Anorexic suicidal woman to be force fed

I also said that, when your thought-process touches your condition, you don't think straight, correct? She may not want to die... but knows she definitely doesn't want to eat, with a high emotional charge on that, backed up by years of circular thought. Not eating = death. But, death is an unknown, with, most likely, not as high an emotional charge to it. Not wanting to eat is a big, hairy known she's got a huge thing about. It's doing a very good job of looming.

Ergo: not thinking straight about the death, neither. Death just seems a whole load easier at this point than eating thanks to the years of self-imposed brainwashing (to use an analogue).

edited 19th Jun '12 5:12:55 AM by Euodiachloris

We can play this game for a long time. That "she doesn't really want to die" and "it just seeems easier than eating" to her is your interpretation (though it has been suggested by the judge in the article first).

Frankly, who of us really, really "wants to die"? Few if any. Does an old, sick person suffering from a terminal illness and experiencing a lot of pain "really want to die"? Wouldn't s/he much rather be young again, be an intelligent, good-looking millionaire and at a great party? Probably. So you could say even people wishing for PAS don't really want to die. You may still chose dying as the lesser of two evils, though.

Whether "death is an unknown" obviously depends on your beliefs. There are many people who would disagree, religious or not. By your argument, nobody can think "straight" about one's own death, ever.

edited 19th Jun '12 5:19:07 AM by LordGro

Let's just say and leave it at that.

Whether we can think straight about our deaths at any point is pretty moot. For most people, suicide is acceptable if there is a terminal condition extracting a heavy price for continued existence for which treatment is insufficient to even be palliative. And, note: those are the ones even you have raised.

Conditions like anorexia, anxiety, depression, bi-polar, acute psychosis and schizophrenia are not, in and of themselves, terminal or debilitating. But, they can become so in their symptomatology if left untreated. Suffering can be alleviated through the treatment of the actual condition, and not just through allowing a quick death, however acute the suffering can become in the short-term.

Ergo: it cannot be the equivalent of allowing somebody with late-stage MS, Motor Neuron or even persistent locked-in syndrome to have euthanasia, even though those conditions also have cognitive effects associated with them. They cannot be palliated, past a certain point.

Yes: being of sound mind is important in law, as well as in practice. And, yes: people can and will debate what "sound mind" is and is not. And, whether the understanding of what death would mean is there or not.

The one thing that cannot be debated is, when there is a known treatment for a condition which is shown to alleviate symptoms and allow life to be lived, that it should be shut off due to a potentially temporary state of affairs. Terminal illnesses are, by definition, not temporary. States of depression and anxiety are. Locked-in syndrome is an interesting case in which law has yet to decide. See this BBC report on a specific case.

edited 19th Jun '12 6:09:30 AM by Euodiachloris

The thing that you wipe away a little too quick is that this woman expressed the wish for no further treatment herself.

It may be that you hold a different position on suicide itself: That (for whatever reason, religious or not) it's society job to force adult people that don't want to live to do so, as opposed to let such individuals have their own will. — People tend to feel strongly about this and there's probably no agreement in sight, and besides, this is a discussion for another thread.

However, mark that for answering the questions of whether the woman in the article should be allowed to commit suicide from an ethical viewpoint, and how far society should go to hinder her (or not), the fact that the woman is suffering from anorexia nervosa is ultimately irrelevant.

Let's just say and leave it at that.

Any acute suffering, no matter how transient, be it physical, social, mental or spiritual, is sufficient to endorse suicide? Ah, sorry: if that's your standpoint, no wonder we were talking at cross-purposes.

You're right: I couldn't agree to that. I didn't agree to be born: doesn't mean I should give life up without an incredibly good cause beyond a temporary state of affairs, whatever they may be. I won't get a second to try again with (probably: and, even if I do, it won't be with this identity). That's my view.

From the first posts, part of the problem is that being underfed as she is (an effect of her anorexia and not the anorexia itself) has been declared to cause enough additional psychological effects to get you declared insane.

edited 19th Jun '12 7:12:24 AM by Medinoc

"And as long as a sack of shit is not a good thing to be, chivalry will never die."

They're not just psychological effects: they are physiological effects that impact on psychological function. No amount of hemming and hawing gets away from what starvation does to the endocrine levels and what they, in turn, do to the conductivity within the brain.

These are known effects. Full stop. Very similar ones to those that would have somebody turn away water when they are dehydrated: cognition not working right. As it seems like she has been underweight for a prolonged period of time (from the looks of it, quite severely so), such deprivation will have had longer-term effects. Even her previous written statements would more than likely be written in a state unlikely to be declared competent by any judge.

