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Forums > Social Discussion > Protecting citizens from themselves.

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NYC


NYC

NYC
Location: NYC, NY, USA

Total posts: 9232
Posted:It was only a little news article that got me thinking about it this morning. Apparently, they raised the 'minimum payments on credit cards'. The rational was to make it more difficult for people to rack up huge credit debts and have them loom for years.

But it got me thinking:

What responsibility does a government have for protecting its citizens from themselves?

This is often a fundamental question which oversees many smaller arguements.

Cigarettes, seat belt laws, drugs, assisted suicide, unheathy food, disease prevention, education... the list goes on.

Granted MOST of these things have SOME implications on others (such as drunk driving, second hand smoke, loss of parents... or even my tax dollars paying for the ambulance to drive the guy who didn't wear a seatbelt to the hospital..)

I find a HUGE difference in philosophy between the UK and the US on this one on many different issues (drugs, guns, even spending tax dollars to advertize healty living...)

"Infringe upon civil rights to protect the public", or stick a warning label on it and "let the buyer beware"?


Well, shall we go?
Yes, let's go.
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Icer
SILVER Member since Apr 2005

Icer

just a shadow of my former self...
Location: Christchurch, New Zealand

Total posts: 205
Posted:i think if someone wants to kill themselves they will, as sethis pointed out. three of my friends have used three different methods and they all worked. they are soooooo many ways to kill one self, restricting a potentially fatal medication for fear of intentional death is niave at best. protecting people from mistakes is, ofcourse, a good reason, but the highest cause of accidental deaths, im sure, would not be misused medication.

It took a while, but once their numbers dropped from 50 down to 8, the other dwarves started to suspect Hungry.

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Stout
SILVER Member since May 2004

Stout

Pooh-Bah
Location: Canada

Total posts: 1872
Posted:OWD, I was thinking that rape was the reason behind drink spiking, or maybe in the mind of the rapist, getting some sex, which is why I find the whole thing sad. Is that what it takes for these guys to get laid? If that's the case, then I don't see these guys making the leap to cold blooded murder even though in the eyes of the law they're both very serious crimes.

Was that council worker trained in the storage and application of pesticides? Licensed even?

It's the extreme poison angle I was looking at too. Around here, those types of poisons are hard to come by, and yes cyanide is an extreme poison. If I were going to do myself in with poison, that's what I'd take. It's quick and effective. I spent a couple of years working in a mining research laboratory, I know all about cyanide.

The whole idea is interesting as an academic discussion, but in reality, it's never going to happen, for the same reasons suicides don't make the news. Just the availibility of cyanide pills might be thought of as encouraging the act and given the protecting us from ourselves idea of this thread I can't see suicide pills ever being legalized.

Doc Lightning, just curious, I see a difference in the morality between writing a prescription and physician assisted suicide it's a very fine difference, but the ethics of the whole idea are a direct violation of your sacred oath so hopefully this is an issue you will never be faced with.

I hear most building jumpers change their minds half way down.


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onewheeldave
GOLD Member since Aug 2002

Carpal \'Tunnel
Location: sheffield, United Kingdom

Total posts: 3252
Posted:Written by: NYC

I knew cyanide pills was a bad example.

Well, let's say that every Wallmart had one of those Dr. Kavorkian thingies. You'd really be OK with people signing a waver and then killing themselves?

I think there are many moments in people's lives where they'd hurt themselves if it was easy and accessable. It's certainly going to take more effort to hang one's self then just to drive to Wallmart.



Out of consideration for those, who like me, have no idea what a 'Dr. Kavorkian thingy' is; could you give a brief explanation please? smile


"You can't outrun Death forever.
But you can make the Bastard work for it."

--MAJOR KORGO KORGAR,
"Last of The Lancers"
AFC 32


Educate your self in the Hazards of Fire Breathing STAY SAFE!

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FireTom


Stargazer


Total posts: 6650
Posted:we're jumping from credit cards to suicide?

that's inflation!


the best smiles are the ones you lead to wink

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Written by: NYC

Well, let's say that every Wallmart had one of those Dr. Kavorkian thingies. You'd really be OK with people signing a waver and then killing themselves?




Of course not. It'd make it too easy for people with, say, uncomplicated depression to do themselves in.

It's one thing to criminalize an activity that harms nobody but the individual performing the activity. It's a different thing entirely to readily provide multiple ways for people to harm themselves and others.

Incidentally, do you know why I'd never be in favor of a Kevorkian-style suicide machine? Because someone has to start the IV on those machines.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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coleman
SILVER Member since Aug 2002

coleman

big and good and broken
Location: lunn dunn, yoo kay, United Kin...

