'Condemned to a life of torture'

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'Condemned to a life of torture'

Postby retrofuturist » Fri Aug 17, 2012 6:23 am

Greetings,

I realise the official position of Theravada Buddhism is that euthanasia is never OK, but the following makes me sad...

Condemned to a life of torture': UK denies right-to-die legal challenge
http://www.theage.com.au/world/condemne ... 24bya.html

I wonder whether those who determined this official stance had considered the likes of folks like Tony Nicklinson who would, back then in the days of the anicents, probably already have died well before their situation and way of life became so dire.

As the poll on the aforementioned link presently stands, 95% of respondents feel he should be able to determine his own fate. When you take out the fraction of the 5% who said "No" automatically for dogmatic religious grounds (e.g. "sactity of life", "an affront to God"), those who, after giving forth due consideration would condemn him to continuing this hellish experience are very few and far between.

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Re: 'Condemned to a life of torture'

Postby reflection » Fri Aug 17, 2012 6:40 am

Buddhism isn't a religion that tells you what to do, so I think there is no "official Therevadan position". So I think we should use our own understanding in cases like this. In general I think euthanesia doesn't always have to be against the dhamma.

Also, while this case is much too far away from me to say anything specific about it, I think Buddhism doesn't have anything to say about what non-Buddhists should or shouldn't do anyway. Their choices should just be left to themselves. And so I think the law should allow it. If so, people with certain religious beliefs can practice their beliefs. Others who don't share it, can do what they think should be done.
Last edited by reflection on Fri Aug 17, 2012 7:28 am, edited 4 times in total.
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Re: 'Condemned to a life of torture'

Postby cooran » Fri Aug 17, 2012 7:02 am

Hello Retro,

Not discusing this case in particular, but speaking in general - I don't think Theravada is opposed to some types of 'passive euthanasia'.

· non-voluntary euthanasia refers to the termination of life without the consent or opposition of
the person killed;
· voluntary euthanasia refers to the termination of life at the request of the person killed;
· active euthanasia refers to a positive contribution to the acceleration of death;
· passive euthanasia refers to the omission of steps which might otherwise sustain life.


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Re: 'Condemned to a life of torture'

Postby Bhikkhu Pesala » Fri Aug 17, 2012 7:10 am

Who knows what the future holds for him?

If he could commit suicide he might fall straight into hell. If he remains conscious and able to read or at least listen, then he has a precious opportunity to understand the Dhamma.

There are also precedents for people recovering from "locked-in syndrome."

Just a few months later, however, Mr Miles left the medics 'utterly bewildered' by taking his first faltering steps.

Kerry Pink was paralysed and unable to speak for 18 months, but she was able to hear what was going on around her.
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Re: 'Condemned to a life of torture'

Postby Alobha » Fri Aug 17, 2012 9:24 am

I know of a case where a family father got a heart attack at night, his wife and daughter tried to keep him alive for more than half an hour until the ambulance arrived. He survived but eyes closed, seemingly unconscious and very severe braindamage. The only reactions of his body are moving when in pain. Euthanasia is not allowed here and now the family is facing the situation, where he will be moved to a coma-facility costing 2000€+ per month, basically making the family bankrupt. Everybody involved knows that he would never give his permission to living like this, nor to put such an incredible emotional and financial burden on his beloved family. Now he can't interact with people but only feel pain.

edit: Yes, a case in Germany @Annapurna. My best friend knows the whole family and knew the father personally, too. Nursing homes for coma patients are not paid for by health insurance in all cases as it seems and relatives are expected to pay, even more so since the family owns a house. It's not yet totally clear what they will do and how it will end financially. Maybe they will find a possibility to not pay 1000€+ a month for nursing.
Last edited by Alobha on Fri Aug 17, 2012 10:33 am, edited 1 time in total.
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Re: 'Condemned to a life of torture'

Postby manas » Fri Aug 17, 2012 9:36 am

Bhikkhu Pesala wrote:Who knows what the future holds for him?

