How you die is as important as how you live

Thursday, January 17, 2013

Doctor-assisted suicide should be a medical option for anyone over 18 and in their right mind. If you read the headlines, you will have seen the story earlier in the week regarding deaf twins in Belgium who chose to be euthanized after they were told they are going blind and would not be able to see each other again.

To the American ear, this will sound like some horror story. Callous, at the very least. But why?

The answer is we are taught it is better to extend the process of life for as long as possible, beyond what could be achieved without modern technology, even if in so doing we destroy other lives involved in the situation through financial deprivation or cause long-suffering to the one dying.

Assisted suicide is legal in several jurisdictions, including Belgium, Luxembourg, the Netherlands, Switzerland and three American states -- Oregon, Washington and Montana.

What is wrong with this? Ask yourself: You are dying. You know it, everybody knows it. It is terrible, but honestly, that's the situation. So why destroy the financial lives of everyone you love due to the cost of keeping you alive beyond heroic effort? And why suffer brutally when it is unnecessary?

"They were very happy. It was a relief to see the end of their suffering," said the doctor in the Belgian case. "They had a cup of coffee in the hall. It went well and a rich conversation. Then the separation from their parents and brother was very serene and beautiful," he said. "At the last there was a little wave of their hands and then they were gone."

Arguments in favor of assisted suicide include that people have a right to self-determination and should be allowed to choose their own fate; also, that assisting a subject to die might be a better choice than requiring that they continue to suffer. Pro-euthanasia activists often point to countries and states where it has been made legal to argue that it is mostly unproblematic.

This study also stated that approximately 46 percent of physicians agree that physician-assisted suicide should be allowed in some cases; 41 percent do not, and the remaining 14 percent think it depends. So, depending on the case -- and all cases are a little different -- 60 percent of physicians are in favor of it at least part of the time.

There are, of course, arguments against this. Some feel that allowing PAS would create a slippery slope -- in other words, once PAS is initiated for the terminally ill, it will progress to other vulnerable communities and may begin to be used by those who they feel less worthy based on their demographic or socioeconomic status. However, recent studies claim that the available evidence suggests that the legalization of PAS might actually decrease the prevalence of involuntary euthanasia.

Another argument: physicians and healthcare practitioners feel there may be a conflict of interest when it comes to abiding with legislation and patient requests for assisted suicide. This is because most physicians, especially in the United States, must swear under the Hippocratic oath. Physicians agree to do whatever is in the benefit of the patient. More specifically, to give no deadly medicine when asked, nor suggest such counsel or treatment. Many physicians feel that they must stand by this oath as a professional health-care provider.

Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal. The use of pain medication in order to relieve suffering, even if it hastens death, has been held as legal in several court decisions.

At its heart, the argument against doctor-assisted suicide is an emotional one. Nobody wants to die, and in our culture we are taught to avoid dealing with death until it is shoved into our faces. Not all cultures are like this. Some accept death as part of the package. And that being the case, why turn it into a long painful brutal undignified process that causes suffering for everyone on every level, with the same result?

As the late assisted-suicide advocate Dr. Jack Kevorkian put it, dying is not a crime.