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I mean functional enough to live the life they've chosen, as in, if someone wants to live and can live without treatment. If someone wants to live without treatment but can't and ends up in hospital, or simply can't express an opinion either way any of the time, give them treatment on the assumption they would want it. Unless they have explicitly refused it, in which case you shouldn't, as with a DNR. If they don't want to live then that's up to them, isn't it?
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May 28, 2015 04:57
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OwlFancier posted:I mean functional enough to live the life they've chosen, as in, if someone wants to live and can live without treatment. If someone wants to live without treatment but can't and ends up in hospital, or simply can't express an opinion either way any of the time, give them treatment on the assumption they would want it. Unless they have explicitly refused it, in which case you shouldn't, as with a DNR. because their ability to make decisions is compromised. Yes this can lead to a slippery slope of ignoring consent, but it hilariously, obviously true in quite a few cases, so you default to "death=bad"
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May 28, 2015 05:09
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Let's say you get in a horrible accident, and you're a quadrepalegic. You want to end your life painlessly instead of starving to death, and being a quadrepalegic, you can't even starve to death without someone else's permission. Why shouldn't you be able to end your life painlessly? A whole lot of people would not want to continue living in that situation, no matter how 'pleasant' the care might seem to YOU (who isn't a quadrepalgic/terminally ill person). There's been actual situations where this has happened and the person was kept alive against their will for years. Arguing that all terminally ill people who want to die just aren't thinking clearly because they're suffering from depression because they're a quadrepalegic or terminally ill or suffering from an excruciatingly painful disease, is pretty ridiculous. Of course they are depressed they're dying/have lost all autonomy/are in excruciating agony. This doesn't somehow make it OK for you to force an existence of unending torment on them because it feels wrong to you. Duh you shouldn't just give anyone who asks for it assisted suicide drugs, but passive euthanasia is already allowed and is far crueler than doctor assisted suicide, and just like how people accept they have the right for DNR and passive euthanasia, you should accept the right for people suffering incurably to die peacefully just because they weren't 'lucky' enough for their specific injury or sickness to kill them thoroughly enough for a DNR order to count. You can make it take several counseling sessions, or a time delay, or whatever, sure, to make it so spur of the moment decisions don't happen, but there are going to be a significant number of people who no amount of time or treatment will change their mind, and the law should respect that decision. Wolpertinger fucked around with this message at 05:50 on May 28, 2015 |
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May 28, 2015 05:47
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OwlFancier posted:
How the heck do you define 'living' here? A guy with PTSD that is dangerously unstable is living and there is no guarantee that they'll act out violently, but they definitely need treatment even if they think they know better. Was John Nash 'living'? He revolutionized game theory so it's had to say he wasn't functioning on some level but at the same time people surrounding him understood he needed help more than he did. Does someone with mild epilepsy who only suffers 2 or 3 seizures a year, who decides not to take anticonvulsant medication due to the side effects (which are really horrible, trust me) but doesn't grasp that each seizure could stop thier heart or rewire thier personality or worse really know better than those prescribing the medication? These aren't gotcha questions, they're something we need to consider and simple axioms are not going to cut it. PAS is easy to deal with when we're talking about DNRs and terminal illnesses (for the record a support both and beleive casting amoral judgement on suicides is bad), which is why there's little to discuss there. Mental illness has more nuance and I'm not certain your line of reasoning has captured it.
