End of Life Issues
Assisted suicide and euthanasia is a confusing subject. However, this subject will greatly affect future generations as we continue the slide down the slippery slope. Please carefully consider all factors before making a judgment. The following are a list of questions that many have asked on this subject and answers that address these provocative questions.
1. ISN'T A DECISION TO KILL ONESELF A PRIVATE CHOICE ABOUT WHICH SOCIETY HAS NO RIGHT TO BE CONCERNED?
This position assumes that suicide results from competent people making autonomous, rational decisions to die, and then claims that society has no business "interfering" with a freely chosen death decision that harms no one other than the suicidal individual. But according to experts who have studied suicide, this basic assumption is wrong.
A 1974 British study, which involved extensive interviews and examinations of medical records, found that 93% of those studied that committed suicide were mentally ill at the time. A similar St. Louis study, published in 1981, found a mental disorder in 94% of those who committed suicide for reasons other than a settled desire to die, and that they are predominately the victims of mental disorder.
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2. WHAT ABOUT THOSE WHO ARE TERMINALLY ILL?
Contrary to the assumptions of many in the public, a scientific study of people with terminal illness published in the American Journal of Psychiatry found that fewer than one in four expressed a wish to die, and all of those who did had clinically diagnosable depression. As Richman points out, "effective psychotherapeutic treatment is possible with the terminally ill, and only irrational prejudices prevent the greater resort to such measures." And suicidologist Dr. David C. Clark observes that depressive episodes in the seriously ill "are not less responsive to medication" than depression in others. Indeed, the suicide rate in persons with terminal illness is only between 2% and 4%. Compassionate counseling and assistance, such as that provided in many hospices, together with medical and psychological care, provide alternatives to assisted suicide among those who have terminal illness.
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3. STILL, SHOULDN'T IT BE THE PERSON'S OWN CHOICE?
Christopher Reeves, famous Hollywood actor who played Superman, admitted to being depressed after his horse riding accident. Because he was depressed, he thought of suicide. Yet, with encouragement and care those thoughts passed.
Almost all of those who attempt suicide do so as a subconscious cry for help, not after a carefully calculated judgment that death would be better than life. A suicide attempt powerfully calls attention to one's plight. The humane response is to mobilize psychiatric and social service resources to address the problems that led the would-be suicide to such an extreme. Typically, this counseling and assistance is successful. One study of 886 people who were rescued from attempted suicides found that 5 years later less 4% had gone on to kill themselves. Paradoxically, the prospects for a happy life are often greater for those who attempt suicide, but are stopped and helped, than for those with similar problems who never attempt suicide. In the words of academic psychiatrist Dr. Erwin Stengel, "The suicidal attempt is a highly effective though hazardous way of influencing others, and its effects are as a rule...lasting."
4. WHAT ABOUT THOSE IN UNCONTROLLABLE PAIN?
They are not getting adequate medical care and should be provided up-to-date means of pain control, not killed. Even Dr. Pieter Admiral, leader of the successful movement to legalize direct killing in the Netherlands, has publicly observed that pain is never an adequate justification for euthanasia in light of current medical techniques that can manage pain in virtually all circumstances.
Why then, do so many personal stories of people in hospitals and nursing homes have to cope with unbearable pain? Tragically, pain control techniques that have been perfected at the frontiers of medicine have not become universally known at the clinical level. What we need is better training in those techniques for health care personnel-not the legalization of physician-aided death.
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5. WHAT ABOUT THOSE WITH SEVERE DISABILITIES?
What would this thinking say about our attitude as a society? On the one hand, we tell those who have neither terminal illness nor a disability, "You say you want to be killed, but what you really need is counseling and assistance." On the other hand, we tell those with disabilities, "We understand why you want to be killed, and we'll let a doctor kill you"? It would certainly not mean that we were respecting the "choice" of a person with the disability. Instead, we would be discriminatorily denying suicide counseling on the basis of disability. We would be saying to the non-disabled person, "We care too much about you to let you throw you life away." To the person with the disability we would be saying, "We agree that life with a disability is not worth living."
Most people with disabilities will tell you that it is not so much their physical or mental impairment itself that makes their lives difficult, as it is the conduct of the non-disabled majority toward them. Denial of access, discrimination in employment, and an attitude of aversion or pity instead of respect are what make life intolerable. True respect for the rights of people with disabilities would dictate action to remove those obstacles, not "help" in committing suicide.
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6. IS THIS REALLY AN IMPORTANT ISSUE?
If you are healthy and relatively happy, you might not think so. However, the National Council on Disability definitely thinks it is. In their position paper, Assisted Suicide: A Disability Perspective, states, "The dangers of permitting physician-assisted suicide are immense. The pressures upon people with disabilities to choose to end their lives…are already prevalent…People with disabilities are among society's most likely candidates for ending their lives, as society has frequently made it clear that it believes they would be better off dead…Persons with disabilities who are poor or members of racial minorities would likely be in the most jeopardy."
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7. OPPONENTS OF LEGALIZING ASSISTING SUICIDE SAY IT WILL LEAD TO INVOLUNTARY EUTHANASIA. AREN'T THESE OVERBLOWN SCARE TACTICS?
Absolutely not. Those who desire to see assisted suicide and euthanasia legalized say there will be strict limitations to guard against abuse of this power to kill. Holland is often pointed to as being a good example of the humane use of euthanasia. The reality tells a different story. A report released by the Dutch government reveals that in 1990, 5,941 of the 11,800-recorded cases of active assisted killing were done without the patient's consent. Safeguards do not work.
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8. IS EUTHANASIA NEW TO SOCIETY?
The following is from an article in the New York Times dated October 8, 1933. The German Ministry of Justice announced its intention to authorize physicians to end the sufferings of incurable patients.
The proposal stated that, "It shall be made possible for physicians to end the tortures of incurable patients, upon request, in the interest of true humanity…" This was on the eve of the rise of a cruel tyrant, Adolph Hitler, whose inhumane treatment of fellow human beings is legendary.
The real issue of euthanasia is the value of each human life. Traditionally our society has advocated love, compassion and medical intervention to help those who are old, infirm, disabled, or deeply depressed. We are now being conditioned to believe that it is compassionate for a medical doctor to kill a less than "perfect" human. But, when any group of people decide who lives and who dies, based on age, infirmity or mental capacity, the weak and "undesirable" become targets of the strong. Sound familiar?
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9. WHAT ABOUT "WILL TO LIVE" DOCUMENTS?
There is growing evidence that those who do not provide clear directions concerning the life-saving measures they would want are more likely to be denied them than to receive them. Many court cases have been decided in favor of removing all forms of life support. Therefore, it is important that those who do not want to be denied life-saving medical treatment, or even food and fluids, make their views known in some form of advance directive.
Two common advance directives are Living Wills and Durable Powers of Attorney. Living Wills focus on the rejection of life saving medical treatment under certain medical conditions. Durable Powers of Attorney authorize a specified person to make decisions concerning the provision or withholding of life-sustaining measures when the signer is incompetent. Though such laws appear to protect patients' rights, they have some serious flaws from a pro-life point of view.
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National Right to Life has developed an alternative, life-affirming advanced directive called the "Will to Live". This document presumes that food, fluids, and life-saving medical treatment are to be provided. However, it also includes optional sections for the signer to specify conditions under which this presumption does not fully apply, such as when death is imminent or when the signer is in the final stages of terminal illness. Suggestions are given for ways to list one's end-of-life directives with precision and detail.
For a free copy of the Will to Live, contact:
GRTL - Education
Post Office Box 665
Norcross, GA 30091
Or call: 770-339-6880