Less Than Human

24

Comments

  • caroline444caroline444 Shipmate
    edited August 21
    I see this kind of sentiment expressed by (mostly) healthy people, considering themselves as individuals. Which is not the way to make public policy. Assisted suicide is legal in Canada, called MAID - medical assistance in dying. The process is arduous, and there are many safeguards, but it boils down to repeated confirmation that the person wants to be drugged to the point of death. If the procedural checklist is followed, the death by medication is legal.

    What this does not cover is the elderly or frail person who is spending their children's inheritance on care for themselves, which here can approach $5000 per month plus additional expenses related to medical supplies and transportation (ambulance is $325 plus $2.30 per km ~$3/mile including travel to the patient). The point is that the costs add up. Hospital care spends the $5000 in less than 3 days.

    So what I'm understanding is that people are being offered MAID by way of discussion as a "treatment option". The influence of family, of medical opinion etc is dealt with by clearing the room and the person being asked if they want this option on the slate of options. Does having it available make it more likely to occur? is there direct and subtle pressure?

    I understand that a lot of money is spent on care in many of these situations. I have heard the argument that greedy relatives will try and persuade their ill relatives to take the voluntary euthanasia option. It hadn't crossed my mind that medical facilities might try to influence people to accept VE/MAID to reduce care costs. That is quite shocking.
    Of my questions, the only one I know the answer to for certain is that people have decided to not see a particular doctor again because MAID was discussed with them.

    As indeed I would refuse to see a particular doctor if they <i>didn't</i> discuss MAID options with me, were I living in Canada.
    I always return in thought to "life unworthy of life" which my father recalls from 1930s Berlin. From voluntary to necessary in a short while.

    I think the nightmare legacy of the holocaust and other eugenic polices has left a deep scar on our outlook. How could it be otherwise?
    Which leads me in the completely different direction of "palliative sedation" and palliative care generally. It leads away from those whose physical health is not precarious. But leads to appropriate care so that there is not suffering. The poor quality of elder care when they have chronic conditions is not reason to authorize terminating their lives. Which the current MAID procedures in Canada wouldn't allow anyway. The person can't confirm wanting to die with assistance. Thus I don't think a living will would work if the person does not confirm at the time of hooking up the lethal injections.

    Firstly I think there are <i>are</i> serious problems with voluntary euthanasia, and these problems have to be addressed to the very best extent they can be addressed. On the other side though there are people who are suffering dreadfully, whose quality of life would be improved drastically if they knew they could have access to VE should they choose to use that option.

    If necessary one could introduce legislation saying that people could have access to VE if they stipulated they wanted that option in a living will, say as long as they wrote the will before the age of 50. I think relative pressure and hospital authority pressure would have far less influence if people made this choice in middle age. I would consider it very sad if those who lost the capacity to verbalise this choice at the last minute were unable to go ahead with their earlier decision, but at least some people in distress would have access to this option.

    My apologies too for going off track. I can see this thread is meant to be about what constitutes life and consciousness. It's not meant to be about VE.
  • Or what it means to be a human being.
  • Thank you - yes indeed...
  • Barnabas62Barnabas62 Purgatory Host, Epiphanies Host
    DT

    I'm still pretty raw, following my mum's death about a month ago. Over 100 yet remarkably lucid to the end. I've got enough lucidity myself to know that two really good friends of ours, the ones dealing with loved ones far gone with Alzheimer's, in their 90's, zero quality of life and precious little self awareness, would wish their loved ones had the comparatively easy end my mother did. A few painful weeks in hospital following a bad fall and permanent loss of mobility, before contracting pneumonia. The old person's friend. My mum was ready to go.

    But for our friends, their suffering, and the suffering of their loved ones, has gone on for years. They have to live with that. I haven't had to yet. I do not presume to make moral judgments about their thoughts and feelings as they cope, somehow.
  • RicardusRicardus Shipmate
    @Barnabas62 do you agree with Singer that killing any severely disabled person up to the age of three would be a reasonable thing to do ?

