Scientists claim to have restored cellular activity to the brains of dead pigs.

[Broomstick]

Luxembourg and the Netherlands must be sliding freely down that slope then as it is legal in those nations. If they can have it and not devolve into what you fear why can't other nominally civilized nations have such?

Different cultures. Different societies.

I never said it was impossible, just that I had great reservations about it. Frankly, I have had some issues with how the Netherlands do things but it's not my country and I'll be the first to admit I don't have all the facts. How Luxenbourg goes about these things I have no idea. I am VERY concerned, however, that "option to die" can become "duty to die". I also don't like the notion of suicide on general principles. To me it's like cannibalism - there are some very limited and extreme circumstances where it can be justified/tolerated but it's never a good thing (because if you've gotten to the point where that action is tolerable some really horrible things must have happened/be happening) and not at all something I want to become common.

[Jub]

I never said it was impossible, just that I had great reservations about it. Frankly, I have had some issues with how the Netherlands do things but it's not my country and I'll be the first to admit I don't have all the facts. How Luxenbourg goes about these things I have no idea. I am VERY concerned, however, that "option to die" can become "duty to die". I also don't like the notion of suicide on general principles. To me it's like cannibalism - there are some very limited and extreme circumstances where it can be justified/tolerated but it's never a good thing (because if you've gotten to the point where that action is tolerable some really horrible things must have happened/be happening) and not at all something I want to become common.

I expect Canada will have it within the next 20 years, given how these social issues tend to go. Then the US will get it within 30 years of us getting it.

As for your duty to die comment, you'd have to prove that one to me. I doubt you're inclined to put in the effort required to prove your fears founded, so I'll agree to drop the subject if you'll agree that this is just one person's worries.

I actually support ritualistic cannibalism in the societies that practice it. It can help people grieve and, risk of disease aside doesn't seem any worse than other ways of dealing with the dead.

[The Romulan Republic]

That second article's intriguing. I wonder if whatever results they get will match up with the recovery that sometimes happens after someone's drowned in very cold water? I know the accepted "no vital signs" limit is just a few minutes, but I've read of people being successfully resuscitated after a lot longer than that under water. It's not common, but it does happen.

That "a few minutes" limit is being challenged, these days:

www.washington.edu/news/2012/09/06/hosp ... val-rates/

Hospitals that continue CPR longer have better survival rates from cardiac arrests, according to a study published online Sept. 5 in The Lancet. The findings challenge the assumption that, if a pulse is not restored soon, continuing resuscitation efforts is futile.

The results also showed that patients who recovered after an extended CPR effort were no more likely to suffer brain damage than are patients revived after a shorter effort.

“There are no clear-cut guidelines for the amount of time to perform CPR before ending the resuscitation effort,” said cardiologist Dr. Zachary Goldberger, who headed the study. Wide variations exist across hospitals, and any policies are usually set by expert opinions. One of the most difficult decisions hospital physicians caring for patients who suffer a cardiac is when to stop CPR efforts.”

Goldberger recently joined the University of Washington faculty in the Division of Cardiology in the Department of Medicine. He completed a cardiology fellowship and a research fellowship through the Robert Wood Johnson Foundation Clinical Scholars Program at the University of Michigan. The impetus for the study, Goldberger said, was to try to shed light on one of the most challenging problems that practitioners face when caring for hospitalized patients with a cardiac arrest.

Each year in the United States, more than 200,000 hospitalized patients have a cardiac arrest. Less than half of these patients survive the arrest itself, and less than 20 percent survive to hospital discharge. Goldberger and his colleagues analyzed the records of 64,339 patients at 435 hospitals with the American Heart Association’s Get-with-the Guidelines-Resuscitation Registry, the largest sample available in the United States of patients who suffered a cardiac arrest during hospitalization. As expected, the duration of resuscitation before termination of efforts varied across hospitals.

What the researchers learned was that hospitals that routinely practiced the longest attempts at resuscitation, on average, had a 12 percent higher overall survival rate, compared to hospitals with the shortest CPR durations.

Goldberger mentioned that while longer median duration of resuscitation was associated with higher survival, it may be one of several factors at those hospitals that contribute to improved outcomes, when compared to hospitals with shorter efforts.

Most patients who were successfully resuscitated responded soon after the arrest. However, some patients required more time. The researchers found that, in 15 percent of the survivors, a pulse did not return until 30 minutes or more of resuscitation efforts had elapsed. Less than a quarter of those who died during a cardiac arrest were resuscitated for at least 30 minutes.

UW Medicine cardiologist Dr. Zachary Goldberger led a study of CPR duration and survival rates across many hospitals in the United States.

Patients with the least likelihood of recovery were those who didn’t have a shockable rhythm. In those cases, medications, chest compressions and airway management are used to try to regain a more regular heartbeat. Goldberger explained that only a couple of rhythm abnormalities will convert to normal through a defibrillator, a machine with paddles for releasing an electrical charge to the heart.

Dr. Brahmajee Nallamotu, the senior author, pointed out that the study cannot define the exact duration for attempting resuscitation for all hospital patients. .

‘It does suggest that, if hospitals systematically increase their duration of resuscitation efforts, cardiac arrest survival rates may improve for a number of patients,” he said. “There is no question that the decision on how long to try and when to end resuscitation remains in the hands of the physician at the bedside,” Goldberger added. “We hope our study helps shed some much needed light on these decisions.”

The results, Goldberger explained, do not apply to by-stander CPR or out-of-hospital medic resuscitation attempts. These situations are quite different from responding to cardiac arrests that occur in a hospital.

The Lancet paper is titled, “Duration of resuscitation efforts and survival after in-hospital CPR.”

Science: Its awesome.

There are a surprising number of cases of people being revived after prolonged periods of time, either due to hypothermia, prolonged CPR, or both.

