Here's a link to an article about a British couple, both with terminal cancer, who traveled to Switzerland to die together at an assisted suicide clinic. The topic of euthanasia will always incite vigorous debate and as we move into this era where our ability to provide expensive, life sustaining care in cases of terminal cancer or the elderly patient in the ICU with multiple organ failure starts to overlap and conflict with our ability as a society to pay for such care, it is an issue that ought to be brought to the forefront of the entire health care debate rather than being shunted off into the realm of "provocative dinner party discussion topic amongst well to do people who have no stake in it either way".
I'll get my stance on euthanasia out of the way right now: It strikes me as absurd and almost fascist that the State holds the right to determine the terms of how an individual chooses to die in cases where death has become inevitable. Too often we see the poor, broken-down, emaciated, pellucid-skinned, dry mouthed, cracked lipped, hollow-eyed skeletal figures in the hospital, admitted for "dehydration" or "ileus" or "nausea/vomiting" or "abdominal pain" but what their real problem is is terminal cancer and they're dying and they look at you with weary beaten eyes when you walk into the room, hi I'm Dr Buckeye, a surgeon, and there's a slight shake of the head, shoulders sagging and whispering, you can barely hear them, have to lean in close, they say no surgery, I don't want any surgery I want to die, they say. It happens all the time. It's sad and horrifying and you can't imagine how helpless they feel, in a hospital again but they know the score, better than anyone else, but they're too tired, too worn out to fight it anymore as a son or a husband drags them into the ER yet again in the middle of the night.
Some may say--Hey what about Palliative Care/Hospice? And that's certainly an option. But there's something inherently ghoulish about hospice if you think about it. And this isn't necessarily a criticism; the very nature of palliative care and hospice is based on a certain element of ghoulishness, no matter how much we'd like to think otherwise. It's like funeral parlors; no matter how nice they are or how well run or how expertly they apply the make-up to your loved one's face or how personable the owner of the parlor seems to be, you never want to spend a lot of time in one and you don't get all nostalgic about the previous parlors you've visited in the past. It's an industry based on death and dying. Our culture unfortunately is simply not ready to treat death as a normal aspect of the life cycle. That's the way it is.
The set-up for hospice is this--you have a condition whereby your life expectancy is less than six months. You get admitted to a lovely "facility" away from it all, often in the woods somewhere, often described in pamphlets as "rustic" or "pastoral". The floors are often lacquered wood and there's soothing music in the background and every room is spacious and clean and confortable and there's a wide window that's looks out into nature, pine trees, squirrels, tortuous creeks etc etc. It's all quite fine. But what if you're suffering from Stage IV colon cancer and your liver bulges with gnarled, fist-sized metastatic deposits and you're either in too much pain or too doped up on pain medications, too sedated to really care one way or the other about the pastorality of of your chosen stage for dying and really, as long as someone keeps pumping the morphine or dilaudid into you, it wouldn't matter to you if you were here or stranded in a shabby room in some Motel 6 on a barren stretch of Southwestern USA highway. It's sounds awful but I have to believe that a large percentage of the benefit of hospice care is not for the dying, but rather the living who will remain when the loved one passes on. You don't want to have to visit your dying grandma in some soul-withering nursing home or in an ICU with a million tubes sticking out of her; instead, think how soothing it would be to see her in a beautiful private room, with family pictures set up everywhere and the nurses are attentive and never make her wait for pain meds and she just seems so comfortable and driving home, a part of you thinks, well, maybe dying isn't that bad. And you go to sleep that night thinking "at least she's in a good place", an actual place not some euphemism for heaven, and it's powerfully comforting for some reason.
But what about those people who don't want it all dragged out in sedated tranquility and blissful narcotized beatitude? What about the man who's been through 3 rounds of experimental chemotherapy and he's made his peace and come to terms with his own mortality and he's tired and broken and just wants to exert a last bit of control over a life that has already careened so far out of his control compared to the existence he knew prior to being diagnosed with cancer? Why is this even a moral issue? Why is his best option to enter a "facility" that functions solely as final depot on his journey toward death, where everything exists and functions in such a way to make that process more comfortable, soothing, almost stream-lined? And every day waking up he knows it's all a thin veneer, perfume sprayed over a rotting corpse, the day of reckoning creeping ever closer but he doesn't know when, he just has to keep going, day after day, passively slogging through the rest of his existence with a docile resignation.
It's time to start having a legitimate conversation about euthanasia. Modern medicine now has the power to drag patients past previous lines of demarcation between life and death and sustain them artificially for a time. There's always another chemo regimen. Admit to the hospital for dehydration. Place a feeding tube. There's always something we can do to attenuate the long slow decline. But what about when we've exhausted all the weapons in our arsenal and the futility of the situation becomes undeniable? There are unforeseen consequences to modern medicine. Swept under the rug for far too long has been this effect of creating a population of patients who, in previous generations, would have died quietly at home, but now are re-animated so to speak, just enough to allow discharge, just enough to get them through another few months. We have a responsibility to these people. They've trusted us to bring them to this point of utter defeat. The "moral" thing, to me, would be to at least give them the option of quickly and painlessly ending it on their own terms.....