How to Die in Oregon

SifuPhil's Euthanasia Worksheet (SPEW)

Category 1
[h=3]Pain Testing[/h]

  • Sub-Section A: Pain Assessment

    • Paragraph 1: Pain Assessment Scales

      • Visual Analog Scale (VAS)
      • Verbal Numerical Rating Scale (VNRS)
      • Verbal Descriptor Scale (VDS)
      • Brief Pain Inventory
      • Alder Hey Triage Pain Score [SUP][/SUP]
      • Behavioral Pain Scale (BPS)[SUP][/SUP]
      • Brief Pain Inventory (BPI)[SUP][/SUP]
      • Checklist of Nonverbal Pain Indicators (CNPI)[SUP][/SUP]
      • Critical-Care Pain Observation Tool (CPOT)[SUP][/SUP]
      • COMFORT scale[SUP][/SUP]
      • Dallas Pain Questionnaire [SUP][/SUP]
      • Descriptor differential scale (DDS)[SUP][/SUP]
      • Dolorimeter Pain Index (DPI)[SUP][/SUP]
      • Edmonton Symptom Assessment System
      • Faces Pain Scale - Revised (FPS-R)
      • Face Legs Activity Cry Consolability scale
      • Lequesne Algofunctional Index
        • Original index (1987)[SUP][/SUP]
        • 1991 revision[SUP][/SUP]
        • 1997 revision[SUP][/SUP]
      • McGill Pain Questionnaire (MPQ)
      • Neck Pain and Disability Scale –NPAD[SUP][/SUP]
      • Numerical 11 point box (BS-11)[SUP][/SUP]
      • Numeric Rating Scale (NRS-11)[SUP][/SUP]
      • OSWESTRY Index
      • Palliative Care Outcome Scale (PCOS)[SUP][/SUP]
      • Roland-Morris Back Pain Questionnaire [SUP][/SUP]
      • Support Team Assessment Schedule (STAS)[SUP][/SUP]
      • Wong-Baker FACES Pain Rating Scale[SUP][/SUP]
      • Visual analog scale (VAS)[SUP][/SUP]
    • Specialized Tests
      • Disease-Specific Pain Scale: DSPI = (ΣX · Y) · 100 where X is the highest pain level on a 0–10 scale and Y is the percentage of this pain level in the group. The DSPI is different from the simple numeric 0–10 scale in that it is measured for a group of patients with a specific diagnosis whereas the numeric 0–10 pain scale is administered individually.
      • Pediatric Pain Questionnaire (PPQ)[SUP][/SUP] for measuring pain in children
      • Premature Infant Pain Profile (PIPP) for measuring pain in premature infants
      • Schmidt Sting Pain Index[SUP][/SUP] and Starr sting pain scale both for insect stings
      • Colorado Behavioral Numerical Pain Scale (for sedated patients)
      • AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.
      • WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.
      • Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain


Now, then ... let's make a decision on the very first part of determining pain levels ... which test to administer ...
 

That hasn't always worked out so well in the past 238 years ...

In a lot of major instances, yes.. people that are benefitting from the civil rights movement, gay lesbian legislation, and your beloved marijuana laws in certain states to name a few would agree. Laws regarding these civil issues were overturned and new ones adopted. These are all laws that pertain to individual's rights. Laws are constantly being assessed and reassessed to reflect the opinions, morals and attitudes of the times.

But you'll never get laws passed on individual desires - there are always going to be those that don't agree with any law passed. The whole idea of a Democracy (even though we're not one but claim to be) is that everyone is voicing their opinions, and part of having an opinion is deciding what is good for the majority.


Wrong...individual desires are the fuel that fans the flame for legislation. A great example of that is the Washington's Death with Dignity Law, passed after Oregon's law. A woman spearheaded the movement for the legislation did so because her husband asked her to promise on his death bed as he lay dying a very painful prolonged death from cancer, that she would do every thing in her power to help pass a Death with Dignity law in Washington. She had never had any experience lobbying for a law, no public speaking experience and had no idea where to start. But start she did, and persevered until she was successful in getting the law passed. I'd say that was an individual desire.

Apparently, more people of Washington agreed with her, than those who didn't.

Of course, every law has it's opponents and proponents, and you're right that's what a democracy is all about (if we really had one, which we don't).

But if that were indeed the case here then we wouldn't need any law on the matter at all. We already have the right to pursue happiness, which could be interpreted as being the right to choose our death.