Total posts: 7330
Posted:i thought the point of the kevorkian machine was that once it was set up, its the patient that presses the sodium chloride button and does the actual deed?

yes, a doctor has to set up the machine and insert the i.v. but until the button is pressed the patient is fine.

morally that's no different to prescribing a potentially lethal dose of narcotics to someone and telling them how to use them to that that effect is it?

the kavorkian machine is not for 'suicidal' people anyway, its for terminally ill people that want to end their lives.

i see a big difference between someone who wants to kill themselves to escape life and someone who wants to end their life in a dignified way (what i would call 'embracing death').


cole. x


"i see you at 'dis cafe.
i come to 'dis cafe quite a lot myself.
they do porridge."
- tim westwood

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Written by: coleman

i thought the point of the kevorkian machine was that once it was set up, its the patient that presses the sodium chloride button and does the actual deed?

yes, a doctor has to set up the machine and insert the i.v. but until the button is pressed the patient is fine.

morally that's no different to prescribing a potentially lethal dose of narcotics to someone and telling them how to use them to that that effect is it?



There's a difference, but a subtle one. In one, I am doing something medically defensible, such as prescribing fentanyl patches for a terminal patient. I'm simply advising the patient not to apply them all at once because that might be lethal.

In the other, I'm actually actively taking part in the suicide.

It may seem like a technicality, but to me it's very important. I cannot actively do anything that would kill a patient, but I could passively sit back and not try to stop it.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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coleman
SILVER Member since Aug 2002

coleman

big and good and broken
Location: lunn dunn, yoo kay, United Kin...

Total posts: 7330
Posted:i get ya but that still doesn't sound morally any different to me since the intention is the same in both cases - give a patient a means of ending their life.

how is that ethically different to setting up the kavorkian machine and saying "whatever you do, don't touch this button here as it will kill you".

in reality, if you know they are 'suicidal' do medical ethics not dictate that should you should keep their prescription sizes low enough so that there is no risk of overdose, accidental or intentional?

in both cases, you are conciously giving them a means to die - your method just happens to have a cover story - you have covered your arse and won't be struck off since you can say "i warned them about the dangers of the medication that they required. i did my job to the letter".

is that not a case of applied 'plausible deniability'?


cole. x


"i see you at 'dis cafe.
i come to 'dis cafe quite a lot myself.
they do porridge."
- tim westwood

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Written by: coleman

i get ya but that still doesn't sound morally any different to me since the intention is the same in both cases - give a patient a means of ending their life.

in reality, if you know they are 'suicidal' do medical ethics not dictate that should you should keep their prescription sizes low enough so that there is no risk of overdose, accidental or intentional?

is that not a case of applied 'plausible deniability'?




Well, first of all, I'm not going to make a terminally ill patient go to the pharmacy every day to get a new fentanyl patch. That would be cruel.

Plausable deniability and liability figure into it, to be sure. All I'm saying is that I would never prescribe a lethal dose of medicine (let's face it, a number of medicines are supplied in one-month supplies and could be lethal if taken all at once). I would not, however, go out of my way to stop a terminally ill patient from taking her own life in a painless manner, such as slapping thirty fentanyl patches on her body at once.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Stout
SILVER Member since May 2004

Stout

Pooh-Bah
Location: Canada

Total posts: 1872
Posted:Morally, the technicality prevents you from having to live with the thought that you actually killed someone. Ethically it's all about covering your ass

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Here's how I'd handle it:

"These are fentanyl patches. You'll apply one to some part of your body (arm, thigh, chest) once daily and you'll remove the old one when you do. I'm giving you a 30-day's supply.

"Now, please DON'T apply them all at once in an attempt to kill yourself, even though it would probably work. If the pain is that bad, call me and we'll come up with something more aggressive to make sure that you're comfortable."

Now, I've done my job. I haven't prescribed a lethal dose of medication, I haven't directed the patient to kill himself, and I've done something perfectly medically defensible, which is that I've treated the patient's pain.

If he goes and slaps them all on at once and dies of respiratory failure, it's not my fault.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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NYC


NYC

NYC
Location: NYC, NY, USA

Total posts: 9232
Posted:But you have prescribed a lethal dose of the medication. If you give someone an unloaded gun in one hand and bullets in the other and say "Don't use this", is that really different than giving them a loaded gun?

And how could you support selling suicide at wallmart but not prescribing it yourself? Does it then fall on the walmart cashier?

And would your fentanyl patch situation be different if you knew your patient was depressed? Suicidal? Previously suicidal but now only depressed?

