Wednesday, May 27, 2009

Can We Talk About Assisted Suicide?

A recent news story, First Death for Washington Assisted-Suicide Law has brought this subject up for discussion again.

The woman, Linda Fleming, 66, of Sequim, Wash., died Thursday evening after taking lethal medication prescribed by a doctor under the law, according to a news release by the group, Compassion and Choices of Washington. The release said Ms. Fleming received a diagnosis of Stage 4 pancreatic cancer a month ago, and “she was told she was actively dying.”

Ms. Fleming was quoted in the release as saying: “I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death. The powerful pain medications were making it difficult to maintain the state of mind I wanted to have at my death.”

Assisted suicide falls into an interesting philosophical subject called situational ethics where something that is normally considered to be wrong can actually be the right thing to do as in these interesting examples.

So when somebody indicates that they want to end their life, is it ever the right thing to do to accommodate that wish? Some would say no; others would say it depends upon the situation.

If an otherwise healthy person is suffering from depression (unlike in the
strange story from China where an onlooker actually pushed a bridge jumper over the edge) any rational and caring person would want to do all they could to prevent that person from resorting to A Permanent Solution to a Temporary Problem.

The number one reason for suicide is untreated depression, and depression is highly treatable.

For those wishing to explore this subject in more depth, please refer to one of my previous postings, Can We Talk About Depression?

But others who are suffering through a terminal illness, perhaps with untreatable pain, clearly their problem is not temporary. And if the only alternative to more suffering and imminent death is to relieve the agony through assisted suicide, doesn’t this situation require a rational and caring person to help comply with that wish?

When the pets we love are facing a painful and debilitating terminal illness, most of us feel that having the vet ‘put them down’ is more humane than just letting them suffer until the very end. But many of those same people would insist on making a human being suffer until the very end! Does that make any sense?

The American Psychological Association offers
this article outlining the argument for and against assisted suicide for those wishing to explore this further.

An even more difficult ethical dilemma is posed by the 1981 film
Whose Life Is It Anyway? in which Richard Dreyfuss portrays an artist who after suffering an accident that makes him a quadriplegic, wants to die even though he is not terminally ill.

But what about the legal ramifications? Laws on assisted suicide have been traditionally vague about what really constitutes a crime. As this article
Assisted Suicide Laws Around the World explains:

A great many people instinctively feel that suicide and assisted suicide are such individual acts of freedom and free will that they assume there are no legal prohibitions. This fallacy has brought many people into trouble with the law. While suicide is no longer a crime – and where it is because of a failure to update the law it is not enforced – assistance remains a crime almost everywhere by some statute or other.

There are several groups in the US who have been actively involved in the assisted suicide movement — and have gotten in trouble with the law.

After an investigation, four officials of the group, known as the Final Exit Network, were arrested (in February 2009) on charges of racketeering and assisted suicide.

The arrests raised questions about whether the group, which has helped some 200 people commit suicide since 2004, merely watched people take the leap into death, or pushed them over the edge.

Indeed, one of the legal technicalities centers on whether the person assisting is merely providing the means of suicide (with the patient initiating the final act) or actually providing physical assistance. In the widely publicized cases around Dr. Jack Kevorkian, he was able to escape jail time until he aired a video on 60 Minutes showing him fatally injecting an ALS patient who was too incapacitated to do it himself. Although he was released from prison in 2007, he remains a controversial figure who will be played by Al Pacino in a future HBO film.

Clearly what we need is more compassion for those who are facing their final days in pain and suffering as in Washington's recently passed law. Although many of us do not approve of assisted suicide, we do have to ask the question that the movie asked, Whose Life Is It Anyway? and respect that person’s right to make a dignified and painless departure from this life when there is no other alternative.

And although conservatives may cringe at this suggestion, this is something for which we need more clearly written laws and guidelines. We should make sure that each case is reviewed by medical experts to ensure that the person is mentally competent and truly beyond any medical help to provide comfort and/or prolong life. And if so, then physicians who offer their help within the bounds of the law should not have to worry about prosecution as punishment for their compassionate act.

Admittedly, it is difficult to address this issue in a proper way because it is such a delicate one. But for those who along with their affected families need our help in their hour of need, we owe them no less!

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