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Thursday, July 16, 2009

More on the Assisted Suicide

A blog I regularly read, Firstthings at Secondhandsmoke by Wesley J. Smith always makes me think. I do not agree with Smith all the time but even when I take exception to his words he makes me reconsider my views. For this reason alone, his blog is at the top of my reading list. Smith often effectively takes proponents of assisted suicide to task and yesterday he took exception to a stunning article by Barbara Coombs Lee of Compassion and Choices in the Huffington Post ("Healthcare Reform and the Price of Torture"). Lee's article shocked me. I understand reasoned debate. I understand why some people advocate for assisted suicide. I understand and do not like the fact that some people needlessly suffer at the end of their life. What I do not understand is fear mongering. Lee's article is designed to do generate fear--fear of doctors, fear of dying, fear of hospitals, generate mistrust, and drive a wedge between patient and health care providers. Who then can step in? Compassion and Choices who will lovingly end your life. This is is not helpful, indeed it is counter productive. How disturbing was Lee's article? Judge for yourself as I will quote a single passage that is indicative of the tone of her article:

Lee writes:

"In this country we usually torture people before we allow them to die of whatever is killing them --- cancer, emphysema, the multi-organ failure of diabetes or heart disease.
Like the episodes of military torture from which our nation is recovering, medical torture reflects a culture and a set of assumptions. Reform is not about just identifying a few "bad actors" and weeding them out. Our medical-industrial complex follows a cultural paradigm to do as many things to people near death as is medically possible. Our broken system rewards that paradigm with fee-for-service payments.
Standard routine is to torture those in the process of dying by inflicting upon them a host of toxic chemicals, invasive machinery and painful surgeries. It's the American way of dying --- agonized and prolonged imprisonment in an intensive care unit, pinned down under a maze of tubes and machines, enduring one medical procedure after another, unable to hold or be held by loved ones."
It's an American tragedy, really. Every player in the medical-industrial complex is in on it."

The above words by Lee are designed to incite people's rage. No doctor or institution wants patients to suffer much less be tortured to death as Lee maintains. I know this as do most people familiar with hospital settings. In part this is why we have hospice's today--to provide end of life care designed to ease pain and suffering. In this regard, great strides have been made in the last two decades. However, this does not mean people do not suffer at the end of their life. But there are reasons, many complex variables, that go into a death that is difficult and painful. This is a discussion worth having, one that can benefit us all. Thus I find Lee's words extremist. Excellent exceptions exist. For instance, I recently read an outstanding book by Robert Martensen, a physician, historian, and bioethicist. His text, A Life Worth Living: A Doctor's Reflections on Illness in a High-Tech Era, is must reading for any person about to enter the crucible of the hospital or facing end of life issues. You will find no clear cut answers in Martensen's book just conundrums encountered by patients and physicians that will force you to think about the way we live our lives and the manner in which it ends. I have spent more than a few nights tossing in turning in bed thinking about the issues raised by Martensen. For this, I am grateful to Martensen. In contrast, I am disappointed with Lee and Compassion and Choices. Lee did not make me think, rather she made me wonder why she needed to use such extreme rhetoric designed to generate fear and mistrust. This is not advocacy. This is not nuanced debate. This is not constructive at any level. For me, Lee's article reinforces why the debate associated concerning assisted suicide is so frustrating.


The Goldfish said...

What an atrocious article! I am not 100% certain on assisted dying (see here and here), but one nonsense myth about the subject is the idea that there are loads of people out there in unbearable suffering and that most of us can face this kind of end.

Most people who die of cancer in the West - as very many of us will eventually - probably die of diamorphine overdoses, because the necessary pain relief becomes deadly. Heart disease, another very common killer, usually (though not always) takes people out quite quickly. People are not usually made to suffer just so they might live another few days or weeks. And out of all the people I have known who have died at the end of an illness, not one of them died in Intensive Care; they died on regular hospital wards or being nursed at home or in a hospice.

The pro assisted dying lobby would have much more weight if they focussed on the very small handful of individual cases when a person will have a very slow painful death without the physical capacity to end their own life - these cases are very rare, but to me they really do pose a genuine moral dilemma. When they make out all of us are going to suffer, well I think most people know better than that from experience.

Incidentally, there's a kind of silly, strange but curious video satirising the UK media coverage of these issues here which you might be interested to see. Be warned, although comical at points, it does include some upsetting footage, as broadcast on UK television.

william Peace said...

Goldfish, I agree end of life care usually can ameliorate pain and suffering. The idea hordes of people are dying in agonizing pain in an ICU is not true. Yet both those for and those against assisted suicide can point to deeply moving cases: on one side people that die in great pain and suffer, on the other people that are needlessly pushed into suicide or have their life end because someone else determines their life has no value. Both extremes are wrong.

I saw the video in question (Not Dead Yet has a link). I love the song, Euthanasia Blues, but the video you mention is not the best. I prefer the song accompanied by black and white images available on You Tube. To me, these gritty images are more moving than spliced video clips.

FridaWrites said... the new Peter Singer article yet? Apparently our lives are so crappy he wants to help us die now by denying medical care--it's the ethical thing to do (sarcasm).

william Peace said...


Yes, I saw and read the article by Singer. The lives of people with a disability are so costly under a new medical system we can save lots of money and not treat them. This is not wrong or right, just a social response. I will post about Singer today or tomorrow.

FridaWrites said...

I probably will post about him too, maybe on the doctors' blog I post on to let them know about these issues.

The two pieces you've just written are excellent--I've meant to write a more cogent response to them, but for now I'll have to say thanks for writing them.

Becs said...

Peter Singer - to what absurd lengths does he carry this? Using his arguments, since I'm content with my life, I should stop looking for a job, live in a hut with no running water and without the wild luxury of air conditioning. And food is just food...there's no need to have a drink other than water.

This man doesn't want "just" to kill people - he wants to suck all the joy and comfort out of those left alive. Although apparently it IS okay if someone wants to go out and have sex with a goat...