Euthanasia

Euthanasia

There are what I consider as being two perfect ‘killing machines’ on this planet; Viruses, and the Human species. Any form of life that resides higher than Porifera on the food chain – (Sponges) is intrinsically instilled with a will for survival. We Humans, have debated as to whether we have the right to end that survival voluntarily, whether or not that debate is logically sound, or filled with non sequitur arguments. This debate is about death. Death is not pretty. Death does not hold that dignified Shakespearean glory that vacillates between tragedy and triumph. Death is ugly. When we die, we all lose control of our bodily functions; the last strained groan for breath falls short, and it is in that moment that we will all realize that Death is the teasingly loneliest act in our regrettably short plays. Whether Euthanasia is done through voluntary or involuntary assertion, we deserve the option of not dying this ugly, and this lonely.  I argue that we all have the right to die with dignity, even though there is no "Dignity"; there is nothing to be proud about... YOU LOSE! I will give you the answers to questions regarding the practice of Euthanasia, and, if decriminalization, or the legalization of this option can be provided with guarantees of it not becoming an abused privilege if we take our lessons who know what they are talking about.

Whether we agree or disagree, many people who are in constant suffering, or are, or have been diagnosed as being terminally ill in today’s society, want to die. I know this is true through drawing on personal past experiences. How and when we die, and for the “correct” reasons is what is constantly being debated. When we hear stories of a teenager in high school who kills himself or herself because they have trouble with their sexuality, or when a person kills himself or herself because of body image, or he or she are being bullied, or are having trouble at home is wrong (physical abuse/sexual abuse/alcohol abuse). It becomes a cat-and-mouse game with a turmoil experienced by virtually every youth in their adolescence.

Doctors are trained to care; they are sworn to care – Hippocrates assured us of this promise. There are Doctors for the depressed; high school years will pass; people become accepting of one another as they grow older, and attitudes, and beliefs adapt and evolve to the expectations of societal morals and standards.

Nevertheless, there are people in our society who want to die, regardless of what society can do for them – existence for these people is just too painful, and unbearable. I put to you then that it is our duty and moral obligation to assist these people as much as we can. Many, many people are very repulsed by this idea, and there are many people who completely agree with the concept of euthanasia. Nevertheless, the fact remains that – eventually, at some point in time, in some corner of this country’s political history – the issue will have to be formally addressed within a socially acceptable environment, and resolved amicably.

Many religious people object to euthanasia. Christians object that it is not God’s will to kill someone, and with the current levels of technology, coupled with the application of the most current pharmaceutical relief it is possible to make the prevention of suffering feasible, if doctors have the will. A person’s life is regarded as being God’s property, and, therefore, it is God's to take. Destroying a human life would be an insult to divinity. Furthermore, most civilized Western nations uphold the prohibition on killing because the taking of another human life is considered an ethical guideline that cannot be crossed, or controlled and conditioned through ethical concerns and argumentation, although this is clearly an ethical debate.

Further proclivity against euthanasia is it is not prudent to advocate the practice of euthanasia. That is to say, eventually, in all our lives, we may suffer some form of pain or discomfit, and if we think far enough ahead, we might think that it is better if the doctors that we depend on are not tempted to practice euthanasia on anybody, particularly ourselves. Like all medical procedures, euthanasia can fail, or bring additional suffering. Some people will claim, and some people have claimed, that if euthanasia is legalized, doctors will begin to provide peer-pressure that will force people into euthanistic scenarios for any number of reasons some being to reduce medical costs, or because their family wants them to die. Many people will be influenced that they will be saving their family the exorbitant medical costs – none of these are coercive arguments, and they should not disqualify any individual from providing their consent. Many doctors speak against euthanasia by stating that death is diametrically opposed to any Physician’s primary function, and it is an immoral action vis-à-vis their Hippocratic Oath. If a doctor is trained to both cure, and kill, then a doctor will be placed in a position where they would, or could, be continuously asked to provide their judgment as to when euthanasia is necessary. In addition, any best effort a physician might be able to provide in saving a Human life might not be exploited.