    I've always had a suspicion that Singer is actually a very conservative Roman Catholic in deep cover, his mission being to undermine utilitarianism from within via the reductio ad absurdum ...
  • Gee DGee D Shipmate
    There is an enormous difference between euthanasia and withdrawal of treatment. A mate of mine is a judge and had to decide if a patient could direct the hospital where he lived could direct the withdrawal of treatment. The particular patient was in his late 20s, with a birthday coming up. About a decade before, he'd been severely injured in a car accident. Since then, he'd been paralysed from the top of his spine down and totally dependent on others for everything. There were some other issues as well, but his brain continued to work well, he could speak and use a keyboard. He wanted the hospital to withdraw his life support and the hospital sought a judicial opinion that they could follow that direction. After hearing all the evidence and the submissions counsel on each side presented, my mate decided that the patient could give such a direction and the hospital safely follow it. On the eve of the birthday, having said his farewells, he asked his younger brother to turn off the life support; that happened and he slipped way peacefully. My mate said that it was the hardest decision he'd ever had to make.
  • Barnabas62Barnabas62 Purgatory Host, Epiphanies Host
    It can get to be a very fine line, Gee D. Lots of folks suffering from terminal illnesses get moved over to a "pain relief only" regime. That is a common means of withdrawal of treatment. But, as is pretty well known, gradual increases in the administration of morphine will lead to a crossing of the line. And where it is for any individual patient may not be easy to tell. Folks build up a tolerance.

    In effect, it is very often assisted death but with legal protection for the doctor or nurse.

    But I recognise that your example does address DT's point, re care for someone who is not terminally ill, but chronically deficient. I've argued "case by case" and I think your example supports that. Decisions by lucid people should be respected and obeyed. I believe that should apply to living wills also, made when the person was of sound mind. That seems to me to respect the autonomy and humanity of the persons concerned.
  • But Colin’s specific point is that we are talking about people who lack mental capacity.
  • The problem I have with saying an end-stage Alzheimer's patient is "dead" (besides the misuse of the English language) is that I have witnessed people at this point pull off amazing episodes of lucidity for short periods. They never last, of course, but what the hell is going on when such a person who is no longer even verbal suddenly opens her eyes, recognizes you, and has a coherent, complex conversation with you for several minutes before falling asleep and returning to her normal state? Especially when the last time she was coherent was years ago.

    Judging by stories I've been told, I'm not the only person who has run into this phenomenon.

    Which leads me to believe that the "real person" is in fact still there, hiding somewhere inside that shell, apparently cut off from normal life and interaction 99% of the time by ... shall we call it a problem with the cable? As when a computer screen goes dark, not because the computer itself is bad, or because the screen is bad, but because the cable linking the two is on the fritz and only occasionally wonks itself back into momentary usefulness. That's the model I'm currently thinking about for Alzheimer's.

    If correct, we have a situation much closer to locked-in syndrome than to "she's dead."

    From seeing my mother's deterioration, that isn't my understanding of what's happening, though the analogy to electrical connections is partially correct.

    There isn't a single cable connecting the 'person' to the external world. It's more as though there is a complex loom of wires connecting all the component parts of the 'person' together. (I think persona or psyche would be more accurate terms) Most of the time this loom doesn't work because too many of the connections are fritzed. Very occasionally though, enough of the connections are working, or the brains ability to rewire itself and make new connections, gives moments of apparent lucidity, albeit how much that apparent lucidity is really a return to the real person or in fact merely resembles the person we remember is debatable.

    The proof that it isn't like the conventional understanding of the locked in syndrome is that during these moments of apparent lucidity the individual has no knowledge of being locked in. It's more a case of the individual flitting in and out of existence.
  • I ask the question, because people are tending to engage with this thread around, essentially, end of life issues. Whilst I understand that happening given the context in which the OP arose. That is not really what I am trying to discuss.

    It’s more, if you justify defining someone as effectively dead or less than human through the loss of intellectual skills - which becomes your reason for advocating euthanasia - have you thought about the implications of those specific reasons when applied to disabled life. Not the process of dying.

    So it seems to me, that Colin’s view - forgive me if I have this wrong Colin - is not just that dementia robbed him of his mother and who or what that left was not worth keeping for the last 6 years, but that anyone with an intellectual disability serious enough to mean they can not reliably recognise people (e.g. “serious Downs”) has a life not worth living. Moreover it is unreasonable to expect others, and by extension society, to provide the care and support they need to live that life.

    I fundamentally and passionately disagree with this, (and if I have misrepresented Colin’s position - it certainly not an exaggeration of Singer’s position).

    You have not misrepresented my views.

    For me, it comes down to this: if we know when it is right to euthanase a much-loved dog why is it never right to euthanase a human?

