Deaf twins going blind euthanized by request in Belgium

[Alyeska]

Pity alyeska has not came in to explain why doctors are to be condemned for doing thier jobs in accordance with the law.

Oh fuck off. Just because it is legal does not make it right.

Forced sterilzation. The Tuskegee syphilis experiment.

Given the circumstances of this case, I am very uncomfortable with what happened. I believe that people suffering from a terminal illness or an incurable debilitating disease have the right to die.

But that does not mean I believe everyone has the right to die just because they want to commit suicide. And when I see a doctor assisting two people in their deaths over blindness, that puts a very bad taste in my mouth.

From the facts available, it appears that these twins were depressed. And suicide from depression is one of the most heart breaking possible outcomes. It is almost always treatable. They want to commit suicide because they are depressed. But had their depression been treated, they almost certainly would no longer have had suicidal thoughts.

There was a lady who called a radio host who specialized in talking to people about debt. This poor lady calls in because her family had significant credit card debt that ended up causing them to go into foreclosure. The husband was incredibly depressed and was talking about suicide. The radio host told her to get off the air and call for help immediately.

It feels like half this thread would instead say "Get the man a gun, its his right to kill himself".

Well guess what, the husband got help. The family filed for bankruptcy and got rid of all their credit cards. They restarted their lives and the husband ended up calling the radio host and thanked the man for giving advice to his wife.

What would that family have gone through if that man had killed himself because of his depression?

[Grandmaster Jogurt]

Alyeska, I don't think you actually know the difference between people being distraught and clinical depression. If the doctors thought the twins weren't in a sound state of mind (which they wouldn't be if they were suffering from depression) then it wouldn't have been allowed.

[Alyeska]

Alyeska, I don't think you actually know the difference between people being distraught and clinical depression. If the doctors thought the twins weren't in a sound state of mind (which they wouldn't be if they were suffering from depression) then it wouldn't have been allowed.

I do know the difference. Hence why I am using the word Depression.

[Grandmaster Jogurt]

Not everyone who commits suicide suffers from depression; it's wikipedia but that site puts the figure at only 60% of suicides stemming from depression. And either way, I'd much rather trust the diagnosis of doctors spending more than a year with the patients over a layman who's read one news article. Do you seriously think that in a country where physician-assisted suicide is legal and regulated that the doctors involved wouldn't think to check if the twins were suffering from something that would impede their judgement over this matter?

[Alyeska]

Not everyone who commits suicide suffers from depression; it's wikipedia but that site puts the figure at only 60% of suicides stemming from depression. And either way, I'd much rather trust the diagnosis of doctors spending more than a year with the patients over a layman who's read one news article. Do you seriously think that in a country where physician-assisted suicide is legal and regulated that the doctors involved wouldn't think to check if the twins were suffering from something that would impede their judgement over this matter?

The twins were going blind. Why would people who had been living suddenly decide they want to die at this point? Being distraught and/or depressed about the change of their circumstances.

I can understand wanting to die quickly and without pain to be preferable to suffering and agony. Unavoidable suffering and agony. Hence why I do not have a problem with the terminal ill or those suffering from incurable debilitating diseases. And in many of these circumstances these are beliefs that people hold before they encounter the illness or disease. So it wasn't even formed from being depressed about their impending problems.

I suppose the twins could have formed a suicide pact that they wanted to die if their lives ever got worse. That would be a non depression decision. But then that simply becomes an issue where I honestly cannot understand or fathom such a choice. To me, someone of sound mind who is not actively suffering from incurable disease or terminal illness, suicide is not a rational choice. And it is a choice with a permanent consequence.

Hmm. What to compare it to? I would compare the desire to commit suicide by a personal of sound mind (who is not suffering from an incurable debilitating and/or terminal illness) to be equivalent to Apotemnophilia. The desire to have ones limbs amputated.

[Gaidin]

So the doctors were incompetent? I just want to clear this up. The law does come down to the doctors' assessment that the patients are of sound mind.

[Alyeska]

So the doctors were incompetent? I just want to clear this up. The law does come down to the doctors' assessment that the patients are of sound mind.

