Intentional death is a matter for philosophers, not doctors. They have no right to intervene in someone's personal choice to take drugs or to end their life, and a decent Human, regardless of credentials, would not allow someone to continue suffering whether or not that meant death.
Jake, thank you for sharing this story. I'm sorry you've faced such hardship - not only because of your cancer, but because of the bureaucracy and bumbling of a system that was supposed to help but sometimes just makes things harder and worse. I wonder if things would have gone differently for you, both from a symptom standpoint and a decision-making standpoint, if you had been referred to see a palliative care team. You may have been; you don't mention it. I care for many people with head and neck cancer, and it's a wicked disease.
Regardless, I've not suffered the way you suffer. The appeal I've been making in this series on differentiating between killing and letting die is a bit different than arguing against suicide itself. As I'll pull together in the concluding essay, I think it's wrong for clinicians to intend the death of their patients, that they have a duty to help their patients pursue health (which doesn't necessarily mean longevity at the expense of comfort, but also doesn't mean killing them), and that they don't have the authority to kill them. There's great latitude for comforting them in the midst of their suffering though.
Whether someone should be permitted to end their own life is another matter. I may eventually write on that, since I spent a fair portion of my career as a psychiatrist preventing suicide, even as I recognized that not all forms of death-wish were driven by mental illness. Some people were entirely rational in their desire to die.
As Stephen Jenkinson, the palliative care social worker who wrote Die Wise, observes, we each die the death of our culture. That is, we die the way the culture teaches us to die. Most Western cultures have a highly medicalized script for dying now, if we recognize "dying" at all. Others have said if we're going to die, we want death with as little dying as possible. I don't want to romanticize it, because it's terrible, but in bygone eras there was a script for dying that allowed the dying and those closed to them to find closure, to pursue reconciliation, to say what Ira Byock calls the four most important things: thank you, I'm sorry, I forgive you, and I love you. Sure, you could do those things on the eve of your assisted suicide or euthanasia, but there are challenges with that practice that I've written about elsewhere.
I'm glad you're recovering and finding a new equilibrium in life. I hope the hardships you wrote about continue to ease.
Intentional death is a matter for philosophers, not doctors. They have no right to intervene in someone's personal choice to take drugs or to end their life, and a decent Human, regardless of credentials, would not allow someone to continue suffering whether or not that meant death.
“people who express a wish to die are either shunted toward suicide prevention or suicide permiss”
Sometimes life is intolerable and heading towards the end anyway: https://jakeseliger.com/2024/01/23/will-things-get-better-suicide-and-the-possibility-of-waiting-to-find-out/
Jake, thank you for sharing this story. I'm sorry you've faced such hardship - not only because of your cancer, but because of the bureaucracy and bumbling of a system that was supposed to help but sometimes just makes things harder and worse. I wonder if things would have gone differently for you, both from a symptom standpoint and a decision-making standpoint, if you had been referred to see a palliative care team. You may have been; you don't mention it. I care for many people with head and neck cancer, and it's a wicked disease.
Regardless, I've not suffered the way you suffer. The appeal I've been making in this series on differentiating between killing and letting die is a bit different than arguing against suicide itself. As I'll pull together in the concluding essay, I think it's wrong for clinicians to intend the death of their patients, that they have a duty to help their patients pursue health (which doesn't necessarily mean longevity at the expense of comfort, but also doesn't mean killing them), and that they don't have the authority to kill them. There's great latitude for comforting them in the midst of their suffering though.
Whether someone should be permitted to end their own life is another matter. I may eventually write on that, since I spent a fair portion of my career as a psychiatrist preventing suicide, even as I recognized that not all forms of death-wish were driven by mental illness. Some people were entirely rational in their desire to die.
As Stephen Jenkinson, the palliative care social worker who wrote Die Wise, observes, we each die the death of our culture. That is, we die the way the culture teaches us to die. Most Western cultures have a highly medicalized script for dying now, if we recognize "dying" at all. Others have said if we're going to die, we want death with as little dying as possible. I don't want to romanticize it, because it's terrible, but in bygone eras there was a script for dying that allowed the dying and those closed to them to find closure, to pursue reconciliation, to say what Ira Byock calls the four most important things: thank you, I'm sorry, I forgive you, and I love you. Sure, you could do those things on the eve of your assisted suicide or euthanasia, but there are challenges with that practice that I've written about elsewhere.
I'm glad you're recovering and finding a new equilibrium in life. I hope the hardships you wrote about continue to ease.