Hannah's+Letter

media type="file" key="hannaha-wesleysmith-euthanasia.mp3"

Dear Mr. Smith, You raised some interesting and understandable points in your articles, "Million Dollar Missed Opportunity" and your blog post to us; however I must ultimately disagree with you. Perhaps though before I become so presumptuous as to attempt to refute your claims, I should introduce myself: I am a senior at Foothill Tech and next year I hope to go into Pre-Med at a UC, which I am sure will scare you given my view points, of course I suppose opposition is always frightening. Thank you for working with us on this project, your responses added a new level to my thinking and changed my mind about a few points. In the condition of the terminally ill, I believe active euthanasia is morally right and the doctor's duty if, and only if the doctor has that patient's express consent. Of course other restrictions may be imposed, using the Netherlands’s system, as in "Listening and Helping to Die: The Dutch Way" by Pieter Admiraal, as a model. Euthanasia has been legal in the Netherlands since 1973 and in all this time there has been no “slippery slope” or patients being euthanized against their will. I believe the United States could benefit by modeling some of their criteria such as: a waiting period, a consistent wish of the patient to die, a review of the patients care to make sure that all the care that could be given was provided and counseling was given, review under a board made up of the attending doctor, a nurse, a chaplain, a palliative care specialist and I would add: a spiritual advisor, a bioethicist, a family member and the head of the hospital or unit. Also I would include the necessity of a living will that expresses the desire to not be resuscitated and passive euthanasia through the removal of a respirator or feeding tube. In the case of a patient on a respirator they may decline further treatment and express the desire to be taken off but patients with terminal illnesses have no way to achieve dignity without breaking the law. It seems a sorry state to force people to exist in when they are already suffering greatly. We have no moral qualms about euthanizing animals that have no quality of life so why should humans be denied the choice. Granted there are several key differences between the two species, not the least of which are opposable thumbs but shouldn’t our morals be influenced by how we treat our pets? I think there is something wrong if we will kill them without consent but call it murder when a human begs for the same consideration. As Admiraal acknowledges from experience, many patients who are offered the option of euthanasia do not actually follow through. Merely having the option of an escape as their condition progresses creates enough peace of mind to allow the patient to live out their final days with dignity. This act of mercy protects patients from the distress that often accompanies terminal illnesses by eliminating it or easing it. Sometimes society needs to shoulder the burden of doing things we aren’t quite comfortable with and doing it for other people because it is what is best for them. Admiraal defines the euthanasia as “sometimes morally right, as not only compatible with the properly understood duties and responsibilities of a doctor, but as an act sometime //required// by them.” I believe while life should be valued, it should not be forced as a punishment on someone who has no chance of recovery. I would like to be very clear. This does not to extend to people who are just tired of living as with depression and the mental illnesses that can be relieved with medication or therapy. I believe everyone should be given a chance to life and that euthanasia should never be applied to babies unless the parents and hospital agree their quality of life would be next to nothing or the surgery required to rectify their condition would be painful for the infant and has a small chance of success. Just a few examples are babies who are born with debilitating genetic illnesses who would survive just a few weeks and in pain, I think these babies shouldn’t have to suffer through that, they should know life as a kind place full of mercy and not have to learn the hard truth of pain and suffering. However most of all, I believe each case is up to the individual and their healthcare provider. It is unfair for society to impose its insecurities on everyone else in an effort to ignore what bothers us most as a society, death. We are so scared of death because it is inevitable and yet we do not know what happens after. We should support those who are ready to move on in hopes that it will be less painful than this life instead of ostracizing them and denying them the basic right of autonomy. The solution to chronic conditions such as multiple sclerosis is a shade grayer to me however I believe the same options should exist for them. These poor people have been dealt an unfortunate hand and so should be given the option of active euthanasia. This is not out of a disregard for their life but rather out of respect for them as human beings. It is an act of compassion, of mercy. To see a human suffering and to do their best to end that suffering is a doctor’s duty. I understand the official Catholic opinion of “rejecting a culture of death” which they believe is created by active euthanasia however I believe euthanasia allows the patient to die with the memory of how glorious life was instead of the sluggish drudgery of inescapable pain. The Archbishop explains that everyone has a duty towards God to live their life, which is the basis of all good. When someone asks for euthanasia the Catholic Church believes they are really calling out for love and help and if these deficits are ended so will the person's desire to be euthanized. While they believe that “nothing and no one can in any way permit the killing of an innocent human being…” I believe that that innocent human being has a right to decide for themselves whether their life is ended before more suffering of after. Furthermore an act of mercy should not be treated as a crime against humanity. Life should be preserved at all cost but we shouldn’t lose sight of the person within by being blinded by the idea of life. While the Catholic Church allows the use of painkillers and claim that the pain of most illnesses can be relieved by this medication, many illnesses would require doses of morphine great enough as to actually kill the patient or at least bring death closer. For them to believe that active euthanasia and assisted suicides are against God’s will is naïve and arrogant, I think. Who are we to say that we know God’s will? Maybe it would be for them to live until the illness shuts down their body but it could be for a person to act with compassion and end the suffering. I am inclined to believe in the latter, and a merciful God. The most complicated issue of this debate is regarding handicapped euthanasia. While ultimately the choice resides with the individual, I do not think doctors should be required to participate in the euthanasia of these individuals, however assisted suicide should be made legal. Many of the people in this condition who have a wish to die will not be stopped by the legality. In the instance of Ramon Sanpedro, he spent 20 years fighting the law, trying to make it legal for him to die without others being persecuted for wanting peace for their friend. Alas the law prevented Sanpedro from being with loved ones as he died from potassium cyanide poisoning. Many attempting to reach the same fate would be forced to resort to more painful and messy methods such as driving wheelchairs down