Medical Forum / Diseases and Disorders / Prostate Cancer / January 2006
SCOTUS Case on End of Life Care -- Oregon's Death With Dignity Law
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Steve Jordan - 04 Jan 2006 23:36 GMT The Oregon Death With Dignity Act case has been submitted to the Supreme Court of the United States.
Should the Drug Enforcement Agency be empowered to review a physician's care of a terminal patient whose pain is unmanageable?
For a physician's viewpoint, see the New England Journal of Medicine article at: http://content.nejm.org/cgi/content/full/354/1/1?query=TOC
Regards,
Steve J
I.P. Freely - 05 Jan 2006 01:26 GMT > The Oregon Death With Dignity Act case has been submitted to the Supreme > Court of the United States. [quoted text clipped - 4 lines] > For a physician's viewpoint, see the New England Journal of Medicine > article at: http://content.nejm.org/cgi/content/full/354/1/1?query=TOC The most pertinent paragraph in that link, IMO, is this: "Patient 3 had advanced metastatic lung cancer and had been receiving opioids at home when he was admitted to the hospital with new metastases to his thoracic spine. He was confused, could not move his legs, had difficulty breathing, and was in excruciating pain - screaming whenever he moved and grimacing with each breath. He was near death, and the primary goal of medical care was to control pain, agitation, and dyspnea. He was given a subcutaneous infusion of opioids at an equianalgesic dose 30 percent higher than his usual dose, and the nurses were instructed to give him another dose, equal to 10 percent of the total daily dose, "as needed" every half hour if he appeared to be in pain (the proper approach, according to standard guidelines). But several nurses and physicians refused to give the "as needed" doses, despite evidence of continuing distress, because they feared hastening his death. Ethics and palliative care consultants were called in, and they refocused the team on the professional obligation to relieve pain and suffering. The patient died hours after receiving the additional doses, and some staff members remained unsettled about whether they might have been legally liable for "causing" his death."
Dammit ... when do I get to get on with my OWN agenda and quit having to fight stuff like this? If it isn't eminent domain abuse, or the ACLU, or the ignorant "Bush Lied" brigade that's eating into my time, it's the goddamned federal government trying to tell me how to DIE! This is NOT the government's business, and if I can't help a tiny bit by opposing this BS locally and nationally, then by God if and when I'm Patient 3 I'll do my very best to make my point with a speech and a hand grenade or shotgun on live TV. It's *M*Y* damned life, not anyone else's.
WHEN are people going to stop letting the government run every tiny or totally personal part of their lives?
I.P.
Pops - 05 Jan 2006 14:55 GMT You tell 'em IP. I'm right behind you.....way behind.....
Just kidding, I totally agree. This crap can get really depressing.
judamd@aol.com - 05 Jan 2006 16:40 GMT My plan if and when the time comes is to "do something about it" on my own and screw the legislators, the priests, and all the other ***holes who think they know what's best for me. My father, who died of Parkinson's, always use to say the same thing but he neither accumulated the right "stuff" nor was he physically able to do anything about it when he had had enough suffering. My dad even asked his brother to kill him which of course his brother didn't do since he would have spent the rest of his life in jail. Sounds like Patient 3 waited too long too. Dave Perry
You smiled, you spoke, and I believed - 05 Jan 2006 17:25 GMT >>The Oregon Death With Dignity Act case has been submitted to the Supreme >>Court of the United States. [quoted text clipped - 39 lines] > > My brother in law died from cancer in 1977. At the end, they were giving him a cocktail of drugs, which were designed to relieve his pain, and to hasten his death. As far as I knew, no medical professional protested this very practical solution.
j.
Steve Jordan - 05 Jan 2006 23:20 GMT On January 5, j. wrote:
> My brother in law died from cancer in 1977. At the end, they were > giving him a cocktail of drugs, which were designed to relieve his > pain, and to hasten his death. As far as I knew, no medical > professional protested this very practical solution. I can only hope that a majority of the Court are familiar with this wisdom from John Stuart Mill:
"...the sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right...The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign."
Regards,
Steve J
Brian - 06 Jan 2006 02:04 GMT > His own good, either physical or > moral, is not sufficient warrant. He cannot rightfully be compelled to do > or forbear because it will be better for him to do so, because it will > make him happier, because, in the opinion of others, to do so would be > wise, or even right.. Damn straight!
If it's right to compel me to be "morally upright" in a matter that brings no harm to others, such as enduring screaming pain as was in this case, then it's also right to compel me to not be overweight. The difference is degree, not the scope, of making me Do The Right Thing.
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