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May 28, 2015 16:30
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Bifner McDoogle posted:How the heck do you define 'living' here? A guy with PTSD that is dangerously unstable is living and there is no guarantee that they'll act out violently, but they definitely need treatment even if they think they know better. Was John Nash 'living'? He revolutionized game theory so it's had to say he wasn't functioning on some level but at the same time people surrounding him understood he needed help more than he did. Does someone with mild epilepsy who only suffers 2 or 3 seizures a year, who decides not to take anticonvulsant medication due to the side effects (which are really horrible, trust me) but doesn't grasp that each seizure could stop thier heart or rewire thier personality or worse really know better than those prescribing the medication? These aren't gotcha questions, they're something we need to consider and simple axioms are not going to cut it. So long as the person isn't going to pose a risk to others, it should be up to them whether they seek treatment or not. PTSD doesn't automatically result in violence but I was under the impression that it can be unpredictable enough to result in it sometimes, that would be a case where confinement for the safety of others could be supported. For the benefit of the sufferer however, you should respect their decision. The epileptic is entirely within their right to refuse treatment because they don't like the side effects, they shouldn't be allowed to say, drive a car while doing so because then they pose a risk to others, but if they consider the side effects worse than the risks of the seizure, so be it. Whether you agree with them or not isn't relevant, it's their decision, you don't share the same values and what is important to you is likely not as important to them.
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May 28, 2015 17:04
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OwlFancier posted:So long as the person isn't going to pose a risk to others, it should be up to them whether they seek treatment or not. PTSD doesn't automatically result in violence but I was under the impression that it can be unpredictable enough to result in it sometimes, that would be a case where confinement for the safety of others could be supported. For the benefit of the sufferer however, you should respect their decision. I beleive consent needs to be informed, though. For the hypothetical epileptic let's assume he lives in a place that has public transit and revokes his drivers license (I'm in that situation, so it's not unbelievable), but does not grasp the severity of thier condition and how serious the damage resulting from a seizure can be. Lets take a humorous example - this is a comedy site after all - of an epileptic who doesn't get that sometimes you poo poo your pants during a seizure. This leads to a very embarrassing work incident that would have lead the epileptic to take meds, had they understood that it was a side effect before hand. I'm using the epilepsy example a lot because it's relatively objective, I suffer from it and am less likely to say something ignorant, plus I'm related someone who refuses to take meds for it for reasons that may or may not be based in reality (this person beleives thier neighbors record his conversations and plays it back to him through thier walls). The axioms you've laid out are ones I mostly agree with, but they simply don't capture the nuances of these situations. It feels like an easy answer to a very, very difficult problem with as many variations as there are individuals. And this is for a relatively objective mental illness. I do beleive these questions are important and must be asked constantly, its how we realized callings trans people mentally ill and denying them HRT is hosed up. I'm not looking to win this conversation so much as I want to broaden it.
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May 28, 2015 18:47
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Certainly consent should be informed where possible, part of going to a doctor to investigate epilepsy (or any other condition) should include information about the condition and how to manage it with or without treatment. But in the event someone isn't well informed about their condition, I don't think it's appropriate to ignore their wishes as a result. Especially as they may still come to the "wrong" conclusion even with information, due to a difference in values. Make information as available as you can, but also accept that not everyone will necessarily make use of it. Which again is fine so long as the consequences affect them, rather than others. I fully accept that this won't produce optimal outcomes all the time, in fact it's probably never going to produce an entirely optimal outcome. The ideal of course would be that we would have an absolute authority which can accurately decide what is best for everybody and give them it so that nobody complains, but as we're a long way from that, even a long way from being able to accurately guess at what is best for others who are dealing with complex and difficult situations, the best thing to do, I think, is to make as much help, information, and support available as you can, and then let people choose. The choice is important, people have to make decisions for themselves, and we have to trust that they are making the best one they can, and not remove their choice when we disagree with it, because it offends our sensibilities. The choice isn't for our benefit, it's for the benefit of the person affected by it. I think that approach is the best way to avoid things like declaring trans people insane, the help you give should adapt to the needs of the person, as they express it, it shouldn't be there to make people conform with what is socially or personally acceptable to the person in charge of administering the help. Swapping stories, I have a relative who is, bluntly, quite mad. She functions but it's quite clear that she isn't happy or healthy and likely never has been. I would like to see her treated and her life improved but she won't consent to it. I could try to have her sectioned but that wouldn't help either, it would take what little happiness she does manage to draw from life away, and she would resist every step of the way. In theory she is treatable but in practice, nobody would possibly be able to find out exactly how to best do so. So all I can do is respect her wishes, offer what help I can, and let her get on with it. It isn't optimal, but I do think it's the best of a bad lot. OwlFancier fucked around with this message at 19:10 on May 28, 2015 |
