Saturday, January 29, 2005

A matter of life & death


In recent times, a topic that has simmered under the surface of society, and a topic that sits only just out of reach of polite conversation is that of euthanasia. It is a topic that is of keen interest to most of us by virtue of possessing a quality that moves the subject uncomfortably close to our own mortality.

Rare is the man or woman that has the power to influence the meandering course of their life in such a way as to be sure of time and means of their own demise.

I’m not going to run off and dig through recent stories, naming names and circumstances. I find that kind of thing to be intrusive and undignified, given the nature of the most recent cases in particular.

So for those who might doubt me, maybe a visit to the BBC News website would help corroborate the following circumstances that happen to recollect.

A recent case was that of a woman in her forties who was struck down by an irreversible and progressively degenerative decease that had already taken away her ability to take care of herself.

She required constant care, and although her husband doted on her, her condition would only ever get worse until her body eventually gave up and she died.

The saddest thing is that her mental faculties were untouched. So she had to ignominious and unenvious fate of watching her own body descend into decrepitude.

So, she decided that she wanted to die.

However, the courts saw differently and she was refused the right to die a death of her own choosing and in a time of her own choosing. So instead, she was doomed to die a slow and undignified death.

Reasons for and against

I’m at a loss as to why the courts simply refuse to allow euthanasia when it is used so responsibly in other countries around the world. And given the shear weight of medical evidence showing that her condition would only worsen and that the quality of her life would grow inexorably worse.

There is the argument that euthanasia could be abused. For example: a family wishing to get rid of a wealthy family member so that they might inherit their fortune. With the help of a complicit doctor, between them, they could manufacture a way of dispatching said relative to a less than timely death.

I’m no news hound, but I’ve yet to hear of such an instance taking place. But that does not preclude the possibility of such a thing taking place. So I do not discount the possibility, but I would contest such an occurrence would be uncommon.

My reasoning is simple: in you imagine such people banding together, people so obviously prepared to end a life for simple material wealth, I feel sure their greed would ultimately betray them one way or another.

The other obstruction is one posed by those people that feel that euthanasia is just wrong. This mindset bares additional scrutiny in its own right, because it’s a point of view that owes more to an emotional response than an opinion couched in logic.

There is such an organization in Britain that is run by christians that opposes euthanasia vehemently and often instigates a media campaign as a means of attack against such people as those discussed above.

I’ll leave that aside for a second and move onto something else.

More recently, a couple went to court to fight for the right to travel abroad to a country that allows the controlled and managed practice of euthanasia so that they could find the dignity they were looking for. For a while, it appeared that the couple would be prevented from traveling abroad.

In the end, it was decided that the courts simply could not prevent them from doing so.

As expected, the aforementioned organization took exception to this finding and were suitably outraged and saddened by the decision.

I have to ask a very simple question: what would have been the alternative, given this could were so determined? Place them under house arrest? Place them into some mental care facility?

There is a wealth of ethical duscussions to be found on the BBC website -- and almost anywhere else you might choose to look. But I’m not particularly interested in that kind of thing.

Why? Well lets go back to the issue I left open earlier, the issue of the christian organization that so opposes euthanasia.

I’ve often found that those who stand highest on the moral high ground, those that see themselves as the pious curators of all things moral and ethical are usually those that have the most tenuous grasp of the depth of the problems they oppose. Or if the depth and scope of the issue is not being lost on them, they instead prize something else in higher regard.

When you press these people harder, forcing them to base their opinion more in logic, you will find them curiously reluctant to do so.

I found this deeply suspicious, and on occasion, I’ve managed to force them to verbally paint themselves into such a dilemma-ridden corner, that they have resorted to something akin to what you’d expect from a petulant child. They would promptly fold their arms and make some spurious rebuttal coloured in its entirety by their religious beliefs.

And therein lies the problem.

It seems that in their mind, belief and the rigor in which they choose to follow their belief should not be questioned. In fact, in their mind, their belief is exempt from the scrutiny of logic and is, as such, unimpeachable.

Suffice to say, this is a deeply flawed way of thinking.

To place religion before the well-being and the welfare of your fellow man is to divorce yourself from logic in its entirety and to abandon common sense all together.

