THE ETHICAL DILEMMA OF A PROPER DEATH

The hot button issues that confront our culture rise and fall in cycles, it seems. At times, abortion takes center stage. At other times, capital punishment is the prevailing controversy. Let us not forget the periods in which the use of potentially life-saving drugs not yet approved by the Food & Drug Administration (FDA) is so hotly debated. And then, of course there is the age old battle over the Second Amendment to the Constitution – guns or no guns. Consider the common element to all of these issues – death.

Slowly and with a building intensity, the most recent issue to re-emerge is euthanasia. Who should be able to say when and how you will leave this earth? Is it a political issue? Is it a social conundrum? Is it time that we stop socio-politicizing issues that are inherently simply personal? Maybe. Recent developments have reignited the age old debate over one’s right to die:

• An investigation has been launched into a group that calls itself “Final Exit.” The members allegedly comprise an assisted suicide ring that has aided up to 200 individuals with their deaths. Without my telling you, you can easily write the script here. One side cries, “Compassion,” while their opponents cry, “Murder.” You have heard this debate. You have thought about it, at least minimally. You either have a strong opinion one way or the other, or it lingers in your mind as “undecided.” The debate is about you, and me, since all of our lives will one day end. Do we want some authority over our demise, or do we have spiritual, religious or moral beliefs that preclude that authority? Here is more on Final Exit:

•The debate rages as intensely in Europe as it does here. Just weeks ago, in Italy, the highest court ruled that feeding tubes could be removed from Eluana Englaro , (below,right in a photo held by her father) a woman who had been in a vegetative state for 17 years, the result of a car crash. But the government — pressured by the Vatican — defied the ruling and tried to pass an emergency law that would prevent doctors from removing all life support from ailing patients. Englaro died during the Senate debate. No one knows yet how Englaro died. Her condition was labeled “stable” as recently as the morning of her death. The process of removing the feeding system started shortly before her death. A country-wide battle began to brew between the right to die advocates and the preservation of life contingent. Further, the battle widened to one between church and state: The Vatican declared a right to life stance, while the Italian president, Giorgio Napolitano, said the Vatican was interfering with a court order. Just this past Friday, Milan authorities announced an investigation has been launched, targeting 17 people, including Englaro’s father and her anesthesiologist.

These are merely the most recent uprisings in the battle between death with dignity proponents and sanctity of life supporters. So, where do we stand legally in 2009? According to The International Task Force on Euthanasia and Assisted Suicide, here are the facts:

“Oregon, Washington, the Netherlands and Belgium are the only jurisdictions in the world where laws specifically permit euthanasia or assisted suicide. In February, 2008, Luxembourg passed a law to permit euthanasia and assisted suicide. However, the law will not go into effect until additional procedures are completed. Implementation is expected in mid-2009.

Oregon and Washington have passed laws permitting assisted suicide. The Netherlands and Belgium permit both euthanasia and assisted suicide. Although euthanasia and assisted suicide are illegal in Switzerland, assisted suicide is penalized only if it is carried out ‘from selfish motives.’

In 1995 Australia's Northern Territory approved a euthanasia bill. It went into effect in 1996 but was overturned by the Australian Parliament in 1997. Also, in 1997, Colombia's Supreme Court ruled that penalties for mercy killing should be removed. However the ruling does not go into effect until guidelines are approved by the Colombian Congress.”

Elsewhere in the U.S., 36 states have laws that explicitly criminalize assisted suicide. In six other states and the District of Columbia, the practice has been rendered illegal by court rulings, but not legislative actions. In New Hampshire, an assisted suicide bill is pending. A proposal in Massachusetts is under legislative consideration.

Make no mistake: there are no definitive answers here. There are only grey areas. These were never more clearly demonstrated than by John Peyton, a victim of Lou Gehrig’s disease, who opposed Washington State’s initiative to legalize physician assisted suicide.



I have had cause to think about this issue lately because of the recent death of my 92-year-old father, who lingered in a highly sedated state for weeks before he finally died. Had there been a humane, gentle way to guide him out of his misery, would I have taken it? Would you? Have you? Anecdotal evidence indicates many physicians have taken steps – privately, of course – to mercifully help their terminally ill patients die. As far back as 1985, journalist Betty Rollin wrote Last Wish, her powerful memoir of assisting her own mother with suicide. The debate is not new. The dilemma never really changes. The decision is almost too horrific to ponder. Nevertheless, after witnessing the compromised humanity and stripping of common dignity my father endured, I have to wonder if I would have – or could have – helped him end his life. My gut tells me that if he had been conscious, and asked me to help him leave, I may have done just that.

As I said earlier, it is strictly personal.