Again, at what point do we protect them from themselves?


Well, shall we go?
Yes, let's go.
[They do not move.]

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coleman
SILVER Member since Aug 2002

coleman

big and good and broken
Location: lunn dunn, yoo kay, United Kin...

Total posts: 7330
Posted:well explained - i get the difference now.



it doesn't answer my "what about if you know they are 'suicidal'" question but its shows that there is no direct intention of giving a means of killing themselves - you have not changed your assessment of the situation based on whether you thought they wanted to end thier life or not.





cole. x



edit: hmm, it seems nyc asked the same thing but better - at what point is it unethical to ignore someone's state of mind and give them a possible means of ending their life?



would you think it was just as ethical to say give a recovering heroin overdose patient a month's supply of methadone at once and say "don't take it all in one go now..."?

EDITED_BY: coleman (1136568106)


"i see you at 'dis cafe.
i come to 'dis cafe quite a lot myself.
they do porridge."
- tim westwood

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NYC


NYC

NYC
Location: NYC, NY, USA

Total posts: 9232
Posted:Written by: coleman

it seems nyc asked the same thing but better -



Only because my keyboard has a shift button. wink


Well, shall we go?
Yes, let's go.
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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Written by: NYC

But you have prescribed a lethal dose of the medication. If you give someone an unloaded gun in one hand and bullets in the other and say "Don't use this", is that really different than giving them a loaded gun?




Yes, it's difference. Nobody needs a gun. Pain control in terminal cancer is a different issue than a loaded gun. If they'd like to do it with a gun, I can't prescribe that.

Written by:
And how could you support selling suicide at wallmart but not prescribing it yourself? Does it then fall on the walmart cashier?


I think I recanted the Cyanide-at-Wal-Mart thing...

Written by:
And would your fentanyl patch situation be different if you knew your patient was depressed? Suicidal? Previously suicidal but now only depressed?



Not if the patient had terminal cancer. I'd never give fentanyl patches to a patient who wasn't in terrific pain.

Written by:
Again, at what point do we protect them from themselves?



Lord knows. Timothy McVeigh blew up a building with motor oil and fertilizer. Now, should we ban both?


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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NYC


NYC

NYC
Location: NYC, NY, USA

Total posts: 9232
Posted:We do. Sort of. Ammonium nitrate is pretty tightly controlled since then.

Well, shall we go?
Yes, let's go.
[They do not move.]

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Sethis
BRONZE Member since May 2005

Sethis

Pooh-Bah
Location: York University, United Kingdo...

Total posts: 1762
Posted:Isn't it a moot point? Anyone dedicated enough can kill themselves with a long tie pin. Granted, some things are more likely to be used in suicide than others, but regulation is not the method to deal with it.

I could kill myself with 3 different objects within a foot of me. Is that an argument for controlling their issue, or for counselling on my part?


After much consideration, I find that the view is worth the asphyxiation.
--------------------------------------------------------------------------------------
I may disagree with what you have to say, but I will defend to the death your right to say it.

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MiG
GOLD Member since Apr 2004

MiG

Self-Flagellation Expert
Location: Bogged at CG, Australia

Total posts: 3415
Posted:Like that picture of a road sign, saying: "WARNING: This sign has sharp edges"...

I think there is a point where we need to sit back and say to ourselves 'time for evolution to take over again.' The fact that there's warning signs on chainsaws telling people not to stop the chain with their hands, Winnebago's that now have notices that cruise control isn't, in fact, a full autopilot, and all sorts of other idiotic things to protect people from themselves, maybe we should stop for a bit. Let the ones that can figure out that no, you shouldn't try to fly wearing your superman costume be the ones to pass those genes on.

Again, there's points along the way where that line squigles. Kids, or people who haven't had much of a chance to get a grasp on their mortality, probably should get a notice, but, in this example, that'd be about it.


"beg beg grovel beg grovel"
"master"
--FSA

"There was an arse there, i couldn't help myself"
--Rougie

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onewheeldave
GOLD Member since Aug 2002

Carpal \'Tunnel
Location: sheffield, United Kingdom

Total posts: 3252
Posted:Written by: Sethis

Isn't it a moot point? Anyone dedicated enough can kill themselves with a long tie pin. Granted, some things are more likely to be used in suicide than others, but regulation is not the method to deal with it.

I could kill myself with 3 different objects within a foot of me. Is that an argument for controlling their issue, or for counselling on my part?



I doubt that there's one person in 10,000 who would be capable of killing themselves with a long tie pin.

Where suicidal individuals are concerned, I've seen an appalling lack of understanding on this thread.

