here.
     
  8. Gleevec

    Gleevec Peter, those are Cheerios

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    I will address mashce since not only do I disagree with the opinion, but the manner in which it is presented as well:

    You are addressing a completely different issue. For those people in constant pain and no cure in sight, they deserve to make their own informed choice about assisted death.

    According to Social Contract theory, when you enter society you give up certain rights to have others protected. You do not give up the right to control your own life. If people are given the proper information and can make a coherent judgement with their family, assisted suicide is fine.

    We are not talking about automatically euthanizing old people or the mentally ill, we are talking about euthanizing those in extreme pain constantly with no end to their suffering in sight.

    Patients have a right to die. Their life is their own and their choice to end it is their own. How arrogant is it of everyone else, including doctors, to think that they can tell people to live or die? It is not their choice, it is the patients. The doctor is merely the enactor of the decision the patient has made, to ensure the process goes smoothly.

    And please, refrain from these emotion-grabbing "we will turn into Nazi germany" examples. I do not appreciate when people go overboard with loaded words to try and bring people towards their viewpoint. If your case is good enough, you do not need to resort to the lowly, deceiving, McCarthyian practice of name-calling and purely emotional appeal. :rolleyes:

    Several countries have euthanasia policies and are valid stable democracies. The abuses you name are rare and are already occuring in our nursing homes (there are numerous cases of neglect that result in death). These few exceptions arent the reason to go against euthansia, because exceptions exist for any plan. You must evaluate euthanasia on what is best for society. And I argue that it is best for society to let coherent (not mentally ill), intelligent, informed, and supported people make a choice to die if they are in extreme pain.

    It is not our choice to tell people to live or die, it is theirs.

     
  9. Tweetie_bird

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    It's like you and I are twins.... :love:
     
  10. Pre-Dent-David

    Pre-Dent-David Super Hero

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    Soct Assist Sui : Something that I would never participate in as the role of a doctor, but I do believe that people should have the right to do it if it is really necessary.

    As a doc you have an oath to treat anyone who appears before you so I guess whoevr came first according to that, but I'd take the US citizen personally.
     
  11. Pre-Dent-David

    Pre-Dent-David Super Hero

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    Maybe they should have executioner residencies.
     
  12. tedstriker

    tedstriker wicked retahhded

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    I thought I'd contribute by mentioning that Youthanasia is an awesome Megadeth album! :D
     
  13. manicmaven

    manicmaven all aboard the nerd train

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    Tweetie and others have made very good points. In Oregon, the rates of PAS have been very low, mainly due to excellent hospice education and communication regarding end of life care. For many, it is the fear of being in excruciating pain that makes them consider assisted death. Often, doctors can work with patients and provide a dignified, pain-controlled end of life. For those patients that understand their full options and still choose to end their life early, the opportunity exists. I'm proud that this state has voted again and again to provide this freedom to residents. I hope other states soon follow suit.
     
  14. NineSixteen

    NineSixteen Senior Member

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    I disagree that the AMA has "really good" ideas for reform, but they do have ideas :) There are major problems with the incremental reforms proposed by the AMA and other conservative groups - but that's discussed a whole lot on the Universal Health Care Thread! For another idea, please go and read the www.physiciansproposal.org. If your interviewer is really conservative and you want to just agree with him/her to gain access to med school, read and understand the AMA's stuff. If you want to go out on a limb and talk about a reform that will really work and actually provide converage for the uninsured, read the physicians proposal.
     
  15. Gleevec

    Gleevec Peter, those are Cheerios

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    Haha definitely sounds like it after I went back and read your post again :p

    I think my decision to support euthanasia is like my decision to be pro-choice. I am not psychologically ready yet to perform any of these procedures, but I support their intents (and for others to perform them).
     
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  17. jdg222

    jdg222 Member

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    I think that the majority of us agree that if a patient is in severe pain, and will continue to be in severe pain until a death days or weeks later, PAS is the morally correct thing to do as long as the patient requests it. Those who disagree probably do so out of religiously rooted reasons, not utilitarian ones. However, mashce brings up a good point about the slippery slope that could arise from legalizing PAS. What if a patient is in pain and the prognosis is weeks, months or years? Where do we draw the line? In drawing that line, we run into the philosophical problems that mashce talked about, namely, how do we put a value on life? I think that PAS can work as long as the laws are written in a careful manner. Otherwise, the practice could get out of control, and unscupulous people could misuse PAS to detrimental effects.
     