Notably, while hypothermia delays brain death, it also makes it harder to actually revive someone until their body temperature has been raised. Hence the saying "They're not dead until they're warm and dead."

https://www.sciencedirect.com/science/a ... 7214005243

Abstract
Hypothermic cardiac arrest has high mortality and few known prognostic factors. We studied retrospectively 34 victims of accidental hypothermia with cardiac arrest admitted to The University Hospital of North Norway during 1985–2013 who were resuscitated and rewarmed by extracorporeal circulation. No patient survived prior to 1999, while nine out of 24 (37.5%) survived hypothermic cardiac arrest from 1999 to 2013. The lowest measured core temperature among survivors was 13.7 °C; the longest time from cardiac arrest to return of spontaneous circulation was 6 h and 52 min. The only predictor of survival identified was lower blood potassium concentration in the nine survivors compared with the non-survivors. Submersion was not associated with reduced survival. Non-survivors consumed modest hospital resources. Most survivors had a favourable neurological outcome.

1. Introduction
Accidental hypothermia is defined as an unintentional drop in core body temperature below 35 °C. Hypothermic cardiac arrest is defined as cessation of circulation caused by hypothermia, including ventricular fibrillation (VF), ventricular tachycardia without pulse (VT), pulseless electric activity (PEA) and asystole (AS). Hypothermia is classified as mild (32–35 °C), moderate (28–32 °C), severe (20–28 °C) and profound (<20 °C).1 These definitions represent respectively: a preserved capability to maintain core temperature through compensating thermoregulatory mechanisms (mild), loss of ability to sustain temperature voluntary and autonomic (moderate), high risk of malignant arrhythmias (severe) and cardiac arrest (profound).2

The clinical presentation of severe and profound accidental hypothermia is difficult to distinguish from clinical signs of death. The salvageable accidentally hypothermic patient could present without pulse, respiration and consciousness and with dilated non-reacting pupils and muscle rigidity. We have therefore advocated resuscitating and treating these patients aggressively regardless of clinical presentation, risking over-triage.

Hypothermia protects vital organs during ischaemia but can also lead to cardiac arrest, increased bleeding and may impede conventional resuscitation.3, 4, 5, 6 The combination of hypothermia with trauma is therefore especially dangerous.7, 8, 9, 10 Lifeless, hypothermic snow avalanche victims without air pocket have been found to have poor prognosis.11, 12 Excessive hyperkalaemia and asphyxia are other known predictors of death.13, 14, 15, 16

Although mortality is high, the long-term outcome in most surviving hypothermic cardiac arrest patients is good with favourable neurological results and high quality of life, but some suffer neurological sequelae.17, 18, 19

Apart from consensus on using extracorporeal life support (ECLS) for rewarming,20, 21, 22 details regarding the emergency treatment remain ambiguous.5 An algorithm for in-hospital triage and treatment of hypothermic cardiac arrest patients, The Bernese Hypothermia Algorithm, have recently been suggested.23 This algorithm focuses on the integration of trauma diagnostics with ECLS rewarming.

The University Hospital of North Norway, Tromsø (UNN Tromsø) is located in subarctic Norway at 69 °N latitude. The warmest month is July with a mean air temperature of 11.8 °C and mean sea temperature of 10.8 °C. The coldest month is January with a mean air temperature of −4.4 °C and mean sea temperature of 5.1 °C.24 As a consequence of this all trauma patients in this region are at risk of hypothermia both summer and winter.25 Cases of accidental cooling in water and snow combined with asphyxia are common due to the costal and pelagic fisheries and increasing outdoor activities with water and snow sports. Our hospital catchment area is large but sparsely populated, covering the northern part of Norway and Svalbard with about 500,000 inhabitants. The region has 12 smaller and larger emergency hospitals with cardiac surgery and extracorporeal circulation centralized to UNN Tromsø.

Our region has a well developed public Emergency Medical System (EMS) with a dense network of ground and sea ambulances staffed with professional paramedics working closely with decentralized doctors watch stations. Governmental air-ambulances with a total of four rotor-wing and six fixed-wing aircrafts are located at six different bases on 24/7/365 service. This EMS system has yielded excellent results in typical time-critical medical emergencies such as survival to discharge from out-of-hospital cardiac arrest and from acute myocardial infarctions despite long prehospital evacuation times.26

We have previously reported survival with good outcome from extreme accidental hypothermia with cardiac arrest and core temperature of 13.7 °C; and from long-lasting resuscitation with return of spontaneous circulation (ROSC) 6 h and 52 min after hypothermic cardiac arrest.27, 28

We wanted to review treatment results in victims of accidental hypothermia and cardiac arrest over the last 28 years in our institution.

2. Methods
We identified all patients with accidental hypothermia and cardiac arrest admitted to UNN Tromsø and rewarmed with ECLS during the period 01.01.1985–15.06.2013.

Patients were found by searching our electronic patient record system for the ICD-10 codes hypothermia (T68), asphyxiation (T71), drowning and nonfatal submersion (T75.1) and other codes including avalanches and natural disasters. Data were matched with the hospitals database for extracorporeal circulation and the hospital ICU-database.

We analysed three time-periods: 1985–1991, 1992–1998 and 1999–2013. The first period was prior to moving to new university hospital buildings in 1991; the second represents the time until our first surviving victim of hypothermic cardiac arrest rewarmed with ECLS, and the third the period following this successful break-through case.

Death by asphyxia was defined as cardiac arrest following mechanical asphyxiation, snow avalanche burial without confirmed air pocket or drowning with no information on the use of life jacket, survival suit, or immersion before submersion. The hypothermic victims were divided into three groups: no asphyxia, snow avalanche burial or submersion. We defined the time from exposure to cardiac arrest as 0 min in avalanche victims if no air pockets were found. Likewise this time interval was set to 0 min in drowning victims when the patient story did not reveal immersion prior to submersion.

During the last time period studied, we have used patients hospital admission hyperkalaemia defined as [K+]s > 12 mMol L−1 as a guide to terminate further resuscitation or rewarming efforts.

Rewarming by extracorporeal circulation was performed using standard cardio-pulmonary bypass techniques with either peripheral femoral or central cannulation. During the rewarming, ECLS-flow was set to match the venous drainage at low temperatures, and at 34 °C nominal cardiac output was targeted. Veno-arterial temperature gradient was set to 10 °C initially. Final target temperature was between 34 and 37 °C depending on cardiopulmonary stability after rewarming. When extra-corporeal membrane oxygenator (ECMO) was used after rewarming, temperature was kept at 34 °C for 24–48 h.

Survival was defined as survival one year after the accident or at the end of the inclusion period.

Patients were scored using the 2005 Abbreviated Injury Score (AIS).29 AIS scores were transformed to Injury Severity Score (ISS) as the sum of the square of the highest AIS scores in three different body regions.

