A Life of Dignity

In the late winter of early 2007, my family and I watched as my grandfather slowly succumbed to six years of terminal leukemia. Throughout his battle with cancer, he was strong, exercised, listened to the advice of his doctors, and assured his family he wasn’t scared, that everything was going to be fine. Over these same years, he became diabetic and lost most of his once thick hair, his energy, his appetite, was now under one hundred pounds, and by February, he had also lost his dignity. This man, who for seventy years took care of his family, built furniture, and owned a small business had become dependent on us for everything. His skin itched so badly from the medications that my grandmother had to trim his fingernails down to the skin to keep him from scratching. But the morphine and all the other drugs were not enough to keep the pain at bay. One day he asked my grandmother to take him to the hospital; he said that he was ready to die.

It’s not that easy, though. Here in America and in many other countries around the world, we have come to fear death so much that it has, along with suicide, become taboo. While it is important to do everything in our power to prevent suicides caused by mental illness, it is time to make a distinction between traditional suicide and a dignified death. When an animal is beyond treatment, when it is impossible for it to live without pain, it is euthanized, and we consider this humane. However, as my grandfather lay in a hospital bed for a week, semiconscious, having hallucinations and nightmares from all the painkillers, we watched. As he forever lost consciousness and slipped into a shallow sleep, his lips drawn back and noises of pain still escaping his mouth, we watched. All the planning, the Do Not Resuscitate order, the living will and power of attorney didn’t matter. It was illegal to assist in what was truly the inevitable, so we watched. My mother and her siblings publicly and privately begged the doctors, nurses, even their brother-in-law who is a surgeon, to do something. They all sadly shook their heads. He needed more morphine for the pain, but more would kill him, it was impossible.

Technically, there are three kinds of euthanasia: passive, non-active, and active. Passive euthanasia involves withholding treatment or medication for treatment, and is for the most part widely accepted for terminally ill patients. Non-active euthanasia is the withdrawal of life support, and while at times controversial, is somewhat easily attained, especially if the person in question has a living will. Most recently non-active euthanasia made headlines when a 13-year-old British girl living with a heart condition brought about from drug complications from leukemia, won the right to refuse an extremely dangerous heart transplant, and live out the remainder of her life at home. Doctors involved in the case say they support her decision, and that she understands the risks involved. Active euthanasia, however, is the lethal use of controlled substances or forces to kill a patient, and is highly controversial and most often illegal.

In 1994, the state of Oregon became the first state to allow its citizens to choose the right to die. The Oregon Death with Dignity act made it legal for doctors to prescribe a lethal dose of drugs to a patient, if it was determined by two doctors to be within six months of dying from a terminal illness. In 1997, the Oregon Legislative Assembly tried to have the law repealed, but was defeated by a 20-point margin. Then in 2005 members of the Bush Administration took aim at the law, in Gonzales v. Oregon. The Supreme Court Ruled in favor of Oregon, citing, among other things that the U.S. Attorney General did not have the right to overrule state laws on legal controlled substances. As of 2007, only 341 patients in Oregon has chose to end their lives using this new measure, and an overwhelming majority were suffering from end stage cancers. In a recent study, it was determined that the people choosing this option were not at a heightened risk due to being elderly, uninsured, of low education, a minority, suffering from psychiatric illnesses, or even physically disabled or chronically ill, when compared to the overall population. In just this past general election on November 4, 2008, Washington passed Initiative 1000, becoming the second state allowing patients to end their lives using medication.

Some of the main arguments against a patient’s right to die include that it violates doctors’ Hippocratic oath, that it devalues human life, and that it may give doctors, families, and insurance companies too much power, or that they may give up prematurely on a patient. What needs to change is the way in which we interpret the Hippocratic oath of “first do no harm,” and what value a human life has that has been so far degraded. Death must be seen as a part of life, not as a final stage in a disease. When death is more valued than life by a patient, we have crossed the threshold in the very definition of what it means to help or harm someone. The checks and balances in laws like in Oregon and Washington, as well as the independent studies showing no problems with exploitation should be enough to make these laws nationally acceptable. As for others who may argue that it is religiously, morally, or ethically wrong, that is their choice, just as it is their choice to follow a religion, or hold a belief: it is what makes this country so great. But we aren’t talking about what is natural anymore. These patients would not be alive now if it wasn’t for advances in medicine, and unfortunately many will reach a point where modern medicine can do nothing more for them. Unexpected recoveries – or “miracles” – can happen, but they weren’t coming for my grandfather, and they aren’t coming for almost anyone with a terminal, end stage disease. If we are willing to accept the miracles of modern medicine, and everything it can help us with, we must also accept there are things with which it cannot help. Death is the end of life, but still a part of it. Let us accept that death with dignity is just as important as a life lived with dignity, in fact, they are one in the same.



http://www.oregon.gov/DHS/ph/pas/docs/History.pdf
http://www.law.cornell.edu/supct/html/04-623.ZS.html
http://www.balancedpolitics.org/assisted_suicide.htm
http://ballotpedia.org/wiki/index.php?title=Washington_Death_with_Dignity_Initiative_(2008)
http://news.bbc.co.uk/2/hi/uk_news/7721231.stm