Freedom and Euthanasia!

Freedom and Euthanasia!

“Freedom? What do you mean by that?” said the person I was discussing my situation with.

“There are lots of definitions of freedom but what I mean by that word is that I want the freedom to choose to die if and when my life becomes no more than a pain filled burden.”

“But you only have Parkinson’s and that is not a killer in itself it is just a progressive brain disorder.”

“How dare you dismiss Parkinson’s as being just a progressive brain disorder? I have witnessed just how having Parkinson’s can affect some people as it progresses. For example, losing the power of speech, having to be fed by a tube in the stomach and double incontinence and that is not a life I want.”

“So you think you should have the right to choose to leave this world when it suits you? There are people who are in a great deal of pain themselves yet say all life is precious. How do you answer that?”

“I have no argument with their belief but just because they feel that way does not give them the right to dictate to me that I must live by their ideas of what is right and what is not. Besides, many of those same people would euthanize a pet as an act of kindness if it was suffering yet they would condemn another human being to live beyond what is reasonable to expect a person to suffer.”

“Yes, but these days there is such good palliative care there is no need for you to be concerned about your future level of pain. It can all be kept under control.”

“Oh so you think palliative care does away with the need for euthanasia? Who are you trying to kid? First off, one has to have access to that care and if it is in the form of a Hospice, they are charity funded, so they are few and far between.”

“There are hospitals.”

“Yes, indeed there are, like the Stafford hospital which hit the headlines sometime ago where patients were drinking water from flower vases. Care in that hospital saw patients dying of malnutrition and dehydration.”

“Yes, but surely euthanasia undermines the motivation to provide good care for the dying and good pain relief.”

“Euthanasia could not be used as an excuse for the lack of motivation to provide good palliative care in the Stafford hospital. They lacked the motivation to give good quality care for many reasons none of which involved euthanasia.”

“Okay, so what about the historical argument that voluntary euthanasia is the start of a slippery slope that leads to involuntary euthanasia such as that used by the Nazis. You can’t ignore that.”

“Nor would I want to. Euthanasia does not rid the world of evil people. There will always be people who subvert ideas for their own purposes and what the law says will, in any case, be irrelevant to those people.”

“Well I don’t think you will be able to dismiss the religious argument so easily. The religious argument says euthanasia is against the word and will of God.”

“But whose God? There are many religions and none of them seem to agree on anything so for them to agree on this one issue I find a difficult concept to believe in. Moreover, what if the patient is not religious; must he or she have other peoples’ religious views forced on them?”

“Okay, so you discount the religious argument but what about the non religious argument that says suffering has value?”

“I think that is a ridiculous thing to say.”

“Nevertheless, the non religious argument holds to the view that suffering provides an opportunity to grow in wisdom, character and compassion.”

“My answer to that is that I don’t see how a person who is in dreadful pain is gaining wisdom and character by the experience. I also think the person suffering is the one in need of compassion and we ask too much if we expect that they should be the one to give it.”

“Now that brings me nicely to my next point. How can any one know the level of someone else’s suffering as we are told it isn’t easy to define suffering?”

“That is not an argument against euthanasia for precisely the reason that one person’s pain threshold may be different to another so the force of that argument seems to point in favour of euthanasia because how can an outside person say you must bear your pain because I do not think it is sufficient to warrant euthanasia?”

“So what is it that you are asking for?”

“Well, I can tell you what I am not asking for and that is to be allowed to die by means of passive euthanasia if that is what you think?”

“Can you explain what you mean by passive euthanasia?”

“Well, as I understand it, it is the act of hastening the death of a terminally-ill patient by altering some form of support and letting nature take its course. Passive euthanasia can involve turning off respirators, halting medications, discontinuing food and water so the patient dies through dehydration or starvation. I can’t imagine a worse way to go. How can anyone think that is a kindness? To starve someone to death or have them die of thirst…no, there has to be a better way and there is.”

“So what is it you are advocating?”

“Active euthanasia! For myself I want nothing less. In my opinion it is the most humane way of ending a terminally ill pain filled life. Why for example can we not follow a common veterinary procedure whereby an animal is given an injection to send it to sleep before it is given the fatal dose? That would be the most humane way as far as I can see. Moreover, I have witnessed the pain free way an animal exits this world. If that seems cowardly then okay I am a coward. I can live, or rather, die by that.”

