It's Time for Voluntary Euthanasia and Assisted Suicide


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America Needs Voluntary Euthanasia

 

        There are at least two forms of suicide. One is 'emotional suicide',

or irrational self-murder in all of it complexities and sadness. Let me

emphasis at once that my view of this tragic form of self-destruction is

the same as that of the suicide intervention movement and the rest of

society, which is to prevent it wherever possible. I do not support any

form of suicide for mental health or emotional reasons.

 

     But I do say that there is a second form of suicide -- justifiable

suicide, that is, rational and planned self-deliverance from a painful and

hopeless disease which will shortly end in death. I don't think the word

'suicide' sits well in this context but we are stuck with it. Many have

tried to popularize the term 'self-deliverance' but it is an uphill battle

because the news media is in love with the words 'assisted suicide'. Also,

we have to face the fact that the law calls all forms of self-destruction

'suicide.'

 

     Let me point out here for those who might not know it that suicide is

no longer a crime anywhere in the English-speaking world. (It used to be,

and was punishable by giving all the dead person's money and goods to the

government.) Attempted suicide is no longer a crime, although under health

laws a person can in most states be forcibly placed in a psychiatric

hospital for three days for evaluation.

 

     But giving assistance in suicide remains a crime, except in the

Netherlands in recent times under certain conditions, and it has never been

a crime in Switzerland, Germany, Norway and Uruguay. The rest of the world

punishes assistance in suicide for both the mentally ill and the terminally

ill, although the state of Oregon recently (Nov. l994) passed by ballot

Measure 16 a limited physician-assisted suicide law. At present (Feb. l995)

this is held up in the law courts.

 

     Even if a hopelessly ill person is requesting assistance in dying for

the most compassionate reasons, and the helper is acting from the most

noble of motives, it remains a crime in the Anglo-American world.

Punishments range from fines to fourteen years in prison. It is this catch-

all prohibition which I and others wish to change.

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In a caring society,

under the rule of law, we claim that there must be exceptions.

 

ORIGIN OF THE WORD

 

     The word 'euthanasia' comes from the Greek -- eu, "good", and thanatos,

"death". Literally, "good death". But the word 'euthanasia' has acquired a

more complex meaning in modern times. It is generally taken nowadays to

mean doing something about achieving a good death.

 

     Suicide, self-deliverance, auto-euthanasia, aid-in-dying, assisted

suicide -- call it what you like -- can be justified by the average

supporter of the so-called 'right to die' movement for the following

reasons:

 

     Advanced terminal illness that is causing unbearable suffering to the

individual. This is the most common reason to seek an early end.

 

     Grave physical handicap which is so restricting that the individual

cannot, even after due consideration, counseling and re-training, tolerate

such a limited existence. This is a fairly rare reason for suicide -- most

impaired people cope remarkably well with their affliction -- but there are

some who would, at a certain point, rather die.

 

What are the ethical parameters for euthanasia?

 

     The person is a mature adult. This is essential. The exact age will

depend on the individual but the person should not be a minor who come

under quite different laws.

 

     The person has clearly made a considered decision. An individual has

the ability nowadays to indicate this with a "Living Will" (which applies

only to disconnection of life supports) and can also, in today's more open

and tolerant climate about such actions, freely discuss the option of

euthanasia with health professionals, family, lawyers, etc.

 

     The euthanasia has not been carried out at the first knowledge of a

life-threatening illness, and reasonable medical help has been sought to

cure or at least slow down the terminal disease. I do not believe in giving

up life the minute a person is informed that he or she has a terminal

illness. (This is a common misconception spread by our critics.) Life is

precious, you only pass this way once, and is worth a fight. It is when the

fight is clearly hopeless and the agony, physical and mental, is unbearable

that a final exit is an option.

 

DOCTOR AS FRIEND

 

     The treating physician has been informed, asked to be involved, and

his or her response been taken into account. What the physician's response

will be depends on the circumstances, of course, but we advise people that

as rational suicide is not a crime, there is nothing a doctor can do about

it. But it is best to inform the doctor and hear his or her response. For

example, the patient might be mistaken -- perhaps the diagnosis has been

misheard or misunderstood. It used to be that patients raising this subject

were met with a discreet silence, or meaningless remarks, but in today's

more accepting climate most physicians will discuss potential end of life

actions.

 

     The person has made a Will disposing of his or her worldly effects and

money. This shows evidence of a tidy mind, an orderly life, and forethought

-- all something which is paramount to an acceptance of rational suicide.

