Euthanasia - whose choice is it?

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There has been much debate in the UK recently regarding the choice facing terminally ill patients on whether they should be able to determine a right to die. It is a moral, ethical and practical minefield - is it ever right for another person to end the life of a terminally ill patient who is in severe pain or enduring other suffering? If euthanasia is sometimes right, under what circumstances is it right? Is there any moral difference between killing someone and letting them die by say withdrawing vital medications or fluids? Who should carry out euthanasia and where?

Having had a relative who died from Motor Neurone Disease - and two friends who died with Alzheimers and abdmonial cancer - all within the last 12 months - it is a issue I have struggled to resolve in my own mind and therefore I would like to open it to a the Arena for comment - not least because as podiatric practitioners we will be exposed to a fair percentage of the population who are terminally ill with any number of conditions.

For me, I think the choice should be with the individual concerned - should they have the capacity to make that choice in an informed, dispassionate manner. But what happens when illness is caused by trauma or acute disease such as severe CVA - should the relatives be able to choose? In a way they can presently - such as when deciding to terminate life-support systems. But where you you draw the line?

Personally I would like to endure to the very end - and experience everything and anything life has to offer, for good or ill. You only get to die once and I think I would like to be conscious - or as close as - when the time comes; not for any religious, moral, ethical or legal considerations, but just to experience what happens at the passing of life.

What do you think?

MR

 

Having had a family member suicide (sufferer of MSA), I wish he would have had the choice. But to legalize it? Too many risks of abuse..like you say...where do you draw the line?
My dear mother reckons (81) every one should have legal access to a cyanide pill at age 60, and you choose to take it when you want.

 

Mark certainly a tricky subject.

I look at it this way. I beleive that it should be my choice and that we as an individual people should be able to decide, just like we write a will we should be able with mediacal information be able to decide at which point enough is enough.

So at a certain age say 18 or 21 ie the age of legal drinking, when you can go to war for your country and vote we should be able to fill in a form which you have made the decision about your life if you ever got sick or had a major accident . If you choose not to fill in the form then you have stated that you want to be kept alive as long as possible as it is today.

I certainly think that we should be able to decide oursleves.

I would want the process to be a quick and painless as possible in an controlled enviroment.

 

The document that are referring to is a living will or Advance Healthcare Directive. This records what you want to be done if you become so ill or severely injured that you cannot speak for yourself.

If you do not want to be subjected to medical treatments & interventions which might prolong your life but result in a quality of life you would find unacceptable, you can make a living will.

That said, as with all wills, it is not watertight. My mother in law was told by 2 seperate solicitor firms that her will was incontrovertible, only to have it contested and ignored on her death.

Cheers,
Bel

 

But a living will not allow Euthanisia only stop treatment, I was meaning that at a certain point Euthanasia should be used if I had filled out a document stating that´s what I wanted if I was left in certain way after an accident etc.

 

Agreed. But it is the closest thing that you can get in instructing preferred treatment or no treatment in the event of you not being able to convey this yourself. Any document, at least here in the UK, requesting euthanasia would be completely ignored by the medical community all the time that euthanasia is illegal.

However, I do happen to be of the same opinion as you. It would be ideal to have the opportunity to express my wishes to die with dignity in advance.

Bel

 

My father died at 56 y/o. We weren't asked but told (after continued and at times 'forceful' questioning) that no interventions to prolong life were to be used. Passive euthansia? Which my mother, sisters and I agreed with. We read to him, although he was unconscious, over a 2 day period, his favourite poetry & prose. Dad seemed to be less 'disturbed' when we were reading. I don't want to die, I'm enjoying life the more I am getting older, but hopefully I won't be subjected to life-prolonging interventions if I get to a certain point, also. My wife and I have made the 'pact' (like many other couples),
have a great day, mark

 

There seems to be a common argument that it is up to the individual to decide whether he/she wants to die. However this doesn't take into account that one is not just an individual but also a part of a family and community and that every life affects not just that person but also others. I believe a patient has a right to refuse treatment but not to actively kill themselves as their life does not belong to them only. From my own religious view I believe that life ultimately belongs to God and only He has the right to take it away.

