Wallows
8.2k
I don't feel as though all the alternatives were exhausted before her final decision.

Like what?

MDMA assisted psychotherapy, prescription antidepressants, more therapy. So on so forth. — Wallows

HER final decision.

SHE also gets to make the decisions on what "alternatives" must be considered.

YOU do not get to "feel" what alternatives must be considered.

And "death" is a decision that each individual should be able to make for him/herself...without the intrusion of people like you. — Frank Apisa

IF that person is in full control of their mental capacities, the case is more convincing. However, not when we're talking about a child and a mentally ill person who is likely unable to think clearly. In that case we have the overriding duty to save that person from themselves.

But NKBJ will not be able to acknowledge it. — Frank Apisa

You are unable, I think, to acknowledge, that a person can be unable to think clearly. Perhaps you are in favor of letting children choose to use heroin as well? Or I suppose you would advocate for getting rid of all care facilities for those with mental disabilities?

You, very simply, are not being empathetic to the various states of mind that can befall a person and are superimposing your current ability to make autonomous decisions on others.

The analogy is appropriate to the feelings of the person the receiving end, rather than the feelings of the performer of the act. Interesting that you seem to regard the feelings and motivation of the rapist or medic more significant that those of the victim/patient. But from their pov both are violations of the body by forcible penetration of an intimate orifice against one's will, and in such a case, forced feeding would almost certainly be experienced as a third rape. — unenlightened

You conveniently neglect the main difference I pointed out: rape is only to harm the victim. Force-feeding is to save them. It couldn't be a more wholly different scenario.

But perhaps you think oral vaccines are rape too.

If you believe that your value that death is the worst possible harm can be deduced from other, lower-level values then show your reasoning and we can discuss it. — andrewk

I already showed it. It's your turn. I guess you got nothing.

NKBJ
1k

And "death" is a decision that each individual should be able to make for him/herself...without the intrusion of people like you. — Frank Apisa


IF that person is in full control of their mental capacities, the case is more convincing. However, not when we're talking about a child and a mentally ill person who is likely unable to think clearly. In that case we have the overriding duty to save that person from themselves. — NKBJ

DEATH IS A DECISION THAT EACH INDIVIDUAL SHOULD BE ABLE TO MAKE FOR HIM/HERSELF...WITHOUT THE INTRUSION OF PEOPLE LIKE YOU...WHO THINK THEY CAN DECIDE WHETHER AN INDIVIDUAL CAN MAKE THAT DECISION.

Butt the hell out of other people's business on issues like this.

You do NOT have an "overriding duty to save that person from themselves"...although you do seem to have an overriding duty to massage your ego.

Anyway...to show you that we can agree at times...I am here to acknowledge your are doing a hell of a job with that latter item.

NKBJ
1k

But NKBJ will not be able to acknowledge it. — Frank Apisa


You are unable, I think, to acknowledge, that a person can be unable to think clearly. Perhaps you are in favor of letting children choose to use heroin as well? Or I suppose you would advocate for getting rid of all care facilities for those with mental disabilities?

You, very simply, are not being empathetic to the various states of mind that can befall a person and are superimposing your current ability to make autonomous decisions on others. — NKBJ

You are an intrusive individual who apparently wants to substitute your decision for the decisions of the people who actually have the right to make them.

Get off your high horse, before you fall an damage your massive ego.

You conveniently neglect the main difference I pointed out: — NKBJ

No I didn't. I noted that it related to the feelings and motivation of the actor, and not the feelings of the recipient of their action. I even commented in particular that your focus was directed away from the victim's feelings. You conveniently neglected this.

But perhaps you think oral vaccines are rape too. — NKBJ

Forcing something down one's throat, or up one's arse, or into one's vagina, or even directly into one's bloodstream, against one's will are somewhat similar. I think you might be able to acknowledge that much.

For someone who has been raped twice, having another forced penetration of another orifice is liable to be traumatic to the extent of putting in her mind, the medics on a par with the rapists; I do not think oral vaccines are rape, but I do think forcible administration is an assault unjustified in most circumstances where the individual is capable of giving or withholding consent.

For someone who has been raped twice, having another forced penetration of another orifice is liable to be traumatic to the extent of putting in her mind, the medics on a par with the rapists; I do not think oral vaccines are rape, but I do think forcible administration is an assault unjustified in most circumstances where the individual is capable of giving or withholding consent. — unenlightened

Yeah, so under that psychological assessment, then doesn't this lead to the conclusion that she was non compos mentis?

Your ad hominems don't impress me, Frank. But it's clear you're too upset to continue this conversation productively. Perhaps we can continue when you've gained some perspective.

I can acknowledge that it may be a triggering eveng for a previous rape victim. I do not think that makes it tantamount to rape itself, though.

