Ah, Euthenasia (not Youth-In-Asia as I thought the term was when I was 12)... The pinnacle of freedom. For others the slipperiest of slopes. For some the impossible to conceive. How have I not written about this topic yet, when it is one of my all time favourite thiings to ruminate on?
An article on Jezabel reminded me of this topic, it can be viewed here: http://jezebel.com/5912031/our-obsession-with-longevity-is-making-our-lives-miserable
In a nutshell, the article talks about how the "miracles" of modern medicine are keeping people alive for longer, but often with devastating economic, and of course emotional, consequences. What Mother wants her adult children to see her wither away into a demented state, a state where she oftyen doesn't recognise them, wanders off and causes panic for them, even in some cases assaults them? Or, the alternative, where the mind remains sprightly but the body fails, kept alive on machines and personal carers while you suffer the indignity of not being able to control your bowel movements.
I have always been a passionate advocate for Euthenasia, to the point where I considered contacting Exit Australia and smuggling back Nembutal from Mexico to donate to their cause (Nembutal is the clinical name given to the drug veterinarians use to euthanise animals- it is rigourously controlled here but freely available from pet stores in Central/ South America. It is the drug that Exit Australia condone using for end of life as it is relatively painless and very effective). But Legalising Euthenasia is not a popular song to sing in my particular field. Why you ask? I'll try and explain why...
Firstly, we have to define what we mean by Euthenasia. Sounds simple? Not really, but I'll give it a shot, in classic Missy confusion:
- Voluntary Euthenasia is when a person who is terminally ill/ has a disability or condition that will ultimately lead to death, performs an act (injecting a substance into themselves, swallowing a pill etc) that will kill them. The key is it is an action that the person takes themselves.
- Assisted Suicide is when a person has a terminal illness and has someone assist them with ending their life (most often has a doctor prescribe and administer the substance that will kill them). This is very controversial, there is a common argument that the more people that are legally allowed to be involved, the more likelyhood of coersion. It is also controversial as there are businesses set up who profit from assisted suicidde (The Dignitas facility in Switzeland, for example. Nicnamed the "Death Hotel", it has been condemned for making money out of providing a space and means for people to end their life).
Note that both Euthenasia and Assisted Suicide are illegal in Australia. What is legal in Australia is Advance Medical Directives, which is basically a legal document that states that, once you get to a certain point, you don't want any medical intervention that will prolong your life. This makes me uneasy because even if you're not actively prolonging life, by not having the medical treatment and allowing whatever illness to overcome you, you are likely to be in a great amount of pain.
Anyway, back to why people working in the disability sector don't tend to agree with the legalisation of Euthenasia. Most of the arguments used for Euthenasia centre around what I desribed above- not having the ability to attend to ones own toileting needs. Many people with significant physical and/or intellectual disability need personal care to help them with their toileting needs... Why does society think we are not of value if we cannot perform these tasks on our own? A lot of the arguments used for the legalisation of Euthenasia have a very narrow view of what a person should be able to do, and if they can't, then why not dispose of them because they OBVIOUSLY have no quality of life!?!
In addition to this, is of course what is colloquially known as the "slippery slope" argument. Disability advocates have argued that voluntary euthenasia will lead to pressure on people to assist in the killing of people with disability, as they are such a drain on both economic and emotional resources. Much like the legality of aborting foetuses that have a very slim chance of living outside the womb has led to the legalisation of aborting foetuses who have Downs Syndrome or other chromosomal abnormalities, but would live for many years if born.
Adding to this already potent mix of arguments is the grim knowledge that Hitler and the Nazi Party used the term Euthenasia to justify killing people with disability that were "plaguing" Germany at the time.
So as you can see, I'm just rambling non sensically here, I have no argument, no point. I guess writing about these things just helps me to get it straighter in my head. I acknowledge the challenges and the concerns about legal Euthenasia, however I still whole heartedly agree with it. Because, at the end of the day, when you ask yourself "Do I want to be able to decide when to leave my family and let myself rest?" The answer, invariably, is YES.
For more information on Exit Australia, visit their website: http://www.exitinternational.net/page/Home
Showing posts with label Medical Discussion. Show all posts
Showing posts with label Medical Discussion. Show all posts
Monday, 21 May 2012
Monday, 27 February 2012
Compulsory Immunisation- where are we now?
