planned suicide

Pt 2 The Suicide Plan – Investigating Planned Suicides

SuicideThe assisted suicide movement is, if anything, indefatigable. Not only is it undeterred by its failures, but it is now more energized than any other time in recent years. By the end of March of 2015, bills were introduced in twenty-five state legislatures to legalize assisted suicide.

Defining the Subject

Many people remain confused about the exact nature of assisted suicide advocacy, sometimes confusing it with other medical issues involving end-of-life care. Thus, to fully understand the subject, we must distinguish between ethical choices at the end of life that may lead to death and the poison of euthanasia/assisted suicide.

1.      Refusing unwanted medical treatment is not assisted suicide: Fear of being “hooked up to machines” when one wishes to die at home has traditionally been a driving force behind the assisted suicide movement. But we all have the right to refuse medical interventions—even if the choice is likely to lead to death. Thus, a cancer patient can reject chemotherapy and a patient dying of Lou Gehrig’s disease can say no to a respirator.  Indeed, in 1997, the U.S. Supreme Court ruled unanimously that the right to refuse medical treatment is completely different from assisted suicide.[9]

2.      Assisted suicide/euthanasia is not the same as medical treatment for pain control: Because pain control may require strong drugs, which can cause death, assisted suicide advocates often claim that palliation and euthanasia are ethically the same under the “principle of double effect.” But this is all wrong:

  • Any legitimate medical treatment can unintentionally lead to death, including pain alleviation. In assisted suicide death is the intended effect.
  • We would never say that a patient who died during open heart surgery was euthanized. Similarly, a patient who dies from the unintended side effects of pain control has not been assisted in suicide or euthanized.
  • Pain control experts state that aggressive pain control generally does not shorten life.

3.      Assisted suicide/euthanasia is antithetical to hospice: Hospice was founded by the great medical humanitarian Dame Cicely Saunders in the late 1960s as a reform movement to bring the care of the dying out of isolated hospitals and into patients’ homes or non-institutional local care facilities. Its purpose is to provide dying people with proper treatment of pain and other disturbing symptoms as well as to render spiritual, psychological, and social support toward the end that life be lived as fully as possible until natural death.

In contrast, assisted suicide is about rushing death, making it happen sooner rather than later through lethal actions. Or to put it another way: Hospice is about living. Assisted suicide/euthanasia is about dying. As the noted palliative care expert and assisted suicide opponent Dr. Ira Byock has written, “There’s a distinction between alleviating suffering and eliminating the sufferer — between enabling someone to die gently of their disease and ending that person’s life with a lethal pill or injection.”

4.      Assisted suicide/euthanasia are acts that intentionally end life: In contrast to the above, the intended purpose of assisted suicide and euthanasia is to end life, e.g., to kill. In assisted suicide, the last act causing death is taken by the person who dies, for example, ingesting a lethal prescription of barbiturates. In euthanasia, the death is a homicide, an act of killing taken by a third person, such as a doctor injecting a patient with poisonous drugs.

From an Investigators Standpoint 

With the above statements we can see that the topic of assisted suicide is at best conversional.  As a death investigator, our job is simple; to report the facts and the facts only.  However, it is well understood that our own emotions and bias on the topic can and will play a role in how we approached these scenes. The investigators must guard against allowing these personal feelings to interfere with the proper reporting and interpretation of  the scene.

Conversation with Prosecuting Attorney 

It is  a good suggestion to have a conversation with your  prosecuting attorney and a review of your agency policy to see how best to proceed in these cases. You should always report all facts in the case, but having a better understanding of how you are expected to proceed may well help in your overall review of the case.

With Family

No matter what decision  your Prosecuting Attorney goes, some members of the deceased family will invariably not agree with the decision.  This is why it best to do a proper and complete investigation, report all and only, the facts – and let those responsible for making these critical decision do their job. You, as the investigator , can rest in the knowledge that you have done your job and can properly explain to the family exactly what took place and why decision  are made based upon these facts.  Many family members may still not agree with the outcome, but it is much better for them to have the facts than them come up with their own set of “facts’ as they see it.

Anita Brook-corner talk-secondary stressAnita Brooks    anitabrooks.com

The Suicide Plan – Investigating Planned Suicides Pt1

SuicideThe Centers for Disease Control and Prevention (CDC) collects data about mortality in the U.S., including deaths by suicide. In 2013 (the most recent year for which full data are available), 41,149 suicides were reported, making suicide the 10th leading cause of death for Americans. In that year, someone in the country died by suicide every 12.8 minutes.   With those totals, we are all bound to be involved in investigating suicides.  Suicides can be acute, meaning short term or spur of the moment final decision, or a well planned and risk assessed  action.  In this episode of Coroner Talk™ we are going to look at the pros, if there be any, and the cons of planned suicide.

Featured in this weeks show is a PBS production of  Frontline that deals with the topic of a well planned suicide and the legal and moral implication that accompany such a decision.  Regardless of where you stand on the topic, this episode will start you thinking of the other side.

The Assisted Suicide Debate

Since Oregon legalized physician-assisted suicide for the terminally ill in 1997, more than 700 people have taken their lives with prescribed medication — including Brittany Maynard, a 29-year-old with an incurable brain tumor, who ended her life earlier this month.

Advocates of assisted-suicide laws believe that mentally competent people who are suffering and have no chance of long-term survival, should have the right to die if and when they choose. If people are have the right to refuse life-saving treatments, they argue, they should also have the freedom to choose to end their own lives.

Opponents say that such laws devalue human life. Medical prognoses are often inaccurate, they note — meaning people who have been told they will soon die sometimes live for many months or even years longer. They also argue that seriously ill people often suffer from undiagnosed depression or other mental illnesses that can impair their ability to make an informed decision.

At the latest event from Intelligence Squared U.S., two teams addressed these questions while debating the motion, “Legalize Assisted Suicide.”

Before the debate, the audience at the Kaufman Music Center in New York was 65 percent in favor of the motion and 10 percent against, with 25 percent undecided. After the debate, 67 percent favored the motion, with 22 percent against, making the team arguing against the motion the winner of this debate.

http://www.npr.org/2014/11/20/365509889/debate-should-physician-assisted-suicide-be-legal

The Suicide Plan – Investigating Planned Suicide

Investigators are offered a hard road when it comes to investigating a planned suicide when it is found that family or friends may have assisted in some manner, regardless of the extent of the that assistance.  Even providing a cool drink of water to wash down the pills that will end life can be enough in some states to charge a person with assistance.  But where, as investigators, do we stand on the issue.  Some investigators are only providing cause and manner of death determinations, which can be clouded by the assistance issue. While other investigators are charged with the task  of deciding the criminal aspect of the assistance rendered.

In part two of this issue we will take a deep dive into the debate that will most assuredly muddy up the waters a bit.  That is next episode on Coroner Talk™..

suicide-prevention-lifeline-logo