tag:blogger.com,1999:blog-9216787076261944467.post1094020382410989206..comments2024-03-28T13:26:59.030-04:00Comments on Euthanasia Prevention Coalition: Assisted suicide and the autonomy myth. Do patients really have rational autonomy?Alex Schadenberghttp://www.blogger.com/profile/07649977828342637842noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-9216787076261944467.post-60789317062405611122021-10-31T10:49:58.016-04:002021-10-31T10:49:58.016-04:00The depression that fuels the desire ti die is wit...The depression that fuels the desire ti die is without a doubt complex with a plethora of reasons. We often forget that tbose who commit suicide almost always have a rationale that is logical to the person. But that does not mean the decision is viable; it almost never is. <br />The act of promoting or even witnessing the death of another human being is also affectual, even in justifiable circumstances. This is PTSD. We have seen the effects among combat soldiers, but also recently in the pandemic with doctors and nurses who have not been able to weather the adverse number of deaths. Being able to advance death is not the solution as it will accelerate the onset. Only the cold hearted can not be affected, and then it becomes a lack of discriminatory value on life, and that leads to those who kill pathologically. Just because a doctor may have a degree and a gang member/ hitman does not, the brain physiology / rational complacency and reasoning from frequency are one and the same. Legal does not change human nature.<br /><br />Dcn William Gallerizzo, MBe<br />Unknownhttps://www.blogger.com/profile/15179727967413723314noreply@blogger.comtag:blogger.com,1999:blog-9216787076261944467.post-14653760353450183932021-10-30T15:37:08.140-04:002021-10-30T15:37:08.140-04:00My summary of the article:
This is one of the mor...My summary of the article:<br /><br />This is one of the more important papers to recently address a key flaw in arguments for physician assisted suicide and Euthanasia. One of the chief arguments in favor of permitting these procedures is based on the notion of autonomy. <br /><br />Pies and Geppert deftly challenge the idea that there is true autonomy for patients seeking Physician administered death. They note that it is more about “Physician Autonomy“ than the patient’s, as it is the physician who ultimately decides to provide or deny the procedure, in the end trumping the patient’s autonomy. Indeed, the patient cedes their autonomy to the physician, making this “heteronomy,” not autonomy.<br /><br /> They also explore other cultural models of “autonomy” besides the western mainstream one, and observe that autonomy seems to have crowded out other vitally important values in medical ethics in this context. <br /><br />They also point to the way assumptions about the patient’s autonomy may be quite flawed and require a far deeper investigation than a brief capacity assessment (even that is a specialized skill which most physicians, even non-forensic psychiatrists, do not possess). True autonomy in this context —for which they use the term “authentic volunteerism” — means freedom from the hopelessness, despair, alienation, and cognitive distortions that serious illness can produce. These “internal coercions” they explain, add to “external coercions” e.g. from a family that may stand to gain (practically or emotionally) by a patient’s death, poverty, etc. <br /><br />Also as seasoned psychiatrists, the authors observe that “ a request for assisted suicide may mask deeper, underlying wishes or fantasies—eg, the request may be a covert plea for the physician to be more empathic about the patient’s situation, or amount to a test of whether the physician still values the patient’s life as death approaches…. Yet, even if patients who are terminally ill do not meet full DSM-5 criteria for a major depressive disorder, they may nevertheless feel hopeless, demoralized, or despairing.Or, patients may be experiencing anticipatory grief over impending death; ambivalence regarding assisted suicide; or the fear that their loved ones, and even their physicians, will abandon them. Patients may soon come to view PAS, irrationally, as the only way out of loss, conflict, and isolation. These subtle emotional states may cloud judgment and undermine rational autonomy, yet will not be picked up by a brief, one-time, cognitively based assessment of decisional capacity”<br /><br />Significantly, lethal prescriptions for assisted suicide May sit around unused for weeks, months, even a couple of years. Meanwhile the patient’s capacity and autonomy may have deteriorated in that time. However, no jurisdiction requires that it be reassessed prior to such delayed use. <br /><br />Current statues, procedures, clinical training and time constraints all lead to failure to provide the kinds of guidelines, investigations, witnessing and evaluation that would ensure that true autonomy or “authentic volunteerism” is present. This article shows how the notion of “autonomy” deployed in support of assisted suicide and euthanasia —is a vacuous shibboleth. <br /> <br /><br />Mark S. Komrad M.D., DFAPA<br />Faculty of Psychiatry, Johns Hopkins, Tulane, and University of Maryland Mark Komrad MDhttps://www.blogger.com/profile/09102922499192203579noreply@blogger.comtag:blogger.com,1999:blog-9216787076261944467.post-43682972450135332832021-10-29T17:05:11.650-04:002021-10-29T17:05:11.650-04:00So true!
Ron PanzerSo true!<br /><br />Ron PanzerRon Panzernoreply@blogger.comtag:blogger.com,1999:blog-9216787076261944467.post-39546688542760933952021-10-29T16:44:04.334-04:002021-10-29T16:44:04.334-04:00Moreover, in Canada vulnerable sick and suffering ...Moreover, in Canada vulnerable sick and suffering people are manipulated by the government into accepting PAS/MAID, as in doing so they are benefiting the common good of society - meaning they will no longer be a financial burden to the government.<br /><br />Sadly, in my experience some churches don’t care about this either. They declined to show the last video I made available to them, and instead returned it to me. On the other hand, Christians may not minister to vulnerable people under the law forbidding “proselytizing “<br /><br />Tershiahttps://www.blogger.com/profile/17855600848602336920noreply@blogger.comtag:blogger.com,1999:blog-9216787076261944467.post-67329113941452107602021-10-28T12:25:46.889-04:002021-10-28T12:25:46.889-04:00Many thanks for the kind call-out to our article, ...Many thanks for the kind call-out to our article, Alex...much appreciated, and I hope it does some good!<br /><br />Best regards,<br />Ron Pies MDRonald W. Pies MDnoreply@blogger.com