It’s Time to Pull the Plug ~ Part I

In the struggle to gain equal footing across the spectrum, a number of people are working for the right to put an end to the suffering of terminal patients. As with any topic deemed “controversial”, the discussions regarding euthanasia (also known as assisted suicide) are all over spectrum. Euthanasia has been getting some attention recently in several countries as laws regarding it’s legality are being brought to vote. Why? Well, there is a lot of momentum growing in cases involving personal choice and personal freedom. People are seeking the right to govern what they can or can’t do with their own bodies. The result is an emotional debate. Let’s back up a bit though and see what exactly all the fuss is about.

To better understand, a defined explanation is needed to put everyone on the same ground. Euthanasia is the termination of a life either by lethal injection, overdose, or withdrawal of life support or medications. There are four types of euthanasia:

  • Physician-Assisted: a doctor provides a prescription to bring on a patient’s death. Generally the patient carries out the act him/herself.
  • Non-Voluntary: approved by the patient but performed by someone else
  • Voluntary: patient refuses life-support, medication, or simply overdoses.
  • Involuntary: patient is unaware or cannot give consent, and is usually by way of terminal sedation. Patient is usually just given a much higher dose of pain medication (often through IV) so that s/he may pass while sleeping.

Currently, some form of euthanasia is legal in four countries (Belgium, Luxembourg, Nederlands, and Switzerland), and four states in the U.S. (Montana, Oregon, Washington, and Vermont). There are differences here in how that legality works though. For example, in the U.S., in order to be legally protected in the states that have legalised it, you must be residents of those states. However, in Switzerland there is no residency requirements. They have what they refer to as “suicide tourists,” or people who visit the country simply to end their lives with the aid of a doctor.

For those who seek out an attempted suicide, most are suffering from a serious, painful or debilitating illness or disease. Often it’s Parkinson’s, Multiple Sclerosis, Lou Gehrig’s Disease, Cerebral Palsy, Cancer and even extreme cases of Dementia are all given for reasons to choose what many consider to be a more peaceful and pain-free exit. Because statistics vary, to understand just how many are in support of this decision, we look to Dr. Ezekiel Emanuel, an American bio ethicist of The Hastings Center (a research institute in the U.S.).
“The best way to understand public opinion might be the ‘Rule of Thirds.’ “The Rule of Thirds” is as follows:

  • Roughly 1/3 of Americans seem to support voluntary active euthanasia no matter what.
  • Approximately 1/3 support for euthanasia in extreme cases.
  • This leaves 1/3 who strictly oppose no matter what the situation or the patient.

Now, we have to keep in mind that Dr. Emanuel is an American. However, it stands to reason that the same could be said every where. The only difference is in how the decision for lawmaking happens. In the States, for example often in these types of decisions the laws are made in protest by people using faith as a driving force. In other, more secular-driven countries (the aforementioned Switzerland, for one) religion doesn’t even come into the picture.

Those in support of assisted suicide have several reasons for it, however the four most common are as follows:

  • Choice: choice is a fundamental principle, and every person should have the right to decide what happens with their own body, while still of sound mind to do so
  • Quality of Life: The pain and suffering a person feels during a disease, even with pain relievers, can be incomprehensible to a person who has not gone through it. Even without considering the physical pain, it is often difficult for patients to overcome the emotional pain of losing their independence.
  • Opinion of Witnesses: Those who witness others die are generally “particularly convinced” that the law should be changed to allow assisted death.
  • Economic costs and human resources: Today in many countries there is a shortage of hospital space. Medical personnel and hospital beds could be used for people whose lives could be saved instead of continuing the lives of those who want to die. It is a burden to keep people alive past the point they can contribute to society, especially if the resources used could be spent on a curable ailment.

On the side Stephen Hawkingof pro-assisted suicide are such allies like Stephen Hawking, well-known physicist and cosmologist who suffers from Motor Neuron Disease. Reports show, however that when he was put into a coma he had stated that he did not want to be taken off life support. He simply feels that everyone should have the option to choose for themselves.
Okay, that’s practically a given though, right? Although not true of every atheist, it’s certainly common enough within the atheist community that people should have full autonomy with their bodies. So how about a supporter from the other end of the “faith” spectrum. Hans Kueng
Hans Kung, a Swiss Catholic priest (you read that correctly, Catholic). A theologian who is suffering from Parkinson’s disease (the illness brought more into mainstream spotlight by Michael J. Fox). Due to his more liberal views on several topics including euthanasia, he isn’t even allowed to minister any more and has actually been stripped of his “robes” within the church. He holds the position Patrick Stewart 1of President for the Global Ethic Foundation.

Okay, just for fun we’ll fill out the trifecta with someone everyone knows. Patrick Stewart, actor and activist who, although personally fit and healthy himself also agrees that everyone should have the right to end their own life if unable to live without some form of life support.
Those who oppose euthanasia feel pretty strongly about their reasons why as well, although those on the opposing side tend to feel like they aren’t valid enough to warrant laws against such practices. The most popular reasons include:

  • Professional role: Critics argue that voluntary euthanasia could unduly compromise the professional roles of health care employees, especially doctors. Often citing the Hippocratic Oath, which in its ancient form excluded euthanasia: “To please no one will I prescribe a deadly drug nor give advice which may cause his death..”
  • Moral/Theological: Some who oppose (often Christians) claim morality as a reason to create laws against the practice.┬áConsidering it to be a type of murder and/or suicide, both of which are considered mortal sins.
  • Necessity: Hoping for the possibility of a cure or solution in the near future.What happens if a person’s life is ended and sometime within what would have been part of that patient’s remaining time alive, something is discovered that could have saved him/her?
  • Feasibility of implementation: Euthanasia can only be considered “voluntary” if a patient is mentally competent to make the decision. Does the patient actually understand what is at stake and the finality of “pulling the plug.”
  • Consent under pressure: Was the patient talked into the decision, or was guilt used to talk him/her into it, with impending concerns of hospital bills or long-term care?

There is also the argument of the slippery slope. Where does the line get drawn? There are some who feel that allowing assisted death will lead to allowances for any excuse to “pull the plug”, whether on a loved on or oneself. For example, is clinical depression enough? Not for the opposition it’s not. Their view is that a depressed person, no matter just how bad it is will one day feel better (whether by medication or counseling).

As I bring this to the end, I want the reader to consider a couple of questions. As laws are made and boundaries are set across the globe, there are decisions that need to be made. Generally speaking, the number of people who have some sort of living will (or a “do not resuscitate” order) is very low (thought to be about 15%). I make sure to have at least one on file in whatever state I happen to live in, with my orders clearly stated, but it took me going into my first and only surgery to actually think about it. They are generally free to file and can be kept at whatever hospital is closest (or really any at all), but make sure you give copies to closest family members. So, I am going to leave these questions. Feel free to comment with your thoughts, feelings, or views on this topic.

  • Have you thought about having anything like a DNR order set in place?
  • Would you ever consider euthanasia for yourself?
  • Would you ask someone you loved or do it yourself?
  • If asked, could you assist in the euthanasia of someone you loved?
  • What if your own freedom was at risk?
  • Do you think it should be legal?

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Organisations for Euthanasia/Assisted Suicide:

Compassion and Choices – United States
Death With Dignity – United States
Dignitas – Switzerland
Compassion in Dying – United Kingdom
EXIT – Scotland
Final Exit – United States

Organisations against Euthanasia/Assisted Suicide:

Care NOT Killing – United Kingdom
Euthanasia Prevention Coalition – Canada
United States Conference of Catholic Bishops – United States

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