Well-Reasoned Arguement or Millitant Crazy Disabled Nutjob Rant? You Decide...I'm Going to Bed.

Well, Shannon, who is always challenging my thinking with her thought-provoking posts, requested a nice, light easy topic for me today:

Explain in detail your end of life ethics and politics. I was intrigued by what you said months ago about the Terry Schiavo case. I want to be all "freedom to die" but I am enough of a Marxist to know that this kind of freedom would most likely be offered disproportionately to the poor, minorities and others capitalist society doesn't value.

Please discuss.

Yeah, OK, no problem. I can do this in my sleep while prying dangerous objects from toddlers with one hand tied behind my back and while juggling three loads of laundry. Well, here goes:

I know Shannon has taken bioethics courses and I have not, nor have I done extensive research into the policy/legislative side of this topic. My views are shaped almost entirely by the disabled community, and most of that is through anecdotal stories and experiences. Every disabled person either is someone, knows someone, or knows someone who knows someone who has been negatively affected by right-to-die politics. Just about Every major (and minor, that I know of) disability advocacy group, leadership/policy committee, or direct-service provider outside of health care has come down on the side that right-to-die/death with dignity laws and politics are discriminatory and very dangerous to the disabled population. The reason is that although very few are helped by these laws, a great majority of disabled people are harmed and even killed when it was not as they wished.

One of the main problems for the disability civil rights movement in this case has been that assisted suicide has become a pet issue, like gay marriage or abortion, for the republicans to swing the evangelical vote their way. This has caused such a knee jerk reaction among liberals that the disabled perspective on this has not even been able to enter the national discussion because our practical issues cannot be heard around all the Godbags and and all their talk about, well...God. The liberals go all separation of church and state (as I would do as well in this case) and the very horrid slant that the consequences of this issue take are lost to the liberals, and the conservatives. With whom so far have made for very strange bedfellows in this case, because they won't listen to us either, they just want to talk about God. So, for the purposes of our discussion here today--we are going to leave God out of it, Okay? This is not about God, the Sanctity of Life, Playing God, or anything of that nature. This is about the value, or lack thereof, that is put on the lives of the disabled. This is a civil rights issue.

Personally, I believe that in a perfect world (you all know how I love to tout my Perfect World(TM) theories) I would not have a problem with assisted suicide/right to die issues. I think in most cases, the current laws that allow anyone to decline medical intervention and to have the right to comfort measures and palliative care are enough for the vast majority of terminally ill people to die in as comfortable and quick way as possible. I also don't see a mass problem with doctors or family members wanting to hold on to a dying person indefinately against their will. (Which makes disabled people suspicious of why policy makers are telling us we need right-to-die laws in the first place.) I do believe that in a small number of cases, it is appropriate to allow a person the freedom to control his/her own death via suicide or assisted suicide. In instances where death is very imminent, and the person is in a horrendous amount of pain that cannot be controlled, I do concede that it may be the merciful thing to do to assist in death if that is what the person desires. In fact, I've been involved in health care enough and talked to nurses enough to know that this does, in fact, happen on a very under the table, informal way. A person is given a large dose of morphine to control pain. The dose would be large, but not kill a healthy person, but due to the person's declined health, it is enough to cause death. There is a difference to me in providing palliative care by withholding intervention and providing comfort measures to ease a person into an already eminent death, compared to ending a life prematurely. There is a process to dying that depending on several factors, can take several days or weeks while the body slowly shuts down. I don't see a problem at all with a person deciding that they do not want any intervention or resuscitation during this death process. However, there is a difference between using medical care to prolong death, and using medical care to sustain life.

Most people do not know or have never thought about the difference. Most people do not understand what life support is, what a feeding tube does, what the difference is between a life saving intervention and a futile medical procedure that just briefly puts off death. Also, most people have a tremendous fear and lack of understanding about what it means to be terminally ill, permanently disabled, and brain damaged or "hooked up to tubes." etc. This fear causes anxiety, prejudice and sometimes hatred towards people with disabilities. The prevailing common wisdom in our society is that people would rather be dead than disabled. I cannot tell you how many times I have introduced a nondisabled friend to a disabled friend and been told later, Geez, I'd rather die that live like that. In particular, my former boss, who had CP and used a wheelchair, and was a well-published Ph.D. and was a likable guy, was always the target of passerby hatred and disdain. We traveled together a lot, and people often took me aside to tell me that he grossed them out in a restaurant, or that people like that should be put away, or be better off dead. The disabled, people say, especially severely disabled individuals are scary to look at, scary to think about, and make them uncomfortable, should just go away. Therefore, even though in my perfect world I would probably not object to assisted suicide or right to die legislation, in my current world, I know that we are not ready yet for this type of power that has been so easily abused. We do not talk about death and disability in this country, even though 80% of us will be disabled for some part of our lifetime and we are all gonna die. We are not grown up enough yet to handle this type of power. We have not proved ourselves trustworthy enough for the responsibility.