    Who are you to insist that some humans live a life that we would, if they were non-human, consider not worth living?
  • Barnabas62Barnabas62 Purgatory Host, Epiphanies Host
    edited August 22
    Doublethink

    Is there really an ethical distinction between severe chronic physical impairment and severe chronic mental impairment? I appreciate there is a difference re current personal decision-making by the affected individuals but I think it ought to be possible to include a 'please put me out of my misery' clause in a living will, made when one is of sound mind.

    My difference with Colin is that I do not think we have the right to take that decision for anyone else, unless we have been given that right clearly in a living will.
  • Barnabas62 wrote: »
    Doublethink

    Is there really an ethical distinction between severe chronic physical impairment and severe chronic mental impairment? I appreciate there is a difference re current personal decision-making by the affected individuals but I think it ought to be possible to include a 'please put me out of my misery' clause in a living will, made when one is of sound mind.

    My difference with Colin is that I do not think we have the right to take that decision for anyone else, unless we have been given that right clearly in a living will.

    Ideally, it would always be done with the prior consent of the individual and a living will would do that.

    No, I don't think we do have the right to take that decision for anyone else, but there are many things we do ordinarily without having the right to do them: humans have no right, for example, to eat meat but many do so out of habit, culture, and enjoyment.

    I would suggest that when it comes to taking a decision to end a human life, or allow a human life to end because we consider to be unendurable or beneath human dignity that we do not act because we have the right to act but because we have an obligation to act.
  • lilbuddhalilbuddha Shipmate
    Ricardus wrote: »
    @Barnabas62 do you agree with Singer that killing any severely disabled person up to the age of three would be a reasonable thing to do ?

    I've always had a suspicion that Singer is actually a very conservative Roman Catholic in deep cover, his mission being to undermine utilitarianism from within via the reductio ad absurdum ...
    I've always had the suspicion that he is a sociopath who likes animals.
  • BoogieBoogie Shipmate
    @Colin Smith -
    For me, it comes down to this: if we know when it is right to euthanase a much-loved dog why is it never right to euthanase a human?

    We don’t really know when it is right for our much loved dog. What we do know is when we are ready to let them go. Sometimes that is later than it should be - for the sake of the dog it would probably have been better a few days earlier, but it’s hard to let them go.

    If I had had the right to euthanise my dearly loved Mum I wouldn’t have done it. I could not take that kind of responsibility, it would have caused me to be unable to live the rest of my life.

    Selfish? Maybe. But her death was peaceful and very special in the end, it was as if her body ‘knew’ what to do. The six years leading up to it were terrible for us all - but you know that, you’ve walked that road too.

  • From seeing my mother's deterioration, that isn't my understanding of what's happening, though the analogy to electrical connections is partially correct.

    There isn't a single cable connecting the 'person' to the external world. It's more as though there is a complex loom of wires connecting all the component parts of the 'person' together. (I think persona or psyche would be more accurate terms) Most of the time this loom doesn't work because too many of the connections are fritzed. Very occasionally though, enough of the connections are working, or the brains ability to rewire itself and make new connections, gives moments of apparent lucidity, albeit how much that apparent lucidity is really a return to the real person or in fact merely resembles the person we remember is debatable.

    The proof that it isn't like the conventional understanding of the locked in syndrome is that during these moments of apparent lucidity the individual has no knowledge of being locked in. It's more a case of the individual flitting in and out of existence.

    I agree that it's a complex web, but "flitting in and out of existence" is AFAIK not actually a real Thing™ that happens to anything. We talk that way, but what we really mean is that something appears, disappears, appears again, and so forth. We don't IMHO believe that it is actually non-existent in the disappeared-periods. It is just out of perceptual range.

    That's what I think is going on to some extent with Alzheimer's patients. Whatever the link is between invisible psyche and visible body/brain, it's on the fritz, and occasionally manages to set itself right for a brief period--but not permanently. But the existence of periods when the individual actually DOES reappear in fullness, or near-fullness, suggests that the psyche-bit is actually always in existence somewhere--but that the connection is screwed. Not that the person has sprung out of nothing, then died again, then re-sprung out of nothing...

    In short, we are talking about object permanence, as they call it when they are explaining how babies learn to look for hidden objects. They realize at some point that the object is highly unlikely to have simply gone out of existence, whether they can locate it or not.
  • DoublethinkDoublethink Shipmate
    edited August 22
    I am going to write a longer more detailed post - but - you keep all keep taking about dying, about deteriorating conditions.