  18. Tweetie_bird

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    I agree with you jdg. The slippery slope hypothesis does get a lot of anti-euth. people riled up and I believe that is one of the main reasons people are against euthanasia. If you look at the laws that regulate euthanasia in these communities, you'll see that there is a very tight control on who gets to perform these procedures and how long a patient/physician should have spoken about the options after palliative care options to actually consider euthanasia. Some countries even have options like having to do an autopsy after death to confirm that other drugs were not in the patient's body during time of PAS. Others have their patients evaluated multiple times by psychologists/psychiatrists to ensure patients are not depressed or suicidal. Yet others require strong documentation about all services applied to the patient and how many times end of life care was brought up and by WHOM.

    I do acknowledge the need to regulate euthanasia because of the slippery slope, yet, the WAY in which Mashce's point was delivered was in very poor taste. PAS supporting clinics/hospitals are hardly going to become the murder factories that was implied. Again, if you see the stats, you'll see a different story. Numbers speak!!
     
  19. whyadoctor?

    whyadoctor? Senior Member

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    life, at any stage or in any state, is precious. it should not be tossed aside in despair. see Book of Job.
     
  20. lola

    lola Bovine Member

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    is there really a difference between euthenasia and physician assisted suicide? my interviewer told me that physician assisted suicide involves writing a prescription while euthenasia refers to the physician having a more active role in letting the patient die. is this true? i couldn't tell if he was just messing with me or not?! i felt pretty stupid actually, which i think might have been his intention :p
     
  21. Peter Parker

    Peter Parker Senior Member

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    Since when did the Book of Job become a primer on the moral relevance of euthanasia? :rolleyes:


    P. Parker
    Baylor College of Medicine
    Class of 2007
     
  22. Gleevec

    Gleevec Peter, those are Cheerios

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    I agree completely. This is a classic example of christianity projecting religion into areas it does not belong. I think this is the ultimate example of pride at the cost of diversity.

    It is a christians OWN choice that determines whether they want to commit suicide or not. The doctor is just the actor, s/he does not make any decisions for the patient.

    If the patient is non-Christian, then there is no point at all to Job. Who cares what the Bible says if you're not Christian? Religion is a personal decision, and it should not be applied to others at the cost of ignoring people's individuality and personal rights.
     
  23. kam730

    kam730 Senior Member

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    QUOTE]Originally posted by lola


    From what I learned in my Death and Dying philosophy class, PAS is a type of euthanasia. Euthanasia can be voluntary or involuntary, passive or active. PAS would be the same as voluntary euthanasia and could be active or passive depending on circumstances. Generally when people think of euthanasia they think of involuntary. That would be when a doctor takes action to end a patients life without the patient's knowledge or consent. They are not exactly the same thing, which is a misconception many people have. Hope that somewhat cleared things up for ya.
     
  24. Tweetie_bird

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    Kam beat me to it. :p

    I think of euthanasia as a big umbrella with two branches--Voluntary Active Suicide or Physician Assisted Suicide.

    I don't like the word "suicide" too much but I'm trying to give a bone to the opponents here because if I don't, they might call me on it. So anyway, voluntary Active suicide from most of my readings usually involves things like curare/potassium injections etc, it is ACTIVE in the sense that the doc prescribes a lethal dose to the patient which is self-administered. PAS is a situation where a physician actually gives increasing doses (say, morphine) to a patient to help cure pain or ease suffering; sometimes, in these cases, the therapeutic index of the drug may be maxed so much cumulatively it becomes a lethal dose, thus killing the patient. So the main difference between VAS and PAS is really the INTENT of the physician--in the former, we have a physician specifically giving a lethal dose to a patient, versus in PAS, it happens in increasing doses and death may unfortunately become a "side effect" of the medication. It is claimed here that the onset of death was not the intent of the physician practising PAS, but is IS for a physician practising VAS, thus making VAS morally wrong in some peoples' opinions.

