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Old 2008-11-13, 10:20   Link #1
TinyRedLeaf
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Euthanasia, Discussion and Debate

Let me die

Ailing British teen refuses heart transplant

Quote:
London (Nov 12, 08): Hannah Jones, 13, is not afraid of dying — she is afraid of spending her remaining days in a hospital bed.

In a case that raises a host of medical and ethical issues, the British teenager from a small town northwest of London has won a battle to refuse a heart transplant operation.

That decision by British medical authorities has ignited a debate over whether children should have the right to refuse potentially life-saving medical treatments or if health authorities have an obligation to intervene.

Hannah, from Marden, 145 miles (233 kilometers) from London, was diagnosed with leukemia at age four. Doctors later found a heart defect. In eight years, she has had chemotherapy and nearly a dozen operations. "I've been in hospital too much — I've had too much trauma," she told Sky News on Tuesday.

Hannah's story surfaced when her parents complained about medical officials who threatened to force her into a hospital.

"They phoned us on a Friday evening and said that if we didn't take her in they'd come and take her. We still refused to take her," said her mother, Mrs Kirsty Jones.

A social worker was then sent to interview the teenager about her refusal to have a heart transplant to treat her cardiomyopathy, a serious disease where the heart muscle becomes swollen and sometimes fails. The social worker backed Hannah's decision.

In Britain, children younger than 16 aren't automatically considered legally competent to make decisions about their health care. Still, British courts have said that a child's decision can be valid if they have "sufficient understanding and intelligence to enable him or her to understand fully what is proposed".

- Time.com
Coincidentally, Singaporeans have been debating our country's Advanced Medical Directive Act, which allows a person sign a legal document to inform his doctor that he does not want any extraordinary life-sustaining treatment, in the event he becomes terminally ill and unconscious.

Even though the AMD was passed into law in 1996, only 10,000 people — out of a population of 4 million — have signed such a document in the past 12 years. So, it seems that the majority of Singaporeans see no need for the AMD.

However, Singapore's health minister believes otherwise. Based on feedback he has received, and from the personal experience of his wife, who agrees with the philosophy behind the AMD but hasn't yet signed one, he concluded that there are other factors holding people back.

Namely, the moral objection to what seems, at first blush, to be legal support for euthanasia.

Archbishop says NO to euthanasia
Quote:
Singapore (Nov 3, 08): Archbishop Nicholas Chia read out a special message to all Catholic churches on Sunday.

In his letter, Archbishop Chia came out publicly to condemn the practice of euthanasia or mercy killing.

This has been a hot topic making waves in local media recently with discussions of changes made to the Advanced Medical Directive, or living will, which has been seen by some as condoning the act of euthanasia.

- The Straits Times
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Old 2008-11-13, 10:57   Link #2
ZephyrLeanne
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Quote:
Originally Posted by TinyRedLeaf View Post
Let me die

Ailing British teen refuses heart transplant



Coincidentally, Singaporeans have been debating our country's Advanced Medical Directive Act, which allows a person sign a legal document to inform his doctor that he does not want any extraordinary life-sustaining treatment, in the event he becomes terminally ill and unconscious.

Even though the AMD was passed into law in 1996, only 10,000 people out of a population of 4 million have signed such a document in the past 12 years. So, it seems that the majority of Singaporeans see no need for the AMD.

However, Singapore's health minister believes otherwise. Based on feedback he has received, and from the personal experience of his wife, who agrees with the philosophy behind the AMD but hasn't yet signed one, he concluded that there are other factors holding people back.

Namely, the moral objection to what seems, at first blush, to be legal support for euthanasia.

Archbishop says NO to euthanasia
Although I'm in Japan, I was in Singapore for some time before, just about the time the current health minister stepped in.

Now what he's doing, on one hand, (at least to him and MOH) is to reduce suffering of patients with terminal illness... BUT what if just a little later after, a new cure for the ailment appears? I know of a case of someone with osterocoma - he almost went for an amputation - then they found out that liquid nitrogen can stop the disease, especailly since it wasn't the final stage yet. Close call, huh?

