(This essay was originally written for an All India Essay Competition)
Introduction
Who decides when a life no longer
has value? Doctors? Patients? Spouses? Parents? Insurance companies? What if
there are differences of opinion? Are doctors ever motivated by cost factors?
Are patients sometimes in an emotional state that makes good judgment unlikely?
Are parents ever motivated by unreasonable hope, spouses by an understandable
need to move on? Might doctors ever slant the truth to make families
comfortable with end-of-life decisions? Might insurance companies possess a
narrower view of what “value” means than most of us would be comfortable with?
These questions affect not only end-of-life issues, but also quality-of-life
issues for persons with disabilities. They are therefore of grave interest to
ponder, practice and to propagate.
Although the term euthanasia
originally meant a good happy death, it has become synonymous with “mercy
killing”. The judgment is made that an individual person is better off dead
than alive and that a benefit is conferred upon the person by relieving him of
a life that has become an intolerable burden[1].
Active euthanasia refers to mercy killing when someone does something precisely
in order to bring death about. Such active euthanasia can be voluntary,
non-voluntary, or involuntary. It is voluntary if death is brought about only
after securing the informed consent of the person whom is to be mercifully
killed to being so killed. It is non-voluntary if such free and informed
consent has not been given because of the individual’s inability to give such
consent[2].
In addition, passive euthanasia refers to mercy killing achieved not by
someone’s doing something in order to bring death about but by someone’s not
doing something precisely as a mean of achieving the same effect. Passive
euthanasia is needed a form of mercy killing and is utterly different, both
morally and legally, from legitimate decisions to forgo or withhold treatments,
even if one foresees that by doing so death will come about[3].
The history bore witness how the
concept of euthanasia has traversed in its process of evolution. Right from 400
B.C.’s Hippocratic Oath[4]
testifying the antagonism towards euthanasia to October of 1939 when the
Dictator who fed on hate and not compassion, the Hitler’s order of widespread
“mercy killing” codenamed “Aktion T 4” of the sick and disabled, the saga about
the euthanasia was in its best and worst. “From the Soviet gulag to the Nazi concentric
camps and the killing fields of Cambodia,
history teaches that granting the state legal authority to kill innocent
individuals has dreadful consequences”[5].
Today’s stories turn to be tomorrow’s history and the stories about euthanasia
and suicide will be on its making in the days to come.
Words seem inadequate to elucidate
the ghastly experience faced by the countless oldest, littlest and lowest
people due to the mercy killing. The truth about the odyssey is stunning.
Perhaps that is the reason why a very few number of countries have legalized
euthanasia and suicide by having a mercy towards the greater cause of humanity
overtaking the individual “Right to Die”.
Fulmination
against legalisation of euthanasia
“I
will neither give a deadly drug to anybody who asked for it, nor will I make a
suggestion to this effect”.
– Hippocrates, Father of Medicine, c. 460-377 B.C.
Since the beginning of history,
society assigned the task of saving life to physicians. If killing people was
required, that task was given to executioners. How these two opposite roles
became confused? How killing and healing were mixed? Moreover, how physician’s
loyalty was no longer to the individual patient, but to “society” or the State?
Once the Nazis took over, medical graduates no longer took the Hippocratic
Oath, but an oath to the health of the state. Most American medical graduates
also no longer take the Hippocratic Oath, but a variety of other oaths,
including one that refers to “humanity” but mentions neither abortion nor
euthanasia[6].
How did all this happen? The vociferous fulmination against all these could be
evident from the succeeding paragraphs.
Traditional medical ethical codes
have never sanctioned euthanasia, even on request for compassionate motives.
The Hippocratic Oath never supported it. The International Code of Medical
Ethics[7] as
originally adopted by the World Medical Association in 1949 never holds it up.
The World Medical Association[8]
confirmed that assisted suicide, like euthanasia, is unethical and must be
condemned by the medical profession. Swift, in his early 19th
century treatise on the laws of Connecticut,
stated, “If one counsels another to commit suicide, and the other by reason of
the advice kills himself, the advisor is guilty of murder as principal”[9].
“Now if the murder of one’s self is felony, the accessory is equally guilty as
if he had aided and abetted in the murder.”[10]
The right to life and to personal security is not only sacred in the estimation
of the common law, but it is inalienable. There is no cell of this world, which
says that euthanasia is good.
