Montana Legalizes Doctor-Assisted Suicide

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Narmerguy

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Montana has become the third state to legalize doctor assisted suicide.

http://www.nytimes.com/2010/01/01/us/01suicide.html

Article about it here. (quoted in next post)

What do you think? It's my understanding that there are a lot of nuances regarding physician assisted suicide and what that actually constitutes.

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Montana Ruling Bolsters Doctor-Assisted Suicide
By KIRK JOHNSON


DENVER — The Montana Supreme Court ruled on Thursday that state law protects doctors in Montana from prosecution for helping terminally ill patients die. But the court, ruling with a narrow majority, sidestepped the larger landmark question of whether physician-assisted suicide is a right guaranteed under the state's Constitution.

The 4-to-3 decision, in a case closely watched around the nation by physicians and advocates for the disabled and terminally ill, was a victory for the so-called death-with-dignity movement. But it fell short of the sweeping declaration advocates had hoped for.

And by avoiding the question of constitutional rights entirely, the court kept the debate in the Montana Legislature, where passions over the issue run high and where tinkering with existing laws is much easier than changing the Constitution.

The state attorney general's office, which had argued to the court that the Legislature and the democratic process — not seven Supreme Court justices — should decide the weighty philosophical questions raised by the case, Baxter v. Montana, said in a statement that the questions were still alive and still to be answered.

"The Montana Supreme Court recognized that physician-assisted suicide is a policy question for the people of Montana and their Legislature," the Montana state solicitor, Anthony Johnstone, said in the statement. "As we have argued, that is where the resolution of this important issue belongs."

A spokeswoman for Compassion and Choices, a group that supports physician-assisted death for terminally ill people and which participated in the case as a plaintiff and co-council to the lead plaintiff, Robert Baxter, conceded that a broader ruling would have been better for their interests.

Mr. Baxter, a retired truck driver from Billings, died last year of complications related to lymphocytic leukemia at age 76.

"We would have welcomed a broad and robust constitutional ruling," said Kathryn L. Tucker, the legal affairs director for Compassion and Choices. But Ms. Tucker said there was also no doubt that the court had expanded the choices available to the dying in Montana, and extended protection to their doctors, too.

"The court recognized that this is a right patients have," she said.

The court, which heard oral arguments in the Baxter case in September, was deeply divided, with four separate written opinions among the seven justices — a four-justice majority; a two-justice dissent, and two concurring opinions.

One justice, James C. Nelson, concurred in part, saying he would have upheld the lower court ruling and found a constitutional right to die with dignity.

Two states, Washington and Oregon, allow physicians to help terminally ill people hasten their deaths, but in those states the laws were approved by voters in statewide referendums, and neither state's highest court has examined the issue of a constitutional right to die. Montana would have been the first.

"This right to physician aid in dying quintessentially involves the inviolable right to human dignity — our most fragile right," Justice Nelson wrote in a passionately worded opinion.

The majority's language, by contrast, was muted and lawyerly. A measure passed by the Legislature in 1985, which addressed the withdrawal of treatment for terminally ill patients, created "public policy," the majority said, that in effect shielded a physician from prosecution for helping hasten the death of a consenting, rational, terminal patient.

The dissenting justices said the majority had misread the intent and meaning of the 1985 law and given it a breadth it was never intended to have.

"The statute provides no support for physicians shifting from idle onlookers of natural death to active participants in their patients' suicides," they wrote.

Here's the report in its entirety.
 
I live in Oregon (most of the time), so I'm pretty familiar with physician assisted suicide. Our "Death with Dignity" Act caused a TON of controversy when it first passed, but I think it's done a lot of good. Some of the questions it has brought up:

1. Does assisting a patient in ending their life violate the Hippocratic Oath?
2. Are there degrees to a 'terminal' diagnosis?
3. Does familial opposition to ending a patient's life factor into the doctor's decision to help?
4. Is it morally praiseworthy for a physician to take such action to minimize a patient's pain?
5. Under what circumstances is it appropriate to decline assistance?
6. Should doctors asked to aid a patient's 'suicide' ask the patient to seek a second opinion?
7. Should there be a mandatory waiting period?
8. Should permission to request physician assisted suicide be determined by illness, age, or any other factors?

