Commentary
Those who oppose assisted suicide depend on illusions
By Robert Pieh
Robert Pieh, a recent graduate of St. Olaf College in Northfield, will be teaching English in Costa Rica beginning in August. He is a source in MPR News' Public Insight Network.
The actions of Doreen Dunn, an Apple Valley woman who euthanized herself in 2007, have brought assisted suicide to the attention of Minnesotans. The Dakota County attorney is charging the Final Exit Network, the Georgia-based group that helped Dunn, with several counts of assisting a suicide and crime-scene tampering.
The cross-state lawsuit has forced Minnesotans to confront the legality of assisted suicide in our state. Among other common themes, two illusions are prominently being used by anti-euthanasia advocates.
Anti-euthanasia voices present legalization of assisted suicide as an invitation to a euthanasia party with an unacceptably large guest list. Like many overhyped parties, fewer people are actually attending than you imagine. Those who do appear have very deliberately chosen to do so.
The second deception maintained by euthanasia opponents is directed toward themselves. They convince themselves that they are protecting the lives of vulnerable people when they are really protecting themselves from acknowledging the possibility that sometimes death can be better than life. That someone of sound mind might actually choose to end his or her earthly life is horrifying to them. This horror is not surprising when we look at the value that quantity of life has over quality of life in America.
The prolonging of life often supersedes the fulfillment of life. When there isn't the possibility of the latter, there is no reason for the former. Doreen Dunn, who experienced chronic and debilitating pain for nearly 16 years, was free to decide whether or not this was the case for herself.
The last line of her physician's note reveals the nonphysical realm of pain in which Doreen's condition had placed her. It reads, "This pain also prevents any social life." The brevity of this statement should not undermine its importance. It is not only physical pain that pushes suffering people to euthanasia.
Like a football star's career-ending ACL tear, physical trauma can cause emotional devastation. When we ignore the psychological, emotional and social reasons for choosing assisted suicide, we ignore every aspect of an ill person that is not physiological. While said football star might be able to find another calling in life, many who suffer with chronic illness and pain do not have that option.
I worked at a nursing home during high school. For several residents, the home functioned as an unofficial hospice. My most vivid memory from the time is that of a tiny, skeletal woman in a wheelchair, pushing uselessly against the colossal double doors that led to the exit. When I asked her what I could help her with, she replied in a whisper, "Let me out. Please. Let me out. I won't tell anyone."
Her tone wasn't the usual one that residents used when they made unreasonable requests. It didn't contain the resignation that would have told me she didn't expect her wish to be granted. Instead, the woman's tone was desperate, tired and sincere. She had had enough and she wanted out.
Opponents of euthanasia would do well to spend some time in an end-of-life care center or hospital.
Some worry that legalized assisted suicide will coax vulnerable people into brashly choosing death over life. They may think that euthanasia is heavily prevalent where it is legal. They should look at euthanasia statistics in a state like Oregon, where it is legal.
Readily available on the state's official website are annual reports monitoring the effects of Oregon's Death with Dignity Act (DWDA). Over the past 14 years, 935 people received prescriptions under the act, and 596 ended their lives by ingesting them. This averages to 43 Oregon residents per year electing to end their lives. Their reasons for doing so varied. Some of the reasons are included in the reports. In 2011, 82.4 percent had cancer.
Although the fervor surrounding euthanasia can make it seem like an epidemic, only a moderate number of people with a variety of legitimate reasons are choosing the option.
Doreen Dunn had the strength to persevere through wretched pain longer than our state's eighth-graders have been alive. Her conviction to fight was as admirable as her conviction to contact the Final Exit Network. If we allow it, Doreen's story can function as a call to examine the ethics of euthanasia and its current illegal status in Minnesota.
Comments (21)
The right to die quickly becomes the duty to die. Everywhere where assisted suicide is legalised- it quickly descends to involuntary euthanasia. As soon as the principle that there is life not worthy of life is established - the elderly feel a coercive pressure of having a duty to die.
Nonsense. In saying the elderly will feel a coercive pressure to die, you are denying the common human experience we all live every day. Nobody wants to die except those who are in such misery that death is a better option. Your view is based purely and singularly on your religious beliefs, one that most of us do not share. The opponents of aid in dying know their view will be rejected if they say what they really think (that their view is based on God's commandment), so they make up these patently absurd talking points (like "duty to die" and "descends into involuntary euthanasia") and repeat them over and over again, as if they will become someone's truth someday.
Data belie the anti-euthanasia critics and the notion that the elderly feel a coercive pressure to die. The elderly are among the fastest growing segments of the population and the highest suicide rates are among 16 to 20 year-olds. Additionally, in those states where assisted suicide is legal, there has not been an increase in the annual mortality rates. It is too bad that religious dogma gets in the way of critical thinking and free choice.