Besides, I don't think life is something we can play with. Our lives are intertwined with others. Our decisions affect others - even from non-religious view. Apparently, almost all major religions (except Hinduism and Haruhiism) in Singapore are against it. That should give some idea of public's views.
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Old 2008-11-13, 11:48   Link #3
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Originally Posted by ShimatheKat View Post
BUT what if just a little later after, a new cure for the ailment appears? I know of a case of someone with osterocoma - he almost went for an amputation - then they found out that liquid nitrogen can stop the disease, especailly since it wasn't the final stage yet. Close call, huh?
In Hannah's case, what if the heart transplant fails to cure her? More years spent in hospital, instead of living life as normally as she can. Tough luck, huh?

Quote:
Besides, I don't think life is something we can play with. Our lives are intertwined with others. Our decisions affect others - even from non-religious view.
I agree. Particularly if it's someone else's life. What gives me the right to decide for him? Or worse, to force him to accept my decision?

Quote:
Apparently, almost all major religions (except Hinduism and Haruhiism) in Singapore are against it. That should give some idea of public's views.
Actually, there is a subtext to the debate that is mainly of interest only to Singaporeans. In my view, there is a curious situation here today, where some of our politicians appear to be getting too progressive for many people's liking. Not surprisingly, the conservative backlash will usually be led by prominent religious groups.

I'm not too fond of religion. But that's just me, of course.
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Old 2008-11-13, 13:21   Link #4
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Very well put, TinyRedLeaf.

I believe that people should have the right to end their life gracefully if they feel that their suffering is too much to bear. We even put our pets down if they're in too much pain, and I think that humans should be given the same opportunity. Your life is just that; yours.

It's heartbreaking that someone who's barely in her teens has been through so much already. Life can be much too cruel.
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Old 2008-11-13, 13:21   Link #5
Shadow Kira01
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Originally Posted by TinyRedLeaf View Post
Let me die

Ailing British teen refuses heart transplant

Archbishop says NO to euthanasia
I could understand why the British teen refuses the heart transplant. First of all, the success of a heart transplant isn't very high meaning the teen could suffer a lot more before dying, when it could all be avoided. Secondly, it isn't painless to have your heart removed and replaced. Thus, its not like the teen will survive if accepted the heart transplant in the first place, but may end up suffering a lot more of pain before dying in the end. Why go through the trauma of a surgery and suffer pain when it will end naturally?

On the issue of euthanasia, this isn't the same thing. Euthanasia is intentionally ending a patient's life by means of utilizing toxic substances, whereas the refusal of a heart transplant is a complete different issue and should not be mixed. If it is the archbishop's idea of forcing the heart transplant, then the teen has no choice. He or she should have not followed the religion knowing that its religious belief is absolute (dictatorship).
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Old 2008-11-13, 14:01   Link #6
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Originally Posted by Shadow Minato View Post
On the issue of euthanasia, this isn't the same thing. Euthanasia is intentionally ending a patient's life by means of utilizing toxic substances, whereas the refusal of a heart transplant is a complete different issue and should not be mixed. If it is the archbishop's idea of forcing the heart transplant, then the teen has no choice. He or she should have not followed the religion knowing that its religious belief is absolute (dictatorship).
The arch-bishop may be illegitimately trying to expand the definition of euthanasia and also illegitimately trying to redefine "voluntary withdrawal of treatment" suicide or existing suicide. To be blunt, the arch-bishop is an idiot if that was his purpose. A few hundred years ago, absolutely sincere Catholic Christians would wander the battlefield slitting the throats of comrades who would have died horrible infected gangrene deaths, so he can't even fall back on tradition with that one.

