TAG | Euthanasia
Vermont may be a lefty sort of place, but occasionally it gets some things right. MSNBC reports:
After 10 years of emotionally-charged debate, Vermont became the first state in the country to pass a doctor-assisted suicide bill through the legislative process. Governor Peter Shumlin signed the “Patient Choice and Control at End of Life Act” into law Monday allowing physicians to prescribe a lethal dose of medication to dying, mentally competent patients who want to end their lives. This would apply only to residents of the state.
“Vermonters who face terminal illness and are in excruciating pain at the end of their lives now have control over their destinies. This is the right thing to do,” said Gov. Shumlin, a Democrat.
Three other states have similar “death with dignity” laws on the books. Oregon and Washington enacted these laws through ballot measures. In Montana, a court ruling made it legal in 2009. Similar to Oregon and Washington, the new Vermont law provides built-in safeguards to make sure these patients meet certain requirements and that they are of sound mind. For the next three years, sick patients must formally make the request at least three times. And the patient’s primary care doctor and a consulting physician must agree with the diagnosis that the person is, in fact, terminally ill and able to make an informed decision. The Health Department will get reports from doctors on how many patients they prescribed lethal drugs. After July 1, 2016, Vermont won’t require as much monitoring and reporting under the law.
According to the AP, Vermont Health Commissioner Dr. Harry Chen estimated doctors will write between 10 and 20 lethal prescriptions a year, but not as many patients will go through with the process and actually take the lethal drugs…
Over at the Wall Street Journal Paul McHugh complains about this modest measure in an unconvincing article that is childish:
And then there is this talk about “death with dignity,” as the Oregon and Washington laws are titled. Surely what we want is “life with dignity.” Seeking life, we’re ready to endure much in order to keep it going. Think of the life-saving and life-preserving colonoscopy—all dignity drops with your trousers.
And comes complete with guilt-by-association:
For you see, the terminators ultimately are not merely interested in killing people who are suffering the throes of a final illness. They have even others in mind, as history tells us. The drive to allow doctors to “assist” in suicide is not recent. Its roots are in the Progressive era of the early 20th century, when many Americans placed utter confidence in reform and in technocratic elites. Then the enthusiasts for euthanasia lined up with those clamoring for government intervention in the name of eugenics and population control.
And, well, this:
Another argument for physician-assisted suicide is that many patients with cancer live too long in pain. The suffering could be reduced if their legitimate wish for death were fulfilled. These are the arguments pressed by Dr. Timothy Quill and many in the Oregon “death with dignity” group.
But scientific publications from oncologists such as Kathleen Foley, who studies patients with painful cancers, reveal that, quite to the contrary, most cancer patients want help with the pain so they can continue to live. Suicide is mentioned only by those patients with serious but treatable depressive illness, or by those who are overwhelmed by confusion about matters such as their burden on loved ones and their therapeutic options. These patients are relieved when their doctors attend to the sources of their psychological distress and correct them.
The simple (and encouraging) answer to that is that a huge majority of cancer patients do indeed choose to live on, and, yes, proper counseling and treatment for depression can encourage them to make that choice.
That said, there are doubtless some terminal patients who—quite rationally—decide that enough pain is enough, and that it’s time to move on. The Vermont law will help some such individuals reassert, one last time, control over the lives that are theirs, and theirs alone.
In a 2002 New York Times piece, Dr. McHugh (a Roman Catholic) was described as “religiously orthodox, politically liberal (he is a Democrat) and culturally conservative”. The latter is an infinitely debatable term. If we look, however, at the other two attributes listed– religious orthodoxy and political liberalism—it’s not hard to see why respect for individual liberty ranks so very low on his list of priorities.
This article by the British cook, writer and entrepreneur, Prue Leith, on the death of her brother is a harrowing read, but it is a reminder of the suffering that those such as Boston’s Cardinal O’Malley (a key opponent of the recent Massachusetts ballot initiative on assisted suicide) insist on imposing on others.
Here’s an extract:
In the end, David, determined to end the pain, refused any more antibiotics, so allowing the next dose of pneumonia to kill him. Dying of pneumonia is a horrible death. Basically you drown, slowly and painfully, as your lungs fill with mucus and you cannot breathe. David’s family had to endure the sound of laboured breathing for the last five days, a constant loud “death rattle”. They had to bear the sight of their father and husband, thick green discharge running from mouth and nose, veering from semi-coma to excruciating pain.
Death is always distressing, but in 2012, with all our talk of respect and consideration for others, how can it be that a wife ends up praying for her husband to please, please, just die?
