Chronic Pain Victims More Likely to Commit Suicide
I have met people with severe chronic pain in my travels and at my speeches. These people live very difficult lives that requires strong medical and emotional support from family, friends, and communities to help them keep going. Unsurprisingly, suicide levels among sever chronic pain sufferers is higher than the general public's. From the story:
People with severe headaches or other forms of chronic pain may have an increased risk of suicide, a study published Tuesday suggests. The study, of nearly 5,700 U.S. adults, found that those who reported chronic pain other than arthritis were four times more likely to have attempted suicide than adults not suffering from persistent pain.And this is another reason why the euthanasia/assisted suicide movement is so dangerous. Once we accept the idea that an acceptable societal response to severe health difficulties is facilitated killing, on what basis will we deprive these suffering people--whose pain can be more severe and longer lasting than that of people who are dying--from assisted suicide or euthanasia? In the end, as in the Netherlands, Switzerland, and the public's widespread support of Kevorkian, we won't.
Head pain and pain in multiple areas of the body were particularly linked to suicidal thoughts and behavior, according to researchers at the University of Michigan Ann Arbor.They found that men and women with frequent or severe headaches were twice as likely to have either contemplated or attempted suicide. These risks were also elevated among study participants who reported multiple forms of pain.
This is the reality and it is the debate we should have. I submit our response to any suicidal ideation should be prevention and attempts at ameliorating the cause--the hospice approach developed by Dame Cecily Saunders. Society should support people in living, not killing themselves.
In any event, the pretense that "death with dignity" is about the terminally ill "for whom nothing else can be done to alleviate suffering" is a ruse intended to soften society for the ultimate abandonment of near death on demand.
Labels: Chronic Pain. Assisted Suicide.
posted by Wesley J. Smith @ 9:55 AM
24 Comments
24 Comments:
The study doesn't suprise me.
The assited suicide implications simply break my heart. Chronic pain and other chronic conditions are becoming both more common, and at the same time more studied. As the studies increase, we realize that so much can be done for these people... it is difficult, since the answer is different in almost every case, but it can be helped.
Yet, with the increase of encouragment for these people by way of treatment, depression and suicide increase by way of the assited suicide idea becoming more recognized.
It is simply an awfull thing for the medical community to be involved in.
The opponents of physician-assisted suicide continue to ignore the most compelling reason against them: the fundamental autonomy of the individual. By what right do they presume to forbid an individual to end his own life on his own terms? If they claim that the state has a higher interest in my life than I, that makes me no better than a slave. Please stop trying to mind other people's business.
History Writer: Gee, we'er all slaves then, because the state prohibits many things from being done with our own body. We are not fully autonomous. We are also part of a society.
And libertarians confuse freedom with anarchy. The issue in assisted suicide isn't "just" doing something with one's own body, it is getting others involved in the killing, which makes it not just about "choice. It also undermines medical ethics, exposes the vulnerable to the potential for terrible abuse, and denigrating the importance of protecting the weak in society.
Then there is the awful truth that some die who might want to have lived had they carried on a little longer.
But that's the price of freedom, right? Jeez.
Libertarianism is just a polite term for Social Darwinism in my view.
The same old, tired "slippery slope" argument. I fail to see how that applies either in Oregon or Washington. And yes, other people's personal autonomy IS the price you and other social conservatives pay for freedom. Hurts, doesn't it? Kindly stop patronizing me with "Jeez" and "Gee." I'm old enough to be your father --- and better educated than either you or Rita.
Ad hominems aside, you seem to be claiming that someone or some entity has rights superior to my own? Excepting the usual religious nonsense, on what is this based?
Not patronizing, astonishment.
Oregon and Washington are not the final salvos, they are the opening bell, if I might mix my metaphors. Besides, under your theory, those laws reflect a slave mentality since they limit the freedom of assisted suicide to those diagnosed with a terminal illness. Indeed, under your theory, anyone should have access to assisted suicide at any time for any reason--or we're slaves.
