Right To Die-Revisited
May 30th, 2007 | by Ken Grandlund |This week, Dr. Jack Kevorkian will be released from the Michigan prison he’s called home for the last eight years. Kevorkian, aka Dr. Death, was convicted of second-degree murder for prescribing lethal drugs and helping to administer them to a terminally ill patient.
Yet while most Americans say that there are circumstances when a patient should be allowed to die (68 percent say yes), the split over whether doctors should be involved is much narrower (48% yes, 44% no). And about 30% (or the approximate number of the religious right evangelical base) say doctors and nurses should do everything possible to save the life of a patient. Presumably, this is the Terri Schiavo contingency.
In light of the imminent release of Kevorkian, I offer for renewed conversation this post which I wrote back in 2005 and posted here first in December of 2006. I’d like to hear your thoughts…
The Right To Die
If there is one thing that we can count on in life it is that someday we will die. For most people, this is not a thought that is dwelt upon; it is simply a fact of existence. We know that someday, somehow, our life will come to an end. In most cases, the time and manner of our demise is not something which we can foretell, nor is it something that we spend a great deal of time thinking about. Rather, we go through our lives attempting to enjoy as many moments as we can without worrying about its ultimate end, assuming it is sometime far off in the future. Most of us yearn for a long, healthy life filled with unique experiences, or at least one with little strife. And we attempt to structure our lives so that they offer enjoyment and satisfaction not only for ourselves, but for our families as well.
The religions that guide humanity tend to teach us that life is sacred, something to be cherished and protected. These religious beliefs hold that life is a gift from God and it is only God that can determine when a life should end. For many religious individuals, the concept of taking ones own life is usually looked upon with great disdain, and the act of suicide promises eternal damnation in the ever after. There are no exceptions to this rule, no provisions for those whose quality of life has been degraded by health concerns or by circumstances that delete all happiness from life itself. (Readers may note that some forms of religion are currently encouraging suicide as a means of political expression, with their goal to take as many “infidels” to the grave with them as they can. I assert that the people who commit these types of suicidal acts are not doing so to relieve their own suffering, but rather are murderers.)
Despite modern advances in medical technology, there are people among us who’s lives become either too painful to continue living or that are, due to an unrecoverable illness, not worth waiting for the inevitable, at least in their estimation. Shouldn’t those individuals have the right to choose an end to their lives that would afford them the least amount of continued pain? According to the laws of society, the answer would be no. But does the prohibition against suicide, in all forms and under any circumstances, truly represent the values of a society based on the concepts of personal freedom and personal happiness? Does society even have the right to determine what constitutes happiness? Provided that the ending of ones own life does not also cause the end of another’s, what right has society to dictate when an illness renders life unlivable?
While it may be true that for cases of depression, suicide is often less a desire to end life than it is a cry for attention, for those suffering from a fatal illness, the desire to end life on ones own terms is often a well thought out decision to reduce the pain that their illness is causing themselves and their family. Society has the duty to respect these desires and to allow the suffering individual a legal option for ending their life, without punishing them or their survivors through punitive or criminal means. Society has the obligation to allow individuals, their families, and their physicians the option of bringing an end to their suffering in a way that is acceptable to them. With that in mind, laws prohibiting suicide for the terminally ill should be amended or abolished altogether.
Terminally ill people, should they decide to end their lives in order to spare themselves the increasing physical pain of illness or their families the mental pain of watching a loved one deteriorate before their eyes or their survivors the financial ruin often associated with the long term medical costs of prolonging a painful illness, should be allowed the option of ending their lives in a manner of their choosing, if they so decide. There should be counseling programs available that educate these folks on the least painful methods of ending their lives as well as offering ways to mitigate the anguish of their survivors. With the diagnosis of terminal illness, a person has many choices to make, and the fear of financial or legal retribution for themselves or their survivors if they decide to end their lives should not be among those that dictate what path they choose to take. This decision should rest with the affected person, their doctor, and their family.
Similarly, removal of legal restrictions regarding this kind of suicide would prevent the actions of disinterested parties (government) or non-nuclear family relatives from artificially prolonging the life of someone rendered incapable of making the final choice to end their life. Today’s Living Will provisions could be strengthened to include the circumstances whereby a person could assert the desires of a loved one to end life in cases of severe incapacitation, provided those directions were clearly set out prior to the cause of permanent injury, regardless of the religious prohibitions of other family members or the possible future medical remedies that may be years or decades away, if they ever appear at all.