An article in the Huffington Post today reminded me of one of my looong standing interests- immunisation and whether it shoudl be mandatory. Oh, I've had many a discussion with many a person on this issue, and I find it really hard to be at peace with my own opinion on this issue.
So, for those who don't know the score, it goes a little something like this: Back in the good old days we kept the poor, the young and the black man down by awful deadly viruses such as small pox, ruebella and polio. Then scientists discovered that these dreadful diseases could be prevented by one or a series of injections (don't ask me how immunisations actually work, I'm no scientician). Everyone was happy, and the prevalence of these diseases decreased dramatically (at least in the Western World- if you want to help immunise those in developing countries, you can, and should, donate here: http://www.oxfam.org.au/donate)
This is, until the 1990's, when the horror of those diseases and the pain, disability and death they cause were a distant memory for most people. Along came Dr Andrew Wakefield, who published a medical article stating that he had found a link between the common MMR (measles, mumps, ruebella) vaccine and autism in children. As the number of children diagnosed with autism spectrum disorders had exploded in the past decade, it is completely understandable why parents jumped on this bandwagon. It's so much easier to blame a third party than to accept that there was nothing that could be done for your child to be "normal".
Even though the research provided by Dr Wakefield has since been discredited, and allegations of conflict of interest have been somewhat proven, the link between MMR and autism, and immunisation and abnormal child development in general, has stuck. Now parents don't tend to attribute they refusal to have their child vaccinated to Dr Wakefield's research specifically, but often cite "religious reasons" for not vaccinating their child.
Which brings me to the Huff Post article. According to this paper, many State laws in the US are making it incresingly easier for parents to refuse to vaccinate their children on this ground. At what point do we say "you don't have the right to bodily integrity, one of our most basic human rights, because you may endanger other people"? Apparently, many US States have changed their answer to this question, and are adjusting their laws accordingly.
One question that I'm always left asking is "do the parents of the child realise the impact of their non comforming is probably not going to impact on them, but someone else who did not have the choice, such as someone elderly who's vaccine has worn off and is weak, or a child who is not old enough to have been immunised"?
At the end of the day, I do side with "herd immunity", but I'm not completely comfortable about it. Also, we must ask ourselves if the governement can ovverride the rights of the child for the good of society, can we override the rights of the adult? Does society have the right to make it compulsory for adults who have not been immunised to do so?
What do other people think? Individual freedom, or rights of the collective?
So, for those who don't know the score, it goes a little something like this: Back in the good old days we kept the poor, the young and the black man down by awful deadly viruses such as small pox, ruebella and polio. Then scientists discovered that these dreadful diseases could be prevented by one or a series of injections (don't ask me how immunisations actually work, I'm no scientician). Everyone was happy, and the prevalence of these diseases decreased dramatically (at least in the Western World- if you want to help immunise those in developing countries, you can, and should, donate here: http://www.oxfam.org.au/donate)
This is, until the 1990's, when the horror of those diseases and the pain, disability and death they cause were a distant memory for most people. Along came Dr Andrew Wakefield, who published a medical article stating that he had found a link between the common MMR (measles, mumps, ruebella) vaccine and autism in children. As the number of children diagnosed with autism spectrum disorders had exploded in the past decade, it is completely understandable why parents jumped on this bandwagon. It's so much easier to blame a third party than to accept that there was nothing that could be done for your child to be "normal".
Even though the research provided by Dr Wakefield has since been discredited, and allegations of conflict of interest have been somewhat proven, the link between MMR and autism, and immunisation and abnormal child development in general, has stuck. Now parents don't tend to attribute they refusal to have their child vaccinated to Dr Wakefield's research specifically, but often cite "religious reasons" for not vaccinating their child.
Which brings me to the Huff Post article. According to this paper, many State laws in the US are making it incresingly easier for parents to refuse to vaccinate their children on this ground. At what point do we say "you don't have the right to bodily integrity, one of our most basic human rights, because you may endanger other people"? Apparently, many US States have changed their answer to this question, and are adjusting their laws accordingly.
One question that I'm always left asking is "do the parents of the child realise the impact of their non comforming is probably not going to impact on them, but someone else who did not have the choice, such as someone elderly who's vaccine has worn off and is weak, or a child who is not old enough to have been immunised"?