In my opinion, potentially. To me it would be the same as a psychiatrist that prescribed amputation for a patient suffering from that illness I described.

[AniThyng]

"If the facts are on your side, pound on the facts. If the law is on your side, pound on the law. If neither is on your side, pound on the table."

This seems to be a most appropriate quote for this entire debate!

The story about the guy who got over his suicidal thoughts due to depression is nice, but aren't all these ultimately appeals to emotion? And these are not spur of the moment decisions, the process drags on long enough, and you have up to the last minute to change your mind.

[Stark]

Has this really collapsed down to 'having never met these people and having no relevant training, I think they were not competent to make this decision regardless of what their doctors and clinicians decided. Coincidentally, I dislike their decision'?

Is the idea that other people in other places or other cultures have different values to you really this hard to internalise? I mean, Alyeska owning five thousand AK-47s probably 'leaves a bad taste' in many Belgian's mouths too.

[El Moose Monstero]

At the risk of shedding any ideas of a lone doctor murdering his way through american tourists, some information on the process of Euthanasia in Belgium, a ten second google returns the information below.

From Smets et al. (2009) Legal Euthanasia in Belgium. Characteristics of All Reported Euthanasia Cases, Medical Care, 47 (12).
Quoted more or less verbatim, except for some minor formatting tweaks.

To make a legitimate euthanasia request, the patient must be:

Adult
Conscious and legally competent at the moment of making the request
In a condition of constant and unbearable physical or psychological suffering resulting from a serious and incurable disorder caused by illness or accident, for which medical treatment is futile and there is no possibility of improvement.

The physician decides whether the disorder is incurable based on the actual state of medicine, and the patient alone determines whether suffering is constant and unbearable.

The physician must have several conversations with the patient in which he ascertains whether the patient experiences his/her suffering as constant and unbearable.

The physician must inform the patient about their medical condition, prospects, and possible alternative treatments, including palliative care.

He must consult another independent physician about the serious and incurable character
of the condition. This physician does not need to be a palliative care specialist.

After performing euthanasia, the physician is required to report the case for review to the Federal
Control and Evaluation Committee Euthanasia (the Committee). This Committee determines whether the reporting
physician has complied with all legal due care requirements. In case of irregularities, the Committee can ask the
physician for additional information and send the case to the judicial authorities.

The Belgian euthanasia law is not limited to terminally ill patients who are expected to die within months. A euthanasia request from a nonterminal patient who is in the same medical condition as mentioned above may also be granted under the same requirements of careful practice. However, a third physician, a psychiatrist, or specialist in the illness from which the patient suffers, must be consulted, and there must be at least 1 month between request and performance of euthanasia.

Selected points of interest from the text of the actual law (Google rank number 5 or 6), slightly paraphrased because the article won't let me just copy and paste.

http://www.kuleuven.be/cbmer/viewpic.ph ... DOCS&ID=23

If there is a nursing team has regular contact with the patient, discuss the request of the patient with the nursing team or its members.

Be certain that the patient has had the opportunity to discuss his/her request with the persons that he/she wanted to meet

(In the case of non-terminal (or non-near-death illness) the doctor must consult a second psychiatrist (unconnected in any way to the patient) or a specialist in the illness or disorder, informing him or her of the reason for the consultation. The consultant reviews the medical record, examiens the patient and must be certain of the cosntant and unbearable physical or mental suffering that cannot be allieviated, and of the voluntary, well-considered and repeated character of the euthanasia request.

Patient's request must be in writing, drawn up, date and signed by the patient (or a designated legal representative with no material interest in the death of the patient). The patient may revoke the request at any time, in which case it is removed from the medical record.

My only gut response was that a minimum period of a month seems like quite a short period in the event of non-terminal or non-imminent death cases, but I suppose if I was in unbearable psychological or physical pain but wasn't going to die of it any time soon, I'd be keen to make sure this sort of process was no longer than it needed to be.

[Alyrium Denryle]

The twins were going blind. Why would people who had been living suddenly decide they want to die at this point? Being distraught and/or depressed about the change of their circumstances.

