Dying to live!

You may think me macabre when I say I find the Straits Times heading for an interview on euthanasia in the Nov 5 edition well, rather amusing!

dying to live

dying to live

Perhaps amusing ain’t the appropriate word. What I’m trying to say is I find the headine — Helping the dying with living – and the whole current thrust and rush to make euthanasia a part of our lives wryly ironic.

Ironic because most have forgotten that all of us are dying, in various degrees, depending on our age, our genes, our circumstances — from the day we were born.

Shouldn’t the efforts of humanity be focused on all who are dying to live, and that must surely be everyone? We all die to live, like in we “die” to have a Rolls Royce, Madonna’s success, to carry a Coach hand-bag and to eat in three-star Michelin restaurants like they are Kopitiam food courts.

It’s true that some of us take a heck sight longer to die than others — even when we suffer from multiple ailments – and so we weigh on the lives of those for whom death is someone else’s affair, not theirs.

So for this group who unashamedly takes such a long time to die, some bright sparks have been arguing, alarmingly ever louder, that euthanasia is designed for them, so that they can go with “dignity and without distress”.

Note however, as the good Dr Rosalie Shaw in the ST interview states categorically, euthanasia “is an act with the intention to kill”, no more, no less, so let’s not glorify this greatest cruelty of man to man, made worse because it’s dressed up as for the good of the victim.

The grounds on which Dr Shaw opposes euthanasia are both professional and personal, she says. As a doctor taught to heal or cure, the ‘intent to kill’ is anathema.

She believes most terminally ill people — just like all of us born to die, even if we don’t acknowledge it (to die, I mean)–don’t really want to die. I agree. That’s a no-brainer, really. As Shakespeare said 500 years ago:

“Ay, but to die, and go we know not where;
To lie in cold obstruction and to rot;
This sensible warm motion to become
A kneaded clod; and the delighted spirit
To bathe in fiery floods, or to reside
In thrilling region of thick-ribbed ice;
To be imprison’d in the viewless winds,
And blown with restless violence round about
The pendent world.”

Even those who have faith in another world still cling tenaciously to this one that we know — or there won’t be Lourdes and the continuous chase for medicines and miracles to prolong life, rather than cut it short.

 Dr Shaw’s parting shot in the interview is that ‘a society that allows euthanasia devalues life’.

To which I must add: “a society that allows euthanasia also devalues its medical profession” because which decent doctor would want to prescribe death as the ultimate cure for his patients?

Certainly not among the dozen or so doctors I know. Certainly I believe not among all the doctors who have taken the Hippcratic Oath.

Meanwhile for those of us who can, let us eat and drink.. “for you don’t know when you can’t,” as one wise old man once said to me when he saw me picking over my food because I don’t eat things that are too gamey, boney, fat, lean, sweet, salty, oily, hard, soft, overdone, underdone, yucky to look at.. u get the drift.

While I’m still as picky over my food, I’ve learned to appreciate more deeply what I can eat, as the truth and wisdom of the old man’s words dawned on me when I watched a friend fight every mm of her way against death.

Although she cldn’t keep down her food in the last weeks of her life, she nevertheless asked for all her fav foods and drinks. She ate and drank everything with gusto, never mind if every morsel and every drop came back up within minutes, as she gagged and gasped for breath.

Yet never once did she say she wanted to die or turned away the food and drinks. Euthanasia wasn’t for her. Neither is it for me or anyone I love. Thank you very much.

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15 thoughts on “Dying to live!

  1. Eh. Ditto to your post. Just wanted to mention that Hippocratic Oath is a Hypocritic Oath in modern times – some things just don’t apply anymore. That’s why very rare few med schools make their graduates take it. I didn’t.

  2. Yeah, Areya, I know all abt the hypocritic jokes. If as you say, some medical schools don’t make their products take the HO any more that at least leaves the good doctors the choice of conscience. And I trust any doctor who is good professionally and morally will not go with the wind.

  3. Man proposes, God disposes.

    It has been over a year now since I’ve been taking care of my invalid mum. She’s perfectly healthy now except that she can’t walk. But on two occasions, she was hospitalised…and on one, the quack “specialist” doctor said she was going to die. She was suffering from depression and was hallucinating and seeing dead people! I though a qualified practitioner would not believe in such old wives’ tales.