    People with moderate and severe learning disability (intellectual disability/mental retardation) are not dead, are not less than human, are not incapable of having meaningful existence, are not incapable of achieving a good and enjoyable life. Every argument about voluntary or involuntary euthanasia that starts from the premise that you can have no life worth living if you can’t:
    • manage your own personal care without help
    • use language
    • engage in complex abstract thought
    • live independently

    Fundamentally devalues the existence and worth of these people.
  • I think most people who advocate voluntary euthanasia would keel over in horror were any of these suggestions used to decide that someone had no life worth living.
  • CrœsosCrœsos Shipmate
    Golden Key wrote: »
    (Years?) later there was news that people like Terri may be more "here" than they seem. I don't have any particular opinion on what was done, other that it was a horrible, painful situation. But I have sometimes wondered how Terri could move and display some awareness if no one was home inside.

    Some of it was automatic actions, some of it was people seeing what they wanted to see, and some of it was cynical exploitation by those trying to advance a larger agenda. I believe the brief video of Ms. Schiavo seeming to track a balloon with her eyes was the result of multiple "takes" winnowed down to the one shot where she seemed to be following the balloon. Ms. Shiavo's autopsy report [PDF] showed her brain to be "profoundly atrophied" with extensive damaged to nearly all brain regions.
    Every argument about voluntary or involuntary euthanasia that starts from the premise that you can have no life worth living if you can’t:
    • manage your own personal care without help
    • use language
    • engage in complex abstract thought
    • live independently

    Fundamentally devalues the existence and worth of these people.

    Yet you're apparently willing to "devalue" Terry Schiavo for checking off every box on your list.
  • I’m sorry I didn’t meet your standard of pedantry - would you like me to find you a link to an explanation of brain death - or perhaps you could google ?
  • DoublethinkDoublethink Shipmate
    edited August 22
    Some humans, including the little boy playing with the bells. More humans.
  • And here are some of the humans most likely to be impacted by Singer’s ideas and those who share them.
  • CrœsosCrœsos Shipmate
    edited August 22
    I’m sorry I didn’t meet your standard of pedantry - would you like me to find you a link to an explanation of brain death - or perhaps you could google ?

    Just pointing out that you're still drawing a line on what constitutes a human being based on certain disabilities (in this loss of higher brain functions). It should be noted that Ms. Schiavo was actually in a persistent vegetative state (some/most functions of the brain lost but some, particularly in the brainstem, remain), not brain dead (irreversible loss of all functions of the brain, including the brainstem).
  • My apologies, I hadn’t read her case in detail. But please watch the videos I posted above, especially the last one.
  • DoublethinkDoublethink Shipmate
    edited August 22
    NHS link on disorders of consciousness, if Terri Schiavo had pvs she would have had a small chance of recovery that became less likely over time. Recovery in pvs is poorly understood.

    But - “severe Downs” is nothing like a persistent vegetative state (and in most circumstances nor is dementia).

  • CrœsosCrœsos Shipmate
    Still not clear on why Schiavo falls outside your criteria. She couldn't "manage [her] own personal care without help" (i.e. required artificial hydration and nutrition), "use language" (i.e. consistently unconscious), "engage in complex abstract thought" (i.e. had lost most of her cerebral cortex and other higher portions of her brain), or "live independently" (i.e. the whole couldn't eat or drink without assistance thing again). She checks all the boxes for things you use to warn against devaluing people, and then you devalue her.
  • Oh dear God, have you read the whole of this thread ? Do you understand the point I am trying to make ?
  • CrœsosCrœsos Shipmate
    Oh dear God, have you read the whole of this thread ? Do you understand the point I am trying to make ?

    Sure, it's right there at the top. "I am deeply concerned about any perspective that so devalues the life of people with disabilities. And any perspective that labels Homo sapiens sapient any stage of thei[r] life as less than human." Except that you seem to put anyone with PVS outside "any stage of their life" for reasons that seem no less arbitrary than any of the other standards suggested here.
  • DoublethinkDoublethink Shipmate
    edited August 22
    No Croesus, I had not realised, as I said several posts up - that she was diagnosed as being in a persistent vegetative state rather than being brain dead.