    There are arguments about how both are actually more similar in practise than one would think, but you haven't asked that question so I won't write another essay. :D
     
  25. AlternateSome1

    AlternateSome1 Burnt Out
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    Tweety,
    I just read the definitions you gave for VAS and PAS and I was curious where a doctor who would give a lethal injection with the intent to kill, rather than numb pain, would fit in?

    ~AS1~
     
  26. Tweetie_bird

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    Hi there,
    It would fit under VAS. Because that the intent is there (VOLUNTARY on the patient's part, giving doc. the consent to do so) and and it's also active in that the doctor is doing something (an action) to specifically bring on the death of a patient.

    Does that make sense?

    Again, definitions may change depending on the text you are reading. These are just my own opinions.
     
  27. whyadoctor?

    whyadoctor? Senior Member

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    i didn't know you had to be a christian in order to apply the philosophical understanding of the bible to life. i'm hardly a christian, yet it is obvious that fundamental human truths are available in its teachings... as they are in nearly every religion.
     
  28. Blitzkrieg

    Blitzkrieg 1K Member

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    Well, I'll add my 2 cents..

    I believe that Euthansia is wrong, and that any step towards that direction will in fact lead us to the health care system so enjoyed by the people of the Third Reich.

    Why?

    Well, euthansia shows an obvious lack of respect of human life, which I believe should be pre-eminent above all. Without respect for human life, what is to stop us from declaring some people fit for life, ubermensch, and those not fit for life, untermensch? Such was the thought process behind the Third Reich. Alas, without the basic respect for life (which is based on presuppositions), I fear that we shall go down this path. And if not we, then our children, and their children. Such is the nature of philosophy: An inch towards one side leads to miles on that side via the passage of time and generations.

    Once again, my 2 cents....
     
  29. Gleevec

    Gleevec Peter, those are Cheerios

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    You cant just say, "it says blah blah blah" in Job. And expect that to be an argument. The fact that that the bible quote was the entirety of your argument tells me that you believe it being the bible is necessary and sufficient for you to be right. That kind of assumption makes me think that you believe just because it says something in the bible, it suddenly becomes a fundamental human truth.

    The fact is, many of the things said in the bible are good, and in concurrence with what I myself believe. But many things said in the bible I disagree with as well (women are inferior and the cause of man's fall, the southern baptist belief that women are property of their husbands, and the hatred of homosexuals).

    So no, you dont have to be a christian to apply its philosophy to life, but if all you do is quote the Bible as an argument, you imply that whatever is said in there is the undebateable truth. That is the kind of supreme arrogance, whether overt or inadvertant, that I constantly have to argue against with extremely religious people (regardless of religion).
     
  30. Gleevec

    Gleevec Peter, those are Cheerios

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    People have a right to their own life, and doctors should respect that right be listening to their patients (see my previous post on Social Contract theory)

    Yet again, with all do respect, stop using loaded words and historical examples to make your argument.

    Otherwise you are just being a Nazi-Communist-Fascist-Wife Beating-Alien-Homophobe-Terrorist. ;)

     
  31. Blitzkrieg

    Blitzkrieg 1K Member

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    Those that do not study history are doomed to repeat it. Don't you agree? :)
     
  32. San_Juan_Sun

    San_Juan_Sun Professor of Life

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    Yep, those big, bad Christians holding everybody down. :)

    On it's face, Christians (as citizens) have just as much right to voice thier opinions on moral issues as other citizens. And religious institutions (as moral institutions) have every right to voice their opinion on euthanasia. No one's rights are being denied when someone cites the reasoning for their moral stance (religiously based or otherwise).

    At worst, it will stimulate more discussion on the topic. And if you (or anyone else) are so confident in the correctness and moral standing of your take on this issue, then surely you'd feel that increased discussion would be to your advantage. Moral issues are precisely where religious beliefs DO belong.

    That being said, I'm sure you'd agree no one wants a physician that paternalistically imposes their beliefs on patients. But opposition to euthanasia in a public forum isn't exactly the same as slipping in blood transfusions to an unaware Jehovah's Witness patient (for example).

