Refusing to Save Life of Suicide Victim: What We Are Becoming
A young woman who attempted suicide was allowed to die because hospital staff feared they would be accused of assault for ignoring her wishes, an inquest heard.
I am having trouble keeping up: Every day now almost, it is one once unthinkable thing after another.
In the UK, a woman tried to commit suicide by swallowing anti-freeze, and doctors refused to save her! From the story:
Well, then why prevent a person from jumping off a bridge? Indeed, why not just get it over with, since this is clearly where we are headed, and set up the euthanasia clinics to make sure nobody is hurt by jumpers! Remember the death of E.G. Robinson's character in Soylent Green at the euthanasia clinic? It's almost not science fiction anymore.
Kerrie Wooltorton arrived fully conscious in hospital clutching a 'living will' in which she stated she did not want to be saved and was '100 per cent aware of the consequences'. The former charity shop worker called an ambulance after drinking the anti-freeze at her flat. The consultant who would have treated her for swallowing anti-freeze sought legal advice before deciding not to intervene and Miss Wooltorton, 26, died the following day...
Consultant renal physician Alexander Heaton Alexander Heaton told the inquest in Norwich that the hospital's medical director and legal adviser informed him Miss Wooltorton clearly had the mental capacity to make the decision about her treatment. Asked what would have happened if he had intervened, he said: 'It's my duty to follow her wishes.'I would have been breaking the law and I wasn't worried about her suing me but I think she would have asked 'What do I have to do to tell you what my wishes are? ''She had made them abundantly clear and I was content that that was the case. It's a horrible thing to have to do but I felt I had not alternative but to go with her wishes. Nobody wants to let a young lady die."
This reminds me of another horrible story that I wrote about in Forced Exit:
The bioethicist Arthur Caplan...writes of the sad case of Thomas W. Passmore, a man with a history of mental illness, who, thinking he saw the sign of the devil on his right hand, cut it off with a circular saw. He was taken to a hospital, where, according to Caplan, things took a "crazy turn." Upon being told by the surgeon that his hand could be saved, Passmore refused treatment, still believing that his hand carried the sign of evil. A psychiatrist interviewed Passmore; lawyers were consulted; a judge refused to intervene. In the end, no one would decide that Passmore was incompetent to make his own medical decisions, and his hand was permanently lost.In a postscript to the story, Passmore sued unsuccesfully, terribly distraught that no one cared enough about his wellbeing when he was delusional to save his hand.
This was a profound abandonment of a mentally ill, self-destructive man in desperate need of help from his community. Thanks to the increasingly extreme view of self-determination, those who should have assisted Passmore were instead morally paralyzed. So distorted were their perceptions of their responsibility to Passmore, so stunted were their facilities to engage in critical thinking, that they allowed a hallucinating man to dismember himself because of a sign of evil that was not really there. As Caplan so aptly put it, "A nation that has created a healthcare system in which doctors, nurses and administrators are not sure whether it is the right thing to do to sew a mentally ill man's severed hand back onto his arm is a society gone over the edge regarding autonomy."
This is runaway terminal nonjudmentalism. We are so lost in the fog of relativism and amorality that we can't even save people's lives anymore, nor even, preserve their limbs when in a psychotic delusion, they self amputate.
"Choice" is just another word for "abandonment."
Labels: Terminal Non Judgmentalism. Abandonment. Suicide. "Choice."
posted by Wesley J. Smith @ 8:22 PM
25 Comments
25 Comments:
This is horrible, but it seems to me to be the logical outcome in permitting or arguing for assisted suicide. PAS leads to rational suicide. Supporters of PAS should not be surprised. If we permit suicide for certain cases and demand physicians and others to get involved, it seems to me that we have little or no argument against people like this young woman trying to kill herself and keeping our hands off. What's the difference between her and the terminally ill who doesn't want to live? It's not her condition, it's that she doesn't want to live. How do you say no to one and not the other? This case and the culture that led this doctor not to intervene is one of the biggest arguments against PAS.
"PAS leads to rational suicide" !!There is nothing "rational" about suicide...no matter how it happens,Don.
Wesley,the photo with this article,is it a real t-shirt..for sale??
As, the mother of a young woman who has suffered from depression for over 10 yrs....that shirt just kind of hit me...and took my breath away. Heaven forbid that she should see such a shirt when she is not on her meds! Frankly, I think this whole world is rushing toward the brink of insanity!
