Althouse: "'All she could do all day was clean. It was impossible for her to maintain a relationship. Her whole development had stalled.' The patient wanted to die in the evening..."

May 14, 2016

"'All she could do all day was clean. It was impossible for her to maintain a relationship. Her whole development had stalled.' The patient wanted to die in the evening..."

"... at 11 minutes past eight, in her own home. (She chose the very precise time for reasons she kept to herself.) She had already prepared the invitation cards for her memorial and had bought champagne for the four women who would watch her death. The quartet were psychiatrist Ms Casteelen who would kill her, an assisting nurse from the End Of Life clinic, the patient's GP and a close friend. Ms Casteelen recalls that the patient was wearing grey pyjamas and says she was happy and relaxed. 'At eight o'clock, I said: 'We have to start preparing things now. She replied: 'No. I would like another glass of champagne.' We asked her if she still wanted to die. She told us how she had been looking forward to this moment; how she was going to be free.'"

From "The woman killed by doctors because she was obsessed with cleaning: Just one of growing numbers of Dutch people given the right to euthanasia because of mental, not terminal, illness" in The Daily Mail. The highest-rated comments over there approve of what the Dutch are doing: "The Dutch are a thoughtful and civilised people who recognise that we all have the right to die if that is what we wish." "It was HER life. Her decision. And sometimes mental illness IS terminal. Why don't people but [sic] out of other people's lives?" "Whats wrong with that? At least she's going to a clinic rather than throwing herself off a bridge onto a busy road! I have always said if you want to kill yourself (suicide) then fine, go ahead, just don't take others with you as that is selfish! Those who are in that dark place, fair enough, but why should train drivers or car drivers etc have to suffer too?"

ADDED: Key phrase: "No. I would like another glass of champagne." Does "no" mean "no" when you've gathered 3 medical personnel to perform a specific procedure at a precise time? Interesting that someone who supposedly obsessed about cleaning put champagne ahead of precision at the last moment. How do you call it off once such an occasion has been made of it? And yet, without the occasion, there would have been no cause for champagne.

48 comments:

Beloved Commenter AReasonableMan said...: I was speaking to a train conductor a few months ago and suicide by train came up. It is surprisingly common, the conductors deal with it using dark humor, 'we provide a service'. Certainly it is better to commit suicide in your own home rather than to scar some innocent train conductor with your death.; 5/14/16, 10:39 AM
Fernandinande said...: "The woman killed by doctors because she was obsessed with cleaning: "

A click-bait fake headline.; 5/14/16, 10:45 AM
Michael K said...: OCD (Obsessive Compulsive Disorder) is often curable by surgery. I wonder if she ever considered it or her GP did ? I'm not about the read the story.

The treatment works pretty well.

CONCLUSIONS This systematic review of the literature supports the efficacy of both dorsal anterior cingulotomy and anterior capsulotomy in this highly treatment-refractory population.

Two surgeries. Both work.; 5/14/16, 10:46 AM
Qwinn said...: And if the State can get a political troublemaker to "volunteer" for euthanasia with a few subtle, well placed threats to family members... wait, no, that's just crazy talk, no government has ever killed it's own population off before! Course, now, they can do it all legal and clean-like and out in the open, which is kinda new. What could possibly go wrong?; 5/14/16, 10:46 AM
MisterBuddwing said...: I can't cite a source. But I've heard that people who try to commit suicide by jumping/falling from a bridge and manage to survive end up saying afterward that the moment they began to plunge, they were seized by overwhelming regret and an intense wish that they hadn't chosen self-destruction.

Is suicide never, ever justifiable? I for one can't say - that's way above my pay grade.; 5/14/16, 10:46 AM
Ann Althouse said...: @ MisterBuddwing

It's a New Yorker article: "Jumpers/The fatal grandeur of the Golden Gate Bridge."; 5/14/16, 10:56 AM
Ann Althouse said...: "Survivors often regret their decision in midair, if not before. Ken Baldwin and Kevin Hines both say they hurdled over the railing, afraid that if they stood on the chord they might lose their courage. Baldwin was twenty-eight and severely depressed on the August day in 1985 when he told his wife not to expect him home till late. “I wanted to disappear,” he said. “So the Golden Gate was the spot. I’d heard that the water just sweeps you under.” On the bridge, Baldwin counted to ten and stayed frozen. He counted to ten again, then vaulted over. “I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”"; 5/14/16, 10:56 AM
tim maguire said...: I'm conflicted. I think assisted suicide should be legal, but I despise the way society (we do it too in many ways, if not yet this way) caters to and even celebrates mental illness.; 5/14/16, 11:06 AM
William said...: There can't possibly be anything in life more depressing than a botched suicide. I've read of a vet with PTSD who tried to kill himself with a gunshot wouind to the head but only managed to sever the optic nerve. Life doesn't look better when you're blind.......I don't know if stories about botched suicides make me think more favorably of assisted suicide.; 5/14/16, 11:08 AM
JackWayne said...: Pretty nice setup for the doctors. They have failed in their chosen profession so they sweep the failure under the rug. Because the insane patient wants it.; 5/14/16, 11:10 AM
jr565 said...: "rom "The woman killed by doctors because she was obsessed with cleaning: Just one of growing numbers of Dutch people given the right to euthanasia because of mental, not terminal, illness"