It is tragic to see how a persons strong religious beliefs can so thoroughly distort his understanding of the realities at life's end. For some there really does comes a time when the pain is unbearable or when the very reason for living has been lost. I saw the latter with my father who couldn't wait to die after he lost my mother. I saw it with a client with advanced Parkinson's who was rapidly losing his ability to use his arms or legs. As a 90+ year old I can see the time in the near future when my life will no longer be worth living either because of pain or the inability to live a meaningful life.
I an grateful to the Final Exit Network that I will not have to put up with the horrors of a miserable old age and the distress it could cause my children.
Believe what you want but stop fabricating "Duty to Die" and other such nonsense and let those of us who want to choose a dignified comfortable death, do so.
Bob Levine, Princeton NJ
At least half of my disabled friends have had the experience of being asked, encouraged, pestered, or even coerced to "give up" and refuse treatment, sign "do not resuscitate" orders, or otherwise check out. The example you give of an inaccessible door in a nursing home is illustrative of the discrimination and neglect faced by elders and people with disabilities, not a reason to die. The failure of a doctor to properly care for pain is not a reason to kill oneself, it's a reason to fight for better care.
"Encouraged, pestered, coerced"? Are those your friends' words? Under what circumstances? There is a big difference between DNR orders (which simply mean no extraordinary measures to prolong suffering) and assisted suicide. My father had the opposite experience--about half a dozen people double-checking (pestering him about) his own DNR request, and he made his own choice (at 91) to go gently--with control of pain and without continuing the weekly, exhausting and fruitless return trips to the emergency room that his doctors said could keep him going. He didn't see the point.
The author uses terms "euthanasia" and "assisted suicide" when referring to the laws in Oregon and Washington. This is incorrect as voluntary euthanasia is illegal. Physician Aid in Dying is what Oregon and my state have legalized, and there is a big and important difference. Euthanasia is when another individual/physician administers a lethal dose. Aid in Dying is a physicians response to a terminally ill, mentally competent adult for the means to hasten an inevitable death, that the patient themselves would administer. Furthermore, Aid in Dying is not suicide as suicide is an irrational and often violent act.
I think this well-intentioned article on a complex and troubling subject left out an incredibly important side to this issue: the fact that disabled people and elderly people are treated abysmally by our society.
When disabled people experience poverty at ridiculous rates, barriers everywhere we look, and shocking employment discrimination; when elderly people are forced to live in depressing places that lock them in and treat them like luggage; is it a wonder some of us want to end things? Is the answer to kill us off, or to fight for our rights and freedoms?
I don't know how I feel about assisted suicide. I know people in constant pain and their lives are not pleasant. But a discussion of this without addressing the way our society marginalizes, oppresses, and damages disabled and elderly people is only half a discussion.
Minnesota has already revised its law against assisting a suicide, permitting physicians to help their patients to die in some specific ways. But laypersons do not have the same right to help others to die. See a full explanation here: http://www.tc.umn.edu/~parkx032/MN-SUIC.html.
Should our law be revised again so that wise end-of-life choices will be permitted without fear of criminal prosecution?
James Leonard Park, advocate of the right-to-die with careful safeguards.
Legal assisted suicide is a recipe for elder abuse. See www.choiceillusion.org
No one had the choice of whether he or she should be born nor when. I firmly believe that every mentally capable adult should have the right to choose death under certain circumstances. And while these circumstances may be limited and may vary, one should have the right to choose death when in untreatable and enduring pain. Affordable medical care should be seriously considered by congress, political parties, and medical agencies.
We should all ask why would any god allow the terrible earthquakes, storms, drownings, and other natural events that take lives of millions of humans, but against those enduring untreatable and extreme pain. I'm not for suicide due to depression or other curable conditions. Giving the untreatable painful adult the option to end life by commendable means is certainly more humane than jumping in front of a train. There are many well-written books to read on this subject. I highly recommend reading "To Die Well, Your Right to Comfort, Calm, and Choice in the Last Days of Life" by Sidney Wanzer, M.D. and Joseph Glenmullen M.D.
Robert Colquhoun says that "everywhere where assisted suicide is legalised- it quickly descends to involuntary euthanasia." This is simply false. There have been no reports of people's lives being ended against their will, but there have been cases of assisted dying without explicit consent. They are typically for patients who are very close to death and where there has been an earlier discussion about hastening death with them and/or their relatives. And in the Netherlands, the percentage of assisted deaths without explicit consent fell from 0.8% in 1990 to 0.4% in 2005. Similar figures apply in Belgium.
As others have observed, the author fails to make the appropriate distinctions between e & pas. He also creates an argument out of a false assumption: namely, that he (and therefore all e & pas supporters) are compassionate whilst their opposition clearly are not. I'm prepared to assume compassionate motivation on both sides - that's not the question at all - it's about who is right and who isn't. Correspondent Mills also attempts to make a distinction that is invalid. Both in the Netherlands and in Belgium there are significant percentages of cases where consent was absent. We cannot truly know whether these were non or in-voluntary, but what we can say is that choice was denied these people. Consent is the hallmark of good medical care - how is it absent here - someone else is deciding, not the patient. CHOICE is an illusion!