    There is an argument to be made about when palliative care is and is not appropriate - but that should not involve denying people their humanity.
  • We had the Robert Latimer murder trial in the 1990s in Saskatchewan. Robert killed his daughter due to what he thought was her suffering; she was a severely disabled child in constant pain. The medical people involved sympathized with the tragedy of the situation, but I've not spoken to anyone who thought the solution chosen by the father was reasonable or correct. The public opinion was more positive to the father's decision.
  • What a massively tragic situation....
  • Gee DGee D Shipmate
    Fr Frank Brennan draws a clear distinction between taking a life - eg by lethal injection - and withdrawal of treatment even if the inevitable result is the death of the patient. He argues that for some, withdrawal of food (especially that given by artificial feeding) and water is the appropriate treatment as long as steps are taken to alleviate suffering, such as moistening of lips.
  • BoogieBoogie Shipmate
    edited August 23
    Gee D wrote: »
    Fr Frank Brennan draws a clear distinction between taking a life - eg by lethal injection - and withdrawal of treatment even if the inevitable result is the death of the patient. He argues that for some, withdrawal of food (especially that given by artificial feeding) and water is the appropriate treatment as long as steps are taken to alleviate suffering, such as moistening of lips.

    Yes - if someone is at the end of their life.

    But, as @Doublethink is asking, what about disabled people, nowhere near the end of their life, who can’t eat/breathe etc without help?

    Where would you draw the line?

    I wouldn’t draw the line at all - I would give them every scrap of help family, health service and technology can. My husband was a carer for a young man who had had a skiing accident. He couldn’t eat or breathe by himself but he could operate his wheelchair with his head. He needed intensive 24 hour care. Of course it was worth every penny and every effort. He is human and he is worth it.

    If only humanity could stop wasting resources, human and other, we’d have plenty for all the care people like him and my step niece - and the even more disabled - need, worldwide.

    It’s entirely another question when those in pain ask to be euthanised. (Why didn’t I type ‘killed’?)



  • Gee DGee D Shipmate
    I like what you say, but your last line recalls Clough's Thou shalt not kill; but needst not strive Officiously to keep alive.
  • Barnabas62Barnabas62 Purgatory Host, Epiphanies Host
    Boogie draws the right distinction.
  • FirenzeFirenze Shipmate, Host Emeritus
    edited August 23
    Gee D wrote: »
    I like what you say, but your last line recalls Clough's Thou shalt not kill; but needst not strive Officiously to keep alive.

    You do know that line (and the rest of The Latest Decalogue) was intended satirically?

  • Gee DGee D Shipmate
    Firenze wrote: »
    Gee D wrote: »
    I like what you say, but your last line recalls Clough's Thou shalt not kill; but needst not strive Officiously to keep alive.

    You do know that line (and the rest of The Latest Decalogue) was intended satirically?

    Yes, I know the entire poem.
  • From seeing my mother's deterioration, that isn't my understanding of what's happening, though the analogy to electrical connections is partially correct.

    There isn't a single cable connecting the 'person' to the external world. It's more as though there is a complex loom of wires connecting all the component parts of the 'person' together. (I think persona or psyche would be more accurate terms) Most of the time this loom doesn't work because too many of the connections are fritzed. Very occasionally though, enough of the connections are working, or the brains ability to rewire itself and make new connections, gives moments of apparent lucidity, albeit how much that apparent lucidity is really a return to the real person or in fact merely resembles the person we remember is debatable.

    The proof that it isn't like the conventional understanding of the locked in syndrome is that during these moments of apparent lucidity the individual has no knowledge of being locked in. It's more a case of the individual flitting in and out of existence.

    I agree that it's a complex web, but "flitting in and out of existence" is AFAIK not actually a real Thing™ that happens to anything. We talk that way, but what we really mean is that something appears, disappears, appears again, and so forth. We don't IMHO believe that it is actually non-existent in the disappeared-periods. It is just out of perceptual range.

    That's what I think is going on to some extent with Alzheimer's patients. Whatever the link is between invisible psyche and visible body/brain, it's on the fritz, and occasionally manages to set itself right for a brief period--but not permanently. But the existence of periods when the individual actually DOES reappear in fullness, or near-fullness, suggests that the psyche-bit is actually always in existence somewhere--but that the connection is screwed. Not that the person has sprung out of nothing, then died again, then re-sprung out of nothing...

    In short, we are talking about object permanence, as they call it when they are explaining how babies learn to look for hidden objects. They realize at some point that the object is highly unlikely to have simply gone out of existence, whether they can locate it or not.

