Sunday, June 28, 2009

Certainly the question of morality comes up most often when considering life and how it ends. Our decisions impact not only ourselves, but those that we love around us. To consider the meaning of life the same for all people is unfair. Each of us has a different set of criteria we determine to be important for what is referred to as “quality of life”. As much as we would like to believe that life is fair, it is proven time and time again that fairness is not what matters, nor does is appear to exist. There are those that get sick that are healthy, active people, and those that survive despite bad life style habits. Nothing fair about it. The one thing that we can control, however, is how we die.

As they say, nothing is as sure as death and taxes. We are all going to die. Some of may die sooner then we might like due to unfortunate circumstances. In this case, our morality is questioned in perhaps no greater way. It is my great belief that, since we have the resources and skills to assist us, having as much control of ones ending that is possible is the morally correct thing to do. For some this distinction may be too difficult to deal with- for them, they may need help understanding, and may not wish to participate in the discussion and indeed prefer a different sort of route. In accordance with the same sort of belief system, allowing them this freedom to make that choice is important. By allowing someone to participate in decisions made about their life, we grant them dignity, and support the value of life and principal of goodness for our moral base.

The concept of allowing someone to die is hard for some to accept. We do have all of these amazing resources to keep someone alive. But is this the right thing to do? I can argue that it is not always in the patients best interest to delay the natural process. In many cases, the person’s quality of life is so diminished that what we would consider the person is gone, and what remains is a shell. It is selfish to hold onto this as the remaining person-unwilling for whatever reason to let the person “go.” Sometimes it’s the doctors that don’t want to admit that there is nothing left to help the person. Sometimes it’s the family that has issues that prevent them from making that hard decision. Take the person is in that middle state of persistent vegetative state, where the patient looks alive- their eyes are open, they are breathing but cannot interact with their environment. These people are kept alive with a variety of measures, any of which, if stopped, would lead to the person dying a natural death.

In our book, (pg 215) Thiroux points out that dialysis has saved the life of many people. But even for some, this, too, may violate their sense of a quality life. While for some, being connected to a machine would be okay, as their values differ from someone else’s values of life, some people may not mesh well with the dependence on a machine for survival. While this is tough, it’s a fair question- does this person have the right to say no to dialysis? If they do, it would lead fairly quickly to their condition being such that death would indeed be knocking on their door. For this situation, it’s a cross between mercy death and allowing someone to die. For this person, I also believe that it’s their decision. They must have the right to decide how they wish to end their life. The concept of mercy death is more complicated. By taking a direct action in ending another person’s life, by necessity another person is involved. There are certainly moral issues with this. A medical doctor takes an oath that states “do no harm” as a primary responsibility. Causing death could certainly be considered doing harm. Or is it? If the patient requests death, and indeed demands it, I again believe it’s a patients right to ask this of their health care provider. What I am questioning here is the morality of the person helping. It would take two of similar moral beliefs to make this happen for a person. Indeed, it would unethical for someone to request assistance in their passing of someone that was morally opposed to causing one’s death.

It is my greatest hope that one day things such as mercy killing would be considered mercy death and perhaps morph even further to calling it allowing someone to die. The important question of what someone considers a meaningful life would have been asked and documented long before someone entered such a state. In this, for example, I say that I don’t want to be hooked up to a ventilator for more then a couple weeks, and if my condition looks to be one that would rely on others to take care of me forever, I would rather die. In this case, I have asked, but asked before I was unable answer. So, in this case, if someone were to allow me to die, or perhaps overdose me with some lovely sedative, my passing would be peaceful. I find it ironic that we treat our animals better then we treat humans at the end of life. While it is difficult to consider, it is all important to discuss, while it may be sad, it may save many a great deal of sadness.