The study was approved by the regional ethical committee (REK Nord) and the hospital management.

2.1. Statistics
Data were registered in Office-Excel®. Relevant data were analysed using SPSS (IBM SPSS statistics version 21). p-Values less than 0.01 were considered significant due to the relatively small number of cases and the high number of statistical comparisons performed. Results are given as median (minimum–maximum) unless otherwise stated.

Our material has relatively few patients and many variables, mostly not normally distributed. We analysed continuous data by nonparametric methods. Mann–Whitney U tests were used when comparing two groups, Kruskal Wallis tests when comparing three groups. Pairwise comparisons were performed by Mann–Whitney U tests when relevant. Chi square was used when testing nominal data. With a frequency less than 5 for any observation in 2 × 2 tables, we used Fisher's exact test. Rates of events were analysed by Poisson regression. Relevant data were analysed by logistic forward and backward likelihood regression analysis.

3. Results
3.1. Age, survival and temperature
Thirty-four patients were included in the study, 25 males (73.5%) and 9 females (26.5%). Nine patients survived (26.5%) while 25 died (73.5%). Their age was 27.5 years (2–73 years). First presenting core body temperature was 24.0 °C (8.9–32.9 °C). There was no difference in temperature between survivors and non-survivors (p = 0.44) (Table 1; Fig. 1).

Not quoting the full article, because there are a bunch of stats/charts that don't format well on this forum, but its probably worth a read. Notable is that survival rates for hypothermic cardiac arrest are low, but those who do survive usually have good neurological outcomes. Also, that the record for survival is an impressive six hours and fifty two minutes.

[Broomstick]

I never said it was impossible, just that I had great reservations about it. Frankly, I have had some issues with how the Netherlands do things but it's not my country and I'll be the first to admit I don't have all the facts. How Luxenbourg goes about these things I have no idea. I am VERY concerned, however, that "option to die" can become "duty to die". I also don't like the notion of suicide on general principles. To me it's like cannibalism - there are some very limited and extreme circumstances where it can be justified/tolerated but it's never a good thing (because if you've gotten to the point where that action is tolerable some really horrible things must have happened/be happening) and not at all something I want to become common.

I expect Canada will have it within the next 20 years, given how these social issues tend to go. Then the US will get it within 30 years of us getting it.

Wouldn't be too sure about the US - still lots of religious types who forbid suicide on religious grounds. I don't see that changing any time soon (although I've been wrong before). If it does exist it will most likely be only in certain states with the highly rural, highly religious "flyover" country still forbidding it. Federal law says nothing about this issue, it would be a state matter (as is most crime) and thus we'd have 50+ separate laws on it.

As for your duty to die comment, you'd have to prove that one to me. I doubt you're inclined to put in the effort required to prove your fears founded, so I'll agree to drop the subject if you'll agree that this is just one person's worries.

Mostly it's one person's worries, but it arises out of several things in my background. What follows is a dissertation length essay on where I'm coming from, if you care to read it. After which I'm done and we can agree to disagree.

First of all, in the 1930's Germany practiced involuntary euthanasia beginning with the handicapped then, as we all know, it was moved onto a massive scale. Of course, the motivations of that government were based in a very different set of goals than current advocates of assisted suicide for the terminally ill and/or hopeless crippled, the word "voluntary" being a key distinction, but what happened once before could happen again. Thus, part of my concern. Also the concern of many handicapped people who don't want to be murdered and have it labeled a mercy kill.

Second, I was married three decades to a man with a pretty significant birth defect. Granted, in his case is was on the more mild end of the spectrum, but you can imagine how he felt when people would say things like "I wouldn't want my child to live with that disorder - it's too painful and too limiting" when he's off running his own business, had traveled extensively, married, and very much wanted to live despite, yes, chronic daily pain, suffering, and limitations. MANY people view the lives of the disabled as being more horrible than they really are. I fear a push, coming out of an altruistic but mistaken place, towards ending situations before a person really gets a chance to figure out whether the situation is tolerable or not, or to disbelieving that someone has adapted to a situation. Hearing people say "Well, I'd rather die than live like that!" when you yourself are living like that and OK with it is toxic at best. Too often I hear assisted suicide advocates talk as if their opinions on something are the only correct ones and those in those situations who are disagreeing with them are mistaken or somehow victims of ethics the advocates disagree with. Again, this is something many disabled people fear - that they will be subjected to "I'd rather die than be like you" and/or be pressured to give up deeply held beliefs that they should deal with their situation rather than kill themselves. It is NOT an irrational fear given the history of how society has dealt with the handicapped, from infanticide of defective infants to the Nazis to stories of doctors or nurses that euthanize people against their will murder the patients they are supposed to be caring for.

Then there is the possibility that in a health care "system" like the US has there could be financial incentives for people to kill themselves rather than continue living or seek expensive treatments. Which is why I think the default decision should continue to be towards preserving life rather than ending. You have to make a case for suicide each and every time. You have to justify it each and every time.

Now, IF there was a system that very carefully determined that a person wishing voluntary suicide was of sufficient competence to make such a decision - which does not necessarily mean entirely sane or without some deficits, but there has to be some minimum - and truly was not pressured by any outside influence be that financial or social/family, that it was a decision that was not momentary or likely to change, then ... well, no, I'm not going to approve of it because I don't think suicide is a good thing, at best it would be the least evil thing... then it would be something tolerable.

I am aware that in localities where this is permitted there are people who sign up for the program, get a bottle of pills and instructions, and never use them at all, they wind up dying of natural causes. What they really wanted there was not so much an instant end but a security that, if it DID get too bad they had an out, an option, and it was under their control. So, on that level I'm OK with it. It seems to be functioning as it should. I do view it as a necessary evil, and far preferable to alternatives where you have people attempting to kill themselves and botching the job, making things much worse for all concerned, or friends/relatives going to jail for murder, and the like. As I said, I don't approve of suicide but I disapprove more of those alternatives.

But when you start involving not the ill/handicapped person in administering the means to the end but another human being I get nervous. If the person requesting suicide is the one to actually do the deed - swallow the pill, push the button, whatever - then yes, it was voluntary. If someone else is doing the final act of killing the situation can get questionable.