I know this is hard to understand for people outside the disability community, but try to live in our world for just a few minutes. In our world, we are constantly told, through the media, through our health care providers, through our friends and families, that it is better to be dead than disabled. That if we weren't so selfish, we would just go off and die so that we wouldn't be burdens to society. We have no value, we cost too much money to keep alive, we burden the health care system, we add nothing to the fabric of society. This admittedly affects more of your high quads and folks with mental/cognitive disabilities more than it effects me (cuz I don't "look" disabled) but even I have dealt with this. I have been told by health care providers that ideally I need my kidneys to go before my vision and hearing goes, so that I can have a shot at the kidney transplant list. For if I go totally deafblind first, my chances on the transplant list will be considerably less.

D and I just talked to a woman on the train the other day who I believe had muscular dystrophy. She lost her apartment when the caregiver funding agency took her 24 hour caregiver away and cut her to hourly care. The 24 hour live in caregiver contributed to the rent, and without that money, she had lost her apartment. She was currently on the waiting list for section 8 accessible housing. The section 8 waiting list for the nondisabled poor is usually between 6-12 months. For the disabled, it is upwards of 5 years. So she was put in a nursing home while she waits. (The nursing home will put her further down on the list, her other alternative would be to become homeless for a better spot on the list.) To leave the nursing home, this very independent woman now has to someone come in and sign a release to get her out each time she sets foot outside. She said that when filling out the admissions paperwork, she was required to fill out an advanced directive (aka living will). She faced high pressure tactics from the administrators to sign a DNR. She is also on a trach, she was told that she should say that if for some reason she has an issue where she loses her trach, she would not want to be retrached. This is a woman in her 30's who just nine months ago lived in her own home, did volunteer work on her own, and had a social life. Incidentally, she was going to visit a friend at an apartment complex that is run by the residents who live there. All are quadriplegics who need 24 hour care. They have incorporated into a private non profit in order to share attendant services. Point being, there are reasonable solutions in the world to get her out of the nursing home (which disabled people term "False imprisonment") and back into mainstream society.

This story (which we hear all the time) illustrates a couple of things. First, we have not decided in our society what it means to be terminally ill. To many people, those like this woman who have long term or permanent illnesses such as muscular dystrophy, multiple sclerosis, ALS, spinal cord injuries, cerebral palsy, etc. are terminally ill. Well, technically they are (as we all are.) They will probably die from complications of these diseases, but possibly not for 20, 40, or even 80 years. Trachs, feeding tubes, and wheelchairs to them are not life support that needs to be shut off so they can die with "dignity," They are just the tools they use to get on with their lives. Is Michael J. Fox terminal? Is Stephen Hawking? Is D? According to many, they are.

You can see this in the media all the time. In movies like "Million Dollar Baby" where a prize fighter has an accident and becomes a vent dependant quad and then is "mercifully" killed by her coach, a nonterminal patient with a full life ahead of her is thought to be better off dead, and thus considered terminally ill. Most people who are disabled describe adjusting to a new disability as being very similar to adjusting to a death of a close loved one. They go through the stages of grief just as if it was a death. It was in a sense, a part of them died. They go through shock, denial, anger, guilt, depression, and finally do get around to acceptance. Then, although they may still miss that part of them that was different before, they go on and it becomes less and less a factor in their life. Medical personnel and the general population have been shown in studies to greatly underestimate the happiness and well-being of the disabled. Disabled people SHOCK! actually don't go around thinking that they are a poor disabled person all day long. They don't really think about it at all that much after they adjust. Do you think everyday about how you don't have as much money as Bill Gates or that you are not as beautiful as Denise Richards? Would it be nice? Yes. Does the fact that you don't have these advantages make you think your life is not worth living and that you should kill yourself? No. The problem is, that when a newly disabled person is going through their stages of grief, instead of helping them to get the support they need to go on, people just decide that death is a better option. If you knew someone had lost a husband or a child and was grief stricken with depression and sadness to the point where they didn't want to get out of bed, you would support them in getting help to get over their grief. You might also take up a collection to help with the practical side of money issues or the like. You might make them food, run errands for them, clean their house, listen to them cry at 4 in the morning. You would do anything to help them get on with their lives and process their loss. If they were, in fact, suicidal. You would get them emergency help. The medical staff would be obligated to provide services to them to prevent suicide if they were a danger to themselves.This is what newly disabled people need as well, and what they often don't get. Instead, they get told that they will get help to die. They get asked if they want to live "like this." They get told that they will be a burden to society and their families. They get medical staff that decides they are too futile to care for and that they or the family should be encouraged to pull the plug. They are grieving and they get a gun pointed to their heads. Imagine handing a gun to a despondent woman who just lost her husband and telling her to go ahead and shoot herself. If she stays alive and is a burden to others, she is just being selfish. This is what many newly disabled people face, instead of getting the help they need to put their lives back together. It is discriminatory for the health care professions to be obligated to provide preventative services to any other potential suicide victim, yet encourage suicide or death and not provide these preventative services to the disabled. Yet it happens all the time.