Voluntary withdrawal of treatment or refusing high-risk treatment is basically letting the natural course of the disease take effect. Heart surgery/replacement is *high risk*. Secondary complications from diabetes can be horrible (e.g. internal organ gangrene and necrosis) and some patients choose to stop treating their diabetes because death from a diabetic coma is preferable to screaming uncontrollable painful death from rotting inside.

However..., there doesn't seem to be any direct connection between the Singaporean arch-bishop's comments and the English teenage heart patient. These were two totally separate and unrelated news stories. The teenager's big issue was that she is 13 (her religion isn't even mentioned but its probably Church of England) - not normally an age where they get to decide their fate legally. She convinced her parents to opt out of the high-risk surgery and I'm just glad to see medical policy supports her.
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Old 2008-11-13, 15:32   Link #7
TinyRedLeaf
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Originally Posted by Vexx View Post
However..., there doesn't seem to be any direct connection between the Singaporean arch-bishop's comments and the English teenage heart patient. These were two totally separate and unrelated news stories.
They are two completely different issues. That's the Archbishop of Singapore's Catholic community, by the way, not the Archbishop of Canterbury.

The relation comes in with regard to Singapore's Advanced Medical Directive, which allows a terminally-ill Singaporean to refuse extraordinary treatment that may or may not prolong his life.

But, predictably, some people here have mistaken the health minister's support for the AMD as a "yes" vote for euthanasia. They invoke the same old fear of slippery slopes, that is, voluntary death by natural causes today, assisted suicide tomorrow.
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Old 2008-11-13, 16:07   Link #8
Vexx
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Ah, thanks for the clarification --- the arch-bishop's diatribe just sounded sort of ambiguous. Didn't know there was an AMD issue in Singapore (glad to hear there's an AMD though). I can only think that people against the options of an AMD have never had to deal with messy dying situations that pain meds will not placate.
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Old 2008-11-13, 16:17   Link #9
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Originally Posted by Kyuusai View Post
That's pretty much it. My post was very poorly worded (I shouldn't have used the word "news", for instance), but I'm in rapid-posting mode most of the time due to my limited time online. It's not news, but it's an excellent layperson summary for a field that's getting near-zero attention. I've been reading news snippets for years about research results that clearly showed more was going on than the old DNA model, but never did those stories actually have anything to say about what's actually being learned in this field.


On the issue of AMA... I really don't find those figures surprising at all. Not only does it sound like a process most people would be willing to go through, but I can't think of any legal process which the general public is sufficiently educated about in any country, so I don't imagine that something like this would be well understood by the populace.

On the other hand, I really have to wonder what could have caused confusion such as people mistaking it for a euthanasia. I can't imagine how a person could confuse being able to die naturally with being euthanized. Surely there must have been some misinformation being spread?
There's an "euthanasia light", which is legal in some places, where instead of taking actual poison or some such, doctors unplug life support, or you just stop taking your medication. It's kinda like that.
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Old 2008-11-13, 17:30   Link #10
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Originally Posted by Anh_Minh View Post
There's an "euthanasia light", which is legal in some places, where instead of taking actual poison or some such, doctors unplug life support, or you just stop taking your medication. It's kinda like that.
I'm just surprised that there are people who consider this to be anywhere near comparable to euthanasia. I can sort of see where this idea might come from, but I still can't bring myself to see them as even anywhere near equivalent. Death is natural. Sustaining death is not.

I hope that doesn't come across as an argument. I'm just expressing my (ever-growing) shock at the failings of society.

And, while I think it's a slippery slope, being from the country I can understand mercy killing.
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Old 2008-11-13, 17:40   Link #11
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Well, I'm for euthanasia. Especially in cases where the patient is explicitly asking for it.

That removes the moral difference between poisoning someone and turning off his life support. They're both "OK", in the same circumstances. (Except in cases where there's no life support to unplug... Then euthanasia's still fine, but the other option is moot.) So, to me, they're pretty much the same, in that they allow the patient to escape the pain at the cost of his life. I don't see where the "failing" is.
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Old 2008-11-13, 21:37   Link #12
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Originally Posted by Anh_Minh View Post
Well, I'm for euthanasia. Especially in cases where the patient is explicitly asking for it.

