Death is an inevitable part of life. It is a rite of passage that no one on this earth is exempt from or can escape. All deaths are difficult, although some are inordinately painful and drawn out. Those with a terminal illness or who have suffered an accident that leaves them hovering between life and death with very little quality of life often contemplate suicide as a means to stop the pain and suffering.
With today’s modern technologies, people with terminal diseases often are able to live months, or even years, longer than they would have only decades earlier. Unfortunately, in the late stages of many diseases, pain can be intense if not unbearable. Some patients lose the ability to do things for themselves, to communicate, or even to think. For many, life at this stage no longer is worth living. For these unfortunate people, assisted suicide can provide a compassionate end to difficult lives.
Assisted suicide allows people to avoid the unnecessary suffering that often accompanies the end of life. A patient that is no longer able to walk, move or speak coherently and is confined to a bed and has to rely on nurses to turn their body to prevent bedsores on their body could have slipped away peacefully and not been made to endure the weeks of pain and immobility the mark the end of their life.
For others, assisted suicide is a compassionate end because it gives people who are unwilling to endure a slow and painful death a dignified alternative to drastic and violent acts such as suicide by jumping from a building, hanging or using a gun. Having the option to obtain a lethal prescription and would allow one to end their life peacefully and spare themselves the pain of a violent suicide and saved their family the memory of how they died.
The nineteenth century philosopher John Stuart Mill argued that individuals are, ultimately, the best judges and guardians of their own interests. In a famous example, he said that if you see people about to cross a bridge you know to be unsafe, you may forcibly stop them in order to inform them that the bridge may collapse under them, but, if they decide to cross, for only they know the importance to them of crossing and only they know how to balance that against the possible loss of their own lives. Terminally ill people who are going to commit suicide do it without help all the time.
The most common way is by hoarding a supply of barbiturates, deciding when and what time that they will practice their self deliverance and leaving behind a hand written note and a very clear do not resuscitate order so that if they are discovered before the suicide is complete medical personnel cannot legally attempt to resuscitate them. Having done their homework, most will take an antiemetic to prevent the vomiting up of the 60-80 barbiturates they will wash down quickly with an alcoholic beverage. Then they lie down and wait.
What eventually happens is that they fall asleep, and then proceed to a deeper sleep and finally, as much as 8 hours later succumb to death. Other more barbaric forms of suicide that the desperately ill use to end their own life is the use of inert gases, such as helium that is fed into a plastic bag secured around the neck and then breathed in until the helium flushes the oxygen from the body. Complete lack of oxygen initiates brain death painlessly and within a few minutes. This approach to suicide is often used by patients who are unable to secure the needed supply of barbiturates to lay themselves down to permanent sleep.
Basically, the bag fits over their head and is held in place while the bag fills with gas, the patient then exhales and pulls the bag down over their face where the elastic band secures around the neck and consciousness is lost in seconds and death happens in minutes. There is even a company in Canada that manufactures and sells the “Exit Bag” specifically designed for this purpose. Imagine the trauma involved when finding a loved one, dead with a bag on their head. The terminally ill and elderly also have the long standing option of self-starvation to end their life.
A person who is refusing all food and drink will usually die within 10-14 days after they stop eating and drinking. This type of death is quite painful and can be psychologically painful for the family. Because assisted suicide is not legal many people facing life limiting illness take the desperate route and end their life in even more violent or traumatic ways such as hanging or gunshot and these people deserved the choice to end their own life in a more dignified and calm manner. The trauma left behind for the families of such suicide victims is devastating, especially when it could have been handled in a better way.
Consider the suicide of terminally ill patient Lovelle Svart. “Lovelle Svart woke up Friday knowing it was the day she would die. Once she knew she had less than six months to live, Lovelle also decided to try to start a more open public discussion of dying. During the past three months, mostly through a series of online video diaries for The Oregonian, she shared publicly the experience of facing death. Swallowing was more painful than ever, like choking on broken glass or razor blades, she said. She had barely eaten in two weeks. She started taking morphine to dull her pain.
She told family and friends to come Friday. Lovelle sat on the foot of the bed, while 10 others gathered around. A photograph of Lovelle as a curly-haired 5-year-old stood on one bedside table; on the other were a glass tumbler containing the liquid medication, which looked like water, along with a container of morphine and Lovelle’s ever-present mug of Gatorade. On the wall above the head of the bed were five more family photographs. With some help, Lovelle yanked off her shoes and socks and slipped partway under the covers. Eighmey stood by her bedside.
He has attended more than three dozen deaths of this kind. “Is this what you really want? ” “Actually, I’d like to go on partying,” Lovelle replied, laughing before turning serious. “But yes. ” “If you do take it, you will die. ” “Yes. ” Ever the detail person, she reminded him that she wanted her glasses and watch removed, “after I fall asleep. ” Eighmey warned her that the clear liquid would taste bitter. She needn’t gulp it. She would have about a minute and a half to get it down. Lovelle dipped her right pinky into the glass and tasted. “Yuck,” she said. “That’s why I need the Gatorade. Holding the glass, Eighmey asked her again to affirm that this was her wish. Yes, she replied. Someone asked, “Can we have another hugging line? ” One by one, they came to head of the bed for hugs and teary whispers. “Sweet dreams. ” “It’s all right. ” “I know. ” “Thank you for being my big sister. ” “All the church is praying for you. ” Lovelle was sitting up in bed, three pillows propping her up. She held the glass tumbler in her right hand, raised it to her lips and drank. It was 8 minutes after 5. “Most godawful stuff I ever tasted in my life,” she said, aking a face before taking a sip of Gatorade and plain water. She lay back and scrunched down under the covers, glasses still on to see her loved ones. She reached for her mother, who leaned closer, then lay down next to Lovelle, stroking her hand. “Are you OK, honey? ” “I’m fine, Mom. ” “You’re not sick? ” “No. I’m peaceful. It stopped raining, the sun’s out. And I’ve had a wonderful day. Her eyes closed. “It’s starting to hit me now. ” For a while, no one moved or spoke, as Lovelle drifted into a coma. Then Lovelle’s mom asked for a prayer.