Opponents of the concept of the right to die most often insert their religious doctrines into their reasoning for their objections. But just as often, opponents cite fears of suicide or euthanasia becoming just a means to rid society of the elderly and the infirm. They claim that terminally ill individuals will be pressured into prematurely ending their lives to spare their families the financial costs associated with long-term terminal care. However, due to the religious beliefs that are held by so many, the instances of this kind of practice would likely be only a small percentage of those suffering from terminal illness. Just as with other relaxations of so-called morality based legislation, the mere legalization of an act does not mean that many millions will choose this as a course to follow. In fact, Oregon’s Death with Dignity law (the nation’s first legal assisted suicide law) shows statistics of only 129 cases of this kind of suicide from 1998 to 2002.* Surely, many more than 129 people were diagnosed with terminal illness in Oregon in those years. The argument is hollow when the facts are revealed. Simply making this option available does not mean that it will become the preferred choice for those facing imminent death.
Suicide is never an easy decision, and in cases not related to terminal illness, society has the obligation to try and treat those whose suicidal thoughts stem from depression or temporary malcontent. But for those whose time has run out, or is running out, due to disease, properly crafted laws that allow them to choose death on their terms would go a long way towards ensuring that the right to die is included in the other “inalienable rights of life, liberty, and the pursuit of happiness.”
*updated information: through 2006 this number is 292.
[tag]Kevorkian, right+to+die, health, medicine, physician+assisted+suicide, terminal+illness[/tag]
19 Responses to “Right To Die-Revisited”
By SteveIL on May 30, 2007 | Reply
Ken Grandlund said:
Ken Grandlund said:
It’s obvious you don’t want to have the conversation with those that would have a different opinion or have a similar opinion but with a different political point of view.
By Paul Watson on May 30, 2007 | Reply
SteveIL,
And on the issue itself rather than the pointless insults? Do you have a view on whether patients should have the right to choose to end their own life?
By ken grandlund on May 30, 2007 | Reply
You couldn’t be more wrong SteveIL- I do want to hear the rationale from people on both sides of this. I may not agree them, but I am interested in people’s rationale. And besides, what is a debate but an exchange of ideas and a back and forth rebuttal of why one thinks their point is more logical?
By manapp99 on May 30, 2007 | Reply
It’s your life and you should be able to end it at anytime for any reason. In the event that you are unable to make the decision and have not made your prior wishes known, I think we are obligated to assume that you would want to have all measures taken to keep you alive. Having just spent two weeks watching my mom die (she passed May 5th) after having life support removed, I feel that my dad should have been able to make the decision to end her life on day 1 and not have to endure watching her die slowly. A little extra morphine would have done the trick.
By tammara on May 30, 2007 | Reply
uh ken, IL has no idea what a debate is. he just comes here to heap scorn and derision on us progressive patsy, pansy ass, american hating, islamofacist lovers. i thought you knew that.
By Paul Watson on May 30, 2007 | Reply
manapp,
I agree with you, but there is a serious ssue in how to protect those with dementia from being confused into signing something they don’t want to sign.
Also, are we going to force doctor’s to be involved because I know many doctors in the UK have issues about it. In the parts of Australia where this wa slegal, you had to be conscious because you administered the drug. The machine required you to press a button to inject. That sort of system would work.
The case of coma patients is difficult as, even if they have expressed a wish, who has to enact it? A doctor? Parent? Partner? Adult children? If the case has been made to turn off the life-support, I can’t think that adding enough morphine that there’s no possibility of them experiencing anything would be a bad thing, but again, some doctors may object strongly.
By Paul Merda on May 30, 2007 | Reply
manapp,
Sorry about your Mom…
Ken,
Agreed! After all we put our pets down when they are suffering terribly, why should we force people to live a miserable existence when they don’t really want to…
By tos on May 30, 2007 | Reply
Personally I believe if there is no hope for someone except for inevitable suffering then I believe that a person should be able to decide to end their own life. How to do it is another story. It’s a tough decision to make when actually faced with it for some people.
In the case of Terry Schiavo I do believe it was in her best interest not to continue her life as it was. Although if that were my daughter I cannot say what I would want to do. More than likely I would err on the side of ending her life. But to watch her starve to death had to tough on her parents whether she was aware or not she was still their child.
By tos on May 30, 2007 | Reply
Manapp- So sorry about your Mom.
By ken grandlund on May 30, 2007 | Reply
manapp- sorry for your recent loss.
Back when I initially wrote this piece (in 2005), this topic was more academic for me than not. But then in 2006, my father had his 5th open-heart surgery (he’s only 58) and designated me as his “pull the plug” guy. I had to understand his wishes as well as understand that it was my job to make those wishes reality if/when the time came. it almost did. as with every surgery he underwent, complications arose and his life was only saved by the skill and determination of his doctors and staff. but there was a real chance that I’d have to make the call to not extend life artificially according to his wishes.
however, turning off a machine when someone is brain dead is different than averting a prolonged suffering with a right to die ’suicide’, and as each case is different, I think that the option should be left to each individual and their family.
