October 23, 2008
I-1000 Requires Death Certificate Falsification

Amazing, but true: I-1000 requires doctors to write down a false cause of death. In a sane society where we value truth from our government and public documents, this would be enough to kill the initiative.

The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death.

Yes, it means what it says: the death certificate shall -- must -- have the underlying disease as the cause of death, even though it wasn't the actual cause of death. The government requires doctors to lie about how people died.

The Yes-on-I-1000 give a completely illogical analogy to defend against this claim, saying, "Just as when physicians discontinue an artificial respiratory or kidney dialysis, or help someone die by continuous sedation, the underlying disease is legally and accurately the cause of death." But in those cases, the cause of death actually is the underlying disease.

Proponents are intentionally blurring the distinction between allowing someone to die by withholding treatment, and causing their death.

I am generally against I-1000 because I don't like the government getting involved in these sorts of decisions, which is what I-1000 represents. And this is a good example of why it's so dangerous.

Cross-posted on <pudge/*>.

Posted by pudge at October 23, 2008 09:06 AM | Email This
Comments
1. Are you kidding me..........

So much for the truth.

Posted by: Army Medic/Vet on October 23, 2008 09:15 AM
2. While I, also, am against the Government making these kinds of decisions... Without I-1000, we would be unable to make this decision in the first place!

Posted by: jeremy on October 23, 2008 09:16 AM
3. Jeremy, false. In fact, people choose the path to end their lives due to terminal illness every day, without the help of government. It's just not talked about much, because it's illegal. But the problem is making it legal makes it even more prone to abuse, as this example shows. Yes, right now doctors are falsifying death certificates; but at least the government isn't ordering them to do it.

Posted by: pudge on October 23, 2008 09:21 AM
4. While I would never personally usher myself into the presence of my Creator unbidden, the free choice to do so is what makes such a decision meaningful.

Not sure how I'll vote on this yet, but in general I support giving people the option.

Posted by: Andrew Brown on October 23, 2008 09:22 AM
5. Pudge writes: "I am generally against I-1000 because I don't like the government getting involved in these sorts of decisions..."

Is that irony, a typo, or confusion?

I-1000 removes the government from these decisions. OK, not entirely, but it eliminates the government's right to put you in jail for these decisions, provided that you follow some safeguards.

The death-by-sedation analogy that you pooh-pooh actually seems quite apt.

Posted by: Bruce on October 23, 2008 09:24 AM
6. Making something legal and defining the manner inwhich something can or can't do leads to more abuse? C'mon. If that's true then we should do away with liquor stores and regulations....so alcohol won't be abused as badly.

I just hope that if I ever have a terminal illness and my quality of life is diminished so much...I'll still have enough strength and connecton to get myself a lethal does of good drugs....since I don't have a clue where one would score heroin. I'd rather not have to resort to a Winchester Rx, because a 12 gauge makes a nasty mess somebody else would have clean up. Without I-1000 that, unfortunately, that could be the only personally acceptable alternative.

I-1000 is fair, reasonable, and people that claim it will be abused are Chicken Little's wanting to inflict their own personal dogmatic beliefs on others.

Posted by: Matty on October 23, 2008 09:33 AM
7. Bruce:

Wow. Have you read I-1000? It is all about injecting government into the decision. What part of it do you think removes government from the decision? Yes, it decriminalizes it, but it happens now without government interference. A lot. And while decriminalizing has its merits, the price -- extreme government regulation, to the point of requiring falsified public documents -- is a disease worse than the cure (no pun intended).


Matty: I already proved, beyond ANY doubt, that the law REQUIRES abuse. There is no denying it, unless you deny that falsifying public records is abuse, which is nonsensical on its face.

Posted by: pudge on October 23, 2008 09:46 AM
8. I would support I-1000 if it was for the extermination of the republican party :)

Posted by: Hill Bill on October 23, 2008 09:50 AM
9. #8.

Go away child...

gezzz

Posted by: Army Medic/Vet on October 23, 2008 09:56 AM
10. I'm actually kind of selfish about this for two reasons.

First, Pudge... have you ever taken someone's life? Ever had to unplug somebody, or pulled a trigger or killed someone in hand to hand combat? Ever even trained to do those things?

Ever stood by helplessly as someone (family member, friend, stranger or even an enemy) has died, even a 1/4 of an inch at a time, in front of your eyes, begging you to help them die because the pain is unbearable?

The second reason is entirely a selfish one.

We all remember that stain on the Constitution of the United States referred to as the Washington State Smoking Ban, don't we?

That's where many people, even so-called "conservatives," chucked principle out the window and joined with the rest of the lemmings to stamp on common sense and force onerous rules and bans on people and businesses because, what the heck, THEY weren't smokers, so it didn't cost THEM anything.

Smoking cost me my parents, my next oldest brother and has caused my oldest brother to live with the effects of a massive and debilitating stroke. Fortunately, I have never engaged in the habit, tho God knows why given my background.

That said, I voted against the ban, since I would NEVER give up MY right to decide what *I* want to do with *MY* life. I voted against it, even though I hate smoking, and would only go out to non-smoking environments. I believed then as I do now that no one ever forces a non-smoker (or a smoker, for that matter) to work at, in or around a smoking establishment; nor does it force anyone to patronize such an establishment against their own will.

In the case of my brother, I made the decision to implement our previous discussions over the years on the subject and end his life by stopping his life support.

So... did *I* kill him? Or did the massive stroke that he suffered with terrible, irreversible destruction of his brain do that?

