I once heard this story a long time ago. I can’t remember what I was doing at the time, and it is rare that I can remember a story in such detail, but when I do, I consider it has profound meaning. Wait, now I remember. I was working in a cancer ward and I took my break next to the patient rooms. Oddly enough, the place seemed dreadfully empty, except for one old man whom I suspect had cancer. I thought to myself there could not be any harm in having a conversation with him so I meandered over until I sat next to him. Without hesitation, he asked me, “Have you ever seen anyone die?” I never had, nor had I ever known anyone close to me die. Sure, thousands die on the news everyday, but I’m completely desensitized to issues far away from home. So this question struck me as quite peculiar and I knew I was in for an interesting conversation. I did not want to sound boring, so I boasted that I had seen nearly every way a person can die. I left out the part that I had seen all those deaths on television. He gave me a smirk, but whether he was impressed or saw through my facade, I will never know. He’s probably dead now, you see. But I suspect it was the latter. So he began to tell me this story. It goes something like this.
Not too long ago in a kingdom lived a king, and this king loved all the joys that life could bring. He especially loved to laugh, often waking up in the middle of the night laughing hysterically from a dream he had. All his advisors could not understand the source of his laughter. Indeed, they tried many methods to curtail his humor in the hopes that he would act more like a king than a jester. Finally, at their wits’ end, they decided that they should hold a great contest to find the best court jester to entertain the king. I think that’s where the saying “if you can’t beat them, join them” came from. Anyway, in the great court, the funniest men in the kingdom convened to prove who could be the king’s personal court jester. After hoards of laughter, the contest came down to two men. One, a very care free and jovial man, and the other, a knight from the king’s calvary. In the end, the jovial man beat the knight and became the court jester. The knight, embittered, vowed to take revenge against the court jester. He planned and he connived until he could not think any longer, and he came up with a plan. He plot to put poison into the king’s water and blame the court jester. When the moment arrived, he stoutly stopped the king from drinking the water and gave it to a dog at the table. The dog dropped immediately. He then claimed that he saw the court jester put poison into the cup. The king, enraged, proclaimed the immediate beheading of the court jester. Fortunately, his sense returned and he told the court jester, “You have given me many years of great service. Although you now make me sad, I cannot forget the times you have made me laugh. Therefore, I allow you the option to choose your method of death.” The court jester, sad for himself and the king, began to ponder his method of death. The entire hall stood still as the seconds turned to minutes, and the minutes turned to hours. Finally, the court jester slowly looked into the eyes of his king and said, “My dear king, though it kills me to have you think I have plotted against you, I am grateful that you have the kindness to choose my own death. Therefore, sire, I wish to die of old age.”
So you can imagine how I thought about this man afterwards. He knew he was going to die, yet he was absolutely resolute that if he was, he was going to die with some dignity. I’ve often asked myself if there is a good way to die. Well, maybe I’m stretching the truth for its dramatic sake, but when I really think about the issue, I really do want to die in a peaceful, serene setting. I don’t want to be plagued by disease, hurt, or the knowledge that I’m causing great pains for my family and friends. In the end, I want to die of old age. Fortunately for the court jester, I suspect that the king saw his folly and granted the court jester his wish. For others, some diagnosed with cancer or aids, others in comas, and even those with terminal illnesses, they do not have the luxury of that choice. Most often, they die in painful, stressing ways. They place the burden of grief and money on the family. Some of those terminally ill patients opt to end the misery by committing suicide, or as the legal code puts it, euthanasia. In Canadian society, euthanasia is illegal and the Criminal Code threatens punishment of fourteen years, yet the courts will put different interpretations to different situations. In 1991, Bill C-203 was enacted, thus preventing physicians from assisting in a suicide. The following year, Bill C-385 was enacted to amend the Criminal Code. This bill repealed Section 14 and in its place subjected anyone who counsels, aids, or abets a person to commit suicide guilty. Thus the issue of “the right to die” is hotly debated because society is so divided by it.
