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MIGF may not actually be human.
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Mar 15, 2016 22:19
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My Imaginary GF posted:So, you don't live in a vacuum. I assume your parents interact with individuals other than yourself. Do you think that their emotional response to your addict impacts any of their other relations? I'd imagine it'd be quite stressful to work full-time while knowing that you have a sick child. Your first instinct would be to turn down opportunities, such as working late in order to earn a promotion, so that you could be home and ensure your sick child doesn't overdose themselves. there are limits MIGF, this is well beyond them
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Mar 15, 2016 23:38
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My Imaginary GF posted:So, you don't live in a vacuum. I assume your parents interact with individuals other than yourself. Do you think that their emotional response to your addict impacts any of their other relations? I'd imagine it'd be quite stressful to work full-time while knowing that you have a sick child. Your first instinct would be to turn down opportunities, such as working late in order to earn a promotion, so that you could be home and ensure your sick child doesn't overdose themselves. Every once in a while I forget you're a greasy dumpster fire of a human being, but then we get flare ups like these.
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Mar 16, 2016 00:23
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My Imaginary GF posted:Have you considered that your addiction may also be straining your parent's relation? Which do you love more, your mother, or your addiction? Sorry, but addiction doesn't work like this. It's not simply about making a rational choice of choosing the "love" of addiction over your love for your mother. A number of factors are involved, but simply speaking, it's about being able or unable to engage with life and society. You can be an addict and still love your mother very much, but the shame you feel about yourself and inability to cope with life leads you to withdrawing from life and personal relationships. I believe in the "Rat-topia" hypothesis that if life/society and personal relationships are there, the need for addiction would be lessened. But our "Bowling Alone" society in America with its emphasis on individualism makes it particularly difficult to feel connected to society and so we end up more vulnerable to addiction and excess to make up for the difference in trying to cope with the stresses and pressures of adult life. This is why (unfortunately all too common) appeals to social shaming and burden are totally ineffective and in fact harmful. The addict is all too aware of this, it's a big reason why they are driven to addiction in the first place. e: I also like how you classify "law-abiding citizens" as if they are a different species from Neanderthal-like criminals who behave and think totally differently from other humans and not something that any person can be victim to given the right environment and circumstances. 
Teriyaki Koinku fucked around with this message at 09:37 on Mar 16, 2016 |
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Mar 16, 2016 09:23
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pangstrom posted:CDC released some guidelines, which I haven't read yet, but from the article gist they sound reasonable to me. For other opinions you can see the comments! If these guidelines become standard of care it will be bad new for chronic pain patients in the United States. Opioids should be an option for all chronic pain patients. There are definite risks and the long-term outcomes in terms of pain and function are likely minimal but a reasonable patient could conclude that the immediate pain relief outweighs the harms. Guidelines like these take the decision out of the hands of patients, and go so far to treat pain patients in a punitive/adversarial fashion. Some particular complaints of mine are that the guideline authors downplay the risks associated with nonopioid pharmacologic treatment(ex: cardiovascular and gastrointesinal risks of NSAIDs described as " nonopioid therapies ... are also associated with short-term benefits, and risks are much lower") and overstate the effectiveness of nonpharmacologic treatment(ex: Cognitive bias therapy and exercise) in chronic pain disorders. Categorical statements like "Opioids should not be considered first-line or routine therapy for chronic pain outside of active cancer, palliative, and end-of-life care" are especially egregious. Furthermore, the authors include measures that could be seen as punitive such as regular urine screening for all long-term opioid users despite a complete and utter lack of evidence of efficacy(the only non-grade A recommendation included and based primarily on "clinical experience and observation"). The analysis and presentation of evidence seem to try to justify a politically popular "crackdown" on opioid use rather than an objective summary of available evidence.
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Mar 16, 2016 13:09
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I don't think they're off the table, they just aren't the first thing on the table. Agree that this is bad news for people for whom all-told it's the least bad option but, again, for every one of those stories there are a lot of a different story and ultimately it's hard to tell which person is which story, and even those people have friends and family and live in the society with everyone else. I totally agree with that categorical statement re: chronic pain outside of the usual caveats. It really should be the last-resort option there, and if you have a better objective summary of available evidence feel free to lay it on us.
pangstrom fucked around with this message at 19:57 on Mar 16, 2016 |
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Mar 16, 2016 14:40
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SedanChair posted:What in the wasteful, murderous gently caress? I guess we could just improve the law and medical practice, or we could, you know, go all Aktion T4 about it. Of course, the question of whether the individual is able to provide meaningful consent remains salient, but that's resolvable.