If he could commit suicide he might fall straight into hell. If he remains conscious and able to read or at least listen, then he has a precious opportunity to understand the Dhamma.

There are also precedents for people recovering from "locked-in syndrome."

Just a few months later, however, Mr Miles left the medics 'utterly bewildered' by taking his first faltering steps.

Kerry Pink was paralysed and unable to speak for 18 months, but she was able to hear what was going on around her.


Greetings Bhante,

I'm not sure if you were implying that he might fall straight into hell as a possible result of committing suicide per se. But to clarify that issue, isn't it intention that is the most important factor in kamma? In an ordinary, run-of-the-mill suicide, the state of mind of the person could be any number of things, such as hatred for oneself, or for others. But as I understand it, this man does not hate himself, or anyone else; he just wishes to avoid pain - a state of mind that many of us can relate to. I can envisage his parting state of mind as one of gratitude towards his doctor, and of love for his family etc as he says farewell with them at his side, rather than a mind of anger or hatred. I don't see why he should go straight to hell, with any more likelihood than an ordinary person might, after having lived an ordinary life of seeking pleasure, and trying to avoid pain. Because most people do just that their entire lives anyway.

respectfully,
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Re: 'Condemned to a life of torture'

Postby Annapurna » Fri Aug 17, 2012 9:46 am

Alobha wrote:I know of a case where a family father got a heart attack at night, his wife and daughter tried to keep him alive for more than half an hour until the ambulance arrived. He survived but eyes closed, seemingly unconscious and very severe braindamage. The only reactions of his body are moving when in pain. Euthanasia is not allowed here and now the family is facing the situation, where he will be moved to a coma-facility costing 2000€+ per month, basically making the family bankrupt. Everybody involved knows that he would never give his permission to living like this, nor to put such an incredible emotional and financial burden on his beloved family. Now he can't interact with people but only feel pain.


A case in Germany? With all the social security in such cases, with health insurance paying?

Are you sure they would go bancrupt...?

I don't think our system allows that. I'm pretty sure they can keep an amount to live, and the rest is covered by the institutions...

Everybody involved knows that he would never give his permission to living like this, nor to put such an incredible emotional and financial burden on his beloved family. Now he can't interact with people but only feel pain.


That's why a "patient's declaration" is recommended, where people can state black on white which kind of life sustaining or prolonging methods they don't want to receive...
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Re: 'Condemned to a life of torture'

Postby Annapurna » Fri Aug 17, 2012 10:17 am

Our doctors are in a dilemma:

They have to do the oath of Hippokrates "Nil nocere", never harm.

They have the legal obligation to do all they can to save lives, even if that means that the patient will remain badly handicapped thereafter.

They can get sued if they do not fight death will all that is at hand.
And so they do, -because they have to. Knowing the person will have large handicaps...

They have to bring patients back to life, who would not have survived still 50 or 30 years ago.

There is a lot that needs to be done here.

Like, if he may not die, he should be taken out and someone else be his legs and arms and go to a lake with him and watch ducks and swans and enjoy the sun and make his suffering less. Paid by the state who rules he must live.

He should be given alternative treatments too, if he has to live, like, acupuncture, TCM, homeopathy, whatever it is.
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Re: 'Condemned to a life of torture'

Postby Cittasanto » Fri Aug 17, 2012 7:48 pm

Annapurna wrote:Our doctors are in a dilemma:

They have to do the oath of Hippokrates "Nil nocere", never harm.