These people were being cut off from both primary senses that humans use. Sensory deprivation. They have been deaf. Everything that hearing uses got routed through a beefed up visual cortex. Now that is gone, and their brain is to old o be plastic enough to transition over to using nothing but their tactile senses. The languages they had learned over the course of their lives have become useless. Their primary mode of communication with the most important person in their lives has to be relearned as tactile contact, which they may be too old to learn effectively. In fact, everyone they want to interact with has to learn to particular form of sign language that does not rely on movements of the arm. Safe travel becomes difficult. Cant drive anymore, can barely walk from place to place. Forget about using public transit. Employment? They are cobblers. How are they to do their jobs? Have customers talk to them with Braille? Cant cook effectively. Cannot clean effectively. The only alarm clock that will work is something that literally shakes them awake or vibrates against the skin.

They will lose their autonomy.

I can understand if someone wants to die if faced with that prospect. I can only conclude that you have not thought about it sufficiently.

[PeZook]

Those of you who keep asking me for some "justification" for my views have already had my answer: my ethics. As there is no universal, self-obvious ethical code, or objective reason for choosing one ethical code over another, what the hell are you expecting me to say? "Oh, after a 30 year intensive study of Kant I have chosen his system as the best" or "Nietzsche was right" or "I worship John Galt" or "utilitarianism is totally the thing!"?

There might not be a SINGLE objective moral system that is absolutely and objectively right, but I seriously doubt you have never philosophised on these issues. Most people do, and thus trying to pick your mind about this seems only fair, ESPECIALLY since you are making comments about legal matters (ie. saying something should or should not be legal)

I find very few instances where I can justify self-harm, asking someone else to cause you permanent harm (which killing would definitely be) is absolutely abhorrent to me. Sorry if my morals don't exactly match yours, would you rather I lie?

I think I was pretty clear that I am not trying to judge you because you disagree with me, but instead asking how you arrived at this conclusion. Is this a long-winded way of saying "My gut tells me so"?

I get the distinct impression, however, that there is an attempt here to convert me. It is very unlikely to happen. These aren't opinions hatched at the spur of the moment but matters I have thought about for many, many years.

If you thought them out, why not share the thought process so that we can discuss (and yes, perhaps even criticize) it? What's the problem?

Belgium obviously has a very different view of killing dying people than I do. I'm actually glad I know that now as I will very strenuously avoid any possibility of entrusting myself to any medical personnel in Belgium unless I can determine their views on this matter in advance. Should I have reason to spend time in Belgium I will make sure I have on my person legal documents expressing my absolute opposition to doctors killing me in the event I become too incapacitated to make my wishes known. Actually, a lot of problems involving end-of-life care could be avoided if people would just write this stuff down in advance, it's a good idea for everyone to make their wishes clear.

Look, Broomstick, I respect you a great deal, but you really should know better than that. If an American tourist gets into an accident and lands in a Belgian hospital in a coma, there won't be veritable Mengeles standing outside the room, cackling maniacally and looking for an opportunity to inect an OD of morphine and get at the organs. In fact, UNLESS the patient EXPLICITLY asks, in writing, several times, in a sound state of mind, the issue of euthanasia won't ever come up. People in this thread talked about this at length, and an actual Belgian even outlined some problems with doctors not wanting to do it and refusing to helo the patient find another doctor who will.

For an American tourist, even if you ask, they probably won't even bother starting the procedure, for obvious reasons.

No, I'm not stating the patient can't have help, I very much stated that the most severely disabled patients should receive help in setting up an apparatus enabling the patients to take such actions themselves when suicide is justified. I draw the line at someone else doing the active killing. If the patient wants to die then the patient has to kill him or herself.

So again, what causes there to be this huge, major difference between handing someone a syringe full of morphine so that he can OD, and doing the injection? You absolve the doctor of responsibility in the former case, but say it's murder in the later, but is handing a suicidal person the necessary tools really that different, or is it just an illusory line?

Because I think the ONLY moral reason for taking the life of an another human being is self defense. A severely disabled patient is not a threat to anyone else, therefore no one else is morally justified in killing that person.