In my mind, I do not believe there can be any difference between implementing the previously expressed desires of an unconscious individual, with a system we already have in place, a system that does not list the cause of death as "Complications relating from the voluntary termination of life-support procedures," but instead does that thing that you find so horrendous, so despicable... so dangerous... the listing of the underlying cause.

So, in that sense, doctors are "lying" about the actual cause of death EVERY DAMNED DAY, AND THEY'RE DOING SO WITHOUT A PEEP FROM YOU.

At the end of my life, I want control over that. "Illogical analogies" provided by those opposed to this initiative do nothing to provide a reason to oppose it. Complaining about a system set up in this initiative that has been in place since the option of ending life support has been provided does not come close to making your "concern" (which is really a smokescreen for your moral take on this) any reason at all to oppose this measure.

I will support this because *I* reserve the right to determine the time, manner and method of my death if I am ever inflicted with an incurable disease.

So, Pudge... if this thing passes, feel free to not utilize it. Whether you do or not is up to you. But the very idea that we require medical personnel to follow the dictates of a DNR when someone is unconscious but we would not allow them to follow the dictates of a conscious individual is beyond the bizarre... and I support this and hope that it passes.

It is not perfect legislation (what ever really is?) but it's a start.

Posted by: Hinton on October 23, 2008 09:56 AM
11. "Matty: I already proved, beyond ANY doubt, that the law REQUIRES abuse. There is no denying it, unless you deny that falsifying public records is abuse, which is nonsensical on its face."

You're whole post is actually a fairly pointless strawman argument to try and undermine the larger question. If you're so hung up on what a line on a current death certificate says...it would be exceedingly easy to change that form. Add a checkmark if they avail themselves of provisions of the new law. I'd even agree to that point.

It seems pretty clear though you're just grasping at whatever argument you hope will stick because it seems others offing themselves offends your sensibilities.

Posted by: Matty on October 23, 2008 10:04 AM
12. Hinton:

First, have you ever lied on a public document? I don't see what your question to me has to do with anything at all.

Second, no, you're wrong: when you take someone off life support to allow them to die, the medical cause of death clearly and unequivocally is the disease that kills them.

And if you feel that a legal requirement to lie about the medical cause of death is not good reason to oppose it, then we'll have to disagree.

If you want to put together a better bill then by all means, I'll consider it. But on life-and-death issues, a bad bill is worse than no bill, especially since you can kill yourself now without the government's help. Happens every day.


Matty:

You're whole post is actually a fairly pointless strawman argument

You do not know what a "straw man" argument is, because no, I provided no such thing. A straw man is when you attack an argument not being made by the other side. But this IS in the bill, so therefore, it cannot be a straw man.

If you're so hung up on what a line on a current death certificate says...it would be exceedingly easy to change that form.

I cannot change I-1000. I am not voting on the "principle" of "death with dignity," I am voting on I-1000 itself.

Indeed, far from me providing a straw man or any other fallacy, you're the one with the fallacious argument: you're telling me to ignore the text of I-1000 and vote on the principle instead. But I am incapable of doing that, because the principle is not on the ballot, I-1000 is.


It seems pretty clear though you're just grasping at whatever argument you hope will stick because it seems others offing themselves offends your sensibilities.

You're completely making things up. Do not pretend to know what I am thinking, unless I actually say it. I am against I-1000 not because "death with dignity" offends me: there is no truth whatsoever in your claim. I am against it because the government regulations of the procedure are dangerous, and one of them -- that I pointed out -- is a literal abuse of the public records system.

If you want to off yourself, I won't stop you. People do it every day, with the help of doctors, and not just in removing life support, but in actively killing themselves. One of the most common ways is with a self-administered overdose of morphine. I do not complain that this happens. I complain about this particular example of government involvement represented in I-1000.

Posted by: pudge on October 23, 2008 10:17 AM
13. @10: But the very idea that we require medical personnel to follow the dictates of a DNR when someone is unconscious but we would not allow them to follow the dictates of a conscious individual is beyond the bizarre... and I support this and hope that it passes.

Today is a day when hell does freeze over! I agree wholeheartedly with everything Hinton has said. Even though we don't respect each other at all, he did make a good argument.

Your logic, pudge, is really lacking with this one. What you're essentially saying is that by keeping this illegal and informal, the rights of a patient are being respected, but if there are safeguards imposed to ensure that this is what the patient wants and the doctors involved will not be prosecuted, that is somehow taking away from the rights of patients?

And on top of it, the death certificate question *is* a straw man. In fact, you're essentially saying that people that lie about it when it is done informally are right when they falsify those records!

Posted by: demo kid on October 23, 2008 10:20 AM
14.
When I think of assisted suicide, you know what I think of...I think of all these little 8 and 10 year old boys and girls with cancer who would do anything just to be alive for a few months more. I think of them walking around with shaved heads, hoping day after day, in incredible pain, for something to keep them going.

Then I think of these "adults" who can't take it any more and want the easy way out.

Posted by: John Bailo on October 23, 2008 10:24 AM
15. demo kid:

Your logic, pudge, is really lacking with this one.

False.

What you're essentially saying is that by keeping this illegal and informal, the rights of a patient are being respected

False. I never said that.

but if there are safeguards imposed to ensure that this is what the patient wants ...

False. You're committing the question-begging fallacy by saying that these ARE safeguards, and I already proved that in one significant sense they are not: the falsification of the death certificate.

And on top of it, the death certificate question *is* a straw man.

False.

In fact, you're essentially saying that people that lie about it when it is done informally are right when they falsify those records!

False. I am saying there's a big difference between individuals choosing to falsify a death certificate, and government requiring the same. I am not justifying either one, but the latter is far more objectionable to me than the former, as it should be to everyone.

