People are living longer than ever, we understand, and many young “Builders” and older “Boomers” are being cared for by their younger Boomer or older Gen X family members. Tensions sometimes exist around care and issues of termination.
Children benefit from grand- and great-grand-parents in their lives and sometimes fear their death. Children and youth may also be keenly interested in ultimate questions about life and death. This article and topic are meant to be helpful as an introduction to these questions—and sometimes critical decisions.
In the Greek language thanatos is the word for death, the prefix eu means good or well. So, the term euthanasia literally refers to “a good death.” The Encarta World English Dictionary defines euthanasia as “the act or practice of killing somebody who has an incurable illness or injury, or allowing or assisting that person to die,” (p.615). For Wikipedia, “Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering.” http://en.wikipedia.org/wiki/Euthanasia, accessed 23Jul2013. Historically, the term has been used more broadly—more along the lines of dying a timely or good death.
Before moving into debates surrounding this idea and practice some other terms need brief explanation.
“Voluntary euthanasia” denotes clear consent of the patient.
“Non-voluntary euthanasia” refers to situations in which the consent of the patient is not possible.
“Involuntary euthanasia” denotes euthanasia against the will of the patient.
These three types of euthanasia also have “passive and active variants. Passive euthanasia entails the withholding of common treatments… Active euthanasia, the use of lethal substances of forces…. A number of authors consider these terms to be misleading and unhelpful.” (from same Wikipedia article above)
The term death is also not as simple as often supposed. There are transitional stages between life and death.
Patients in what is called a “vegetative state” are physically awake but mentally unconscious. They may open their eyes, breathe on their own and move reflexively, but have no awareness of their surroundings or ability to think. Typically, they cannot communicate, feed themselves or be continent. The condition is considered “persistent” if it lasts more than a month.
Patients in a “comma” may breathe and respond with basic reflexes, but are less “alive” than those in a vegetative state. They are in a deep brain sleep from which they cannot be aroused.
Patients are considered “brain dead” when they cannot breathe on their own and show no response to stimulation or reflexes such as gagging or blinking their eyes—when there is no activity revealed by an EEG.
The Euthanasia Movement in the United States may be traced to Felix Adler and Robert Ingersoll at the end of the 19th century—arguing that voluntary euthanasia ought to be offered to adult patients suffering terminal and painful ailments. In the United Kingdom Charles Killick Millard campaigned for legalizing voluntary euthanasia through The Voluntary Euthanasia Legalization Society, founded in 1935. The organization is now called Dignity in Dying.
Jack Kevorkian was the activist and public champion of a terminal patient’s right to die through physician-assisted suicide. He claimed to have assisted some 130 patients do so. Kevorkian and others in the Euthanasia Movement, see assisted suicide as a matter of a patient’s autonomy. Later studies of his patients intimated that Kevorkian may have been “hasty and somewhat callous about death in his 10-year crusade…. His detractors, including many who support the concept of assisted suicide, argue that Kavorkian’s methods resulted in the deaths of some who, if properly counseled, might have gone on to live productive and relatively happy lives.” (Raja Mishra, “A study of deaths raises questions on Kevorkian image,” The Boston Globe, 7Dec2000, A3)
Kevorkian’s first four trials resulted in three acquittals and a fourth mistrial. After allowing a video to be broadcast by CBS in 1998, which showed him administrating the lethal dose (in other cases patients themselves had made the final move), he was convicted on a charge of second degree murder and served prison time from 1999 to 2007. Kevorkian died in 2011, noted as a pathologist, activist, author, painter and musician.
Two cases dramatized the Euthanasia issue in the United States. In April 1965, having turned 21, Karen Ann Quinlan left home and moved in with friends. She seemed obsessed with losing weight in order to fit into a new dress. Having had nothing to eat in two days, she attended a party and reportedly drank two gin and tonics and took some Valium. Complaining of feeling faint, she was taken back to her bed, but friends noticed she had stopped breathing. Mouth to mouth resuscitation was administered, but she never regained consciousness. Admitted to New Jersey’s Newtown Hospital, she lapsed into a coma before being transferred to larger hospital. Soon she was put on a ventilator and given nasogastric feeding. Her condition, that of a persistent vegetative state, deteriorated and her weight progressively declined to 80 pounds.
After several months of visitations, Karen’s parents, devout Catholics, consulted their church and asked that Karen be relieved of artificial devices—be returned to her “natural state.” A County prosecutor threatened charges of homicide. Finally, in 1976, the Quinlan family succeeded in taking Karen off the ventilator, but she was fed artificially a further nine years until her death from pneumonia in 1985.