That's a pretty categorical statement. What about assassinating war criminals during an occupation? Killing enemy soldiers from afar while they're asleep?

This thread is not the first time I've stated that. I've brought it up in pretty much every death penalty discussion we've had here.

Alas, you also defended a patient's right to refuse medical treatment and die because of it.

[Vendetta]

Has this really collapsed down to 'having never met these people and having no relevant training, I think they were not competent to make this decision regardless of what their doctors and clinicians decided. Coincidentally, I dislike their decision'?

No, that was a couple of pages ago. We're on to Belgian death panels now.

[Thanas]

I like Broomstick's attitude as she voted for Obama illegally killing people all over the world and people arguing against that are clearly anti-american, but people chosing to end their own lives with a long and legal process is somehow a great moral outrage.

[Ralin]

Long delayed response, sorry.

Not here, no, but rather famously one of his uncles offered to kill him at birth if his parents couldn't bring themselves to do it. He even had a pretty thoroughly thought out method of doing so. I've also seen people argue that any pregnancy involving a fetus with his problem be summarily aborted, usually in ignorance that the disorder involves a spectrum of disability from "not much effect" to "will probably die within a week of birth no matter what we do". So yes, that does come up from time to time.

And I’m very sorry he’s had to deal with that, as I’m sure most everyone else in this thread is. But there’s a world of difference between that and an adult choosing to ask a medical professional to do the job for him. The doctors who went around killing and sterilizing the disabled not so long ago were doing it because they wanted to get rid of those people. They gave no fucks about what their victims wanted. The people you’re making out to be the victims here explicitly made their wishes clear. Even if it seems very similar to you, what everyone else in this thread is talking about is not eugenics.

Everyone else has addressed the rest at length, but I think you should take a step back here, because at this point this isn’t so much a debate as your gut versus everyone else’s ethics, and that tends to be a losing proposition.

[JLTucker]

I like Broomstick's attitude as she voted for Obama illegally killing people all over the world and people arguing against that are clearly anti-american, but people chosing to end their own lives with a long and legal process is somehow a great moral outrage.

I think the fact that one of her relatives killed themselves plays a big part in her arguments. To put it short: emotion trumps cohesive arguments.

[Losonti Tokash]

It's also pretty easy for a person to make grand pronouncements about how other people should think and act, particularly when it isn't their decision and they wouldn't have to deal with any of the consequences.

[Scrib]

So the doctors were incompetent? I just want to clear this up. The law does come down to the doctors' assessment that the patients are of sound mind.

In my opinion, potentially. To me it would be the same as a psychiatrist that prescribed amputation for a patient suffering from that illness I described.

And this entire opinion is based on you ,personally, not being able to fathom someone being in enough despair to want to kill themselves.

How can you not see the difference between someone feeling that their leg, which is perfectly healthy, isn't theirs or shouldn't be there and this case? Like seriously?

Do you truly believe that people cannot be driven down enough to want to kill themselves without being insane? You must either be very resilient or very lucky.

[Alyeska]

And this entire opinion is based on you ,personally, not being able to fathom someone being in enough despair to want to kill themselves.

Correct.

How can you not see the difference between someone feeling that their leg, which is perfectly healthy, isn't theirs or shouldn't be there and this case? Like seriously?

Do you truly believe that people cannot be driven down enough to want to kill themselves without being insane? You must either be very resilient or very lucky.

I do not consider depression to be sufficient cause for suicide. It is treatable in almost every case. Yes, I said almost every case. Not every case. And I don't have an answer for those that cannot be treated.

It is a permanent solution that cannot be undone which almost always rises from a mental health issue.

Which would make it comparable to people who want amputations. Certainly not identical, but comparable.

[Grandmaster Jogurt]

Alyeska, are you going to address the absurdity of you thinking that you, as someone with absolutely no training or experience and having never even met the patients in question are able to better diagnose them than doctors who are trained for this exact circumstance and have been with them for years?

[Alyeska]

Alyeska, are you going to address the absurdity of you thinking that you, as someone with absolutely no training or experience and having never even met the patients in question are able to better diagnose them than doctors who are trained for this exact circumstance and have been with them for years?

