Assisted-Suicide:  For or against?

  Thesis

     It was a sunny, but cold November morning, when lying in his hospital room doctors informed him he had inoperable, incurable cancer.  Along with the grim diagnosis came a prognosis of two to three months to live.  He not wishing to die in the hospital, had the family arrange for a hospital bed to be set-up in the living room of his house and bring him home to die.  Oxygen was brought in for emergency usage and a potty-chair was set-up next to his bed.  Within 5 weeks of bringing him home, he could no longer walk, talk or eat.  This fun loving, sensitive man, dazed and confused and ravaged by a disease that no longer allowed him to enjoy food and the company of loved ones, laid in a hospital bed waiting for nature to take it’s ugly course.  One-and a half weeks later, Jimmie slipped away.  A skeleton of the man he once was.

     Just six months earlier, his niece had to make the agonizing decision to put down her beloved dog, Brandi.  It was clear that Brandi’s organs were failing and in order to spare her pet the pain and suffering of dying a slow, painful death, she placed Brandi in her car and drove her to the veterinary hospital.  The vet calmly explained that euthanizing Brandi was the right decision, and that surely she wouldn’t want Brandi to suffer needlessly.  So, with only the pinch of a needle, Brandi was gone in less than 5 minutes.  A peaceful and humane end.
     “To die at one’s own hand, or to allow a disease to ravage the body until it is so diminished it ceases to continue is a topic being discussed with family and doctors all over the world.  This topic is so controversial that it often creates an undue rift between family members, the dying individual, God and state.  Why is the idea of assisted suicide such a hard topic to deal with?  After all, we feel compassion and love in order to aid our beloved pet to a peaceful death when they no longer have a viable, sustainable life.  Therefore, why is it necessary to subject a loved one to the brutality of a disease when a viable life no longer exists and death is certain?

     A known death is certain, and hastening of a known death is a far cry from an actual death by suicide.  Certain death simply means that death is impending; a matter of time.  This certain impending death is a death that no amount of medical or emotional intervention can stop.  And, to hasten a death is merely speeding up the already known ending.  On the other hand, suicide is a death yes, but a death brought about due to impulse and despair.  A death that medical and emotional intervention could have prevented had the person reached out for help.” (Lombard, Sept. 2009, p.2-3). 

     Dr. Peter Brindley wrote in the Journal of Palliative Care of the last 18 months of his mother’s life.  As a doctor he was under an obligation to follow medical and ethical rules, but as a son watching a loved one become “mute, immobile, incontinent, frequently scared and bereft of dignity”, he was powerless to do anything about it (p. 1).  Even with the medication aiding symptom control with tranquilizers and painkillers, these same medications brought on an agitated delirium.  “In addition, pain control became a constant battle, a source of intense distress that hijacked” the (his) grieving process (Brindley, p. 2).  There were the times inadequate doses of medication were given and the home-care personnel were not allowed to stop, change or administer a different dosage.  Her life became months of a vegetative existence and excruciating pain that destroyed the memories of her loved ones and went against her very wishes to die a dignified death.

     It was Dr. Brindley’s and this writer’s belief that assisted suicide could be regulated to allow for a merciful death in extreme cases, where the patient becomes merely a shell of a no longer living being.  But unlike Dr. Brindley and this writer, many doctors, religious groups, families, government etc., continue to view assisted suicide as a murder.  They believe that the advances in palliative care are sufficient to aid patients in their final months and days.  And to some degree, that is factual.

Anti-Thesis

     While the writer strongly favors assisted-death, it is only in extreme cases when there is no hope for recovery.  However, that being said, there are documented cases of people living well past their original prognosis.  If they were to have chosen death, they would have missed out on many good years of living.

     David Williams was 35 years old when he was diagnosed with a tumor of the spine.  His pain was excruciating and he was bed-ridden.  He was given the prognosis of only 6 weeks to live.  But David had a young family and was determined to do whatever it took to stay alive.  He was admitted to the Hospice program and after just a few short weeks of treatment he began to improve.