A patient with a terminal illness is
vulnerable. He lacks the knowledge to alleviate his own symptoms, may be
suffering from fear about the future and anxiety about the effects his illness
on others. It is difficult for him to be objective about his own situation[11].
“The terminally ill are a class of persons who need protection from family,
social, and economic pressures, and who are often particularly vulnerable to
such pressures because of chronic pain, depression, and the effects of
medication”[12]. In
succinct, they may feel great pressure to request euthanasia ‘freely and
voluntarily’.
Medical research is essential if
medicine is to advance further. When the focus changes from curing the
condition to killing the individual with the condition, this whole process is
threatened[13]. A
conspicuous danger of legalizing euthanasia is that Medicine would be robbed of
the incentive to discover genuinely compassionate solutions to the disease and
difficulties of patients. The kind of humane impulses, which have sustained the
development of hospice medicine and care, would be undermined, because too many
would think euthanasia a cheaper and less demanding solution[14].
Rather than being employed to care and console, funds are being diverted to
fuel the strategy of ‘search and destroy’ accelerating the decline of our
health care system.
Rights need protection, but must be
balanced against responsibilities and restrictions if we are to be truly free.
We are not free to do things, which limit or violate the reasonable freedoms of
others. No man is an island. No person makes the decision to end his or her
life in isolation[15].
Others are affected. Friends and relatives left behind, and the healthcare
staff involved in the decision-making process include in that. Personal
autonomy is never absolute and one cannot simply consent to be killed.
By legislation, voluntary euthanasia
gives too much power to doctors. If a doctor confidently suggests a certain
course of action, it can be very difficult for a patient to resist. Diagnoses
may be mistaken[16]. The
doctor may be unaware of recently been developed medicines, may not be
up-to-date in symptom control, may misguide the Prognoses. Doctors are humans
and subject to temptations, affecting their own decision-making, consciously or
unconsciously. The ultimate product of legalization will be the manufacturing
of the dangerous draconian doctors.
There is significant danger that
many people would take this “escape” due to external pressure. For example,
elderly individuals who do not want to be a financial or caretaking burden on
their families might choose assisted death. In Oregon’s third year report, “A startling 63%
of [reported cases] cited fear of being a ‘burden on family, friends or
caregivers’ as a reason for their suicide”[17].
“Society always is attempting to
make the physician into a killer to kill the defective child at birth; to leave
the sleeping pills beside the bed of the cancer patient… It is the duty of
society to protect the physicians from such requests”[18].
We all have a crucial role to play with our full potential.
“You matter because you are you.
You matter to the last moment of
your life,
And we will do all we can,
Not only to help you die peacefully,
But also to live until you die”.
– Dame Cicely Saunders,
Founder of Hospice.
Voice
and noise in favour
Methods
and methodologies of taking a persons life differ from a doctor to doctor but
the reason why the doctors apply those techniques could be obvious from the
below crammed powerful words in favour of the euthanasia and suicide.
In an ethical binocular if we look,
we could see that some people wish to die because they are suffering from
clinical depression. In an age when total medical funding is restricted and
being continually reduced, is it ethical to engage in extremely expensive
treatment of terminally ill people in order to extend their lives by a few
weeks, if it is against their will? Drugs used in assisted suicide cost only
about $40, but that it could take $40,000 to treat a patient properly so that
they don’t want the “choice” of assisted suicide[19].
The money used in this way is not available for pre-natal care, infant care,
etc. where it would save lives, and significantly improve the long-term quality
of life for others. Is it not this a significant contention to be focused?
Through a microscopic view, it is
evident that in voluntary euthanasia the person to be killed mercifully wishes
to be killed and has freely given informed consent to being killed. Hence, by
doing this one is not acting unjustly; rather, one is respecting his wishes.
Moreover, the person’s desire to be killed is reasonable in view of the pain
and/ or suffering and/ or humiliation he is experiencing; at times, others are
suffering terribly too, psychologically or economically or both. Everyone –
whether it be a person with a life-threatening illness or a chronic condition –
has the right to pain relief. With modern advances in pain control, no patient
should ever be in excruciating pain. Relief from the pain is ones right and why
there is a ruckess about this.
Should people be forced to stay
alive? No. in addition, neither the law nor medical ethics requires that
“everything be done” to keep a person alive. There are no laws, medical
associations, church denominations, or right-to-life groups who insist that
unnecessary, heroic, or truly futile treatments be provided to prolong life and
all recognize the right of competent patients to refuse medical treatment[20].
