Euthanasia – a peaceful end at a time of my choosing..?

I have been working as a physiotherapist for more than 30 years, and during this time I have been with a number patients as they lived the final weeks and months of their lives, knowing that in the near future they will die. A few lived their last few weeks with a nobility and joy which was inspiring to everyone around, a few fought bitterly against the hand that fate had given them, and some even lived their final weeks denying that life was coming to an end. Treating these patients was, on the whole, a rewarding experience, as everyone is grateful if you can ease their pain for even a while.

Equality and Freedom

Much of the debate around the topics in this Ethics MOOC have centred around 2 very basic concepts: equality and freedom. There seems to be a good consensus that equality for all is a Good Thing, and should be a moral absolute, and that each of us should have freedom to think and act as we wish, albeit with many limitations placed by the society we live in in order to ensure that one person’s free act does not rob another person of their life/health/freedom.

Freedom to choose the end…

So, looking at the last stages of a person’s life, does it make sense that they should be free to choose the manner of their death?

You or I certainly have that freedom right now: if I wanted to, I could end my life at a time of my choosing with a choice of several different methods, and I suppose I do consider this a freedom.

Now, a terminally ill patient suffering from the late stages of, for instance, Motor Neurone Disease, does not have the same freedom you and I do to end their life: they no longer have the physical ability to kill themselves. A person with Locked-in Syndrome similarly lacks that freedom.

This certainly seems to be unequal – I am allowed to end my own life, but simply because they are “disabled” they are not.

Is this not discrimination?

We might argue that life is unfair, and that their cruel disease has robbed them of many freedoms: to walk, talk, feed themselves, etc. and that it also robs them of the freedom to finish their life. However, we can also argue that the Law does not prevent them walking, talking or eating, yet the Law as it stands in the UK and in South Africa does prevent them ending their life.

Does “right to life” mean “an obligation to live”?

To my mind, Locked-in Sydrome and terminal illness with intractable pain certainly diminish human dignity, and it’s harder morally to justify letting somebody die a slow and painful death than it is to justify helping them to avoid it.

Euthanasia Legislation

I find myself thinking that in the context of the UK, on balance I believe that some form of euthanasia (perhaps similar to that currently practised in The Netherlands and Belgium) should be made legal.

I feel certain that I would be glad of it were I to be diagnosed with MND or something similar.

However, I do wonder whether in the context of South Africa legalising it might just bring certain problems which it wouldn’t in the UK.

Please forgive me: I know this sounds terribly prejudiced – it’s ok for me in my country but not ok for you in yours – but here are my reasons for being unsure:

Euthanasia is an extreme act used as a last resort when medical interventions are unable to provide a cure, and really needs to exist in a society where every person has access to very good medical care, especially palliative care services – I wonder whether this is the case at present in South Africa? I have no real knowledge of this, so I’m just asking the question.

I can imagine a scenario where a newly established – and maybe also as yet underfunded? – health care system might struggle to provide good care for terminally ill patients, due to lack of resources and experience; and in this case encouraging patients to undergo euthanasia might seem to be a good way of making sure that funds were saved to spend on patients with a better prospect of cure/recovery.

Please comment on this last section – do I have the right to make these sort of remarks about South Africa?

The illusion of free choice

The whole euthanasia debate is certainly difficult.

But I believe that we are morally obliged at least to have the discussion…