    That being said, Christians need to be more articulate in developing their reasoning in moral questions. Arguing simply that "The Bible says so" is pretty weak. The theological basis for such arguments is complex and deserves thoughtful application.
     
  33. actually, although whyadoctor? and I have exchanged words; he is correct that the book of Job is in the old testament (hence read by Jews and others who are not Christian) and I too believe that most people can learn a little about life from the Bible or Koran or whatever similar doctrine you may follow (I'm an agnostic). however, to boil complex moral AND social issues down to pat solutions via biblical quotes doesn't solve the problems associated with the issues of euthanasia or abortion or the health care system. It would be nice if no one who was dying a slow, horrible death felt depressed enough to want euthanasia, but the fact is that it is that way and with current medical research funding, we don't have the pain management systems in place to make life bearable. It would also be nice if we lived in a society that would find good homes (NOT the awful foster care system) for ALL babies born to teenage moms and other women with undesired pregnancies and not punish single moms and teenagers with removal of welfare and other forms of aid once the baby is born. And it would be even better if we could prevent unwanted pregnancy by better educating teens about birth control and using condoms. The # of abortions in teenagers has, however, decreased a great deal due to better education about both sexual abstinence during high school AND using effective birth control, and IMO this is a good thing. I think that educating people about the issues is really key; just saying "euthanasia/abortion/this or that medical procedure is very bad and it should be illegal b/c the bible says so" doesn't really foster an understanding of the issue in society. peace.
     
  34. San_Juan_Sun

    San_Juan_Sun Professor of Life

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    I'm not seeing how doctors are able to have secret "accidents" (as you described) with their patients, and yet in places where euthanasia is practiced there is virtually no abuse of the system.

    Don't get me wrong, I feel that pro-PAS doctors absolutely care for their patients well-being (even though I'm not pro-PAS).
     
  35. Gleevec

    Gleevec Peter, those are Cheerios

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    The Bible isnt history, and you have to admit that quoting one liners from the Bible and assuming that is an argument in itself is not very solid.
     
  36. Blitzkrieg

    Blitzkrieg 1K Member

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    I was referring to nazi history in the post that you quoted, and spoke of me "using history".

    Oh, btw, the Bible is in fact history, at least you must admit it is in part. Ever heard of the Hittites? Said not to exist by scholars, but it was in the Bible. Well, due to work in the past century, the Hittites were found to have existed. Not history, eh?
     
  37. Gleevec

    Gleevec Peter, those are Cheerios

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    Every post here that has invoked the term Nazi has been a vain attempt to use loaded words to try and bring sympathy to their cause. It is McCarthyian in its use, because people are applying it to associate moderate views with extremist views that are unpopular.

    First off in regards to your Nazi analogy it is completely different. Their purpose was to create an aryan race of superiors. The purpose of euthanasia in america and in other countries with such a policy already is to end suffering, not cause it to create a super race.

    Secondly, no the bible is not history. There are aspects of history in the bible, but that doesnt mean that it is history. For example, Tom Clancy bases his novels on real historical events, but his books are not considered history. In the same way, the Bible is not a history as much as it is a text that incorporates some real history in it on occasion.
     
  38. San_Juan_Sun

    San_Juan_Sun Professor of Life

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    No, of course the Bible isn't a history (neither was it intended to be at it's compilation in the fourth century). But it is what historians call a primary document, oftentimes the only primary document covering history of the period. It is, without question, an invaluable source as a historical document.

    Of course, as a devotional document it is (I'm sure most would agree) on the short list of most inspirational works ever written/compiled.
     
  39. whyadoctor?

    whyadoctor? Senior Member

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    my reference to the Book of Job was not an argument. it wasn't intended as an absolute reference to the truth. it is my opinion that the bible includes relevant teachings that are applicable to human nature, culture, and understanding. this includes the absolute value of human existence. the whole idea of euthanasia presumes that some doctor is able to predict the future. is that possible? everyone here who is arguing for PAS automatically assumes that a patient who is deemed "terminally ill" has no hope of survival. that's pretty amazing! when i get my MD will i be able to predict the future as well? if not the bible, how 'bout greek mythology... what was it that was left in pandora's box?

    i, like my dear friend Katie, am an agnostic. and i agree with Blitz that euthanasia and PAS shows a gross lack of respect for human life.
     