Consider the problem of nations. In Canada, a doctor assisted suicide is illegal. Once the life support has been plugged, the doctor cannot remove the plug from the patient. Yet the patient can, under certain instances where competency has been established, refuse the machine and thus die. In the United States, the law is varies from state to state. In Kentucky, euthanasia is permitted when a panel of “experts”, which include a physician, psychiatrist, and a surgeon, declare that the patient has no chance of recovery and the patient will only continue to suffer until their death. In California, euthanasia is outright illegal and the vast interpretation of the law will label any who assist in the suicide guilty. At the extreme side, the Netherlands totally permits euthanasia when assisted by a physician. Indeed, public opinion in the Netherlands holds that eighty percent of the population favor euthanasia, while only ten percent are against it. The remaining ten percent have no opinion on the matter. Even though the Netherlands is a more progressive country, leaning towards the left, the problem can be seen across the globe. The problem of euthanasia must be considered a global problem, or a social issue because it does not relate to just one individual, nor a group of individuals, but to society. It was once said that how we treat our sick is a good measure of our society. Canada may be rated the best place to live in the world, but does that mean if we do not let our terminally sick die, then we are barbarians? Conversely, does that mean that the Netherlands, because they allow those in pain to die, is a better country?
Like all social problems, society must be divided on the issue. One side will be for the legalization of euthanasia, and the other will be against it. Their respective arguments tend to support their ideas, but may also help the other side as well. An often cited source for both arguments is the Hippocratic Oath, which all physicians must take before being permitted to practice. Those favoring euthanasia quote the Oath as saying “I will do my best to alleviate the pain of the patient”. Those against favoring euthanasia quote the Oath as saying “I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect”. Apparently, the very core of the matter is inconsistent with its logic. The doctor is divided between providing the best care he can give and alleviate the pain the patient feels, yet must decide when the pain is too great for the patient to bear. In an anonymous survey of doctors in Canada, thirty eight percent admitted that if the patient was suffering beyond what medicine can cure, and if the patient had no chance of recovery, the doctor would end the patient’s life if requested. According to the World Medical Association’s Statement on Physician-Assisted Suicide, their statement ended with the following paragraph: “Physician-assisted suicide like euthanasia is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient.”
The recent case of Sue Rodriguez, who was terminally ill with Lou Gehrig’s disease, made headlines when it went all the way to the Supreme Court of Canada. Because of her articulate and consistent stand, Rodriguez has played a powerful role in creating sympathy and understanding for the right of people to choose their own death, says Professor Earl Winkler of the University of B.C.’s Center for Applied Ethics. She argued that she had the “right to die with dignity” and that she does not want to die in such a pathetic manner. The public was extremely divided on this case. Many argued that she would continue to feel pain until her death and that a cure was nowhere in sight. In addition, she was reduced to a withering dummy who was incapable of even feeding herself, let alone defend herself in court. She required a translator to speak for her. Sue contended that the financial burden on her family was too great and to see her family in such grief all the time made her final days even more difficult to bear. Conversely, those who favored to keep euthanasia illegal contended that there is no dignity to committing suicide and that it is the coward’s way out. Furthermore, should a cure be discovered, the patient would already be dead. This topic is often likened to the issue of capital punishment. If a prisoner was discovered innocent after the execution, then they could not be brought back. Finally, they argue that one cannot attach a monetary price to life and that everyone is entitled to lead a fulfilling life. Money should not be an issue and it is the government’s responsibility to provide for the patient. Again, this brings up another issue of health care and the two tier system where the rich pays for quality health care whereas those who cannot afford premium care must relegate themselves to crowded hospitals. So as you can see, euthanasia is not just a social problem itself, but has many other problems which arise from it. In this manner, euthanasia must be thought of as a global social problem that affects other areas of society as well. In the case of Sue Ferguson, she ultimately lost her battle in court. The Supreme Court was not yet ready to legalize euthanasia, and I imagine that Canada as a country was not yet ready to embrace such a radical idea. Sue Ferguson died before the decision was made, so depending on your view, whether that was a fortunate or unfortunate thing is your opinion.