Jan, I believe that legalizing Physician Assisted Suicide (PAS) leads to the concept of rational suicide. I don't believe that suicide is rational. I'm a fierce opponent of PAS and the idea of rational suicide. The concept of rational suicide and the culture that led this doctor not to treat this woman are strong reasons to oppose PAS.
History note: When he wrote his opinion in Cruzan, Justice Scalia made it clear that he believes the state does have the right to feed and hydrate a person against his wishes. He expressly made the following analogy: If a man tries to commit suicide by drinking poison, his stomach can be pumped against his wishes. If we can pump a man's stomach against his wishes to prevent him from killing himself, we can give him water against his wishes to prevent him from killing himself.
As often happens, the logic has been taken the other way: "We must respect people's wishes to the point of not pumping their stomachs if they take poison in an attempt to commit suicide."
I wonder why she bothered to call the ambulance. Why involve the doctors at all? Just to prove something?
Legal question, Wesley: We were talking in the comments on another post about how American law (except in Oregon) does not yet recognize so-called "rational suicide." Rather, you can be restrained from harming yourself if you have such tendencies, even though suicide is not considered any longer, for the person himself, a matter of criminal law.
Now, suppose for the sake of the argument that the legal advice this doctor in the UK received was correct, and he could have been successfully sued for ignoring this woman's wishes and treating her for poisoning herself with anti-freeze. Does that mean that British law now recognizes a category of "rational suicide"?
Not necessarily, Lydia. It just means that the right to refuse medical treatment is so absolute, that doctors can be prevented from saving life via instructions not to render care.
I suppose that if they learned BEFORE THE ATTEMPT, treatment could be required. Ironic, no? Try it and they have to leave you alone. But if they catch you before you try it, and they can try to save your life, assuming a proper level of proof. (Don't know if the UK laws in this regard are the same. But you could see the same result here quite easily. I wrote in FE, I think, of a woman who signed a DNR before hip replacement surgery. When she had an embolism, they let her die rather than treat her, even though she was saveable. They thought the DNR was the same as do not save--and so they didn't.
So, abondonment is justified and excused by "choice."
I see your point, Wesley, but that's such a very fine line that, if that is the current state of law in the UK, I cannot imagine that that line will be held. It's so obviously illogical. Of course, people _do_ live with illogical sets of laws, but I have a strong feeling that if we've gotten to the point where you can be stopped ahead of time but can't be saved after taking the poison, it's pretty much a foregone conclusion that soon they will conclude you can't stop the person ahead of time either.
Of course, it's also possible that the lawyers were just guessing. But I'm afraid that's what lawyers often have to do in deciding how to advise clients to avoid suit. Perhaps the best thing that could happen (cruel as this sounds to the doctor) would be for him to be successfully sued by relatives for not treating.
What is wrong with letting these people exercise there free will? They aren't hurting anyone by checking out early. In fact, given that we already have 6 billion people living on the planet, all veiying for natural resources and all of which do not have clean drinking water, a shirt on thier back and food in thier bellies, you could argue that suicide is doing some good in this world by removing people that aren't contributing to the greater good or progressing the species.
Lydia: Six of one, half dozen of the other.
Primus: You demonstrate how humanism has warped into anti-humanism. The nihilism is so thick you can cut it with a knife.
According to the article, the patient was judged to have the mental capacity to make a decision to refuse treatment. Once we start forcing medical treatment upon compentent people, against their will, where does it stop? If a patient decides to forego surgery that the doctors believe would prolong her life, is it OK for the docs to strap her down, anaesthesize her, and do the surgery anyway?
The fact is that a person who is competent to make treatment decisions, and who makes an informed decision to refuse treatment, has every right to be left alone, even if we think that the treatment will be good for them.
I know that many of the people who comment on this blog believe that if a competent patient decides that he wants life-sustaining medical treatment, he should have it regardless of any other consideration; so why is it that a patient's wishes to refuse such treatment should not be similarly honoured?
Sorry Wesley, I just don't see it that way. I don't think we are 'so lost in the fog' as you put it. This woman drank anti-freeze and signed a note saying she didn't want to be saved, I don't see how anyone has the 'right' to intervene. Someone jumping off of a bridge is another matter. Anyone 'threatening' suicide on the other hand is actually reaching out for help.
