Many people support the right of a terminally ill patient to die-but
what if the right became an obligation? And what of the potential for
abuse by impatient heirs?
Should dying patients have the legal right to order their doctors not
to start or continue medical treatment? Should doctors be protected from
prosecution if they shorten a patient's life expectancy with pain
killing drugs?
Most of us would answer yes to both questions. But does that mean that
we need a "right to die" law? Or is there more to the issue then first
meets the eye?
Public discussion of the treatment of dying patients often confuses two separate issues. First is the right of a terminally ill person to be allowed to die without being subjected to invasive medical procedures. Second is the question of whether a dying person should also have the right to hasten his own death, and require the help of doctors and nurses to do so.
It is often overlooked that patients have the right to refuse any
treatment. a doctor who treats a patient against his wishes can be
charged with assault. It would be wise to educate people as to their
right to refuse treatment. There is no need to try to convert this well
established legal principle into legislation.
Regardless of the intentions of "right to die" or "aid in dying" laws,
they could very easily open the door to active euthanasia.
In the present climate of opinion, it is easy to imagine a doctor giving
a lethal dose of a pain killing drug and then claiming that death was
the best way to eliminate the pain. If the doctor who also show that
the patient requested the lethal dosage (quite possible the form you
filled out giving permission for him to give treatment), the court might
well interpret the law in the doctor's favor.
Many people do not find the prospect of legal voluntary active
euthanasia alarming. But two things should make us think.
First, as soon-to-be-published Canadian study will show, most health
care professionals who work with the dying endorse the patients right to
refuse medical treatment, but oppose legalizing active euthanasia. The
professionals recognize that if pain is controlled, as it can be in
virtually all cases, very few terminally ill people ask to be put to
death. Second, experience in Holland tells us that voluntary euthanasia
can quickly become involuntary euthanasisa.
Holland is widely regarded as one of the world's more civilized
countries . Active Euthanasia is illegal there, but for the past decade
the government has not prosecuted doctors who report having assisted
their patients to commit suiside.
A recent Dutch government investigation of euthanasia has come up with
some disturbing findings. In 1990, 1030 Dutch patients were killed
without their consent. And of 22500 deaths due to withdrawal of life
support, 63% (14175 patients) were denied medical treatment without
their consent. 12% (1701 patients) were mentally competent but were not
consulted.
These finding were widely published before the Nov. 1991 referendum in
Washington State, and contributed to the defeat of the proposition to
legalize lethal injections and assisted suiside.
The dutch experience seems to demonstrate that the "right to die" can
soon turn into an obligation. This concept could be dangerous, and you
could find yourself the victim if euthanasia becomes legal in the
USA.
We have all heard, and some of us have experienced moving stories of
elderly people in great pain, unable to perform even the most basic
human functions, who have asked to die, or have perhaps brought about
their own deaths.
What these stories overlook is that today, in almost all cases, it is
possible to kill pain without killing the patient. When someone's pain
is relieved, that person usually wants to go on living. We need to
reflect carefully on the consequences of legalizing active Euthanasia.
If we enshrine the absolute right to die, will it then become illegal to
intervene to obstruct would-be-suisides? Will pharmacists be obligated
to sell a lethal dose of hemlock to anyone who is temporarily
depressed?
We need to think of the potential for abuse if Euthanasia becomes legal.
What if someone stands to inherit $1 million when Aunt Jeane dies? Might
the heir not find it tempting to nudge her in the direction of accepting
lethal injection? Or if she didn't get the hint, to make her miserable
enough to want it.?
If voluntary euthanasia is made legal for "persons of sound mind" there
will inevitably be tremendous pressure to provide it for those who
"would request it if they were able to"- the mentally ill or the
handicapped, the senile, etc. etc.
Finally, despite genuine compassion for the suffering of dying people,
does there not also lurk in the hearts a less admirable motive? Few
people are so tasteless as to link euthanasia and health care costs in
the same breath, but there is a widespread view that medical care for
the elderly costs more than we can afford. These finachial pressures
will multiply in the coming years as our population ages.
Many elderly people are already responding to this message by declaring
their willingness to die when their lives are no longer productive.
Their reluctance to be a finachial burden on the young is admirable, but
the long term consequences could be brutal.
What will happen to the trust that people still feel toward their
doctors if the USA follows Holland? What emotion will elderly or
seriously ill patients feel when the nurse approaches them with a full
syringe? How soundly will they sleep in the hospital.
The alternative to legalized Euthanasia is not extraordinary, futile treatment to hopelessly dying patients. The alternatives are the appropriate medical care-including 1) the withdrawal of treatment upon request and 2) dispensing drugs as necessary to control pain. No doctors, laws, or organizations oppose ceasing care when the time to die has arrived.
Each of us can talk to our loved ones openly about these subjects. Talk to your doctor, and if you are not comfortable with his or her approach, change doctors. Find out about palliative care and hospice programs in your community. These emphasize care and comfort for the dying. Support their growth, as this will reduce the attractiveness of mercy killings. Keep informed about the issue of Euthanasia and make your views known to politicians and the media. Your actions can help shape the way you and your family will be treated in your last days.