fbpx

Euthanasia and physician assisted suicide – Part 1: Life in our own hands?

Note to readers: This commentary deals with a topic that not everyone will agree with, or even want to talk about. The subject of suicide is a sensitive one to most religions, and even the topic of death is taboo for most cultures. As such, we encourage readers to read this with an open mind - rather than simply accept or oppose these views, do discuss how you agree or disagree with them.

By Richard Woo

As Gary Hayden has asked in his column, "What makes life meaningful?", the question about the meaning of life is a deep and difficult one. Thus, not surprisingly, Bertrand Russell, touted as one of the greatest thinkers of the 20th century, found it difficult to answer. It was said, probably with tongue in cheek, that someone had tried to provide an answer at a philosophical level, and ended up in a psychiatric ward.

I concur fully with Gary’s comments that we are all unique. We face different problems and encounter different opportunities. We possess different talents and are motivated by different desires. We have different hopes and different fears. We have different histories and operate under different sets of circumstances. Our challenge, then, is not to find some abstract meaning of life, but rather to find specific goals and tasks which will bring a sense of meaning to our individual lives.

Hence, “What makes my life meaningful?” is a more meaningful question to ask than “What is the meaning of life?”. And the answer of course may differ from person to person.

But what is life? Can there be life without death? Pragmatically speaking, the answer is a resounding NO. Everyone has to die, sooner or later. However, to be able to die peacefully, with dignity and without pain or fuss, can be considered a life achievement.

Just as “What makes my life meaningful” is likely to have a diversity of answers, the question “Can I decide on the manner of my exit from this world?” is likely to evoke a variety of answers, and several articles published in the forum page of The Straits Times on 29 April and 1 May are proof that different people may think differently; where people are concerned, subjectivism cannot be ruled out.

However, a matter of personal perspective is not necessarily about a matter of fact or truth. An argument, on the other hand, must be decided on the basis of its being factual or non-factual, persuasive or unpersuasive, logical or illogical. Furthermore, any stalemate needs to be resolved, if necessary, through further arguments, but still on the basis of logic and/or facts. But where an argument can be resolved through logic and/or facts, we can expect logic and/or facts to prevail.

In certain matters there is no right or wrong, while in others questions of right or wrong may have to be decided, using our common sense plus the knowledge and experience we have acquired. We can’t be wrong in saying that morality is culturally rooted, thus what is right or wrong is what individuals or cultures agree on collectively at a particular time or place.

Judging from the forum page articles referred to above, two writers were evidently prompted by Dr Andy Ho’s article: "Better to die good death at home". If I am not wrong, four writers were apparently supportive that patients should be free to decide how they wish to end their days. One writer thinks that assisted suicide is a slippery slope; a downside of permitting assisted suicide is that, according to research, “many elderly people seeking assistance to end their lives in Switzerland suffered not from terminal illnesses but chronic and other non-life-threatening conditions.” Another writer thinks “while the right to life is a human right, the ‘right to die’ is not.

According to a website on assisted suicide and assuming the information given is up to date, there are only four places in the world where assisted suicide has been formally codified as legal:

  1. Oregon (since l997, physician-assisted suicide only)
  2. Switzerland (1941, physician and non-physician assisted suicide only)
  3. Belgium (2002, permits 'euthanasia' but does not define the method)
  4. Netherlands (voluntary euthanasia and physician-assisted suicide lawful since April 2002 but permitted by the courts since l984).

There are also countries where euthanasia (voluntary euthanasia, active euthanasia or passive euthanasia) has been allegedly made legal or being allowed, although this list may not be representative of the actual situation today:

  1. Albania
  2. Andalusia
  3. Belgium
  4. Colombia
  5. Finland
  6. India
  7. Ireland
  8. Luxembourg
  9. Mexico
  10. Netherlands
  11. Norway
  12. Sweden
  13. Thailand
  14. US (States of Oregon, Washington, Montana and Vermont)

Whether Dr Andy Ho has since changed his mind concerning the right to die, he once wrote: “My self-autonomy does not imply an absolute authority to decide my own life,” in an article concerning euthanasia and/or suicide. As a counter to Dr Ho’s position, in the context of this comment, and to the writer who thinks that the right to die is not a human right, I would say: This is of course subjective. Others may think differently. Others may hold that the right to life comes with a tacit understanding that one has to die sooner or later, and with the right to die in a manner and at a time of one’s choosing, and with assistance of medical technology, if necessary, to make the exit as peaceful and hassle-free as possible.

Some people (and I am one of them) dread living to a stage where their mentality becomes impaired - through dementia or Alzheimer’s disease, for instance. When a person is at this stage they would not be aware of the problems they may be causing to others. Some of us now alive today may find ourselves going through a state of anxiety and anguish before making our final exit. If continuing to live means enduring or suffering pain or anguish, physically and/or mentally, must life continue on its natural course and, if so, on what grounds?

Sometimes it can be hard to die, even if you want to. “Let death come like a thief at night” seems an innocuous enough advice but let’s not forget that death may be a long time away or that waiting for the thief can be a very distressing or harrowing experience. People who talk of palliative care often forget or omit to mention the financial cost involved. If money is not an issue — for example, employing domestic maids or nurses to provide full-time nursing care — then it may be a non-issue.

The situation can, however, be problematic if money and manpower resources are areas of contention. It is easy to talk from the sidelines about caring and so forth, but one really needs to evaluate who else suffers along with patients who are, say, in a vegetative state, and the financial aspect that may add damage to the state of being of their family members. When we talk about suffering we cannot exclude mental anguish. What if the patient is without the financial means to employ, say, a full-time nurse or domestic maid but has two young children and a spouse who is now the sole bread winner and the spouse’s income is at a level that any talk of engaging a full-time nurse or domestic maid is out of the question? Would the government arrange all the essential care for such a patient at its own cost? If the answer is No, should the patient be left to rot to death?

To live is to risk having downsides, although one can always hope for the best. Looking at our surroundings, with all kinds of suffering and setbacks affecting the human condition, we can say that life is risky, and thus to be born is to risk experiencing its downsides. Undoubtedly, one can even start life with a severe downside, for example, being born blind or with some other serious, physical or mental handicap. And one can also end this life with another severe downside, by being counted among the goats rather than the sheep on Judgement Day, as indicated in Jesus’ preaching expounded in the New Testament. If you are unlucky you may encounter more downsides than upsides. If we take poverty as a downside and wealth as an upside, and we can’t be wrong in assuming such a hypothesis, then it is true to say that in this world there are far more downsides than upsides.

We all have to live by our choices or decisions. Sometimes, and for some people, there are no other options, and living the kind of life they were born with and have been experiencing since early childhood is the only option available.