Do we? We make people stay alive a long time and in a lot of pain unless they ask really loud not to. Even if you think that’s torture, adding morphine solves that. (It does not solve the sacrifice of resources that buy more QALYs.) What are you thinking of?
I think a lot of times they can’t “ask really loud” because they’re mentally impaired and sick. Also, it sometimes happens that people have pension benefits that stop or substantially decrease when they die, such that their spouse (who is likely to have legal control over medical decisions) has a giant financial incentive for them to be kept “legally alive” but stored out of sight and mind in a inexpensive facility somewhere. In such cases, if you’re being uncharitable by imagining the capacity to calculate on the part of seemingly stupid people, then “feeling icky” is just an emotionally plausible cover for “pursuing money despite the moral horror involved”.
Legal bright-lines combined with tragic and unforeseen circumstances can produce kind of bizarre and horrible outcomes that no one has much incentive to talk about when they personally find out about them. Since they aren’t much discussed, they don’t enter into people’s calculations very much… which helps them remain “unforeseen” for many people (and thus potentially increases the tragedy, due to lack of advance planning). Its like an ugh field, except functioning at the interpersonal level where epistemic hygiene starts to be relevant, rather than being a matter of confused stuff going on in a single person’s head.
If you think that morphine solves that, you have had the very good fortune to never experience severe pain. I’ve watched my father bellow in pain for hours while he was on several times the maximum recommended dose of every pain medication a hospital could provide.
We are very bad at controlling severe pain; any belief to the contrary is simply mythology believed by people who have never been there (I have as well, and I can assure you this is true).
My father was in severe pain, every day, for the last decade or so of his life. It happens to be the case that he wouldn’t have chosen suicide were it offered, but what if he had wanted to choose that? WTF is wrong with our culture that a person in such a situation cannot get help? He certainly couldn’t handle it himself; he could barely walk, and many days couldn’t function at all. RomeoStevens is quite correct here.
I’ve seen claims that doctors know how to control pain, and no evidence that it’s true in general. (One of my friends has severe neuropathy from no known cause, and heavy duty meds, electrical stimulation, and I forgot what other medical methods have been tried leave her barely able to walk.)
I would like to have a method of recognizing it when someone makes a comforting generalization (“it will get done soon” is a small scale example) to check for evidence. There’s a temptation to accept the comfort too fast.
Another angle on doctors and pain control is that you don’t always know where to find competent help. A friend who had a major cancer and was picky about being able to think clearly didn’t get decent pain control until he was in a hospice.
Some people find that having access to suicide makes a hard life easier to endure.
Yes. In the UK and US, medical authorities treat opiates as inherently evil and give doctors prescribing them a hard time. (This is worse since Harold Shipman.)
it’s worse than you think. We routinely torture people behind the veneer of medicine just so that healthy people don’t have to feel icky about death.
Do we? We make people stay alive a long time and in a lot of pain unless they ask really loud not to. Even if you think that’s torture, adding morphine solves that. (It does not solve the sacrifice of resources that buy more QALYs.) What are you thinking of?
I think a lot of times they can’t “ask really loud” because they’re mentally impaired and sick. Also, it sometimes happens that people have pension benefits that stop or substantially decrease when they die, such that their spouse (who is likely to have legal control over medical decisions) has a giant financial incentive for them to be kept “legally alive” but stored out of sight and mind in a inexpensive facility somewhere. In such cases, if you’re being uncharitable by imagining the capacity to calculate on the part of seemingly stupid people, then “feeling icky” is just an emotionally plausible cover for “pursuing money despite the moral horror involved”.
Legal bright-lines combined with tragic and unforeseen circumstances can produce kind of bizarre and horrible outcomes that no one has much incentive to talk about when they personally find out about them. Since they aren’t much discussed, they don’t enter into people’s calculations very much… which helps them remain “unforeseen” for many people (and thus potentially increases the tragedy, due to lack of advance planning). Its like an ugh field, except functioning at the interpersonal level where epistemic hygiene starts to be relevant, rather than being a matter of confused stuff going on in a single person’s head.
If you think that morphine solves that, you have had the very good fortune to never experience severe pain. I’ve watched my father bellow in pain for hours while he was on several times the maximum recommended dose of every pain medication a hospital could provide.
We are very bad at controlling severe pain; any belief to the contrary is simply mythology believed by people who have never been there (I have as well, and I can assure you this is true).
My father was in severe pain, every day, for the last decade or so of his life. It happens to be the case that he wouldn’t have chosen suicide were it offered, but what if he had wanted to choose that? WTF is wrong with our culture that a person in such a situation cannot get help? He certainly couldn’t handle it himself; he could barely walk, and many days couldn’t function at all. RomeoStevens is quite correct here.
I’ve seen claims that doctors know how to control pain, and no evidence that it’s true in general. (One of my friends has severe neuropathy from no known cause, and heavy duty meds, electrical stimulation, and I forgot what other medical methods have been tried leave her barely able to walk.)
I would like to have a method of recognizing it when someone makes a comforting generalization (“it will get done soon” is a small scale example) to check for evidence. There’s a temptation to accept the comfort too fast.
Another angle on doctors and pain control is that you don’t always know where to find competent help. A friend who had a major cancer and was picky about being able to think clearly didn’t get decent pain control until he was in a hospice.
Some people find that having access to suicide makes a hard life easier to endure.
Because of fears about addiction and odd cultural beliefs about the value of pain, the morphine isn’t always available.
Yes. In the UK and US, medical authorities treat opiates as inherently evil and give doctors prescribing them a hard time. (This is worse since Harold Shipman.)