 

Podalog,

I wholeheartedly agree with all your statements here - especially the one about God. But to witness a loved one suffer, knowing that they are going to die a horrible prolonged death, does cause you to wish there was an easier way to ease that kind of torture. It is easier for the believer -1 Cor 10:13.

 

I´m not sure that a long prolonged debate about religion should occur here on PA, but I guess that it was bound to be mentioned with a thread start such as this. Before it heads in that direction I beleive that people should be very careful with their comments as not to offend anyone .

 

In Aus the 800lb gorilla in the room that no-one talks about is the fact that it is legal to manage pain by the administration of opiods, when the pain is high enough the doses administrered are going to kill some one, this is legal .......not as euthanasia but as palliative care for pain.....and as long as we don't make too much of a fuss about it, it all works out fine. I have seen it work beautifully with a very (potentially) painful death from pancreatic cancer. It is silly that we handle dogs and cats more humanely than people.
regards Phill

 

Too late.
Let's do a poll; God-believers, agnostics, atheists, others? I for one don't trust anyone who says that there "there definitely is a God" nor do I trust anyone who says "there definitely isn't a God"
Belief is different, like Podalog said "(he) believed". Fair enough!

 

I believe the problem behind any system implemented and used by humans is the fact that someone, somewhere is going to abuse, misuse or accidentally get the blasted thing wrong at some point. With an issue as final as euthanasia if the system goes a little wrong for one person, then that person is dead. Is there an acceptable error margin with euthanasia that we are willing to work with..?

So, where do you draw the line in the sand with regards to who qualifies and who doesn't qualify for the option to kill themselves..? Does anyone have the right to decide bar the person and their own family?

On the other hand, I very firmly agree with Phil Carter with regards to allowing someone a dignified, peaceful and gentle end in the case they are terminally ill. Who could deny someone that??

With regards to religion, you are welcome to your opinions. But surely your rules only apply to people that subscribe to your religion?

S

 

" I beleive that people should be very careful with their comments as not to offend anyone ."

Isn't that part of the problem? We are so UP TIGHT and INTOLERANT of things that we all feel we need to walk on egg shells least we OFFEND someone's feelings.

I say get a thicker skin and be an adult. Why would an honest discussion on how we view life and death and the world and our place in it possibly be HURTFUL or OFFENSIVE to anyone unless they are looking to be OFFENDED.

My take: Life is precious. Health is the MOST precious possession. Can or should anyone else have any say in the continuation (or not) of your life?

How about abortion? Is this not inseparable from a discussion on euthanasia? Is it not an individual who cannot speak and argue on his own behalf. OR- one who for whatever the reason wishes to end his own life (or a mother deciding on behalf of an unborn child?)

You either defend and protect life or you do not. You don't get to choose when and where and for whom. You have a belief that transcends various social situations or you do not.

Steve

 

It is inevitable that such a discussion as this raises personally held beliefs and brave of the OP to raise the whole point (not simply because of the belief issue).

I do agree with the above poster who suggests that such a topic needs airing, regardless of our religous sensitivities.

In regard to the issue of beliefs perhaps, if this discussion is going to go ahead, I can offer the following, hoping that it is helpful. (thought more than twice about writing this so hope it has some value)

In general, a persons belief, in relation to God, is something that will fall within a theological spectrum. A contributor to this topic needs to acknowlege this and acknowlege this to themselves. We may hold a view within a spectrum but this view is not "itself" beyond dispute. Disagreeing with someones view "in this thread" is not critiquing that persons own position with regard to the existence or not of God.

Indeed, discussion that can occur within the creative tension of the spectrum is healthy, indeed may even enable personal growth. Let's face it, whatever our belief now, we may will undergo re-evaluation if the cutting edge of the coal face is our life or death.