  40. latinfridley

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    ...no we can not predict the future, but that does not mean that we should not do everything we can do end pain and suffering in the present. There is always reasonable doubt about any procedure in medicine, some unforseen complication or 'miraculous' healing, but that does not mean we shouldnt have confidence in our judgement and do what we as doctors deem the best course of action. Doctoring or medicine doesnt have any absolute outcomes, never has never will. Only probable outcomes. That is what we have to work with. If it is highly improbable that a patient will overcome some terminal condition, given that said patient has tried every concievable and practical treatment, and that condition or diseases pathogenesis will more than likely progress into a worse state given its nature, i.e - Lou Gherigs(sp?) disease with no probable hope for a new treatment within the patients lifetime, AND there is a confident plea for an end to life by the patient, then and only then, I believe PAS is a reasonable course of action. That's alot of AND's. You should not impose a belief system on a patient that will limit that patients FREEDOM TO CHOOSE the course of his/her life, given all the above mentioned 'and' statements.
    I mean, seriously, are u going to stand their next to some patient with some untreatable condition, in unbearable pain, whos asking you to help them end their suffering, and say 'sorry, you're just gonna have to suffer, i cant help u out, tough luck.' Please.

    As far as this whole 'the bible is history' talk, yes the bible does have historical events interlaced with fanciful tales of miracle healings, a guy hangin out in the belly of a whale, supernatural apparitions, etc...

    In regards to the book of Job, I dont think its an absolutely wonderful teach to teach morals. I mean God made a bet with the devil to prove he was right and the devil was wrong. Isnt pride a sin? Doesnt God have enough confidence in His own being to not take that bet?
    Sorry didnt mean to start ranting about the bible there.
     
  41. latinfridley

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    sorry for the typos, i was typing on the fly.
     
  42. Saluki

    Saluki 1K Member

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    Here are some actual opinions from leaders in the physicain community...
    David Stevens, MD, Executive Director: "It is essential to every patient in America that our courts preserve the role of a physician as healer--not killer. Every patient needs to know that his or her physician is going to do absolutely everything possible to heal them--and in the absence of a cure, to provide compassionate comfort. Oregon's implementation of the assisted suicide law undermines an important and established function of the federal government, which is to prevent the abuse of controlled substances. Oregon's assisted suicide travesty also opens the door to incredible abuses of patients by profit-driven HMO's, which can undermine patient health and safety in the process of slashing costs of care. Don't forget that killing patients will always be cheaper than curing or comforting them. I can't help but wonder how quickly a 'right-to-die' can become a 'push to die,' and completely erode trust, the foundation of the doctor-patient relationship. Contrary to media reports, Attorney General Ashcroft's action will not ban physician-assisted suicide in Oregon or overturn the law there. Doctors just won?t be able to use controlled substances to take a person?s life. Which ever way this appeal comes out, I expect this issue to go to the Supreme Court."
    Elderly Suicide Rate on the Rise

    Summer 2002
    American men aged 65 and older commit suicide more than any other age group in the country, accounting for 19 percent of the country?s suicides, says a study out this week in the American Journal of Geriatric Psychiatry. Results showed that the overwhelming reason for suicide was depression, and that African-American men are less likely to be depressed than Caucasian men because they are more spiritual.

    Dr. Herbert Hendin, medical director of the American Foundation for Suicide Prevention, said that palliative care plays a critical role in helping the terminally ill feel emotionally healthy. He says that ?a major area where you could do suicide prevention? lies within a doctor?s understanding of depression and the complications it causes in the elderly, such as heart disease.
     
  43. Saluki

    Saluki 1K Member

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    "...Dr. Zbigniew Zylicz, a Polish-born specialist in internal medicine and oncology, recounted for me the incident that ended the life of one of his elderly patients ? and irreversibly changed the direction of his own life and career:


    'It was a case in an academic hospital. She was afraid to go to the hospital because she was afraid of euthanasia. She was not asking for this; she did not even want this. And they promised her that nothing would happen to her,' he told me.