Further, you also do not know what a "straw man" is, since even if you were right that I was saying what you said, it still would not be a straw man fallacy. How hard is this, people? A straw man fallacy is when I attack an argument or point that is not being made on the other side. But this is a part of their bill; therefore, not a straw man.

Posted by: pudge on October 23, 2008 10:31 AM
16. If one wants to kill himself, there is no law in place that will punish him for doing so.

I-1000, however, makes it legal for doctors (whose job it is to preserve life and relieve pain) to kill. In addition to requiring the falsification of records, a doctor assisting an ill and vulnerable person--like say, someone in a nursing home--to kill himself, will have no requirement that the patient's loved ones be notified.

Thankfully, many doctors, and even the Washington State Medical Association oppose this initiative. However, even though they oppose it, if it passes, this may end up being considered "just part of their job".

Posted by: Michelle on October 23, 2008 10:53 AM
17. Ask Barbara Wagner what she thinks of I-1000. She is fighting cancer and lives in a low income apartment. Her oncologist recommended a chemotherapy drug, but the Oregon Health Plan refused to cover it. But they DID say they would pay for doctor-assisted suicide. You would think the Democratic party would fight to protect the poor, but alas the leadership of the party in this state is out of step with the poor and elderly.

Posted by: Moondoggie on October 23, 2008 10:59 AM
18. Am I missing the falsehood here?

The current law says the doctor signs a death certificate listing the cause of death.

The new law, if passed, says the doctor signs the death certificate listing the underlying cause of death.

Where's the lie?

When a patient terminally ill with cancer contracts pneumonia in the hospital and dies, what did they die of? What gets listed on the death certificate?

If they die on the operating table, does their death certificate say they died of the condition being addressed or the fact that humans cut them open and they died from the wound?

There's lots to talk about regarding this initiative, obviously from the comments so far - this particular point isn't one of them.

Posted by: BA on October 23, 2008 11:31 AM
19. pudge - you are clearly a statist who wants to control people's lives. Admit it.

Posted by: Crusader on October 23, 2008 11:42 AM
20. BA:

Am I missing the falsehood here?

Obviously.

The new law, if passed, says the doctor signs the death certificate listing the underlying cause of death.

No, it does not. It says it shall list the underlying disease AS the cause of death, even though it is NOT the cause of death.

When a patient terminally ill with cancer contracts pneumonia in the hospital and dies, what did they die of? What gets listed on the death certificate?

Simply answering "pneumonia" is insufficient: in such cases, the state -- properly -- asks doctors to give more information on the certificate of death.

If they die on the operating table, does their death certificate say they died of the condition being addressed or the fact that humans cut them open and they died from the wound?

They are required to put both. By bringing all this up you're actually making my case for me, since if similar procedure were followed in I-1000 for cases of death in surgery or pneumonia, then the top cause of death would be listed as the procedure used under I-1000, with the underlying disease listed second.

There's lots to talk about regarding this initiative ... this particular point isn't one of them.

Shrug. You're ignorant.

Posted by: pudge on October 23, 2008 11:51 AM
21. You better Believe there will be Plenty of abuses from I-1000. Relatives even Caregivers can take advantage of your perhaps, temporally helpless state. The Relatives who greedily want your money and possessions and or just don't like you or the Caregiver who may not like you or is just a serial Killer. It is not unheard of for serial Killers to get into the medical profession aka Doctors, Nurses and Caregivers. This will open the door to risk of Wholesale Murder of anybody who gets sick.....Young or Old.

GOD gives you a deck of Cards. You are to play it out to the last Card. That means you don't Quit and throw the last cards away. To Quit before all the Cards are played....That's Suicide! However, if one is on Life Support and there is no hope for recovery then, the plug should be allowed to be pulled and the individual be allowed to die Naturally. But, the individual should Never be Killed before his Time of Leaving. Again, that is Killing and with the request of the Individual to do so......is Suicide and a DAMNATION!

Posted by: Daniel on October 23, 2008 11:51 AM
22. This piece of legislation hits particularly close to home to me through very recent experience. Medical professionals are legally and ethically bound to preserve life unless instructed otherwise. There are currently vehicles to instruct otherwise, like a POLST, for example. There are other more specific arrangements that can be arranged with legal and health professionals that specialize in end of life issues.

There really should be an indemnity for family members and medical professionals following the instructions of an individual should that individual want to accelerate their termination. However suicide is still suicide and calling it by any other name is a total fantasy.

Whether or not a family can be legally or financially injured by a health decision made by another family member should be handled in a separate area of state legislation and is a valid but separate issue. All sorts of arrangements with other parties are at risk when the cause of death is shown as self inflicted.

That said, I'd like someone who thinks this is a good idea to explain in detail how a medical professional should legally dispense life terminating treatment to a patient while ensuring that this treatment is actually the patient's request. Deep depression and suicidal thoughts go hand in hand with terminal illness. No matter how good the rapport is between a patient and a physician, leaving differentiating between a sound request and one made while in agony to a professional relationship isn't where a legal definition should sit. It's just not fair to either party.

Death with dignity is a great slogan and a high standard to reach, but the act of suicide has far reaching implications that need to be addressed by actions far more comprehensive than this bumper sticker of a ballot initiative. I hope they can come back with something better next time because it really does need to be addressed.

Posted by: Acid Brain on October 23, 2008 11:54 AM
23. As a medic. Does anyone know what would happen to me if I lied on a medical form!

Pudge is right. Change the wording, don't lie just to make you feel better about the death of a person.

Posted by: Army Medic/Vet on October 23, 2008 12:02 PM
24. @13,

Add another ice cube to hell freezing over. I agree with Demon Kid and Hinton. I hope it passes.