That isn't in the oath, it is derived from the oath and found in a text from the 1800's but the exact phrase does not mean that
http://en.wikipedia.org/wiki/Primum_non_nocere

the oath was modernised in the 1960's and here are the two versions
http://www.pbs.org/wgbh/nova/body/hippo ... today.html [edited to the link used by the BMA]

The Oath refers to not deliberately causing them to get worse and to always have an aim to promote health or keep stable,although they can prescribe medicine which will quicken death if it is for the benefit of the patient! i.e. the patient is approaching death regardless of what they can do and the more important care for them is pain relief.
I am speaking for here, not in a global scene though.
Last edited by Cittasanto on Fri Aug 17, 2012 11:04 pm, edited 1 time in total.
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Re: 'Condemned to a life of torture'

Postby Annapurna » Fri Aug 17, 2012 9:10 pm

Cittasanto,

not to get all TOO nitpicking, but the Hippocratic Oath includes the promise "to abstain from doing harm" (Greek: ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν) but does not include the precise phrase.

But to "abstain from doing harm" and "nil nocere" is absolutely the same in meaning, if you know Latin.

But perhaps it was taught differently in the medical university you went to.
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Re: 'Condemned to a life of torture'

Postby Cittasanto » Fri Aug 17, 2012 10:40 pm

Hi Annapurna,
I am sorry I have simmply looked at the ethics of the Parajika rule and this very situation described in the OP from multiple angles.
As one medical ethicist put it
Dr Daniel Sokol, Director of the Applied Clinical Ethics (ACE) programme at Imperial College, London. wrote:The Oath continues: "And I will use treatments for the benefit of the ill in accordance with my ability and my judgement, but from what is to their harm and injustice I will keep them."

In other words, doctors should act in the best interests of their patients, and when unjust circumstances arise - for instance, a certain life-prolonging drug may not be available on the NHS - they should strive to correct the injustice harming their patients.

Being informed about ethics in medicine does not necessarily mean one has to undergo medical training at university, however the scope of interest (be it ethics or medicine itself) is delved into as the need to understand and find workable solutions are pressent.

Regarding the precept as my understanding has it, it does not dictate that one should force life upon someone. Deliberately killing them is (obviously) a breach, although allowing them to pass-on in accord with nature - when there is nothing else to be done for their benefit - is not necessarily a breach.

If one has a direct say in the life and death decision the best possible answer to stay in-line with the precepts is possibly "do what is best for the patient".
If you know that that may mean treatment is withheld due to the detrimental effects through a sufficiently reduced quality of life and life would be unbearable I do not believe it is a breach of any precept - medical or otherwise - to allow the person to die with dignity (passive euthanasia).
This offering maybe right, or wrong, but it is one, the other, both, or neither!
With Metta
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Blog, - Some Suttas Translated, Ajahn Chah.
"Others will misconstrue reality due to their personal perspectives, doggedly holding onto and not easily discarding them; We shall not misconstrue reality due to our own personal perspectives, nor doggedly holding onto them, but will discard them easily. This effacement shall be done."
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Re: 'Condemned to a life of torture'

Postby manas » Sat Aug 18, 2012 6:34 am

Deliberately killing them is (obviously) a breach, although allowing them to pass-on in accord with nature - when there is nothing else to be done for their benefit - is not necessarily a breach.
I wonder how the law stands in relation to a fully conscious and mentally fit person with a terminal or otherwise unbearable and incurable illness simply refusing food, and only accepting water, along with medication to manage the pain of starvation. That would be one way to legally 'exit' one's life, without having to drag one's doctor or loved ones into it, surely?
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Re: 'Condemned to a life of torture'

Postby Mr Man » Sat Aug 18, 2012 9:53 am

"Now I would like to talk about the way that the sick and diseased should prepare themselves for death. When one knows that death is inevitable, such as when suffering from a terminal disease like tuberculosis, one should make the very best of it with mindfulness and self-awareness, without cowardice or fear.