    I disagree. I don't think the psyche is a separate 'thing'. Instead I would draw on a comment I made on the thread preceding this that the word 'human' (and by extension the word 'person') are best understood as verbs and not nouns. In other words, 'human' and 'person' are phenomena not artefacts. It follows that all the parts of the brain dealing with our various functions need to be connected up for the whole system to work.

    From that I would argue that a person can flit in and out of existence in much the same way that a malfunctioning car will sometimes work and sometimes not.
  • Boogie wrote: »
    @Colin Smith -
    For me, it comes down to this: if we know when it is right to euthanase a much-loved dog why is it never right to euthanase a human?

    We don’t really know when it is right for our much loved dog. What we do know is when we are ready to let them go. Sometimes that is later than it should be - for the sake of the dog it would probably have been better a few days earlier, but it’s hard to let them go.

    If I had had the right to euthanise my dearly loved Mum I wouldn’t have done it. I could not take that kind of responsibility, it would have caused me to be unable to live the rest of my life.

    Selfish? Maybe. But her death was peaceful and very special in the end, it was as if her body ‘knew’ what to do. The six years leading up to it were terrible for us all - but you know that, you’ve walked that road too.

    Actually, I decided not to walk that road. I last saw my mother in September 2013. I decided not to participate in an activity I thought pointless.

    Some thirty years ago my mother saw her mother decline with dementia. In her case, it was blessedly brief but my mother saw enough to ask her children not to allow her to get to that stage. What I have now is regret that I could not do as she wished.
  • I am going to write a longer more detailed post - but - you keep all keep taking about dying, about deteriorating conditions.

    People with moderate and severe learning disability (intellectual disability/mental retardation) are not dead, are not less than human, are not incapable of having meaningful existence, are not incapable of achieving a good and enjoyable life. Every argument about voluntary or involuntary euthanasia that starts from the premise that you can have no life worth living if you can’t:
    • manage your own personal care without help
    • use language
    • engage in complex abstract thought
    • live independently

    Fundamentally devalues the existence and worth of these people.

    I would say that only the third one really matters since mental abilities are the defining quality of what is to human. Stephen Hawking was fully human right to the end and required vast amounts of care just to survive.
  • RicardusRicardus Shipmate
    edited August 23
    I ask the question, because people are tending to engage with this thread around, essentially, end of life issues. Whilst I understand that happening given the context in which the OP arose. That is not really what I am trying to discuss.

    It’s more, if you justify defining someone as effectively dead or less than human through the loss of intellectual skills - which becomes your reason for advocating euthanasia - have you thought about the implications of those specific reasons when applied to disabled life. Not the process of dying.

    So it seems to me, that Colin’s view - forgive me if I have this wrong Colin - is not just that dementia robbed him of his mother and who or what that left was not worth keeping for the last 6 years, but that anyone with an intellectual disability serious enough to mean they can not reliably recognise people (e.g. “serious Downs”) has a life not worth living. Moreover it is unreasonable to expect others, and by extension society, to provide the care and support they need to live that life.

    I fundamentally and passionately disagree with this, (and if I have misrepresented Colin’s position - it certainly not an exaggeration of Singer’s position).

    You have not misrepresented my views.

    For me, it comes down to this: if we know when it is right to euthanase a much-loved dog why is it never right to euthanase a human?

    But we don't euthanase a dog because it's lost cognitive function or because we think it's no longer a dog. We euthanase a dog because it's in pain, and we judge that death is in its best interests.

    It may be possible to argue that for a human in chronic pain, death is also in their best interests, but that doesn't seem to be the argument you are advancing; you seem to be arguing that a patient with sufficiently advanced dementia isn't human any more, so they don't really have interests at all, best or otherwise.

    Also for the record, I am not in a position cast any stones here; my grandmother gradually died with advanced dementia / possible Alzheimer's, and towards the end I stopped visiting her and it was only my Dad who saw her. I now think that was a moral failing on my part.
  • BoogieBoogie Shipmate
    @Ricardus said -
    It may be possible to argue that for a human in chronic pain, death is also in their best interests, but that doesn't seem to be the argument you are advancing; you seem to be arguing that a patient with sufficiently advanced dementia isn't human any more, so they don't really have interests at all, best or otherwise.

    Yes he does seem to be saying this.

    My answer would be ‘how do we know?’. They can’t communicate, often their brain connects so poorly they can’t even grasp a cup. Eventually they can’t swallow. But how do we know what’s going on internally, what thoughts are still there?

