stories

Responding to the issue with heart and mind

To Be or Not to Be?

2000. Norman has always been a man of decision and authority; in fact some people have found him difficult and boorish.

He has recently, at the age of 56, suffered a heart attack and then, some four days after a severe stroke as a result of a blood clot detaching itself from the wall of the heart. The brain swelling after the stroke made his condition much worse and it was feared that he would die. He was ventilated and treated vigorously for his heart, lung and brain damage.

He is, now, some six weeks ‘down the line’, a semiparalysed individual with no control over his bowel or bladder and no ability to swallow food or fluids by himself.

He appears to recognize his relatives but only can produce grimaces and tears when they talk to him.

It is obvious that he can exert no control over his fate and he is prone to bouts of pneumonia. His nutrition is sustained by a naso-gastric tube. One day his son says to the doctor, “Dad would have hated to be left like this, can’t you do something to put an end to it?” (From A New Zealand Medical Association Report on Euthanasia, prepared by The Bioethics Centre, University of Otago, principal authors Grant Gillett and Sam Bloore, September 1996).

The New Zealand Medical Association Report on Euthanasia contributes a range of arguments and possible solutions to Norman’s (and other sufferers) predicament, although the authors of the report “have deep misgivings about any legislative moves to legalize euthanasia”.

According to the Medical Association’s report, it needs to be noted that euthanasia that is performed within a medical setting and is done with the intention of terminating a human life, such as by lethal injection, is outlawed in New Zealand (at the time of writing).

It is this “active” euthanasia that the authors of this report underline as the issue being debated. Passive euthanasia is the withdrawal or withholding of some necessary treatment for the maintenance of human life and is acceptable by law in New Zealand.

In 1995, former MP Michael Laws and his Death with Dignity Bill attempted to give active euthanasia legal status. However, the law was not changed.

Anglican chaplain at Wellington Hospital, David Tannock, believes the primary issue becomes one of intention.

He explains: “If a dose of a drug is administered with the primary intention of ending the patient’s life, then it is euthanasia.

“The distinction would become a fine one if the amount of a drug necessary to ease pain was a lethal dose.”

Is it better for Norman to allow him to die or to provide compassionate care for him in his suffering? Whose decision is it?

Dr Malcolm Watson, now retired and formerly a specialist physician for thirty-six years who has “lived with the dead and dying in private practice and the public hospital environment”, believes the discipline of palliative care that relieves symptoms with intelligent and compassionate consideration “gives many people a kind of care in dying they did not believe was possible”.

He perceives these measures reduce to a small number the cases in which active euthanasia would seem to be the only alternative to a cruel death.

“Experienced carers are well aware how stressed dying patients are and if still suffering more and more better palliative care is the answer.”

Dr Watson notes that ninety-one per cent so treated die free of pain, ten per cent may need more medication, but ninety-eight per cent can be controlled.

The arguments for and against active euthanasia perpetuate.

David Tannock believes the difference is the underlying philosophies between the proponents and opponents of euthanasia is the question of the origin of life.

“If you believe that we are created as the children of God then we are accountable to God for our stewardship of human life.”

Therefore, says Mr Tannock, it makes sense to talk about responsibilities as well as rights.

“Without the underlying belief in a Creator then the balance will go over to the importance of rights rather than responsibilities.

“If you are agnostic about the origin of human life, or believe it to be simply the result of a physical process, then it is logical to believe that we are free to do as we wish with our lives, provided we do not harm others.”

David Tannock is sure euthanasia “can be administered out of motives of very nearly pure compassion, but that does not in itself make it an acceptable alternative to continuing life.”

He says if we respond to situations only with our feelings and not also with our minds and our moral sense, then we are responding as less than whole beings.

By Peter Veugelaers. Published 2000, Challenge Weekly

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