    I admitted her on the weekend to a bed of another patient who would be coming back Monday morning. I had no other facility for her. She was very ill, and I expected she would die on the weekend. But she improved. With good treatment and pain control, she started to talk, and she was not dead.


    The woman's improvement proved short-lived because Dutch doctors already had begun to believe their mission was not just to be healers, but killers as well.


    'On Monday morning when I went off from my shift and went home,' Dr. Zylicz recalls, 'my colleague came and did something. I don't know exactly what he did, but she died within 10 minutes. And the nurses called me at home. They were very upset about this. And I was very upset about this, too.'"
     
  44. Peter Parker

    Peter Parker Senior Member

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    Just for the record, Dr. David Stevens is Executive Director of the Christian Medical Association. He is also the author of Jesus, M.D.
    From the publisher: "It is an inspiring and challenging invitation to partner with Jesus in his 'practice,' accompanying him on his rounds to people whose lives he wants to make whole. Discover how to participate with him in bringing his healing touch to your corner of the world. You don?t need a medical education--just determination to trust God as your 'attending physician,' your mentor, your source of guidance, discipline, and encouragement."
     
  45. galen

    galen Senior Member

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    Amen, Maven...I am from Oregon too and have 1st hand experience with hospice. 2 people I talked to with advanced cancer both said they dont want PAS now but they are soooo glad the law is there just in case they get into intractable pain(for ex if bone mets occur).
    Also since there is quite a procedure to go thru 1st, doctors are IMO more motivated to really control pain in order to avoid PAS for them or for the family& pt. I think in other states drs might be more inclined to under-prescribe for pain since they could be accused of oversedation. I know this sounds harsh on docs but people(even drs) tend to take the path of least trouble.
    Anyway, I agree with Gleevec & Tweetie. We Oregonians have twice voted in favor of this law giving people end-of-life control. If you are ever dying of cancer & in great fear of intractable pain, then youmight be very glad PAS was there. If its not your thing morally or Biblically thats okay--u dont have to ask for it. But I wish these pple (like Ashcroft) wouldnt tell everyone else what to do ---ie that they must endure hours & days of pain at the end of their lives
     
  46. galen

    galen Senior Member

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    I forgot to mention that in the Oregon PAS law, no doctor or pharmacist is required to prescribe or fill prescriptions if it is against their beliefs. In our town one onc is pro PAS and the other one isnt but he does refer his pts to the pro-dr if they ask .
     
  47. jenni4476

    jenni4476 Senior Member

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    Just one question on this:

    Why, if he is a Christian and believes in the goodness of people, is he so eager to believe that once the law steps away from adherence to the Bible that it will quickly become a "push to die"?

    Yes, there are "bad apples" out there and there is a "slippery slope" element associated with this, but arguing that what is currently a long, narrow road filled with obstacles (to be able to provide PAS under correct legal and ethical conditions) will quickly turn into a four-lane freeway with no exits is a gross exaggeration. All the information about statistics posted earlier defies this theory.

    In THIS PARTICULAR religious argument (in no way am I trying to devalue religion's teachings and its value to people in general) it seems like he is trying to use the fear tactic, i.e. if you don't believe what's in the Bible and what I am saying, horrible things will happen so you'd better step in line if you don't want to be a part of it. Unfortunately, this tactic is widely used and it seems like the people that come up with it forgot the basic right of "freedom of belief". They are given the freedom to believe what they want to yet they don't seem able to extend that right to others and respect something different.

    Also, it takes a huge altruistic motivation to become a physician. And yes, again, there are a few out there who may be "heartless" but the vast majority of physicians are very concerned with the well-being of their patients and would not tolerate a push by the insurance companies to start killing people off to save money.

    My .02-any opinions?
     