Ian

 

Euthanasia,well what a tricky topic!The word comes from the Ancient Greek for 'a good death' but what death by euthanasia can be a good death?I was with my father when he died in a hospice after a year of pain caused by a widely disseminated cancer,his death was very peaceful,I would say even serene,as my mother and I were sitting around his bed in the middle of the night.An air of amazing tranquility descended in that curtained off part of the ward which was dimly lit and very quiet when his breaths became shallower and shallower,almost imperceptibly until he breathed his last and was gone...his death was a good death.I feel very sorry for people who would go to some foreign land to drink a glass of poison and bring about a concocted death,there must be some better way for their lives to end.I want my life to end from the final illness I shall suffer from,and for it to end in peace with as little medical intervention as possible although I understand this may not be so,and I want it to end naturally.Jeffrey Jones.

 

My opinion is not intended to offend. My own thoughts on euthanasia are that our choice regarding selecting to end our lives should be just that. Our own choice. I have no God or higher power in my life. My life is my own to choose whichever path I decide upon.

I was blessed with two wonderful parents who gave their three children the confidence to enable them to have opinions which while considering the opinions of others also enabled us to trust in our own decisions & select what we believe to be right.

My father was a very proud although quiet man. His death in the year 2000 was not dignified or peaceful. Without unecessary details suffice it to say I can assure you given the choice he would without doubt have chosen to have quietly gone to sleep after saying his goodbyes to those who loved him. Not for a moment do I believe he would have wished for his loved ones final image of him to be what now remains.

Euthanasia: I would say yes. Given the person choosing has the ability to decide their own end.

Just my thoughts.

Regards, Mandy.

 

Wow, what an incredible topic. Something that made me sit back and think about it a little.

When someone is dealing with a life ending disease it's amazing how their whole thought process changes. You have two extremes, 1.) the person who wants to experience everything they are going to miss out in life, and 2.) the person who wants to just end it and get it over with so they don't go through the pain and suffering. I can see both sides and why they would want to do what they choose.

This is deifinitely food for thought. Thanks for the posting.

 

Sorry but here in the UK we are a secular state. The Christian God doesn't make the laws. The rule of law is based on human morality.

What if I said I believe in the Jedi and the force? Yoda and Obi-wan had no problem in losing their earthly shackles Your religion is not necessarily mine.

The right to die at ones own behest is quite legal and in many cases moral. What is legally difficult to frame are so-called living wills ie writing a document that sets out the future circumstances in which you would prefer to die. These may well be circumstances in which medically "life" is quite "viable" but the individual is no longer capable of commiting the act themselves. How is not abused and who does the termination?

 

Thanks for the replies to date - interesting reading and indicative of the wider opinions in society. I think it inevitable that religion comes into the debate given its prominence in the issue generally. Those who have belief in an afterlife and/or an all-seeing, all-knowing diety are a powerful lobby in the euthanasia debate and should not be underestimated, but like many contributors, I think they are misguided simply because their basic premise is one based on superstition of which there is not one thread of evidence to support. Hopefully, in time, as we discover more about what is beyond our solar system, we will see the folly of our parochialism and discard the shackles that bind us to these primitive rituals and superstitions.

I was particularly touched by the case of Sir Edward Downes, one of Britains most respected conductors, who, at 85, had become virtually blind and deaf - and after learning that his wife had terminal cancer - decided to end his own life along with his wife at the Dignitas Clinic in Switzerland. They died peacefully and under circumstances of their own choosing. What is clear is that they were completely devoted to each other and had enjoyed a long and happy marraige of 54 years. Are we really saying that it is immoral, unethical and illegal to end one's life in this manner based on religious views only? There are serious considerations to take account of with assisted suicide - where, when, how, who - but I would have thought these could be relatively easily addressed with sufficient safeguards in place to prevent abuse either by the State of by individuals.

Surely quality of life is a far more important consideration than the duration?