I would at this time like to provide some history regarding humanity’s precocious relationship with death. The death penalty has been practiced for all of recorded history ... and then sum. Humans have no problem justifying murder through acts of war – just or otherwise; as an act self-defense, or as a genuine religious practice. Muslims have continued the practice of stoning a person to death until as recently as seven months ago. In medieval Europe, methods of execution would depend on the social class of the condemned. The nobility would usually be executed in as painless and honourable a method as possible, generally with an axe (which occasionally, gruesomely failed). Those in the working class, serfs, peasants, and possibly the bourgeoisie would usually be executed publicly, in a more gruesome and painful method of execution, typically by hanging or by the wheel. Specific crimes would sometimes warrant specific methods of execution: suspected witchcraft, religious heresy, atheism, or homosexuality would usually be punished by burning an individual at the stake. Unsuccessful assassinations of royalty warranted a horrible, and prolonged death.

Several years ago, I wrote on Capital Punishment and the Canadian Penal system. After reflecting on that paper, and doing a more thorough research on the topic, a glaring fact remained; the removal of capital punishment from the Canadian Criminal Code in 1976 has not led to an increase in the murder rate in this country (Canada). Statistics Canada has reported that the murder rate for 2003 was the lowest it has been since 1967 (1.73 murders for every 100,000 population).

This brings me to my first issue – that of responding to the false assumptions that the legalization of Euthanasia will provide a starting point for unmerited, wanton, and uncontrolled acts of sanctioned murder of all walks of the human race – from the depressed to the terminally ill. The assumption that Euthanasia would induce family, friends, and doctors to kill those individuals that do not measure up to the status quo standardized assessment of what society would term as being ‘normal’ if Euthanasia becomes legalized. People would be forced into positions where decisions that warranted deaths of any individual would be based on virtually interminable arguments of legal costs, or the burdens that the sick, or perhaps our own health, places on us individually, or on our loved ones.

Arguments of fear have been used as a ‘logical’ response in the opposition’s argument against Euthanasia. Visions of Swastikas marching down the corridors of hospitals, or ‘Centers for Dispensation of Burdens’ will crop up on every corner of our cities, or religious wars will rise up because we would be disgraces to God, have been cited as a ‘sound’ basis for argument. All of this oppositional saber rattling fills this seemingly endless debate. What is interminable, with respect to this debate, is the complete lack of objectivity, and logic that is being brought to the table of euthanistic discussion. Emotions are freely used as logical qualifiers in support of a personal and emotional issue. Nevertheless, the use of emotion does not provide the ethically stable background that is required in addressing an issue that is as complex, and as divisive as euthanasia. Emotion provides psychological instability in the decision-making processes that need to be exercised in determining whether a person “who has made the request to die” be allowed to follow through with this most permanent course of action.

What are the complexities surrounding the debate of Euthanasia? On examination, I submit that this is not as complicated an issue as what has been reported through the press, religion, or political media have been presenting. Most of the complexity lies in the underlying fabric that often is overlooked with, or through the power of propagandizing the debate. There are incentives with being associated with the ‘talks’. They can be attributed to popularizing a political candidate or their party; institutionalizing the association between religion and state; or granting the right to exclaim that ‘murder is murder’, no matter what face has been embellished upon it – freedom of speech. These practices lead dogs by their tails to borrow an expression. That is to say, the arguments bring no support in lieu of the opponent’s point of view, but only serve as a means to an ends, and the ends justify opposition to Euthanasia. If we are skilled enough artisans in the art of rhetoric, we can see through this tangled skein of argument, and that these positions serve as ulterior self-serving motives. Why, now you ask, have I taken the stance that Euthanasia is not a complex debate? It is simple. Remove the emotion from the decision making process. Supply as much support as needed or not needed to the people who wish to die, and the imposition of safeguards would, hopefully, eliminate any possibility of abuses being made in selection processes.