In short: this way, she has a chance to have her treatment for the starvation occur... to later start tackling the underlying cause: the anorexia. If, after some long-term treatment for the anorexia, she still wishes to choose to starve to death and puts that in writing... well... maybe it'll be taken on board. I doubt it, though. If she chooses suicide by other means, probably a different story.

edited 19th Jun '12 7:48:13 AM by Euodiachloris

If she only made the decision not to eat, even if it means her death, after becoming underfed and getting some derangement as a result, then the government stepping in and forcing food into her is absolutely the right thing to do.

However, if, after gaining enough nutrients to be of sound mind, she still prefers death to eating, and signs an a living will to that effect, then I'd say it's time for the legal system to back off.

"It takes an idiot to do cool things, that's why it's cool" - Haruhara Haruko

Even upon hitting the right weight, she still has years of self-conditioning to tackle. She's locked herself into a thought-loop. If she doesn't wish to come out of it, fine: but she should be given enough treatment to at least notice the loop for what it is and see that there are alternatives that do, indeed, correspond to her and her life. Nothing says she needs to accept them.

Yeah, anorexia doesn't work that way. One does not automatically decide they like eating again once they're back to a normal body state. Anorexia, as was stated, takes a great deal of effort to overcome and deal with.

Insert witty and clever quip here. My page, as the database hates my handle.

I do in fact believe that there is suffering in the world. Along with impermanence and anatta (the idea of there being no intrinsic and eternal "self" or essence there of) to be three constants of reality. With desire, attachment, and ignorance being causes of the suffering portion of things. I'm noticing this quite a bit with my relationship with my girlfriend. I'm highly attached to her and feel very strongly for her. Problems involving her tend to be among the most emotionally taxing. We've broken up temporarily and that experience was very far from pleasant. I've noticed this in less extreme ways as well. I'll get slightly grumpy if we lack some type of snack I like to consume and when I don't know how to proceed in some manner of activity I get frustrated or potentially afraid. My belief that suicide is wrong and will just cause suffering for those around me and that I will be reborn anyway keeps me from killing myself in part. I have many other reasons I don't but those are the ones related to my religion. My belief that to suddenly drop all my things and enter the Sangha would be based solely on fear that I'm not learning or being a good person will just result in suffering for those around me and my leaving the Sangha because I wasn't ready. And so I stick with suffering for the moment. It still has things to teach me and I am not ready. I will be one day.

The serious sexual deviance example doesn't take into account inpatient care psychiatric wards. Whether the treatment is forced or based on the patient's will.

Placement in a ward or other such environment is thus preferable to allowing the person to kill themselves. We must first search and exhaust all non-death related scenarios that are within reason. Forcefully interring a pedophile exists within the "within reason" category.

Now if treatment has been tried then even then I would not go for death. Merely permanent interment into some form of facility such as a mental hospital or a prison. Sadly the environments of prisons tend to be very bad. So perhaps death would be preferable to living in such an environment as that. Their will may not be strong enough, the situation may be too dire, and the prison may lack ways of actually treating the disorder as opposed to just keeping them locked up.

As you don't use a system of morality based on kamma (the Pali spelling of karma, I'm a Theravadan) your argument is intriguing, but I don't find it particularly true or convincing. I will think it over though. I'm often thinking the kamma thing over as I do still have doubts about it and the rebirth system.

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

If you quit the lesson before you've learned all you can from it, aren't you just cheating your later self? Whether you take this to mean your rebirth or just you in 20 years, same deal.

That's the argument that kept me reaching for the razor blade seriously at one of my lowest ebbs. But, then, by nature, I'm an optimist of a kind. I was just very, very low.

Actually, that's funny: it is almost 20 years. 17, to be precise. I think I made the right call, back then. Life is a lot better than it looked when in the hole I could actually get out of. With help. Yay, old me! See, you weren't that dim, girlie!

edited 19th Jun '12 10:05:15 AM by Euodiachloris

That's part of what keeps me going too. There is so much to learn, but if I stop now and end it all I am cheating myself. The next life will go on without whatever I could have gained from furthering myself in my practice. Because I ended it then and there. It is the same with just ending practice. I ended my Japanese study abruptly because I deemed it dull. I was making visible progress as I could read small bits and understand small bits of things. And I was getting progressively better. So where could I be now if I had kept it up? I will not know as I killed it.

I can still take up the practice again later as I can with my Buddhist practice in other births though. Still that's not really an excuse to give up. Yes you can do it later. But will you?

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

No, that’s not my standpoint. I did not say that suicide is an option to go to in any case of “acute suffering no matter how transient”, or should considered in any “temporary state of affairs”.