Oregon’s law does that, as well as having several checks- two physicians must agree that a patient is terminal and has 6 months or less to live; the patient must be mentally cognizant; and I think (but am not 100% sure) that the patient administers the drug cocktail themselves with a doctors prescription, or if physically unable to do so, has it done intravenously.
The right to die as one wishes is simply humane. It is the forced extension of life beyond the wishes of family and patient that is not right, IMO.
By manapp99 on May 30, 2007 | Reply
Paul, the pet analogy is the thing that came to mind with my mom. Even though the hospice lady assured us that she was not suffering, I would not have made my dog deal with the starvation and thirst that being removed from life support entailed. Everytime, until the last day, that we would wet her lips with the sponge she would clamp down on it desperate for water. When there is no hope for recovery and the decision to let someone die is made, the humane thing would to be a shot that ends then. As far as suicide goes, I am a believer in living the life that God gave me even when it gets rough. Others do not believe this way and I think it should be their choice. Clearly if the person attempting suicide is successful, it doesn’t matter what the law says. But if you are unsuccessful, they are going to put you away against your will.
Thanks for the condolences.
Paul, you are right about the slippery slope issue especially in the cases where the patient cannot or has not made clear their wishes. I think you would have to defer to the current way of keeping them alive. This would be a great reason for living wills. There will still be gray areas as there are in all things.
By tammara on May 30, 2007 | Reply
i’ve worked in hospice for years, and watched the way people die. i’ve spent much time at bedsides, including the bedsides of my beloved gramma and grampa. in many cases, just a little extra morphine would make the journey so much easier. the question is though, on who?
let me give my grampa for an example. whenit was clear that the stroke he had the last time had damaged so much of his brain he would not recover, the family decided to have the doctors shut off his pace maker. we decide this, because the docs told us, that with the pacemaker, he could continue indefinately, but would not ever recover. they said, given the condition of his heart, if we shut the pacemaker off, he would die with in minutes most likely, and within a couple of hours for sure.
well, papa roy had other ideas about that, as he had other ideas about everything else in his life. he held on for over 14 hours and dies within minutes of the same time that one of his grandsons had died, on the same day, years before. now…what that was about is hard to know. but having watched so many people through the end of life process, i believe it had a purpose to papa roy, even if we didn’t understand it.
my sister always wants to put humans out of their misery. but because of my counsel on this, she now understands that it is at least as much about putting people out of her misery, not theirs. people go through some of these changes as they die in what i call, getting right with their god. by this, i don’t mean that they are suffering because of things they have done- but that they are turning things around in their heads, no matter if we can see it or not, just getting it all straightened out.
some people have come back from this state, and they have spoken about what they did there, what they remembered about everything they had ever done, etc. to deprive them of this time to get the world right in their heads is not a good thing i think.
that having been said, i believe that they should not have to suffer- and that as medical professionals we should use what means we have to make them comfortable and ease this process.
and if someone is of sound mind and wants to do this to avoid the end of life situation, they should by all means be allowed to do that. there should not be a question about it.
man- i am sorry about the death of your momma. take good care of your dad through this time. men often don’t do as well as women do through this event. moms have always had to figure out how to get the food on the table and the house stuff done, and they usually figure out how to do, even after they lose their mates… but men… many times don’t recover that as quickly. lord knows in my family, we were forever grateful that papa roy was first to go, because he could not have lasted a day without gramma martha.
By tos on May 30, 2007 | Reply
Tammara-Very interesting prospectives. Thanks for enlightening us with your own experiences.
My family never had to endure these decisions as all my grandparents and my dad passed very quickly. I do however think my Dad would have been an exception to the rule as he was quite self sufficient being an officer in the Army for 22 years.
By Jersey McJones on May 30, 2007 | Reply
It is interesting to note that with many of these “Hot Button” issues (abortion, right to die, drug laws, homosexuality, etc), when they hit close to home, when they become personal, the “liberal” position is most often assumed.
JMJ
By Jet Netwal on May 30, 2007 | Reply
I understand where you’re coming from, Tammara. My mother-in-law contracted pneumonia in Jan of 2006. When it became clear that she would not recover, her husband followed her wishes and had the life support removed. He asked her if she was ready, and she nodded. She held on, amazingly, for more than a day. I believe with all my heart this was her choice. She had 10 children, and they scrambled to get there and see her. During the last night, some of her daughters stayed in her room and sang to her all night, every song they could think of, from her favorites to theirs. She slipped away on a sea of love.
What does this have to do with Ken’s post? I think there is no one answer. What’s critical is that all the options be respected. What is the way for one is not the way for another, and we need to let each follow their own path. Having an advanced health care directive/living will is so important to ensure you have a say when you no longer can.