Sorry, but I think that kind of thinking warrants a "jeez."
Rita is a lawyer and, more than that, she is perhaps the smartest person I know. It is a mistake to conflate disagreement with presumed greater intelligence, and high education with being right.
I shall repeat the question, since you seem to have ignored it:
You seem to be claiming that someone or some entity has rights over my body superior to my own? Excepting the usual religious nonsense, on what is this based?
As for Rita being the smartest person you know --- well you obviously haven't been around too much, have you?
Historywriter,
What is the reason for your position? There are other implicaitons to suicide. The suicide affects more than the person taking his or her own life. Family is impacted. Even if the family is seemingly on board with the decision the psychological effect it will have on them can not be taken out of the equation or underestimated.
Families are always impacted by death, regardless of the reason for it. Why should it make any difference to them if a terminally ill member decides to end his or her life on his or her terms? I fail to see how the matter ultimately concerns anyone other than the person making the decision to end it all. Where shall we draw the line? Shall we have spectacles like the Terri Schiavo matter, with total strangers intervening in a matter that was none of their concern? Are you willing to have a bunch of self-righteous busybodies interject themselves into the private affairs of YOUR family?
I am of the belief that my life is not my own. I know you probably don't share that view. I think the point of the article is that palliative care makes suicide a less likely consideration. There is hope. Suicide is a cheap fix and very final. Why be in such a hurry to take away hope?
I think the kind of palliative care you're talking about is relevant to the argument. For example, if all it accomplishes is to put someone into a drug-induced state of stupefaction there would seem to be no advantage to it over suicide. I think, too, that the amount of pain that's bearable is a matter for the individual to decide rather than his or her doctor. Incidentally, not every terminally ill person is hopeful; you understand, hope is a feeling that the non-terminally-ill are far better able to indulge than those for whom every passing moment is filled with agony.
By the way, if your life isn't your own then whose is it?
I am glad you asked. Please bare with me.
God is the creator of all life including ours. As you may or may not have heard, God created everything perfectly, including man. Adam and Eve were given the opportunity to worship their Lord and show their love for Him by obeying Him. This included not eating of the tree of knowledge of good and evil. They failed and did what God had forbidden. Because of their fall into sin, we have all become sinful.
Now here is the important part. God shows his mercy for us. He didn't wipe out Adam and Eve and start over, but He immediately gave them the promise of the Savior. The gift is free. We only need to have faith in the gift given. Now part of believing is wanting to share this gift with others. It is hard to share that gift with someone if they have committed suicide or euthanized.
We are God's creation. He only has the right to end our existance. We have no right to prematurely end our lives or anothers. What if that life is ended before the gift of salvation can be shared with that person? What a tragedy if that person would exist eternally separated from God. I would not want to be part to that.
I realize you may totally disagree with me. I am glad you asked me the question and I hope you take the opportunity to read the first few chapters of Genesis and the Gospel of John to check out my statements. So as you can see my life really belong to my Lord.
I respect your religious beliefs on the subject, which explains why you, yourself, would never opt for assisted suicide. However, you must understand that not everyone shares those beliefs. That being the case we need to look at practical issues of individual rights concerning the quality and duration of one's own life. Those of us who favor assisted suicide certainly don't advocate its adoption by anyone. We simply demand the same respect as you do for our own deeply-held religious and ethical beliefs. We do, after all, live in a secular society in which religious precepts aren't mandated by law.
I'll leave behind my Catholic preconceptions for a moment and present this argument.
Btw - I'm a lady; I'm only mentioning that because I always feel a little weird when someone replies to something I write in the masculine. I never quite know how to take it...
ANYWAY!
Supposing that evolution is correct and Darwinism says that only the members of the species who are fit for survival will live, human beings seem to defy the rule, because throughout the ages we've helped those who aren't "fit" to survive in the hopes of having a happy life. It's in our blood, or else why would we venerate those who do good for the lesser? Why would there be anyone willing to follow, say, Buddah, who cast away all his goods for Enlightenment and who challenged his followers to do good for others? Why would this appeal to us?