Thank you for recognizing that the proverbial Emperor has no choice. I am incapable of noticing that the basis of this discussion is rooted firmly in man's inability to accept that they have no control over their own mortality.
A reasonable person might be able to concede that they have no new information or insight to bring to this "discussion" .
The discussion is morbid curiosity - an irresistible compulsion of man that supersedes logic.
Everyone on any side of this discussion has the right to his or her own opinion, but no-one has the right to impose a personal belief on others. The ineluctable fact is that, until someone invents a happily-ever-after Immortality pill, we are all going to die. What you are arguing about is how OTHER people "should or shouldn't" die, as though it were any of your business; which it is not. My life, which began with birth and ends in death, is my business, not yours (and, of course, vice versa). If laws could cure cancer, prevent traffic accidents, eliminate acts of war and stop the myriad lightning strikes of circumstance there might be a point to legislating the individual's right to end-of-life self-determination. But until then, and only then does any other person or any state have the standing to meddle with my Last Human Right.
The points by Paul and others about the difference between the terms euthanasia, voluntary euthanasia, and physician assisted suicide are completely valid. Space is limited in a commentary, so defining terms and allowing for all contingencies was not an option. I apologize for the ambiguity. Regardless, the concept is largely the same. When a suffering person wishes to end their time here, I think that they should be free to do so. Those who provide comfort and care on the person's final journey should not be tried for their assistance.
Haddayr's comment about the marginalization of the disabled and elderly is spot on. Reduction of this marginalization would reduce the risk of abuse if assisted suicide were legalized.
And thank you Bob Levine for your comment. You have far more insight than the rest of us.
Lastly, don't be so scared of the "Duty to Die" concept. I acknowledge it could be a result of assisted suicide. I also acknowledge that it could be a legitimate concept. Maybe it's true! If other people can thrive on the resources one consumes, but one doesn't have the capacity to enjoy life, that doesn't strike you as selfish?
1. What exactly IS the law in Oregon regarding who can take advantage of the pas? 2. Do you have to be within six months of inevitable death? 3. Are there only certain illnesses --perhaps somehow categorized as "terminal" that qualify? 4. Is Parkinson's one that qualifies? 5. Do you have to wait until you have already suffered for years and are probably reduced to such a weakened state that you can't really any longer be considered in control of your decisions or that you have been so worn down by the pain (emotional or physical--I imagine it is always both--that you can't assert your desires or demand your "rights"' anymore? 6. Where can we read the actual law in Oregon. 7. How does that law for Oregon compare with Switzerland, where we have DIGNITAS?
I asked several questions and numbered each question in the previous post. Perhpas because this was 6-6-12--a week ago, I am thinking that no one will even SEE my previous post. But if some kind sould DOES see it, could someone tell me of some format or forum or chat room or other interactive place where somone could rspond to such questions--or maybe our laws are so forbidding and chilling that it's not even safe to respond...I'm right now at one of those library computers where you are timed and so I don't have time to correct my typographical errors --for that I apologize.
Norman,
The following resources may be helpful for you.
Minnesota: http://www.tc.umn.edu/~parkx032/MN-SUIC.html
Oregon: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ar-index.aspx
Washington, Montana, Oregon, BC: http://www.vancouversun.com/news/Physician assisted suicide legal three states/6793321/story.html
Montana: https://www.compassionandchoices.org/sslpage.aspx?pid=452
Washington: http://www.npr.org/templates/story/story.php?storyId=101499792
World conversation: http://www.reuters.com/article/2012/06/12/us-swiss-assistedsuicide-idUSBRE85B1ES20120612
Assisted suicide has been legal in Switzerland since 1942, if performed by a non-physician who has no direct interest in the death. Euthanasia, or "mercy killing", is legal only in the Netherlands, Luxembourg, Belgium, and the U.S. state of Oregon.
This is going to be very helpful and I ceratinly appreciate your comment, Sally. I wish I was more skilled with the computer--I tried to print out your list but it just gave me "page one" which was not helpful, since page one turned out to be about thirty pages back--the beginning of the article itself. I am going to try to figure out how I might be able to communicate with you via email. Starting perhaps with regular old-fashioned mail or phone or something
I want to clarify a post from Sally from Alaska:
"Euthanasia, or "mercy killing", is legal only in the Netherlands, Luxembourg, Belgium, and the U.S. state of Oregon."
This comment is only partially correct: Euthanasia is NOT legal in Oregon (and I don't think it is legal in Belgium or Luxumburg yet). The Netherlands is the only place that now has legal euthanasia.
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