    I would keep a dementia patient as comfortable as possible right to the end. Comfortable mentally and physically - however hard that is for the rest of us.

    My Mum, after three years, recognised nobody and communicated with nobody. When I visited with my dog, however, she said ‘aahhhh’, smiled and stroked her. Dogs communicate entirely non verbally and my dog was somehow above to make a connection with my Mum that I couldn’t. It certainly made me smile.
  • MrsBeakyMrsBeaky Shipmate
    I am not sure whether it is wise for me to enter this discussion as I am far from detached emotionally but I feel I do have something to say so here goes.....

    Two and half years ago my youngest daughter gave birth to Little Beaky. He was a much longed for baby as she had been told that due to cancer treatment several years earlier she might never conceive and she and her husband were thrilled when it just happened.
    Little Beaky was perfectly beautiful and healthy in utero and entered this world on his due date. However he sustained catastrophic brain damage during the birth and is now apparently one of the most seriously disabled children in his health authority. He has both cognitive and physical impairment.

    If some of the schools of thought up-thread had been applied to him then he could have been assisted in dying in that first week of his life. However he fought to breathe and he then fed orally and so we have him with us. It will be a lifelong commitment from all of us in his family to care for him and at the moment his quality of life is somewhat compromised but plans are afoot for that to be rectified as of next week.

    Is he less than human because mistakes were made by other humans during his birth?
    I'll let you decide for yourselves!

  • lilbuddhalilbuddha Shipmate
    Ricardus wrote: »
    Also for the record, I am not in a position cast any stones here; my grandmother gradually died with advanced dementia / possible Alzheimer's, and towards the end I stopped visiting her and it was only my Dad who saw her. I now think that was a moral failing on my part.
    One of my grandparent slowly deteriorated over time, and at the end it was difficult to visit with him.
    Two older friends slowly were taken by dementia and one is going through it now. It is fucking difficult to deal with, so no judgement on that.
    But the "they are not the same person" thing that Colin refers to is difficult. I am not the same person I was at 5, 15 or even 20. My father is definitely not the same person he was when I was those ages. What we have is the continued recognition of each other and a relatively unbroken continuity of experience.
    Is that all that is valuable about our relationship? I get not wanting to deal with a situation and I am not judging opting out as making someone bad. But it is opting out.
  • Ricardus wrote: »

    But we don't euthanase a dog because it's lost cognitive function or because we think it's no longer a dog. We euthanase a dog because it's in pain, and we judge that death is in its best interests.

    It may be possible to argue that for a human in chronic pain, death is also in their best interests, but that doesn't seem to be the argument you are advancing; you seem to be arguing that a patient with sufficiently advanced dementia isn't human any more, so they don't really have interests at all, best or otherwise.

    Also for the record, I am not in a position cast any stones here; my grandmother gradually died with advanced dementia / possible Alzheimer's, and towards the end I stopped visiting her and it was only my Dad who saw her. I now think that was a moral failing on my part.

    Pain can be one reason. No longer able to do the things it once enjoyed doing is another.

    Yes I am arguing that a patient with sufficiently advanced dementia isn't human any more. Being 'Human' to me requires the possession of mental faculties that are simply not present in patients with advanced dementia.
  • MrsBeaky wrote: »
    I am not sure whether it is wise for me to enter this discussion as I am far from detached emotionally but I feel I do have something to say so here goes.....

    Two and half years ago my youngest daughter gave birth to Little Beaky. He was a much longed for baby as she had been told that due to cancer treatment several years earlier she might never conceive and she and her husband were thrilled when it just happened.
    Little Beaky was perfectly beautiful and healthy in utero and entered this world on his due date. However he sustained catastrophic brain damage during the birth and is now apparently one of the most seriously disabled children in his health authority. He has both cognitive and physical impairment.

    If some of the schools of thought up-thread had been applied to him then he could have been assisted in dying in that first week of his life. However he fought to breathe and he then fed orally and so we have him with us. It will be a lifelong commitment from all of us in his family to care for him and at the moment his quality of life is somewhat compromised but plans are afoot for that to be rectified as of next week.

    Is he less than human because mistakes were made by other humans during his birth?
    I'll let you decide for yourselves!