To my mind, if we're going to be Darwinists here and not Catholics, there's a reason that fits - society as a whole needs a diverse group within the species for our very survival. I've seen men who qualify as "macho" voluntarily give up their time and money to help out kids with special needs, or strong high-class business women take time off of work to care for ailing parents. It's part of our makeup, and it makes us better people.
Think of it this way - society is an organism. The health of the organism requires us to all work together, and every part, like every cell in the body, has a place, even if it doesn't seem to fit right.
Total autonomy will lead to the breakdown of the organism and lead to absolute chaose, which then leads to the organism's death, much like a cancer. Like a cancer, bad ideas spread (euthanasia, abortion, etc) that lead to untimely deaths. If it grows out of control, then BAM, the whole thing suffers and dies, and it won't be a pretty death.
If, however, a wounded cell is supported by a strong immune system and by other functioning cells, the entire creature survives and grows and prospers. Life continues. Society grows and enriches.
Putting personal autonomy ahead of society might seem nice for you, but that's overlooking the big picture. The entire animal needs to survive. Otherwise, why bother to have children at all, since they're only going to inherit the problems that the previous generation created? It seems rather selfish to scream about personal autonomy and then shuck a dying society off on the next generation. If, however, you see a good reason to have kids, then you should consider what kind of society you're helping to create for them. That may mean having to willingly make sacrifices, such as doing away with euthanasia, to ensure that the next generation has a good, strong chance at survival.
By the way, I'm using the generic "you" here, not the specific "you." Ordinarly I'd use "one," but I'm NyQuiled right now and I'm too tired to go back and edit, so blah.
ANYWAY!
So, sometimes we have to reign in our desires for the good of the whole. Like, it's wrong for men to rape women, because rape leads to mental trauma and causes sexual and personal problems in the victim. That leads to a disruption in that cell's ability to function in the whole animal, and society suffers. That's why we have laws against it, despite the fact that some men think that, say, marital rape should be legal, and that porn sites promote rape as legitimate sexual acts. A man might want to, but he has to reign in his desires for the good of society. This is also why we have empathy - the ability to envision the feelings of others and respond to them.
So, there's a sociological reason for it.
...Plus, God's the only One who can legitimately end our existance and I want everyone to go to heaven, so everyone should get a fair shot at life, and anyway, I don't think there's ever a reason to give up hope. ^.^
Historywriter -
P.S.: Thank you for your commentary and I look forward to chatting with you more in the future! I very much enjoy a good debate and I think highly of opponents who, like you, are logically consistant, even if I disagree with them.
mhgdairy -
I have enjoyed reading your responses as well and I agree with you on all counts, and I admire the fact that you are as patient and logical as you are in your replies. I look forward to talking with you, too, in the future. ^.^
Thanks for your input, t e fine. I think you make out a reasonable case, albeit one based on religious proscriptions which not everyone recognizes. You overlook an important aspect of assisted suicide --- at least as it's legislated in both Oregon and Washington state: that is, the people eligible to exercise it as an option need to be certified as terminally ill with 6 months or less to live. Consequently the self-removal from society of someone who believes he or she is unlikely to make any further contributions to the common good in his/her remaining time is unlikely to be of significance to society. You may think it's callous to ask, but this question needs to be raised and discussed dispassionately: what contribution to society did Terri Schiavo make when she was vegetative that we now miss?
Admittedly a religious individual may find that "leaving it to God" has an ameliorating effect on his or her condition, however, many of us who don't believe in an interested, actively intervening deity feel that acute suffering has no redeeming value whatsoever, and that the choice between dying in agony or living by means of "palliative care" that stupefies, is no choice at all.
Hello Historywriter,
I think the Schiavo's would tell you that their daughter's life was of significant importance to them. They loved her unconditionally and were willing to take care of her. I heard her brother speak at a Christian Life Resources conference a few years ago.