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May 28, 2015 19:02
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Shouldn't someone drunk or otherwise impaired in a similar manner be prevented from suicide? Their judgement is clearly not correct, and the condition is temporary, or in the case of an alcoholic; treatable. Similarly, shouldn't we still be able to have a family member committed to a rehab center for a cocaine or heroin addiction? Their agency is in jeopardy, not from their loved ones, but from their chemical dependencies or impairments. Society is obligated to help this sort of person, rather than stand aside and watch them kill themselves, because of some misbegotten belief that human life has no inherent value. Depression is just that; an impairment of your judgement that can lead to you wanting to kill yourself. It's the brain chemistry screwing up and making you miserable over what amounts to temporary or trivial setbacks. I suffer from it and anxiety issues quite a bit. Without medication, I'm a nervous wreck who is barely able to drive a car, sleep away my life when I'm not working and generally think about death all the time. With it, I have a productive and mostly happy life with a wife and child. It works for me and millions of others. Other people respond to other methods, of which there are many. Therapy works great to get people through specific issues, even if it falls short on others. But many times, if it was the stance of the government and people everywhere to just shrug and say "go for it." in regards to suicide? I'd not have made it past 16. I'm glad that I was stopped from eating a shotgun, and received the treatment (against my will!) that I needed. It gave me a real chance at life, before teen hormones mixed with depression could get me killed.
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May 28, 2015 19:31
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Their agency is in jeopardy if they do not want to live as they are. And as before, I support the provision of as much aid as possible to people who want to change their life, because self determination is important. The role of care providers should not be to say "go for it" but to say "we have alternatives we can offer, but we won't force you to take them" If someone with no prior predisposition to suicide gets drunk and behaves recklessly, yes, they should be prevented from injuring themselves, because there is a fairly established personality there which is obviously in contradiction to their current behavior, "they" don't want to die, as in, the person they are 90% of the time doesn't, so that person should have their wishes honored. There is a difference between that and somebody whose whole, long term personality is depressive. I have that problem myself, as does some of my family. Either you have to argue that a depressive person is not a legitimate person, because their outlook is not sufficiently optimistic, and they need to be changed into something more acceptable, or you have to acknowledge that a depressive person has a right to self determination as well. If your judgement consistently functions in a particular way, it's difficult to describe it as "impaired" or to view that judgement and associated personality as illegitimate. Do you do so because the judgement doesn't correlate with your own? Most people's judgement will not. Do you do it because it isn't reasonable? Most people's judgement is not. Do you do it because it sometimes produces results you find impossible to conscience? Often the case with many people. Unless you plan to lock people up in general for making judgements based on ideology or faith, or for making judgements you don't like, I'm not sure how you can justify delegitimising a person on the basis that their personal judgement isn't to your liking. Whether or not you once held similar views in the past and now intensely oppose them doesn't signify, I don't think. I don't oppose you seeking treatment despite it being something I personally would much prefer to avoid, but it is your decision, and that's important. Hence why I favor permissiveness. Medication works for some, therapy for others, neither work for still others, and, while it may not be my choice, suicide most certainly solves problems for the people who choose it. That people may choose it challenges us to be better, to provide other options, as I very much doubt it would be anybody's first option. But if someone is driven to it, has exhausted everything else they have available to them, and still chooses death, how on earth do I turn round and say, always, until moments before their death cannot be prevented: "no you can't do that because I don't think you've tried hard enough at the other alternatives/because I don't believe you can think straight" As before, offer alternatives you think are better, don't legislate against the ones you don't like. OwlFancier fucked around with this message at 20:08 on May 28, 2015 |
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May 28, 2015 19:55
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The depression I've dealt with isn't triggered by anything in particular, and isn't solely represented in mental and emotional tolls, but physical ones. Loss of appetite, lethargy, lack of interest in activities you normally enjoy, etc. It's a change that occurs, not your inherent and default state. It comes and goes in episodes. I hate feeling that way, because it's not who I am most of the time. A lot of people I know are in similar situations. Suicide would be a tragedy born of rash decision during an episode.