That removes the moral difference between poisoning someone and turning off his life support. They're both "OK", in the same circumstances. (Except in cases where there's no life support to unplug... Then euthanasia's still fine, but the other option is moot.) So, to me, they're pretty much the same, in that they allow the patient to escape the pain at the cost of his life. I don't see where the "failing" is.
Well, if you see them both as perfectly acceptable, it's pretty natural to not distinguish them, but for a person who does see euthanasia as wrong or unacceptable for some reason to not distinguish between them is to deny the reality of natural death.
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Old 2008-11-13, 22:48   Link #13
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/\ /\ /\ Oh, now I get it. I thought the two articles were meant to be interlinked.

Still, I'm against euthanasia for people who are still alive and kicking. For those who are brain-dead, that's a different story for a different place.

For whoever can still have awareness of what is around oneself - it is a miracle that he is still alive, whatever one has. One more day may mean one more day of suffering, but it gives you one more day to do something one has forgotten to do.

Then again, there are others who have absolutely no idea of what to do in their lives as they had, have (and possibly never have) purpose in their lives. That's pretty meaningless. Still, that, I feel =/= argument to go thru euthanasia.

For those who don't know what euthanasia is like, as someone who provides "pastoral care" (read - consoling and kind words - but I'm no nurse - I'm not even employed by the hospital!) It's actually rather painful. It's usually administered as an IV jab. The poison is not exactly anywhere near the fast-acting of Zyklon B in WWII. Nowhere near. It's so slow, it can take as much as 30 min in cases to kill.

The patient, while trying to achieve a 'merciful death", has to suffer just before dying. Compare this to someone who dies naturally. There is a huge difference. As far as i know, euthanasia is usually an order from the patient, not family/friends/doctors. The family has no choice but to accept. The doctor has no choice but to follow orders. I have no choice but to see the patient suffer more than ever.

Sometimes after seeing this, I run to the toilet and scream "WTF" in full. (In Japan, few understand English of THAT level) It's painful for the family too, but it's a choice they have to accept.

Therefore, I don't really agree with Euthanasia.
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Old 2008-11-13, 23:11   Link #14
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Originally Posted by ShimatheKat View Post
For those who don't know what euthanasia is like, as someone who provides "pastoral care" (read - consoling and kind words - but I'm no nurse - I'm not even employed by the hospital!) It's actually rather painful. It's usually administered as an IV jab. The poison is not exactly anywhere near the fast-acting of Zyklon B in WWII. Nowhere near. It's so slow, it can take as much as 30 min in cases to kill.

The patient, while trying to achieve a 'merciful death", has to suffer just before dying. Compare this to someone who dies naturally. There is a huge difference. As far as i know, euthanasia is usually an order from the patient, not family/friends/doctors. The family has no choice but to accept. The doctor has no choice but to follow orders. I have no choice but to see the patient suffer more than ever.
While I don't know what standard procedures are for euthanasia, I'm willing to bet that multiple methods are employed and that they aren't as painful as you're making them out to be. Hell, in the United States we have laws about how animals (such as those used in research) must be heavily anesthetized before having serious operations performed, many of those operations resulting in the animal being killed. Given that there's such a stigma against animal suffering, I have a very hard time believing that euthanasia could be legal if human suffering (physically) were involved.

As to dying naturally - well, let's hope that none of us ever die during a battle with cancer while undergoing chemotherapy. That's dying naturally, but the pain and agony (according to my grandmother, who died while undergoing chemotherapy and probably would have opted for euthanasia if it were available) is terrible.

Quote:
It's painful for the family too, but it's a choice they have to accept.
The death of a family member would be painful for anyone. In general, euthanasia cases are not those where someone who needs a serious operation but has a good chance of survival and living for many more years requests death. This is generally for people who have a very unlikely chance of survival, or who are already reaching the end of their life and then encounter a big complication.