As a teenager Terri Schiavo found herself overweight, 5’ 3” and 200 pounds. Rigid dieting about the time she entered college brought that weight down to 135 pounds. She met and married Michael Schiavo in 1982. They moved to Florida where Michael managed a restaurant and Terri worked for an insurance company. Still trying to keep her weight down with her own dieting methods, she restricted herself mostly to liquids—drinking 10-15 glasses of ice tea a day. In February of 1990, Terri collapsed outside her apartment. Paramedics found her not breathing and with no pulse. The hospital assessed her condition as suffering electrolyte imbalance with a seriously low potassium level. She had suffered massive brain damage and after a couple of months was diagnosed as having moved from a coma to a persistent vegetative state.
Relationships between Michael and Terri’s parents, the Schindlers were amicable through this tragedy. In November of 1990 Michael had Terri taken to the University of California, San Francisco for experimental nerve stimulation—to no avail. Believing there was no longer any hope of Terri’s recovery, Michael filed a “do not resuscitate order.” In 1998, Michael filed a petition to remove Terri’s feeding tube—a request to which Terri’s parents strongly objected.
The Schiavo case is a dispute between family members. Terri’s parents argue that she would want to receive artificial feeding if she were able to make her wishes known; her husband believes she would not wish to be so treated if she were aware of her condition. The main Florida courts who have heard this case have consistently sided with her husband. (Leonard H. Glantz, “The Schiavo Tragedy,” The Boston Globe, 22Mar2005, A19)
The dispute highlights the importance of writing a living will. The public debate pitted many conservative Roman Catholics and Protestants against more liberal thinkers.
John Leland (“Did Descartes Doom Terri Schiavo,” The New York Times, 27Mar2005, WK, 1,3) adds a bit of philosophy to this discussion. “Aristotle… considered existence itself to be inviolable…. Descartes, the Enlightenment philosopher… defined human life, not as biological existence… but as consciousness….”
The ideas at play over this (intellectual) history do not conclude with Ms. Schiavo’s case, but feed into arguments over abortion, stem-cell research, assisted suicide, the death penalty—and even animal rights
(Leland quotes Courtney S. Campbell, a professor of medical ethics at Oregon State University, who has argued for patients’ rights to euthanasia) It goes back to the foundations of the Republic—the right to life and the right to independence. It’s a deep-rooted conflict that goes to the core of who we are as a people and as a political society, so it’s not surprising that is can be polarizing.
Compassionate scholars and physicians who stand against voluntary euthanasia or doctor assisted suicide prefer giving patients enough pain killing medicine to reduce their suffering and often hasten their death—while still allowing “nature to take its course.”
As to euthanasia’s actual civil status: In the United States, assisted suicide is legal in Oregon, Vermont, Washington and Montana. Euthanasia is legal, often with certain criteria, in the countries of Netherlands, Belgium and Luxembourg.
Questions for Reflection and Discussion
1. What, honestly, was your first reaction to the term and idea, “Euthanasia?” What are you further responses to “right to die,” “assisted suicide,” and “dying a good death?”
2. Do you consider this article with its definitions and stories and a few facts a good introduction to this complex and controversial issue?
3. What from science, philosophy and from you religious faith or humanistic moral code, would you want to add to this article?
4. How important is this issue to you? And how important do you think it should be to politicians, academia, the church and other religions?
1. The number of euthanasia deaths in the Netherlands in 2011 has been reported as an increase of 18% or 3695 deaths—an increase from 1923 in 2006. Since the Deaths with Dignity Act of 1997 in Oregon, 129 persons were euthanized and 265 lethal prescriptions written.
2. The timing of one’s death can be postponed by a liver, lung, or heart transplant. It can be hastened by refusing further difficult cancer treatments. Physicians have commonly accepted the fact that the timing of 80% of deaths occurring in a hospital is chosen. Active euthanasia, assisted suicide, is a signficant further step.
3. The “sanctity of life”: with all its religious or secular meaning versus the freedom to chose to leave this life—that is the question before us. Terminating excruciating pain, loss of dignity, and timely conscious farewell to loved ones with inevitable demise, on the one hand, or on the other, looking for meaning and hope through exquisite suffering and degradation, relinquishing autonomous choice to the higher power of nature or of Nature’s God—these are the conflicting perspectives.
4. Without understanding the meaning of death, we can hardly understand a full meaning of life. How a society thinks about life and death is crucially important.