As for the nihilism, call it what you will. To me, it is straight economics. The planet can only support so many people and out of 6 billion or so, you're bound to have 500k or so per year making decisions the rest of us wouldn't or couldn't comprhend. Throughout history, there has always been that swath of the population that has felt life isn't worth living.
Did you read that she had a mental illness? Did you read that she had called an ambulance?
No right is absolute. It should be the policy of the state to consider all suicides irrational to permit authorities and medical personnel to save lives. Self destruction isn't deciding against heart surgery. Suicidal people do not have a "right" to be dead, and they shouldn't be permitted to make the medical system complicit in their deaths.
It should be the policy of the state to protect the lives of all citizens, even against suicide. Laws should permit doctors to stop all suicides from being completed. I mean after all, I can just see bioethicists saying that the act of hanging herself (in a different scenario) was also a symbolic advance directive refusing rescusitation and that trying to save the person's life is disrespecting autonomy.
Once we decide that suicide is "rational" and that a suicidal person's desire to die trumps the responsibility of doctors to save lives, we might as well open the euthanasia clinics.
Good grief, man: She might have changed her mind and wanted to live two weeks later! Sometimes important rights come into conflict, suicide isn't choice, it is the end of choosing. The state has a right and a duty to prevent it, and so do doctors.
Wesley, I lived in the area where the Passmore incident happened--southeastern Virginia. It's been nearly 20 years ago. However, the incident made a big stink locally and some details still stand out in my mind. Other factors existed that Caplan's analysis did not mention.
He cut off his hand on a contractor job site on the Outer Banks of North Carolina. A medical helicopter took him to a Norfolk hospital. Not only did Passmore still say he saw the mark of the devil on his hand when refusing reattachment, but he told the doctors that he would take the hand right off again should they reattach it anyway. One of the doctors expressed the same concern later that the doctor in this tragic UK suicide case did: that he could be held liable for assault should he reattach the hand anyway against the patient's will. The lesser of two evils to the doctors was to close the wound and leave a stump, given the possibility that Passmore would simply seek to rip off the hand again after all the work.
Passmore did indeed attempt to sue the medical facility later for not reattaching his hand despite his wishes. A jury did not buy his anguish and refused to hold the facility liable. What made matters worse for him, in my opinion, is that he was not a particularly sympathetic character. With unkempt hair and a straggly beard, he bore a striking resemblance to Charles Manson in photos of the time (as all too often do others who commit heinous acts and later claim diminished mental competency), and he complained to the local newspaper about how having a stump with a hook instead of his original hand prevented him from learning typing to try to get a job with computers. To some observers then, it all came across as a ploy for sympathy (and a big payday) as opposed to genuine feeling. As a result, some people felt free to take attitudes that were a bit appalling. Someone I knew said, "They should have told this guy, 'Look! The mark's on your head now!' "
Just a matter of months before, another man had walked into a public school shop class in the Roanoke area and cut off his hand with a power saw in front of students there after claiming that he, too, saw Satan's mark on his hand. The publicity might even have inspired Passmore to commit his act.
My feelings on his situation are mixed. Doctors should probably have tried to reattach his hand, but I understand their decision not to. The phrase "rock and a hard place" comes to mind.
"Once we start forcing medical treatment upon compentent people, against their will, where does it stop?"
Makarios, are you really unaware that it has been for many, many years standard behavior in the West to pump people's stomachs when they attempt suicide by taking poison? And guess what: We didn't start having people strapped down and given chemotherapy or given "life-prolonging surgery." Surprise, surprise. The sensible course of regarding suicides as irrational and attempting to save their lives _didn't_ mean that we were either logically compelled or sociologically likely to be unable to see the difference between extraordinary treatment and life-saving for suicides.
(It's amazing how lame and how contradicted by the plain evidence of history liberals' attempts at slippery slope scare scenarios always are and how prescient pro-lifer's predictions in the other direction always are.)
Wesley wrote:
Suicidal people do not have a "right" to be dead, and they shouldn't be permitted to make the medical system complicit in their deaths.
It should be the policy of the state to protect the lives of all citizens, even against suicide. Laws should permit doctors to stop all suicides from being completed.
