Tuesday, May 08, 2007

Euthanasia

I watched the Four Corners show Final Call last night. It concerned the euthanasia debate and the right of elderly citizens to suicide when they feel their lives are not worth living.

The elderly people interviewed impressed me with the care of their planned exits and with their resolve to achieve this final act of self-determination. They seemed highly intelligent people who had thought through the consequences for their families and for themselves of suicide. For the most part they wanted to die peacefully by taking a dose of Nembutal. They were not depressed, they were enjoying life now to the fullest and were not making their plans on the basis of short-term discomfit or pain or because of concerns they might be a burden on others.

The strength of their convictions was illustrated by their journeys to Mexico to secure illegal supplies of Nembutal and by their organization into groups to home-produce the drug. When the interviewer asked one chirpy 96 year old whether he was worried about being sent to jail for being involved in illegal activities his response was simple ‘they won’t be able to keep me there long’. It was a great reply.

The views of the medical profession and the ethicists on the show were unconvincing and shallow to me. They were essentially trying to impose their values (and in the case of the medical profession to secure a valuable market) on sensible, independent people who seem to have a perfect right to choose – it is their life.

Denying the right of such people to painlessly die forces citizens to unnecessarily experience pain and suffering. It is asserting the value of extending life as an absolute ideal irrespective of the views of the person whose life is being extended.

I am in favor of developing a pill, such as Nembutal, that provides a painless death to well-informed adults who seek to die. A concern is that the pill might come to be abused by adolescents and others who experience transitional emotional or other difficulties. Such deaths are unnecessary and impose enormous costs on others. I am absolutely not in favor of an open access regime to death pills for all. The difficulty of avoiding suicides by irrational youth or those needing urgent transitional care can be dealt with by prescribing the pill only to those people who are judged by a knowledgeable councilor to be well-informed and not acting irrationally on the basis of short-term problems.

It seems to me perfectly reasonable to suppose that elderly people make a rational judgment that their life is not worth living. It is their ‘Final Call’ and I cannot think of good reasons why their choice should not be respected. Of course those who choose to live their lives to the end even in the face of pain and suffering also deserve to have their views respected.

I am interested in the views of readers on this long-standing debate. I must acknowledge that I have not searched hard for counterarguments to the pro-euthanasia position and I would be interested in thinking about such arguments.

9 comments:

AdamR said...

I always find euthanasia an interesting topic Harry, particularly from an economic point of view.

For example, merely having the option of accessing euthanasia must surely be utility enhancing for lots of individuals, regardless of whether they eventually access that option or not.

I am also always curious as to the point 'suicide' becomes 'euthanasia'. Is there an age-related point at which the former becomes the latter? Should euthanasia require a terminal illness before access is granted, or should an elderly person be able to access it merely so they can make a 'positive' choice about when they leave the earth? Interesting issues.

hc said...

Most of the people in this show were looking for can option rather than a commitment to take the action. They were anticipating health issues that would make them, once these issues arrived, take their life. There is option value in having this and having the worry of facing a medical profession who want to endlessly prolong your life against your wishes.

I hadn't thought clearly about the meanings of the terms suicide and euthanasia. Suicide means taking your own life (or trhe name of someone who does so). Euthanasia has had the specific connotation of a painless klilling done to you because you suffered from an incurable painful disease. Pro-euthanasia groups define it as the intentional killing by act or omission of a dependent human being for his or her alleged benefit.

I think that euthanasia probably should require aq termional illness and assent of the patient if possible. Suicide I think should remain an option for others who might not face immediate death but instead face suffering or an enmpty life.

Francis Xavier Holden said...

I've never seen a group of people having as much fun as those elders fiddling around cooking up Nembutal on their bush hideaway.

More fun than a speed cookup at a bikie gang farm near Castlemaine.

I'll respond later

observa said...

