If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really? It's absolutely hospice care in the approach, but they are literally helping them die more quickly. More happily, but more quickly. And euthanasia has nothing to do with absolute speed, only relative; a less-painful death at the expense of a shorter life. It's a trade-off everyone makes, but at what point does it switch from normal life / hospice care to occurring "too early"?
If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really?
The difference is that people have the right to choose what treatment they take or don't take. Forcing a treatment on someone (antibiotics, chemotherapy, sewing a laceration) when they don't want it is legally called medical battery, and it's against the law.
This is particularly poignant in the case of diseases like alcoholism or drug addiction. I often have conversations with alcoholics along the lines of "Your alcohol level was 5 times the legal limit. If you keep drinking at this level, in a couple of years, your liver will be shot, and you're going to die of liver failure. Liver failure is one of the worst ways to die, because you die looking like a swollen yellow gourd."
Most don't care, and keep on drinking. Same thing with smoking. I smoked for 10 years while I was a Critical Care nurse. It was my choice and my addiction. It took trying to quit 15 times before I did it successfully. Some people aren't able to quit, or don't want to quit, and it kills them.
Should we deny people with lung cancer hospice because their disease was self inflicted? Should we deny people with heart disease hospice because they didn't manage their cholesterol properly? Should we deny people with type 2 diabetes hospice because they didn't manage their diet appropriately, exercise or lose weight?
I should point out that I do enjoy playing Devil's Advocate. But I'm not just trying to be contrary, these are essentially things running through my mind.
I largely agree with what you're saying (how could I not?), but I'm having difficulty finding testable definitions in it. Something hard-edged and consistent that can serve as a basis.
One of the problems with respecting the person's choices in cases of addiction is that there's room for arguing that they're not capable of making decisions for themselves due to the addiction. This comes up all the time in legal and medical situations - otherwise, we'd have no insanity clause, no forced rehab, no insane asylums (not that I think those are fantastic places, of course). I have no idea where the legal line lies in most situations, but would be interested if anyone does know it.
At what point do we decide whether it's the person or the disease that's talking? Alcohol in particular has a far longer history than the newer, "harder" drugs that our society has drawn clear distinctions for, and it's going to be much harder to find or make or convince others where the line for it lies.
I have no idea where the legal line lies in most situations, but would be interested if anyone does know it.
Sure, I deal with this on a nightly basis, when I'm at work. Most state laws stipulate that the only reason a hospital can hold someone against their will, is if they are a danger to themselves (in imminent danger of committing suicide), a danger to others (in imminent danger of committing homicide.) or gravely disabled ( e.g. walking around quacking like a duck and drinking from puddles).
And, even then, an ER can only place someone on a 72 hour hold. Then it has to go to court to hold someone against their will on a 10 day paper.
Getting someone committed to rehab for alcoholism is generally a court driven exercise that happens after a person has multiple DUI's or instances of committing crimes that are drug use related.
The law takes committing someone to drug, alcohol or psychiatric treatment against their will very, very seriously and only does so in extreme circumstances. And, frankly, providing a wet house for people to continue to choose to drink themselves to death is probably the path of least resistance, it's cheaper and in my opinion is the most humane of all the bad options.
>Then it has to go to court to hold someone against their will on a 10 day paper.
I don't quite follow that sentence... is that to get a 10 day period enforcement, or to go over 10 days? Or something else?
All in all, pretty clear, thanks! That sounds like a pretty rational set of rules. My main difficulties lie in that people seem to only care about things when they become imminent and obvious, while ignoring steady trends that are just as dangerous (or more). Legally, imminent is a nice, clean line to choose, because it's pretty clear most times. It's a line that can be protected, which is hugely important.
Ethically, I don't know, and any actions would be at odds with their free will... unless you view addictions as violations of their free will to begin with. A loss of free will that they chose, but that decision doesn't hold up against extremes like suicide. Is suicide somehow worse when it's immediate rather than over the course of, say, a year? What if they planned it for a year, and you only interrupted it at the crucial moment?
