“Better Dead Than Disabled”: Bad Date and Bad Balance

To be fair, I should give an opposing view to the entire PBS presentation on the suicide issue particularly with regard to the date and the philosophy of the initial broadcast. So here is a
press release by Steven Drake of Not Dead Yet on the eMediaWire. I must say, however, that my postings about the film was about the presentation of personal character of a man, how he rationalized his suicide decision to his family and not about political issues. ..Maurice

Disability Activists Blast PBS for ADA Anniversary Promotion of Better Dead than Disabled Film


Disability activists blast PBS for choosing to air a "better dead than disabled" documentary on the anniversary of the Americans with Disabilities Act.
For Immediate Release

(PRWEB) July 25, 2005 -- In an all-too-common feat of cultural insensitivity, PBS has chosen July 26th, the anniversary of the signing of the Americans with Disabilities Act (ADA), to air “POV: The Self-Made Man.” The documentary features the videotaped statements of Bob Stern, an elderly man deciding to commit suicide rather than face possible disability, medical uncertainly or complications.

“The choice of this particular air date is an affront to people with disabilities in this country,” says Diane Coleman, president of Not Dead Yet, a national disability rights group based in Forest Park, IL. “The 15th anniversary of the ADA is, for people with disabilities, the nation’s largest minority, what the Civil Rights Act of 1964 is for people of color. Not only is it being ignored by PBS, but the network is featuring and promoting a program about a person so terrified of aging and disability that he commits suicide. In terms of sensitivity to diversity issues, this puts PBS in the same league as the Fox News Channel. And, no, that is not a compliment.”

Stephen Drake, research analyst for Not Dead Yet, notes that the film is a slanted portrayal of the broader issues. “Normally, we don’t comment when a rich, privileged guy decides to take his own life. We didn’t comment when Hunter Thompson shot himself. After all, Thompson wasn’t asking for a change in the law, a permission slip, or help from anyone.”

Drake says the situation is different with “The Self-Made Man.” “It’s being promoted as a tool for adding to the public discourse in regard to assisted suicide, an issue confronting the U.S. Supreme Court and legislators in California," he said. "Whether society will treat some suicidal people differently than others is a public policy issue. The film, however, frames the issue as a dispute between religious conservatives and those who “believe in autonomy.”

Coleman and Drake say this ignores the fact that secular disability rights groups have been at the forefront of opposing legalization of assisted suicide. Twelve national disability groups filed an amicus brief supporting the Attorney General in the Gonzalez v. Oregon case currently before the Supreme Court.

Moreover, disability opposition is well known to the official “advisors” to the documentary. Three out of the four credited advisors to the program are long-time assisted suicide/euthanasia advocates: Paul Spiers, ex board Chair of “Compassion and Choices;” Margaret Battin, advisory board of the Death with Dignity National Center; and Dennis Kuby, ex-regional director (California) of the Hemlock Society. These “advisors” could have advised a truthful portrayal of the policy debate, including disability opposition. “Obviously, balance is one thing producer Susan Stern wasn’t looking for,” says Drake.


Contacts:
Stephen Drake 708 209 1500 ext 29
Diane Coleman 708 420 0539

Rational Suicide Considered: "Fire in the Belly" and Whose Quality of Life?

I watched last night the PBS “Point of View” presentation of the film produced by the daughter of Bob Stern. As you may recall from my July 25th posting, Mr. Stern videotaped his explanation to his family of his intended suicide. His son and wife were present to listen and argue. The suicide was completed by the next morning. The film was very interesting and enlightening since most people who commit suicide never openly discuss their rationale, in detail, to their family in advance of their act. The film provided a extensive look into the life a man who tried to be in control of his life throughout the years and insisted to be in control up to the end when he found he was losing control because of the medical problems of an earlier stroke and then cancer of the prostate and finally scheduled surgery for an abdominal aortic aneurism.

The question is whether his death represented a “rational suicide”, one based on a thought out decision considering the gains and losses, as he had always done in his business life, but without an underlying mental depression to sway that decision. After reviewing the film, I find it difficult to define Bob Stern’s act as fully thought out and free of depression. First, I truly doubt some clinical depression was not present despite his fairly upbeat appearance that he had made a clear thinking analytical decision. He talked about losing the “fire in [his] belly” which had provided the drive for many of his previous business and personal accomplishments. Couldn’t this comment suggest underlying depression?