Others spoke up with prayers and memories, which prompted other stories. Lovelle’s brother Larry read part of William Wordsworth’s “Intimations of Immortality. ” Lovelle lay motionless but for the gentle rise and fall of her chest. Her heart slowed but didn’t stop. About an hour into the vigil, Lovelle’s mom lit three white candles in cut-glass candlesticks in the living room. “She’s still with us,” she said. Hours passed. Given what Lovelle’s body had been through — not only lung cancer but also open-heart surgery in 2004, Eighmey was surprised how long she was lingering.
But not her family. “I hate to say this,” one said with a smile, “but this is just like her. ” “A little spitfire,” agreed another. “Above average — that’s Lovelle. ” “One last reminder that she’s the one in control. ” Jane O’Dell, a volunteer for Compassion & Choices, sat at Lovelle’s bedside all evening, holding her right hand, monitoring her breathing and regularly checking the pulse in her wrist and neck. About 10:30 p. m. , more than five hours after she had taken the drug, O’Dell signaled that Lovelle’s breathing had become shallower and more labored.
Her pulse dropped, her skin turned pallid and her fingernails bluish. It was more than a minute between breaths. Family and friends resumed their bedside vigil, and silence again fell over the dark room. Lovelle’s chest stopped moving. Eighmey leaned over at 10:42 p. m. and put his ear to her chest to listen for a heartbeat. He stepped back, shaking his head and spoke in a quiet voice. “She’s gone. ” As simple as this sounds, there is much debate about the morality and legality of assisted suicide in the United States and in the world today.
Oregon is the only state in the United States that has passes a law making assisted suicide legal. To be eligible for assisted suicide under Oregon’s Death with Dignity Act a patient must be 18 or older, a resident of Oregon who is able to make and communicate his or her own health care decisions and be diagnosed with a terminal illness with six months or less to live. The law further requires that the patient make two verbal requests separated by fifteen days to a physician and that the request be witnessed by two individuals who are not family or caregivers to the patient.
The patient must be able to self administer the lethal prescription and the doctor must request that the patient notify the next of kin of the prescription request. According to the Eighth Annual Report on Oregon’s Death with Dignity Act published by the state of Oregon 246 people elected to die by assisted suicide between 1997 and 2005. The top 5 reasons given were fear of decreasing ability to lead an enjoyable life, loss of dignity, loss of autonomy and fear of losing control over bodily functions and fear of being a burden.
Those who elected to end their life by using assisted suicide most commonly suffered from cancer or AIDS. There are only four countries in the world that openly and legally allow assisted suicide; Switzerland, Belgium, Netherlands and Oregon. Former pathologist, Jack Kevorkian and eventual poster child for assisted suicide launched a decade long campaign for assisted suicide awareness before he was finally convicted of murder in 1999, after videotaping himself giving lethal injections to Lou Gehrig’s disease patient Thomas Youk.
He participated in as many 130 suicides between 1990-1999. He had developed a “suicide machine” which allowed patients to be hooked up intravenously to a lethal drug combination that they themselves release, ultimately causing their death. An interesting note is that “Dr. ” Kevorkian lost his medical license in 1991 and though he was sentenced to life in prison, he was eventually paroled. Though he had put a face to assisted suicide in this country, many medical professionals feel that he crossed the line in the Youk suicide and it became euthanasia.
Still, there are several right to die advocacy groups in the United States such as Compassion and Choices and the now defunct Hemlock society that inform and advocate the freedom of terminally ill patients to make end of life choices. One of the strongest arguments against assisted suicide is that assisted suicide decreases a doctor’s commitment to treat patients and it is a direct violation of the Hippocratic Oath. Doctors have a duty to safeguard life. A doctor given the power to write a prescription for lethal drugs is a direct contraindication of that duty.
It is also a doctor’s duty to reduce unnecessary suffering and safeguards are in place to prevent abuse of the law such as coercion, or overlooking patients dealing with depression or mismanaged pain. Doctors should be free to exercise their best judgment utilizing their unique set of skills dealing with medical knowledge and with people. In his book “Final Exit” author Derek Humphrey discusses the practicalities of “self –deliverance” and assisted suicide for the dying.
There are references to shopping for the right doctor which implies that many doctors out there are not naive to the patients suffering and would want to help given the right set of circumstance. Doctors can play a critical role in helping the terminally ill end their lives with dignity and comfort. When a patient is going to die anyway, how can a doctor be wrong for making sure that his patient’s life ends as comfortable as possible? Their job is to alleviate suffering.
All people deserve the freedom to control their life and laws against assisted suicide restrict individual liberty. All people should have the right to comfort, calm and choice in the last days of life. Death is not ever any easy thing to face and when deaths are made worse by prolonged suffering and anguish assisted suicide should be made available to those want to die in peace. Assisted suicide offers those who are very ill a chance to end their lives with dignity and control. To make such a option available is the sign of a truly compassionate and evolved society.