Posted by: pbj on October 23, 2008 12:08 PM
25. Bottom line, folks. Assisted Suicide isn't suicide. It's homicide. When you get the help of someone else to commit suicide, you're asking them to help kill YOU.

We have a long tradition in this country in protecting people's right to life. We only kill those in war, in self-defense when necessary, and after long consideration in punishment of a crime. In all of these cases we don't make the decision to kill lightly and only do it because not killing is worse than killing.

There is a world of difference between pulling the plug and actively killing. It's a line I hope we as a society never, ever cross, because it would mean we have reduced the value of life and the meaning of homicide. We have elevated comfort over life, and have made the decision that it is more important to be happy and comfortable than alive.

Posted by: Jonathan Gardner on October 23, 2008 12:15 PM
26. pbj: so you don't care that it requires falsifying an important public record?

Posted by: pudge on October 23, 2008 12:17 PM
27. I tend to follow great (potential) leaders in this and similar regard. Our esteemed Ms Burner claiming an Econimic degree from Harvard when in fact her degree is in Computer Science shows that exact data is not really necessary in certain situations. If you die you die if you have a degree you have a degree. So, what's the issue?
Pudge, that WAS a revelation to me and I thank you for sharing that data...it matters in my vote.
:)

Posted by: Duffman on October 23, 2008 12:25 PM
28. My mom had advanced stages of cancer. Yet, she didn't die of cancer. It was organ failure or something. This was very deceptive IMO.

I'm with pudge on this one.

Posted by: swatter on October 23, 2008 12:26 PM
29. Pudge, great lucid argument - name calling is always your strongest comeback.

Jonathan, I'm not seeing a world of difference between "pulling the plug" and "actively killing".

If the "plug" be it machine or drug is required to keep you alive and it is terminated - you're just as dead as if the drugs are changed to ones that are designed to kill you. Either way someone is making a decision and doing something actively.

The difference might be only that the person physically doing the final act might be the patient rather than the caregiver.

Posted by: BA on October 23, 2008 12:28 PM
30. I-1000 is nothing more than people's desire for the government to condone or approve of their decision to end their own life. By seeking the government's approval for such a thing you are ceding your last bit of control over your life to the government. Who owns you? Why do you need the approval of government to make this decision? This does nothing, but attempt to assuage the guilt one faces in these situations, by saying the government approves. If you want to kill yourself, do it, but don't seek the approval of government for your actions.

Posted by: Stitch Jones on October 23, 2008 12:36 PM
31. If your personal decision in this matter is influenced by approval, or disapproval, of the government - then you've long ago ceded control of your life to the government.

Posted by: BA on October 23, 2008 12:40 PM
32. BA: name calling is always your strongest comeback.

Shrug. You misrepresented the bill, you ignored my argument while calling it irrelevant, and you continue to ignore my argument. Complaining about name-calling while avoiding the actual issue is worse than name-calling.


Jonathan, I'm not seeing a world of difference between "pulling the plug" and "actively killing".

The practice of medicine does. Death certificates do. I've already proven this, and we have a medical care professional in AMV who agreed with me.

Posted by: pudge on October 23, 2008 12:42 PM
33. I am truly conflicted on how to vote on this initiative. I do believe that if you are of sound mind and want help with suicide that you should be able to get it. But AB makes good points @22 regarding whether we can actually rely on these requests. I am more concerned with that and about potential abuses than I am with the cause of death on the certificate.

Posted by: Palouse on October 23, 2008 12:43 PM
34. Might I remind everyone of the lady in FL when her husband who wanted to (pull the plug)on her. Now she didn't depend on life support (respirator) just a feeling tube which in not a life support device.

She was killed by starving to death.

So I ask all to walk a fineline when it comes to dying and the gov.

Posted by: Army Medic/Vet on October 23, 2008 01:23 PM
35. This is where I need clarification - a respirator is a life support device because in its absence death follows. A feeding tube is not a life support device, but in its absence death again follows.

I see a semantics difference but no practical difference.

I suspect that the "system" takes care of this issue generally now in a humane and thoughtful way. AM/V - comment?

Posted by: BA on October 23, 2008 01:43 PM
36. Palouse, I am shocked at your opinion. It is going to require some introspection on my part.

Posted by: swatter on October 23, 2008 02:02 PM
37. THis part of that law is incredibly bogus. I can't believe they are required to lie on birth certificates. And they can be 6 months away from dying? Heck, I know of a guy who was told he had two months and he really WAS dying. He was healed and lives very productively today. What if he'd been given this option the day they pronounced him two months from death? He may just not be here today and his family would not get to enjoy his now healthy presence! NO to this crappy law!

Posted by: Michele on October 23, 2008 02:15 PM
38. @14: Then I think of these "adults" who can't take it any more and want the easy way out.

I hope that we never meet in person, you lowlife... I'm pretty keen on making you eat your teeth at this point. Go back to your mom's basement and photoshop yourself a girlfriend.

Better yet, I hope that you develop late-stage cancer or ALS, so that we can see how you deal with it.

@15: Your logic, pudge, is really lacking with this one.

False.

You're using an argument about a legal interpretation to try to discount the entire initiative. Pointless and illogical.

What you're essentially saying is that by keeping this illegal and informal, the rights of a patient are being respected

False. I never said that.

You state that "I am generally against I-1000 because I don't like the government getting involved in these sorts of decisions, which is what I-1000 represents." Suicide is also illegal, including assisted suicide, under current law. Therefore, any assisted suicide done now is performed outside of the jurisdiction of the law, in a completely unsupervised way, and since you state that you don't want "the government getting involved", you favor this more informal process with no government oversight. In effect, you are stating that when this does come up, people should be allowed to break the law and potentially compromise someone's civil rights protected by that law, and they shouldn't be held accountable by the government because they should be able to "handle it" on their own.