 

     The person has made plans to exit that do not involve others in

criminal liability or leave them with guilt feelings. As I have mentioned

earlier, assistance in suicide is a crime in most places, although the laws

are gradually changing, and very few cases ever came before the courts. But

care must still be taken and discretion is the watchword.

 

     The person leaves a note saying exactly why he or she is taking their

life. This statement in writing obviates the chance of subsequent

misunderstandings or blame. It also demonstrates that the departing person

is taking full responsibility for the action.

 

NOT ALWAYS NOTICED

 

     A great many cases of self-deliverance or assisted suicide, using

drugs and/or a plastic bag, go undetected by doctors, especially now that

autopsies are the exception rather than the rule (only 10 percent, and only

when there is a mystery about the cause of death). Also, if a doctor asked

for a death certificate knows that the patient was in advanced terminal

illness then he is not going to be too concerned about the precise cause of

death. It hardly matters.

 

     I find that police, paramedics and coroners put a very low priority of

investigation of suicide when evidence comes before them that the person

was dying anyway, and there is a note from the deceased. Detectives and

coroners' officers will walk away from the scene once they are satisfied

that the person who committed suicide was terminally ill.

 

     But, having considered the logic in favor of auto-euthanasia, the

person should also contemplate the arguments against it.

 

     First, should the person go instead into a hospice program and receive

not only first-class pain management but comfort care and personal

attention? Put bluntly, hospices make the best of a bad job, and they do so

with great skill and love. The right-to-die movement supports their work.

But not everyone wants a lingering death, not everyone wants that form of

care. Today many terminally ill people take the marvellous benefits of home

hospice programs and still accelerate the end when suffering becomes too

much.

 

     A few hospice leaders claim that their care is so perfect that there

is absolutely no need for anyone to consider euthanasia. While I have no

wish to criticize them, they are wrong to claim perfection. Most, but not

all, terminal pain can today be controlled with the sophisticated use of

drugs, but the point these leaders miss is that personal quality of life is

vital to some people. If one's body has been so destroyed by disease that

it is not worth living, that is an intensely individual decision which

should not be thwarted. In some cases of the final days in hospice care,

when the pain is very serious, the patient is drugged into unconsciousness.

If that way is acceptable to the patient, fine. But some people do not wish

their final hours to be in that fashion.

 

     There should be no conflict between hospice and euthanasia - both are

valid options in a caring society. Both are appropriate to different people

with differing values.

 

RELIGION

 

     The other consideration is theological: does suffering ennoble? Is

suffering, and relating to Jesus Christ's suffering on the cross, a part of

preparation for meeting God? Are you merely a steward of your life, which

is a gift from God, which only He may take away. My response is this: if

your answers to these questions is yes, then you should not be involved in

any form of euthanasia.

 

     But remember that there are millions of atheists and agnostics, as

well as people of varieties of religions, degrees of spiritual beliefs, and

they all have rights, too. Many Christians who believe in euthanasia

justify it by reasoning that the God whom they worship is loving and

tolerant, and would not wish to see them in agony. They do not see their

God as being so vengeful as refusing them the Kingdom of Heaven if they

accelerated the end of their life to avoid prolonged, unbearable suffering.

 

     Another consideration must be that, by checking out before the Grim

Reaper calls, is one is depriving oneself of a valuable period of good

life? Is that last period of love and companionship with family and friends

worth hanging on for? The argument that this is so is heavily used by our

critics.

 

     But after my in depth research, and being aware of many hundreds of

self-deliverances, I can attest that even the most determined supporters of

euthanasia hang on until the last minute -- sometimes too long, and lose

control. They, too, gather with their families and friends to say goodbyes.

There are important reunions and often farewell parties.

 

     Euthanasia supporters enjoy life and love living, and their respect

for the sanctity of life is as strong as anybody's. Yet they are willing,

if their dying is distressing to them, to forego a few weeks or a few days

at the very end and leave under their own control.

 

KNOWLEDGE IS COMFORT

 

     What many people do not realize is that, for many people, just knowing

how to kill themselves is in itself of great comfort. It gives them the

assurance to fight harder and therefore often extends lives just a bit

longer. Many people belive  that the book, Final Exit, is "the best

insurance policy they've ever taken out." Once such people know how to make

a certain and dignified self-deliverance, they will often renegotiate the

timing of their death.

 

        Now that we have the knowledge and the drugs, with control and

choice in  grasp, we can negotiate new terms with life concerning our fate.

Surely, for those who want it this way, this is commendable and is in fact

an extension rather than a curtailment of life. What is needed now are

careful laws permitting  physician-assisted suicide -- voluntary on

everybody's part. The new Oregon Death With Dignity Act is a beginning.


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