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The right to die

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Does a person, suffering and ill, have the right to choose to end their life? Is it correct to assist such a person to die?

This debate continues to rage in various courts of law. Countries, such as Netherlands, Belgium, Colombia and Luxembourg have legalized regulated euthanasia. A person, suffering and in pain from a disease, has the right to take his or her own life without the help of a doctor.

Doctor assisted euthanasia is legal in Switzerland, Japan, Germany and Canada. Certain states in the US have also legalized it. Many other states are debating it.

There is a precedence of legalizing hitherto unlawful activities. In 1978, Spain removed adultery from their list of crimes. In 2003 the US legalized sodomy as a permissible sexual act between willing partners. And so far 37 states have legalized gay marriages.

Governments no longer regulate many things they used too. But we still consider taking one’s own life as wrong and most governments don’t allow it in law.

 

Viewpoints

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A school of thought believes suffering and pain in life carries its own sense of dignity. But this may not be how those suffering would see it. For them it may be cruel to subject a few people to a life of suffering and misery so as to support abstract concepts about the importance life.

Another viewpoint is that legalized suicide is a cheap substitute for those that do not want to invest in palliative (end of life) care. They fear a slippery slope to a place that threatens the old and vulnerable. But evidence from countries that have legalized euthanasia proves that there is no such trend. Instead, the facts seem to show the need for bolder euthanasia schemes.

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Liberty

Those that oppose the practice have firmly held views that deserve serious consideration. Data alone will not sway them. For those that consider the deliberate termination of a human’s life to always be wrong it’s a question of values. But liberty and autonomy are sources of human dignity, too. Both add to the value of life.   

One argument is that the decision of a person to die undervalues the lives of those suffering from the same illness. But people suffer and cope in different ways. There are others that consider a disabled person’s choice to die as an expression of individuality. We all have a choice.

These arguments continue to be debated around the world. However, it is Oregon’s more restrictive Death with Dignity Act that is most likely to be adopted.  Under it only those with terminal illnesses can request to end their life.

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Restricted

Doctors can prescribe lethal drugs to patients, after a second doctor’s opinion confirms that they have less than six months to live. Neither doctor is under any lawful obligation. There is a 15-day waiting period after the request, which gives the patient time to change their mind.

The Oregon Act requires the patient to self-administer the lethal dose, either by injection or pill. But this restricts the incapacitated from making this choice. Not surprisingly, many patients inflicted with illnesses, such as motor neuron disease that causes paralysis, resent this. They may live much longer than the stipulated six months. There is a fierce demand for the inclusion of such illnesses into the Act. 

The amendment will allow for the incapacitated, to choose the option of dying with drugs administered by a doctor. 

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Exceptions

Some Human Right Activists working for the cause of the disabled, believe that categorizing a disabled person with those that can choose to opt for assisted deaths means considering them less worthy. Conversely, Stephen Hawking claims it to be the “ultimate indignity” to keep a person alive against his will.  For many disabled people choosing is an expression of autonomy.

One exception is children. The decision to end one’s life should only be allowed for adults. Yet, children with debilitating terminal conditions also go through an agonizing period before their death. Shouldn’t they be spared their last painful hours, if they so wish? As long as their parents and doctors agree.

The most difficult question is whether assisted dying should be available for those in mental pain. Many of those depressed will get better and relish life again. But mental pain is as real as physical pain, though it is more difficult to see and measure.

And those that are terminally ill are often opting for death on the basis of mental not physical trauma. Shouldn’t we allow Doctor-assisted death for mental suffering as well?

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Safeguards

Because patients’ decisions may be ill-informed and states of mind can change, especially among the mentally ill, society should help people to die only when safeguards are in place. The process should always include the following steps.

A counselling session with the awareness of options.

A cooling period to ensure the decision by the patient is firm.

And a consultation with a medical expert to confirm the patient’s condition is irreversible. 

People in dire situations make errors in judgement. An incorrect choice will end with the termination of life and there are no second chances. But does that give us the authority to prevent their right to choose? Abortions and sex change operations are irreversible decisions that an adult takes. Choosing an assisted death requires the same freedom of decision.

Which is better? Dying after a long drawn-out painful battle with an irrecoverable disease in a hospital under bright lights, sterile equipment and busy strangers, or, closing your eyes forever by your choice, in the proximity and comfort of loved ones. 

Dignity requires the freedom to be able to make a choice.

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This essay draws on the work of physician Atul Gawande, particularly his New York Times Best Seller, Being Mortal: Medicine and What Matters in the End


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