Establish a network of support for friends and families specifically tailored for the person about to die. Remove any ability to interfere, or any power of decision-making from the above-mentioned groups, and people who have agendas, and we are left with a clearly logical approach to Euthanasia. This is a simple and clearly dignified way for a person to end their life – without outside interference. It is, after all, these most closely related parties mentioned above that would be most affected by the death process. Death with dignity is, after all, the only request that these individuals are wanting to achieve, and that is also, I should assert here, what we would all like to receive should a day such as one requesting, or having a loved one make a decision, to terminate a life befalls any one of us. What do my suggestions yield? Proper decisions would be made with respect to care-providers, and the exhaustion of any other possible courses of action that could be undertaken. Terminally ill; Incurable; Otherwise insufferable predicaments will be addressed with the assurance that the most has been done, and the most will be done to comfort any individual faced with giving up life, and those who are left to deal with its aftermaths.

Supporting evidence – actual case studies – exist. These are found in the following examples set by the countries of Australia, Belgium, and Holland that practice voluntary/involuntary Euthanasia, and Physician Assisted Suicide (PAS).

These countries exercise Euthanasia and PAS with the following methods and practices. Voluntary euthanasia is a form of euthanasia wherein an individual requests euthanasia - either during illness or before, if it is suspect that complete incapacitation is expected. Euthanasia in these cases differs from suicide by existing only within the context of the amelioration of suffering in the process of death. Volition must be informed and free. This means that any decisions made will have been done so without undue duress or influence from another party. Euthanasia that deemed as Non-voluntary is practiced when an individual lacks sentience – the individual is comatose, or legal brain death has occurred – and hence this person is incapable of deciding, or distinguishing, between life and death. It is such a person who cannot consent, or cannot give an informed decision, that distinguishes this type of euthanasia as non-voluntary. This form is often applied when any possible chances for recovery is not a possibility. The Rights of the Terminally Ill Act of 1995 legalized euthanasia in Australia’s Northern Territory. However, this law soon became ineffective because of amendments made by the Commonwealth’s Northern Territory’s Self-Government Act of 1978. Nevertheless, three people had been already been legally euthanized, but this was before the Commonwealth government had made their amendment.

After extensive debate in the Belgian parliament, Euthanasia became legal in September 2002. It was estimated that several thousand illegal acts of euthanasia were being carried out in Belgium each year. Belgium’s new legislation involves a complicated process, with critics labeling these political efforts as an attempt to establish a Bureaucracy of Death. Nevertheless, euthanasia is now legal, and its proponents in Belgium hope that it will stop the illegal practice of mercy killing.

In The Netherlands, the Termination of Life on Request, and Assisted Suicide Act, legalizing Euthanasia and PAS in certain circumstances, took effect on April 1, 2002. This law permits euthanasia and PAS when each of the following conditions is stringently obeyed:

•            The patient has asked repeatedly

•                The patient's suffering is unbearable with no prospect of improvement

•                The doctor has, prior to the act, consulted a colleague.

Doctor’s must also report the cause of death to the coroner in accordance with provisions of the Burial and Cremation Act. A committee then assesses whether the case of termination of life on request, or assisted suicide has been carried out in full compliance, and with all due criteria of care. The legislation offers an explicit recognition of the validity of written consent, or declarations of the will of the patient regarding euthanasia – this is referred to as a ‘Living Will’.

Such wills are permitted when a patient falls into a coma, or is otherwise unable to state whether they want to be euthanized.

Nevertheless, Euthanasia remains a criminal offense in the Netherlands in cases not meeting the review committee’s approval, as well as the law's specific conditions. There are exceptions with respect to several situations that are not subject to the restrictions of the law at all, because they are considered as being normal medical practices:

•            Stopping or not starting a medically useless treatment

•                At the patient's request stopping or not starting a treatment

•                Speeding up death as side-effect of treatment necessary for alleviating serious suffering