False. You're committing the question-begging fallacy by saying that these ARE safeguards, and I already proved that in one significant sense they are not: the falsification of the death certificate.

You didn't prove anything of the sort. All this says is what should be written as the specific cause of death. And if you DON'T think that I-1000 represents "safeguards", I'm really fascinated as to whether you think the requirements are just merely suggestions or something.

And on top of it, the death certificate question *is* a straw man.

False.

Again, see above. You're protesting the initiative for a completely different reason. Trying to invoke this aspect of it is totally unrelated to your actual objections to it.

False. I am saying there's a big difference between individuals choosing to falsify a death certificate, and government requiring the same. I am not justifying either one, but the latter is far more objectionable to me than the former, as it should be to everyone.

"Falsifying a death certificate"? It's paperwork. The extensive paper trail required by I-1000 should be clue enough as to exactly what happened beyond one line on a form. In fact, I'm imagining that this system is to circumvent issues with strict life insurance requirements that might result from listing "suicide" on a death certificate, and nothing more.

Further, you also do not know what a "straw man" is, since even if you were right that I was saying what you said, it still would not be a straw man fallacy. How hard is this, people? A straw man fallacy is when I attack an argument or point that is not being made on the other side. But this is a part of their bill; therefore, not a straw man.

No pudge, I think that you need to refer again to your Logic for Dummies book. A "straw man" is when you set up an argument that you can easily win (the "straw man") to try to prove an unrelated point. In this case, linking a requirement about what to put on a death certificate has NOTHING to do with objections to the bill. It's a minor paperwork requirement and nothing more, and it has no relevance to the real issue.

@2: That said, I'd like someone who thinks this is a good idea to explain in detail how a medical professional should legally dispense life terminating treatment to a patient while ensuring that this treatment is actually the patient's request.

How do you do that normally? If someone were to get a POLST, as you state, how is that "actually the patient's request"? Heck, what about refusal of treatment for a terminal disease?

Posted by: demo kid on October 23, 2008 02:23 PM
39. On the bright side, this is a step to solving the problem with Social Security.

The Sandman Solution will fix it.

Get the oldsters out of the way. They're not contributing anyway.

(That's sarcasm, in case you missed it.)

Posted by: Dishman on October 23, 2008 02:31 PM
40. Clarification for you, BA:

Both can be classified as "life support", if you call food and water "life support" also.

A respirator is a life support device, because it does the breathing for the person. If one cannot breathe on one's own for a long period of time, one has lost what it takes to live. Removing the respirator would result in instant death, because without it, the person would have been dead already.

A feeding tube, on the other hand, provides nutrition to sustain life. We all need it to live, but when we are able, we voluntarily help ourselves. In the case of infants and small children, however, they rely on their mothers and fathers to provide them with it. Does not a mother or father have the moral obligation to provide food and water for their children?

My brother is on a feeding tube right now? He has been for months. He just had surgery. Still, he is living, breathing and speaking to family members. He went through this before (about 15 years ago), and then went on to live a very full life, as a chef and has traveled around the world with no handicaps. He even became an avid skier.

Removing his feeding tube then or now would have starved him to death. He wouldn't have died immediately, as he would have, had he been relying on a respirator. A death resulting of removing a feeding tube is not instant, but a slow, agonizing process of starving to death.

That's the difference.

Posted by: Michelle on October 23, 2008 02:42 PM
41. demo kid:

You're using an argument about a legal interpretation

False. Well, true only in the sense that EVERY argument about the effects of EVERY initiative is "about a legal interpretation."


Therefore, any assisted suicide done now is performed ... in a completely unsupervised way

False. Unsupervised by government, true, but I trust doctors more than I trust government. And I don't trust doctors much.


and since you state that you don't want "the government getting involved"

That was in the context of the involvement represented by I-1000.


you favor this more informal process with no government oversight

Between those two options -- status quo and I-1000 -- yes.


In effect, you are stating that when this does come up, people should be allowed to break the law

It's better than I-1000.


and potentially compromise someone's civil rights protected by that law

Someone's civil rights can be compromised under I-1000, too. In fact, I consider it a civil right to have true and accurate information on public documents ... which I-1000 violates on its face.


You didn't prove anything of the sort. All this says is what should be written as the specific cause of death.

Which in fact is NOT the specific cause of death, and is therefore a potential way around safeguards.


And if you DON'T think that I-1000 represents "safeguards"

I already proved it doesn't, in one big way, so ...


Again, see above.

You first. A straw man is an argument attacking something the other side isn't saying. I am not doing that.


Trying to invoke this aspect of it is totally unrelated to your actual objections to it.

Please do not lie about me. Thanks.


"Falsifying a death certificate"? It's paperwork.

It's lying on the public record.


In fact, I'm imagining that this system is to circumvent issues with strict life insurance requirements that might result from listing "suicide" on a death certificate, and nothing more.

Oh, so the ends justify the means?


No pudge, I think that you need to refer again to your Logic for Dummies book. A "straw man" is when you set up an argument that you can easily win (the "straw man") to try to prove an unrelated point.

False. The straw man MUST be a misrepresentation of the opposing side. That is what makes it a fallacy. Please read something so you will realize how foolish you're being. Attacking an unrelated point is a separate fallacy, the red herring fallacy.

You may think I am using the red herring fallacy here, but that would be dishonest: all you're saying is that you don't find my point to be important, but you have no logical reason to claim that there is something objectively wrong with believing otherwise. I do think this is an important point, and while you can disagree, there's no rational basis for saying I am wrong.