I have tried to make logic of this, but it must be too deep for me. All I can add is that we do have the right to choose our death (who can stop you if you're bent on it) to the point we are physically able to swallow pills or poison, put a gun to our head, jump off a cliff or throw ourselves under a train. Hell, I guess even demanding plugs be pulled after the agony is too much to bear is another good way to go in your interpretation of having the right to choose death.

However if we wish to have end of life comfort care, be aided and in the company of loved ones at the end, someone is going to jail, unless you live in a state that embraces that..

Speaking for myself only, I know which I would choose.
 
SifuPhil's Euthanasia Worksheet (SPEW)

Category 1
Pain Testing



  • Sub-Section A: Pain Assessment
    • Paragraph 1: Pain Assessment Scales
      • Visual Analog Scale (VAS)
      • Verbal Numerical Rating Scale (VNRS)
      • Verbal Descriptor Scale (VDS)
      • Brief Pain Inventory
      • Alder Hey Triage Pain Score
      • Behavioral Pain Scale (BPS)
      • Brief Pain Inventory (BPI)
      • Checklist of Nonverbal Pain Indicators (CNPI)
      • Critical-Care Pain Observation Tool (CPOT)
      • COMFORT scale
      • Dallas Pain Questionnaire
      • Descriptor differential scale (DDS)
      • Dolorimeter Pain Index (DPI)
      • Edmonton Symptom Assessment System
      • Faces Pain Scale - Revised (FPS-R)
      • Face Legs Activity Cry Consolability scale
      • Lequesne Algofunctional Index
        • Original index (1987)
        • 1991 revision
        • 1997 revision
      • McGill Pain Questionnaire (MPQ)
      • Neck Pain and Disability Scale –NPAD
      • Numerical 11 point box (BS-11)
      • Numeric Rating Scale (NRS-11)
      • OSWESTRY Index
      • Palliative Care Outcome Scale (PCOS)
      • Roland-Morris Back Pain Questionnaire
      • Support Team Assessment Schedule (STAS)
      • Wong-Baker FACES Pain Rating Scale
      • Visual analog scale (VAS)
    • Specialized Tests
      • Disease-Specific Pain Scale: DSPI = (ΣX · Y) · 100 where X is the highest pain level on a 0–10 scale and Y is the percentage of this pain level in the group. The DSPI is different from the simple numeric 0–10 scale in that it is measured for a group of patients with a specific diagnosis whereas the numeric 0–10 pain scale is administered individually.
      • Pediatric Pain Questionnaire (PPQ) for measuring pain in children
      • Premature Infant Pain Profile (PIPP) for measuring pain in premature infants
      • Schmidt Sting Pain Index and Starr sting pain scale both for insect stings
      • Colorado Behavioral Numerical Pain Scale (for sedated patients)
      • AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.
      • WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.
      • Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain


Now, then ... let's make a decision on the very first part of determining pain levels ... which test to administer ...

Phil, are you using this apparent textbook content just for the sake of an argument, that no one unless they were a qualified medical doctor or studying to be one could possibly understand, or is this what is really and actually involved in moving forward with a decision to have assisted death in a right to state?

I don't hear you saying why you are so adamantly against an individual being able to have this as an option, other than possible mental issues and exploitation.
 
Phil, appreciate the work but.... Why exactly is all that necessary? Isn't it all just fancy legalities promulgated by people who make a living out of their complexities?

Why is that one decision in life so much more complex and focused upon than other equally life ending decisions we make? Like driving into walls and base jumping?
Why is that responsibility for action taken away from suffering individuals only, by people it doesn't affect in any way whatever?
When did a person have to prove they are sane to anybody to jump off a bridge?
The bus driver who dropped them off at the nearest stop isn't charged with assisting their suicide.
The bridge builder isn't either.
The jump was that individual's decision and it isn't even illegal.
... and it doesn't matter what was going on in their head because it was obviously bad enough to make them jump.
Their decision.
We can try and talk 'em down if it makes us feel better about ourselves, but unless we can (not 'might' can) fix what ails them I don't see that we have the right to stop them by force.

Does it come down to "oh, too weak to climb the bridge rail eh? Tough, you'll just have to lie there and suffer in agony then won't you?"

