Few subjects stir passions like matters of life and death, such as abortion and capital punishment, to name two. When does life begin? Who has the right to terminate life? Good people on both sides of these issues stand firm in their beliefs.
And then there are end-of-life issues like euthanasia, assisted suicide, and the right to die. While there are some differences in the meanings of these terms, they are all about what can done to end pain and suffering when human life is drawing to an end. Should people have the right to end their own lives when they are suffering from painful and debilitating illnesses for which there are no cures? Should a medical professional be allowed to end a patient’s life, at the patient’s request, when the patient is unable to do so for himself? And what about discontinuing life support when to do so will surely hasten death?
Talking about end-of-life issues demands a common understanding of end-of-life terms and their sometimes subtle differences. For purposes of this discussion,
Euthanasia is the act of ending the life of a human or animal in a painless manner. Because it is generally intended to end suffering, euthanasia is sometimes referred to as mercy killing.
Assisted suicide is the act of providing an individual with the means (drugs or equipment) to end his or her own life. Assisted suicide is distinguished from euthanasia in that the patient is the one who performs the action that ultimately leads to death, whereas in euthanasia, a medical profession or other party performs that action.
“Do Not Resuscitate (DNR)” is a medical term that directs medical professionals to refrain from performing cardiopulmonary resuscitation (CPR) should a patient stop breathing or his heart stop beating. You can stipulate DNR in an advance directive, or you can ask your doctor to write a DNR order on your medical chart.
“Right to die” is an umbrella term, encompassing everything from overt acts like euthanasia and assisted suicide to more passive actions, such as DNR orders, withholding food or water, or ending artificial life support, even when doing so will mean certain death.
The Right-to-Die Debate: Point and Counter Point
People who support an individual’s right to die see the issue as a matter of individual liberty and compassion. Those who are opposed to allowing people to make their own decisions regarding the time and manner of their death express concern that allowing euthanasia or assisted suicide will lead to wholesale disregard for life.
Currently, euthanasia is outlawed in most of the U.S. Only three states have passed legislation to allow assisted suicide: Montana, Oregon, and Washington. In those states, some right-to-die proponents, like Scott Mendelson, M.D. in his opinion piece It Is Time to Grant the Right to Die, describe a paradox that is seen in some terminally ill patients. Knowing that they have the right and the means to decide the timing and circumstances of their death, some patients stop short of taking the final action, and instead find the strength to hang on a little longer.
Although there are concerns that right-to-die legislation may lead to abuses, the three states that allow assisted suicide have built rigorous safeguards into their laws. In Oregon, for example, assisted suicide is legal ONLY if all of the following are true.
- Two doctors have certified that the patient has six months or less to live.
- The patient has made at least three requests – two verbal and one written – asking the doctor for a lethal dose of medication.
- A 15-day waiting period is observed before the lethal prescription is filled.
- The patient must take the drug himself; the prescribing doctor may not administer the drug.
With such precautions in place, the debate is primarily a religious one. Those who oppose any human action to hasten death often do so on the basis that God and God alone has dominion over such matters, but many good people on the other side of the argument, far from being God-less, simply have a different understanding of God.
As for alleviating suffering, many who argue against the right to die claim that the wonders of modern medicine have yielded more than adequate methods to relieve pain, and certainly great strides have been made in the field of pain control. Those who support assisted suicide, on the other hand, point out that medication can’t always eliminate a patient’s pain and agitation, and that administering mega doses of pain medication in an attempt to comfort the patient may actually lead to death as a secondary effect.
Only one thing is certain in the right-to-die debate: the debate is far from over.
What Do You Think?
Most people have strong views on euthanasia, assisted suicide and the right to die. What do you think? Should terminally ill people be allowed to end their own lives? What are the beliefs, values, and experiences that have helped to form your views?