In this case, linking a requirement about what to put on a death certificate has NOTHING to do with objections to the bill.

Again you're lying about me. Please stop. This has a great deal to do with my objections to the bill. It is one of several, and this one matters to me a great deal. I demand honesty in our public records. Lies and misrepresentations are not acceptable to me, at all, and even worse is when it is required to lie.


It's a minor paperwork requirement and nothing more, and it has no relevance to the real issue.

As it is a part of I-1000, it absolutely is relevant to the real issue, which is, of course, I-1000 itself. If you wish to talk about "death with dignity" without regard to I-1000, fine, but that is not the issue here.

Posted by: pudge on October 23, 2008 02:46 PM
42. Jonathan, I'm not seeing a world of difference between "pulling the plug" and "actively killing".

As in "shutting off the respirator" vs. "holding a pillow over their face"?

Wow. You don't? Really? The former is passively enabling the inevitable, the latter actively hastening the End. World of difference.

Posted by: furious on October 23, 2008 02:50 PM
43. Mercy killings are done on a fairly regular basis, and I had the extreme displeasure of witnessing this with my own Grandmother many years ago. Unfortunately, the doctor needed to wait until she was in extruciating agony, even with the contant drip of morphine she received. By the end, even a slight bump of the bed would cause her to scream. Her death from pervasive bone cancer was inevitable, but the complete loss of her dignity was not. Just enough of an O.D. to stop her breathing was a blessing to her, my mother and the rest of our family.

I suppose some of the anti-initiative posters here think we should have pressed charges against the doctor for murder?

All this law does is allow the individual, when the person's medical providers agree that the end is at hand, to die at the time and place of their choosing, before the person's last shred of dignity is gone.

Posted by: Splinter on October 23, 2008 03:42 PM
44. Splinter:

I suppose some of the anti-initiative posters here think we should have pressed charges against the doctor for murder?

Perhaps, though I certainly don't. I am against I-1000, which does not imply I am against "death with dignity," or in favor of jailing those who administer it.

Posted by: pudge on October 23, 2008 03:52 PM
45. But it's telling that you don't say that you support death with dignity, only that your statement "does not imply" that you don't support it.

One other thing that's a little confusing in this post and I honestly don't know the answer. The text you provided in the post says, "The attending physician MAY sign the patient's death certificate...". So doesn't this mean that if a doctor objects to listing the underlying cause of death, he can simply refuse to sign the death certificate? The last part of the text, "...which SHALL list the underlying terminal disease as the cause of death." is more of a protection for the patient and family in my opinion. I can't imagine that in my own Grandmother's case, that if the doctor had written "Drug Overdose" on her certificate, that my family would have been very happy about that... nor would it have been true (in my opinion) given that she fought a very nasty battle with bone cancer for years... only to slip into fits of screaming during the final days. Any reasonable person that would witness this sort of scenario would understand that she was killed by cancer... only spared a few last hours of extreme agony by a little too much pain killer.

Posted by: Splinter on October 23, 2008 04:09 PM
46. But it's telling that you don't say that you support death with dignity, only that your statement "does not imply" that you don't support it.

Yes, but what do you think it tells you?

What it actually tells you is that I am not talking about "death with dignity," and am not going to engage in such a discussion, but that I am only talking about I-1000 itself, because that is the initiative before us.

I'd be happy to discuss "death with dignity" broadly on some other occasion, but this is not that occasion. I have other things going on, including work, campaigns, and I-1000.


So doesn't this mean that if a doctor objects to listing the underlying cause of death, he can simply refuse to sign the death certificate?

Perhaps, but in any event, the death certificate MUST state THE cause of death as the underlying disease.


I can't imagine that in my own Grandmother's case, that if the doctor had written "Drug Overdose" on her certificate, that my family would have been very happy about that...

No offense, but their happiness is unimportant to me in this context. Falsifying a public document is bad. Government mandating it is very bad.


nor would it have been true (in my opinion) given that she fought a very nasty battle with bone cancer for years

Medical science disagrees with your opinion. Now, if they want to write "a drug overdose to stop the pain of terminal bone cancer" (or something similar with proper medical terminology) then I have no problem with it. But that's not what I-1000 does.

Posted by: pudge on October 23, 2008 04:27 PM
47. Still a lot of semantics and I think false parsing of this issue.

'Michelle' says the difference between a respirator and a feeding tube is, in the end, one of time. The "slow agonizing" death by starvation versus the fast agonizing death by suffocation.

In my mind both require a decision to be made, and a physical act to occur with the same end result in mind.

Is it the potential for life to continue after the respirator is stopped that makes the morality of the decision different than administering drugs to stop a life?

'Furious' says that shutting off the machine is a passive way to let the inevitable happen, versus holding a pillow over someone's face to hasten their death - and this is a "world of difference".

I'll bet if I walked into a hospital and turned off someone's respirator I'd be charged just as quickly with murder as if I held a pillow over their face. Not a world of difference there.

Is the difference then that since we as humans created the technology to prolong life we have the right to turn off the machines with impunity, versus no right to use technology to shorten life - is that really it?

I think this is the difference; fairly cut and dried in that sense, but why do we seem so comfortable that turning off the machines really is OK?

