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by DHIRAJ FERNANDO

"Death is a remedy against all evils: It is a most assured haven, never to be feared and often to be sought. All comes to one period, whether man makes an end of himself, or whether he endures it, whether he runs before his day, or whether he expects it, whence soever it comes, it is ever his own, whereever the thread be broken, it is all there, it's the end of the web. The voluntarist death is the fairest. Life dependeth on the will of others, death on ours".

You are lying in a dreary hospital ward, depressed, lonely and scared. However, you are not completely by yourself. Pain has been your constant companion for the past six months.

The agony you have been enduring is so intense that mere words fail to describe it in all its intensity. Debilitating, excruciating, blinding and unbearable are words that drift through your mind in an effort to lend the sensations a degree of definition. Every action of yours has to be contemplated in terms of painful effort.

Adding to the misery of your dire circumstances is the official prognosis of the condition afflicting you. You have been informed by your doctors that the outlook is grim, for the condition is terminal and incurable. However, the most optimistic of predictions give you a full six years of life. You are far from releived at this news. To you it merely means six interminable years of horrendous suffering.

Given the context of the situation you are in you naturally seek a way out, to stop the pain. The potent opiate based painkillers you have been prescribed nauseates you and does little to relieve your suffering. All sense of instinctive self preservation desert you, as you justifiably long for a quick death which you consider infinitely preferable to the alternative of six years of agony.

Terminally incurable patients such as this have few if any choices in deciding their own fate.They are denied the only chance of relieving their suffering; death, by a rather ironic law that criminalises suicide in certain countries with archaic laws. The inability of a patient to commit suicide due to his bedridden state and the resultant lack of access to the necessary implements to do so makes him dependant on another to help him;-`Euthanasia', assisted suicide, commonly referred to as `mercy killing' and also called physician assisted suicide.

The word euthanasia originates from the Greek language: EU means `good' and THANATOS means `death'. Euthanasia is a question of choice: empowering people to have control over their own bodies. One meaning given to the word is; "The intentional termination of life by another at the explicit request of the person who dies". That is , the term euthanasia normally implies that the act must be initiated by the person who wishes to commit suicide. However the term defines both voluntary and involuntary termination of life of which several forms exist.

PASSIVE EUTHANASIA: Hastening the death of a person by altering some form of support and letting nature take its course. For example; removing life support equipment, stopping medication, stopping food and water and allowing the person to dehydrate or starve to death.

ACTIVE EUTHANASIA: This involves causing the death of a person through a direct action in response to a request from that person.

PHYSICIAN ASSISTED SUICIDE: A physician supplies information and\or the means of committing suicide.

INVOLUNTARY SUICIDE: This term is used to describe the killing of a person who has not explicitly requested aid in dying. This is most often done to patients who are in a persistent vegetative state and will never regain consciousness.

Unless a person lives in Columbia, Japan, the Netherlands or in the state of Oregon, the only lawful option is to remain alive, in intractable pain , until their body finally collapses. Euthanasia is illegal elsewhere and renders the person thus assisting liable to prosecution on a charge of homicide and presents a severe conflict between moral, ethical and legal ramifications.

The first machine built to legally kill patients was developed by Dr. Philip Nitschke of Australia. It involved a computer that asked the patient three times whether he really wanted to die. If the patient agreed each time, then 100 ml of liquid Nembutal was pumped through a fine needle into the patient's arm killing him within five minutes.

Another person who openly advocated euthanasia and whose actions highlghted the issue on the world stage was Dr. Jack Kevorkian, an American physician from Michigan. Dr. Kevorkian assisted the deaths of hundreds of his patients by hooking them up to a machine that delivered measured doses of medications, but only after the patient pushed a button to initiate the sequence. More recently, he provided carbon monoxide and a face mask so that his patient could initiate the flow of gas.

In 1988 Dr. Kevorkian injected controlled substances into a patient with ALS (Lou Gehrigs Disease), thus causing his death. He was subsequently charged with 1st degree murder. The jury found him guilty of 2nd degree murder in 1999.

The Hippocratic Oath, the ethical and moral code of conduct that doctors pledge to abide by in practising medicine legally binds them to prolong the life of their patients for as long as it is possible to do so. Questions of sympathetic consideration for the patient are superseded by the moral and legal imperative to prolong life.

The euthanasia debate has raged on for decades in the United States and Europe. If suicide is a legally available option to those who are able bodied, Should'nt a patient suffering indescribable pain be allowed to take a decision to end his life, and if incapable of doing so by himself should'nt another person be permitted to assist him?

The main opposition to euthanasia comes from conservative religious groups, medical associations, anti abortion activists and groups concerned with disabilities. The primary contention among religious groups is that euthanasia is sinful,"for life is a `gift of God', thus only God can start a life and only he can end it". Another view being; "God does not send us any experience we cannot handle. God supports people in suffering. To actively seek an end to ones life would represent a lack of trust in God.

These theologically based arguments are countered by a significant and growing percentage of agnostics, atheists, humanists, secularists and liberals who quite correctly point out that each person has autonomy over his life. Persons whose quality of life is nonexistent should have the right to decide to commit suicide and to seek assistance if necessary.

The bottom line is that sometimes a terminal illness is so painful that it causes life to be an unbearable burden, death can represent the only available means of relief, euthanasia the only acceptable human answer. 

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Copyright 2001 The Associated Newspapers of Ceylon Ltd.
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