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#31
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![]() A researcher, with full condemnation of the Nazi work, asserted that using the results of certain experiments (e.g., anoxia and hypothermia) for legitimate treatment-oriented research was at least some ethical recompense that the victims hadn't died completely in vain. That certainly makes sense to me. How can we possibly justify throwing away knowledge because we don't like the way in which it was attained? When we start making judgment calls like this, we could, for example, demand that the U.S. dismantle its nuclear plants on the ground that they would not exist if the Manhattan Engineer District hadn't set out to build the bomb that killed the residents of Hiroshima and Nagasaki. all the best -- Dan Ford email: see the Warbird's Forum at www.warbirdforum.com and the Piper Cub Forum at www.pipercubforum.com |
#32
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In article , Cub Driver
wrote: A researcher, with full condemnation of the Nazi work, asserted that using the results of certain experiments (e.g., anoxia and hypothermia) for legitimate treatment-oriented research was at least some ethical recompense that the victims hadn't died completely in vain. That certainly makes sense to me. How can we possibly justify throwing away knowledge because we don't like the way in which it was attained? While some of the argument against it is pure condemnation of the physicians involved -- we cast you out of our consideration (indeed, a later Nuremburg trial cast several by the neck until dead, while others committed suicide), a more mainstream argument is that they don't ever want to leave a loophole by which some future researcher might do work with involuntary subjects, and damage them. It's not a simple situation, with many ramifications beyond what I've described. Some researchers feel it is totally impossible to get truly independent consent from prisoners. An unfortunate reality, however, is that prison medical care can be very bad outside research trials -- which have separate funding and personnel. I recently went through some expert testimony in a suit regarding close to 100 deaths, relatively recently, in a US state prison. Most of these -- not associated with a research trial -- could either have been prevented with proper care, or at least have been much more comfortable and dignified deaths than lying on the floor outside the prison infirmary. When we start making judgment calls like this, we could, for example, demand that the U.S. dismantle its nuclear plants on the ground that they would not exist if the Manhattan Engineer District hadn't set out to build the bomb that killed the residents of Hiroshima and Nagasaki. I can't really give you a reasoned reply to that other than a gut feeling that such an argument is farther from the specifics than of the research studies. There's no question that the research subjects of Siegfried Rascher and his ilk (especially known for anoxia, but also hypothermia experiments) were not in any sense licit volunteers. The problem in the other argument is that the residents of Hiroshima and Nagasaki may have been licit collateral victims of a lawful attack. There's a lot of professional nervousness about "medicalizing" things that don't have a pure medical quality. These range from forcibly treating a psychotic criminal [1] with medications to render them sane, to some of the truly bizarre features of an execution by lethal injection [2]. There are questions about whether it is constitutional to rely on psychiatric testimony to confine a prisoner who completed the court-ordered sentence. I have no simple answers. [1] My gut reaction here is that it can be reasonable to medicate a prisoner so they are not a danger to themselves or others. It can be reasonable to medicate them so they can participate in their defense, although if it's necessary to medicate them for that purpose, it seems you've made the case for hospitalization rather than prison. It gets very messy if the mental illness developed after the crime, so you can't really use an insanity defense. Medicating someone simply to let them understand they are being executed, however, strikes me as cruel and unusual punishment. [2] The apparently universal protocol used for lethal injection simply doesn't make much sense. It uses three drugs in succession, the only rationale for this is that it essentially duplicates the procedure used for stopping the heart for open heart surgery -- which I have had. In the lethal injection protocols I've first drug injected, an ultrashort acting barbiturate, differs in the quantity that would be given in surgery. The protocols note that a lethal dose is given. Short and ultrashort acting barbiturates are the drugs used in veterinary and legal human (Dutch, for example) euthanasia. That drug would suffice, unless someone has a bizarre desire to make it more of a standard medical procedure. Using an alcohol swab, ostensibly to prevent infection, on someone who will be dead in an hour seems to speak for itself. Ironically, European practice is generally not to use alcohol rubs for normal injection. At best, in normal practice, a quick rub does some cleaning, but clearly does not disinfect. Alcohol must be in continuous contact with the surface for at least 2 minutes for even low-level disinfection, and 10 minutes for greater surety. |