I believe I have told some stories about people who have become severely disabled, got crap for services, ended up in some kind of institution, and then petitioned the court for assisted suicide. Which in many cases, the courts have granted, often siting it to be the duty of the plaintiff to take his own life for the good of the public. (See Larry McAfee, Tracy Latimer, Robert Wendlund, etc.) . The problem here isn't the disability or illness itself, it is the social services system that is oppressing these people. When disability rights groups have come in and helped the individual get out of the institution and have their lives back, they suddenly no longer wanted to kill themselves. These examples are even more heartbreaking when it comes to parents who wish to or do kill their disabled children and get off the hook because it was considered a mercy killing. Some of these kids are merely autistic or have Down syndrome or CP or something, yet society accepts death as being in the child's best interest, because they apparently were suffering. In the case of Tracy Latimer, a child suffocated by her father because she had CP, her mother wrote a note the day before saying she ate well and was smiling and happy. He didn't end her suffering, she wasn't suffering as far as we know. He was ending his suffering. He got a 2 year suspended sentence for killing his child. It happens to the elderly as well. The elderly have been systematically shut out of disability rehabilitation services due to the fact that there is considered little cost benefit to rehabbing them as they will not likely return to work. However, when grandma has Alzheimer's, family members are not given the simple strategies and tools that work for millions of children and working age adults with cognitive disabilities that might also help grandma out. Things like color coding items, putting up picture cues, leaving a radio in the bathroom on at night to help her find the way, setting a routine, giving respite care, etc. are not provided. The family can only suffer and wait for grandma to die. Grandma is going to die, we know, but her time left doesn't have to be such a horrible wait that we try to find legal ways to "end her suffering." Someone made an analogy once that "assisted suicide" in this country is like if you were to go up to a lynch mob and shoot the poor guy about to burn on the cross out of mercy to end his suffering (Golly gee, it is too bad that guy is black), meanwhile you are totally ignoring the lynch mob for putting him there in the first place.

What Shannon alludes to above about capitalistic influences having more to do with which lives will be ended that anyone's "right to die" is very true. Especially in the very corrupt, very powerful nursing home industry. People don't realize that the vast majority of nursing homes are private, for-profit corporations. They are a huge national lobbying force. Almost entirely republican and profit-oriented. They have had enough influence in Washington to ensure that the majority of all Medicare dollars available to assist in the daily living of disabled and elderly get directed to nursing homes. The money does NOT follow the patient. The money goes directly to the nursing home bed, and the nursing home tries to find the most cost effective patient to fill the bed in order to maximize their profit. The perfect nursing home patient is someone who will be there a long time, but needs a very low amount of care, then who suddenly dies without much need for more advanced care at the end of life. (If you remember, D was rejected from 4 nursing homes earlier this year because they would not net enough of a profit from him.) When a nursing home patient gets too expensive, nursing homes either try to buck the patient out sometimes sending them far away from their family, or encourage DNRs or other withholding of care. It costs less to care for patients in their homes with paid care providers such as myself. Let me repeat that: IT COSTS LESS TO PROVIDE CARE IN THE HOME. The nursing home industry is one of the biggest money fleecing crocks in this country. The end of life care provided is of varying quality, but the financial incentive to get financially costly patients to die is a conflict of interest to this mythical political cause called "right-to-die." What sounds like personal freedom is really the health care system's ploy to weed out the extra expense and thus gain a higher profit margin.