WHen you say that those suffering from an obsession (or a body identity disorder) are absolutely right in their views, even though we can objectively show they they are being obsessive about something, there's no reason not to help them kill themselves. Or chop of their penis.; 5/14/16, 11:13 AM
Captain Drano said...: @10:46 "Is suicide never, ever justifiable? I for one can't say - that's way above my pay grade."

I think it can be justifiable from an "it's your right" perspective (and I acknowledge that those that do commit suicide are in unimaginable psychological pain and dread, but that's another story) however, I think it's fucking selfish and chicken shit to ask others to do it for you, even if, as in these two recent Dutch examples, state-sanctioned medical personnel are willing and/or compensated for it. I would think by virtue of the fact that one is unwilling to do it to themselves, proves they are not really "suicidal." I have to wonder if they subconciously are playing the Paschal's wager game--that in the remote chance of a God, they can plead murder and not suicide.

Unless you are physically unable, raise the fucking cup of hemlock to your own lips.; 5/14/16, 11:13 AM
jr565 said...: (cont) it is their body after all yes?; 5/14/16, 11:14 AM
jr565 said...: "
@10:46 "Is suicide never, ever justifiable? I for one can't say - that's way above my pay grade."

The issue is it ok for DOCTORS to assist people commiting suicide. If someone is really commited to offing themselves can we really do much about it? However, shoudl doctors help them along?; 5/14/16, 11:15 AM
Sebastian said...: More marvelous Prog victories in the culture wars, though there's not much warring across the Atlantic anymore.; 5/14/16, 11:15 AM
buwaya said...: Ref Walter Miller "A Canticle for Leibowitz"
My favorite SF novel of all time, and one of the more complex.
The last third, "Fiat voluntas tua"; 5/14/16, 11:16 AM
CWJ said...: First, do no harm. I found the presence of her GP disturbing. The other two specialists I somehow imagine have rationalized their participation as part of their "specialty." But the GP? It feeds my fears of someday coming out on the death side of some societal cost benefit analysis.; 5/14/16, 11:16 AM
Jane the Actuary said...: It seems to me that our society, in general, is far more accepting of suicide than we once were. Sure, among teenagers, there's great concern (especially since it's popularly believed that teens are most at risk), but when Robin Williams died, I had the impression that the common opinion was that his killing himself was a reasonable response to intractible depression, just as much as assisted suicide is reasonable in the fact of terminal illness.

The odd thing about this article is that these advocates speak of euthanasia as a way to "save" people from suicide, figuring that the controlled environment of a doctor killing the individual is less traumatic than a sudden, unexpected death.; 5/14/16, 11:17 AM
Captain Drano said...: Sorry, I meant to make it clear I am not talking in any way about someone that is in the end stages of life. It's just really hard for me to go there, and it's an incredibly complex subject after having lost two close family members where end of life issues were in play.; 5/14/16, 11:23 AM
buwaya said...: To add, "A Canticle for Leibowitz" is the best commentary on the modern world ever written. Funny, ironic, erudite (with great subtlety), tragic beyond measure. Only a truly damaged man, as Miller was, could have written that.
A book that can be inscribed on every headstone, for cases like this.; 5/14/16, 11:28 AM
Mark said...: It's the culture of death.
You reap what you sow -- especially when you so enthusiastically sow the seeds of personal and societal self-destruction.

But we really should not blame too much the poor deluded broken corpses at the bottom of the pit -- for them we mourn -- rather, it is those who pushed them over the cliff who bear the most responsibility. If only they would own up to that responsibility.; 5/14/16, 11:29 AM
steve schmidt said...: all five in the room were ill. unless your paralyzed no assistance should be needed; 5/14/16, 11:32 AM
Mark said...: It seems to me that our society, in general, is far more accepting of suicide than we once were.