Part of my thinking on this involves a victim of Dr. Jack Kevorkian. Unfortunately, due to US laws on medical confidentiality I am unable to provide supporting details. At the time I was working as a disability benefits administrator (basically, I made sure the people assigned to me got their monthly benefit and tried to resolve any issues that came up in that regard) and said person was on my caseload. I only ever dealt with the patient's spouse because the patient was completely disabled due to a deteriorating and eventually terminal condition. The patient was unable to communicate. At all. And had been in that state for at least two years.

According to Dr. Kevorkian, the patient had given consent to be killed. Having had access to the person's medical records and history I can't possibly believe that. Either he lied, or he was delusional.

Mind you, I completely understand the distress of the spouse - after all, I had spoken with that person, listened to tears over the phone, tears of frustration and despair. I understand that many people truly would not want to live in that state. Even back then I understood the physical, mental, emotional, and dare I say spiritual exhaustion involved in caring for a dying loved one, and I understand it on an even more visceral level now. But the patient concerned COULD NOT have given consent. It was impossible. If the person was still capable of consciousness at all the person still had no means to communicate with others.

Kevorkian said he had consent. He did not. He murdered that person, plain and simple. He didn't even have the decency to claim the spouse gave consent, he claimed the patient did. He lied. He murdered. He was, eventually, convicted of murder and sent to jail, although it was not over the patient I had involvement with, it was because he had videotaped the death of someone else he killed.

Now, I am also fully aware that there will always be edge cases, exceptions. Those should go to a court of law to make a determination because that is the mechanism society has set up for that sort of decision making. As an example, in the 1970's when C. Everett Koop was asked to separate a dying set of conjoined twins and it was painfully apparent that in order to save even one of the two the other must die, and that the surgery would entail the deliberate killing of one human being to save another, Koop went to court BEFORE the surgery to resolve the legal issues involved. THAT is the proper way to resolve such an issue involving patients who can not give consent. Koop did get consent and himself severed the blood vessel connections between a shared heart that could support only one person and a little girl that only a few hours before had been a fully conscious and aware human being in an attempt to save the life of her sister. I can't say that was a good thing, but it was an ethical thing and an example of how to make hard medical and end-of-life decisions.

A big difference is that Kevorkian acted alone. Koop pulled in all sorts of people to help in his decision making - hospital ethics committee, the courts, a rabbi or two (the family was Jewish)... One act was done in a furtive, secretive manner. The other was subject to the harsh light of society and law. If we're going to have physician assisted suicide it MUST involve multiple people and a LOT of scrutiny. Death is irreversible, we have to be right if that's the path we want to take.

Now, I want to make clear my view on advance consent (yeah, I am long-winded). In the case of the patient I mentioned, the one both Kevorkian and I had some connection to, that person had never made clear their wants or intentions regarding end of life. Which is actually pretty typical. In such cases the decision making is then put on the head of the spouse (or other nearest next of kin if there is no spouse). But we're all human - absent other instruction the spouse is likely going to make assumptions based on what he or she would desire in similar circumstances which may or may not be congruent with what the patient would want. I know this from experience - my dying spouse was able to give me instructions before he became incapacitated, some of which differed from what I would have wanted. When the time came, even knowing what he wanted it was sometimes difficult for me to carry out those wishes where they clashed with what I would have wanted. If he had not given me those instructions I would have guessed wrong. I am uncomfortable with a spouse, absent other supporting evidence, advocating for euthanasia for that reason. Now, if a person had, in advance specified that they would prefer euthanasia to a particular sort of existence, preferably in a legal document, then I could support it for that particular case, still subject to a proper ethical review. I mean, I don't agree with Jehovah's Witnesses' opposition to any and all blood transfusions, but I would not force one on an adult of that religion who had made his/her opposition to that treatment clear even if it meant the death of that person. I think it's wrong, but I think it would be even more wrong to usurp that person's decisions about their body.

But, again, it can't be spur of the moment. As an example, most people rendered quadriplegic go through a period of desiring death. In fact, it's so common a reaction that it's consider abnormal not to have those thoughts upon such a devastating injury. It's a combination of shock, pain, a side effect of some of the drugs they give you to minimize further injury to nerves, and so forth. It's also not a time to kill people, even if they state they want it. Quite a few people get through that phase and wind up wanting to continue to live afterward, even with severe limitations. It's not until after the person heals from the acute injury and undergoes some rehabilitation that a decision can really be made, and even then only in a context where the person is able to receive adequate care and assistance in regards to living. People who are paralyzed from the neck down should have the opportunity to live meaningful lives. On the other hand, if such a person decides that no, it's still intolerable, that's a situation where assisted suicide might be an option, arguably should be an option, but I've spoken long enough already on that.

I actually support ritualistic cannibalism in the societies that practice it. It can help people grieve and, risk of disease aside doesn't seem any worse than other ways of dealing with the dead.

The Fore tribe of New Guinea might disagree with you - the few that are left. Prion diseases are such a bitch and eating the dead is a good way to pass them on. Fortunately, with the end of cannibalistic funeral practices the final kuru infected individual is believed to have died in 2009 so we don't have to worry about that disease any more. But it very nearly wiped them out.

That said - I can't say I'm fond of the notion of eating the dead, but eating someone already dead is different than killing someone for the purpose of eating them. If it's a long-established funeral custom OK, sure - can't say I approve but it's not my culture. And there are people in the West who eat the cremated remains of loved ones in various ways, but again, that's different than killing someone with the intent to eat them. It's certainly not MY cup of tea, but I'll shut up around folks with customs I don't agree with so long as no one else it getting hurt.

[Broomstick]

That second article's intriguing. I wonder if whatever results they get will match up with the recovery that sometimes happens after someone's drowned in very cold water? I know the accepted "no vital signs" limit is just a few minutes, but I've read of people being successfully resuscitated after a lot longer than that under water. It's not common, but it does happen.

That "a few minutes" limit is being challenged, these days

It's actually been challenged for years.