I'm personally okay with it. I have seen firsthand the pain people suffer even after they receive a terminal diagnosis. I don't know if it violates the Hippocratic Oath, but I feel it is wrong to let a patient suffer when he or she can do nothing about it. It needs to be mandated - have a specific set of rules, at the very least - but otherwise, I have no issue. Besides, individual doctors are permitted to refuse to give this assistance if they want to, no questions asked.

It's a tricky issue, though. I'm interested in hearing what others have to say about it.

(Perhaps unrelated, but for the record: I was born in the same hospital as Dr. Jack Kevorkian and grew up down the street from him. Apparently, he once told my mother I was a blessing when they bumped into each other at the grocery store while I cheerfully ran up and down the aisles as only a three year-old can. Still don't know what to think of that.)
 
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From Oregon as well. After working a couple of years in the hospital with stroke patients and others that will never ever recover but only get more bed sores and essentially "rot" in bed as people forget to turn or change them regularly I have no problem with this at all. No one should have to live in their own filth, and if they want to go then I say let them go with what dignity they still have.
 
I think it's okay too. Sometimes people just need to let go to live. I'm not much of a spiritual person, but in times of death I find myself always looking up. If someone has the courage to admit it's their time, taking into account what would constitute a rational decision, I think it would be wrong to deny them death. Death is never easy but it's a part of life and, taking that into account, it should be our right to decide (again, taking into account rationality) when the tine comes. I think it make help us fear it less.
 
This is a very interesting topic, and has been an ongoing controversy in Oregon.

Of the things I find comforting in this initially disturbing concept is the requirement that doctors must counsel their patients, informing them of all options. I can't find it right now, but the organization Compassion & Choices (http://compassionoforegon.org/) stated on their site that a high percentage (I think it was actually the majority, but again, can't find the data now) of the people in Oregon who pursue physician-assisted suicide actually choose to enter hospice care instead after they learn of their options. In addition, only about half of those who receive the prescription take it. Granted, this is little comfort to those who believe that any suicide is wrong. One of the compelling arguments is that the Death with Dignity Act prevents people from taking their lives by more traumatic means, although I realize this argument isn't entirely satisfying either.

Finally, a prescription for a life-ending drug cannot be given unless a patient is 1) over 18, 2) able to make and communicate their own health care decisions, 3) and diagnosed with a terminal illness that will lead to death within six months. I find the third point especially important.

In addition, it is bit of a process to receive the prescription, and certain waiting periods are built in. You can learn more about it from Health and Human Services: http://oregon.gov/DHS/ph/pas/ar-index.shtml.

It's definitely controversial, but I'm not so opposed after a bit of research.
 
Assisted suicide disgusts me.

Is it the 'suicide' part or the 'assisted' part? Because hey, I'm not cool with suicide 99% of the time. But there are situations where I think it's okay: you're in great amounts of physical pain and have a prognosis of 6 months or less to live is one of them. (Okay, and if you're Kim Jong Il, maybe that's okay too.)

This thread is for discussion, Sweetpea. Either explain your opposition like a grown up or don't post.
 
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The reason people don't like it is that it spans a wide range of situations...some appropriate, some not. Let's be honest...some people may spin and twist the law to have it do what they please.

I am not against having people go peacefully, rather I'm against certain physicians who are pushing their patients to chose this option even if they are not ready. Hopefully the latter is only a small percent of doctors.

It just is a touchy subject..and I feel one can not say that its good nor bad. It really is a case by case thing. Also realize many physicians do not feel comfortable assisting in suicide, just as many don't work hard all those years to perform abortions etc.
 
Assisted suicide disgusts me.