Like I said in the Trump thread, wrong is now right, evil is now good. And the result is death.

And, no, there is no "right to suicide," that is, a right to make yourself dead. The idea of "rights" make sense only for the living. The dead have no rights. And you cannot logically claim that there is a right to have no rights, just as there is no freedom to be a slave.; 5/14/16, 11:39 AM
YoungHegelian said...: The Dutch are a thoughtful and civilised people...

It's a little aspect of WWII that the Nazis encouraged the rise of "native" National Socialist movements in their conquered lands as long as the conquered peoples were Nordic or close enough (e.g. Norwegians were fine, Slavs were most definitely not). These movements also proved very useful as the war continued as sources of manpower to be sent to the front(s).

So, take a wild, woolly guess as to what country supplied the second largest contingent of SS soldiers after Germany? Yep, the Dutch.; 5/14/16, 11:57 AM
robother said...: "A permanent solution to a temporary problem" was the folk wisdom about suicide I heard growing up in the rural northwest. I expect that is the insight realized in the bridge jumpers' regrets.

Lately, though, a schizophrenic nephew's suicide has made me see that people suffering from mental conditions can be far more trapped in life than others, even with severe physical handicaps. To remember a time when you imagined growing into a normal adult, and then to experience years of just being a burden to everyone around you, the side effects of medication, the realization that its not really ever going to get better.... I don't think he had any regrets when he stepped out that window.; 5/14/16, 11:58 AM
Etienne said...: A guy I worked with had colon cancer. They cut it out and said they got it all. But just in case, they gave him chemo. Well, they destroyed his liver with the chemo, and he croaked.

I always thought it was an expensive way to die.; 5/14/16, 12:00 PM
damikesc said...: They KILL their mentally ill people.

WE demand that society change itself to keep their delusions.

Not sure which option is better. Both seem terrible.

There can't possibly be anything in life more depressing than a botched suicide.

As Seinfeld said, it just provided one more thing that you're bad at.

All kidding aside, assisted suicide is utter bullshit. If the problem is that bad, kill yourself. Don't ask others to do what you're too much of a pussy to do yourself.; 5/14/16, 12:18 PM
Mark said...: It's a little aspect of WWII that the Nazis encouraged the rise of "native" National Socialist movements in their conquered lands

Before the Nazis finally arrived at a solution to Europe's Jewish question, the German medical community was already implementing that solution with the mentally ill and deficient. And the later idea (and equipment) for the gas showers at Auschwitz came from the mental hospitals where it had been used.; 5/14/16, 12:33 PM
M Jordan said...: This reminded me of this SNL sketch ... a great one with Phil Hartman. Sorry it's gonna take up so much space.

87d: Robert Mitchum / Simply Red

Compulsion

Narrator.....Phil Hartman
Man.....Dana Carvey
Woman.....Jan Hooks
Model.....Nora Dunn

[ open in a dark, French setting ]

Narrator: She was like the air. Brittle and easily broken.

[ shows title: COMPULSION, as dramatic music starts ]

How could one so perfect, be so flawed?

Man: Dearest..

Woman: Not now. I'm busy. [ is seen scrubbing the stairs ]

Narrator: She was an incondescant angel, dancing on the edge of a ritual that was both innocent and jejune.

Man: Yes. She was.

Narrator: [ annoyed at man ] Her translucent figure, glowing in the light and fire of her overwhelming passion.

[ Woman picks up a chess piece and wipes under it, then looks at the sponge and sees the dirt it picked up ]

Woman: Save me.... [ Man pulls her toward him ]

Man: Why?

Narrator: I wonder what was the greater transgression. Loving her, or abiding her immaculate madness.

[ a wine glass is knocked over, as Woman tries to clean up the mess ]

Model: A little club soda will get that out.

Woman: Liar!

Narrator: She was consumed. Obsessed. Never able to enjoy her own party.

Man: I alone felt her torment. Her deepest secrets known only to me.

[ Narrator slaps Man in the face ]

Woman: If keeping a clean house is a crime, then let me be guilty!

Model: Guilty! [ another model gasps ]

Narrator: A horrifying creature. What was it we could not give her, or she understand? [ everyone is dancing, while woman tries to vacuum after them ]

[ setting is now black and white and shows Woman behind bottle of Compulsion ] Woman: Somewhere between cleanliness and godliness lies Compulsion, the world's most indulgent disinfectant. From Calvin Kleen.

