Monday, October 5, 2009

Reality blurs ideology behind euthanasia.(Editorial). USA, LLC

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I STRUGGLE with voluntary euthanasia -- the idea of it. Back when I was younger it was straightforward. It was about rights. Everyone should have their say over whether they want to live or die. And from that went the argument that if someone wanted to assist in taking life, then that too should be their decision.

But since the recent Graeme Wylie manslaughter case, my views have changed.

Mr Wylie's de facto wife, Shirley Justins, gave him a lethal dose of Nembutal. He was 71 and had Alzheimer's disease. He'd apparently tried many times to kill himself, including an attempt to slit his own wrists.

When giving him the drug, Justins said she told him: "This will relieve your pain, Graeme. If you drink this you will die."

For her it was a mercy killing. The jury decided it wasn't.

What makes the case disturbing is that Justins had, with the help of pro-euthanasia campaigner Dr Philip Nitschke, applied the year before to the organisation Dignitas for legal euthanasia in Switzerland. Dignitas refused on the grounds that Mr Wylie's cognitive abilities seemed "ambiguous".

At Justins' trial, the jury had been told Mr Wylie's did not know he had daughters, could not identify the day, month or season, and struggled with simple spelling and arithmetic.

Yet Dr Nitschke -- a witness in the case -- came out of the court defending Justins, claiming her conviction for manslaughter was an injustice. Perhaps it was.

But what I don't understand is this: shouldn't the Dignitas rejection have rung alarm bells in Dr Nitschke's mind, that perhaps Mr Wylie didn't have the capacity to understand what was happening to him, that euthanasia in this case should never have been considered because it could never be voluntary?

The case has come at a bad time for euthanasia supporters, with the debate back on the agenda -- Senator Bob Brown is pushing a private member's bill for new euthanasia laws.

There are a few reasons to doubt this will succeed. Governments see the push for euthanasia laws, like debates on abortion, the legalisation of drugs or any other medically vexed issue, as a political trap, one that either exposes fracture lines in its own party or expends political energy better used elsewhere.

So governments come down on the side of caution -- air the debate, have a conscience vote and move on.

Do the laws need changing? They could bring out in the open what often goes on in private -- the role doctors and families take in assisting deaths of loved ones. It's usually in the form of 'terminal sedation'for people at the end of their lives. Doctors talk about the agonising emotional dilemmas involved, especially when confronted with the anguish of patients they have known for many years.

That this is so rarely acknowledged in public suggests that we invest considerable faith in the miracle of modern medicine, but as a society we still seem to struggle to accept the darker truth that medicine is often futile in the face of profound mental and physical suffering.

But while greater transparency may be welcomed, the Wylie case is also a reality jolt. It shows how vulnerable we often are as we grow old and frail.

There's a Philip Larkin poem about this called The Old Fools . It starts:

What do they think has happened, the old fools,

To make them like this? Do they somehow suppose

It's more grown-up when your mouth hangs open and drools,

And you keep on pissing yourself, and can't remember

Who called this morning? Or that, if they only chose,

They could alter things back to when they danced all night,

Or went to their wedding, or sloped arms some September?

Or do they fancy there's really been no change,

And they've always behaved as if they were crippled or tight,

Or sat through days of thin continuous dreaming

Watching light move? If they don't (and they can't), it's strange:

Why aren't they screaming?

Larkin captures what euthanasia advocates often sidestep. The times in our lives when death perhaps makes rational sense are the times in our lives when we have lost rational sense of who or what we are. I'm not against euthanasia in certain circumstances -- but it's identifying those certain circumstances that is the problem.

When I first heard of Dr Nitschke a few years ago, he was running workshops in undisclosed locations explaining how to mix your own DIY killer cocktails and how to suffocate your loved one using a plastic shopping bag. He's been unswerving in his campaign for voluntary euthanasia laws.

But it feels to me now as it did then that this is euthanasia as an ideology. And in the end, ideologies are dangerous because they are invariably blind to the fragile complexity of real life and death.

Source Citation:"Reality blurs ideology behind euthanasia.(Editorial)." Australian Doctor 00.00 (July 25, 2008): 24. General OneFile. Gale. Alachua County Library District. 5 Oct. 2009

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