By tammara on May 30, 2007 | Reply
lisa,
some men do just fine. most don’t. as today’s generation gets older, i think we will see a difference in this, because household tasks etc, while still being mostly “womens work” are shared more. i’m telling you, my grampa could not have boiled an egg.:) he could use a toaster. he went from his mother cooking for him to his wife doing same, and he never cooked a thing. when gramma had the babies, the neighbor ladies brought the casseroles and that was it. if she was ever sick and in the hospital, the kids came to stay and cook.
when end of life issues are up for decision, there are many of them. things such as iv fluids, suction, O2, morphine pain control, etc, will make the patient more comfortable. they will also prolong the process, especially the iv fluids. prolonging this period is really hard on family members, and good hospice care is very important here, as much for the family as for the patient. because they fear prolonging this time for themselves, they often chose to believe that if they with hold all of this, the person will die faster, thus suffer less. i don’t believe this.
i can remember sitting at many bedsides, with family members who did not know how to care for their dying. they gained a great measure of calm to see that i knew how to position their mom, suction their dad, adjust O2, check O sat levels, etc. as many as would learn, i taught, so they had a measure of power over the event and did not feel so helpless. a calm atmosphere of assurance and spiritual acceptance goes miles toward helping family cope.
i always cautioned them to speak as if their loved one could hear them, because hearing and smell are the last senses to leave. when they worried about pain or what their loved one was feeling, i talked to them about the idea that people need time, even if they knew they were dying to make it through this process. they need to get right in their heads. they have a big bucket of life experiences to sort through, and that takes time. the key is to keep the comfort at a level where they can do this work, though not snowing them to the point that they can not, and not allowing them to go to a point where it is nothing but pain.
the very last one who died with me, was not that long ago. about a year now. she was 23, and she died of metastasized colon cancer. she had two little boys, 5 and 3. they were both in the foster system as their dad was severely mentally ill.
amy held on for those boys as long as she could. she slipped into unconciousness more than once, and after a day or so, came back. doctors declared she would die within 24 hours, 3 times. yet she came back, all 3 times.
in one of those times, she called for her mother, who she had been separated from in foster care since she was 6. as an adult, she had always refused her mother’s attempts to reconcile. when amy was dying, her mother came to the hospital, but amy refused to see her. amy gave medical power of attorney to one of her son’s foster mothers, a woman i came to respect greatly.
we brought amy’s mother to the hospice home where we were caring for her, and they were able to reconcile. after that, amy drifted in and out of consciousness for several days. when she would wake, she asked for me to corn row her hair. she held on until i finished the front of it, over a series of several days.
then one night, i got a call from the hospice home, they said come now. i went, and amy was on the back porch. she had communicated to them, she wanted to be outside. they had lifted her into the wheel chair and put her on the porch. she held on even then, until both foster mothers for the boys, her mom, one of amy’s favorite foster mothers and i were all there.
when we were all with her on the porch, she hummed amazing grace very lowly, we could barely hear her. when the sun dropped below the mountain she was looking at, she squeezed my hand and she left.
many times before this time, we could have decided to end her life. i knew how to do it, the morphine was there. i didn’t do it, not because there was a law about it, but because i wanted to give her the time it took for her to be at peace with what she faced. i believe she found that peace and she was right with herself, and her god when she left.
what if i had taken the opportunity early on, when she was so close, to decide for her, and thereby taken from her the choice she made to reconcile with her mother. what if i had taken from her mother that same thing? this was a very difficult thing, for amy had good reason to be upset with her mother, and yet, even then, i knew that amy’s forgiveness of her mother was more about amy than it was about her mom.
her mom was difficult to work with, suspicious of case workers, state officials, etc. with reason. and when she showed up and tried to take power of attorney, i went to court and faced her down, and saw it was denied to her. she was disposed to hate me, but she came to love me, the same way amy did, and i her. i know why she did what she did, but my job was to see amy’s wishes proceed.
i know this is a long piece, but, this is a spiritual matter for me, and i long for the time when i can return to this work, to help the dying and their families find peace in the face of this loss- and i find that this is just another thing taken from me and who knows how many families, while i fight against the evil in our nation.
By tos on May 30, 2007 | Reply
Wow Tammara that was an amazing story. It’s important to people to keep their dignity and to go in peace with themselves.
Very important message you have there.
My husband did go through it with his mom and more recently his sister. Both of them had the entire family with them when they went. My niece played her guitar and sang for her mom and they all pretty much reminisced at her bedside for 3 days.
Unfortunately we are all going to die from something but to go in peace is more than one could want in the end.
By tammara on May 30, 2007 | Reply
although many people compare the situation with animals to that with humans i don’t.
here’s why.
no dog or cat is ever at odds with themselves, their people, their god. they don’t need the time to make it right. they were always right.
By Craig R. Harmon on May 30, 2007 | Reply
I tend to be strongly pro-autonomy, as long as that autonomy does no harm to others and that individuals face any consequences of their autonomous actions. I think people have as much a right to die as they have to defend their life. With that in mind, I have no problem with individuals choosing the time and manner of their death.