"We really sorry, we can't do a thing about the suffering, but we're quite content to sit here and pretend sympathy while we watch and discuss the finer ethical details among ourselves, because we have a really severe self preservation fear of getting into trouble with gods and lawyers over the technicality of giving you a hand to climb over the rail."


When can we ever let go of trying to control everyone and everything and let people bear their own responsibilities for their decisions?
Why do we get so bloody precious about this and ignore other potentially harmful 'rights' that are killing people too?

What are we thinking? Really. Do we care about their suffering, or just about our own smug clear consciences and winning points over trivial legal intricacies? Who's benefit is all the argument really for? Them? I don't think so.

It's about what 'might' happen to someone who 'might' exist in a possible scenario in the future that 'might' be illegal or at least, gasp, unethical, and which we 'might' feel responsible, or distantly guilty for.

Like that never happens already! No one ever smothered Grandma for the inheritance? Never? Would that only happen if Voluntary Euthanasia was legalized.?
We'd better not legalize bank robbing then because that won't happen without a law enacted okaying it either.
Apparently, according to the obsessively ethical, everyone is a latent bank robber, or murderer, just waiting for the nod to do it.

People won't become homicidal maniacs busily culling their relatives because a law legalizing the voluntary form of euthanasia is passed. People remain who they are and the overwhelming majority are good people trying to do the best they can for those they care for.

I've heard it argued that legalizing Weed is okay because people who don't want to smoke it won't take it up just because it's legal. And that most wont become addicted to it because it's not in their nature. Probably true.

Why doesn't that same theory of human nature apply to Euthansasia laws? What insidious danger lies there that doesn't lie in many laws and rights? Bad people do bad things right? Isn't that how it goes? Why are good people denied their rights because of that?


I thought I was pretty cynical, but not as much as those who suspect that anguished relatives are' likely to suddenly take the notion to snuff their loved ones for their own financial or emotional gain as soon as there's a loophole that 'might let them get away with it. Wow, now that is really being cynical.

The only difference between us is that you apparently believe you have some kind of tenuous control over people's behavior
with ethical laws, when I accepted long ago that we will always live with a fair ratio of arseholes among us no matter what the law is.
Get over it.
 
Phil, are you using this apparent textbook content just for the sake of an argument, that no one unless they were a qualified medical doctor or studying to be one could possibly understand, or is this what is really and actually involved in moving forward with a decision to have assisted death in a right to state?

Legal decisions such as this one don't come about by having tea and crumpets one sunny afternoon, then unanimously agreeing to a new law. The crafting of such an emotionally-laden piece of legislature is, I am pretty sure, a very complex affair, and I see this list as being just a part of the decision-making process that would be carried out by a conscientious law-maker.

I don't hear you saying why you are so adamantly against an individual being able to have this as an option, other than possible mental issues and exploitation.

I am NOT against it. I am against the government setting out laws and rules that govern my say over my own life. My body and soul are mine - no one else has a right to tell me what to do with them.

Phil, appreciate the work but.... Why exactly is all that necessary? Isn't it all just fancy legalities promulgated by people who make a living out of their complexities?

Yes, it is, exactly, and that's the law-making process.

Why is that one decision in life so much more complex and focused upon than other equally life ending decisions we make? Like driving into walls and base jumping?

I once ran into a wall that left a big bump on my forehead that is still there to this day. I assure you there was precious little decision-making involved in the process.

I've also base-jumped (on a very small scale, in my youth) and while the pros and cons WERE weighed a bit more carefully, it was still not on the same scale as inducing my own death.

Why is that responsibility for action taken away from suffering individuals only, by people it doesn't affect in any way whatever?

Because of the need of others to exert their control.

When did a person have to prove they are sane to anybody to jump off a bridge?

They don't - unless they are unsuccessful, in which case society deems them as dangerous and "not quite right" and locks them up "for their own good".

The bus driver who dropped them off at the nearest stop isn't charged with assisting their suicide.

Technically, if he KNEW they were going to jump he could be legally involved.

The bridge builder isn't either.

It's called "professional malfeasance" - if they did not include sufficient safeguards in the design and construction then they too could be held liable.

The jump was that individual's decision and it isn't even illegal.
... and it doesn't matter what was going on in their head because it was obviously bad enough to make them jump.

First, they were probably trespassing.

Second, in this country it IS illegal to attempt suicide (with the exceptions of course of the areas being discussed here).