     When David first received his death sentence, he considered assisted suicide, even discussing it with his wife, however, in the end he chose to forge ahead.  Eleven years of remission followed.  Had David decided to end his life when he received the grim prognosis, he would not have been around to see his children grow-up and he wouldn’t have been able to help his children through the loss of their mother who died of cancer 10 years after David’s initial diagnosis.  He says, “ If they changed the law to allow assisted suicide, I think a lot of people would press the button to early or other people would want them to” (Wightwick, p. 10).

     Other people wanting them to die is exactly what happened in the case of Barbara Wagner of Eugene Oregon. (Oregon is one of three states, which have laws allowing assisted suicide).  Wagner was diagnosed with terminal cancer.  She was prescribed an expensive cancer medicine called Tarceva to help with the symptoms.  The state refused to pay for this life prolonging medication, but sent a letter to her saying they would be happy to help with palliative care, or physician assisted dying (Mitchell, 2009, p.5).  Ms. Wagner did not want to die, but the state appeared to push her in that direction.

     In another instance, a woman who suffered memory problems was “shopped” from doctor to doctor by her daughter (described by a psychologist as “coercive”) who demanded her mother had a “right” to assisted suicide.  She ultimately found a physician who approved” (Toffler p. 10).  Still other cases of patients with early stages of MS, AIDS and other slow-moving diseases, as well as depression, were assisted in suicide when they still had many viable years of life to live.

     The examples above are cases where the ulterior motives of others and some patients themselves outweighed the price of human life.  In the instance of the state, money was the factor that caused their refusal to fund the drug for Ms. Wagner.  In the case of the daughter, it appears she didn’t want to be bothered with a mother who was losing her memory.  And, in the last cases, patients simply didn’t want to live knowing the pain they will suffer as time went on.  Thus, the theory is that the numbers of cases like these will only rise if legislation is passed legalizing assisted-suicide.

     Because of people’s perception of the pain they will experience as their disease progresses, there have been numerous writings explaining the gains in medication therapy as a way to offset any thoughts to speeding up the death process by assisted suicide.  In an article written by Liora Finlay, she states that there “has been considerable advancements in palliative care and the extreme suffering of yester year no longer exists today”  She continues by saying, “effective pain relief actually prolongs life by ensuring that patients do not die from the exhaustion of uncontrollable pain” (Finlay, 2009, p.1840-41).

Synthesis

     While Ms. Finlay’s report of improved palliative care is wonderful news, the fact that the medication administered in order to ease the pain, renders the patient in a confused, delirious and most times, unconscious state.  Jimmie spent the balance of his life hooked up to a machine that continuously released potent medication, but left him scared and confused.  And, when he did sleep, which was often, it was not a peaceful sleep, but one filled with agitation.  His body kicked and flailed uncontrollably.  Yes, the medication aided his pain, but produced side effects that were difficult for him to endure and painful for the family to watch.

     As stated previously, his niece euthanized her dog when it was realized the end was near.  It was peaceful and humane.  While the pain of losing a beloved pet or a loved one is unavoidable, it is comforting to know that they are no longer suffering.

     People whom are against assisted-suicide are often the same people whom view the death penalty in a favorable light.  And, this writer would like to know why we would put someone to death who should be made to rot behind steel bars, but would not consider ending the life of a loved one who is suffering beyond understanding.  It is plain selfishness.

     Susan Wolfe advocated against assisted suicide for many years, but that was before watching her father battle years with metastatic head and neck cancer.  Her father begged the family to help him die, and while they finally granted removal of his feeding tube, they could not allow themselves to grant his wish of assisted-suicide (Wolfe, p.2).

     As a result, Susan came to a new understanding of assisted-suicide.  But there are many who never spent a day watching a loved one die a slow death.  And others who only aide the loved one by offering reasons why the loved one should continue to fight-the-fight.  While there are those who will never understand assisted-suicide for the terminally ill, there was one man who believed a person should have the right to chose death over suffering the pain of terminal illness.