I think suicide is not justified by mere emotional distress or ordinary dangers and threats. It is definitely not justified by dissatisfaction. There are many ways in which life can flourish, and many harms which one can survive and learn to live beyond. To attempt suicide in the vast majority of difficult situations is a betrayal of one's own life and values. One should never consider suicide before one has truly thrown oneself body and soul into the attempt to find a way to live: to escape the concentration camp, to find a cure for one's illness, to stick out a wave of depression, to ignore social pressures, to move to a new place, or to seek a new career.
 
I think suicide is not justified by mere emotional distress or ordinary dangers and threats. It is definitely not justified by dissatisfaction. There are many ways in which life can flourish, and many harms which one can survive and learn to live beyond. To attempt suicide in the vast majority of difficult situations is a betrayal of one's own life and values. One should never consider suicide before one has truly thrown oneself body and soul into the attempt to find a way to live: to escape the concentration camp, to find a cure for one's illness, to stick out a wave of depression, to ignore social pressures, to move to a new place, or to seek a new career.

This is where some people are worried- while I assume the majority of docs will use assisted suicide only when its the last resort and the patient cannot stand to be alive, there are always a few crazies who ruin it for everyone else. The regulations must be strict enough to ensure its only used in the right way.
 
I can think of situations, where people out of guilt, would feel pressured to commit suicide. Allowing suicide allows for increased pressure.
Sympathy with the patient: Feeling guilt is bad, i.e, this is a bad part of the legislation and it is BAD.
Sympaty with the surroundings: Families have to pay less to keep the patient alive, society gets rid of elderly individuals, costly individuals = GOOD
Sympathy with nursing home workers: greater turnover and decreased through of potential customers = more unemployment = BAD.

As mentioned, depressed people get assisted suicide, and could potentially have had their depression alleviated, or at least attenuated to the point where they would no longer wish for their life to end.
Ending ones life can be BAD, or it can be GOOD. I figure most individuals will sympathize with the wish to live, and that living itself constitutes a "good" and that killing suicidal patients who could've lived longer is BAD. But, then again, we all have to die at some point, why not die when you are in the mood for it?

If the logic above looks messy, it is merely a result of life/yin-yang.

I don't have any set preferences or sympathies here. I also don't have any need to define legislation as either good or bad, although I generally seem to favor libertarian values, e.g in this case, removal of legislative obstructions. This is subject to change at any time, and more likely the more sucidal I get. :D
 
I say leave it up to doctors, the patient, the family. What's disgusting to me, is that a patient is terminally ill, in pain we cannot begin to appreciate, and decides to end his/her life in a dignified way before the gubment rushes in with LITTLERICHARD-minded *****s and imposes their morals and ethics on me.

this is arrogance and shameful.
 
Okay. So there are three types of replies to this thread. Let's have a look:

1. Looking at the issues in physician assisted suicide and expressing an opinion.

2. Looking at the issues in physician assisted suicide ONLY.

3. Expressing an opinion ONLY.

I'd love to see explanations looking at the issues surrounding physician assisted suicide (called "Death with Dignity" in Oregon, fyi) from those stating opposition. So far I've only really seen "it should be a last resort" and a whole bunch of "IT'S WRONG BECAUSE I SAY IT IS :mad:"

We're having this thread to hear all the different opinions and the reasoning behind them. Please outline your argument for us. Most of the supporters of this movement have given their reasons. I think it's time the opposition catches up.
 
No one wants a painful and/or unexpected death...
 
Okay. So there are three types of replies to this thread. Let's have a look:

1. Looking at the issues in physician assisted suicide and expressing an opinion.

2. Looking at the issues in physician assisted suicide ONLY.

3. Expressing an opinion ONLY.

I'd love to see explanations looking at the issues surrounding physician assisted suicide (called "Death with Dignity" in Oregon, fyi) from those stating opposition. So far I've only really seen "it should be a last resort" and a whole bunch of "IT'S WRONG BECAUSE I SAY IT IS :mad:"

We're having this thread to hear all the different opinions and the reasoning behind them. Please outline your argument for us. Most of the supporters of this movement have given their reasons. I think it's time the opposition catches up.