Third, it DOES matter what was going on in their heads, and that's why it would be important to ascertain their psychological state - because it DOES matter whether they were jumping because they had terminal cancer, or because their pet turtle just died from an overdose of those nifty little turtle-food flakes.

In the first case, most people could empathize. In the second, they might have been making an emotional, irrational decision, one from which there is usually no return and which in the eyes of most others would be a waste of the most precious gift we have.


Their decision.
We can try and talk 'em down if it makes us feel better about ourselves, but unless we can (not 'might' can) fix what ails them I don't see that we have the right to stop them by force.

And we DO have the ability to "fix" them, whether it's just a good friend talking them back down to sensibility or a course of professional therapy. Of course, this applies to the turtle-episode survivor, not the terminal cancer patient. So once again we have the need to categorize the causes of the suicide attempt, in order that we know whether or not intervention is truly warranted.

Does it come down to "oh, too weak to climb the bridge rail eh? Tough, you'll just have to lie there and suffer in agony then won't you?"

"We really sorry, we can't do a thing about the suffering, but we're quite content to sit here and pretend sympathy while we watch and discuss the finer ethical details among ourselves, because we have a really severe self preservation fear of getting into trouble with gods and lawyers over the technicality of giving you a hand to climb over the rail."

Again you're focusing on the Alpha cases, which are in reality only a minority of suicide attempts. Much more often you're going to encounter the turtle-people. Theirs is the real gray-area, not something as cut-and-dried as terminal disease cases.

When can we ever let go of trying to control everyone and everything and let people bear their own responsibilities for their decisions?
Why do we get so bloody precious about this and ignore other potentially harmful 'rights' that are killing people too?

As I mentioned previously, I believe it the desire to exert one's will over others. That's a disease that is epidemic among politicians and do-gooders.

What are we thinking? Really. Do we care about their suffering, or just about our own smug clear consciences and winning points over trivial legal intricacies? Who's benefit is all the argument really for? Them? I don't think so.

It's about what 'might' happen to someone who 'might' exist in a possible scenario in the future that 'might' be illegal or at least, gasp, unethical, and which we 'might' feel responsible, or distantly guilty for.

Like that never happens already! No one ever smothered Grandma for the inheritance? Never? Would that only happen if Voluntary Euthanasia was legalized.?

I totally agree.

We'd better not legalize bank robbing then because that won't happen without a law enacted okaying it either.
Apparently, according to the obsessively ethical, everyone is a latent bank robber, or murderer, just waiting for the nod to do it.

I've often said that the line that separates the model citizen from the true psycho is tissue-thin, and requires only the smallest of catalysts.

People won't become homicidal maniacs busily culling their relatives because a law legalizing the voluntary form of euthanasia is passed. People remain who they are and the overwhelming majority are good people trying to do the best they can for those they care for.

We don't know that for sure - we will only know it after the law is passed, by which time it will be too late and the entire law-making process will have to gear up again, wasting yet more years.

I've heard it argued that legalizing Weed is okay because people who don't want to smoke it won't take it up just because it's legal. And that most wont become addicted to it because it's not in their nature. Probably true.

The first part is true, as has been seen with alcohol and cigarettes.

The second part is false, mainly because marijuana is not an addictive substance.

Why doesn't that same theory of human nature apply to Euthansasia laws? What insidious danger lies there that doesn't lie in many laws and rights? Bad people do bad things right? Isn't that how it goes? Why are good people denied their rights because of that?

Perhaps it's because it's such an emotionally-charged issue. Birth and death are certainly the two biggest events in a person's life, so I think it only proper that due consideration and deliberation be taken before enacting laws concerning them.


I thought I was pretty cynical, but not as much as those who suspect that anguished relatives are' likely to suddenly take the notion to snuff their loved ones for their own financial or emotional gain as soon as there's a loophole that 'might let them get away with it. Wow, now that is really being cynical.

That isn't being cynical - that's being a student of human nature. Relatives have snuffed relatives for a few bucks - hell, one guy killed his own son over a turkey leg at Thanksgiving! - so I don't think it outside the realm of possibility that someone is going to bend this law to their own purposes.

The only difference between us is that you apparently believe you have some kind of tenuous control over people's behavior
with ethical laws, when I accepted long ago that we will always live with a fair ratio of arseholes among us no matter what the law is.
Get over it.

You are SO, so wrong on that ... look up "Anarchist" in the dictionary - you'll see my picture.
 


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