Toxicology Rule

Uncle Roach@lemmy.world to 196@lemmy.blahaj.zone – 390 points –
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I had a friend watch this recently with a relative and they weren't allowed to say what was in the cocktail (so I wonder if this person could get in trouble for making this public lol). There was also an attending physician who made sure the patient finished the whole thing. The second he stopped, they said he has to keep going and finish it. And they were right next to him to the whole time, inches from his face.

Sounds like this was a failure by the attending paramedic, who was too far or had the slowest reflexes in the world lol.

The second he stopped, they said he ha as to keep going and finish it

That's kind of fucked up to me. Seems like it's putting the doc in a real bad position. What if the patient stops halfway through because they freaked out and want to change their mind? Is it a matter of a slow death vs a quick one or can they be saved? If they can't be saved is the doc empowered to force them to finish it so they don't suffer?

I never would have thought the suicide treatment would be a cup of liquid you have to drink let alone something that's more then one swallow. Seems like a button that just dumps it all into veins would be a much cleaner way to go.

I mean, what are they doing to do, put a gun to their head?

It sounds bad, but try to think of it in context - you give a child a drinkable antibiotic. They drink half, then make a face... So the doctor tells them they have to finish it in an authoritative voice

Would half a dose of antibiotics work? Maybe, but the full side is what has been tested to work as intended.

Would a half dose still be lethal? Would it be just enough to cause them terrible side effects when they wake up from a coma? Who knows.

They can't actually do anything other than tell them to drink though, otherwise it's not exactly assisted suicide

I'm sure there's an answer to "what if they back out after drinking it?" and "why make it drinkable instead of through IV?"... Those kinds of programs are designed and thought through with extreme care, because it's terrifying to the public

I am thinking about it in context that's why I said it's putting them in a really bad position. I'd really like to know the answers to those questions because the situation described in the post I responded to makes me real uncomfortable with the whole thing. There shouldn't be a scenario where a doctor has to say "you have to finish it" when they're assisting you with ending your life. The mental toll of that would be horrible.

Let's look at it another way - what does a doctor do when a dying patient begs them for help? All they can do is make it as painless as possible, which is what the cocktail is for

To put it another way, this isn't some ethical struggle, it's advising a patient to properly take their medicine. It's normal, they've probably done it thousands of times. People don't like drinking medicine, and people in a lot of pain often act like children. They'll resist taking it, lie, hide, or just whine, despite understanding it's necessary

It's basically reflexive healthcare providers to encourage patients to immediately power through - if you stop halfway and think about it, you can start gagging at the thought and make the whole experience worse

Plus, these people have already gone through a process and had people sign off, and you just asked them multiple times if they were sure. I don't think it's likely to change their mind after tasting it

But if they refuse to finish it, that's that. The doctor can't force them, giving medicine needs informed consent (outside of a few specific situations). If they revoke consent, all they can really do is try to talk you out of it

This situation doesn't bother me much, but I'm a bit curious as to a couple others...

Let's say they start drinking, but then immediately vomits. They've now taken an unknown dose, what then? Do you run to get a second batch? Is there one in the room?

If you want to read up on it, I'm guessing this is Canada. They'll have FAQs for the public somewhere

To be clear I'm not saying the doctor is in the wrong here. I'm just criticizing the method. Having the patient drink it is putting them in a difficult position that I would think could be easily avoided with a different method that wasn't dependent on the faculties of someone who is facing their imminent death.

I get you, it's certainly a heavy act. But ultimately, it's a mercy. Certain specializations of healthcare require a certain mindset, and this would be one of them, much more so than most

I'm totally convinced you're coming at this from a place of empathy for all involved, and I understand why you feel that way. I don't have a clean answer... I spent a lot of time in the hospital as a child (as a relative of staff), and I grew up eating dinner while seeing surgery pictures and hearing pretty disturbing events described with gallows humor.

I'll just share my thoughts on it - I'm not trying to convince you so much as give perspective about the attitudes held by the doctor/nurse handing over the drink. They don't see it the way you would - it's part training, part coping mechanisms, and part conviction that brought them there

A family member of mine used to work in the ICU and geriatrics... Not many roles where you're going to see more pain and death. People die a lot, and it might've been your job to save them.

How do you go home and live your life like that?

You accept you did the best you were able to at that moment. You lessened their pain, and helped them pass as peacefully as you could. You showed them care in their most vulnerable moment. You gave them dignity.

She literally cleaned shit off dying people on a daily basis. They would lash out at her and act like toddlers, because they're afraid and in pain. She'd make a connection with many of them, knowing they could pass while she's out on a date.

Sometimes, they would have no one. They might be confused and she'd be a soothing voice they can't understand, sometimes they'd give her their final words and regrets, and thank her for not letting them be alone.

She chose to specialize in this, specifically. When I asked her why, she told me all of that with a smile... She's the only one in my family (of many) who was drawn to this. Most of them decided to go for children, and when they were forced into situations like this (early on their careers, when they didn't have much choice), they'd mostly grimace remembering it and say they'd have quit medicine altogether.

It takes a very specific type to do this for long. Most are fueled by hope at a happy ending or just as a career... End of life care has no hope or happy ending, it's just to ease suffering.

I get your concerns, but helping them end their lives on their own terms is why they'd go into that specialty. Whatever their specific beliefs, they're in that position because they were drawn to it. It's controversial (meaning personally dangerous), emotionally challenging, and tedious process/bureaucracy.

It's also very specialized... Not any medical professional can just jump into the role. They had to have sought it out

As for why not injection... Partially, it's probably because what if it goes wrong? IVs can slip, blow out a vein, the mechanism could fail... And it's also much more direct than giving them a cup. They could've mixed up something. It probably would've been more painful, terrifying, and more likely to end with them surviving with a much lower quality of life.

There's also more dignity - they can be anywhere, without being covered in tubes and wires.

The ultimate question is: is this what's best for the patient? Because that's what they hang into - that's what lets them keep going, what lets them wake up and do it tomorrow

This was a pretty stream of consciousness reply, it's a vague concept to put into writing, and I mostly only know it second hand. Hopefully some of it got through

Huh... Ya, no idea lol. I wonder. They ask you multiple before times before you drink it and between steps, so hopefully that wouldn't happen but that's a good question.