Dying with dignity: An option or crime?
Until now, Holland has attracted tourists with its flowering meadows and charming cities. But in the future it might see another kind of tourism – the tourism of death. Macabre though the idea may sound, it cannot be dismissed, because on April 10 Holland became the first European country to allow euthanasia – though only if the patient has an incurable disease or is suffering unbearably without hope of relief. In addition, patients are required to submit a written application to be allowed to die, and their condition confirmed by two doctors. A committee, consisting of a doctor, a lawyer and a specialist in medical ethics, will scrutinize every case and advise judicial authorities in case a challenge is mounted. The new law, however, simply confirms what is already common practice. Studies have shown that in 2000 alone, Dutch doctors used euthanasia (either actively, by giving fatal doses of medicine, or passively, by withholding life-supporting treatment) on 2,123 people, the vast majority of them cancer sufferers. Advocates of euthanasia all over Europe greeted the move with great satisfaction, stating that each person has the right to die with dignity and cannot be forced to endure unbearable pain or total helplessness without hope of recovery. The British High Court recently reserved judgment in the case of a woman (known only as «Miss B» to protect her anonymity) who is suffering from an incurable disease and wishes to decide when to end her life. Euthanasia champions exist in Greece as well. Yiannis Tountas, professor of social medicine, asks, «What reason is there to keep a person alive on a ventilator, when there is no hope of bettering their condition?» Doctors say no Is there a trend in favor of euthanasia? Lacking the right to a dignified existence, are we now trying to establish the right to a dignified death? However, there have been fierce reactions, not just from religious and conservative circles. Naturally enough, the churches are wholly opposed. «Reviling God» was how the Holy Synod termed the Dutch decision. But more importantly, medical circles have spoken out. The World Medical Association has expressed the view that any form of euthanasia flies in the face of medical practice, while it issued a virtually unanimous condemnation of the Dutch initiative (with the Dutch representative the sole dissenting vote). The medical community in Greece is of the same mind. Many doctors feel that euthanasia contravenes one of the fundamental tenets of medical philosophy, the Hippocratic Oath, which expressly says, «I will not give a fatal draft to anyone if I am asked, nor will I suggest any such thing.» Others stress that euthanasia completely undermines medical ethics, built in the wake of the barbarity of World War II. As set out in the Geneva Convention in 1949, these both confirm the right to life and forbid doctors to experiment on or kill human beings. Significantly, medical or other associations opposed to euthanasia often refer to the Nazi euthanasia programs, which were used to exterminate thousands of disabled people. But more radical voices have also been raised against euthanasia. The Green Party candidate for the American presidency, Ralph Nader, is typical. Castigating the legalization of euthanasia in the state of Oregon, he warned of the danger that doctors and healthcare managers might push patients toward euthanasia in order to reduce the costs of treating incurable diseases. People would inevitably be driven to opting for death if their pain was not effectively dealt with, he pointed out. Many Greek doctors have also expressed opposition to euthanasia as the perfect – and final – analgesic. Savvas Matsas, a radiologist, called euthanasia an «appalling choice,» and underscored that a doctor’s duty lay in «fighting for life to the end.» He also pointed out that «the process whereby medicine is turned into healthcare management holds tremendous dangers. Recently, a medical conference in Britain was thrown into turmoil by the granting of bonuses to old people’s homes that could show a reduction in costs. But in many of those institutions there was a rise in the number of senior citizens quitting the home – by dying.» Organizations of people with special needs, with expressive titles such as «No More Dead,» charge that numerous US hospitals refuse to care for people they judge incurable. Could this be the thin end of the wedge for the vested interests of hospitals, insurance companies, or the more sordid motives of relatives, playing the role of God? Tountas regards such concerns as exaggerated, since the «the person’s decision concerns his own life and is impossible to take without great deliberation.» He also feels that to safeguard against problems, «there must be two strict, and simultaneously applicable conditions: that the patient responsibly, and in writing, expresses the desire to embark on the euthanasia process, and that he should be ascertained to be lucid, calm and rational. Secondly, the doctor must agree that science can do no more.» Dilemmas Despite this, the decision is not an easy one. How can somebody be judged lucid when they are in unbearable pain? Or when they belong to the margins of society and suffer from low self-esteem? Even the non-reversable nature of the illness is open to question, both biologically and psychologically. During the recent debate in the UK over Miss B’s request to choose the moment of her death, a 43-year-old doctor, Ian Basnett, paralyzed from the shoulders down for 17 years, said, «In the beginning, I wanted to die. Now I am happy I didn’t.» The fact is that there are no easy answers. Tountas stresses that «the problem of euthanasia… is a delicate and complex one. It will need to be examined and discussed. But its legalization in Holland gives us the chance to explore possible problems that will be created.» But extending the culture of death could have tragic results. In the Netherlands, debate has already begun on whether «suicide pills» should be prescribed for old people who want to die, even if they are healthy.
