My wife and I have a pact that if we make it to our 90’s we are going to eat chocolate ice cream three times a day. Such reckless consumption of saturated fats would be quite tasty, even if it hastened our ultimate deaths. It’s a way of trivializing and coping with the stress of a more grave concern – that one day we might have so much pain, disability, incontinence, and dementia that admonitions like eating healthy seem petty and absurd. Plan B, for when the ice cream comes up in a bilious storm of vomit and nausea, is too upsetting to contemplate – yet people are forced to heroically consider it somewhere in the world, each day.
Yesterday the controversy surrounding euthanasia for the terminally ill was thrust into the spotlight after reports that a famous orchestra conductor and his wife ended their lives together.
Sir Edward Downs, past conductor of the BBC Philharmonic Orchestra and of the Royal Opera House in London, and his wife Joan, a choreographer and ballerina suffering from terminal cancer, both ingested a lethal dose of sedative medications and died peacefully alongside one another after 54 years of marriage.
From the New York Times:
The couple’s children said… that last week they accompanied their father, 85, and their mother, Joan, 74, on the flight to Zurich, where the Swiss group Dignitas helped arrange the suicides. On Friday, the children said, they watched, weeping, as their parents drank “a small quantity of clear liquid” before lying down on adjacent beds, holding hands.
“Within a couple of minutes they were asleep, and died within 10 minutes,” Caractacus Downes, the couple’s 41-year-old son, said in the interview after his return to Britain. “They wanted to be next to each other when they died.” He added, “It is a very civilized way to end your life, and I don’t understand why the legal position in this country doesn’t allow it.”
There are several layers of controversy in this matter. The most obvious is the notion of assisted suicide for the terminally ill. Should a person suffering from an incurable illness be allowed to end their life? Washington State voters approved a “Death with Dignity” referendum in November, 2008 by a 58 to 41% margin, becoming only the second state in addition to Oregon to allow physician-assisted suicide for the terminally ill. A majority of American’s responded “Yes” in a 2005 Gallup poll, although the specific wording of the question impacted opinions.
From Gallup:
Gallup’s latest annual survey on values and beliefs suggests that 75% of Americans support euthanasia — allowing a doctor to take the life of a patient who is suffering from an incurable disease and wants to die. But the survey also finds that a much smaller proportion of Americans, 58%, support doctor-assisted suicide for patients in the same condition.
The apparent conflict in values appears to be a consequence of mentioning, or not mentioning, the word “suicide.” When asked if doctors should be allowed to end the life of a patient who is suffering from an incurable disease and wants to die, 75% of Americans say “yes.” But when asked if doctors should be allowed to help a patient commit suicide under the same circumstances, only 58% of Americans say “yes.”
By way of contrast, a 1998 Michigan voter referendum called “Proposal B to legalize physician-assisted suicide” failed by a vote of 29% to 71%.
Britain does not allow assisted-suicide or euthanasia, regardless of which term for the process might be less offending. Yet more than 100 people from Britain have traveled to Switzerland to end their suffering since a recent change in the law. A more contentious issue, and one that is being investigated by Scotland Yard, is that Sir Downes was not diagnosed with a terminal illness. His family stated that he had become “almost blind and increasingly deaf,” and that “after 54 happy years together, they decided to end their own lives rather than continue to struggle with serious health problems.”
Most of the commenters on the NYT article were generally supportive of the couple’s decision, citing the devotion, love, and compassion that such an end displayed. Others called the act cowardly. Should any of our opinions really matter in the decisions of others, and how much of a say should government be allowed in our most private of life experiences?
Should humans be allowed to end their own lives in cases of suffering? What about in cases of extreme devotion? I’m not talking about the ancient servants of the kings and pharaohs who were killed to serve their masters in the afterlife. I’m talking about Romeo and Juliet, had they lived out 54 years of partnership.
Unfortunately it seems there are controversies surrounding the company Dignitas, which has been accused by a former employee of being motivated by profits and responsible for some botched events. Their financial books are closed to the public and Dignitas has not opened them upon prior requests. While I’m sure legal costs and the high risks involved in such an enterprise add up, it would seem that financial transparency would remove this understandable suspicion among critics. Dignitas reportedly charges about $6,500, which I think is less than or comparable to for-profit funeral homes (which no one seems to get too angry about).
This issue is very interesting because it echoes the abortion/choice conundrum in many ethical, political, semantic, and religious ways. The debate over euthanasia has raged through the human centuries, and despite some growing acceptance recently, political tolerance still lags greatly behind the conventional wisdom of classical antiquity.
One can only eat chocolate ice cream three times a day for so long. We all know there is a time to let go, to die with some grace and dignity left intact, and some final peace achieved. I’ve seen that moment at the bedside of patients and of family, and it hurts like nothing else. Should we be allowed to extend a helping hand to others, or is it only an overstepping push?
Are we the masters of our own ultimate destinies?