I do wish you'd acknowledge the very basic, and most important difference that rape is ultimately just a harm whereas forced feeding is ultimately a life-saving measure, and therefore to the benefit of the patient, even if it causes some harm in the process. Just like surgery is not the same as being stabbed by a mugger.

noted that it related to the feelings and motivation of the actor, and not the feelings of the recipient of their action. — unenlightened

It does not relate to the feelings of the actor, as much as the consequences for the receiver. The consequences in either case couldn't be more different.

According to this BBC article:

Hers was the dreadful story of a teenager with a desperate mental illness who starved herself to death.

She had once enquired about euthanasia without telling her parents - but was turned away, considered too young and presumably curable.

Euthanasia by a doctor is legal under strict conditions in the Netherlands, but this was not one of those cases.

...

Noa Pothoven was not given the lethal cocktail of drugs provided - in a drink or by injection - when someone has been granted the right to die.

She went on hunger strike and was being fed through a tube. Eventually her family accepted her wish to die, so they stopped forcing her to stay alive and instead used palliative care to make her final days as peaceful and bearable as possible.

Does that count as euthanasia?

My guess ( and I could be wrong) is that you over simplify the prohibition against forced medical care in The Netherlands, as I assume there is a way to obtain a court order to impose care on those suffering psychological issues. If the rule is that the severely depressed must be permitted to live out the consequences of their self-neglect in all cases, the Dutch rule needs to be reconsidered. — Hanover

Only if you can show that she was incapable of making rational decisions and therefore legally incapacitated, in which case the decision would fall to her parents. Being depressed does not make you incapacitated though. In any case, het parents supported her to refuse treatment.

I strongly disagree that the rule needs to be changed. Doctors do not get to decide what treatment patients should get unless they are incapacitated. And as far as I'm aware, the US is no different where people refuse blood transfusions or donor organs that would save their lives on, for instance, religious grounds.

Hypothetically, would you have supported euthanasia in this case? — Hanover

Any easy call given the fact she ended up starving herself: yes, if only to avoid the suffering of starvation and dehydration itself. A shit life that ended shitty as well, could've at least avoided the shitty end.

Not knowing how it ended, I don't know whether I would've supported it in this specific instance since I'm not a psychiatrists and have little understanding of depressions and how much suffering that can entail.

I do know her story isn't unique. Even for adults suffering from depression euthanasia is often not open to them and results in a significant number of grisly suicides. I would like it to be better available for people who mentally suffer unbearably without any chance of improvement but I have no idea how realistic that is without it becoming to freely available.

It's clear the initial reporting was inaccurate, so the question now rests in the hypothetical. That Noa's case can be distinguished as having been inevitable and could have as much occurred in Alabama as in The Netherlands is possible.

But to the questions that were posed by the incorrect story:

1. Would you allowed her to be euthanized given her several year history of serious depression?

2. Would you have forced care upon her on the basis she posed a threat to herself (this seems more problematic to@Benkei and @unenlightened than me. ).

Even for adults suffering from depression euthanasia is often not open to them and results in a significant number of grisly suicides. I would like it to be better available for people who mentally suffer unbearably without any chance of improvement but I have no idea how realistic that is without it becoming to freely available. — Benkei

Before we entertain options for assisted suicide for the mentally ill, shouldn't we invest more time, energy, and resources in providing care and treatment for those people to recover? As it stands, we just have an abysmal mental health care system.

Would you allowed her to be euthanized given her several year history of serious depression? — Hanover

No.

Would you have forced care upon her on the basis she posed a threat to herself (this seems more problematic to@Benkei and unenlightened than me. ). — Hanover

I don't know, but according to the World Medical Association:

All kinds of interventions for enteral or parenteral feeding against the will of the mentally competent hunger striker are to be considered as "forced feeding”. Forced feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment.

I can understand wanting to save someone's life (against their wishes), but what if you have to do horrible things to them to do it? Maybe when they're very young, but at 17?

Only if you can show that she was incapable of making rational decisions and therefore legally incapacitated, in which case the decision would fall to her parents. Being depressed does not make you incapacitated though. In any case, het parents supported her to refuse treatment. — Benkei

If you're a danger to yourself, you can have care forced upon you: https://www.educaloi.qc.ca/en/capsules/forced-hospitalization-three-types

— Benkei

Any easy call given the fact she ended up starving herself: yes, if only to avoid the suffering of starvation and dehydration itself. A shit life that ended shitty as well, could've at least avoided the shitty end. — Benkei

As a general matter, life's not shit. That might be where we have a fundamental disagreement. I'm not suggesting there's not an extreme case of just an incredibly horrible life, but Noa's case isn't one of them.

As it stands, we just have an abysmal mental health care system. — NKBJ

As it is, the Dutch health care system is one of the best in the world and absolutely free for children up to 18 years old.

I don't know, but according to the World Medical Association — Michael

:

All kinds of interventions for enteral or parenteral feeding against the will of the mentally competent hunger striker are “to be considered as “forced feeding”. Forced feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment.[/quote]

This relates to politically motivated hunger strikes.