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May 28, 2015 20:07
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Then in your position I would suggest that something to do under a system which is permissive about assisted suicide would be to, during a point when you are the person you feel is 'you', register with your doctor that you don't want to be considered for assisted suicide. Personally I don't tend to swing much so my intuitive understanding is of a rather more unwaveringly grim outlook. We already allow things like that, least over here, you can go to the pharmacy/doctor and ask them to make sure that you cannot be prescribed particular medications. For the same reason I would support the idea of a waiting period for any sort of assisted suicide, I agree with you that it shouldn't be a momentary decision, and needs to be considered. The point of my argument isn't to make depressed people kill themselves, it's to recognise that banning humane and managed suicide doesn't improve access to other healthcare, that it is only going to drive people to more violent, unreliable, and dangerous-to-others methods. I don't think it's necessary to stuff suicide under the rug in order to support better care for the unwell. I would argue it's actively counterproductive to do so. OwlFancier fucked around with this message at 20:20 on May 28, 2015 |
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May 28, 2015 20:13
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OwlFancier posted:Then in your position I would suggest that something to do under a system which is permissive about assisted suicide would be to, during a point when you are the person you feel is 'you', register with your doctor that you don't want to be considered for assisted suicide. Personally I don't tend to swing much so my intuitive understanding is of a rather more unwaveringly grim outlook. mental illness isn't a terminal illness. It is in fact, A Good Thing, to prevent people with brain problems from killing themselves. I have no idea why it's so hard for you to understand that a decision to kill yourself is rarely made on a rational basis.
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May 28, 2015 20:34
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A big flaming stink posted:mental illness isn't a terminal illness. It is in fact, A Good Thing, to prevent people with brain problems from killing themselves. I have no idea why it's so hard for you to understand that a decision to kill yourself is rarely made on a rational basis. If you define wanting to die as irrational then it is tautological, yes.
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May 28, 2015 20:44
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I might also venture that there is a slight element of selection bias in play. As in, people who think suicide is/was the right and rational option, don't tend to speak about it after the fact.
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May 28, 2015 20:47
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spoon0042 posted:If you define wanting to die as irrational then it is tautological, yes. I wasn't referring to that basis. Plenty of depressed folk have massive distortions in how they view the world that lead them to consider suicide (everyone hates them, minor to moderate setbacks in their life are impossible to overcome, etc) and that's not even touching on outright delusions or psychosis
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May 28, 2015 20:51
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A big flaming stink posted:I wasn't referring to that basis. Plenty of depressed folk have massive distortions in how they view the world that lead them to consider suicide (everyone hates them, minor to moderate setbacks in their life are impossible to overcome, etc) and that's not even touching on outright delusions or psychosis
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May 28, 2015 20:58
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twodot posted:Are physicians in danger of killing such people? We aren't talking about whether people should commit suicide, but rather should doctors have the legal capacity to prescribe or administer lethal medication when, as a licensed medical expert, they believe that is the best treatment available to their patient. The thread has actually gone on to be more on whether suicide should be allowed to be prevented at all, as a violation of your bodily autonomy.
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May 28, 2015 21:01
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Talmonis posted:The thread has actually gone on to be more on whether suicide should be allowed to be prevented at all, as a violation of your bodily autonomy.
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May 28, 2015 21:05
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twodot posted:The question of should is preempted by how. What sort of deterrent could you possibly implement that would be effective against people who want to suicide (edit: and have the capacity) and not monstrous? Education, intervention and treatment. A temporary (key word) involuntary psychiatric hold on a person who is in imminent danger of self-harm, as reported by a family member, is done in some states, and is something that I don't see as a bad thing in a worst case scenario. Because again, suicide is final. If you're determined to do it, those 48 hours of treatment and care aren't going to stop you, but it might just stop someone who just needed to talk it out, or have a bit of peace and quiet for time to think, or possibly even medication.