But, these disabled people and elderly people are a burden and take so much money, right? Isn't it a waste to use all those resources on them while healthy children aren't getting vaccinated and stuff? I won't deny that disabled people cost money. But the issue of how much vs. how much disabled people could give back if given the chance is very manipulated by an industry that exploits the disabled and elderly for profit. This issue of them taking away needed health care services from others is largely a myth, at least in this country. It is hard for a disabled person to hear that he or she should selflessly die in staunch, honorable moral utilitarianism rather than take health care dollars away from children and pregnant mothers when the people who are saying these things are CEO's of nursing homes and hospitals that are driving around in $75,000 cars to their million dollar homes. Healthy people do not understand how corrupt and in crisis the health care industry is. This includes providers, nursing homes, and especially insurance companies and employers that provide insurance to their employees. Health care does not work as a for-profit business. Capitalism and free market economies depend on competition and supply and demand, and health care consumers don't work that way. Do you go looking for the bargain basement cardiologist's blue light budget special to get your open heart surgery? Do you buy bulk chemotherapy to get the volume discount? (And if your insurance company does, should it?) Do you wait to get that brain surgery until your next raise or when the economy improves? Do we market the deluxe colonoscopy for those with the means who require a little more luxury when having an anal probe shoved up their ass? (Well, in a way, we do... Health care is rationed in this country and richer people get more options and better care.) In any case, blaming the poor and disabled and elderly for the problems of health care is a scapegoat that will get you nowhere. We either decide that everyone deserves the same access to health care or we don't. And if we don't then that is when we start creating beautiful laws entitled, "Death with Dignity."

And isn't dignity a lovely loaded and prejudicial word when applied to death? The biggest thing people talk about when they talk about wanting to die with dignity is that they don't want to have to be fed or taken to the bathroom or have tubes to breathe. Because apparently dignity comes from how you go to the bathroom. D must have no dignity then. Neither must the late Ed Roberts, a vent dependent quad who started the independent living movement. Neither did Christopher Reeve. He couldn't even feed himself, which according to a judge in the Terri Schaivo case, disqualifies you from being human. I'm not saying that losing your bathroom, eating, or breathing abilities isn't a major sucky loss, but it has nothing whatsoever to do with your dignity. Neither does dying, no matter how it happens. Dying and disability are natural parts of human existence. There is nothing undignified about losing some bodily functioning. I know this is crass, but I always want to ask these people that want to die with dignity, "You know you're going to piss and shit your pants and probably fart and gurgle up a bunch of phlegm no matter how you die, right? Even if you take a bunch of pills in a beautiful room with all your loved ones surrounding you, you know that there will be mass incontinence, right? Because that's the way it works and we still don't have a pill that will cause you to die without that kind of DIGNITY!" But in all seriousness, rather than having the only path toward dignity be killing yourself when the body doesn't cooperate in the traditional fashion, how about treating people with dignity while they are alive despite how their plumbing works? Giving them the support and respect that they need to manage their disabling condition. Giving their families respite and assistance when caring for them. Giving them easy access to appropriate comfort measures when they are near the end of life.