Admittedly she was not living in ideal circumstances. I may find myself in a situation that I wouldn't normally want to live with. For instance I do have MS. I don't want it and wouldn't wish it on anyone, but it is my reality. If my condition would worsen, my family would still love and care for me. This is of benefit to me and to them as well.
Whether you believe in God or not the golden rule is still valuable. Treat others as you would have them treat you. Compassion and empathy is part of that equation. Some may argue that allowing someone to commit suicide is compassionate. In reality it is probably just desparation. Despair being the root word.
As you probably already know I am in favor of palliative care. It does not have to stupify. It may take a while to balance dosages, but it is manageable.
I also enjoy the discussions that we have back and forth. These are important topics and should be discussed openly and honestly.
mhgdairy: thanks for a thoughtful response. The Schiavo case was problematic because Terri hadn't made a living will. Had she done so her husband could simply have carried out whatever her wishes were instead of having to go about establishing them in a court of law. I don't doubt that her parents loved her and wanted to keep her "alive" as long as they could --- but for whose benefit? Certainly not for Terri's, since her condition was both profoundly vegetative and irreversible. At least those suffering from diseases such as MS, Parkinsons and diabetes have some hope for a cure in the near term.
Understanding that some individuals will find assisted suicide unacceptable, I still am at a loss to understand why they should object to other competent, consenting adults availing themselves of it. Do you feel it's appropriate for people who aren't directly concerned (e.g. who are not members of the family) to interfere with such decisions? And if so, why?
Historywriter -
Hello again! Thank you for your response - I agree that I do have some colored perceptions because of my religious beliefs, so please bear with me if I try to make an arguemnt without involving them and they do come to play - I'm trying to think dispassionately, and I appreciate your input and your questions. They help steer me the right way, I think.
The best way I've ever heard your question answered... well, this is a little tricky, let's see if I can be clear and concise here.
Human beings, whether through evolution or divine intervention, have a strongly developed sense of integrity. The original definintion from Anglo-Saxon means, "in the same skin with." This is where we get the sense of integration, blending, combination, etc.
Humans "share skin" with other humans through empathy, love, support, community, growing together, all the positive binds that hold us together and help us to live in peace with each other. Granted, there are many aggressors who push aside those feelings, but everyone *does* have them.
For human society to survive, individuals need to have a strong sense of integrity. They have to feel integrated into society, in all aspects. This is the net that holds us up.
We know from biology that when couples form outside their ethnic groups, there's a better chance of good genes from both sides coming into play, for example. Integrity is what allows us to feel empathy with people who are outside our culture groups. It's what helps us to be non-judgemental and less likely to harm someone because of differences.
One could argue, for example, that Northerns, because of integration that they grew up with, felt a deeper empathy for slaves than Southerners, who were always segregated. When you have segregation, you have annoying people like the KKK crop up. When you have integration, you have Obama in the White House.
I apologize for setting this up so much but I want to be sure where my steps are going.
The more integrated society is, the more empathy we feel for others (even outside our families, our friends, our culture/ethnic groups), and the more stable society is as a whole.
I'll use myself as an example here - I feel a deep empathy for people who suffer physical pain because one manifestation of my major depression / panic disorder is physical pain that makes me unable to eat. I know for a fact that my pain is considerably less than someone else's, so I never think of this as a comparison, or an "I know how you feel" issue, because I don't. But I can picture my own pain and suffering and want to ease the pain of others because of what I do know.
Here's another example: I've never been a mother, but I recently had to put my cat to sleep. I know the agony that I felt then, because I loved her - she was my baby. I know that losing a cat is NOTHING at all like losing a child. I can't compare my suffering at all to a mother who has lost her baby. But, because I know one kind of pain, I know that she *is* in pain, and I will want to offer her my sympathy, love and strenght whenever needed. It's not the same by any stretch, and I don't mean to imply that it is, but recognizing yourself in someone else makes you inclined to want the best for that person, even if that person is of no relation to you.