  48. Street Philosopher

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    LOL PWNED
     
  49. whyadoctor?

    whyadoctor? Senior Member

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    why are many of you so anti jesus? it's unreal how a christian's doctor's opinion and experience, which are both far superior to your own, are, in your mind, worthless because of his belief. i've seen it many times on SDN. An completely valid and strong argument is made that mentions nothing of supernatural forces and it is discarded as being the opinion of the evil christian conspiracy. that simply gives it more credence.

    i am a strong believer in absolute freedom. this includes an individual's freedom to end their life. i don't believe this should be legal or illegal. i don't believe in creating laws that explicitly provide avenues for death. nor do i believe in creating laws that ban such avenues. i live for the ideal world and form my opinions based on the HOPE that we should at least try for that world. artificial death has no place in fantasy land. why should we not seek this land?

    one poster's argument was the consideration of a high probability of events. physicians work under the probability that their treatment will succeed. death is not a treatment. death is an abandonment of treatment, an abandonment of hope.

    also, applying the results of legalization in the microcosm of oregon to an entire nation is fallacious. no one knows what the result of nationwide legalization of euthanasia would be. arguing that it's working in oregon so it will work in america is invalid. the same goes for arguing anectodal evidence. is it possible that euthanasia could get out of hand? of course it could. will it? who knows. "well, we'll regulate it heavily." what, like the FDA regulates clinical trials? that works well. regulation = ignorance. try something else.
     
  50. Blitzkrieg

    Blitzkrieg 1K Member

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    rofl, and McCarthyian isn't loaded? You're all wet!


    No, the issue here is the value of human life, and whether or not it is sacred. Whether we are purifying the german race (nazis), or purifying society by eliminating the unwanted (abortion), old (euthansia), or unable (euthansia/abortion), it's all the same thing!


    Say what you please, but the Bible has given archaelogists much valuable information that would otherwise leave them in the dark RE: certain periods of history. The evidence that the Bible is historical is quite overwhelming, so I'm afraid that your opinion is in the minority. However, even most scholars will agree that when the miraculous is brought up, it is the unexplained (they say myth) within the framework of history. Of course, as a christian, I disagree, but I was using pagan scholars in order to show you that I report, and you decide :D
     
  51. eunice

    eunice Senior Member

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    i step into this heated discussion, gingerly...
    i just spent about 30 mins reading everyone's posts and must say... some heated words were exchanged.

    first of all, we all have free will, so some of us choose to believe in a higher being and some of us don't. and as someone said, is an argument made by a christian less tenable than one made by a secular person? why is that? i think non-religious people should be careful as to not belittle the opinions of religious people and dismiss them as irrelevant. we have the same rational and intellectual abilites as others do, but we just see things differently. And some christians can be all in-your-face about what they believe, but majority of them are not. you just hear about the minority because they are vocal about it. I am a Christian, but I don't go around imposing my belief system on others... so please, do not take out your aggression on the innocent Christians or other religious people who want to merely voice their opinions.

    i believe strongly in what i believe, but i'm not going to try to impose my value system on others. but unfortunately, in the subject of legalizing euthanasia, it inevitably does involve some group of people imposing their moral values on another group. hence the debate. but there is no need to get hostile here.

    with that said, please take this as my 2 cents and do not dismiss it as some religious argument. my religion does shape the way i think, but this argument is not solely based on my belief in God. it is from what i've read(religious and secular) and the people i've interacted with.

    way in the future, when I become a doctor, i will consider it the utmost privilege to be able to heal people. however, i, in no way, would consider myself equipped to make a decision to give or take away life!! i don't think it's our position. who gave us the right to make such a decision? sure it's really sad that people are suffering from terminal illnesses, and teenage girls are raped. life can be bitterly hard and unfair...don't get me wrong, i am not being insensitive. I am, by far, one of the most sensitive and sympathetic people that i know. And if there is anything i can do to help them ease the pain, i would! but i, personally, refuse to make a decision on life or death.... it's not because i don't want to help them... it's because, as a fellow human being, i do not think i am in the position to make such a decision.

    so.. it's my 2 cents.. and i don't have a problem with people disagreeing with me, it's a free country. but please don't attack my arugment and belittle it as 'another one of those religious babblings.'
     
  52. Peter Parker

    Peter Parker Senior Member

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    Since when does the principle of autonomy impose a value judgment on an entity external to the self?

    Autonomy involves individuals making decisions for themselves. In euthanasia, the doctor would not be making any decision. Rather, the doctor would merely facilitate a decision that has already been made by the patient through his or her own free will.
     

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