This essay was given for the Biomedical Ethics Essay Competition 2010 organized by King Edward Literary Society (KELS)
By Farkhanda Qaiser
It was early spring. The birds were twittering on the brightly colored trees. A cool breeze was blowing at that ungodly hour of 5 in the morning. She’d suddenly woken up with a premonition that something was wrong. However the moment she stepped out in the garden, all her fears were dispelled.
“What could go wrong with such a beautifully perfect day?” She thought.
Alas, her optimism didn’t bear any fruit. While preparing breakfast for her two young sons, she suddenly collapsed.
All that she remembered after that was the wailing siren of the ambulance and the bustling activity of frightened people shouting at each other.
She had been diagnosed with Blood cancer. Doctors said that the cancer was in the last stages and she hadn’t long to live. She was still unconscious after the blood transfusion and so entirely dependent on the life support equipment for the numbered breaths of her life.
At this point, a crucial question arose. As there was no hope whatsoever of her living through this predicament, so should the life support be withdrawn from her to relieve her suffering?
The medical term used for this condition is Euthanasia which is the Greek for “good death.” To be more precise, it is the intentional killing by act or omission of a dependent human being for his or her alleged benefit. There is a great debate regarding this issue among the medical, legal, religious and political communities of the world. The huge media hype created around it always amused me because I felt that the verdict was very simple. Euthanasia should be banned once and for all because it was highly unethical to take someone else’s life for one reason or the other.
However once I started researching Euthanasia, I realized that the matter was not so straightforward. It was the perfect example of a labyrinth within a labyrinth.
To begin with, Euthanasia is classified according to different parameters like choice and method to kill.
According to choice, it may be voluntary or involuntary. Voluntary euthanasia a.k.a. Physician assisted suicide (PAS), as the name suggests, is when the person who is killed has requested to be killed. It’s legalized in Belgium, Netherlands, Albania and US states of Washington and Oregon.
The desire to die could be due to a number of reasons. The patient may feel that he’s a burden on his family either emotionally or financially or he could be pressurized to sign his own death will. Or worse still a doctor’s solemn pronouncement of him being a hopeless and incurable case may have catalyzed his decision. Should he be listened to?
Strong proponents of democracy would immediately nod, citing personal autonomy as the reason. They suggest that every person has the right to die and nobody can impinge on this fundamental right of life. How ironic! The opponents would cry. Which right are you protecting? The right of life or death? Which is more sanctimonious? And who would carry out the act? The doctor? The person in whose hands people so trustfully put their lives. Once he has been established as the taker of lives, how will the aggrieved patient go to him with hope of cure? The healer would now be the dealer of death. Moreover he’d be openly violating the “To please no one will I prescribe a deadly drug nor give advice which may cause his death…” clause of Hippocratic Oath that he’d taken at the start of his practice. And if he has dared to violate one clause, it wouldn’t be long before all others are stricken down one by one. Even thinking about the possibility sends a shiver down my spine.
However the next type is more macabre than the first one. It’s called involuntary euthanasia. In this case the person who’s given the death sentence is not in a mental or physical condition to give any opinion about the matter. He may be post traumatic comatose, a newborn with a severe spina bifida, or a terminal cancer case in severe distress due to pains. The decision is then made by the family members. Who could be better suited for this post? You might ask. And the pessimist that I am. I’d say who could be worse? The world has become so materialistic that son can kill father to gain his share of inheritance, husband can kill wife to acquire her property and every Cain can ruthlessly murder his brother Abel for ulterior motives. For the majority, money is the driving force. These money makers should not be appointed as the decision makers of such a sacred thing as life. What to do, in that case? Let life and death take their course at their appointed times. Do not try to be God. If a person is destined to die a painful death, then do not interfere with his fate. Maybe he has been given an opportunity to grow in wisdom, character and compassion. Life is not futile. It teaches its lessons at every step. And it’s said that suffering makes a person reach the highest and noblest points of what they are. So we have no right to take that away from anyone!
Neither can we take someone’s life by omission. i.e. by intentionally not providing the necessary and ordinary care, food and water. It also includes withholding of common treatments, such as antibiotics, necessary for the continuance of life. This classification of euthanasia is based on the method to kill which could be by omission or action.
Sometimes doctors plead the lack of public financial resources to refuse life support equipment or tube feeding for terminally ill patients. They solemnly declare that necessary medical procedures like x-rays, prescribed drugs or lab tests could cost ranging from $50,000 to $100, 000 and this huge sum could be used instead on other types of care, like prenatal, where it would save lives and improve long-term quality of life. Moreover, the already under staffed hospitals are over worked which affects the quality of care that they provide. So attending to dying patients is not the best use of medical staff. These patients should be assisted to a speedy and painless death. They further argue that such patients could be used for organ donation which is a very noble cause. In all my research, these are the only few arguments in favor of euthanasia which sound convincing. However, this could make the financially weak people more insecure and susceptible to mishandling by authorities. And this goes against the socially accepted fact that all human beings are to be valued, irrespective of age, sex, race, religion, social status or their potential for achievement. Moreover the slippery slope argument is valid here which states that if we allow something relatively harmless today, we may start a trend that results in something currently unthinkable becoming accepted.
The example of such a trend is the last type of euthanasia which is Active euthanasia. It is the use of lethal substances or forces to kill. It could be a lethal injection or euthanasia machines like Thanatron, mercitron or deliverance machines. They use diverse mechanisms to end life like pressing a button that release deadly chemicals or a mask fed with a canister of carbon monoxide or a notebook computer and software titled “Deliverance”, which asks the patient a series of questions, and automatically administers a lethal injection of barbiturates if the correct answers are made, respectively. Imagine if all of this were legalized! Hospitals and medical stores would become the devil’s shop full of such deadly instruments. Where would suffering humanity then go? They’d be led to believe that it’s better to be dead than sick or disabled. But that is not what hospitals and doctors are supposed to do! Instead they should provide intensive training in pain control, compassionate care and alleviation of fears. It is believed that the unbearable pain can be controlled to tolerable levels if given proper care from the hospital staff. In the words of Alison Davis, who suffers from spina bifida, hydrocephalus, and multiple other disabilities, May 30, 2009:
“In my experience, when the pain is bad, what I need is not to be told I’m burdensome and it’s my choice whether I want to live or die, and that perhaps I would be better off dead. What I need is to be surrounded by people who tell me, yes, my life does have value, and I’m not burdensome … they can’t take the pain away, but sometimes it’s not the pain that hurts the most, it’s the fear of being abandoned.”
Moreover the focus should be on finding a treatment for incurable diseases rather than disposing off the patients with such diseases. Visualize the impact the physician role models carrying out euthanasia would have on students and young health care professionals. Would we devote time to teaching students how to administer death through lethal injection or save lives? It would be very difficult to communicate a repugnance to killing in a context of legalized euthanasia.
Mercifully, this form of euthanasia is illegal in all countries of the world. But the debate is not just about the legality of euthanasia but also about its ethical viewpoint. If once the doctor has accepted the fact that he can end life, no amount of rules or regulations will protect the public and with that I rest my case.