Posted by: BA on October 23, 2008 05:26 PM
48. Splinter I wouldn't put it that black and white regarding a physician, or a family member for that matter. Particularly in the scenario you describe, and I'm sorry for you and your Grandmother. The hard thing to me is that the law we are looking at wants to apply the same standard to all terminal illness including cancer but not limited to it, and late stage cancer seems to be how most people imagine it in application. The end stages for some terminal illnesses are a little more predictable than others are and in practice there have to be standards reflecting the differing degrees of illness and suffering. I just don't see how that can be accomplished in the manner proposed in this initiative. No one should be forced to suffer needlessly just to meet a state mandated standard quality of life or incur the costs to maintain it. Likewise, surviving family and health professionals shouldn't have to suffer an unclear decision making process or its results.

The decision to terminate is the hardest thing I've ever been a part of. I just don't think the full measure of what is involved with it is best done at the ballot through a simplified universal solution loaded with more political and ideological rhetoric than practical field application and legal clarification.

If there was something in there requiring something analogous to a previously recognized health care directive I'd be more interested. As it stands, this initiative would excuse and it even encourages ad hoc action, which however well intentioned, is not a desirable end. I'm holding out for better law or at least the promise of it.

Posted by: Acid Brain on October 23, 2008 06:50 PM
49. I watched my mother die from lymphoma, at my home where I took care of her for the last 9 months of her life... I speak from experience.

The only one who should be able to make the decision to end their life is the person who's life is being ended. Period. Anything else is murder on the part of others.

And the cause of death - if a person decides to end their life - should be suicide. You can list an ailment they were suffering at the time of death, but that is NOT the cause.

I'm with Pudge on this one - I-1000 is a bad initiative. Decriminalize the act of suicide, but that's it.

Posted by: Shanghai Dan on October 23, 2008 07:11 PM
50. Dan@49, you are so not with pudge. I-1000 would do exactly as you want: let the sick person, and no one else, make the decision to end their life -- even if they need someone's help to actually carry out their wish.

Pudge, on the other hand, wants to make that decision for them.

Posted by: Bruce on October 23, 2008 08:29 PM
51. Bruce, on both hands, is a liar.

Posted by: pudge on October 23, 2008 08:32 PM
52. Bruce,

You're an idiot. I can read what Pudge wrote, and I agree with it:

I am generally against I-1000 because I don't like the government getting involved in these sorts of decisions, which is what I-1000 represents. - Pudge

The biggest issue for me is depression. I-1000 does not mandate you seek a mental evaluation first; only if the doctor feels you're just depressed in general. Having lived with a dying person for nearly a year (she passed away in my family room), I can tell you she was often depressed, but other times happy. Would she end her life because she was depressed, or because she was terminally ill?

Fundamentally, you want to end your life there's not much stopping you right now. I don't know of ANY terminally ill people who do not already have prescriptions for lethal drugs (if taken in high doses). My mom had bottles of morphine tablets around, given out freely as candy, to use as she felt she needed for the pain. If she wanted to end her life, there would be nothing I - nor any one else could do - to stop her from taking a lethal overdose.

So other than legalize suicide, and force doctors to change the way they report information, and allow an easier venue for those who are depressed to kill themselves, what does I-1000 do?

Pudge is right - the Government should simply butt out.

Posted by: Shanghai Dan on October 23, 2008 09:57 PM
53. BA,

First: Why the quotes around my name? I use my real name.

Second: The issue is not simply "time", though you do have a point. It is just a matter of "time" and we're all going to die. Want that inheritance early? Why not take away your mother's food and anyway for her to obtain it?

When someone is vulnerable and in the care of others, ie: the care of a hospital or of parents, they have the obligation of feeding them, but do not have the obligation of breathing for them. When a person can't eat, this does not at all indicate the person is dead.

Posted by: Michelle on October 23, 2008 10:13 PM
54. Michelle,

This is the logical conclusion of the party of Death. After all, when their presidential candidate supports letting newborn infants die, it's not a big leap at all to smothering grandma because she's an inconvenience...

Posted by: Shanghai Dan on October 24, 2008 12:31 AM
55. tough one; struggled w/ this many times yes & no; back to no;

been there with ending life decisions and caregiving; lots of emotions at this time of suffering; i like a person's directives in advance (ideal); it's like unplanned funeral arrangements--mostly made during high emot. times w/ everyone remembering conflicting wishes;

however, the more insidious chance of creeping eugenics and--more scary--lawyers, lawyers everywhere second guessing and 20/20 hindsighting scares me too--even when one has rights to do so;

i'll keep reading here for other opin's--good forum

Posted by: jimmie-howya-doin on October 24, 2008 06:10 AM
56. Michelle, I put the marks around your name because I was replying to two of you, and Furious has a name that might be confusing in a sentence so I think for clarity it made sense...plus you'll notice they were not quote marks, which I used later when I quoted a phrase...plus of course who's to know it is your real name until you say so.

Why is the obligation to assist in feeding different than assisting in breathing?

Posted by: BA on October 24, 2008 07:55 AM
57. The more I've been thinking about it, suicide is an act rather than a cause of death. It doesn't change my mind about what is wrong with this noble but flawed proposition, but an important distinction.

Posted by: Acid Brain on October 24, 2008 10:27 AM
58. My two cents for what it's worth. I am a physician.

I do not think prescribing lethal overdoses of medication is, or should be, part of the practice of medicine, any more than injecting massive overdoses of Potassium Chloride into the veins of condemned prisoners is. In fact, the latter is specifically forbidden by medical ethics, and physicians may have no involvement in judicial executions except for pronouncing death after the fact.

I have no particular objection to suicide by terminally ill adults. If the state wishes to facilitate this, they should arrange for a group of non-medical personnel to dispense these drugs, just as they have non-medical personnel start the IV and inject the lethal dose in executions.

Just because a chemical substance (drug) is involved doesn't make it a medical procedure, any more than dealing crack or putting arsenic in your mother-in-law's tea is.

