Death With Dignity and the Right to Die

Dr. Richard Wesley, who has ALS, has
been prescribed assisted-death drugs

Euthanasia. Is there actually a considerable opposition to it, or is it just one of those taboo things that we don’t want to talk about? It’s high time we advanced the concept from conversation into the legislative arena.

There are several phrases used when discussing the concept of how a person wants to end their life with some semblance of control and/or dignity. Euthanasia is the clinical term. Some people shy away from it, thinking it sounds cold or sinister. “Death with dignity”, “dignity in dying”, “right to die” all refer to the right of a human being to end their life on their own terms, with some level of control and dignity.

Occasionally you’ll hear “assisted suicide” or “assisted dying”. When these terms are used, it always means “physician assisted…”. The two concepts differ slightly. Assisted Dying is when a physician adminsters care or suspends care that ends the life of a patient. This is often in the case where the patient has clearly expressed their wishes to die at a certain point and are physically unable to take the steps to end their life.

Assisted Suicide is what Jack Kevorkian practiced. The name Jack Kevorkian triggers a response from many people. Some respect what he did, and some consider him to be some kind of demon. After a series of videotaped interviews and counselling sessions in which the patient’s sincere desire to die and competence in making that decision was clearly established, Dr. Kevorkian would employ a device that he created called the Thanatron, which allowed his patients to die quickly and with minimal pain. Dr. Kevorkian would set up the device and leave. At a time of the patient’s choosing, they would press a button and the device would automatically administer three drugs commonly used in most lethal injection protocols. If you ever have an opportunity to watch the HBO Films docudrama “You Don’t Know Jack”, I highly recommend watching it. You will get a very clear understanding of what Dr. Kevorkian did and why.

Many proponents of euthanasia have a personal experience that they cite as their epiphanic moment. For example:

I myself witnessed a loved one with terminal brain cancer waste away and linger for far, far longer than could be considered to be humane or compassionate. Our family unanimously resolved that that would not be our experience.

Archbishop Desmond Tutu completely changed his mind on euthanasia and dying with dignity after personally witnessing Nelson Mandela’s prolonged death. He commented, “What was done to Madiba (Nelson Mandela) was disgraceful. … My friend was no longer himself. It was an affront to Madiba’s dignity.” Realizing that he himself was closer to the end of his life than the beginning, Tutu added, “I have spent my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying.”

Sir Patrick Stewart changed his views on assisted suicide after his friend Gillian Pinder took her own life after suffering in the terminal stages of cancer.

Michael Nugent of Right to Die Ireland talks about the peace and increased quality of life his wife found after making her end-of-life plans when she was diagnosed with cancer.

For some, the epiphany is an even more personal one. In 2007, Sir Terry Pratchett announced that he had been diagnosed with early-onset Alzheimer’s. In 2010 he delivered a lecture called “Shaking Hands With Death”, with the assistance of his friend and actor Tony Robinson (you may know him as Baldric from Black Adder). That lecture is given here:

Kim Teske, of Canada, recently starved herself to death in order to exercise her control over her end of life care. She had been diagnosed with Huntington’s Disease, a degenerative disorder that combines aspects of Alzheimer’s, Parkinson’s and schizophrenia. A fearsome combination, to be sure. Canada (with the exception of Quebec now) has no law permitting euthanasia. However, suicide is legal in Canada. Kim tried her best to put a brave face on her choice to end her life over the 12 days that it took, but anyone who has witnessed a death by starvation can tell you that there is little dignity in it. It is not painless and it is not compassionate, as your body begins to consume itself, brain function decreases rapidly and organs and systems shut down to the point of complete system failure.

One commonly heard objection to euthanasia is the danger of the slippery slope, often proffered by religious opponents to the concept. Their fear is that if you give an inch on assisted dying, the next thing you know maniacal doctors and death panels hell-bent on killing will begin hunting people down and terminating patients’ lives prematurely to feed a lucrative trade in human organs and to reduce costs on the health care system and a whole host of other evil things, turning “Right to Die” into “Duty to Die”. The problem with this slippery slope is, we have not seen this kind of thing happen in countries who implement right to die legislation. The reason why is that there are restrictions and safeguards put in place with these legislations that prevent that kind of abuse.

Another objection that is often heard is that euthanasia devalues human life. This is one of my favourites. The example that I use to refute this objection changes from time to time, as there are often recent cases that I can use to update the illustration. The one I’m using at the moment is of the Texas mother, Marlise Munoz, who died while pregnant. She was found unconscious around Christmas time by her husband at 14 weeks pregnant and was rushed to the hospital. She happened to die in the hospital. The definition of death is no brain activity. She was, by all definitions, a corpse. The hospital put her on life support, citing Texas law at the time that life-saving treatment must be administered in the case of a pregnant patient, in an attempt to “save” the fetus. This law meant that machines would force Marlise’s dead body to attempt to carry the fetus to term, from Christmas until some time in May. Marlise’s family knew her wishes regarding life support were very clear – she didn’t want her life prolonged by a machine. Thus, the law that prevented her from exercising her legally established right to die essentially turned Marlise into a bag of meat, animated by machines, a support mechanism for a developing fetus. I cannot be convinced that that doesn’t devalue Marlise’s life. Eventually, a Texas judge ruled that the legal concept of bodily autonomy meant that the fetus has no right to the mother’s body and Marlise was taken off life support, but not after her own wishes were completely ignored and all dignity had been stripped from Marlise’s end of life.

I would argue instead that the ability of one to exercise control of one’s death is an indication of how precious life is, that our instinct is to seek to preserve a certain sacredness around it, rather than surrender to nature’s often undignified course. Richard Branson summed it up best when he said “An assisted dying law would not result in more people dying, but in fewer people suffering

When we euthanize a pet, it’s always out of compassion or sympathy. It’s a consideration for their own well-being and quality of life. Through sympathy we know they don’t want to suffer. Through empathy we wouldn’t want them to suffer at the end of their life. The simple nobility of living things compels us to euthanize as a loving, noble, compassionate, appropriate and dignified thing to do.

It seems to me that we exhibit a deeper consideration for our pets than we do for our human loved ones. Why do we have this apparent contradiction regarding euthanasia? Why would we treat our pets with a sympathy and consideration to their own well-being that we don’t afford ourselves? Or another way to consider it is, Why would we deny ourselves the same compassionate and sympathetic end-of-life care that we so readily give to our pets?

Consider making a Living Will. Also called a “physician’s directive” or “advanced care directive”, your Living Will can speak for you when you cannot speak for yourself. It is a legal document that will dispel any ambiguities about your wishes in an end-of-life scenario and will avert any protracted arguments over your wishes.

Talk with loved ones about your position on euthanasia and other things like organ donation. In the absence of a Living Will, the more people who clearly understand your wishes the better, again to avoid the “pull the plug” arguments from occuring. Talk with them not only so that they understand your wishes, but that you clearly understand theirs as well.

Is it reasonable to expect that one day the right to choose to control one’s own death when that death is clearly imminent and inevitable might be recognized as a human right? I don’t know, but I certainly hope so.

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