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Mar 17, 2016 02:46
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Cugel the Clever posted:As others aptly stated, assisted suicide ≠ forced euthanasia. You can improve law, medical practice, and offer those who wish it a safe, easy way to end their suffering. Whether it is addiction, another illness, or even just old age, assisted suicide empowers people to take control and end their lives on their own terms. Come now SedanChair, I never expected such conservatism from you! That also touches on questions about do not resuscitate orders or people saying "just let me die." Some people argue that forcing medical care on somebody to save their life is the right thing to do as all life must be preserved at all costs. In the case of assisted suicide (and, well, the above issue) that's why living wills are a huge deal. If somebody puts it in writing, talks it over with their doctor, signs it, and puts it on file there isn't much doubt. Then you can have it both ways; people who want to stay alive as long as possible can have that while people that want their plug pulled and the processed of dying sped up can have that as well. The most moral thing to do is to let the patient decide for themselves.
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Mar 17, 2016 03:10
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Cugel the Clever posted:As others aptly stated, assisted suicide ≠ forced euthanasia. You can improve law, medical practice, and offer those who wish it a safe, easy way to end their suffering. Whether it is addiction, another illness, or even just old age, assisted suicide empowers people to take control and end their lives on their own terms. Come now SedanChair, I never expected such conservatism from you! gently caress you. You just want junkies to die so you don't have to think about them.
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Mar 17, 2016 04:27
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For once in my life, I am going to agree with SedanChair. (I know, the thought makes me hurt physically.) If you are seriously, unironically, suggesting euthanasia (or assisted suicide) as a solution to the problem of addiction, you are both not serious and an rear end in a top hat. A creepy, terrifying rear end in a top hat. I am not a fan of "just let addicts be addicted" - I don't think that's a viable option for society. But addiction is a (non-communicable) medical condition, and it is a short step from "kill the addicts" to "kill the mentally ill" or "kill the disabled".
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Mar 17, 2016 11:44
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ToxicSlurpee posted:That also touches on questions about do not resuscitate orders or people saying "just let me die." Some people argue that forcing medical care on somebody to save their life is the right thing to do as all life must be preserved at all costs. Assisted suicide is a biiit different from a DNR, ethically. In the former case (assisted suicide), you are explicitly telling the medical practitioner to administer or allow to be administered a medical procedure which would result in deliberate harm to the patient as the sole intended effect. That violates every bit of medical ethics there is, going all the way back to Hippocrates - or does "First, do no harm" mean nothing anymore? In the second case, it's the patient pre-emptively saying "I do not desire or consent to treatment". Much different.
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Mar 17, 2016 11:47
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There's a difference between applying something and withholding something though. Like food, or water, or oxygen. If someone desired a peaceful, pleasant even, end to their life, they could just have a room where a breathable atmosphere is created from separate tanks of oxygen and nitrogen and then withdraw their consent for the oxygen tank to remain on after the staff member has left the room. Encouraging people to kill themselves just because you consider them a burden on society is horseshit though. (Except maybe land monopolists, but that's a completely different derail.  ) But from the evidence that we have, "just let addicts be addicted" actually works in a number of cases, whether it's Dr. John Marks's Liverpool clinic or the prescription heroin clinics in Switzerland. When you give a heroin addict a prescription for heroin, they are in large part cut loose from the chaotic lifestyle of trying to get money for drugs.It's a dirt cheap drug on the pharmacy market too, it has been out of patent for over a century and costs about $20/g pharma grade if you could get a manufacturer willing to supply. Ideally this would be supplemented with good social care to tackle any other root issues in the person's life, but even without that it seems to work, and reduces crime, drug dealers, and other peripheral problems of addiction under prohibition. Overall it saves lives too, as reliable doses and prepacked drugs cause infections and overdoses to drop massively, so it's the opposite of "just let them kill themselves" really.