So, I need to talk about Terri Schiavo, I know. What you are probably saying by now is that, okay, people shouldn't tell disabled people to go die, but Terri Schiavo and people like her aren't disabled, they are brain dead. Except that she kinda wasn't. Sure she was just a slim sliver of a grey spot on a CT scan to the left of brain dead, but she was not brain dead. She was not on life support. She was not terminally ill. And she was not going to recover. What she was, was severely disabled. The Schiavo case was a very messy one because the families involved were kind of a bunch of crackpots and then the Bush Brothers got involved and we all know they were a bunch of crackpots. It was not a good "model" case for anyone. However, I'm sure the individual, Terri Schaivo, never intended to be anyone's dog and pony show. We don't, in fact, know what Terri Schiavo intended. We don't (and maybe somebody does, but I don't) know whether she was happy. Whether she felt pleasure or pain. I saw video of her, very briefly, and as a trained assessor of individuals with severe cognitive impairments, I'll tell you what I saw. I saw a person who could respond positively to stimuli. I saw a person who smiled and vocalized to touch. It wasn't much, and I would have had to seen what else she smiled and vocalized to (like did she do that in an empty room?) So I don't have a huge amount of information to go on, but I saw someone who was definitely NOT in a persistive vegetative state as I understand the definition, and someone who was NOT totally brain dead with no response to stimuli. But she said to friends before that she would not want to be kept alive like that. Well, that was ten years ago, does she still feel that way? Is there any way of knowing? Do you know how many disabled people laugh at the fact that they said before they were disabled that they would never want to live like that? And this includes happy, well adjusted folks with significant cognitive impairments? This is why, although an advanced directive is a fine thing to have, a more important thing to have is a person who is your medical power of attorney that you trust with your life. That will assess your wants and needs not by what you said and did ten years ago when you didn't know anything about what it was really like to be disabled, but what you want and need in the present. Someone who loves you unconditionally and wants what is best for you in your current situation. Someone with whom you will talk with about these issues extensively over and over again over time, not just offer them checked boxes on a prefab hospital living will document that has very little to do with real life situations. I do not know Terri Schiavo's husband or parents, so this may not be a fair statement: But based on the fact that the mother pushed for rehab and the husband denied it, and my admitted bias towards a mother vs. a fairly newly married husband having the best idea of what is in her best interest, I would have thrown in with the mother as knowing what was best for Terri Schiavo, not the old Terri Schiavo, but  the current one, which is the one that mattered.

But the reason the Terri Schiavo case, and hundreds of other less public ones like it, scares disabled people so much is because the line moved, and is moving all across the country. Most states have futile care policies, in which medical staff can determine that medical intervention would be futile. Although in many cases, the doctors are correct in discontinuing care due to futility, Terri Schiavo's case along with a national trend of other severely disabled people--not brain dead, but severely disabled--are now considered futile cases. Individuals are having actually less freedom in deciding right to die and or live issues. Hospitals, insurance companies, and for profit policy makers are deciding who is too futile to treat and who isn't. Terri Schiavo's case nudged the line a bit. Other cases nudge it a bit more. Disabled people are afraid that next it will be the vent dependent quads and next the cognitively disabled and then the mentally ill and so on...

Before you invoke your "Slippery slope is a logical fallacy" rebuttal to me, allow me to invoke Godwin's Law first. That slippery slope has a historical precedent. Remember that thing called the Holocaust? The one that killed over 6 million able bodied Jews? Do you know your history enough to know how that all got started? It started with the eugenics movement, which was an effort to cleanse the population of the disabled. In the United States, this took mostly the form of forced sterilizations of anyone considered disabled or in danger of having a disabled child. In Hitler's Germany, it  started as forced medical experimentation on the mentally retarded, then the mentally retarded were put into concentration camps and killed, then the folks with CP and the epileptics, then the mentally ill, then the deaf and the blind, then the homosexuals, then I think the poor from the almshouses and the gypsies, then the Jews. This is why the devaluation and culture of 'better dead than disabled' scares the disabled community so much. This is why we think that society has not done enough talking, listening, learning, repenting, and fixing to be trusted with the dangerous power of "right to die" legislation.

Did I lose you with Godwin, there? I do not believe there is a direct corollary between what happened to disabled people in Hitler's Germany, and what is happening in the U.S. right now. However, I do think that it puts in perspective the realities and attitudes that disabled people face currently. This is what we would call a Mockingbird Issue. One in which the law (assisted suicide) itself is not the problem, it is the society in which the law is carried out that makes it unfair. This whole dealy is obviously an opinion piece that has barely scratched the surface of the ethics of death and all the different ramifications of that. But this is my point, as a society, we have not scratched the surface in talking about, dealing with, and finding solutions for the fact that most of us will become disabled and eventually die. You don't let the man convicted of abusing children babysit your children. You shouldn't allow a society who has historically abused disabled and elderly people the mandate to do it some more.

Here is a five minute Google search pile of quick sources:

Not Dead Yet

Amicus Briefs for court cases involving disabled people and right to die

Articles from the Ragged-Edge: Why Disability Rights Activists Are Against Physician Assisted Suicide

The Holocaust and Disabled People

Doctors: Let us Kill Disabled Babies

Freedom Clearinghouse

The Moral Bankruptcy of "Million Dollar Baby"

Disability Law: Oregon's "Death with Dignity" Law

Comments

[cherylc]

Aargh, so depressing. But you are right on, as I usually find you. My husband just took a new job providing psychotherapy and case management for people who are house bound. Not surprisingly, his caseload is mostly poor disabled people and poor old people, both of home could probably get out of the house with more support.