Further, and this is a consideration I would like my visitors to discuss, should a “rational” decision for suicide be made only with regard to the individuals own “best interest” as he described it and not include the best interest of the caring family? It seems Mr. Stern had developed through his presence, attention, interaction and love over the years a concerned, loving and in a sense dependent family. Yet, their need for him seems to have been disregarded in his analytical balancing of his life account as he worked out his decision. Should his considerations of quality of life, as he called it, have been limited only to his own or should he have considered the quality of life of his family with him gone? It is because of these points that if there is such an act as rational suicide, I don’t believe that Bob Stern’s death qualifies. What do you think? ..Maurice.

In the UK Physicians trump Patients: No Artificial Hydration/Nutrition

From today’s BBC News website: Patient loses right-to-food case

The General Medical Council has won its appeal against a ruling which gave a seriously-ill patient the right to stop doctors withdrawing food and drink.
Leslie Burke, 45, who has a degenerative brain condition, fears artificial nutrition could be stopped against his wishes when he cannot talk.
Mr Burke, from Lancaster, had won a landmark ruling, supporting his right to artificial nutrition and hydration.
But the GMC appealed, saying doctors could be put in an impossible position.

On the original May 24, 2005 posting on this blog describing Mr. Burke’s wishes, the previous ruling and the appeal by the General Medical Council, I expressed the following view:


My view is that unless the artificial nutrition and hydration is physiologically futile, which it rarely is, whether this specific treatment is started or removed should be the patient's own decision after comparing the risks vs the quality of life to be gained. I think food and fluid decisions should be that of the patient and in all cases requests should be followed by the healthcare providers. There may be medical resistance to starting other life-supporting treatments if the physician finds the medical benefit to be nil, such as beginning dialysis in a terminal cancer patient. There may be special circumstances, such as temporary prolongation of life, which would make starting them appropriate. All life-supportive treatments should also be stopped at the patient's request. Beyond life-supportive treatments, other treatments requested by the patient should be subject to medical standards of practice. ..Maurice.

Suicide: "No Way to See What Your Last Sorrow Hid"

This poem which I found on Poems for Free puts into a poetic verse the very view that I commented on in my last posting. Those who know the suicide victim and even those who only hear about the suicide, usually feel a sense of guilt for someone not doing something to prevent the act. I suspect often, unlike the Bob Stern case decribed in the last post where Mr.Stern discussed openly his anticipated act with his family on a video, there is at times no unambiguous warning or explanation to those who know the victim or society itself. For more poems about suicide, go to the above link. ..Maurice.

"There's No Understanding What You Did" by
Nicholas Gordon

There's no understanding what you did,
Or why, or what we now should think or do:
No way to see what your last sorrow hid.

What unimaginable agony amid
Our ordinary lives unraveled you?
There's no understanding what you did,

No way for you to tell us why you rid
Yourself of us and family, and . . . who?
No way to see what your last sorrow hid.

Or was it you were just a spoiled kid,
Trying to make us all feel bad for you?
There's no understanding what you did,

Whether mere curiosity had bid
You to sneak ahead a lethal view;
No way to see what your last sorrow hid,

Nor penetrate that awful, granite lid
That lies between our thoughts and what is true.
There's no understanding what you did,
No way to see what your last sorrow hid.

“Rational Suicide” or Is It Depression?

“Bob Stern always was a fiercely logical thinker, and he made the decision to die with the same unflinching reason that had governed his life.
He explained the process to a video camera he set on a tripod in his living room.”

The comments above is from the story of Bob Stern and his family and his self-inflicted death in
“One man's defense of his own suicide
Documentary looks at his 'rational' act” by
Reyhan Harmanci, staff writer of the San Francisco Chronicle in today’s edition

I present this resource now as a followup to the July 16, 2005 posting here on assisted suicide in which commentator Bob Koep discusses the concept of “rational suicide”.