Just because they having training and experience does not make it right.

The Tuskegee Experiment was scientifically sound. But ethically dubious.

Their experience does not make something ethically sound. It just means they are experienced in their specific field.

I am concerned about the ethics here. Ethics are much less concrete. And sadly far more opinionated. But still very important to everyone.

[Aaron MkII]

Quite honestly, I don't think you possess the required education or experience to comment on this at all. In fact the majority of posters here don't.

[Stark]

Just because they having training and experience does not make it right.

Is it only your gut that makes things right? Just admit it.

The Tuskegee Experiment was scientifically sound. But ethically dubious.

You've mentioned this before, so do you honestly think this is a sound argument? Can I get a point by point of how these two situations are comparable?

Again, you just have to learn to deal with the idea that other people have different values to you, and perhaps even values that you disagree with. This might even give you a degree of empathy for those who disagree with your values, if you have the required maturity for that level of self awareness.

[Civil War Man]

The people in this thread making grand pronouncements about how these twins should have been forced to continue living remind me of the all-male Senatorial panels talking to all-male clergy about women's access to birth control.

When you become unable to properly feed yourself, dress yourself, take care of yourself, go anywhere, or do anything, with the knowledge that you will never see, hear, or talk to any of your loved ones ever again for the rest of your life, which could be for several more decades with proper hospital care, then I will take your opinion as to whether these two should have just sucked it up and dealt with it into consideration.

My grandmother died last year, a combination of congestive heart failure and a variety of other ailments resulting from being old. She spent the last month of her life living with my parents on hospice care, the last couple weeks effectively bed-ridden, and the last couple days so doped up on morphine she was effectively in a coma.

As callous as it may sound, when I heard she was dead, I was relieved. It was obviously sad that she's not around anymore, but her dying meant she was no longer suffering. And most important for me, it meant that my mom didn't have to watch her suffer.

My grandmother died mostly on her terms, and in doing so it allowed the rest of us to move on and remember her as she was when she was healthy. I do not begrudge those brothers choosing to do the same.

[Havok]

Given the circumstances of this case, I am very uncomfortable with what happened. I believe that people suffering from a terminal illness or an incurable debilitating disease have the right to die.

But that does not mean I believe everyone has the right to die just because they want to commit suicide. And when I see a doctor assisting two people in their deaths over blindness, that puts a very bad taste in my mouth.

From the facts available, it appears that these twins were depressed. And suicide from depression is one of the most heart breaking possible outcomes. It is almost always treatable. They want to commit suicide because they are depressed. But had their depression been treated, they almost certainly would no longer have had suicidal thoughts.

Way to oversimplify.

First it is not just because they are going blind, it is because they are already deaf, AND going blind. But that isn't even the issue. To these two men, life is not worth living if they can never see each other again. To them it is clearly like they will be dead to each other and just have to suffer until they actually die.

And yes they are depressed you idiot. Do you know why? Because they are going to be deaf and blind. Do you know how to treat this particular type of depression? Wait for it.... stop them from being deaf AND blind. THAT IS THE TREATMENT FOR THEIR DEPRESSION. This isn't something they can spill their guts about and then it will be all better. Gawd you are fucking stupid.

There was a lady who called a radio host who specialized in talking to people about debt. This poor lady calls in because her family had significant credit card debt that ended up causing them to go into foreclosure. The husband was incredibly depressed and was talking about suicide. The radio host told her to get off the air and call for help immediately.

It feels like half this thread would instead say "Get the man a gun, its his right to kill himself".

What the... Are you for real this stupid?

Credit card debt is the same thing as being already deaf, going blind and never seeing your identical twin again ever who will also be deaf and blind and suffering through the same agony over it as you are?

Well guess what, the husband got help. The family filed for bankruptcy and got rid of all their credit cards. They restarted their lives and the husband ended up calling the radio host and thanked the man for giving advice to his wife.

What would that family have gone through if that man had killed himself because of his depression?

Man, you are just the fucking king of moronic analogies aren't you.
I guess these twins should just go out, grab their bootstraps and get cured.

How do you function in real life?