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Mar 17, 2016 12:06
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I don't image for a second there aren't people so far down the path of physical addiction that the next withdrawal would literally kill them who would prefer to just end it all. If you've never been so hopelessly addicted to something then you have no idea how amazingly hosed up and painful it can be.
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Mar 17, 2016 14:27
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Addicts can and do kill themselves! To the tune of 40,000 times a year with prescription drugs... hence all the concern. Dude's just advocating for status quo.
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Mar 17, 2016 14:32
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Spacewolf posted:Assisted suicide is a biiit different from a DNR, ethically. The thing with assisted suicide is that it isn't meant to be available to absolutely everybody on demand. Kind of the point of it is that people who are terminally ill or who would be in extreme pain and misery are to have the option to end it early. The point of assisted suicide is that if somebody is going to only live for another few weeks or months and those months are going to put them and everybody they care about through hell they should have the option to pass peacefully instead. It's kind of a grey area because on one hand the doctor is intentionally giving somebody the means to kill themselves. On the other hand not giving it to them is putting them through unnecessary suffering.
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Mar 17, 2016 15:17
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SedanChair posted:gently caress you. You just want junkies to die so you don't have to think about them. Society needs to be more death positive, in general. Without the stigma around it, choosing to end your life on an up-note in the presence of friends and family would be a welcome option for no few individuals struggling with a terminal illness or chronic/severe disease. Either way, this is a bit of a derail I didn't expect to have to defend.
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Mar 17, 2016 16:39
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Cugel the Clever posted:I'm honestly surprised to find that assisted suicide is controversial on SA. As ToxicSlurpee stated, it's not a service that is provided on a whim to someone who's at a low point. A mandated waiting period plus some measure to ensure the individual is competent to make the decision for themselves would make sense. It's not controversial with me, it's just the most irrelevant cause imaginable to apply to the opiate addiction crisis, and comes from your sadistic motives.
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Mar 17, 2016 16:56
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Cugel the Clever posted:I'm honestly surprised to find that assisted suicide is controversial on SA. As ToxicSlurpee stated, it's not a service that is provided on a whim to someone who's at a low point. A mandated waiting period plus some measure to ensure the individual is competent to make the decision for themselves would make sense. Assisted suicide in many cases is something I would expect you to find significant support for. However "encourage the addicted to kill themselves" as a first response to a growing addiction problem, is not something you will find much support for, and if you cannot see why, I'm not sure if I can begin to explain it to you.
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Mar 18, 2016 00:13
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Ran Mad Dog posted:I don't image for a second there aren't people so far down the path of physical addiction that the next withdrawal would literally kill them who would prefer to just end it all. If you've never been so hopelessly addicted to something then you have no idea how amazingly hosed up and painful it can be. While I think it's impossible for opiate withdrawal to kill you (unless you have heart problems or some complicating factor), I'm sure there are many addicts who become suicidal. But they (kind of obviously) always have the tools available to them to commit suicide; all they have to do is OD. I doubt society would approve of that any less than some sort of institutional euthanasia; most people are still going to think poorly of an addict, even if they chose to die. The number of people who think all addicts are human trash is stunning (I imagine the sort of anti-drug education kids receive might contribute to this perception).
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Mar 18, 2016 00:36
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OwlFancier posted:However "encourage the addicted to kill themselves" as a first response to a growing addiction problem, is not something you will find much support for, and if you cannot see why, I'm not sure if I can begin to explain it to you.  I went so far as to check all my posts in this thread just to make sure I didn't have a brain fart, and in none of them did I ever state that addicts should be "encouraged" or otherwise pushed toward assisted suicide. I'm honestly at a loss here. Cugel the Clever fucked around with this message at 00:42 on Mar 18, 2016 |
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Mar 18, 2016 00:40
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Cugel the Clever posted:Are you guys confusing me with MIGF? Cugel the Clever posted:Watching the Frontline episode on the Opiode epidemic and it's reaffirmed my I'm not entirely sure how else to read that "social programs should be offering to put junkies out of their suffering" on the basis it would "save everyone involved a lot of pain, time, and money" and be better for the community.
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Mar 18, 2016 00:56
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Yeah when you're talking about saving "time and money" you are not talking about the well-being of the person who would be "given the option" of a mercy killing. That's the height of unethical medical practice.