#33
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![]() Using an alcohol swab, ostensibly to prevent infection, on someone who will be dead in an hour seems to speak for itself Well, perhaps it's for the sake of the doctor, either to reassure him that what he's doing is a normal medical procedure, or perhaps only so he won't get out of the habit of disinfecting when he's dealing with people he's trying to save! Thank you, Howard, for a sane and reasoned take on a difficult subject. all the best -- Dan Ford email: see the Warbird's Forum at www.warbirdforum.com and the Piper Cub Forum at www.pipercubforum.com |
#34
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In article , Cub Driver
wrote: Using an alcohol swab, ostensibly to prevent infection, on someone who will be dead in an hour seems to speak for itself Well, perhaps it's for the sake of the doctor, either to reassure him that what he's doing is a normal medical procedure, or perhaps only so he won't get out of the habit of disinfecting when he's dealing with people he's trying to save! Thank you, Howard, for a sane and reasoned take on a difficult subject. The subject gets truly weird at times. One anti-lethal-injection legal campaign, rejected by the courts, pointed out that thiopental sodium, pancuronium bromide and potassium chloride had not been given an FDA "safe and effective" approval for the indication of execution. It turns out that the FDA does, in fact, approve drugs for the specific purpose of veterinary euthanasia, and, in keeping with the regulations on drug approvals, designates them "safe and effective" for the marketed purpose. Think about that one for a while. Moderate consumption of ethanol, in your choice of flavor, is usually safe and effective for the resulting brain tilt. |
#35
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![]() It turns out that the FDA does, in fact, approve drugs for the specific purpose of veterinary euthanasia, Isn't that sodium pentathol? (I'm not sure about the spelling.) We once put down a St Bernard who weighed almost as much as I do, and at the time I marveled what an easy death that was. all the best -- Dan Ford email: see the Warbird's Forum at www.warbirdforum.com and the Piper Cub Forum at www.pipercubforum.com |
#36
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Cub Driver wrote:
Isn't that sodium pentathol? (I'm not sure about the spelling.) We once put down a St Bernard who weighed almost as much as I do, and at the time I marveled what an easy death that was. I've done the "final visit to the vet" on several occasions. It's the downside of the wonderful experience of owning a pet [dog]. The end comes so quickly and quietly, it really makes me wonder. Is it "inhumane" to apply on humans? Would it really be "unethical"? As opposed to often months of watching someone you care for die with the aid of "advanced medicine". Sometimes "ethical" and "humane" seem antagonistic. SMH |
#37
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In article , Cub Driver
wrote: It turns out that the FDA does, in fact, approve drugs for the specific purpose of veterinary euthanasia, Isn't that sodium pentathol? (I'm not sure about the spelling.) We once put down a St Bernard who weighed almost as much as I do, and at the time I marveled what an easy death that was. The standard used to be sodium pentabarbitol (Nembutal), although thiopental would work in lower dose, it is more expensive. My understanding is that some veterinarians use barbiturates specifically compounded for euthanasia, rather than a standard drug. The amount of overdose (corrected for the particular drug) and the speed with which it's injected may have as much to do with the soeed of effect in veterinary use. I've seen cats have their life functions stop almost instantaneously from a large intravenous dose of pentobarbital. In general medical practice where death is not desirable, you wouldn't give it that fast. Pentothal and related ultrashort acting drugs like brevital naturally act extremely fast when being dripped in at a slower rate, which is probably safer for anesthesia. In anesthesia, if something goes wrong, you don't want instantaneous onset -- you want something slow enough such that if something goes wrong, the anesthesiologist has time to react. |
#38
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In article , Stephen Harding