Here by the shores of Lake Michigan every year we have people fall into the icy waters of the lake (or other local bodies of water) and EMT's and the other authorities refuse to refer to the person as deceased no matter how long they've been under until, as you noted, they are "warm and dead". Ditto for dead folks found outside in the winter time. Sure, a lot of them are really dead, but a significant number are revived hours after they stopped breathing and/or went under the water. You can't tell the difference until you've made the effort to revive them which involves all sorts of things beyond CPR - the warming has to be done properly, with all sorts of supporting treatment because when the various bodily systems come back "on line" they tend not to do so in a coordinated manner or necessarily in the ideal order. If the heart starts beating before the lungs start working, for example, that's a problem (albeit one that has solutions) and it also can do very bad things to blood chemistry and so forth. It's not as clean and pretty as TV or the movies usually show.

Anyhow - one consequences of all that is the deliberate cooling of bodies prior to some types of surgery. It is routine for open heart surgery to involve cooling down the patient to a considerable degree to minimize potential neurological damage from interruptions in blood and oxygen supply, as an example, to the point where, if the patient wasn't in an intensively managed situation the patient would die of hypothermia. So the applications are already extensively used although, as I have already pointed out, utilizing them is a surprisingly complicated practice even if it is routine.

Likewise, the research in the OP might well have applications for, example, minimizing damage or even reversing some of it for people with spinal or other nerve injuries, or stroke victims. I suspect that will be more likely and more useful than reviving the dead, especially in the short term.

[Feil]

Mild hypothermia is often used therapeutically too. Apparently inducing a body temp of 33-36 Celsius suppresses cell death from free radical production and inflammation during re-perfusion after resuscitation.

[Jub]

Wouldn't be too sure about the US - still lots of religious types who forbid suicide on religious grounds. I don't see that changing any time soon (although I've been wrong before). If it does exist it will most likely be only in certain states with the highly rural, highly religious "flyover" country still forbidding it. Federal law says nothing about this issue, it would be a state matter (as is most crime) and thus we'd have 50+ separate laws on it.

Apparently, I was mistaken. Assisted suicide is already legal in Canada since 2016. It's also legal in several US states and given that you didn't seem to be aware of this I think it's safe to say that major scandal has been avoided thus far.

First of all, in the 1930's Germany practiced involuntary euthanasia beginning with the handicapped then, as we all know, it was moved onto a massive scale. Of course, the motivations of that government were based in a very different set of goals than current advocates of assisted suicide for the terminally ill and/or hopeless crippled, the word "voluntary" being a key distinction, but what happened once before could happen again. Thus, part of my concern. Also the concern of many handicapped people who don't want to be murdered and have it labeled a mercy kill.

Just because a thing can happen doesn't mean it will.

Euthanasia has been legal in the Netherlands since 2002 with some 4% of deaths since that time being medically assisted. Clearly, the rules and regulations in place are doing their job to the point where there are calls to expand assisted suicide beyond just the incurably ill. No evidence of a slippery slope here.

There are actually more nations that I thought where assisted dying is allowed either nationwide or in select states/provinces/etc.

Australia in Victoria sometime this year.

Belgium as of 2002, right behind the Netherlands.

Canada since 2016.

Columbia since 1997 with further discussion and clarification in 2014.

Germany since 2015.

Japan has a legal precedent set that could make assisted suicide legal though it hasn't been tested.

Luxembourg since 2008.

Mexico decriminalized in 2007.

The Netherlands since 2002.

South Korea since early 2018.

Switzerland since 1942 apparently.

Some US states: While active euthanasia is illegal throughout the US, assisted suicide is legal in Washington, D.C.,[3] Colorado, Oregon, Hawaii, Washington, Vermont, New Jersey (Starting August 1, 2019),[92] California,[93] one county in New Mexico, and is de facto legal in Montana.[94][95]

Uruguay since 1933.

Given the sheer number of nations and the years where assisted suicide has been legal please show any evidence that there has been a plurality of abuses significant enough to validate your fears. You have a lot of nations to choose from, so if there are cases to be found it shouldn't be difficult to do so.

>snipped personal annecdote>

Aren't your concerns solved by passing laws such as the ones in place in the Netherlands?

Then there is the possibility that in a health care "system" like the US has there could be financial incentives for people to kill themselves rather than continue living or seek expensive treatments. Which is why I think the default decision should continue to be towards preserving life rather than ending. You have to make a case for suicide each and every time. You have to justify it each and every time.

So show that this has happened in US states where assisted suicide is legal.

Now, IF there was a system that very carefully determined that a person wishing voluntary suicide was of sufficient competence to make such a decision - which does not necessarily mean entirely sane or without some deficits, but there has to be some minimum - and truly was not pressured by any outside influence be that financial or social/family, that it was a decision that was not momentary or likely to change, then ... well, no, I'm not going to approve of it because I don't think suicide is a good thing, at best it would be the least evil thing... then it would be something tolerable.

This is showing your complete ignorance on this issue. Please actually look into things before making such statements.

Statements like If there was such a system show that you've failed to do even cursory research into this topic before knee-jerking a reaction.

<snip Koop v. Kavorkian>

If you're tying up your courts with every edge case that means your laws aren't clear enough. This suggests that better laws should be written, not that more judges should be forced to make a judgment call. This may also prolong the suffering of the ill or risk lives that could otherwise have been saved. It is not a model to strive for.

But, again, it can't be spur of the moment. As an example, most people rendered quadriplegic go through a period of desiring death. In fact, it's so common a reaction that it's consider abnormal not to have those thoughts upon such a devastating injury. It's a combination of shock, pain, a side effect of some of the drugs they give you to minimize further injury to nerves, and so forth. It's also not a time to kill people, even if they state they want it. Quite a few people get through that phase and wind up wanting to continue to live afterward, even with severe limitations. It's not until after the person heals from the acute injury and undergoes some rehabilitation that a decision can really be made, and even then only in a context where the person is able to receive adequate care and assistance in regards to living. People who are paralyzed from the neck down should have the opportunity to live meaningful lives. On the other hand, if such a person decides that no, it's still intolerable, that's a situation where assisted suicide might be an option, arguably should be an option, but I've spoken long enough already on that.

Show me a single example where this has happened in nations where assisted suicide/euthanasia is legal and I'll give your stance a little more credibility. As it stands you seem to be arguing from an emotional place rather than one of logic and research.

The Fore tribe of New Guinea might disagree with you - the few that are left. Prion diseases are such a bitch and eating the dead is a good way to pass them on. Fortunately, with the end of cannibalistic funeral practices the final kuru infected individual is believed to have died in 2009 so we don't have to worry about that disease any more. But it very nearly wiped them out.