I think there are two types of thought that come into play here: those who feel that life should be as long as possible; and those who feel that life should be as pleasant as possible. I fall into the latter category. For example, suppose you reach a ripe old age and then develop something - let's say it's cancer. If you remain untreated you'll probably only live for another year, but you can live in your house, go where you want, and at worst you'll only experience moderate discomfort (and that isn't even guaranteed). The other option is that you can go to the hospital to undergo operations and chemotherapy - you'll probably be in the hospital for about a year, and the chances that you'll be cured completely are unknown. Your total lifespan is also unknown. You might end up spending your final days in that hospital, confined to your hospital bed and ward, feeling queasy and ill nearly every waking moment. Which option appeals more to you?

If you feel that you'd rather extend your life as long as possible, then that's your philosophy and of course euthanasia goes counter to that. If you'd rather live out your last days in peace, it doesn't indicate that you're a supporter of euthanasia, but you might be open to it.

As far as the suffering it would place on a family, I have mixed feelings about that. I am sickened by families that view an elder member as little more than a trophy - they do not seem to care about how much suffering this person goes through or what their wishes really are, so long as they are alive. If they truly cared for the person then I'd imagine that they'd be in agony no matter what: they'd be sad if that person passed away; they'd be sad to know that this person was physically and mentally suffering at all waking hours. So, ultimately, I feel that euthanasia is the individual's decision. They should be given a mental health examination to ensure that they are of proper mind to make such a decision, and they should be given a week or more between the initial request and the execution of that request. As far as I know those are relatively standard procedures. If you don't like euthanasia, then when your time comes, don't do it. Why force your opinion on others?

And because someone always brings it up: if a doctor is not comfortable with performing euthanasia, then they should not be obligated to do it. As far as I know, most hospitals/laws allow for doctors to pass on the duty if it goes against their beliefs or makes them uncomfortable.
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Old 2008-11-13, 23:52   Link #15
ZephyrLeanne
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If you feel that you'd rather extend your life as long as possible, then that's your philosophy and of course euthanasia goes counter to that. If you'd rather live out your last days in peace, it doesn't indicate that you're a supporter of euthanasia, but you might be open to it.
No, actually, that's not my point.
Spoiler for if you hate religion, this is not for you:


Quote:
As far as the suffering it would place on a family, I have mixed feelings about that. I am sickened by families that view an elder member as little more than a trophy - they do not seem to care about how much suffering this person goes through or what their wishes really are, so long as they are alive.
That's true, I've seen that too. They throw their old man/woman into a nursing home... and leave them there.

Quote:
if a doctor is not comfortable with performing euthanasia, then they should not be obligated to do it. As far as I know, most hospitals/laws allow for doctors to pass on the duty if it goes against their beliefs or makes them uncomfortable.
But some doctors don't feel comfortable turning down a request like that, especially in Japan, as it is regarded as a lack of respect for the patient, if the doctor does so. This is another dilemma.

Maybe this is where East Asia and the West differ - respect plays an important aspect in life. It's a Confucian thing, really. With 1/4-Japanese background, I can understand. (and this 1/4 actually dictates my surname, since it's my grandfather on my father's side which has the Japanese line - the rest are either German or Brit)
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Old 2008-11-13, 23:58   Link #16
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Originally Posted by ShimatheKat View Post
No, actually, that's not my point.
I beileve that life is God's gift to man. We are here as transit passengers to either heaven or hell. That's 'bout it, really, as far as I'm concerned.
It actually is the point. Due to your religious beliefs you may not believe in living as long as possible simply for the length of time's sake, but you believe in taking action to avoid ending life. There's nothing wrong with that.

I'm not clear on how you would feel if people were, say, taken off of medications that were crucial for them to live - that would essentially be giving them a death sentence that could take weeks to months to be fulfilled. That's my own curiosity, though, and I'm sure it varies from person to person even among those who share the same belief as you.