“So, really, if I have understood you correctly, there is little difference between what you are asking for and assisted suicide, am I right?”

“Some people might say that what I am asking for is assisted suicide and maybe in a way I am because even if a person is not terminally ill but they are in intolerable pain then yes, I think they should be helped to die if that is what they want. However, what I am advocating is active euthanasia as opposed to passive euthanasia.”

“You’ll have to explain the distinction to me as I am not quite clear what you mean.”

“Okay, I’ll try. There are people who make a moral distinction between active and passive euthanasia because they think it is acceptable to withhold treatment and allow a patient to die, but that it is never acceptable to kill a patient by a deliberate act.

However, there is a body of opinion that holds to the opposite view and thinks this distinction is nonsense, since stopping treatment is a deliberate act, and so is deciding not to carry out a particular treatment.

If it will help, I will attempt to illustrate the reasons why I think active euthanasia is preferable to passive by using as an example, two people both of whom are in dreadful pain and dying of cancer and their pain has gone beyond the stage where it can be alleviated. With the first case, in consultation with the patient and his family the doctor agrees to withdraw all treatment and the person is no longer fed or watered. That is the passive method of euthanasia but it takes that patient several days to die through dehydration and malnutrition and all the while their pain is unrelenting.”

“I’m with you so far.”

“Now let us look at the other person in this example who is suffering the same level of pain. However, this person is fortunate because his doctor reaches agreement with the patient and the patient’s family that as the person is going to die anyway it would be more humane if the doctor, like the vet, gave an injection to put that person to sleep and then followed this by administering a fatal dose. That person’s pain stops immediately. Tell me who has received the greater kindness? One person had their suffering prolonged because of a decision not to act but the other person’s suffering stopped immediately because the doctor gave assistance.”

“Yes, but did both doctors stay within the law?”

“There is a distinction between active and passive euthanasia which is thought to be crucial and that is that it is acceptable to withhold treatment so that a patient is allowed to die but that it is not acceptable to take direct action in order to kill the patient. However, my argument is that it is not a true kindness just to withhold treatment as it may take the patient longer to die and if his reason for wanting to die is the level of pain he is experiencing then far from being merciful it is adding to his suffering.”

“So what is it you are suggesting?”

“What I am suggesting is that if he was given a lethal injection his suffering would end immediately. The process of being allowed to die can be slow and painful whereas a lethal injection is quick and painless. I know which I would prefer. It is all very well for moralists to say any killing is wrong but I just wonder if they would sing the same song if it was one of them who was suffering.”

“Well I saw a programme some time ago in which Professor Colin Pillinger, who was the lead investigator dealing with the Beagle mission to Mars, who himself is an MS sufferer, said in that programme that we should be talking about how to live, not how to die. He also said that we should look to Sir Terry Pratchett and the way he has spoken about Alzheimer’s.”

“I’m glad you mentioned that because I saw an interview with Sir Terry whereby he stated quite categorically that he thought he should be allowed to be given a lethal injection by his GP when the time is right and preferably when sitting in his garden with a brandy. He also said ‘I am a writer and I want to write my own end.’ In fact, Sir Terry is a patron of Dignity in Dying.”

“So how would you sum up your position in all of this?”

“I would just say having the right to choose when and how I die from this progressive condition secure in the knowledge that I would have ultimate control over the moment when my life becomes intolerable would enhance my ability to enjoy the life I still have. I believe that the will to live is so strong that one would have to be absolutely desperate and in intolerable pain for a person to take the decision that they want to die. The process of being allowed to die can be relatively slow and painful whereas a lethal injection is quick and painless. For me, the most important and humane thing is not to prolong suffering. It is much better for the patient if his agony is swiftly brought to an end by the intervention of a doctor. Given the choice, I would choose active over passive euthanasia every time.”

“Well some people argue that a doctor’s role is to preserve life not take it. What would you say to that?”

“My answer to that would be that I see the doctor’s role as being one of alleviating, not prolonging, suffering.”

“Okay, you have answered all my questions and it is obvious to me that you fully understand what you are asking me to do. Therefore, I can accede to your request and I will schedule your first injection for tomorrow morning and the lethal injection will be administered two hours later. If you will just sign this form then we can proceed as you wish. It is fortunate that the law was changed in 2015 giving you the ultimate freedom of choosing when and how you will die.”

End