Legal euthanasia pressures patients and denies hope for recovery


Fair Use: Associated Press

Brittany Maynard , a 29 year old woman with terminal brain cancer, will end her life on Nov. 1 with the help of death and dignity laws.

The story of Brittany Maynard, a twenty nine-year old brain cancer patient who plans to end her life on Nov. 1, has captured headlines nationwide and revived the debate over physician-assisted suicide. Maynard, who moved from San Francisco to Portland in order to fall under the jurisdiction of Oregon’s Death with Dignity Act, has spent her final months traveling with her family and advocating for right-to-die legislation.

As far as euthanasia decisions go, Maynard’s appears carefully considered. As she explains in a video interview, normal palliative care would likely fail to completely relieve her pain as the cancer progressed, due to the unique severity of her condition. Far from rejecting life, she has continued to live with incredible zeal. All in all, Maynard’s case neatly represents the perspective posed by the pro-euthanasia movement—why shouldn’t mentally sound adults have the ability to die on their own circumstances?

An investigation of the broadly accessible euthanasia available in several European countries provides the first strike against assisted suicide. A 2009 policy brief undersigned by eighty Quebec physicians notes that, among other negative impacts, legalizing euthanasia for non-terminal individuals inevitably results in system abuses and oversights, allows simple depression cases to slip through the cracks,  and exerts pressure on the elderly to hasten their deaths in their childrens’ economic interest. In one instance, a Belgian couple had their deaths arranged by their children, who did not wish to be responsible for taking care of one parent if the other died. Widely inclusive euthanasia clearly indicates an institutional and social disregard for human life that has no place in any civilized society.

American “Death with Dignity” laws, which have been implemented in five states to date, are considerably narrower in scope and more closely regulated. The Oregon law enabling Maynard’s decision applies only to terminally ill individuals whose prognosis allots them less than six months to live. There are several mandatory checkpoints built into the process, at which the patient is given the opportunity to reconsider. And finally, administration of the fatal dose is left to the patients themselves. These three measures effectively eliminate the all-too real possibility under the European model that a patient could be put to death without their consent, and designates euthanasia as only a last resort for the dying. However, even these laws display a dangerous lack of regard for human life, and create problems that outweigh their very narrow functionality.

With regard to functionality, euthanasia is clearly warrantless where palliative care is sufficient to prevent severe and chronic pain on the patient’s part. This turns out to be a significant majority of even terminal cases; the Quebec physicians’ brief notes that:

“The overwhelming majority of patients in a state of physical and mental decline come to the natural end of life in a much fuller environment of support and palliation than ever before… Pharmacological advances and methods of radiation and surgical oncology allow us to relieve patients of much suffering and distress for which we formerly had few options.”

Since the medical establishment’s ability to counter pain is at an all-time high, it follows that the present is the least logical time yet in human history to break with Hippocratic tradition and enable doctors to prescribe death to their patients. Moreover, as palliative capacities are only increasing, the need for desperate measures like euthanasia only will diminish.

So against this highly limited need, what costs does legalizing assisted suicide for the terminally ill entail? To begin with, even the more regulated “Death with Dignity” model still puts financial pressure on patients to end their lives rather than incur large medical bills for their families, and constitutes the first step down a slippery slope that has led to the untenable situation presently enabled by euthanasia laws in Europe. But there is a much simpler and more fundamental problem with euthanasia, in any form—it denies our ability to hope.

David Williams was thirty-five years old when he was diagnosed with terminal spinal cancer, which left him painfully bedridden. Doctors predicted his life would likely end in a matter of weeks. “I purely on the basis of the suffering my wife was going through,” he told the Guardian in 2006. But his cancer unexpectedly went into remission under hospice care. Though his disease later returned, leaving him confined to a wheelchair, Williams has since become an advocate for Care Not Killing, a British anti-euthanasia group. Under a proposed assisted suicide legalization measure proposed in the United Kingdom in 2006, he said “People would be put under pressure because when you are that ill, you just want to do whatever is the easiest thing.”

Surgeon Peter Saunders notes that Williams’ change of heart after his initial depression and despair is hardly unique. “Suicidal thoughts are not uncommon at the time of first diagnosis, and before people have had the opportunity not just to hear about what palliative care is offered but to experience it,” he said. Euthanasia, in addition to addressing a diminishing need, denies the human spirit’s capacity for recovery, even under the greatest duress.

Click here for the recent StarTribune story on Maynard 

 TUESDAYS WITH THOMAS is published weekly.  Columnist Thomas Toghramadjian engages readers in topics ranging from politics to literature to science.