Quote:
But some doctors don't feel comfortable turning down a request like that, especially in Japan, as it is regarded as a lack of respect for the patient, if the doctor does so. This is another dilemma.

Maybe this is where East Asia and the West differ - respect plays an important aspect in life. It's a Confucian thing, really. With 1/4-Japanese background, I can understand. (and this 1/4 actually dictates my surname, since it's my grandfather on my father's side which has the Japanese line - the rest are either German or Brit)
Respect may be a bigger issue in Asia, but the West does not have a lack of ethical dilemmas in the healthcare industry.
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Old 2008-11-14, 01:41   Link #17
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Originally Posted by Kyuusai View Post
Well, if you see them both as perfectly acceptable, it's pretty natural to not distinguish them, but for a person who does see euthanasia as wrong or unacceptable for some reason to not distinguish between them is to deny the reality of natural death.
"Any death that can be avoided, must be". If you believe that, then there's still no difference between euthanasia and giving up on treatment. They're both unacceptable.
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Old 2008-11-14, 07:14   Link #18
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Originally Posted by ShimatheKat View Post
Spoiler for if you hate religion, this is not for you:
In other words, the teen's life is not as important as the will of God? If you believe that you are a transit passenger to either heaven or hell, then where is heaven or hell? And once again, what you are implying is that people who don't agree with your "God" are the same as hating religion. That does not make any sense at all! More over, it is not the will of your God that is against euthanasia, but the will of your arch-bishop. And that's not the same entity or thing at all.

However, it is not your fault to hold such belief. It is good that there are people with religious belief, but it isn't for people to be give up logic and stick to the idea that human life is less important than the will of the arch-bishops and that the only objective of humanity is to reach the final destination known as heaven or hell in your opinion.
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Old 2008-11-14, 16:16   Link #19
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Euthanasia and suicide. It's a free world, you can do what you want, just if it doesn't annoy other people. Like the hell I care. Sure I've never understand them and will mock them as pussies, because that's what they are. They lose at life, they end their own body, no matter how many warning pop-ups and alarms evolution put in man not to do stupid things and kill himself, people still find that the best thing to do after you stepped into poo after getting fired from your job and finding your partner doing another person in home. How about selling all your property and moving to Middle-Eastern deserts (in the middle of nowhere) if you feel so bad at your situation and location? I mean empty deserts could be pretty fun!

Suicides are Darwin's examples. Their brains fail.

For christ's sake little girl, hire a gigolo, rent an elephant, paint the hospital walls in yellow without telling the officials... You have money. People who live in the woods trying to find something to eat to survive don't have money.
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Old 2008-11-14, 17:04   Link #20
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Originally Posted by Eggs in a Bottle View Post
Euthanasia and suicide. It's a free world, you can do what you want, just if it doesn't annoy other people. Like the hell I care. Sure I've never understand them and will mock them as pussies, because that's what they are. They lose at life, they end their own body, no matter how many warning pop-ups and alarms evolution put in man not to do stupid things and kill himself, people still find that the best thing to do after you stepped into poo after getting fired from your job and finding your partner doing another person in home. How about selling all your property and moving to Middle-Eastern deserts (in the middle of nowhere) if you feel so bad at your situation and location? I mean empty deserts could be pretty fun!
You see. The problem here is not tying euthanasia with suicide. The issue is totally unrelated. Maybe, you didn't read the original article and here is the link to it:

http://www.time.com/time/world/artic...858427,00.html

Apparently, a 13 year old British girl is going to die unless she get a heart transplant. A heart transplant generally means that they will be opening up her chest, yanking out her heart, and replacing it with someone else's heart. If the blood type and organ is compatible, it will be considered a successful surgery and she will live. Otherwise, it may cause side-effects and she might die even after doing the heart transplant. And so, not wanting to suffer all these pain and surgery, she chose not to do so and refused the heart transplant. It is not the same as suicide under these circumstances.
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