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May 28, 2015 21:58
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I wouldn't oppose a temporary intervention, my objection would be to the repeatability of such. If someone seeks to end their life in a peaceful way, and is committed to doing so regardless of being given time to think about it, they should be allowed to do so, and not locked up because of it, either indefinitely, or repeatedly.
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May 28, 2015 22:02
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twodot posted:The question of should is preempted by how. What sort of deterrent could you possibly implement that would be effective against people who want to suicide (edit: and have the capacity) and not monstrous? Suicidal people are actually super easy to deter in some cases. Like a fence on a bridge can be sufficient to cause someone to abandon suicidal plans
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May 28, 2015 23:30
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A big flaming stink posted:Suicidal people are actually super easy to deter in some cases. Like a fence on a bridge can be sufficient to cause someone to abandon suicidal plans
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May 28, 2015 23:39
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twodot posted:Sorry I meant what controversial deterrents could exist. I don't believe anyone is opposed to temporary involuntary holds or fences.
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May 29, 2015 00:40
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Infinite Karma posted:Hypothetically, if physician assisted suicide was available with pleasant/painless drugs, it's a deterrent to kill yourself in grisly or painful ways. The hurdle to clear in that case is convincing a doctor that suicide is a good treatment for what ails you, so you can get the drugs instead of jumping off a bridge.
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May 29, 2015 03:07
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twodot posted:I don't disagree, but I was explicitly told we were no longer talking about physician assisted suicide, so I have no idea what's going on now. We could always get back to the original topic which seems to be that if we as a society accept that one life is not worth living soon we'll be rounding up the disabled into camps.
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May 29, 2015 03:19
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Wolpertinger posted:Let's say you get in a horrible accident, and you're a quadrepalegic. You want to end your life painlessly instead of starving to death, and being a quadrepalegic, you can't even starve to death without someone else's permission. Why shouldn't you be able to end your life painlessly? A whole lot of people would not want to continue living in that situation, no matter how 'pleasant' the care might seem to YOU (who isn't a quadrepalgic/terminally ill person). There's been actual situations where this has happened and the person was kept alive against their will for years. Arguing that all terminally ill people who want to die just aren't thinking clearly because they're suffering from depression because they're a quadrepalegic or terminally ill or suffering from an excruciatingly painful disease, is pretty ridiculous. Of course they are depressed they're dying/have lost all autonomy/are in excruciating agony. This doesn't somehow make it OK for you to force an existence of unending torment on them because it feels wrong to you. Yeah, people who use the "you just need better care" argument (we do need better healthcare one way or another, but still...) are basically just insisting that everybody adopt their philosophy regarding what makes life worth living. It's true that numerous quadriplegic people have gone on to be generally happy, but you're still looking at a relatively tiny list of things one can actually do with one's life. And even many of those things require super-expensive specialized doodads that many health plans may not cover (even in countries way ahead of the US in that department). Plus there's the whole "loss of autonomy" thing, where many anti-PAS advocates seem to grossly underestimate the level of suffering that can cause. twodot posted:Sorry I meant what controversial deterrents could exist. I don't believe anyone is opposed to temporary involuntary holds or fences. I've heard of people using suicide to argue for strict gun control. Does that count? spoon0042 posted:We could always get back to the original topic which seems to be that if we as a society accept that one life is not worth living soon we'll be rounding up the disabled into camps. Apparently, people got bored with that when no one managed to put forth a meaningful case that there can be no such thing as a rational reason to desire death.
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May 29, 2015 23:22
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Cockmaster posted:I've heard of people using suicide to argue for strict gun control. Does that count? Talmonis posted:The thread has actually gone on to be more on whether suicide should be allowed to be prevented at all, as a violation of your bodily autonomy.
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May 29, 2015 23:59
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