stairs, biting their tongues or other measures that have no dignity at all. Many may argue that quadriplegics and other such victims of accidents that limit their body should just wait, that they will rise out of their depression. That is something we cannot know. Some may, others like Sanpedro cannot, despite trying to take up hobbies like painting. People who have lived a life full of passion and vibrancy should be encouraged to wait and apply that passion to another aspect of their life but it should not be expected. Some people cannot rise above these accidents and they shouldn’t be expected to. It’s their own life and they should have the ultimate control as they have done nothing to forfeit their control. By disallowing them to make their own decisions society is regarding them as unable to make their own choices which I see as even more of a moral slippery slope. I think as a society we tend to be so afraid of death that we prize life above all else even if it is being lived in a brain dead state like Terri Schiavo. Many people fought to have her body kept alive even as she had no thoughts or emotions as proved by her autopsy when her brain was pretty much non-existent. Instead of forcing her body to stay alive, the doctors and courts should have respected her husband’s wishes and allowed her body to go to rest as her mind already had. After such a traumatic event, her family needed some closure rather than this prolonged agony and false hope they had to endure for 15 years. While we should never give up on a patient that has hope and wishes to keep fighting, in cases such as these where there is no quality of life or no mental state at all, it is a kinder mercy just to let them go. It is an act of love to let those who want move on. Chris Hill is an example of one who lived life to the fullest until it was taken away. While I wish he could have lived a life like that as a paraplegic, I have no right to expect that of him. Only he could know what he was truly feeling and in his case I believe he felt that he had done all he wanted to do and wanted to die remembering that. Hill should have been given the support in taking the next step instead of being forced to do it alone and probably scared. His decision was not a rash one. In his article “The Note” Hill states his reasons ranging from an “utter lack of happiness” to being in extreme pain and always being scared of losing more feeling to refusing to be a physical and financial burden on his friends. Chris Hill felt that there was no other reward the world could offer to him and so he decided to die. Maybe he was right, maybe not. However it was his own choice and he deserved at least that much. I personally believe it was a noble choice, tragic but noble because he died the way he wanted to and on his own terms. Hill’s dealings with the medical community and legal system led him to the belief “that the legislature’s and the medical profession’s attitude of life at any cost was an inhuman presumption that amounted to arrogance.” At what point are we going to prize quality of life over the actual life its self. I believe that each person assigns their own value to their own life and once a person decides, while of their right mind, that their life has no more value I think we, as a society, should respect their wishes instead of forcing them to live an unhappy life. Terminal illness or paralysis is an obstacles and can be overcome with spirit but in other ways is cannot be overcome and those might be the ways that matter most to some people. Allowing assisted suicide for people with paralysis is better for the patient and their families. Since it is illegal now, the family could be persecuted for helping or having knowledge of the victim’s suicide, if it were to become legal, the family would be able to be involved in the whole process and allowed to understand their reasons for choosing death. This would allow the family time to come to terms with the death instead of a regular suicide where it is felt like a person is ripped away and there is no closure. Allowing assisted suicide for quadriplegics is the kinder and more humane thing, for the family and the victim. In the case of paraplegia, the patients could still qualify for assisted suicide but I think there should be a longer waiting period. This could widen the field of gray but since those with use of their upper body would have more independence the likelihood of them being able to live more fulfilling lives is higher. In the article “Right to Life of Handicapped”, Alison Davis claims that allowing euthanasia for people who are severely handicapped would lead to the systematic killing of people who are not completely healthy and eventually those who are “too old to be considered “useful””. As a long time advocate of rights for those suffering from handicaps, Davis was born with spinal bifida and is grateful that her parents decided to let her live when many believed she would have no quality of life. I admire her strength and passion for life which she recounts in tales of her adventures and travels. She also elabotes on her opinion that if euthanasia is legal for those suffering from handicaps then society is lowering the value of their lives. I can see how she would think that but as a society that prizes life so much that they refuse euthanasia and active suicide to those suffering greatly, I find that hard to believe. I think this is a major exaggeration although her points could have a basis if our system of government allowed one person to have absolute control and the power did not lie with the people. It is easy to imagine a scenario where euthanasia goes so far as to target those with disabilities but that is very unlikely as long a certain safeguards are put in place such as the ones mentioned by Peter Admiraal. As long as the law states that the patient must have informed consent under penalty of convicted murder for the doctor performing the euthanasia, I think there is a very small chance of this extreme occurring. Right now even to have minor surgeries, there are several levels of consent and hospitals have their own lawyers to make sure no ones right are being infringed upon. In addition I think it is insulting to compare euthanasia with Hitler’s Nazi Germany. There are several key differences in these examples, first and most importantly, active euthanasia would be given only with consent and if certain safeguards and criteria were met. However because of the extreme gray area of this instance, I think that doctors should not be required to perform active euthanasia on their qualifying patients, at least at first. It is up to doctors to do the hard stuff for the best of their patients. The Hippocratic Oath states “First do no harm” but what if a little harm is necessary to stop more harm from coming to the patient? Sometimes doctors have to do the ugly things, make the hard choices, like who gets to be on transplant lists, which patient to treat first in an accident scene. That is their job, to do the things that common people can. Perhaps we give them too much power but if the government, run by the people, control consent then the power of death is not vested in one group of people. Theoreticals are difficult to deal in but sometimes necessary to understand the whole picture. As we move into a more advanced society, we have the knowledge necessary to move forward in our thinking of pain vs. life. Yet these concepts could easily lead down the wrong path so discussions like this are important to viewing the whole picture and all sides so thank you for writing to us and enriching our knowledge of euthanasia.

Sincerely, Hannah Alday