I'd like to relate to you an account I once came across of the way that people in the time of the Buddha prepared for death. For those who kept the Precepts of Virtuous Conduct fasting was not at all difficult because they were used to abstaining from an evening meal on Uposatha days. When their illness reached the point that they felt that they had no more than ten days left to live they would stop eating. Not like us. These days, if someone is close to death we go out and look for the most expensive and delicious foods, so that some people even die prematurely from the food. Their efforts to avoid food were for the purpose of having a mind completely undisturbed. When the body starts to run down it loses its ability to digest food and so anything consumed turns to poison, making the mind restless and confused.

So they prepared themselves for death by abstaining from food and taking only water or medicine. As death got closer, they would stop taking even water or medicine in order to focus their mindfulness and self - awareness, so as to die in the way of remainderless extinction."

From "Heartwood from the Bo Tree" Ajahn Buddhadassa

http://www.what-buddha-taught.net/books ... o_tree.htm
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Re: 'Condemned to a life of torture'

Postby piotr » Sat Aug 18, 2012 10:40 am

Hi,

Here's documentary on euthanasia by Terry Pratchett:

http://www.youtube.com/watch?v=slZnfC-V1SY
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Re: 'Condemned to a life of torture'

Postby Cittasanto » Sat Aug 18, 2012 1:01 pm

manas wrote:
Deliberately killing them is (obviously) a breach, although allowing them to pass-on in accord with nature - when there is nothing else to be done for their benefit - is not necessarily a breach.
I wonder how the law stands in relation to a fully conscious and mentally fit person with a terminal or otherwise unbearable and incurable illness simply refusing food, and only accepting water, along with medication to manage the pain of starvation. That would be one way to legally 'exit' one's life, without having to drag one's doctor or loved ones into it, surely?

see each countries policy on suicide, although that sound like assisted suicide considering there is medical help to alleviate the pain around the method of ending ones own life.
This offering maybe right, or wrong, but it is one, the other, both, or neither!
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"Others will misconstrue reality due to their personal perspectives, doggedly holding onto and not easily discarding them; We shall not misconstrue reality due to our own personal perspectives, nor doggedly holding onto them, but will discard them easily. This effacement shall be done."
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Re: 'Condemned to a life of torture'

Postby Mawkish1983 » Sat Aug 18, 2012 3:52 pm

Annapurna wrote:He should be given alternative treatments too, if he has to live, like, acupuncture, TCM, homeopathy, whatever it is.
Well I am sure my on-topic and inoffensive comment, abiding to the TOS, was removed in error, so I'll repeat it here.

I believe it would be a total waste of money to prescribe ineffective quack medicine to ANYONE. The fact that this man appealed for his right to die makes it an even bigger waste of money. The state decided he has no right to choose to die and will pay for his treatment, so to suggest he should be given (not offered, just given) this snake oil is an insult to the medical profession as a whole and the patient too!

"Oh, sorry, we're not allowed to let you die so we will treat you with sugar pills that will have no effect, thus leading to your death"? Why, then, waste the money?

And a note to the mods: you have my utmost respect but I will not participate in a forum where superstitious folk medicine is condoned but the scientific method is condemned.
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Re: 'Condemned to a life of torture'

Postby Annapurna » Sat Aug 18, 2012 3:56 pm

Cittasanto wrote:Hi Annapurna,
I am sorry I have simmply looked at the ethics of the Parajika rule and this very situation described in the OP from multiple angles.
As one medical ethicist put it
Dr Daniel Sokol, Director of the Applied Clinical Ethics (ACE) programme at Imperial College, London. wrote:The Oath continues: "And I will use treatments for the benefit of the ill in accordance with my ability and my judgement, but from what is to their harm and injustice I will keep them."

In other words, doctors should act in the best interests of their patients, and when unjust circumstances arise - for instance, a certain life-prolonging drug may not be available on the NHS - they should strive to correct the injustice harming their patients.

Being informed about ethics in medicine does not necessarily mean one has to undergo medical training at university, however the scope of interest (be it ethics or medicine itself) is delved into as the need to understand and find workable solutions are pressent.

