MacDoctor December 27, 2009

Euthanasia (Part 4)

Quality of Life Issues (involuntary euthanasia)

Now we move into tiger country. Involuntary euthanasia is where someone other than the person to be killed makes that decision. Typically, the person whose life is being decided upon is not able to participate in the decision. This is where a current living will comes in handy (see my post on living wills for a fuller discussion on this) although I should note that a living will cannot insist on active euthanasia in this country, only not being resuscitated or given futile medical treatment.

Besides, I can’t tell you the number of times I have listen to discussions on what Granny really would have wanted. And that is not even for euthanasia per se, but for medical treatment.

The problem stems from our value systems. In my previous post I questioned whether someone who wanted to die was actually in their right mind. In this case I wonder about understanding.

I don’t think that most people, when they discuss euthanasia, either theoretically or with a specific personal interest, truly understand the complexity of the problem. They are trying to put themselves into the place of a person who is usually extremely disabled. This in itself is practically impossible even for people with great empathy. Then they wish to try and decide what that person thinks about their situation; to judge whether the disabled person has a “worthwhile” life. Invariably, they superimpose their own values and ideas as an able-bodied person, over estimating the unpleasantness of the disability.

How do I know this? Because every single person who has come out of a “locked in” state has said that they were glad to be alive. Most have said that they lived in constant fear that someone would terminate them while they were “locked in”.

But the problem is even more complex than the wishes of the patient, because family members cannot help but superimpose their own wishes on to the patient. I clearly remember a daughter aggressively suggesting that her mother have her nasogastric feeds stopped because “that’s what mother wants”. When I asked her why she would want her mother starved to death, she broke down in tears and explained that she had looked after her mother alone for more than ten years and could not take any more. Guilt was eating her alive. We talked her through placing her mother in a home, should she survive her stroke. Her mother did survive and lived another eight months in a pleasant nursing home in town, visited by her daughter virtually every day. It was a good arrangement for both of them. That is an extreme example of the dangers of motivations. It is all too easy too ascribe your own desires as the wishes of your loved one.

And that really is the main problem with all forms of euthanasia. Well-meaning people happily stamp their own values onto the disabled and dying and think they are doing them a service. As we shall see in my next post, they are only a stone’s throw from the wacky ideas of eugenics and social darwinists. You only get one life on this planet, regardless of what you believe about the afterlife. It is too short and precious to throw away like some old television that can only receive TV one in black and white.

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