Saskatoon Skeptics had a pub meeting last night where this was one of the (grim) topics of discussion.
By and large, I’m for it, as were the other seven people at the Hose last night. I can’t (and didn’t) give much in the way of well-defined reasons why, but one of the gals last night was quite vocal about it. One of the guys made it his mission to grill her about every reason she suggested.
What it boiled down to was the need to let it be a legal choice, but maybe not a choice everyone would be “allowed” to make.
“Rights of the individual” came up as a reason to allow it (or as I sung it, “It’s my body, I’ll die if I want to!”), but not when the choice is going to be made by someone heavily depressed and suicidal, for example, who could potentially improve with pills. A bit of an argument went around over that idea – why can’t a mentally ill person have the choice to end mental anguish permanently while someone else may be allowed to end terminal physical pain? Her answer basically was because a mentally ill person wouldn’t be of “sound mind” during a decision making process of that nature.
I never thought to suggest it last night, but isn’t a person in tremendous pain going to be mentally incapacitated by the agony of going through that, too? They might not be “qualified” to be make life-ending decisions by that point either. But in the case of a terminal patient, maybe that winds up working in their favour as a reason to end life. Physical pain plus mental torment equals approved candidate?
Talk also went around about comatose patients. If the person can’t make the choice, what steps would need to be taken to allow the choice to be made by someone else? What methods are used to make sure a brain really is dead? Should someone who’s not brain dead but “locked in” and therefore incapable of telling anyone anything about their pain or state of mind also be in the hands of some other choice-maker? What if they don’t want to die?
What about terminally ill kids? Is it more tragic when a child faces the end? Who’s responsible for choosing then? Can a child even be given the choice and understand the impact of his or her own decision on the matter?
I suggested, somewhat off the cuff, that maybe something like “On the scale of 1 to 5, how do you feel today?” would be a start for determining someone’s need to go. One of the other gals piped up, “In that case, I’d be dead by the end of the week,” which got a few morbid chuckles.
All in all, it was a futile discussion. Eight people in a pub can’t change health policies overnight. All we could really do was talk about the issue and possibly decide to make our “Do Not Resuscitate”/end requests very clear in the form of a living will. Stipulate “no extraordinary means” in case of whatever crops up.
One of the guys brought up an interesting point regarding that, though – define extraordinary. While I personally hate the phrase “pushing the envelope,” medical science improves all the time with new techniques and machinery and methods of sustaining and prolonging life. Try this treatment, test that drug.. if the extraordinary is treated like the ordinary every day of the week, who’s going to put the foot down and say enough is enough, say your goodbyes and quit it?
I guess it’d have to be on a sliding scale. Can quality of life be assured or improved? Yes/no. Is there treatment available? Yes/no. Is it reliable and effective? Yes/no. Is there valid assurance and statistics indicating that little to no recovery from this ailment/accident is possible? Yes/no. And so on.
What about in cases like chemotherapy where it might help, but might only add a month or two, most of that time spent vomiting anyway? Death by cancer is completely gruesome (as evidenced by stories some of the people told about people they knew). Why not give those with severe forms the option to circumvent weeks or months of suffering?
We never really got into it, but who benefits from keeping a person alive past all point of improvement anyway? The family? The hospital that can bill them? From, say, a utilitarian standpoint, it should be morally distasteful to engage in that kind of forced existence. From a humanist standpoint, it should be equally distasteful. We’ll put a critically ill dog down because it’s a mercy and a kindness, but we won’t let a doctor help Mother go? Wouldn’t that be kind and merciful, too?
How much does this insistence that people can’t be allowed to go on their own terms have to do with religiously inspired morality (that suffering on earth is the only way to meet Jesus in heaven, as my dying aunt probably would have put it)? How much does it have to do with doctor stubbornness?
I don’t feel like thinking more about this now. You think about it and comment if you like. What’s your impression? What would you do if it was your life, or your parent or child? What about someone like my favourite author, Terry Pratchett, who’s dealing with the fact that he’s on the Alzheimer’s road and would like to get off while he’s still together enough to be rational and sound minded regarding that decision? Is there fear that someone could be very convincing and “trick” a person into giving up on life when there’s still weeks or months of nearly pain free living and time to really enjoy a few good meals and time with the family? Who really has the right to say “keep living” even when that life is like “a corpse, albeit one that moved ever so slightly from time to time,” as Sir Pratchett put it, regarding his father’s last days?
edit June 26/10 German court rules patients can decide to end life