At the end of the day, I do side with "herd immunity", but I'm not completely comfortable about it. Also, we must ask ourselves if the governement can ovverride the rights of the child for the good of society, can we override the rights of the adult? Does society have the right to make it compulsory for adults who have not been immunised to do so?
What do other people think? Individual freedom, or rights of the collective?
Tuesday, 31 January 2012
California Rocket Fuel- Lift Off!
Ok, so let's get personal. Talk about Love and Other Drugs. Ok, mainly drugs.
I have recently started seeing a new psychiatrist to treat my resistant unipolar depression. Doc was unimpressed that I have not been responding (well my waistline has been responding, but we'll get to that later) to venlafaxine aka Effexor, despite the high dose I'm on. He told me there is an anti psychotic, Zyprexa, which, taken in low doses for two weeks, can give the Effexor a "zap", kind of like jump starting a car. Cool? Cool. Wait, not so cool. I was a drooling, spaced out zombie mess for four days, before I kicked it to the kerb.
Missy fails yet another "I'll fix you, take this pill" test.
So, now Doc's bring out the big guns. Or Rockets. Enter "CALIFORNIA ROCKET FUEL". This is the colloquial name for a combination of two drugs, Effexor and a drug called Mirtazapine, aka Avantin. Recommended by Californian therapists the world over. Let's see what medscape.com has to say about it...
"Use of the tetracyclic antidepressant mirtazapine in combination with fluoxetine, venlafaxine, or bupropion is more effective and as well-tolerated in treating major depressive disorder (MDD) as fluoxetine alone, according to results from a new double-blind comparison study published in the December issue of the American Journal of Psychiatry.
In fact, patients treated with these combinations had mean differences of 4.5 to 4.8 points on the Hamilton Depression Rating Scale (HAM-D) by day 42 compared with those treated with monotherapy."
"For years, [California psychopharmacologist] Dr. Steven Stahl has said that the combination of mirtazapine and venlafaxine is 'California rocket fuel,' but I wasn't aware of any controlled trial looking at that. The results here for that combination are quite impressive, as are the combinations with the other drugs in this study. Going forward, this is a good approach in everyday clinical practice to treat depression."
Wow. Sounds like I'm well on the road to recovery. Well not yet. "Why not?" you say "chuck these new pills down your throat and get better and stop whinging already!!!" Well, I can't start until the weekend, as apparently the Avanza knocks you out even MORE than Zyprexa. Cue weekend in bed for me (this side effect apparently wears off after 2-4 days of taking it). Ok. Awesome. Except there's one more side effect that DOESN'T wear off. Appetite stimulation, leading to rapid weight gain. Shit.
To be, or not to be. Specifically, to be fat and happy or skinny and suicidal. Not that either is totally acheivable. I've never been a small girl. But if I get bigger, I'm going to have worse self esteem, and so not happy, whereas if I don't take it, I'll stay still bigger than normal, and unhappy. How fucked up is that?
There's no real point to this post. Just musing over the fucked up-ness of our medical model of treating mental health issues. I think I need to move to a nudist colony and start growing organic chickpeas or something. Feel free to share your drug dilemmas...
UPDATE 23/3/2012: The combinations of medication is going great, and I haven't gained a lot of weight (prob 1-2kgs). Recommend this treatment for anyone with resistant depression (in conjunction with pycho-social treatment of course.... The social worker in me can't condone a drugs only
approach!)
UPDATE 22/9/2013: I know I should have updated this again earlier ... But I'm lazy, ok!?!? I took Effexor + Avanza for about 9 months, and it was ok. I did end up putting on about 4 kgs,,, No great but tolerable. I then had a turn for the worse (life circumstances, more than medication, I believe) but, doctors decided to wean me off Effexor and try Dothep (dothiepin). It was a good call, Dothep has worked better than the other drugs I've tried. Just a word of warning: DO NOT GO OFF EFFEXOR UNLESS YOU ARE BEING CLOSELY SUPERVISED BY A PSYCH. The withdrawals are insanely horrible. You feel so fucking sick. And the brain zaps OH JEEZ THE BRAIN ZAPS! Can't explain to people who haven't been there, but essentially what I mean is that people need to be connected with a good doctor when medication is involved; I don't get those people who just get their script and screw around with their dosage and just think everything is fine. Rant complete.
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