Worse still -- given that both the courts and medical establishments of Britain are conducted under principles that are secular in nature -- having such people infiltrating these establishments only undermines the efforts of those having more objectivity in their decision-making processes.

This troubles me deeply, because we enter into a world where human suffering is tolerated because it is seen as less sinful to allow someone to die an often miserable and agonizing death than it is to oppose the will of one god or another.

To simplify the point, the avoidance of guilt is a more desirable course of action.

I do not filter my perceptions in such limited and coloured ways. Objectivity and an adherence to logic and the needs and wishes of the sufferer are paramount, not an option to be considered secondary to your beliefs.

However, I hasten to add, this is not representative of all of ethicists. That would be both incorrect and unfair. There are some truly great minds out there.

Regulation of the practice of euthanasia

There’s no doubt that in light of such a contentious issue, regulation would be difficult. However, I believe it to be an attainable goal.

To begin with, we must first make the simple -- and yes, blatantly obvious -- assumption that human life is precious.

If the death penalty was still active in Britain, it would be a decision often not arrived at lightly. The sentence of death would be arrived at after an extensive trial which involves evidence presented by both sides for and against.

In that same way, euthanasia deserves, nay commands a similar level of scrutiny and deliberation.

To that end, would it not make sense that there be an extension -- or at least a provision -- be made in law whereby a judicial hearing be formed to oversee the submission of by a sufferer for the right to end their life?

A panel of experts in law, medicine and ‘clean’ ethics who would be able to pool their expertise and preside over each case in a more timely and focused manner.

After all, if we deny someone the right to die, then who are we to consign them to a living death?

4 Comments:

Blogger Wayne Smallman said...

Abortion does wander into exactly the same territory, and as such, gets exactly the same fierce opposition by mainly religious groups who seem intent on foisting their entirely emotive reasons -- such that they are -- onto people who have either much more rational minds or are the ones jammed between the jaws of the dilemma gripping their lives.

Ethically, or 'clean' ethics is far more appreciative of the issues and will deal with them in a broader, holistic fashion.

Ethics driven by religion does not take such an approach. I've seen this for myself many, many times. These people are incapable because of the structure of their beliefs and depths of the dogma which straddles them like some Incubus or Succubus.

And these are the same people that oppose abortion. To them, there is no grey area of ambiguity, no region within which resides justification for abortion.

I thoroughly agree with you on the issue of fetal development. There is a point at which abortion becomes infanticide. I think we know now that this period is well defined, and unless the child is suffering from some terrible congenital mental or physical defect, birth should be allowed to run its course.

Anyway, that's another subject.

There is a deeper problem at hand, euthanasia comes into direct conflict with the hippocratic oath of all doctors. And a number of doctors in Britain have been quite vocal in their opposition to euthanasia.

But I have a question for them: when dealing with a victim of a car accident, or a fall, or some other injury or series of injuries that leave the victim mortally wounded, and they have fought long and hard to resuscitate the victim and failed, at what point do they decide that no more effort is required?

Surely they must persist no matter what? The extent of the injuries be damned!

To me, this predicament is no different to the one they might reject with regards to euthanasia.

Their best efforts to extend the lives of these people is ultimately futile, so when they see that all possible medical help has been provided and exhausted, they then elect to admit defeat.

But the victim will probably suffer more and more. That is not in their best interests.

Surely within the remit of their decision that no more can be done to help the sufferer lies the possibility of a provision for the use of euthanasia should the sufferer request such a thing?

I would certainly balk at the idea of the doctor suggesting euthanasia, clearly that would be wrong. But when all else has failed and all hope is lost, death is often seen as favourable when compared to living death...

5:15 pm  
Blogger Wayne Smallman said...

Hi Gindy! Sorry I didn't get back earlier.

"There is also the possibiity that states with socialized medicine will be more inclination to encourage it (maybe not openly)in order to save the state money. By the way, this is not a dig against socialized medicine, that is a debate for another time. It is just a possibility that is brought up."

That's a good point. It's something that I'd considered, but the article was getting too long to a comfortable read.

Yes, it's a possibility, and I think that by having a panel of professionals overseeing the decision, there's a greater chance -- not a guarantee -- that such incidents would be illuminated...

4:40 pm  
Blogger Wayne Smallman said...

"Indeed, few people would choose to die in agony, except possibly Jesus, as the recent movie The Passion of the Christ has so graphically re-enacted."