Lots of "should" and "shouldn't" there. Also lots of absolutes (ALL citizens, ALL suicides). Is there some supporting reason for engraving these pronouncements on the tablet? I can understand someone having strong feelings on the subject, but we must recognize that they are just that--feelings--and that they ought not to be imposed on everyone else unless there is a convincing argument for doing so.
M: More than feelings. I have been arguing these matters since 1993 and have a long list of arguments that are hardly based on "feelings." It has to do with what constitutes a just and moral society.
That is a primary purpose of society, after all. To promote the common good.
In short, you may disagree with me, but my approach is far more than mere feelings. Indeed, it is the pro side that tends to focus on feelings.
If you are interested in the details, which are far too long to put in a blog, read Forced Exit, my articles, and my testimony before the California Senate Judiciary Committee.
It has to do with what constitutes a just and moral society.
Of course, the question of what constitutes justice and morality is open to argument.
That is a primary purpose of society, after all. To promote the common good.
Assuming, for the sake of discussion, that this is correct, it still leaves us with the fact that your definition of "the good" may differ from that of other people. Some people's definition of the good entails the concept that every life, no matter how miserable and unendurable, must be lived to the full length that medical technology permits. Other people's views clearly differ.
These are not trivial points, nor are they obvious. If they were, then people would not be debating them.
Exactly I am debating them. I am not the dictator, nor do I claim a monopoly on wisdom. I am trying to get people to see things my way so that we have public policies (as well as private conduct) that promotes a just and moral society.
I don't do this to hear myself talk, after all. That's my wife's burden.
It horrifies me to hear that it finally happened. A suicidal patient left to die so young. I am Thomas Passmore's sister. We sued the hospital in order to try to change their policies concerning consent after what happened to my brother. He was clearly mentally ill and should never have even been asked for his consent. He did give his consent to the re-attachment of his hand. After laying on a gurney for a couple of hours waiting for surgery his illness took him over once again and he refused when he arrived in the operating room. The surgeon was more concerned about being sued than he was about doing the right thing. He remarked in surgery that "I'm going to get sued no matter what I do". Had the surgeon re-attached Tom's hand we would have been eternally grateful. What's even sadder is that Tom had tried to get help before the "hand" incident and was turned away. In a nutshell, he flagged down a police officer and explained his situation. He was taken to the police psychologist who told him to go to the Manteo Mental Health Clinic. The next day he walked to the clinic. Since they didn't have a doctor present to prescribe Lithium for him he was given food vouchers and was told to try to get a job and come back on Friday. The job he found the following day was at a construction site. That's when he saw "666" and cut his hand off. When he arrived at the hospital he was immediately assigned to the psychiatric staff. DUH.... Why on earth was he allowed/asked to give consent?
Joyce: Thank you for that. Your brother was abandoned to the quasi-religion of choice. It is really that simple and that awful.
There is a mental illness called BIID, body integrity identity disorder, in which people obsess with becoming amputees. There are some bioethicists out there who have literally opined that it would be proper to cut off healthy limbs in such circumstances surgically.
This is what we are becoming.
My best to you and your brother.
Lydia: She could have gone to the hospital so she does not have to die alone, or it could have been a cry for help, noone will ever truly know.
There is a point that you missed, however, is the fact that she was mentally unwell, having had 9 attempts in the past,and the mental health system failed her.
K-man: your post is idiotic.
I am sure that if this man was treated for his psychotic mental illness, he will no longer believe he has evil numbers on his arm and will probably NOT cut it off again - its called medication.
I can't believe how dumb some people are.
Joyce, I am so sorry to hear about your brother. How is he now, is he receiving treatment? I wish he could appeal or something. That surgeon should resign.
Ms tired: Thanks for stopping by. I have removed your post to Primus because of the ad hominem. I undertand the passion, but that crossed the line. Thanks.
Please keep posting.
Basics
What is the cause?
The cause has not been clearly delineated however several theories have been proposed:
1. The sight of an amputee in infancy imprints the child's psyche and the child feels that that should be their body image.
2. The child feels unloved and by becoming an amputee may attract sympathy and love. There are strong positive thoughts about becoming an amputee.
3. The desire is an external manifestation of an unresolved internal conflict.
4. The condition is a neuro-psychological condition in which there is a structural or functional anomaly of the cerebral cortex (higher part of the brain) related to the limb(s).
Clearly studies of large numbers of patients will be required to make any progress in this field.
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