wrote: Cub Driver wrote: Isn't that sodium pentathol? (I'm not sure about the spelling.) We once put down a St Bernard who weighed almost as much as I do, and at the time I marveled what an easy death that was. I've done the "final visit to the vet" on several occasions. It's the downside of the wonderful experience of owning a pet [dog]. The end comes so quickly and quietly, it really makes me wonder. Is it "inhumane" to apply on humans? Would it really be "unethical"? As opposed to often months of watching someone you care for die with the aid of "advanced medicine". Sometimes "ethical" and "humane" seem antagonistic. It's a terribly difficult question. I did feel a deep emotional bond with my last cat to die, who seemed to tell me when he still wanted to go on -- and there were, indeed, treatment options for his bladder cancer. He wound up not being euthanized but dying at home. Before he died, he spent a long time in my arms, and I'd swear we agreed that it was OK for him to go. To my surprise, as opposed to my other cat, be chose not to die with me holding him. I had fallen asleep from sheer exhaustion, but I (and my ex-wife) sat bolt awake at the same moment, which probably was close to what we can reconstruct was the time of death. It was much more difficult with my mother, although there were significant differenes. She had metastatic breast cancer in 1975, and, while she was in active treatment, I wound up in role beyond the usual surrogate responsibility -- a fair bit of the staff didn't tell her things but would want me to break news and get decisions. She phoned me at one point, telling me that the nurses were annoying her, asking her to put in several IVs to "build up your strength, dear." It fell to me to tell her the truth: that the IVs were very specifically to counter a drug reaction that would, untreated, kill her painlessly in 48-72 hours. I felt I had to give her the options -- there was one more treatment that might have any hope, although the chance of it working was low. I explicitly told her I would suppport her decision either way, and didn't consider it cowardly if she chose to refuse the immediate treatment. The long-term outcome was bad. She did respond to the immediate treatment, but the new treatment was ineffective. She was then transferred to a VA hospital (she had retired medically from the Army Reserve), and the VA staff was far less willing to accept any input from someone even named in an advanced directive. She crumbled for several months, including a phase of brain metastasis where she felt her consciouness and memory slipping away. At that point, I told her staff comfort measures only -- do not attempt to cure potentially fatal complications such as pneumonia. They refused, and, indeed, insisted on intense life support even when she certainly was no longer conscious, and was not going to wake up. |
#39
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On Mon, 19 Jan 2004 07:22:44 -0500, Stephen Harding
wrote: Cub Driver wrote: Isn't that sodium pentathol? (I'm not sure about the spelling.) We once put down a St Bernard who weighed almost as much as I do, and at the time I marveled what an easy death that was. I've done the "final visit to the vet" on several occasions. It's the downside of the wonderful experience of owning a pet [dog]. The end comes so quickly and quietly, it really makes me wonder. Is it "inhumane" to apply on humans? Would it really be "unethical"? As opposed to often months of watching someone you care for die with the aid of "advanced medicine". Sometimes "ethical" and "humane" seem antagonistic. SMH I have problems with actual termination of humans-- it opens so many cans of worms, legal and ethical alike. But... I've seen friends and family kept alive long past the point where they woudl naturally die. Long past the point where there was any hope that they would get better-- in extreme cases where you just had a mindless husk being kept alive by machines. I think the problem is that the idea that the doctor will do everything to keep you alive has ignored the fact that we *are* going to die at some point, and that as medical technology gets more advanced that point that be delayed long past where it should happen. But on the other hand, that's a terrible decision to make-- and there have been cases of criminal or ethical charges being brought against doctors who have done so, even with the cooperation of the family. Dr. Kevorkians antics didn't help the debate any either, of cousre. |
#40
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Howard Berkowitz wrote:
It's a terribly difficult question. I did feel a deep emotional bond with my last cat to die, who seemed to tell me when he still wanted to [...] Definitely the tough side of having a pet. It was much more difficult with my mother, although there were significant differenes. She had metastatic breast cancer in 1975, and, [...] consciouness and memory slipping away. At that point, I told her staff comfort measures only -- do not attempt to cure potentially fatal complications such as pneumonia. They refused, and, indeed, insisted on intense life support even when she certainly was no longer conscious, and was not going to wake up. Sounds like you've been through the wringer. Been there myself so I can sympathize. Problem is, medical people are trained to "keep people alive". You know, "do no harm", at least in a physical sense. Technology can drive a glimmer of hope in immortality. "It's not *fair* to die; we can *fix* it!" We all know we die. We just don't believe it. Death is natural. But sometimes, it seems the medical community, and the consumer of medical services, looks upon it as a cop out or a failure. Irrespective of our feelings, eventually, it's simply time to go! SMH |
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