It may surprise you extremely, but people don’t decide to kill themselves for fun and trifles. That suicides are weak people who just decide to off themselves for self-indulgent reasons of narcissism, convenience, cowardice or laziness is a naïve stereotype and wishful thinking.

Nobody throws his life away lightly. That's a human constant. People who consider or commit suicide, have gone through extreme suffering and have no hopes for a betterment. As with all people, sometimes the assessment of their own situation may be wrong; in other cases, it is not. And suffering is always subjective; that others do not always perceive this suffering doesn’t mean it isn’t there.

Yes I know, people don't like to look at it that way. Stories of neurotic, weak suicides that kill themselves for egoistic, trite reasons on the whim of a moment are so much more comforting (and comfortable).

I think that's a just very shallow, ignorant, and smug view. — But, as I said, this is derailing the thread.

Issue no. 2: “I didn’t agree to be born: doesn’t mean I should give life up without an incredibly good cause beyond a temporary state affairs …” Very well, but these personal convictions don’t answer why you would force others to continue their life even if they personally would rather not. Do you have any arguments to categorically deny others this right, even if you yourself can’t imagine a case where you would exert it?

Besides, you keep presupposing that the woman in the article wants to die "only" because of her disease. It’s not even wholly clear what that means to you: Does she just want to avoid further physical pain? Has the disease destroyed her life plans? Does she resent being a burden to her environment and society? There are many ways a disease can affect you.

You also keep implying that success of further treatment is a guaranteed fact. It would appear you can't be sure about it without having professional knowledge and knowing the details of the case.

If the woman is not in a sufficiently stable mental condition when she expressed the will to relinquish further treatment, then this can constitute a reason to disregard her wish even if you (like I do here) defend the right for suicide. — Experience teaches, of course, that people tend to question the sanity of someone who expresses a death-wish in a knee-jerk reaction, precisely because of the death-wish (or, possibly, its expression).

@Aondeug: Forcefully interning (whether to prison or into an psychiatric ward) a pedophile, or a potential sex killer (I guess you don’t seriously consider burying the poor chap alive, as in “interring” ) is not possible as long as he hasn’t actually broken a law.

Besides, hospitals and psychiatric treatment can’t fix everything. Some things just must be accepted. Well, this is probably turning into a derail, but I don’t think you can lead what they call a full life in confinement, whether it be voluntary or involuntary, and whether it is a prison or a psychiatric ward.

edited 19th Jun '12 12:13:03 PM by LordGro

Let's just say and leave it at that.

It can't fix everything, but still we must search for ways to fix problems that don't involve death. If we somehow exhaust every possible option and death is truly the only way to fix the problem then yes death must be caused.

Until you can convince me that yes every option has been exhausted to its fullest extent and won't work I will not endorse killing.

The fact that it's so hard to forcefully inter people who obviously need help but refuse to get it for whatever reasons is an issue with myself. I wish that were somewhat easier. I also wish the process of getting people to accept treatment was easier as well. Sadly it's not. The prison system is also horrendous. I wish to god it was primarily focused on rehabilitation. Much, much, much so than it currently is. That would be expensive and very hard to put into action however so sadly I must only dream of that.

And no burying someone alive is not interring. That is torture.

A "full life" by my count is merely realizing the Dhamma and accepting it wholly. This can be done in a ward or prison theoretically. It can be done anywhere. A wat and ordination is simply the easiest way in which to do this. It was designed in part for that purpose. Especially if the line of work is taken up after experiencing great amounts of pain from pleasure. That is the fullest life. Taking on the robes after living as a layman and then reaching Enlightenment. Anything less than that isn't full. Though it may be "good".

Also please do note that I mean that for myself and myself in particular. It may be different for others and I accept that. Though it confuses me at times due to how differently people view the world it is fine.

For myself nothing is full unless I accept that everything is empty. Everything else is just a lie.

edited 19th Jun '12 12:29:22 PM by Aondeug

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

You know, I don't remember ever suggesting that suicide was "easy" by either intimation or inference... Because I really don't think that. For one minute. For some, it can be: the decided minority — particularly those who do it expecting to be saved at the last minute. In those cases, it is a cry for help, but never a simple cry. For most, however it really isn't like that at all. Self-harm takes a lot of guts when it's a deliberate act.

It doesn't make it the right choice in the longer term, if you're in a boxed canyon that does have exits you just can't see for looking in all the wrong places. Help is sometimes needed to see them, though. Help you sometimes can't bring yourself to accept until you're forced to.