Insistence, against the patient’s wishes, that death be postponed by every
means available is contrary to law and practice. It would also be cruel and
inhumane. There comes a time when all efforts should be placed on making the
patient’s remaining time comfortable. Then, all interventions should be
directed to alleviating pain and other symptoms as well as to the provision of
emotional and spiritual support for both the patient and the patient’s loved
ones. The only salvation is death.
There is a significant and growing
percentage of agnostics, atheists, humanists, secularists, non-Christians and
liberal Christians who argue: Each person has autonomy over their own life.
Persons whose quality of life is non existent should have the right to decide
to commit suicide, and to seek assistance if necessary[21].
Even Buddha himself showed tolerance of suicide by monks and some Hindus say
that by helping to end a painful life a person is performing a good deed and so
fulfilling their moral obligations.
By considering all these, letting a
person to die who seeks for it seems merciful, reasonable and responsible.
Theological
dialectics and discourse
Religions are for social control and
different religions have different opinions. Nevertheless, there is a common
thread touching through all the religions in its variety and vibrancy, which
reverberates a common echo against euthanasia.
Most Hindus would say that a doctor
should not accept a patient’s request for euthanasia since this will cause the
soul and body to be separated at an unnatural time. The result will damage the
karma of both doctor and patient. By helping to end a life, a person is
disturbing the timing of the cycle of death and rebirth. Other Hindus believe
that euthanasia cannot be allowed because it breaches the teaching of ahimsa.
However, prayopavesa, or fasting to
death, is an acceptable way for a Hindu to end their life in certain
circumstances, which is very different from what most people mean by suicide.
It is non-violent, uses natural means and is a gradual process. It is
associated with feelings of serenity and is a gradual process. It is associated
with feelings of serenity and is only for people who are fulfilled, who have no
desire or ambition left, and no responsibilities remaining in this life. In
total, it is really only suitable for elderly ascetics[22].
Christians are mostly against euthanasia. The arguments are usually based on
the beliefs that life from God, and that “each individual is its steward”[23].
Some churches also emphasize that birth and death are part of the life process,
which God has created, so we should respect them. Therefore, no human being has
the authority to take the life of any innocent person, even if that person
wants to die. Many churches believe that the period just before death is a
profoundly spiritual time. They think it is wrong to interfere with the process
of dying, as this would interrupt the process of the spirit moving towards God.
They never consider that human dignity and value are measured by mobility, intelligence,
or any achievements in life. Therefore, it would be wrong to treat their lives
as worthless and to conclude that they ‘would be better off dead’. Patients who
are old or sick, and who are near the end of earthly life have the same value
as any other human being. “A man, even if seriously sick or prevented in the
exercise of its higher functions, is and will be always a man… [he] will never
become a ‘vegetable’ or an ‘animal’”, the Pope said. “The intrinsic value and
personal dignity of every human being does not change depending on their
circumstances”[24].
Muslims are too against euthanasia.
They believe that all human life is sacred because Allah gives it. “Do not take
life, which Allah made sacred, other than in the course of justice”[25].
“If anyone kills a person – unless it be for murder or spreading mischief in
the land – it would be if he killed the whole people”[26].
Allah decides how long each of us will live. “When their time comes they cannot
delay it for a single hour nor can they bring it forward by a single hour”[27].
And no person can ever die except by Allah’s leave and at an appointed term”[28].
“The message of Judaism is that one
must struggle until the last breath of life. Until the last moment, one has to
live and rejoice and give thanks to the Creator”[29].
Jewish law and tradition regard human life as sacred, and say that it is wrong
for anyone to shorten a human life. This is because our lives are not ours to
dispose of as feel like all life is of infinite value, regardless of its
duration or quality, because all human beings are made in the image of God.
“The value of human life is infinite and beyond measure, so that any part of
life – even if only an hour or a second – is of precisely the same worth as
seventy years of it, just as any fraction of infinity, being indivisible,
remains infinite”[30].
Most Buddhists like other religions
are against involuntary euthanasia. Their position on voluntary euthanasia is
less clear. Buddhism places great stress on non-harm, and on avoiding the
ending of life. Certain codes of Buddhist monastic law explicitly forbid it.