Announcer: Ah, the price of it.; 5/14/16, 1:03 PM
mockturtle said...: Those wanting to off themselves should have the cojones to do it themselves rather than getting a doctor--or a cop--to do it. But, then, I guess suicide is a type of cowardice after all.; 5/14/16, 1:13 PM
Bleach Drinkers Curing Coronavirus Together said...: Proving decisively that Americans aren't really all that interested in any sort of a right to life. They're interested in the right to be made to live a shitty life.; 5/14/16, 2:00 PM
Captain Drano said...: Relevant reads:

By the great Dr. Leon Kass:
http://philosophyfaculty.ucsd.edu/faculty/rarneson/Courses/KASSwhydoctorsmust.pdf; and http://www.firstthings.com/article/1996/08/dehumanization-triumphant

Article quoting a brilliant Bioethicist/ND Law Prof: http://www.thebostonpilot.com/articleprint.asp?id=15273
Excerpt: "... Snead said the most common argument he encounters in favor of physician assisted suicide makes an appeal to individual autonomy. A person should be allowed to decide for themselves when they want to die without interference from churches, government or other individuals.

But, he said, the argument for autonomy fails under its own logic, as soon as proponents attempt to define who should and should not be allowed to end their own lives. By definition, legalized physician assisted suicide requires the involvement the government and medical professionals.

"The only way to limit who kills him or herself or how people kill themselves is with an appeal to a paternalistic argument, which is the opposite of autonomy," he said.

The absence of logic in that argument and failure to protect individuals, he said, manifested itself in the Netherlands once distinctions had to be made regarding who could receive life ending treatments. Non-voluntary and involuntary euthanasia resulted.

"In the Netherlands you see this already. Once assisted suicide was legalized, in the name of autonomy and compassion, there was no meaningful way to argue politically for limits on it," he said.

He said arguments in favor of the removal of moral and religious principles from law and the legal process constitute a failure in understanding the nature of law, and pointed to other laws meant to protect human life.

"That is an argument that I think fails to understand, at bottom, what law is. Law is in many respects the imposition, the coercive imposition, of a particular view of the good. That view is arrived at through the political process, but every single law that is on the books, including things like speed limits, are the consequence of long discussion about normative principals. Speed limits are the result of a debate about the value of human life," he said.

He detailed logical arguments against physician assisted suicide based on principles such as the idea of law as directed toward the common good or healthcare providers as stewards in good faith to treat and heal patients.

"Imagine going to a doctor, and thinking, my doctor is not simply here to try to preserve my life or health to the best of his or her ability. My doctor might make a judgment at some point that the best thing for me to do is to kill myself, ..."; 5/14/16, 2:18 PM
damikesc said...: Proving decisively that Americans aren't really all that interested in any sort of a right to life. They're interested in the right to be made to live a shitty life.

Yes, ignore two surgeries with a solid track record of resolving her issue.

Better to just kill her.

That is the humane way, apparently.; 5/14/16, 2:35 PM
Michael K said...: "There can't possibly be anything in life more depressing than a botched suicide."

My medical students once got to interview a guy who shot himself in the head and missed. The bullet was in his frontal sinus. His temple had powder tattooing all over. It was a pretty interesting interview for a medical student.

" A person should be allowed to decide for themselves when they want to die without interference from churches, government or other individuals."

I agree and will not do positive things to cause death, I have withheld things that would prolong a life without hope, such as end stage cancer, but always with the patient's decision. The pain relief that is now available removes one big issue in suicide for those in end stage illness. If they have family that they want to spend more time with, they can do so pain free with just oral medication.

I have a number of stories in my recent book.; 5/14/16, 2:47 PM
Mark said...: "That is an argument that I think fails to understand, at bottom, what law is. Law is in many respects the imposition, the coercive imposition, of a particular view of the good. That view is arrived at through the political process, but every single law that is on the books, including things like speed limits, are the consequence of long discussion about normative principals. Speed limits are the result of a debate about the value of human life," he said.

And that is an explanation that fails to understand, at bottom, what law is. Yes, in many respects "law" has been understood in the positive sense described here - as a man-made set of rules. But this really has only the force of law. Real authentic law is not created, it is discovered -- it is the recognition by right reason of transcendent and eternal principles and truths. That which conforms to this absolute eternal truth is called "good." Moreover, everyone is subject to this eternal law regardless of how loudly they yell "AUTONOMY."

To the extent that man-made positive "law" conforms to this eternal transcendent law, you will have a just and good civil society. To the extent that it is inconsistent with, or contradicts, this true law, you will have anarchy, tyranny, and injustice. In short, you will have the complete CF that we have today.