I was hoping for the same. I'm more on the fence about this issue actually.
 
We're having this thread to hear all the different opinions and the reasoning behind them. Please outline your argument for us. Most of the supporters of this movement have given their reasons. I think it's time the opposition catches up.

I was hoping for the same. I'm more on the fence about this issue actually.

Well, I could always cough up some arguments against physician-assisted suicide, for those of you sitting on the fence, but I don't think it is the arguments that are lacking, that proves to be your problem.

You are able to see problems with allowing assisted suicide, and problems denying it. You are not bound by ideological barriers that clearly tell you which sympathies are to take higher priority (like Ayn Rand objectivism), or by religious subgroups, where you have to feel that physician-assisted suicide is wrong in order to preserve your self-image as a good person.

You could fall on either side of the fence, and if it wasn't because of the warfare-attitude among humans that you are an irresponsible individual if you change your mind about something, you could have swapped positions every other day, to fit the social settings you find yourselves in.

When you talk about murder, or any other atrocity that 99,999% of the population opposes, there is no problem for you as an animal knowing what stand you have to take. When you talk about taxes, there is a bigger problem knowing what is moral, if you want to have contact with both republicans and democrats. If you talk about stealing a cancer medicine to cure your otherwise dying brother, you have to consider whether you are talking to americans, europeans, or extremely honor-guided japanese. (Or your own brother. ;) ) But you don't know who you will be talking to, here, so you get no help on what you need to see as moral.

Ultimately, it then boils down to why bother.
 
Relativista, with all due respect, your information tells me that you're from Europe. Assisted-suicide in the states is not equatable to the mess going on in some European countries, most notoriously the Netherlands where the slope has become so slick there is no point in trying to attempt to walk up it.
I don't follow the suicide debate in the Netherlands. But I do read the nytimes. What about my location precludes relevance of my take on this, after having access to the same media as you?
 
Oregon's law and the subsequent laws, WA and MT, provide for psychiatric screens and multiple requests for the suicide. Although it may be a very, very small factor, the legislation is written to prevent depression sufferers and "burdens" to family from being approved for the process. Not to mention, there is the 6-months to live clause.
I don't doubt for one second that Oregon's law can increase specificity regarding assisted physician suicide, but no psych screen is foul proof. I get your point, however, and I realize I might have sounded unnecessary snappy here.
 
With the stipulations (psych screen, opinions of multiple doctors) that are in place in the states that have physician-assisted suicide along with the stats to show that it is most likely not being abused, it seems to be working just as it should. A human-being who knows that a horrific and painful end is near should not have to knowingly sit by and wait for those tragic days of pain and agony to arrive. IMO, (and the opinion of a couple of states) a person should, by all means, have the right to end their life and bypass any guaranteed suffering and death that is ahead. As long as there are barriers in place to ensure that everybody and their brother doesn't have access to phys-assisted suicide for any random illness they might be suffering from, the program is of great value, in my opinion.
 
Only 47 to go.

:thumbup: Go Montana!

I second this.

Washington, Oregon, and now Montana. Hopefully this will come across the country to New Jersey! :D

I'm just curious. Regardless of whether you support PAS or not, why would one be so excited and giddy to have physician assisted suicide in their state or in most states? Not trying to get all philosophical but we are still talking about the taking of or loss of a life. It seems to me that when we remove our distaste of death we also loose some to he humanity that makes us human.

So, anyone want to jump in and (seriously) explain why your excited for PAS to come to your town? Not why you support it, but why your excited for it to be in your state?
 
Pennsylvania has a very aged population. With such a population comes terminal diseases (we're living longer). Let someone end it they want to end it.

Its a lot more deep than that, but I'm not getting into it right now.

Sorry, I completely understand the reasons behind supporting PAS. I even understand the deeper implications. Simply curious why such bolstered excitement for it to be in your state. Guess its a deep question....dont worry about it.
 
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