I literally noted the risk of disease. If these people had the proper medical technology to screen the dead the practice would have been completely safe. As it is, now that the disease is gone it will be safe until something new comes along to make it dangerous again.

That said - I can't say I'm fond of the notion of eating the dead, but eating someone already dead is different than killing someone for the purpose of eating them.

Who brought this up? Why are you bringing in out of context shit to justify your emotional reactions?

[Broomstick]

>sigh<

Wouldn't be too sure about the US - still lots of religious types who forbid suicide on religious grounds. I don't see that changing any time soon (although I've been wrong before). If it does exist it will most likely be only in certain states with the highly rural, highly religious "flyover" country still forbidding it. Federal law says nothing about this issue, it would be a state matter (as is most crime) and thus we'd have 50+ separate laws on it.

Apparently, I was mistaken. Assisted suicide is already legal in Canada since 2016. It's also legal in several US states and given that you didn't seem to be aware of this I think it's safe to say that major scandal has been avoided thus far.

I actually am aware that a form of physician assisted suicide is available in some US states and has been for some time. Which is entirely consistent with my statement that it would be done on a state-by-state basis in the US rather than some overall regulation, but go ahead and continue to read what you want into my statements instead of, you know, actually reading what I said.

Just because a thing can happen doesn't mean it will.

Doesn't mean it won't happen again, either. Especially in a nation with a very poor history of treating the poor and minority folks extremely badly, engaging in genocide against various groups, and so forth. Which is consistent with my pointing out that cultural and social differences can have an impact.

Euthanasia has been legal in the Netherlands since 2002 with some 4% of deaths since that time being medically assisted. Clearly, the rules and regulations in place are doing their job to the point where there are calls to expand assisted suicide beyond just the incurably ill. No evidence of a slippery slope here.

Marc and Eddy Verbessem. Neither was suffering from a terminal illness. Apparently NO attempt was made to rehabilitate them with techniques widely used for the deaf-blind. I consider that morally unacceptable. But hey, they're handicapped so it's OK to kill them instead of trying to actually help them, right? OK, it's Belgium, not the Netherlands, but the point is that no, from my viewpoint the laws are not adequate if this sort of thing can happen.

Some US states: While active euthanasia is illegal throughout the US, assisted suicide is legal in Washington, D.C.,[3] Colorado, Oregon, Hawaii, Washington, Vermont, New Jersey (Starting August 1, 2019),[92] California,[93] one county in New Mexico, and is de facto legal in Montana.[94][95]

Uh-huh. Guess you blasted past my discussion of suicide options when the patient self-administers and how it's preferable to people engaging in botched suicide attempts. Why should I engage in conversation with you when you so clearly ignore what i have to say?

Given the sheer number of nations and the years where assisted suicide has been legal please show any evidence that there has been a plurality of abuses significant enough to validate your fears. You have a lot of nations to choose from, so if there are cases to be found it shouldn't be difficult to do so.

Right. Marc and Eddy Verbessem. Jack Kevorkian's victims. Didn't take very long at all.

>snipped personal annecdote>

Aren't your concerns solved by passing laws such as the ones in place in the Netherlands?

No.

Then there is the possibility that in a health care "system" like the US has there could be financial incentives for people to kill themselves rather than continue living or seek expensive treatments. Which is why I think the default decision should continue to be towards preserving life rather than ending. You have to make a case for suicide each and every time. You have to justify it each and every time.

So show that this has happened in US states where assisted suicide is legal.

I have already violated my prior statement that the prior post was the end of my participation in this discussion, largely because you have twisted my words around to be a straw-adversary for your position. I am not playing this game. I am not putting the time into doing any more research for you to pick apart.

My stance on suicide, of any sort, comes out of my personal ethics and thus is based as much on opinion as facts. I freely admit that. Of course, having my family nearly obliterated in WWII by people wished to "euthanize" us based on our religion and ethnicity does color my perceptions of the whole matter - it would be bizarre if it didn't. I also related the story about the person with connections to both my self and Kevorkian to further illustrate the origins of my personal stance on the whole matter. You are free to disagree with me, of course - but you will not argue me out of my position which I have arrived at after a lifetime of thought on the matter by telling me "Europe does it, and it's OK!" Which it isn't, by the way, going by the case of the Verbessem twins. Granted, that's Belgium and not the Netherlands, but the point is that at least one country didn't seem to have a problem murdering two men who were not suffering from a terminal illness.

Now, IF there was a system that very carefully determined that a person wishing voluntary suicide was of sufficient competence to make such a decision - which does not necessarily mean entirely sane or without some deficits, but there has to be some minimum - and truly was not pressured by any outside influence be that financial or social/family, that it was a decision that was not momentary or likely to change, then ... well, no, I'm not going to approve of it because I don't think suicide is a good thing, at best it would be the least evil thing... then it would be something tolerable.

This is showing your complete ignorance on this issue. Please actually look into things before making such statements.

I have. You're just pouting because I didn't come to the same conclusion you did. As a very broad, general rule I am opposed to suicide. It's self-murder. Or, if you're assisting someone else, it's just plain murder. There are a few exceptions - just as self-defense justifies you murdering someone attacking you, something like a painful terminal illness can justify self-murder, or flinging yourself on a grenade to save the lives of your fellow soldiers can justify self-murder - but they are, indeed, very few.

I am aware that many pro-killing advocates don't like my calling it self-murder. Too fucking bad. In my ethics that's exactly what it is to me - it's murder. If you're allowed your opinion then surely I should be allowed mine. Unlike you, I am not attempting to convert anyone to my point of view.

Statements like If there was such a system show that you've failed to do even cursory research into this topic before knee-jerking a reaction.

Right - it couldn't possibly be that I have looked into it and I'm not convinced that ANY current system is truly up to the task. Really, it's like Bible-thumpers who are convinced that if a person would just read this magic book they'd come around to the correct viewpoint. No, that's not how it works. You look at the current systems and think they're OK. I think they're inadequate. But then again, I don't use euphemisms for self-murder, either, I call it what it is: the deliberate killing of a human being.

If you're tying up your courts with every edge case that means your laws aren't clear enough. This suggests that better laws should be written, not that more judges should be forced to make a judgment call.