It is precisely when man thinks that he is the lawmaker, that he can make for himself his own right and wrong, his own good and evil, his own truth and error, that he can make his own reality, and define himself his "own concept of existence, of meaning, of the universe, and of the mystery of human life," in short, it is precisely when man becomes a law unto himself -- a god unto himself -- that we usher in the culture of death.; 5/14/16, 2:47 PM
Michael Fitzgerald said...: Seems like a clear case of pre-death regret, well known among those who survived a suicide attempt. Oh, and the Guardian readers are just a sick, dismal lot. No wonder why England has gone down the hole.; 5/14/16, 3:43 PM
Jane the Actuary said...: Why do these individuals, who are not limited in their physical capability, go to the medical profession rather than doing it themselves? (Can one even use the word "medical" in this context?) Is it a matter of having the certainty that their death will be guaranteed, and painless? Or is it a matter of receiving the confirmation from an "expert" that their decision to kill themselves is the right one?; 5/14/16, 4:18 PM
Lydia said...: @Jane the Actuary -- Or is it a matter of receiving the confirmation from an "expert" that their decision to kill themselves is the right one?

In line with that, maybe also a need for ritual, something like the Catholic last rites.; 5/14/16, 5:08 PM
MaxedOutMama said...: I think they are just encouraging people who are a public burden to whack themselves.

They've stopped looking for solutions; now they are looking at the bottom line. There isn't anything compassionate about this.; 5/14/16, 5:29 PM
Titus said...: Europe is so cool.

tits.; 5/14/16, 5:31 PM
Sofa King said...: A culture that celebrates suicide is not long for this world.

From the Department of Some-Problems-Solve-Themselves; 5/14/16, 5:33 PM
MaxedOutMama said...: PS: For those who didn't read the article, the one clinic referenced is getting a lot of applications from those whose primary treating physicians have refused euthanasia.

The families seem to approve because the involvement of the medical professionals alleviates their responsibiity. How would that lady have reacted with more personal involvement from friends/family/church members (oops, that's a bad word) in her life?

It seems to me that the involvement of the "professionals" is an endorsement of social abandonment of those with problems.; 5/14/16, 5:44 PM
n.n said...: It's probably not Planned Retirement, because there is a lack of secular incentives to cannibalize the remains. Perhaps an abortion clinic for lives that are no longer wanted or convenient to the individual. I wonder if the doctors consider the progressive slope they follow when they elect to corrupt the purpose and integrity of their service as contract abortionists.

Oh, well. There is a refugee crisis, some other mass exodus, or rent-a-woman to compensate for aborted and dysfunctional individuals. Forward, I guess.; 5/14/16, 6:13 PM
Rae said...: I wonder if they screen the attending physicians for mental illness.; 5/14/16, 7:34 PM
Crimso said...: "Before the Nazis finally arrived at a solution to Europe's Jewish question, the German medical community was already implementing that solution with the mentally ill and deficient. And the later idea (and equipment) for the gas showers at Auschwitz came from the mental hospitals where it had been used."

Precisely. Richard Evans' history of Germany during the Nazi era (trilogy) went into some detail tracing the euthanasia program directly through to the death camps. Wonder how genocide as an engineering endeavor can occur? He lays it all out. The euthanasia blended softly and casually into trial uses of their methods in the search for the Final Solution. By the time they reached showers and ovens, people had slowly been conditioned to accept it. Of course, many more were killed by bullets (then burned in open pits) than by the showers and ovens. I obviously don't think euthanasia will always result in death camps. But euthanasia probably makes it easier when that's where you're already headed.

And if you think those conditions were peculiar to Germany, Evans notes that if you could go back to historians living in the mid-19th century and tell them about the Holocaust, they wouldn't be surprised. Until you told them it happened in Germany and not France.; 5/14/16, 8:33 PM
glenn said...: This happened in Holland, right? The Dutch rolled over for the Germans (not the Nazis. They were one and the same) in 1940. It took young Brits and Americans to give them back their country. They'll do it again tomorrow. Ditto the Belgians and most likely the French.; 5/14/16, 8:52 PM
Jaq said...: I am often embarrassed to be Dutch. The first time was when my mother told me that in Holland there were warehouses full of "art" because once the government approved you as an artist, there was some kind of jury process, they were required to buy anything you produced. They should have strict rules regarding the materials an 'artist' may use so that they can burn the 'art' for energy.; 5/15/16, 4:55 AM
ddh said...: I'm from the government, and I'm here to help you.; 5/15/16, 8:57 AM