Physicians must not kill people deliberately; we try to heal and comfort them. Killing those we cannot cure is not just a slippery slope, it is already over the cliff and into the chasm.

Posted by: Steve on October 24, 2008 01:14 PM
59. Why is the obligation to assist in feeding different than assisting in breathing?

Isn't it obvious?

Posted by: Michelle on October 24, 2008 03:13 PM
60. Shangai Dan wrote:

This is the logical conclusion of the party of Death. After all, when their presidential candidate supports letting newborn infants die, it's not a big leap at all to smothering grandma because she's an inconvenience...


True, Dan. Our party's nominee isn't far behind though. A person's a person no matter how small, or how they were conceived.

Posted by: Michelle on October 24, 2008 03:16 PM
61. In addition, the Republican state convention delegates passed a resolution opposing I-1000, among many other great resolutions stating our positions that we were told shouldn't be in the platform. We even passed a resolution stating that all of our passed resolutions shall be posted on the WSRP website along with our platform, but our party leaders have chosen to bury resolutions that were passed by the delegates.

Grassroots Republicans are overwhelmingly pro-life, but party leadership would rather not hold Republican officials accountable to these positions.

Posted by: Michelle on October 24, 2008 03:23 PM
62. BA:

Why is the obligation to assist in feeding different than assisting in breathing?

Apparently none, according to your Slavery Party Messiah, Obama. He's perfectly comfortable letting a newborn infant starve to death and die from neglect, all in the name of convenience.

How is I-1000 any different, other than making it convenient for those who don't want to help out their dying relatives? Just kill them and get them out of their hair?

Death - just a matter of convenience for the Slavery Party!

Posted by: Shanghai Dan on October 24, 2008 03:44 PM
63. Shanghai Dan - I've asked a question "why is the obligation to assist in feeding different than assisting in breathing?"

I've gotten two answers. From Michelle "isn't it obvious" and from you "Apparently none, according to your Slavery Party Messiah..."

I presume neither of you really have an answer.

Both are required to live; turn off the respirator and someone's dead in minutes, turn off the liquids and death is in a couple of days, turn off the nutrients and death follows in weeks.

Michelle, I presume your answer really means you don't know.

Shanghai Dan, I presume you're just are not a deep thinker.

Posted by: BA on October 24, 2008 05:19 PM
64. BA:

No one cares about your presumptions, pretending to be ignorant of plain truth, even after it's been explained to you.

Not trying to argue with you here, just trying to help.

Posted by: pudge on October 24, 2008 05:28 PM
65. Michelle, I presume your answer really means you don't know.

Press-U-Me?

Breathing comes automatically, whether one is a dependent child, an adult, or even a dependent adult, if he is alive.

A living dependent child and a living dependent adult need to be fed.

Posted by: Michelle on October 24, 2008 09:12 PM
66. I thought we were talking about hastening death?

Posted by: BA on October 24, 2008 09:31 PM
67. I think we were, until you took us on this side track of the difference between pulling a feeding tube and pulling a respirator.

Posted by: Michelle on October 24, 2008 10:53 PM
68. BA,

It's pretty simple - if you lose the ability yo breathe, it's usually an extreme trauma. Complete paralysis, loss of brain function, and the like.

Losing the ability to eat can be also from extreme trauma, or from a heavily impacted set of molars, or broken jaw, or other typically-non-lethal trauma.

If you can't figure out those kinds of differences, there really IS no help from you.

Posted by: Shanghai Dan on October 25, 2008 05:41 AM
69. Clearly we're just talking past each other.

What I'm interested in is why we seem to make a distinction between these various methods for keeping someone alive, and why that distinction is important?

I know the physical distinctions, I'm curious why we distinguish them morally?

What is the difference between a patient reaching over and turning off their life support versus ingesting some pills that will kill them? Or is that the same?

What is the difference between one of us deciding for a patient to turn off their life support, versus supplying them with drugs they can take to end their life? Or is that the same?

We do the former now and it is acceptable.

We're voting on the latter and there's strong disagreement that it is acceptable.

Posted by: BA on October 25, 2008 09:20 AM
70. So, Pudge, I assume that when 9/11 happened, the people who were trapped on the 95th floor of the World Trade Center and decided to jump to their deaths should all be listed as having committed suicide on their death certificates, correct?

Posted by: thehim on October 25, 2008 10:06 AM
71. thehim:

Where did you see that I wrote that "suicide" should be listed on a death certificate?

Try again.

Posted by: pudge on October 25, 2008 12:43 PM
72. Where did you see that I wrote that "suicide" should be listed on a death certificate?

You can't possibly be this stupid. No way in fucking hell are you dumb enough to try to imply that this isn't what you meant with this post. No fucking way. Please, please, please try to carry this conversation out further. I want to see what happens to someone when they lose all self-respect.

Posted by: thehim on October 28, 2008 10:28 PM
73. thehim:

No way in fucking hell are you dumb enough to try to imply that this isn't what you meant with this post.

Um.

It isn't. You're the idiot here, who thinks "suicide" is a medical cause of death.

The death certificate should say "death by lethal injection of morphine," or somesuch, not "suicide."

Posted by: pudge on October 28, 2008 11:25 PM
74. Actually, your analogy to the WTC towers is interesting here: by I-1000 standards, the death certificate should read that the death was caused by being burned to death, instead of the sudden impact with the ground.

They jumped in order to avoid being burned to death, so that is the "underlying" potential cause of death being avoided by the jump, and therefore should be the cause of death on the death certificate, according to the logic behind I-1000.

Do you really think "burned to death" should have been on the jumper's death certificates?

Posted by: pudge on October 28, 2008 11:30 PM
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