This issue is also discussed in the Chronicle article with comments by Hemlock Society founder Derek Humphrey who is quoted "Elderly suicidal people recognize that life has run its course and if that's what the person wants…" Whereas Wesley Smith, an opponent of assisted suicide, is quoted "If you end up with a public policy around rational suicide, you might as well throw suicide prevention in the trash…If a mental health professional gets in the business of stamping suicide, it's abandonment."

My question: Does the fact that a person requests “assisted suicide” makes the diagnosis of depression since the person is “asking for help” and if the person such as Bob Stern shoots himself in his head, this act makes a diagnosis of “rational suicide”? Or should we just forget about the term “rational suicide” since all suicide represent mental irrationality of one sort or another?. ...Maurice.

p.s.- Thanks to Alyssa Uphoff for referring me to this article.

Is an Ideal Physician a Simple Physician?

Maybe to some patients the ideal physician is simple physician. At least that is the impression given by Wystan Hugh Auden in his poem below. ..Maurice.



GIVE ME A DOCTOR

Wystan Hugh Auden (1907-1973)

Give me a doctor partridge-plump,
Short in the leg and broad in the rump,
An endomorph with gentle hands
Who'll never make absurd demands
That I abandon all my vices
Nor pull a long face in a crisis,
But with a twinkle in his eye
Will tell me that I have to die.

(Resource for the poem is oldpoetry.com and noted “This poem is thought to be in the public domain”)

Praying and Illness: The Jewish Attitude

Continuing on with the thread of the role of prayer in medicine, the following is an extract from a paper in the Mount Sinai School of Medicine Journal nr2,vol 66, p 102-105, March 1999 titled
"Complementary Therapies and Traditional Judaism" by Fred Rosner, M.D. Prayer appears to be considered as a complementary form of treatment since “the healing powers of God was never allowed to usurp the essential functions of the physician and of medical science.” Read the entire paper, which includes, in addition to prayer, discussion of the views in Judaism regarding amulets, astrology, medical charms an incantations, nostrums, quacks and quackery. ..Maurice.


At one time or another, most human beings offer prayers for the relief of their own illness
or that of others. These prayers may differ in content and in the manner in which they are offered,
by both religious and non-religious people (1). Recourse to prayer in Judaism during illness is not
necessarily an indication that the person lacks confidence in traditional medical therapy.
The patriarch Abraham prayed for the recovery of Abimelech (Genesis 20:17), and God
healed him. David prayed for the recovery of his son (II Samuel 12:16), but his son died. Elisha
prayed for the recovery of the Shunamite woman’s son (IIKings 4:33), and the boy recovered. King
Hezekiah prayed forhis own recovery (IIChronicles 32:24), and God added 15 years to his life. The
shortest healing prayer on record is the famous one uttered by Moses for the recovery of his sister
Miriam, who was afflicted with leprosy. Said Moses: El na r’fa na la [O God, heal her, I beseech
thee] (Numbers12:13),and she recovered. These incidents are anecdotal andhence donot constitute scientific, statistical evidence for the efficacy of prayer, but they are certainly worthy of mention.
One should never be discouraged from praying, even under the most difficult and
troublesome conditions. The Talmud says (2) that “even if a sharp sword rests upon a man’s neck,
he should not desist from prayer.” On the other hand, a person should never stand in a place of danger and say that a miracle will be wrought for him. One should not count on being cured by
direct intervention by God without first having sought out the advice and treatment offered by
conventional human medical practitioners. The Jewish attitude toward prayer is succinctly summarized by Jakobovits (3) as follows:
.while every encouragement was given for the sick to exploit their adversity for
moral and religious ends and to strengthen their faith in recovery by prayer,
confidence in the healing powers of God was never allowed to usurp the essential
functions of the physician and of medical science.

References
1. Rosner F. The efficacy of prayer: Scientific versus religious evidence. J Relig Health 1975;
14:294–298.
2. Rosner F. Medicine in the Bible and Talmud. 2nd ed. Hoboken (NJ) and New York: Ktav and
Yeshiva University Press; 1995. pp. 204–210.
3. Jakobovits I. Jewish medical ethics. New York: Bloch Publishing Co.; 1975. pp. 15–