From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law essentially defined what had already been assumed as an unofficial law because of the outcomes of past judicial proceedings in Netherlands’s courts. In 2003, in the Netherlands 1626 cases were officially reported of euthanasia in the sense of a physician causing death (1.2 % of all deaths). Usually the sedative sodium thiopental is intravenously administered to induce a coma, and after making sure the patient is in a deep coma, typically after some minutes, a muscle relaxant is administered to stop the breathing and cause death. Officially reported were also 148 cases of PAS (0.1 % of all deaths), usually by drinking a strong barbiturate cocktail. During this procedure, there must be a doctor present for the two following reasons:

•                To make sure the potion is not taken by a different person, by accident (or, theoretically, for "unauthorized" suicide or perhaps even murder)

•                To monitor the process and be available to apply the combined procedure mentioned below, if necessary.

There is on Netherlands’ records, two cases where a doctor has been reprimanded for not being present while the patient drank the barbiturate cocktail. They did not realize that their attendance was mandatory. Forty-one cases were reported to combine the two procedures where in these cases a patient will drink the potion, but the poisonous cocktail does not cause death. After a few hours, or earlier in the case of vomiting, the muscle relaxant is administered to cause death.

I have cited very strong examples where Euthanasia has been practiced, and is being practiced without the horrors of where Nazi Germany applied the term "euthanasia" as a reference to the systematic killing of the populations’ disabled children and adults under the T-4 Euthanasia Program. The Netherlands in particular, is truly familiar with the atrocities inflicted by the Nazis during the Second World War. I, yet, have not been witness to reports of wanton murder and uncontrollable murder, and I am reasonably sure that this most civilized country is taking all precautions necessary for the prevention of such acts.

Canada has been experiencing legal challenges to the prohibition of Euthanasia, as well as PAS. In recent years, we have seen the cases of where, on January 28, 2005, Marcel Tremblay of Kanata, Ontario held a press conference to announce plans to kill himself, saying his life with pulmonary fibrosis was unbearable. After attending his own living wake, the 78-year-old man committed suicide. He had previously said he, “would be surrounded by his wife and adult children”, while he placed a bag over his head and filled it with helium. Tremblay said that he publicized his suicide plans to help change laws over assisted suicide. Tremblay’s lawyer stated that the police were satisfied that Tremblay had been of a sound mind, and that authorities would not intervene in Tremblay’s effort to end his own life. Canada decriminalized committing suicide, and the attempt to commit suicide in 1972.

In the early 1990s, 42-year-old Sue Rodriguez, who had Amyotrophic Lateral Sclerosis – known as ALS, or Lou Gehrig's disease, fought to overturn the law against all assisted suicide in Canada. Rodriguez lost her court battle, but she died by assisted suicide through the help of an anonymous doctor. Canada's Criminal Code makes assisted suicide illegal, but suicide legal. Persons found guilty are punishable with up to 14 years in prison. The case of Sue Rodriguez is a truly heartbreaking story. Through her documentary, I witnessed a propagandized power struggle between the powers of the political, religious, and uninformed, and Sue Rodriguez was a pawn in her struggle for a dignified death. I confess that my heart was completely shattered when she said these words while trying to take her medications; “I am so tired”. With respect, I too am vulnerable to the emotions that are involved with a person who wants to die. Nevertheless, do we need to be that weak; that repulsively beautiful; that strong and vulnerable at the same time, before our right to die with dignity, and with a free conscience is granted to us? I believe that I have answered that question.

To summarize further on the insolence with which, and how we view such an incredibly important issue, and how we accept the treatment of this issue by such industries as media, the recent death of Terri Schiavo, it would appear, was simply the flavour of the month with them. I regrettably must confess here, and I believe that it truly is through no fault of my own, that I had to use the Internet because I could not remember Terri Schiavo’s name. My reasons being, I became so disgusted with how American media was treating Schiavo’s plight, that the forced me into a position where I completely stopped watching television, and reading papers, magazines, or any internet news. I was disgusted at the abuse of her dignity.

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[1] This reference is to the use of Wikipedia, and their very informative article on the history of the death penalty. The article can be found at http://en.wikipedia.org/wiki/Capital_punishment.