There is an intriguing debate in this world regarding the sanctity of life. In the vast array of rights, we see persistent weighting and balancing between the various people and rights that strive to coexist on this planet. There are many different people, perspectives, and legalities.
The British Broadcasting Corporation, BBC, recently reported on a California man who concluded that he had reached his end. Under a reasonably recent state law, he was attended by a modern-day Dr. Kevorkian and committed suicide with the support and acceptance of his family. The story was covered by the BBC because Britain is now considering legalizing suicide.
One cannot fault the focus of the story, a man named Wayne Hawkins. He was 80 years old when he drank "a drug-laced cup of juice and drifted off to an eternal slumber." Wayne was happily married for fifty years and the father of two. He spent his life in architecture and his spare time camping, hiking, and raising a family.
He was diagnosed with a terminal heart condition and handed a death sentence. The physicians prognosticated that he would have less than 6 months to live. In the meantime, he would suffer pain and symptoms from other conditions, "including prostate cancer, liver failure, and sepsis." From any perspective, this was a reasonably bleak outlook.
Wayne departed this life in compliance with California law. He planned for it, personally obtaining the cocktail of drugs in advance. The story notes that if the plan passes in Great Britain, the attending physician will be responsible for bringing the drugs to the patient. Semantics. Wayne consumed the poison with his own hand, surrounded by family.
Wayne's was a choice. It impacted others. Not directly, he did not kill anyone else, but it affected others. This included family, friends, and those tasked with assisting him. To accomplish his death, he had to convince "the attending physician" and then "a second doctor." Those doctors may never reflect on their involvement. And yet.
Most doctors in America recite the Hippocratic Oath. It remains a thing after centuries. Notably, it is not today as it began, and has been "rewritten often to suit the values of different cultures." It is frequently referred to almost reverently as providing doctors should "first do no harm," but those words are not included.
It does say the physician will "benefit my patients," and "will do no harm or injustice to them." There appears some subjectivity to both benefit and harm. It is in those perspective disparities that discussion and debate persist.
Death might be viewed as harm. There is a perspective for the terminally ill that the resulting relief of death might instead be a benefit. The Oath also commits "I will not give a lethal drug to anyone if I am asked." The California law requires the patient to do the poisoning. The Oath continues "nor will I advise such a plan," and "will not give a woman a pessary to cause an abortion."
However, the "modern version" of the Oath is a little less clear on the "lethal drug," and instead focuses on the patient, "a sick human being," and the impacts of illness, both personal and familial. It stresses "that there is art to medicine as well as science." And, notably, the physician must "tread with care in matters of life and death," understand "awesome responsibility," and "not play at God."
It is fair to say the modern Oath is less definitive than the original.
There is a significant dignity and power in making such a choice. I have watched many suffer, endure, and eventually pass. I have known some who refused nourishment, knowing that food was sustaining them, but who recognized their choice was a departure from their pain and suffering. They did that without the assistance of any physician. There have been instances when others engaged more actively. Refusal of nourishment does not seem to raise the emotions like assisted suicide does.
It must always be difficult watching those you love suffer. Whose call should it be regarding their end? What criteria would be engaged? How is the interest of society balanced with that of the individual? That is a persistent friction in various examples beyond this topic. One interesting perspective on this was voiced by a Canadian physician about such decisions by those with emotional challenges; it is actually titled First do no Harm.
The self-controlled end idea reportedly began in Switzerland in 1942, according to Reuters. Their process sounds quite simple, and is subject to the singular constraint that "the motive is not selfish." It is difficult to imagine engaging a standard that is more undefined and vague. It is noteworthy, however, that the debate is not recent.
There are opponents to free will in the present British debate. They argue that when suicide is condoned in any form or setting, the practice will increase in broader populations. The limited requirement that is being legislated there, is that death is expected within 6 months. The opponents fear this will slide to 1 year, then two, and eventually, no requirement. This is perhaps a reference to Belgium's law, which is characterized as "the world's most liberal law on physician-assisted suicide."
In Belgium, the patient must meet only two criteria. They must be in "constant and unbearable suffering - either mental or physical - and their condition is incurable." Once these are met, the patient must put in writing "I want euthanasia," and sign it. Thus, there are fewer hurdles in Belgium, but the patient is not allowed to self-administer. In Belgium, the doctor has to do the killing - with a pain narcotic followed by a barbiturate. That is an intriguing distinction, Hippocratically and without the Oath's modernity.
Note: If you’re in emotional distress, there are options available to help you. You can also contact the 988 Lifeline at any time to connect with a skilled, caring counselor and get support. Confidential support is available 24/7 for everyone in the United States and its territories. For more on this hotline see September is Awareness Month (September 2022).