I love the name "Not Dead Yet." I became familiar with the group at a previous job, and I apply the term to myself every day. It makes me laugh, although perhaps I have a sick sense of humor.

[Ian Murphy]

A very well written article that raises cases which are almost certainly going to occur... worryingly. however, you are mixing several situations which are not really related. The movement is 'right-to-die' - not 'right-to-kill'. If a person is not concious a court order would normally be required to have medical equipment disconnected.

Right-to-die is where someone has decided they do not want to go on.

The quandry in recent years has come about because medicine has gotten better and better at keeping the human body going for extended periods of time. A person can be kept alive almost indefinitely.

If the person is not concious the medical system has an obligation to keep them alive. Its up to their guardians and the legal system to decided if they should be disconnected from whatever keeps them alive.

If you are concious and capable of rational thought (and capable of pain) but not of movement, you are trapped between the two systems. A generation ago people in this situation would have simply died from benign neglect at home or in hospices, now they survive. Don't they have a say in the matter?

On the flip side there would exist the problem of someone who feels they are a burden on their loved ones or is pressured by an uncaring family to suicide. Right-to-die legislation should attempt to cover this.

In the end most people cling tenaciously onto life. The number of people who are in this situation and actually say they want to die is very very few.

Perhaps redirecting some of the concern to the *thousands* of fit and healthy people who commit suicide every year would be protecting far more people.

[Kathryn]

Thanks for this well reasoned argument. There's a lot to think about here as usual. There's a lot in the landscape to understand.

[Lisa]

Ian Murphy:

I'm afraid you may have missed the whole point I was trying to make. Although you are right, there are a myriad of situations that are entirely different that will potentially come up in end of life issues, such as a person who is unconsious vs. a person who is severely disabled and who is suicidal, I could not cover them all in one article.

However, I was not attempting to cover them. What I was trying to convey is the culture of death that exists for people with disabilities and/or terminal illnesses. The pervasive prejudicial belief that it is better to be dead than disabled permeates every aspect of these decisions. The economic and profit-driven conflict of interest in the health care field causes coercive pressure that is unfair to either the individuals making these decisions, or the family members deciding on their behalf.

The point of the post is that "right to die" easily, so very easily is confused with right to kill. We have not adequately determined where and under what circumstances the line between the two falls. And history shows that when we have any sort of mandated power to abuse or eliminate disabled people, we use it willingly.

And I should direct my concern to the thousands of fit and healthy people who are suicidal, why? Because they deserve my concern more than disabled people? Because their lives are worth saving and disabled people's lives aren't as valuable? You just proved my point.

[Sarah V.]

Just wanted you to know that for years, I've kind of been in this undecided state of "I think euthanasia probably should be legalised but I'm just not sure and could do with knowing more about it", and I was recently, after some discussions on the subject, leaning more towards the "should be legalised" side. Then I read this, and I swung all the way around to the anti-euthanasia side so fast I'm still getting over the dizziness. So, if you ever wonder whether any of what you write makes a difference; yes, it does.

[shannon]

Brilliant! That is just what I was looking for. It doesn't matter what classes you've taken, you have experience that speaks to this directly in ways no class full of 20-something, able-bodied college students could get from a book.

I think the most salient point here for me is that "right to die" legislation would help very few people but put many more at risk.

People have been getting doctors, nurses and loved ones to assist in their suicides for years--without the law. So it makes sense when you say the law itself is really about something else. And the stuff you have taught me about nursing homes is so damn sinister, I have no doubt they want these laws to help them "manage" their care obligations.

So thanks, this was very educational--as usual when you write about disability stuff. If I ever do teach bio-ethics again, I will at the very least invoke these ideas if not have you as a guest presenter!

[Pronoia]

Linda, I just have to say that this post was brilliant and wonderful and cogent. Thank you!

[Gluten-Free By The Bay]

This is a brilliant post, you articluated my beliefs about this so beautifully and taught me more as well.

[Lindsay]

It was a long read, but definitely worth it! In the past I have typically come down on the "right to die" side, however I realized today that I had done so without having really examined my own position.

Your thought-provoking post convinced me, and I am planning to take away more than a few of your arguments to keep in mind for future conversations about the subject.

Thanks!
Lindsay

[Kathryn]

I agree it's a brilliant post from a more brilliant mind. Your point about what the person would want today versus what they thought they wanted is really important. Well worth the long, long read. Thanks for writing this Lisa!