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Mar 18, 2016 01:22
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I just sat in on a lunch presentation with a Pfizer rep But hey, free lunch.
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Mar 18, 2016 01:32
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reagan posted:I just sat in on a lunch presentation with a Pfizer rep Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. You'd think body/mind-altering chemicals with numerous serious side effects isn't something you'd want freely available to wheel and deal on TV commercials.
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Mar 18, 2016 01:56
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Your Dunkle Sans posted:Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. You would think a great many things about the American healthcare system would not be the way they are but yet they remain so.
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Mar 18, 2016 02:28
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Your Dunkle Sans posted:Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. When healthcare is a product, you have to sell all aspects of it.
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Mar 18, 2016 02:52
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Sorry I just don't get it. Addicts become addicts by choice, they took the drugs, they wanted to get high. They stay junkies by choice, they keep taking the drugs, they like staying high. They refuse to get clean by not choosing to deal with withdrawal symptoms. I feel 0 sympathy for these people, just suck it up and quit. They clearly like being a junkie and all the consequences there of more that the benefits of being clean. Its a clear and rational choice they are making.
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Mar 18, 2016 03:48
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KingFisher posted:Sorry I just don't get it. Okay. If it's so easy to get clean, then I suggest you go get yourself heavily addicted to smack, go clean, then write a book about your experience.
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Mar 18, 2016 04:04
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KingFisher posted:Sorry I just don't get it. If just getting through withdrawal led to cleanliness, jails might be useful. If it were simple, rehabs would post better than the 90% failure rates that are currently common. The best explanation I've seen is in a film called "Pleasure Unwoven" which makes a very convincing argument that "addiction is a disease OF choice." This is to say that the addict does not make choices like other people, because their brains are hijacked and reprogrammed through the drug dependence. I see where you might think what you do, but it's a very naive viewpoint.
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Mar 18, 2016 04:49
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Your Dunkle Sans posted:Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. It's not uniquely American, New Zealand does it too! Probably has something to do with corporations being people, advertising is free speech and a lot of pharmaceutical money goes to lobbying.
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Mar 18, 2016 06:25
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Your Dunkle Sans posted:Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. I dunno, I saw Beer commercials all the time when I travel.
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Mar 18, 2016 07:50
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computer parts posted:I dunno, I saw Beer commercials all the time when I travel. That would actually be great if beer commercials had to have long spoken disclaimers about side effects, including addiction, spousal abuse and death.
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Mar 18, 2016 09:13
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Your Dunkle Sans posted:Why do American pharmaceuticals get away with drug commercials on cable TV and the like? As far as I know, it's a uniquely American phenomenon and a really strange one at that. My favorite is Latuda and it's minute and a half of side effects in a minute fourty-five.
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Mar 18, 2016 22:16
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KingFisher posted:Sorry I just don't get it. You're right, you just don't get it.
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Mar 19, 2016 03:15
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reagan posted:I just sat in on a lunch presentation with a Pfizer rep I don't see anything wrong with that? It's pain medicine with a antagonist that doesn't really affect the pain part of the medication which gets helps with the itching and constipation that usually goes with these medications. We give realistor in the hospital for opiod related constipation.
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Mar 19, 2016 04:22
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blackguy32 posted:I don't see anything wrong with that? It's pain medicine with a antagonist that doesn't really affect the pain part of the medication which gets helps with the itching and constipation that usually goes with these medications. The naloxone is in there to dissuade people from shooting, snorting or smoking the tablets as it blocks the effects of the morphine when not ingested. Same concept as buprenorphine / naloxone combos like Suboxone and Zubsolv. Not necessarily a bad thing, but is realistically unlikely to take off due to cost and established prescriber behaviors.
