- Are there any circumstances under which assisted dying should be allowed?
- If so, what are those circumstances?
- If so, how do we regulate it?
- Should people have a choice?
Normally I do not express personal opinions pro or con any choice since this blog is only intended to stimulate discussion by asking challenging questions, however, in this case, I do have a personal bias.
Over the last two decades, I have witnessed the death of both my parents and both my wife's parents. Three of the deaths involved very serious strokes with a medical prognosis of an extremely low quality of life possibly requiring full life support. The fourth involved terminal cancer. Ages ranged from 75 to 94 years. Two involved a Living Will or Medical Directive specifying palliative care only if the medical prognosis was a very low quality of life (with the living will giving specific examples of what would be considered a very low quality of life).
In all four cases, after extensive consultation with family and medical staff, the patients were provided palliative care only. Death occurred within a few days to a few weeks. Assisted dying was not an option.
While death was apparently pain-free, there was evidence of some distress with all the patients. It is my belief that if euthanasia was an option, all four parents would have chosen it for a variety of reasons.
- Assisted dying would reduce the pain of the family having to watch a slow death
- Assisted dying would have freed resources which may have helped to save a life of someone who did have a prospect of a longer and higher quality of life.
- Assisted dying may have created the possibility of viable organ donations to help improve or save another life (all had given permission for organ transplants).
The money spent on prolonging low-quality life in the developed world could improve and save countless lives in poor countries around the world. Is it our choice to let those people die so that we can prolong a low quality of life for a few (often against their own wishes)? "Is that the will of God?"
Our choices in life are often not easy but it can help one's perspective to project well into the future - 100 years or more. The current rate of growth in health care costs is not sustainable over the long term. We will have to make some tough choices in the future. Assisted dying is one of those choices.
The Living Wills and how the medical community handled them did provide a sense that there is a well thought out process with appropriate checks and balances - a process which could also work for assisted dying.
A website which tries to provide a non-biased discussion is http://euthanasia.procon.org/
3 comments:
Good introduction to a dicey topic. Thanks.
I don't run into very many people in my circles of family, friends and associates who would argue in favour of using "extraordinary measures" to sustain a life in situations in which the body is shutting down and death is imminent anyway. Assuming such measures have already been initiated, it is still a position that poses its own challenges, including: who exactly gets to decide when the quality of life has reached a sufficiently low ebb to justify "pulling the plug" and under what conditions, with or without a health directive AND are any active measures justified beyond just removing life supports? My own answer to those particular questions would be: medical professionals and key "family" members (using an appropriately inclusive definition of the term "family") would make such decisions together AND yes, things like cranking up the morphine or whatever can have its place.
However, the euthanasia option can be interpretted much more broadly than such relatively clear-cut decisions, as you will know. I am intrigued by the challenges presented by even trying to measure things like "consciousness" or "functionality". As someone now close to a special needs child, I have a different perspective on functional ability than I used to. Does loss of mobility or sight or hearing or ability to speak constitute sufficient reason to remove supports? To what degree is age a factor? Can we equate the presence of a coma with lack of consciousness? What about the coma patients who come back and report that they could hear throughout--they were in a coma and maintained consciousness at the same time, it would appear.
So, yes there are lots of questions and this is an important topic but I'd like to pick up on the reference to "God's will". First, I think we must accept that we now know too much to avoid "playing God" with other peoples' lives: if we elect to supply life supports we are playing God and if we elect to remove or withhold them we are playing God. Second, I would prefer to see actions like "pulling the plug" or boosting the morphine levels undertaken after calm and and even prayerful reflection, but I'm not sure we could say in any absolute way that what happens, one way or the other, is "God's will"--unless we mean to say that any thoughtful, respectful decision EQUALS God's will. Third, if we believe that God's will has been and is expressed in the created order, then death is surely encompassed in God's will . . . along with sickness, pain, degeneration, suffering and other factors in life cycles. To say otherwise is to enter into the dangerous and destructive realm of dualism, I fear.
I sometimes wonder if people pull out the "God's will" card to justify the conclusions they've come to with some care and thought, and maybe that's not such a bad idea. It doesn't mean God's will equals my will, exactly, but it may help put second guessing and personal recriminations to rest, at least.
Thanks for your thoughtful comments.
In my experience, I am in fact still surprised how often one does hear about the use of "extraordinary measures" in such circumstances, especially in the USA and some European countries. Perhaps it is a legal thing. I do not have good knowledge about other countries but I suspect the use of "extraordinary measures" is highest in the wealthier countries.
I agree with your own answer that medical professionals and key family members should decide together, although, without a written medical directive, options can be seriously limited in some parts of the world. Again is seems to be a legal thing. For some people "cranking up the morphine" is euthanasia even after thoughtful and even prayerful discussion between medical professionals and key family members.
No matter how carefully crafted, a medical directive will always leave some room for interpretation. However, with a medical directive and several in depth talks about death and dying with family and friends, I personally feel that there is little likelihood that an inappropriate decision will be made in the event my family were faced with such a circumstance. I understand that in some unique circumstances it is possible that I could be in a comma and still be conscious but that probability is extremely small and thus would not change my position as stated in my medical directive.
I agree that bringing religion into the discussion immediately tends to polarize it. And yet religion is hugely important factor for many so cannot be swept aside. My objection rises when some apply "blind faith" to effectively shut down any reasonable discussion of dying and death. If, as a society, we hope to do a better job of dealing with death, then religion has a large role to play in facilitating reasonable discussion. There are still many conflicting messages within religion about dying. In my experience, non-religious people are much less conflicted about death. A bit counter-intuitive eh?
Of course mortal life and death are a package deal. We cannot have one without the other. And yet we still have such difficulty in "Facing Death". Why is that?
I did acknowledge a bias at the beginning of this particular blog, but that aside, I still have the belief that the more people have discussions about issues such as euthanasia, the better the world will be in the long run.
Thanks Linda for your excellent contribution to that discussion.
You said: "Of course mortal life and death are a package deal. We cannot have one without the other. And yet we still have such difficulty in "Facing Death". Why is that?"
Good question. Why is that? Is it because we have bought into a worldview that separates us from the rest of "nature"--not just "the paragon of animals" but something above, apart, superior? Is it something with a somewhat different "flavour" among urbanized peoples in the privileged North? Is it spill-over from ancient Greek thought that separated body and spirit and death has to do with these shabby bodies instead of our glittering souls?
Interestingly, I believe that most religions are rooted in an effort to make sense of death, to tame or explain or dismiss it in some fashion. I would say that in my own life, "Facing Death"--the deaths of people I loved, of tiny children and the possibility of my own because of a life-threatening illness--caused me to look at life differently, to examine my priorities, to consider how I would want to be remembered some day. Because I happen to be a Christian, I have some Christian content I weave into those issues but I assume the best wisdoms have all come from those who have passed through crises, trials, confrontations with death and come out changed.
That ought to make us pursue the opportunities death offers us, but of course many don't. What are your own hunches about this avoidance.
And by the way, allow me the opportunity to recommend that you and your readers come visit my blog on death and dying at http://talkaboutdeath.blogspot.com
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