Bioethics Discussion Blog: A Call for Help

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Thursday, September 25, 2008

A Call for Help

I wonder if the visitors here have any idea what it is like to run a bioethics blog such as mine. I would like to give you an example of the experiences I receive as moderator. I have had many other similar experiences where a visitor has written me about their burdens and want my help to resolve some issue. Do I know if these writers are expressing a true issue in their lives or just "pulling my leg" so to speak? I don't but then should I just ignore their requests? I received the following e-mail from a female visitor today.

Doktor Mo

I realize this is probably your screen name, perhaps not, but I am searching for a way to end life peacefully.

It is my choice. Can you direct me to the right places to go for assistance.

Thank you


I wrote back the following:

You are asking a question that is impossible to answer with the absence of any information about the reasons for your "choice". What I also don't know is what you mean by "peacefully" as compared with other ways that life ends. Does "peacefully" mean without pain? without emotional suffering? quickly? In many terminal diseases such as end stage liver or kidney disease one might look at that kind of dying as peaceful since there is a gradual but persistent loss of awareness until death occurs. My understanding about what you mean by "peacefully" might help me understand why you have made a choice to presumably end your life. ..Maurice.


As a member of the human community how would you respond to this person's request, if you would respond? Do yout think my response was what you might have written? If not, would you have written more, written less? Or not even respond? Any suggestions? ..Maurice.

7 Comments:

At Friday, September 26, 2008 9:01:00 AM, Anonymous TT said...

Dr. Bernstein,

While blogs are a great venue for the free discussion of ideas and opinions, I think there is a very real danger in crossing the line of giving specific advice.

As you correctly pointed out, you simply have no idea who is at the other end of the cybermessage, the reality of their supposed situation or their possible motives.


I'm not a medical professional, but in response to your question, I'd probably tell them something along the lines of I can't provide individual advice as doing so would be unethical, unprofessional, etc., and would recommend that you talk with someone you know and trust - physician, clergy, close friend - about your specific situation and feelings and ask them for their assistance and guidance.

 
At Friday, September 26, 2008 9:41:00 AM, Blogger Maurice Bernstein, M.D. said...

TT,yes, I understand your point of view and of course with the very limited information provided by the visitor and not knowing immediately whether the request was real and sincere should I nevertheless spew out in an uncaring, impartial and rather generic response "I can't provide individual advice as doing so would be unethical, unprofessional, etc., and would recommend that you talk with someone you know and trust - physician, clergy, close friend - about your specific situation and feelings and ask them for their assistance and guidance."? Shouldn't I write back something to encourage the writer to tell me something more regarding what is her burden and why she has come to her decision? Shouldn't the moderator of a medical blog (as well as the blog itself) avoid being seen and acting as cold and impersonal but being humanistic and having concern for others? Shouldn't we all when we are challenged with a "call for help"? ..Maurice.

 
At Friday, September 26, 2008 10:40:00 AM, Blogger Alex Tang said...

Hi Maurice,

I believe you have written a positive and emphathic response to the question.

It is a difficult situation and the blog may not be the right place to answer such questions. I will personally try to contact such people through the email.

 
At Friday, September 26, 2008 12:47:00 PM, Anonymous TT said...

Dr. B,

I wasn't suggesting being uncaring, or cold and impersonal, and I have no issue with being compassionate and humanistic. My suggestion was not intended as something that would be used verbatim, but a structure or guideline. I just think that there is a line you need to be careful not to cross, and there are a number of ways to word a response that is compassionate and caring without doing so. Your response, for example, I think was just fine considering the little you had to work with.

As I've posted before, I'm an engineer, not a medical professional, and we have a little different thought process from most people. My initial thought when I read the text of the message you were sent was "insufficient information".

I see nothing wrong with opening a dialog, but you still need to be careful. The underlying reality is that you really don't know who is at the other end of that cyber connection and what their motive is - could be an older person with chronic health issues, a middle aged person suffering from severe depression, a 13 year old with suicidal thoughts, a licensing board investigator seeing if they can entice you into violating some regulation or some joker just trying to pull your chain.

If it truly is a "call for help", and you realistically have little option but to assume that it is, trying to expand the dialog is a good next step if it is used to help them connect with the resources that can help them. Crossing the line into being that resource via the internet is a whole different issue & therein is where I think the danger lies.

 
At Friday, September 26, 2008 1:21:00 PM, Blogger dethmama said...

Dear Dr. B.,

I am a hospice RN that frequents forums on death, dying and bereavement. Quite often, someone will appear on the forum requesting the same information as your reader did.

The forum members (overwhelmingly non-clinicians) almost always respond appropriately... They ask for more information on the person's situation, extend sympathy about the person's situation and then suggest resources that may be of help to the writer. By resources, I mean ones that will NOT facilitate suicide. After that, for most forum members, it's "back to business".

Yes, it is possible to address this reader's plight with compassion and then (and this is important) "redirect" her.

 
At Friday, September 26, 2008 4:25:00 PM, Blogger Maurice Bernstein, M.D. said...

Alex, I should clarify what occurred. This visitor sent me her "call for help" by e-mail and I have been responding to her by e-mail. I felt that the issue of what a medical blog moderator should do when receiving such an e-mail was a very important issue to discuss here since there are many medical bloggers and I am sure they get personal requests also. Of course, I presented the text of her e-mail here in a fully anonymous fashion without naming names or e-mail addresses.

Medical bloggers, perhaps unknown to their visitors, do not have all the answers, particularly when they don't know all the facts. I wanted to use this visitor's "call" as an example of a situation we medical bloggers have to face. ..Maurice.

 
At Saturday, October 04, 2008 1:00:00 PM, Blogger Chrysalis Angel said...

I think you handled the situation perfectly. You let them know you didn't have enough information, and perhaps in doing so, they then could feel safe enough to open up to you where you could direct them to speak to someone in their vicinity. Sometimes people are so afraid to reach out to one another, it could have been the readers way of trying to seek help, but testing the waters. If you responded with caring and compassion, they then may seek out someone with whom they could meet with face to face with whatever issues they were facing.

On another note. I want you to know the situation Moof and I discussed with you some time ago is thankfully being worked on.

 

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