Surely all that is needed is something like a hospital protocol that if the patient and the next of kin want to end the misery, and two doctors agree that the patient will be dead in a month anyway, they can increase the dose of drugs to the level sufficient to alleviate the pain, even at the risk of death.
If that is a step too far, can we not at least accept Lord Joffe’s proposed Bill, which would allow, if not “mercy killing”, at least “assisted suicide”? This would make it lawful for doctors to prescribe, though not to administer, a drug that would cause death. The patient would have to request it, and take it while still capable of doing so.
The present state of affairs is monstrous. With 80 per cent of the [British] population in favour of assisted dying, what are they waiting for?
Grim reading, I fear, for New Year’s Day, but the (London) Daily Mail has a report here on the evolution of the ‘Liverpool Pathway’, a National Health Service procedure which “involves withdrawal of lifesaving treatment, with the [terminally] sick sedated and usually denied nutrition and fluids. Death typically takes place within 29 hours.”
The notion that allowing someone to die—even if heavily sedated—through starvation or thirst is somehow humane is grotesque. At some level a good number of these patients know what is going on, and often they do indeed suffer.
And then there’s this:
Up to 60,000 patients die on the Liverpool Care Pathway each year without giving their consent, shocking figures revealed yesterday. A third of families are also kept in the dark when doctors withdraw lifesaving treatment from loved ones.
Despite the revelations, Jeremy Hunt last night claimed the pathway was a ‘fantastic step forward’.
So much for consent.
Naturally, anti-euthanasia vigilantes are up in arms over this news, but they would do better to ask themselves the extent to which their own pressure to keep patients alive regardless of what those patients themselves want has done to contribute the creation of this ‘pathway’.
Those opposed to empowering agonized patients to shape their own exit for themselves often talk darkly about a slippery slope. Greedy relatives, stingy governments and all that. Well, the individual being starved or dried-out to death (sometimes it seems without even the courtesy of being asked for his consent), not to speak of someone trapped in the coils of an excruciating disease from which he has no means to extricate himself, may well feel that he has already arrived at the bottom of the abyss.
Appalling. Simply appalling.
That’s the theory. But here’s how it really works. The Daily Mail reports:
The Council of Europe has ruled that euthanasia and assisted suicide should be banned in every country across the Continent. In a declaration that will have huge implications on human rights laws in its 47 member countries, the Strasbourg-based organisation announced that such practices ‘must always be prohibited’.
The move will represent a major setback to assisted dying campaigners in the UK who want Britain to follow Holland, Belgium and Switzerland in allowing doctors to help to end the lives of their patients. The explicit condemnation of euthanasia was inserted into a non-binding resolution entitled ‘Protecting Human Rights and Dignity by Taking Into Account Previously Expressed Wishes of Patients’.
The resolution had originally simply focused on the human rights questions of ‘advance directives’, or ‘living wills’, in which people set out how they wish to be treated if they became mentally incapacitated.
But members of the Parliamentary Assembly of the Council of Europe argued that living wills, which became legal in the UK under the 2005 Mental Capacity Act, were inextricably connected to euthanasia. They successfully moved an amendment forbidding euthanasia by 34 votes to 16 with six abstentions.
The amendment said that ‘euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit must always be prohibited’.
Among those fighting for the amendment was British member Edward Leigh, the Tory MP for Gainsborough.
It’s that “always” that sticks in the craw. What it means (thankfully the resolution is not binding) is that Leigh, and those like him, are insisting that their prejudices should prevail over an individual’s power to decide his or her own fate. The consequences of such absolutism can, of course, be grotesque suffering. A patient with locked-in syndrome, for example, who wishes to end it all has no need to worry about some “slippery slope”. He is already a prisoner, imprisoned in a body that has become its own dungeon, guarded by doctors who have thrown away the key.
And quite why Leigh, a Tory supposedly, a euroskeptic allegedly, believes that a transnationalist body should have the power to police Britons in this way escapes me. He is, it appears, an opponent of the right of Britons to govern themselves — and in more ways than one.
Count me skeptical whether there is a ‘right’ to die, or a right to very much else for that matter, but a truly humane society would not force this helpless man to go to the courts for the relief he seeks:
LONDON (AP) – Former rugby player Tony Nicklinson had a high-flying job as a corporate manager in Dubai, where he went skydiving and bridge-climbing in his free time. Seven years ago, he suffered a paralyzing stroke. Today he can only move his head, cannot speak and needs constant care.
And he wants to die.
To try to ensure that whoever ends his life won’t be jailed, the 57-year-old Nicklinson recently asked Britain’s High Court to declare that any doctor who gives him a lethal injection with his consent won’t be charged with murder. This week, the court will hold its first hearing on the case