In November 2008, Lauren Richardson’s mother decided to “join cooperatively with
A few days ago, ADF attorney Matt Bowman devoted much of an article over at Breakpoint to attacking my response to the outcome in the Richardson case. Much of the attack is ad hominem, and I will not bother responding to that.
But on the merits of the case, Bowman observes that "Lauren never signed any form wishing to be starved to death." That is true. But most people never complete an advance directive.Still, their surrogates proceed to withdraw all forms of life-sustaining medical treatment. Here, the Delaware Chancery Court heard the testimony of several witnesses and concluded that there was "clear and convincing evidence" that Lauren would not have wanted to persist in a permanent vegetative state. Bowman charges that I "seek to impose death without consent." Quite the contrary, it is the ADF and Lauren's parents that are imposing treatment without consent. I want to protect Lauren's autonomy and her rights under Delaware law.
Bowman says that I am wrong that Delaware law allows patients to be killed against a family’s unanimous wishes. But it surely does, as Bowman himself goes on to recognize in his own article. That is why he cautions that "Delaware statutes are therefore in urgent need of amendment." Bowman states that Lauren's "current care plan was signed by her parents, a Delaware Chancery Court judge, and an independent court-appointed attorney." While I do not access to muc of the docket, I assume this is true. But that does not make the settlement decision right under Delaware law.
The focus of guardianship proceedings pertaining to medical treatment is on what the patient herself would have wanted. Here, that was determined and then promtly ignored.
How sad to turn a beautiful family reunion/resolution
ReplyDeleteinto your opportunity to diss life!
http://www.alliancealert.org/2009/02/09/matt-bowman-human-not-subhuman-a-reply-to-professor-pope/
ReplyDeleteBowman responds.
What is obvious to me, is that neither you nor Lauren's parents can competently judge Lauren's will to live. That being the case, it is an ethical and therefore social duty to to sustain her life.
ReplyDeleteI am a mental health counselor. Based on current ethics underlying mental health legislation, it is my social duty to sustain life even if one expresses a wish to end it.
I have had hundreds, close to a thousand, of clients who have expressed a wish to die at some point in their lives. Of these, many have attempted to end their lives, two have succeeded, one by accident, the other in a state of drunkenness on the anniversary of a loved one's death date. Of those who have wished it and attempted it, all have expressed gladness to me that they did not suceed, as they later found will to live. I assume, based on knowing the two who succeeded, that they next day may have rendered their plans void.
Any competant mental health counselor will assure you that suffering, or the fear of suffering, blinds right thinking. They will also assure you that no mindset is permanent - thoughts wax and wane like the weather.
Even if you were able to assume that Lauren at some point in her life wished to die, you can not fix this mindset as permanent. Even her mother, who expressed at some point a wish for her daughter to die, has changed her mind. Fortunately, you and others were not able to help her along with this temporary wish.
Imagine how many accidental deaths society would help people along to if folks believed depression and despair a permanent condition. Outrageous.
I do not wish to open a dialogue with you; however, in reading your responce to Mr. Bowman, I felt compelled to leave some feedback from a mental health counselors point of view.
Dr. Ganser:
ReplyDeleteThank you for your comment. You are right that many people make choices without sufficient understanding. If they more fully understood, they might choose otherwise.
But none of that applies to Lauren Richardson. To the extent she reflected on this issue (living in a PVS), she decided that she did not want that. There is no opportunity for her to change her mind.
Therefore, the issue is whether we honor the wishes that she did express -- even if those wishes are not the most informed and deliberated they could be.
Your write that "her mother, who expressed at some point a wish for her daughter to die, has changed her mind." But it is not the mother's decision to make. The mother is supposed to exercise substituted judgment and decide AS BEST WE CAN DETERMINE LAUREN HERSELF WOULD HAVE DECIDED.
Thank you for your reply.
ReplyDeleteI think everyone, ultimately, is pro 'choice'.
Choice, I understand, at it's most elemental level, is a human right, not a legal right. Ultimately, we can do whatever we wish to do, if we have physical/financial/social/emotional ability to do so.
My understanding legal right to choice is limitted. It is developed enough though, to recognize that laws and restrictions serve individual and social well being. Individual and social well being is defined by a philisophical system of ethics.
In the mental health profession, our ethics and related legislation protect life, even if one expresses a fervent with to end it, to the extent that folks such as myself can physically restrain and remove some legal liberties in order to protect that life.
As mentioned, in my experience, I have never met anyone with a fixed desire to die, though many of my clients are referred to treatment unwillingly, and often from the ER where they were examined and held for suicidal ideation/attempts. A desire to die is fueled by depression, which is treatable.
Even if one exists in a substandard physical/mental state, they can find happiness and desire to live, even if it one may ascertain that the desire to die is at present or was sometime in the past fully informed.
I believe, based on my clnical experience and training, as well as insight in to the human condition, that if we remove laws protecting a person from harming themselves in moments of fear/depression, many will die who could otherwise be helped to live. When a person signs a piece of paper asking another to help them along to their death, they are asking for relief from despair. Death is not the solution for arguably 99.9 % of these. Counseling is.
And, even if one is able able to make the case that some folks, in fact, know exactly what they are doing when they agree to die... I believe that this is such a minor percentage of folks that changing laws to suit them would harm more people than help. As I mentioned, in my experience working with some of the most despairing folks in society, the vast majority of these do not want to die. But they would sign that piece of paper if they had no hope. Hope is psychological.
I can't argue from a legal perspective here, only a psychological perspective. I wish I could express it more coherently, but there it is.
I hope you consider rethinking the individual/social benefit of laws making euthanasia a common option for people who are suffering. In my profession, death is not yet a legal option. I would hate to be forced to help people to their demise who I know I could otherwise help. My hands would literally be legally tied from helping others; and I honestly would never help someone to their deaths.
Also, I would like to clarify, that I am not a Ph.d. I am an LPC. I might enjoy the title of doctor, but haven't earned it. The dr prefacing my screen name are my first and middle initials.
ReplyDeleteAgain, thank you for your responce and your audience. I do not wish to enter in to debate with you, but only to offer you my insights. I do hope you seriously consider them.
Thank you. I will "seriously consider" your insights.
ReplyDeleteMy primary aim is to clarify, not to advocate. I endeavor always to be circumspect and charitable.
Clarity is hard to come by in consideration of such complex ethical issues. Even harder to come by when examining the mind of one person.
ReplyDeleteThank you for considering some of my thoughts on the issue.
Best wishes.
Denise