Buddhist regards death as a transition. The deceased person will be reborn to a
new life, whose quality will be the result of their karma. Therefore, one
should not kill anyone in his or her life. Apart from this, there is Japanese
samurai tradition. The samurai ritual of seppuku came very close to euthanasia
indeed. In line with Buddhist thinking, the seppuku ritual laid great emphasis
on the suicide having a peaceful mind during the action.
Conclusion
A
man is not a thing, that is to say, something, which can be used merely as
means, but in all his actions, be always considered as an end in himself[31].
Dying patients basic human rights are seen to be violated when they lack the
knowledge and power to make decisions, which, in turn, diminishes dignity.
Patients have the right to know their conditions, to choose or to reject the
treatment regimen, to choose or to reject attempts to prolong their life, and
to decide fully as to the disposal of their remains. We need to recognize that
requests for voluntary euthanasia are extremely rare in situations where the
physical, emotional and spiritual needs of terminally ill patients are properly
met. As the symptoms, which prompt the request for highest priority must be to
ensure that top quality terminal care is readily available.
As is the case with any ending –
whether it is music resolutions, the denouements of literature and drama,
conclusion sections of research papers, the logic of deserts, or the completion
of a human life – failure to culminate “correctly” jeopardizes the overall
meaningfulness of the social product. Individuals “in exit” no longer need to
conform neither to trivialities of mass culture nor to the norms of the status
hierarchy. From this perspective, the problem of our times is the apparent lack
of cultural consensus over exactly how endings – whether from work, the family,
or from life itself – should be ideally conducted. As Martin Luther King said
on the eve of his assassination that no one is truly free to live until one is
free to die.
[1] “The
Final Act: Public Policy on Euthanasia & Asst. Suicide”, By William E. May.
[2]
For e.g., infants, persons in a comatose condition etc.
[3] “The
Final Act: Public Policy on Euthanasia & Asst. Suicide”, By William E. May.
[4] By Greek
physician Hippocrates.
[5] Pete Du
Pont, former Delaware Governor.
[6] “Now
Choose Life” – David C. Stolinsky, MD.
[7] The
International Code of Medical Ethics adopted by 3rd World Medical
Assembly, London, England, October 1949.
[8] Handbook
of Declaration, WMA, 1992, France.
[9] Z. Swift
–“A Digest of the State of Connecticut”
270 (1823)
[10] Quoting
Chief Justice Parker’s charge to the jury in Commonwealth V. Bowen, 13 Mass. 356 (1816).
[11] “Twelve
Reasons Why Euthanasia Should not be Legalised” – Peters Saunders
[12] From
the State of Alaska’s
arguments that assisted suicide is dangerous (Sampson et al. V. State of
Alaska, 09/21/2001).
[13] “Twelve
Reasons Why Euthanasia Should not be Legalised” – Peters Saunders
[14] “The
Final Act: Public Policy on Euthanasia & Asst. Suicide”, By William E. May.
[15] “Twelve
Reasons Why Euthanasia Should not be Legalised” – Peters Saunders
[16] Rees, W
et al (1987) ‘Patients with Terminal Cancer’ who have neither terminal illness
nor cancer. BMJ 295:318-9.
[17] United States
Conference of Catholic Bishops, 2001.
[18] Margret
Mead, anthropologist (quoted in Maurice Levine ‘Psychiatry and Ethics’, George
Brazillers Publishers, New York,
1972, Page 325).
[19] Wesley
J. Smith, senior fellow at the Discovery Institute.
[20]
Hospitals/Nursing Home Patients Bill of Rights.
[21]
Euthanasia and Physician Assisted Suicide: Further Information, Author: B. A.
Robinson.
[22] Satguru
Sivaya Subramuniyaswami, a Hindu leader born in California, took his own life by prayopavesa
in November 2001.
[23] Essays:
Euthanasia, Synod of the Great Lakes, Reformed
Church in America,
at: http: // www.euthanasia.com/.
[24] Pope
John Paul II, 2004.
[25] (Quran
17.33)
[26] (Quran
5.32)
[27] (Quran
16.61)
[28] (Quran
3.145)
[29] Dr.
Rachamim Melamed-Cohen, Jewsweek, March, 2002.
[30] Lord
Jakobovits, former UK
Chief Rabbi.
[31] Immanuel
Kant’s Fundamental Principles of The Metaphysics of Morals as translated by
Thomas Kingsmill Abott.