Regarding the precept as my understanding has it, it does not dictate that one should force life upon someone. Deliberately killing them is (obviously) a breach, although allowing them to pass-on in accord with nature - when there is nothing else to be done for their benefit - is not necessarily a breach.

If one has a direct say in the life and death decision the best possible answer to stay in-line with the precepts is possibly "do what is best for the patient".
If you know that that may mean treatment is withheld due to the detrimental effects through a sufficiently reduced quality of life and life would be unbearable I do not believe it is a breach of any precept - medical or otherwise - to allow the person to die with dignity (passive euthanasia).


Hi, Cittasanto,

yes.

As I see it, laws are intended as a protection and should not cause more suffering.

Life-saving machines and life sustaining machines do not allow a helpless person to pass away, since we can always feed them through a tube, even if unconscious.

Like, Cittasanto, imagine someone has had an accident and fell into a coma, and is unable to drink and eat.

Still a hundred years ago this person would have died after a short time....their loved ones experiencing a sharp pain, but then it can heal.

Nowadays, unconscious people are often being kept alive, fed through a tube, the relatives can't let go, can't get over it, and their suffering seems to have no predictable end.

In the case of Tony, he would be dead by now, if medical staff had not saved him and would not continue to keep him alive, him, who would rather be dead.

I believe in free will.

It's such a difficult case.

Perhaps we need to see a case like this with the loving eyes of a mother, a spouse, to know in our hearts what is right.
I hope I will never be in this situation, not before I have become wiser than now.
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Re: 'Condemned to a life of torture'

Postby Cittasanto » Sat Aug 18, 2012 7:25 pm

Laws deal with both social & individual protection & sometimes they do not protect the individual the way the individual may wish to be protected, or someone from elsewhere thinks is appropriate!
This offering maybe right, or wrong, but it is one, the other, both, or neither!
With Metta
Upāsaka Cittasanto
Blog, - Some Suttas Translated, Ajahn Chah.
"Others will misconstrue reality due to their personal perspectives, doggedly holding onto and not easily discarding them; We shall not misconstrue reality due to our own personal perspectives, nor doggedly holding onto them, but will discard them easily. This effacement shall be done."
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Re: 'Condemned to a life of torture'

Postby waimengwan » Sun Aug 19, 2012 11:27 am

I wonder which is the lesser of two evils?

If this person ends his life with a peaceful state of mind due to someone helping him to die, he might get a better rebirth won't he. But that would mean this unfinished karma ( to suffer - for him to artificially ask to be killed) will carry on to the next life.

Or he dies when it is time for him to die, and that he could die with a lot of anxiety, pain and frustrations.
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Re: 'Condemned to a life of torture'

Postby corrine » Sun Aug 19, 2012 7:10 pm

I have never understood why it is okay to artificially extend life even though the quality of that life might be gruesome, but it is not okay to help a suffering individual to end his/her existence if that is what they wish.

This whole heaven and hell thing is problematic. If such places exist, and no one who has not died really knows for sure, then why is it a good thing (heavenly) to force another living creature to suffer and a bad thing to help end that suffering? This is the problem that I have always had with religion. I did not know that Buddhism forbade euthanasia. I thought that the Buddha's entire intent was to ease suffering? I would appreciate someone wiser than I, explaining this to me.

I understand the concerns that others might wish to impose euthanasia upon those who may not wish it, but aside from that, is my life not my own? Is it not up to me to determine the path of that life, as long as I am not harming others? And when the quality of life has diminished to the point where I am no longer able to make a positive contribution to the world and have become a burden on society, and my life is no longer of any value to me, then should it not be my decision as to how it should end?

Yes, there are those who base their entire reasoning on this subject on their belief in a particular religion and its doctrine, but why should that control my life if my belief system differs?

I find it immoral to impose one's religious beliefs on others when it causes those others to suffer. Should the deciders at least be required to care for and pay for the care of, those whose lives they want to control?

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