As paragraph 10 states:

"10. Physicians must assess the mental capacity of individuals seeking to engage in a hunger strike. This involves verifying that an individual intending to fast is free of any mental conditions that would undermine the person’s ability to make informed health care decisions. Individuals with seriously impaired mental capacity may not be able to appreciate the consequences of their actions should they engage in a hunger strike. Those with treatable mental health problems should be directed towards appropriate care for their mental conditions and receive appropriate treatment. Those with untreatable conditions, including severe learning disability or advanced dementia should receive treatment and support to enable them to make such decisions as lie within their competence."

Questions of competence and mental health must be made related to the person in the hunger strike in order for these rules to apply.

If you're a danger to yourself, you can have care forced upon you: https://www.educaloi.qc.ca/en/capsules/forced-hospitalization-three-types — Hanover

I thought you were a lawyer; forced hospitalisation is not forced treatment. In any case, het condition was not acute so the necessary requirement for her to be an immediate threat to herself wouldn't even stand so forced hospitalisation wouldn't even be possible.

As a general matter, life's not shit. That might be where we have a fundamental disagreement. I'm not suggesting there's not an extreme case of just an incredibly horrible life, but Noa's case isn't one of them. — Hanover

I think here I'll respect the primacy of experience. You might not find it extreme enough, but it was to her and that's the measure. Her suffering; not your arm chair estimation of what constitutes unbearable suffering.

As it is, the Dutch health care system is one of the best in the world and absolutely free for children up to 18 years old. — Benkei

Her parents did complain about the year it took to provide her treatment:
https://www.bbc.com/news/world-europe-48541233

I thought you were a lawyer; forced hospitalisation is not forced treatment. , — Benkei

From the same article:

"Right to refuse treatment
You have the right to refuse medical treatment, including medication, unless ordered by a court. But you can be given care for personal hygiene or in an emergency without your agreement.

In exceptional situations, health care institutions can use force, isolation, medication or other types of restraints to prevent harm to you or someone else. The use of these methods must be minimal and must be noted in your medical record. "

In any case, het condition was not acute so the necessary requirement for her to be an immediate threat to herself wouldn't even stand so forced hospitalisation wouldn't even be possible. — Benkei

It seemed pretty immediate and acute, considering she died soon thereafter. If I'm the judge, I order treatment. Best case scenario I save a life. Worst, I add a few more weeks or months and know I did all I could do.

I think here I'll respect the primacy of experience. You might not find it extreme enough, but it was to her and that's the measure. Her suffering; not your arm chair estimation of what constitutes unbearable suffering. — Benkei

I don't doubt she suffered terribly. I question the objective conclusion, which is whether she could expect recovery that might relieve her of what is only a temporary problem.

Yeah, so under that psychological assessment, then doesn't this lead to the conclusion that she was non compos mentis? — Wallows

No. I can see it, you can see it, even @NKBJ can see it. So if someone feels something such that anybody can well understand how they would feel it, that is evidence that they are perfectly compos mentis.

But personally, I would not presume to make any diagnosis or decision in such a tragic and difficult case on the basis of even quite a good newspaper report.

I think in a situation of crisis, one would tend to intervene, but the length of time in this case seems to indicate that many things have been tried and have failed. So it is not a question of intervening or not, so much as a question of stopping intervening when many interventions have failed utterly.

As it is, the Dutch health care system is one of the best in the world and absolutely free for children up to 18 years old. — Benkei

That's great, but I hope you do realize that even their mental health care system is woefully inadequate. We just don't have a very good understanding of how the brain functions, and thus what happens when it malfunctions, and thus how best to fix it. And that's the same globally.

Would you allowed her to be euthanized given her several year history of serious depression?
— Hanover

No. — Michael

Why? @Benkei says otherwise.

I think in a situation of crisis, one would tend to intervene, but the length of time in this case seems to indicate that many things have been tried and have failed. So it is not a question of intervening or not, so much as a question of stopping intervening when many interventions have failed utterly. — unenlightened

Maybe if we were talking about an adult with a fully formed brain.

Noa suffered from various kinds of mental disturbances during her teen years. The brain is undergoing a massive overhaul of the very structure of its synapses during this time up until the age of 25. It's absolutely impossible to say with any certainty that she wouldn't have recovered, if her brain had been given the time to form fully. She was robbed of the chance at recovery.

For a shockingly large number of people, mental illness flares up at this time, trauma-induced or not. Some never recover, but most do. We can't allow all depressed teens to commit suicide, just because they cannot see the light at the end of the tunnel.

To go off on the extreme. She seems to have pigeonholed herself into that decision. And, when you have a suicidal patient that disregards all potential for recovery then what? It's a no win situation.

We can't allow all depressed teens to commit suicide, just because they cannot see the light at the end of the tunnel. — NKBJ

It's a no win situation. — Wallows

I agree.