Or maybe you have too many edge cases and there's something wrong with either your society or your medical system. Why the fuck are you so eager to kill people?

Also, judges routinely make medical judgement calls. This doesn't have to "tie up" the courts for months. There are, for example, routine methods of declaring a legal guardian for an incompetent adult - usually going to next of kin and it's almost a formality in some cases - that's repeated tens of thousands of times a year without collapsing the system. Do you really want to kill tens of thousands of people via assisted suicide in a year?

This may also prolong the suffering of the ill or risk lives that could otherwise have been saved. It is not a model to strive for.

Emergency court orders can be obtained in less than 24 hours for edge cases.

As it stands you seem to be arguing from an emotional place rather than one of logic and research.

Yes, I tend to get emotional about murder, whether it's by a second party or by the murder victim him/herself. Aside from that - I have done my research, I just came to a different conclusion than you did. Why can't you accept that? I view the deliberate killing of humans beings as wrong, with only a very few exceptions to that stance, such a self-defense. Suicide is not self-defense. It may be the least bad option of many, but it's never a good option, it's never a good act.

The Fore tribe of New Guinea might disagree with you - the few that are left. Prion diseases are such a bitch and eating the dead is a good way to pass them on. Fortunately, with the end of cannibalistic funeral practices the final kuru infected individual is believed to have died in 2009 so we don't have to worry about that disease any more. But it very nearly wiped them out.

I literally noted the risk of disease. If these people had the proper medical technology to screen the dead the practice would have been completely safe.

They were a fucking isolated tribe with stone age technology, what the FUCK are you going on about "proper medical technology" for? In actual fact, screening for prion diseases was impossible prior the 1980's anywhere in the world. It's not even done now, anywhere, to screen for prion diseases in the food supply which was/is a real threat (instead, other practices are in place to reduce transmission, such as not feeding animals with the flesh of their own kind).

That said - I can't say I'm fond of the notion of eating the dead, but eating someone already dead is different than killing someone for the purpose of eating them.

Who brought this up? Why are you bringing in out of context shit to justify your emotional reactions?

I am bringing it up to discuss my ETHICAL reactions that the deliberate killing of a human being is wrong. If you're a survivor of a plane crash in the Andes (as an example) then eating the corpses around you until rescue is a logical means of survival and morally excusable. KILLING your fellow survivors to get dinner is NOT. I thought you were intelligent enough to understand that chain of reasoning but now that I know you have a fanatic's attachment to your position that killing people is OK I won't even bother in the future.

So - finally - this is truly the last post I will make on this in response to you. I expect you will continue to poke, prod, dissect, and straw-man my position, as well as call me "emotional" because clearly you disagree with my ethics (I certainly find yours revolting). I can't stop you, but I no longer care to play the game. Fuck off.

[Jub]

I actually am aware that a form of physician assisted suicide is available in some US states and has been for some time. Which is entirely consistent with my statement that it would be done on a state-by-state basis in the US rather than some overall regulation, but go ahead and continue to read what you want into my statements instead of, you know, actually reading what I said.

Then go ahead and show me where this is causing the problems you claim this will lead to?

Doesn't mean it won't happen again, either. Especially in a nation with a very poor history of treating the poor and minority folks extremely badly, engaging in genocide against various groups, and so forth. Which is consistent with my pointing out that cultural and social differences can have an impact.

You're asking me to prove a negative. It's on you to show that it's likely to happen.

Marc and Eddy Verbessem. Neither was suffering from a terminal illness. Apparently NO attempt was made to rehabilitate them with techniques widely used for the deaf-blind. I consider that morally unacceptable. But hey, they're handicapped so it's OK to kill them instead of trying to actually help them, right? OK, it's Belgium, not the Netherlands, but the point is that no, from my viewpoint the laws are not adequate if this sort of thing can happen.

So you can't prove that no attempt was made to convince them to try rehab and the best source you have is from a North American news outlet. As far as killing them, the article doesn't say who ended their life. They may well have been capable of administering the drugs, I assume that is what was used as this poor excuse for an article provides no details, and thus simply been allowed access to a more humane form of suicide.

This is very different from somebody killing them given that they actively sought this even after being turned down the first time. You're moralizing over this is blatant and unwelcome.

Uh-huh. Guess you blasted past my discussion of suicide options when the patient self-administers and how it's preferable to people engaging in botched suicide attempts. Why should I engage in conversation with you when you so clearly ignore what i have to say?

What of patients who can't self administer due to their condition? Are they to be denied now?

Marc and Eddy Verbessem.

Two men that actively sought their own deaths even in the face of opposition with the support of their older brother. Not a good example.

Jack Kevorkian's victims.

That would have been illegal even under current assisted suicide laws. Again, a poor example, as you well know laws cannot prevent crime.

No.

Because you could find a single example of people dying, as was their wish when you thought they should have stuck it out and tried living a deaf-blind life? You presented no proof that they were never offered rehabilitation but assert that it was the case.

Provide proof of this claim or concede on Marc and Eddy Verbessem.

My stance on suicide, of any sort, comes out of my personal ethics and thus is based as much on opinion as facts. I freely admit that.

So you're just as bad as the religious nuts denying abortions because it goes against their personal beliefs. Listen to how you sound Broomstick.

Which it isn't, by the way, going by the case of the Verbessem twins. Granted, that's Belgium and not the Netherlands, but the point is that at least one country didn't seem to have a problem murdering two men who were not suffering from a terminal illness.

The law never stated that it had to be a terminal illness only incredible suffering a condition which can only be accurately assessed by the person suffering. Nor were these men murdered, instead the law worked as intended and ensured their wish to die was carried out. This is no different than the two of them choosing to jump off a bridge together only more humane.

I have. You're just pouting because I didn't come to the same conclusion you did. As a very broad, general rule I am opposed to suicide. It's self-murder. Or, if you're assisting someone else, it's just plain murder. There are a few exceptions - just as self-defense justifies you murdering someone attacking you, something like a painful terminal illness can justify self-murder, or flinging yourself on a grenade to save the lives of your fellow soldiers can justify self-murder - but they are, indeed, very few.

So you're just trying to ride some high horse and using flimsy justifications to make it look less apparent.