There's a huge variety of suicidal states of mind, and what applies to one suicidal individual does not apply to another- and while one person driven to a frenzy of self destruction by the pain of their life could conceivably take their life with a brozen bottle or razor blade, this does not apply to all, or even most.

What is in the minds of many who want to leave this world is simple, quiet despair, and an appreciation that, where suicide is concerned, they are facing the last moments of their life, the last thing they will ever experience.

Sick as they are of existence, this doesn't mean that they don't care about what those last moments will be like.

Quite the opposite, it's a fairly universal human characteristic that the last moments of a life should be as comfortable as possible (think of how you'd like your elderly pet dog to be put down- ideally drifting into a drug induced sleep with the aid of a vet, not pounded to death with a convenient base-ball bat).

To believe that taking ones life with a tie-pin, or a knife, or jumping from a high building is a practical method for all suicidal individuals, or the majority of suicudal individuals, is naive in the extreme.

Yes, theoretically many everyday objects can be used, and will be, by some suicidal individuals.

But most will be far more inclined to use methods they believe to be quicker, less painful, and easier to implement, such as extreme poisons.

And, where these substances are concerned, control of availability is possible, and currently, many are controlled, and, IMO rightly so.


"You can't outrun Death forever.
But you can make the Bastard work for it."

--MAJOR KORGO KORGAR,
"Last of The Lancers"
AFC 32


Educate your self in the Hazards of Fire Breathing STAY SAFE!

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onewheeldave
GOLD Member since Aug 2002

Carpal \'Tunnel
Location: sheffield, United Kingdom

Total posts: 3252
Posted:Written by: MiG

Like that picture of a road sign, saying: "WARNING: This sign has sharp edges"...

I think there is a point where we need to sit back and say to ourselves 'time for evolution to take over again.'



While I wouldn't put in those words, yes, I agree that there are limits to how much is invested into public safety- ultimately there's a line beyond which individuals have to take responsibility for their own safety.

IMO, ensuring that, access to extreme poisons is limited and controlled, lies well within that line.

Especially as I am still failing to see any possible valid reason a member of the public would require possession of a extreme poison- if anyone can think of one, please enlighted me smile


"You can't outrun Death forever.
But you can make the Bastard work for it."

--MAJOR KORGO KORGAR,
"Last of The Lancers"
AFC 32


Educate your self in the Hazards of Fire Breathing STAY SAFE!

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FireTom


Stargazer


Total posts: 6650
Posted:clap well stated dave (oops) wink

besides -

for the part of the general audience that is considering "jumping off a 6 storey + building" as a suiteable method to kill themselves: Apparently some whose attempt failed, reported that they had a pretty strong rush wilst in air and (experiencing this rush) they felt so good that they didn't want to die anymore - but apparently didn't have a chute... shrug

So to all "suicidals" reading this: before you go out and buy yourself a gun and bullets, or whatever medication - maybe you try a bungee or base jump, or a tandem parachute skydive. You may change your mind about the issue as a whole and get a second chance... bounce

Should we prohibit trains (or train stations), because some people throw themselves in front of them? (without wasting any thought to the person that runs the train - whatever the term is)

This thread steered a lot in direction of "suicide and the law" - (no worries, I will not make contradictory statements in this one and also not start argueing with any of you on a certain level wink)

My question: It is possible to restrain a (for say intoxicated) person who is a threat to society - in the UK it seems impossible to restrain a person who is "only" (sarcastic) a threat to himself (at least until he's sober and at clear mind) - why so?
This (to me) is almost outrageous! mad2


the best smiles are the ones you lead to wink

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MiG
GOLD Member since Apr 2004

MiG

Self-Flagellation Expert
Location: Bogged at CG, Australia

Total posts: 3415
Posted:i normally call a person who runs a train a train driver. But i know a couple who call themselves 'locomotive relocation systems operators', 'massive mass transit technicians' and a few other people that call them 'rollercoaster wannabe`s'.

So, i guess you can take your pick...


"beg beg grovel beg grovel"
"master"
--FSA

"There was an arse there, i couldn't help myself"
--Rougie

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Someone once said that if more than 5% of the weight of a device or 5% of the cost is devoted to safety features, then it's either poorly designed or should require special training to use.

-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Kyrian


Dreamer
Location: York, England

Total posts: 4308
Posted:Written by: Doc Lightning

Someone once said that if more than 5% of the weight of a device or 5% of the cost is devoted to safety features, then it's either poorly designed or should require special training to use.



Nice!


Keep your dream alive
Dreamin is still how the strong survive

Shalom VeAhavah

New Hampshire has a point....

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