 

And what is human morality and how do we decide what that is? Euthanasia is primarily a philosophical issue. Everyone has a philosophical worldview from which they interpret the world and to decide what is right and wrong. The position someone takes on this issue will be determined by their philosophy. You may think that the question of God to medical ethics may be irrelevant in the U.K but it is relevant to me. I do not accept the philosophical belief that everyone's life belongs to them to end when they please. My concience will not allow me to support active euthanasia and would seek to dissuade people from carrying it out. You and others may disagree with me - Fair enough, everyone to their own conscience. However I admit that I have never had to face this issue in real life unlike some people here. I can understand why some would support it for good and caring reasons however I could not support it in good conscience.

 

Of course if you are not Christian you cannot be moral.

You have just explained why the state and its laws should be secular, thank you.

 

I did not mean to insinuate that non-christians cannot be moral. What I meant was everyone has a different morality and there is no such thing as a universal human morality which agrees in all areas.

 

I can not agree with Podalog's last statement that there is no such thing as "Dying with dignity". My mother died with great dignaty (at the age of 104 years). As her family all stood around her bed she just closed her eyes and drew a few deep sighs and died. No strugle, pain or distress. I hope that when my turn comes I die in the same peaceful way. I am 80 yeard old by the way, so I might have too long to wait!! Joseph

 

Ah, Bill, this is beginning to sound like the kind of conversation we would have over a few beers in Sandy Bells - and I'm not sure if we would get much further even with the help of some fine lubrication. The nub of the matter is that we simply don't know what is beyond the end - in much the same way as we don't know what was there before we came. Maybe there is some form of reincarnation. If our thinking brain had developed sufficiently in vivo perhaps the whole business of birth would sound just as implausible to ourselves. Can you imagine being thrust out of that cosy environment into the world as we know it? The transition would almost seem as miraculous as the transformation of a caterpillar into a butterfly!

I've had, as I'm sure many other on Podiatry Arena have also, many experiences with patients that have told of phenomenon with a departed loved one - visual, auditory hallucinations - and although sceptics will point out that we could in certain circumstances, wish our brain to create such experiences - sometimes they are so real and/or unusual that they defy yet demand explanation. I remember a few years after my grandmother died, I was driving past the cemetery where she was buried - close to the Regional road in Fife - when incredibly the car - not the supercharged mini - seemed to slow down to almost walking pace (instead of 90mph) for a few seconds and I had the feeling of what I can only describe as a granular sensation passing through me. Instantly I was overwhelmed by a feeling that it was my Grandmother. It lasted for a few seconds and then the car was travelling at the same speed as before. I hadn't been thinking about her prior to the incident - I had driven the same stretch of road at least three times a week since she had died - and yet that is how it felt to me. I still remember it vividly and I can still offer no rational explanation.

I've heard a story from a husband and wife, who, after visiting Cheltenham several years after the death of his mother, both saw her standing opposite them over a busy road. She was standing still - just smiling at them. Both husband and wife are atheists - and general practitioners. Both saw the departed. Neither can offer an explanation.

What I do think is that the development of religious orders - of whatever "faith" - who claim to understand and own the territory of the unknown and unexplained - is extremely unhelpful and disillusionary. Do you remember Bob Main in Edinburgh - and his collection of Ouija Boards and tales of astral flying? I would probably lean towards the supernatural than any established religion, if I were to seek explanation for the unknown - but that is only my view. The fact that some religious leaders try and influence the euthanasia debate based on what they consider divine scripture is to me, as fantastical as belief in Santa Claus or the Tin Man.

But who knows? Another beer?

Mark

 

Bill

Having said all that I came across this piece of writing I jotted down some years ago. Don't really think my views have changed all that much really.

I remember thinking it rather bleak when I wrote it down; and I guess it still reads that way. But for the most part, I think it rings true. Maybe that's why religion is indispensible for so many.

All the best

PS It's all Syd's fault. He synthesised the ergot.

 

From The Times Thurs 27 October

Why I changed my mind on assisted dying
As a doctor I used to think palliative care was the answer. Now I realise that keeping people alive can be unspeakably cruel

Raymond Tallis

Raymond Tallis is a writer and physician. His latest book is The Kingdom of Infinite Space: A Fantastical Journey Around Your Head (Atlantic Books)