I am aware that many pro-killing advocates don't like my calling it self-murder. Too fucking bad. In my ethics that's exactly what it is to me - it's murder. If you're allowed your opinion then surely I should be allowed mine. Unlike you, I am not attempting to convert anyone to my point of view.

Being anti-gay marriage and anti-abortion are just opinions too. Do you consider the people that hold those opinions to be correct?

Right - it couldn't possibly be that I have looked into it and I'm not convinced that ANY current system is truly up to the task. Really, it's like Bible-thumpers who are convinced that if a person would just read this magic book they'd come around to the correct viewpoint. No, that's not how it works. You look at the current systems and think they're OK. I think they're inadequate. But then again, I don't use euphemisms for self-murder, either, I call it what it is: the deliberate killing of a human being.

You're the one sounding like a bible thumper wishing to take choice away from a consenting adult who wishes to die with dignity at a time and place of their own choosing.

Or maybe you have too many edge cases and there's something wrong with either your society or your medical system. Why the fuck are you so eager to kill people?

Is it really murder to save the more viable of a pair of doomed conjoined twins? Was that a case that needed to go to the courts?

Also, judges routinely make medical judgement calls.

Perhaps we should leave such calls to medical professionals rather than glorified lawyers.

Do you really want to kill tens of thousands of people via assisted suicide in a year?

Quote me saying that I did or fuck off.

Emergency court orders can be obtained in less than 24 hours for edge cases.

If the choice is so easy why involve a judge at all?

Yes, I tend to get emotional about murder, whether it's by a second party or by the murder victim him/herself. Aside from that - I have done my research, I just came to a different conclusion than you did. Why can't you accept that? I view the deliberate killing of humans beings as wrong, with only a very few exceptions to that stance, such a self-defense. Suicide is not self-defense. It may be the least bad option of many, but it's never a good option, it's never a good act.

By your standard slaughtering animals for meat is also evil then or are humans somehow special in your eyes?

I should also say that ending extreme suffering is always a good act. To do otherwise is what is evil.

Or would you leave a badly lamed horse to suffer because it's immoral to kill the animal? Are both acts evil even if you didn't cause the horse any injury?

They were a fucking isolated tribe with stone age technology, what the FUCK are you going on about "proper medical technology" for? In actual fact, screening for prion diseases was impossible prior the 1980's anywhere in the world. It's not even done now, anywhere, to screen for prion diseases in the food supply which was/is a real threat (instead, other practices are in place to reduce transmission, such as not feeding animals with the flesh of their own kind).

I never said it was plausible only that wit such screening the practice could be made safe.

So - finally - this is truly the last post I will make on this in response to you. I expect you will continue to poke, prod, dissect, and straw-man my position, as well as call me "emotional" because clearly you disagree with my ethics (I certainly find yours revolting). I can't stop you, but I no longer care to play the game. Fuck off.

Aww, poorly little emotional Broomy can't make an actual argument so she storms off in a huff. As to be expected from you sadly.

[Broomstick]

Again, I have stated I am done with this. Do you want to return to the actual topic or continue shouting into the wind?

I am not stomping off in a huff, I am entirely willing to return to the actual OP topic. It's this diversion I am no longer going to be part of.

[Gandalf]

Again, I have stated I am done with this. Do you want to return to the actual topic or continue shouting into the wind?

I am not stomping off in a huff, I am entirely willing to return to the actual OP topic. It's this diversion I am no longer going to be part of.

You posted the "I'm done" at the end of a post continuing the discussion. What is that but an attempt to get a last word in and scarper?

[Broomstick]

I had a moment of weakness, so sue me - normally I've very good about sticking to "I'm done". I'll also point out that I haven't left the thread, which I think still has some interesting points to discuss, I'm done with Jub's diversion into suicide.

So, when I've had time (after working back-to-back shifts) to return to this with a thoughtful post I will. But I'm not engaging with Jub on the topic of suicide of any sort any more in this thread because I don't feel he's debating honestly. Instead, he's deliberately misinterpreting my posts, moving goalposts, and most recently trying to engage in yet another diversion into the ethics of meat eating. I don't feel like chasing him.

If you or Jub have a problem with that take it up with a mod.

[Jub]

I had a moment of weakness, so sue me - normally I've very good about sticking to "I'm done". I'll also point out that I haven't left the thread, which I think still has some interesting points to discuss, I'm done with Jub's diversion into suicide.

So, when I've had time (after working back-to-back shifts) to return to this with a thoughtful post I will. But I'm not engaging with Jub on the topic of suicide of any sort any more in this thread because I don't feel he's debating honestly. Instead, he's deliberately misinterpreting my posts, moving goalposts, and most recently trying to engage in yet another diversion into the ethics of meat eating. I don't feel like chasing him.

I only brought it up assisted suicide in connection with people who are deeply dissatisfied with their quality of life after a head/brain transplant. You're the one who started moralizing and then getting mad at me for asking you to properly back up your claims. Obviously, the subject touched a nerve with you but I'd ask for you to try to be objective and rational about your part in our debate rather than painting me as the asshole here.

If you or Jub have a problem with that take it up with a mod.

No need for a mod for something this petty.

[Broomstick]

In a commentary that accompanied the research paper in Nature, Farahany and her colleagues Henry Greely and Charles Giattino say the work reminds them of a line from the 1987 movie The Princess Bride: "There's a big difference between mostly dead and all dead. Mostly dead is slightly alive."

Research like this could complicate the effort to secure organs for transplant from people who have been declared brain-dead, according to another commentary written by Case Western Reserve University bioethicists Stuart Youngner and Insoo Hyun.

If people who are declared brain-dead could become candidates for attempts at brain resuscitation, they write, "it could become harder for physicians or family members to be convinced that further medical intervention is futile.

I think this may be more of an obstacle for lay people than for actual physicians. A person can be brain-dead and still have living cells in their brain. After thinking about this for a bit it seems that this technique supports cellular activity but does not restore the complicated interactions we think of when we say "brain function".

I do have a concern that it may lead some to further extend hopeless situations like the Jahi McMath case. Such people can display Lazarus signs leading non-medical observers to think the person is still alive when in reality it's a reflex motion and generate false hopes in onlookers. I would really hate to see dead bodies maintained for long periods under false assumptions and false hope (which is different than doing so for research or organ recovery purposes).