And within the opening paragraph, the agenda of author is immediately betrayed by her own words.

Immediately, the author is making a subtle but nonetheless derisory sideways glance at those people who might otherwise not have the kind of mettle to live on through so much pain. Frankly, I find that insulting.

In my mind, there simply was no other reason to make a reference to such a biblical character.

Throughout here thought-piece -- though superficially comprehensive -- there is actually little thought given to the needs of the patient and more weight given to the failures of the current method in which euthanasia is currently proscribed.

It's apparent to me that the author really does have a fundamental problem with euthanasia that owes more to the fact that such practices offend her sensibilities and her beliefs than the overall effectiveness of euthanasia when practiced judiciously.

This is a shame, and it's pretty much underlines what I've said before -- people in positions of office and responsibility who are utterly incapable of setting aside their colourful beliefs and looking at the matter at hand objectively.

If the practice of euthanasia is performed incorrectly, that does not necessitate euthanasia not being provided as an option.

Do we ban air travel because of the number of air craft that might crash each year because of the failings of pilots, air traffic control and various other people, not able to do their jobs properly?

Of course not.

It is very clear that euthanasia is an option, not a mandatory requirement, which is pretty much how the author of the article might have you believe.

Also, the author does not discuss the types of illnesses or injuries that offer the patient no real alternative, given the stricken nature of their bodies.

The idea of complete anesthesia and unconsciousness (known as "terminal sedation") is just ridiculous.

This proposition is so totally without merit as to be pointless and clearly not held close enough to the light of logic to see the chasm-like holes within.

Let's assume that a patient has asked for terminal sedation. Once the sedative has entered their body, they are unlikely to open their eyes again because they are now unconscious.

Effectively, from the point of view of the sufferer, death occurred the moment they closed their eyes.

Now I ask a simple question: what real purpose does such a treatment fulfill? Other than alleviating the sense of guilt on the part of such people as this author.

I've had to sit holding the hand of my dead mother. The only thing keeping her warm and having her chest heave up and down was the benefit of a battery of machines with cables, pipes and tubes hanging out of her head.

Where is the dignity there?

There is none.

My mother was effectively dead, and my family and I quickly accepted that and allowed her to die.

On the very practical side, do we use up more valuable resources keeping someone alive needlessly and in a hopelessly undignified manor?

For what? What greater good is being fulfilled?

None. Other than a small matter of the likes of Sharon A. Falkenheimer, the author, being able to sleep better at night knowing she's got her front-row ticket in heaven by doing right be her god.

In the cases where euthanasia is considered as an option, the patient is suffering from injuries or an illness that leaves them with a massively diminished, if not non-existent quality of life.

What do we do? Place all of these people into cryo-statis in the belief that medical advancements will improve in the future to the degree that they will be healed?

Of course not? And why? Because it would be enormously expensive.

Then why allow the practice of terminal sedation?

Clearly, logic and reason were orphaned at some earlier point in the lives of the likes of the author of the article and the pursuit of their believes is all that matters...

11:50 am  
Blogger Wayne Smallman said...

Gindy wrote: "I found this article that may or may not be of interest. I thought of one of your posts when I saw this..."

Go to: http://www.politics.co.uk/domestic-policy/leaked-papers-spark-right-life-row-$7731681.htm

I think the use of the word, euthanasia tends to confuse some people.

In fact, in the link kindly provided by Gindy, the word only appears at the bottom of the page.

It's encouraging to see that there are clear mandates in place. The courts have the final say while the hospitals get to advise of the effectiveness of treatment to those that are otherwise incapable of deciding for themselves.

However, in practice, it's not always worked out that way.

What creates even more confusion -- especially amongst the relatives of the sufferers -- is that perception that almost anything is possible.

"You can stitch a leg back on and give someone a new heart. Why can't you help my «insert names of loved one here»?"

Worse still, medical advancements mean that it's possible to 'preserve' someone for years. In the case of my mother, it was explained that she could have been kept on a ventilator for years, although the damage to her brain was so severe, there was never any hope that she would ever recover.

Clearly, this serves no purpose and is simply a waste of vital resources.

It's an emotive issue, there's no doubting that, but I've stood both sides of the argument. At the very least, there needs to be more discussion on the subject...

11:28 am  

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