Dr. Jack Kevorkian.

     There are many who consider Kevorkian a murderer, but John Kjellstrand believed he was a medical hero.  In the 1996 British Medical Journal, Kjellstrand said:

He was a man of action rather than thought and lives by a personal code of honour that admits of his qualification.  His responses are usually instinctive, predictable, and inevitable.   He accepts challenge and sometimes even courts disaster” (Vol. 312, p. 1434).

     “Throughout the years of his assisted deaths, Kevorkian campaigned loudly of the importance to allow a person the right-to-die with dignity.  He explained his reason for helping others was not to help them die, but to end their suffering.  He believed what he did was humane, and continued in his quest to end others suffering until 1998 when he was arrested and charged for murder (Lombard, Nov. 2009).  As of 1998, Kevorkian had assisted in over 130 deaths (Brody, p. 953).

     This writer understands Kevorkian’s concern for a patient’s end suffering, but only believes “assisted-suicide is a last resort method when a person no longer has any ability to live without the aid of machines and large doses of medication.  Once again, when a beloved pet becomes ill and death is knocking, humans show love and compassion by having a lethal dose of medication administered allowing the animal too quietly and comfortably drift in to a forever sleep.  Therefore, the writer asks, why can we not afford our human loved ones the same type of peaceful death? (Lombard, Sept. 2009).

     “Unnecessary measures to keep someone alive, who is near the end and is basically a shell of the person who once lived is not only ludicrous, but damaging for the living family member’s future memories.  After all, when a person who may have suffered severe damage due to an automobile accident is determined by medical staff to be brain dead, a decision is made by the doctor and family to “pull-the-plug.”  Thus, in a sense, assisted-suicide would be pulling the plug on a life that is merely being kept alive to die.

     In conclusion, assisted-suicide is the wrong name for this practice.  It should be assisted-death, because suicide is something that can be prevented.  However, for a terminally ill person with only months to live, death is certain and looming.  And, to maintain a life that is no longer capable of living is inhumane.  Therefore, assisted-death should be viewed as not a killing; not as murder; but as aiding someone who has made the choice on their terms to die; to peacefully drift to sleep forever.  A sleep where they no longer feel pain; where they no longer are hooked up to machines; where they no longer worry about how their life-sustaining care will affect their families financially after they are gone; and, where they no longer worry about when, and how the end will come.  But most importantly above all the rest, a sleep where they no longer live with a horrible, mind and body destroying terminal illness” (Lombard, Nov. 2009).

References

Brindley, P.G. (2008). “Good Grief:  What is a son-and a Doctor-to Do?  Journal of Palliative  

     Care: Vol. 24, Iss 2; p. 117-119.

Brody, H., Kjellstrand, J.  (1999). Kevorkian and assisted death in the United States:  The  

     ethical debate drags on but fuels efforts to improve end-of-life care. British Medical Journal  

     (International edition).  Vol. 318, p. 953.

Finlay, I. (2009). The art of medicine: Dying and choosing. The Lancet, 373(9678), 1840-1841. 

     Retrieved online November 14, 2009, from Proquest.

Lombard, T. (2009). Ashford University ENG .  Assisted-Suicide:  No, I mean Assisted-death.

     September, 2009, p. 1-9.

Mitchell, C. (2009). THE INDIGNITY OF 'DEATH WITH DIGNITY'. Ethics &  

     Medicine, 25(1), 5-6.  Retrieved online November 15, 2009, from Proquest.

Toffler, W. L. USA Today: Oregon law strips dignity. July, 2009 p. 10.  Retrieved online          

     May 30, 2010 from Proquest.

Wightwick, A. Wales on Sunday:  David Williams. May 2010, p. 10.  Retrieved online

     May 30, 2010 from Proquest.

        Wolf, S. (2008). Confronting Physician-Assisted Suicide and Euthanasia: My Father's

             Death. The Hastings Center Report, 38(5), 23-6.  Retrieved online May 30, 2010 from               

            Proquest.