Cooking up nembutal illegally?Seems to me a cheap and easy way to commit suicide would be carbon dioxide/monoxide poisoning where you black out and would then die. Simply take the canister off any safety breathing mask and tape a plastic shopping bag securely to it. With the mask over the mouth and nose, you'd be breathing normally into the bag with obvious consequences. After slowly losing consciousness the inevitable result must occur. Cheap, painless and easy on the discoverer I would have thought.

Jan said...

Totally agree Harry. They seemed perfectly rational (in addition to being so cute) and should have the right to choose to end their lives without having to take a 'how to make nembutal' cooking course...

Steve said...

Harry, don't you find it at all disturbing that it would seem from the attitude of some of these old folks that they were prepared to suicide when they reach an age when life just becomes inconvenient for them? The 90 year old bloke, for example, who still goes ocean swimming every day, yet speculated that maybe in 2 years time he will have had enough (mentioning that he had deteriorated somewhat in the last couple of years.) What, I thought, when you can no longer go for a dip in the sea that will be good enough reason for suicide? There were other people interviewed who also gave me the distinct impression that it would not just be serious disability that would decide them; just whenever they decided they had enough of the inconveniences of old age.

In 2002 there was the case of a 79 year old woman, perfectly healthy, who suicided just because she didn't want to be 80. Philip Nitschke had involvement there too.
(See http://tinyurl.com/28maoq if you missed that story.)

I think people who want to be allowed euthanasia for the ending of serious pain have some sort of case I can respect. (Even though palliative care doctors insist they can help the great majority of cases.) But this idea of some people that they should end it all because of their of loss of enjoyment is not the way to run a society. I think that their attitude is basically narcissistic, to a significant degree.

You mention that they can be said to be acting rationally in deciding when to end it. But what is irrational about some other cases where I presume you would be uncomfortable about allowing suicide? (To pluck an example from thin air, a young person who is aware that he has a disability that makes him physically unattractive to the opposite sex, leading to permanent sadness at the fate life has dealt him).

The thing is, the idea of some counsellor or such deciding who can or cannot have the peaceful pill would, in practice, be fraught with difficulties and too dangerous to implement. There would clearly be cases where not all of the relatives agree with the wishes of the person wishing to die, and while society can cope with that in terms of pulling the plug on artificial life support, it's another question to give authority to a counsellor as to decide the fate of a "rational" person not close to death.

I hope never to be personally tested in this, but for now my attitude is to say suck it up, oldies, and hope you die quickly from natural causes. (And go and do some, or more, community service instead of milling around making drugs for a past time.)

hc said...

Steve, I am sympathetic to your general viewpoint. What I found compelling about these elderly citizens was how balanced, sensible and yet determineed they were.

I'd feel as bit presumpuous standing in their way. Who am I to judge?

But yes people who want to suicide for some foolish reason - it worries me too.

I agree the counseller issue is complex. I'll think more about it. Thanks for your perceptive comments.

jan said...

Steve, a question on your claim that:

'this idea of some people that they should end it all because of their of loss of enjoyment is not the way to run a society'.

It was my belief that the basic principle of the Western society was that it was not run by someone but that people had the freedom to do what they want (as long as it does not interfere with somebody else's freedom - i.e. for an equilibrium to exist).

From that view point all decisions are 'basically narcissistic, to a significant degree'.

On a general note (but related) distinction, I liked the way the people were responding to the question whether it worried them that they were breaking the law.

There is a huge difference between the Law (which comes from the basic principles of a free society - what Hayek called catalaxic rules) and the legislation.

If a piece of legislation contradicts the Law then it is the wrong legislation and we should not feel bound to follow it. For example, if the politicians decided to legislate that you are not allowed to eat, would you feel you are breaking the Law if you ate..?

Dave Bath said...

My grandfather went on hunger-strike after being moved into a nursing home, after falling off a roof when clearing gutters, and then unable to be his normal active self.
This was heartbreaking for us, but at least it gave time for people to get into town (we're a predominantly rural family) and say goodbyes, and my daughter got to remember him.
Nobody should have to go through such hoops when they feel old and useless.
Having studied toxicology in my youth, you can bet I'll find a better way of shuffling off the mortal coil when I can't contribute any more.