That, too, is not easy.

edited 19th Jun '12 12:31:14 PM by Euodiachloris

Suicide is very damn hard. It took me months to muster up the courage to do so. The only thing that stopped me was a teacher telling me that it was time for class. Given time to think about it in class I freaked out and went to the counselor.

The will to do it can be easily broken at times. And others it can be reinforced frighteningly.

Which is why I never ever tell them that I would be sad if they died. Comments of that sort tend to just steel them on. Often out of spite. It damn sure did with me and it's scary...

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

I'm with you on that one Aon. Pity, sadness or... worse... contempt. When you're in that low point, they can all too easily turn into flags you see as "go on, I dare you: I know you won't". Bursts of courage can be got through determination to prove others wrong... in either their pity or their profession that help is possible.

"I'm not stupid. I know my problem. There is no help. I've looked, it's not there. Nobody really believes."

For a while, that was practically my mantra.

No: it's not at the absolute bottom of depressive cycles that people suicide. Mainly because at the absolute bottom, you can't pick up the energy, let alone the wherewithal to actually do anything. Least of all kill yourself. It's when you're on the way back from... or going to the very lowest point that you have both. Mind you, when you're at that low point, you might well wish others would do it for you. Or that you could give up e.g. eating to stop the pain.

I can say for certain: low points are not the best time to make life-or-death decisions. You can't see the wood for the trees.

edited 19th Jun '12 1:09:39 PM by Euodiachloris

@Aondeug: Not to be a bean counter, but inter is indeed "bury". The word you want is intern. An easy mistake to make .

To make it clear, I am not speaking about killing people, but about letting people who firmly want it of their own accord to end their own life.

I don't think it's more humane to lock someone up for life than to let him/her die if she/he wishes to. I don't support death penalty, but I completely understand when (as happens time and again) a convict with a life sentence kills himself, or wishes to be executed. I think one should respect such a choice.

Well, the issue somewhat hinges on the question what you consider as "working". I think every person has a certain right to determine autonomously what a "working" existence means to him/herself.

Fact is that psychiatric internment often does not so much mean "help" as "custody". By and large, psychiatric internment exists more to fix the problems of society by locking them away, than to fix the problems of the interns. As I said, there are limits to what medicine and therapy can cure.

With every religious argumentation, you must consider that other people don't necessarily subscribe to your beliefs, and that (in the Western world, at least) the legislation is supposed to not attach itself to a religion. It's all fine if you personally, as a Christian or a Buddhist, reject suicide, but in a secular society — as you yourself acknowledged in your edit — you have to deal with the fact that there are those people who feel differently.

edited 19th Jun '12 1:18:40 PM by LordGro

Let's just say and leave it at that.

Yeah, and "Care in the Community" works so well when the community wants nothing to do with those who need the help.

Not getting at you. I just think that, as a whole, we suck at sorting out problems like these. As a group of societies, I mean.

I'm just leery at allowing suicide if society is the one applying pressure for those it deems "useless" (for whatever reasons) to do so. However indirectly.

edited 19th Jun '12 1:22:31 PM by Euodiachloris

I do yes but that is the only thing I consider to be proper. Death isn't proper and therefore if presented with someone who wishes to die I will do everything in my power to get them to stop. Even if it means I must nag them with psychiatric care. That is the only form of help I can honestly provide. I refuse to provide forms of help contrary to my belief system as that is not honest nor is it in accordance with the Dhamma. If I help someone commit suicide or convince them that it is fine without having first gone through all the channels of thought and option I believe are necessary to first tread then I have murdered and by murdering I have compromised my morals. Until I have done all that then no I cannot and will not let the person kill themselves or begin to think that this is fine.

If my Buddhist methods aren't working then all I can do in honesty is provide them with other possible people and methods of help that don't at any point involve suicide. And then pray that they don't end up dead.

I myself know what it's like in psychiatric wards. By and large they aren't pleasant and are a way of getting frustrating or dangerous people off the streets. This is why I wish to work in one. The kids forced there by their parents or the legal system deserve better. They deserve much better. I myself reacted positively to the treatment in that it did help me not want to die. My morals were very much shaken by the experience as I saw that psychiatry can't fix everything especially if the person is refusing to accept they have a problem. However at the end this just strengthened my desire to be a therapist and to work in such an environment.

I must help and I must do what little I can to improve the system. Even if only for a few individuals my life must be devoted to this cause. I must be like my psychology teacher, the Achaan Sokchai, and the Buddha all in one. I am failing if I'm not at the least working on this. There is no worth in my existence unless I am helping and this is the fashion in which I have chosen to believe is the one I should be using in terms of being useful to society.