Now then, in a perfect world, we would be able to recognize ourselves in *all* people, including the severely disabled, such as Terri Schiavo. There have been times when we've been hurt, lost, confused, unable to understand, unable to communicate, etc. They're NOTHING like what she went through, but we can know that she was suffering because of our own pain.
Because of this, we would see her as an extention of ourselves - precious, useful, needed. We needed her for us to remember our own faults and failings, our own pain, and to encourage us to render kindness on her. In a perfect world, nobody would have wanted to let her die, because in her we would see our own pain, and a chance to do good to aleviate that pain.
Killing someone isn't really aleviating pain. It's disconnecting them completely from the unit. It's casting them out of the net, throwing them away, making them no longer part of the society in such a profound way that the person isn't able to come back, ever.
What about natural death, then? Even the dying process should be something shared by the community at large, and once upon a time it was. There's strength to be had from sitting together with someone, "dying" with that person, and being united. The dying process isn't something the living can understand, having not done it, but it is a way for the dying to pass on to us a strenght we need, to face that last moment with grace and dignity, even if one is enfeebled and old. It's coming together. Euthanasia is too much of a taking apart.
Gosh, this is wordy. I'm not at my best, I'm sorry, I'm drugged out on NyQuil in the hopes of sleeping through so I can get up for work early tomorrow. Blah.
It isn't that we feel a need to control someone else's life or death, it's that, even when we fail at it, we still want to be able to pour out our love and confer dignity upon persons of all stages of life, to strenghten them and carry their burdens for them, so that by giving meaning to the ends of their lives and to their suffering, we can give meaning to our own lives, and to the greater society.
A part of me dies, whether I know it or not, when someone else dies. Something in my life is changed somehow, something I touch. You aren't me, but under the skin, you and I are the same in so many ways, and I can empathize with you. If I throw you away, or allow someone else to throw you away, because of autonomy, I'm murdering a part of myself as well. I'm saying, "you're not worthy to be a part of my existance."
Well, you're here, you have a right to life, and nobody can say that you should have to die. If some method exists to ease your suffering so that life is bearable, then it should be exercized. If not, then you should have total support of the community at all times. It's our responsibility, for the strenght of everyone.
Finally, at some point someone will say, as they have said before, "There are some people worthy of being in society and some that are not, and the ones that are not should be removed." And the best, most permenant removal is death. It creeps in slowly, through mercy killings, and then eventually envelopes an entire segment of society, until once again we're segregated.
We need to stop casting out our elders and disabled and to show them that life is always meaningful, just because they live it.
Now, this final little bit is 100% personal, so please don't feel you even have to respond to it if you don't want to, but this gets to the heart of *me* and *my* beliefs.
As I've said before, either there is a God or there isn't, and if there is then we should strive to follow His rules, but I won't get into the details about why here - that's for another post.
If there isn't, I can't see casting someone off into the darkness that comes with the grave, that cold nothingness, that total dissipation of self, that comes with death. I've been too heavily influenced by Neitzsche and his nhilism to think that humans, without God, can create some kind of immortality. If that be the case, which is better, to cast someone off into nothingness, or to give that person as much existance as possible before nightfall?
Again, that's me, personally, and I know some very articulate people, both atheists and religionists, who have arguments with that, but I wanted to touch on my philosophy after having shared some of my thoughts on the greater good of society. I know you're likely to disagree with me and I'm looking forward to your remarks. I hope that, even if you disagree, you found something here that you enjoyed reading.
One more thing before I leave this topic entirely:
Christians, such as myself and mhgdairy above, are faced with a two-sided sword - we're required by our beliefs to treat everyone (including our enemies) as precious in the sight of God. That means we have to forgive anyone who hurts us, we have to pray for our enemies and their conversion, we have to administer help to those who repulse us, and we have an obligation of righteous anger to stop evil. Evil, as defined in our code of ethics, is anything that goes against God, and by not treating our neighbors as ourselves (which is paired with Loving God as one of the two highest commandments), that is an evil. That means we have to live by extending our love to those who are hurt or suffering, and to encourage them in life until natural death. It also means we are *required* by our beliefs to make sacrifices for others, to put the good of others before us.