In recent years, a number of proposals have been made to support the legalization of euthanasia. Among them are the ideas of a committee or a panel, much like in the Netherlands, where a number of experts in their field would decide whether the patient should be allowed to die or not. First, the psychiatrist would do an extensive study of the patient to make sure that they are competent enough to make such a decision on their own. Today, there exists many tests which may be used to judge whether the patient is normal or neurotic, or if the patient is sane or insane. A psychologist would decide whether the patient should undergo such an action and would evaluate the consequences the action might have on family and friends. The surgeon of expertise would decide if the condition is indeed terminal and provide the prognosis, citing if a cure is at all possible. The other physician would most likely be the family doctor because this doctor is most personal with the patient and aside from knowing the patient more intimately than the others, would also provide comfort and relaxation in a stressful situation. Those who believe in keeping euthanasia illegal counter that such “panels of experts” are human and are naturally subject to error. The fundamental attribution error, and the error of group-think are most likely to occur when a group of people, who already believe that a person should be permitted to die, will find reasons to support their view and ignore those that counter their beliefs. The error of group-think, as its name implies, means that the minority of a group tend to change their views and shift them more extremely to the other group in the possible efforts to share a common belief and fit in, or to avoid group conflict. Thus far, the use of a panel in the Netherlands, Sweden and Switzerland have superficially proven successful, however the panel is a new concept and further study must be used to fully evaluate its consequences, successes and failures. In addition, these countries have tended to be more liberal in their views and more accepting of differing views. If we implement the panel or committee system in Canada, its effectiveness would most probably be weakened on the grounds that Canadian courts have tended to be more conservative in its rulings. Therefore, any such panel would still be subject to the court’s interpretations and any appeal is under the mercy of the Supreme Court. The lengthy process of the law would certainly prevent most people from pursuing a course of action in that manner.
While terminally ill patients are usually categorized as competent, there remains the issue of comatose patients. Here, the discussion of competence or incompetence is irrelevant because tests cannot be administered. How does the law interpret the euthanasia of comatose patients? Even the prognosis for comatose patients is difficult to predict because head injuries are the most traumatizing. Physicians do not know how long the patient will be in the condition, and the burden of telling the family is not an easy one. For example, the patient who was in a car crash may be in a coma for ten days, or ten years. Similarly, the patient who received a mild concussion from a hockey game may also be in a coma for ten days or ten years. Because it is so difficult to predict when the patient will come out of the coma, it is up to the hospital to provide long-lasting care until the patient awakens. Those favoring euthanasia claim that even in a coma, the patient feels pain and would want the family’s suffering to end. The financial burden of keeping someone in a hospital bed for an indeterminate amount of time is too much a waste of valuable space, especially when others who are in more need of emergency attention cannot get into the hospital. By contrast, others feel that precisely for the reason the patient can wake up at any given time is justification enough to spend the time, money and resources to make sure they will. This argument follows the belief that everyone is entitled to the care that the government health care system provides and that money cannot be affixed to the value of life. Most often, this argument catches the attention of the elderly, females, and those who have lost loved ones. For this reason, society sees euthanasia as a “party-favor” where, demographically speaking, corporate men will favor euthanasia because it saves money whereas the elderly will oppose it because it is inhumane.
There is a battle going on in the courts as to who is in charge of dying. The medical profession, the lobbyists, the religious groups, and the government are at odds as to who controls the monopoly of death. As a society, we cannot actively embrace euthanasia, nor can we disregard it. Archbishop Marcel Gervais said that “individual situations are tragic and very compelling, but they cannot justify disregard of basic values that are critical to a just and humane society. Assisted suicide has profound implications for society because how we treat the dying affects how we treat the living.” Gervais, from a religious stance, must protect the value and posterity of life. Keeping in similar tones, Dr. Scott Wallace, a French physician, once described the role of the doctor in these words: “Guerir rarement, secourir souvent, soulager toujours” (to cure occasionally, to relieve often, to comfort always.) While the physician comforts, the government regulates, and often will forget whose interests they must protect. Society as a whole, or the suffering individual. Euthanasia is not an easy social problem to deal with, and whether or not it is eventually legalized is not the issue. What is important is the question of how society will come to terms with its mortality, and its death.
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