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Mar 19, 2016 05:03
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Spacewolf posted:I am not a fan of "just let addicts be addicted" - I don't think that's a viable option for society. But addiction is a (non-communicable) medical condition, and it is a short step from "kill the addicts" to "kill the mentally ill" or "kill the disabled". This was going to be my response earlier in the thread. Not just from an ethical perspective, but also from a practical one. Assisted suicide for addicts will never be allowed unless assisted suicide for people with chronic depression is allowed. Both of these groups of people would be making a desperate decision while an illness prevented them from thinking clearly. We already institutionalize people for being "a danger to themselves or others" and have essentially agreed as a society that people who would want to kill themselves in the first place are not competent to make the decision. The only exception is for the terminally ill, since "you face certain death anyway, and killing yourself first will prevent suffering or indignity" is one of the only circumstances in which most mentally healthy people would agree that suicide makes sense. Obviously, even that is controversial. The only way it would ever be allowed is if there was some sort of mandatory period (of say, 5 years) before death in which the candidates were given several lines of treatment in an effort to help them recover. Without this, every doctor involved would eventually end up getting charged with malpractice for euthanizing someone who was clearly in a relatively good position to make a recovery. Even after that, there would be all sorts of paperwork involved before the act itself could go ahead. There would be court cases left and right. If the families of people who want to die can be a nuisance now, imagine how much worse they would be in this situation (your dad who is dying of lung cancer, you're not going to get him back under any circumstances, but you might eventually get your addict son or depressed wife back if you prevent them from being stupid and killing themselves first). All of this legal nonsense and mandatory medical intervention from the state would end up wasting more resources than it saved. In any case, most people waste more resources during their life than they produce. It seems absurd to focus on addicts and the disabled, as if they're the only people who do that.
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Mar 19, 2016 11:27
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Weldon Pemberton posted:We already institutionalize people for being "a danger to themselves or others" and have essentially agreed as a society that people who would want to kill themselves in the first place are not competent to make the decision. They're just as likely to be right this time. I'm not sure how we can live in a society where dragging a life into existence without its consent is approved, encouraged even, but a consenting adult who decides that they no longer wish to exist is proscribed, and then turn around and say that as a society we value consent. But I guess that's why they have to medicalize it in order to brush inconvenient thoughts about existence under the carpet. Same goes for Alexander's Rat Park and the idea that some people remain constantly narcotized because their day to day existence sucks, rather than because of some intrinsic evil of the chemical itself. It's as if it's much easier to ban chemicals and institutionalize people than it is to make their lives suck less, because  .
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Mar 19, 2016 12:19
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Guavanaut posted:Which is exactly the same logic that they used when saying that runaway slaves, outspoken women, lazy servants, communists, anti-communists, unwed mothers, and homosexuals should be locked away. We believe in free will, but obviously no sane person would do that, therefore we need to lock up anyone doing that. What do you mean we're just saying this because they're inconvenient to our social values? Well yes, I didn't mean to suggest that the argument about free will and mental competence was a closed book. What you're talking about has more to do with the trouble defining mental illness than anything else. I do think it's a fairly clear case when the same person begging to die one week will soon say "I was feeling really sick last friday, good job I didn't go through with it" without any external intervention. Mentally ill people have a struggle going on between the helplessness and pain caused by their illness and the will to survive that's still underneath. Nobody else you mentioned would do that without significant psychological manipulation, because there is no struggle, except against a hostile society. I don't think it's disrespectful to attempt to achieve the thing that society values when the individual themselves is clearly conflicted, or when it is impossible to ask for consent first. We do this in all sorts of situations, and I can't think of a better way of dealing with ambiguous cases, although you do have to keep an eye out for interest groups who will push for the socially expedient solution against the best interests of the individual. That does leave out the few people who would be consistent about wanting to die, and I see no real reason to deny them if they had been rigorously vetted first. Though they'd be so small in number that it would make more sense for the state to turn a blind eye to it than to actively assist them. There's already nothing stopping opiate addicts from killing themselves in a relatively painless way other than their own will to live (and possibly the absence of a quiet place to overdose where they won't be found and resuscitated). In any case, if you want euthanasia for people with mental disorders on the grounds of respecting consent, you might think of all the things in my second paragraph as being worth it. It's difficult to argue that it wouldn't be more expensive than the situation we have now, not less, which is what the poster who suggested it was concerned about.
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Mar 19, 2016 22:46
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Cugel the Clever posted:Are you guys confusing me with MIGF? Allow me to explain the difference for those who are new here: You have a lovely opinion. Maybe you're otherwise a fine person, good poster, or whatever. Maybe not. Being wrong in weird and fascinating ways sometimes is okay as long as it doesn't become a derail. MIGF... wassss oncccce a man.
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Mar 21, 2016 03:32
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