So the two edged sword? Many people who are not Christians say, "I'd like Christians better if they would only *act* like Christians," and then turn around and say, "Why are you acting this way?" when we do act like Christians. Apparently we are required to be quite little goody-two-shoes who never raise an objection to anything, and fighting what we see as evil is somehow "wrong" in this society.
I don't want anybody to think that I'm saying this to Historywriter - he's been a perfect gentleman and we are having a good discussion, and I'm honored to have someone so thoughtful to contend with. This is something that's happened in my workplace, not here on the boards.
to t e fine. Thanks as always for an interesting response. I doubt that either of us is going to convince the other about assisted suicide. With respect to end-of-life directives, my own specifically provides that food and hydration are to be discontinued if I am in a persistent vegetative state, and that no heroic measures be taken to prolong my life. After the Terri Schiavo incident I revised the directive. It now authorizes my administrator, in the event the directive is challenged or doctors refuse to honor it, to move me to any other jurisdiction in which it WILL be honored, even if the process of moving me shortens my life expectancy. The directive also specifies that all parties to its execution are to be held harmless --- hospitals, doctors, everyone.
Hello historywriter,
I have empathy for people in these struggles. At times I catch myself asking why not let it occur. The person who ultimately decides to commit suicide will not be subject to any earthly prosecution. In the end it will truly be their decision, but I don't think as a culture we should condone or encourage it.
Once one extreme is allowed in society it isn't long and a new extreme is accepted as normal. Nazi Germany learned this lesson well. Make gradual steps in the way you want to go. Send out propaganda into the population and slowly it is normal and accepted. Of course everything they learned they got from America's eugenics movement. My question is where will the line be drawn? Who decides what is right and wrong? Can it be the majority? I don't think we will resolve it here.
I must stand for what I believe to be correct. You already know that I believe God gave life and he alone should take it. This doesn't come without hard decisions. God doesn't spell it out for every detail. In those difficult situations we need to turn to His word and prayerfully work it out.
Good discussion as always.
Historywriter -
I agree, we're probably not going to change each other's minds, but that's okay. What's important right now is that we have the opportunity to dialogue about it. It's terribly important that people be open to a frank discussion and be willing to hear the other person out. That forces one to be more thoughtful in one's own answers. Besides, it's fun to have a good debate - it's like a healthy work-out for the brain and spirit!
Don't you wish that political dialog could be as polite? It's unfortunate that so many people seem to have have forgotten how to be courteous, and how to oppose an argument without attacking the person presenting it. Anyway, it's been a pleasant exchange that has given me some interesting ideas to consider. Although I'm not a religious person in the traditional sense of the word I have a strong sense of ethics. I have to agree that assisted suicide DOES open the possibility of active euthanasia in the future, yet I also believe that people of good will would never let it come to that point.
Political dialog = name calling in business suits.
< frown frown frown >
I'm with you; political debate should be about issues, not about fighting to prove one is "better" than another. If it were just about the issues, we'd iron out everything much easier.
I think it's the climate. They stick our Senators and Congressment in a big, echoy room with lots of people gathered around and nobody paying attention to anybody else.
They ought to mix and match - 3 people from one party, 3 from another, and a few from the outlying parties (Libertarian, Green, etc) and set them down in a parlor for tea. Everybody sitting in big, comfy, oversized chairs, they're more inclined to be thoughtful and relaxed, and not jump down each other's throats, and maybe listen to each other.
Maybe playing Beethoven in the background.
Bah.
I believe you are a person of strong ethics, or else why would you be here talking about ethical situations? I don't always agree with what you think is ethical, but I don't want it said that your religious beliefs (or lack thereof) mean you're incapable of being ethical. I know better. And I agree with you that there are plenty of people of good will out there. My concern is that people of bad will struggle to rise to the top and don't care who they step on, and those are the ones we need to watch out for. Ah well.
By the way, feel free to call me Tabs. I like for my friends to.
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