CALIFORNIA WILL SOON become the sixth US state to approve euthanasia, joining a growing number of countries around the globe either to allow the practice or seriously consider it.
Euthanasia is going to be one of the hot social topics of the coming years. It has been pulsing on the radar with high profile cases here and in the UK. Switzerland has famously become the place to go in Europe to choose to die under medical supervision. Those suspected of helping people get there are finding themselves in court with increasing frequency.
Euthanasia is a controversial topic for obvious reasons. All our lives will end, and all of us will see or have seen loved ones die. We all have skin in the game and opinions based on how we’d like to be treated, or see our loved ones treated, or depending on our moral and religious views. It is a tricky area to legislate for, owing to the dual potential for mistreatment of vulnerable people and for robbing those in sound mind of their dignity in seeking to take control of their own deaths.
Double effect
The fact is, however, that we already have tacit euthanasia here and in most countries with palliative care regimes. Medical ethicists call it “double effect”, where care designed to ease suffering also leads to death.
Its most common expression is in a patient receiving heavier and heavier doses of a drug like morphine to ease their pain, until the dosage leads to their death. As the intention is to ease suffering, the secondary effect of death does not count as euthanasia even though it is clearly foreseen in the treatment. Many of us with the unfortunate but inevitable experience of seeing someone in the final stages of life will recognise the point that doctors agree it is time to ease suffering and abandon all other care.
There is a distinct difference in bioethics and in law between double effect and euthanasia. But the fact is that it exists as a way to end suffering. The Irish Council for Bioethics however reckons that for 5% of patients in palliative care, pain cannot be eased by medical means. For these people, the nature of their illness will see them suffer right up until the final moments. If a doctor was to intentionally accelerate their death, rather than simply administer drugs to ease pain, they would be committing a crime.
Psychological suffering
Why do we force these people to suffer when there are medical means to help them end their pain sooner, and people in the same facilities whose lives will be ended more quickly through medical intervention? And if indeed doctors do quietly provide that service, why must it be carried on in the shadows?
There is also the question of people who cannot end their own lives, such as those trapped in their bodies. Medical professionals may be able to control physical suffering without need for lethal cocktails of drugs to be administered, but the psychological suffering is immense. We as a society do not allow these people to make their own choices because… What? We don’t feel comfortable with the idea of medically assisted suicide? I’d say their comfort or lack thereof in life is a more important consideration.
People should be allowed to make whatever choices they like about their own lives, so long as they harm nobody else. Choosing to end ones own life in the context of deep medical suffering is an autonomous choice that we should all be able to make for ourselves.
For those with religious objections to euthanasia, I suppose I’ll never have a satisfactory answer. But I believe that people should be able to make their own choices in life, and in death. I don’t worship death and I intend on living a long life myself. But if some day I have some illness that would see me lingering in pain I might want to make my own choice and let you make yours.
Robbed of choice
Personal autonomy does not devalue life. Any patient can reject care for themselves at any time, and in a practical sense nobody can really stop an able bodied person from ending their own lives. People who are debilitated are robbed of that choice, however. And so too ending ones life should not have to be a lonely act carried out in secret, with great potential for further suffering if it goes wrong.
Euthanasia is a taboo topic, because the last group to really carry it forward as an agenda were the Nazis. Their euthanasia programs were murder, pure and simple. But people are right to worry that if we introduce euthanasia that people could be pressured into taking their lives prematurely or that it could become the go-to strategy for dealing with certain illnesses.
It is essential therefore that we have a robust formula for multiple medical professionals to assess and ensure that a patient is making an informed decision. Again, we already have this in an informal way in palliative care environments. We cannot use straw man arguments as a catch all excuse to prevent people from making decisions about their own lives. Similarly, we cannot rob liberty from people who would help a loved one to end their suffering; though we are unwise to allow the practice to continue in an unregulated environment.
With other countries and US states making an active move on euthanasia, we should put the topic on the table for a national debate towards legalising it here in Ireland.
Aaron McKenna is a businessman and columnist for TheJournal.ie. You can follow him on Twitter here.
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