    Yes, I would see that child as less than human, however you and your family are free to make that commitment. I would see no point in doing so.
  • You describe yourself as an atheist, but I feel you are making a God of intellect. We do not experience the world, ourselves, our sorrows and joys through reason alone.
  • lilbuddhalilbuddha Shipmate
    MrsBeaky wrote: »
    I am not sure whether it is wise for me to enter this discussion as I am far from detached emotionally but I feel I do have something to say so here goes.....

    Two and half years ago my youngest daughter gave birth to Little Beaky. He was a much longed for baby as she had been told that due to cancer treatment several years earlier she might never conceive and she and her husband were thrilled when it just happened.
    Little Beaky was perfectly beautiful and healthy in utero and entered this world on his due date. However he sustained catastrophic brain damage during the birth and is now apparently one of the most seriously disabled children in his health authority. He has both cognitive and physical impairment.

    If some of the schools of thought up-thread had been applied to him then he could have been assisted in dying in that first week of his life. However he fought to breathe and he then fed orally and so we have him with us. It will be a lifelong commitment from all of us in his family to care for him and at the moment his quality of life is somewhat compromised but plans are afoot for that to be rectified as of next week.

    Is he less than human because mistakes were made by other humans during his birth?
    I'll let you decide for yourselves!

    Yes, I would see that child as less than human, however you and your family are free to make that commitment. I would see no point in doing so.
    That is fucked up. Seriously and unreservedly I say this.
    Utilitarianism.
    scene
    Fred Johnson's office. Fred is working at his computer.

    "Fred! How are we today? Look Fred, I'll come straight to the point. Your numbers have been down for some time and, at your age, further employment seems to be of no benefit to anyone. I've spoken to HR and, pursuant to the Utilitarian Act of 2025, you are to be made permanently redundant"
    Boss pulls syringe from pocket
    "It was a pleasure working with you Fred. Now please tilt your head to the left just a bit."
    inserts needle, depresses plunger
    "We've notified your family and will be sending your ashes to them. I understand they have a lovely service planned. Your replacement will be coming in just as soon as transport has removed your body."
    Fred's head slowly lowers to his chest, all breathing stops.
    Fred's boss carefully places needle and syringe into sharps box, walks out of office.
    scene


    There is no perfect line between functional and not. Aware and not. Valuable and not.
  • You describe yourself as an atheist, but I feel you are making a God of intellect. We do not experience the world, ourselves, our sorrows and joys through reason alone.

    No we don't. But it is our ability to do so that makes us human.
  • lilbuddha wrote: »
    That is fucked up. Seriously and unreservedly I say this.
    Utilitarianism.
    scene
    Fred Johnson's office. Fred is working at his computer.

    "Fred! How are we today? Look Fred, I'll come straight to the point. Your numbers have been down for some time and, at your age, further employment seems to be of no benefit to anyone. I've spoken to HR and, pursuant to the Utilitarian Act of 2025, you are to be made permanently redundant"
    Boss pulls syringe from pocket
    "It was a pleasure working with you Fred. Now please tilt your head to the left just a bit."
    inserts needle, depresses plunger
    "We've notified your family and will be sending your ashes to them. I understand they have a lovely service planned. Your replacement will be coming in just as soon as transport has removed your body."
    Fred's head slowly lowers to his chest, all breathing stops.
    Fred's boss carefully places needle and syringe into sharps box, walks out of office.
    scene


    There is no perfect line between functional and not. Aware and not. Valuable and not.

    I am not a utilitarian.
  • lilbuddhalilbuddha Shipmate
    edited August 23
    lilbuddha wrote: »
    That is fucked up. Seriously and unreservedly I say this.
    Utilitarianism.
    scene
    Fred Johnson's office. Fred is working at his computer.

    "Fred! How are we today? Look Fred, I'll come straight to the point. Your numbers have been down for some time and, at your age, further employment seems to be of no benefit to anyone. I've spoken to HR and, pursuant to the Utilitarian Act of 2025, you are to be made permanently redundant"
    Boss pulls syringe from pocket
    "It was a pleasure working with you Fred. Now please tilt your head to the left just a bit."
    inserts needle, depresses plunger
    "We've notified your family and will be sending your ashes to them. I understand they have a lovely service planned. Your replacement will be coming in just as soon as transport has removed your body."
    Fred's head slowly lowers to his chest, all breathing stops.
    Fred's boss carefully places needle and syringe into sharps box, walks out of office.
    scene


    There is no perfect line between functional and not. Aware and not. Valuable and not.

    I am not a utilitarian.
    Your position regarding the disabled certainly seems so.
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