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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2006

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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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