I know this is a very hot topic. I can only say that when my dog began suffering terribly from cancer, I promised him he would not suffer like that one more night, not one more it was so bad. I’ll never forget his pleading eyes begging me to help him. All I could do was give him benadryl to try to sedate him some, and get him through the night. (The vet on call wouldn’t see him until morning.) When I saw what a peaceful passing he had in my arms, as our vet assisted him, I told Fireguy that I wish they could do that for me when it’s my time.
I think physician-assisted suicide is even more clear cut than abortion. With abortion it’s arguably a separate person whose life is ended. Suicide? Not so much.
It seems a terrible affront to the dignity of a person if he needs governmental permission to end his life — ditto for getting help from a physician. That’s should be a personal decision, government be damned.
However, I feel quite differently about euthanasia, though I’m not sure if it’s intellectually honest. It just feels “wrong” for someone else to kill someone, despite the patient’s request. Maybe it’s because I fear a slippery slope?
Awfully thought-provoking post, Doc — thanks.
Some time ago there was a story about someone who was young, attractive, active, diagnosed with some eventually terminal disease that would have resulted in loss of that beautiful appearance, so he decided to kill himself, and did so that he would make an attractive corpse.
Humans are strange.
It seems that it’s pretty simple when you are only talking about very old people with tragic deseases and disabilities who are in pain and want assistance with ending their lives. It seems a bit more complicated when you start throwing in the rest of humanity…What about the dying person’s loved one who just does not want to go on without them or the kid who doesn’t want to die ugly…what about the profoundly developmentally delayed who are then diagnosed with a painful and life limiting disease? It’s issues like these that make most Americans want to back away from the debate. Unfortunately the debate has trickled down to the pet area. I took my 14 year old arthritic, incontinent bassett hound to the vet and the man refused to put him down because he felt that the conditions could be tolerated and believes all life is to be appreciated. Sometimes insanity reigns supreme. I think that when we stop focusing on the request person by person we lose begin to deal with a world of oppinions. Like Chrysalis, I would like to have the choice to end my life when it becomes obvious that the river is flowing there. What I fear will happen is that my doctor will be so concerned about not causing my death that he will with hold adequate comfort measures. It probably doesn’t happen often, but I have seen it and recently.
We could take a look at events in Holland, where some believe a “right to die” is slowly leading to a “duty to die”.
To off oneself when terminal is one thing– someone else, another thing entirely.
I see you left a comment at the page about Dr. Stone that I cited, and that you have read his writings.
I’m glad that you have context to understand how much of a compliment my comparing your writing to his was.
Been peeking at your older writings with assistance from Mr. Peabody in between helping my wife with some forensic accounting (which makes me want to rip my eyeballs out as I’m a senior-level computer geek, not an accountant!)
Best regards,
WWWebb
Although this is a terribly sad story, and of even greater interest because it is a couple, it is a good story to contrast the Terry Schiavo case from years ago.
For various reasons religion has advocated that individuals don’t have the power of choice in matters like this, instead teaching that we must hang on to “life” at any cost, to prolong life (ironically, with the assistance of modern medicine/technology) until god decides that life should end.
Recent technology has allowed us to prolong life, but to also prolong suffering. In the natural world, years of prolonged suffering are unnatural, as animals who aren’t fit to survive usually don’t. Although this is a sad story, the ability to end one’s own suffering is empowering, and probably more of an act of “faith” than fearfully clinging to life at any cost.
I think adding the element of bashing the religous cheapens the debate and restricts honest oppinion. Many people of faith object, but so do many people who consider themselves non-religous. I am a woman of faith, but I don’t feel the need to prolong my life at all.
re: emmy
I wouldn’t go so far as to say that religion was “bashed” anywhere in that post above. If there is evidence against the idea that every major religion is staunchly against assisted suicide, I’ll gladly stand corrected.
For example, as explained by the catholic church: Human life is a gift from God to be cherished and respected because every human being is created in the image and likeness of God (Gn 1:26). Our Church teaches that we are stewards of life and in heeding God’s command, “Thou shall not kill” (Ex 20:13), we recognize that we cannot dispose of life as we please…
Why shouldn’t assisted suicide be legalized? To sanction the taking of innocent human life is to contradict a primary purpose of law in an ordered society. A law or court decision allowing assisted suicide would demean the lives of vulnerable patients and expose them to exploitation by those who feel they are better off dead. Such a policy would corrupt the medical profession, whose ethical code calls on physicians to serve life and never to kill. The voiceless or marginalized in our society—the poor, the frail elderly, racial minorities, millions of people who lack health insurance—would be the first to feel pressure to die.
“What about competent, terminally ill people who say they really want assisted suicide? Suicidal wishes among the terminally ill are no less due to treatable depression than the same wishes among the able-bodied. When their pain, depression and other problems are addressed, there is generally no more talk of suicide. Courtesy of U.S. Catholic Conference (#257) – http://www.americancatholic.org/newsletters/cu/ac0897.asp
I think it’s great that you have your own opinion on the matter, and I wish that organized religion encouraged debate on that or other subjects. I’m just referring to the official position that is taken by the church when i say “religious”…