As a therapist I thankfully won't have to deal with okaying suicide. Which is nice as I won't have to compromise that moral. And certain Buddhist ideas and practices are being put into practice in modern therapy though in secular fashions. Which is quite nice...

If PAS does get legalized all I can hope for is that the process is a very thorough one in terms of okaying matters. I'd like it to be legal honestly though only under very strict conditions. So that only the most extreme of cases will be okayed.

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

@Eudiachloris: I was rather sarcastic in post #89, mostly at your address. I'm sorry if you feel I got your viewpoint wrong and therefore accuse you injustly, but that's what I was getting at the moment.

Personally, I don't think making the requirements for lawful physically assisted suicide less specific and narrow will lead to society exerting pressure on old, sick or troubled people to commit suicide. It seems to me society tends much more to exert pressure on suicidal people not to kill themselves.

---

@Aondeug: You seem to take your religion pretty seriously. Not to offend you, but if I’d have to pick a psychotherapist or psychiatrist to treat me (again — I, too, was once in a treatment), I absolutely would not chose a religious therapist — Christian, Buddhist, or else.

I don't think that attitude that religious Christians (and apparently, Buddhists too) so often display is sensible: "It's my mission in life to help other people!" It sure is nice to help others, but you shouldn't make it your mission statement or the basis of your self-esteem. You're not responsible for curing all the evils in the world, and you aren't able to. Also, consider that there is an egoistic dimension to helping others. Some (in fact, quite some) people get a kick out playing the helper, especially when people are looking.

If you become a therapist, I’m sure (reading your post) you will be sooner or later be confronted with the experience that you can’t help to the degree that you desire. You will have to cope with the experience that there are things you can’t change, and problems you can’t solve.

edited 19th Jun '12 2:26:29 PM by LordGro

Let's just say and leave it at that.

Nor was I being flip when I said:-

Guess I didn't express myself very well. Again. It's a forté of mine. <abashed>

By suggesting the suffering as being transient, I literally meant "a passing phase" rather than "trivial".

As somebody who's had bad phases... all I can say, is I'm awfully glad I didn't make good on the downward swings. My life is not fantastic, in fact, some would argue I have an existence rather more than a life. And, another person might well deem how I live sufficient in and of itself to commit suicide. If they don't know lower, that is. But, damn me, what I have now beats hugging the floor in pain for hours at a time each and every day for months unable to even put a sentence together verbally, let alone type. I'll take it, thanks. Thinking beats nothing. And, being able to come and go in my flat as I please beats crawling to the bathroom in stages in hopes of making it in time.

It took years, but the long stages of pain (mental and physical) have passed. During the fibromyalgic pain, I didn't think they would. I was wrong. I've not got rid of it. It still visits me. But, it's not as bad as it was, because I've worked to get here. Chronic: not just a word that means 'bad', eh?

edited 19th Jun '12 2:35:43 PM by Euodiachloris

I know that there are things I can't fix or change or help to the point I desire. I'm not naive. I know this. I've seen this. I continue to see it. And it's horrifying but I need to do what I can. You can think me unreasonable and that is fine. I will continue to be unreasonable by your count. I already know that many people help because it makes them feel good.

I don't want to be that person. I am currently but in the future I will grow past that. And then I will help and do not because I want to or because it feels pleasant but because it is right and needed at the moment. It will be like eating. I will only do it as I know that I must.

Talking to me as though I haven't thought about all this does come off as offensive, yes. I must accept that and treat it as a lesson though. You make it sound as though I am naive and not truly thinking about everything. I am not and I am. Perhaps not as well as I will in the future, but I'm not blind to these issues and I see them. I am struggling on in defiance of them. Because that is what I want to do and what I must do. Not because other people are watching. Even if no one is watching or appreciates it or even if they hate me for it I must help. If they kick and beat me so be it. If they praise and love me so be it.

One day it will be only because I must and I hopefully will die with a shaved head and a set of orange robes. Even if it doesn't always work I must as that is Dhamma.

I have purpose in my life and it's quite lovely. You talk as though this is bad or somehow hurting me. I will be a Buddha at some point. Not because I want to but that is because what I will be. I will just be a Buddha as I am just a Buddha. As I am just a human currently as I am just a human. The Buddha could not save the world. That is fine. He knew this and accepted this. But he never stopped trying. Nor shall I.

edited 19th Jun '12 2:35:58 PM by Aondeug

If someone wants to accuse us of eating coconut shells, then that's their business. We know what we're doing. - Achaan Chah

In related news it seemsA British Columbia Supreme Court judge has ruled that Canadian laws banning doctor-assisted suicide are unconstitutional..

I'll be blunt on my opionion of this ruling: Judicial activism.

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