    Sometimes she said it would be good if she would just die. I just told her it is all in God’s hands and to accept it all as penance…and when we take care of the elderly, no matter how hard and taxing, we should accept it too as penance for our sins (And boy! Don’t I have a lot to atone???). Once one can look on thebright side of what’s beyond our control, it will feel much better.

    Only He can decide when we should live…or die.

  4. Well said Pacik Sibu! People sometimes hallucinate when they are very ill– such as high fever; imbalance of salt or sugar in the blood etc.. Such imbalances could also be the result of the wrong drugs being prescribed.

    Our bodies are very complicated mechanisms; none more so than the brain. All this talk of euthanasia must cause untold pain to those who are quite sick and the elderly. People who are sick sometimes do say that they wish to die; but that is as serious as a young child, untutored in the ways of the world, declaring that when he grew up he wants to be the president of the US: just so much hot air.

    I like your filial piety mixed with some jocular asides. Your mother is lucky to have you for a son.

    I always find prayers a good way to deal with any difficult situation. It’s not a matter of having one’s prayers answered. But the fact that prayers are a good pre-occupation. And as they say, more things are wrought by prayers than this world dreams of and God fulfils himself in many ways..”

  5. Eh. Indeed severe illnes can cause hallucinations and confusion and delusions. Of course hallucinations also occur from depression and psychiatric illness. And certain meds (i wouldn’t say that they are ‘wrong’ medications) have the side effects of causing such symptoms too – ofcourse they are withdrawn should the hallucinations happen. Glad your mum is okay :)

    Over here, there are quite a few cases in court that invariably make it in the papers of people who are corpus mentus and insist on assisted death, so I don’t think that people who ponder and think about such a thing actually say that on impulse, especially if they have a chronic illness that does eventually lead to a very slow and painful death. I think the ethics are very grey in such cases – if someone with absolute sound mind who knows what they want andwhat they are doing want to die just so that they can avoid said slow and painful death, but doesn’t have the physical capacity to do it on their own, is it cruel to not help them?

    Most of us have been trained and taught that we cannot put the knife in their hands- ie give them anything to kill them, however if they refuse treatment or food or drink and they are proven to be completely mentally capable of making their own decisions and understand the consequence of their decisions, and perhaps have a legal written advance directive, then we cannot disrespect their refusal.

    And then there are those who gain court orders to enforce treatment on those with sound mind who refused, or the other extreme – to refuse treatment on those who insist on treatment even with the knowledge that the treatment will not help or even makes things worse.

    It’s a whole ethical minefield out there. Only the law protects us and draws the lines in sensitive cases I’m afraid.

  6. Areya, as usual you give a balanced and professional opinion without being clinical and cold. I for one don’t envy the doctors one bit; or nurses for that matter. Also, the law makers knowing when they move in one direction they affect a whole slew of people down the line, even down the generations.

    My mum’s fine but she doesn’t figure in this “conversation”. It’s Pacik Sibu’s mum about whom he wrote.

    What I’m clear about is what I want for myself and those over whom I have some final say; note some, not all.

    Have a good week ahead.

  7. The problem with the Advance Medical Directive is that it can be used against the person who signed it.

    Say, the rich man signs it, and there he is, after a terrible accident, unable to talk, tied up with tubes and things, and in a dazed state. His breathing is difficult.

    But oh, his mind is alive. He wants to live! His grandchildren are on his mind — he wants to be with them again. There is the golf game next week and the holiday he has planned. And here is his son, whom he loves, and his daughter-in-law the gold-digger whom he detests.

    She is now telling his son, “Look at him! Surely he doesn’t want to live! And we mustn’t let him suffer, do we? Let’s tell the doctor to pull the plug. You know your Dad would have wanted it. He signed that Thing, didn’t he?”

    And, to his horror, his doctor agrees, since he is bound to obey the Advance Medical Directive. Although he feebly protests that he has seen people bashed up worst than this and get better, well… it is the Old Man’s wishes. So here goes…

    Old Man sees all the plugs pulled out and beeping stopping. He can’t move. He can’t say a word. NO! No, no, no, no….

    Think about it. This is not fiction. It can happen easily.

  8. For all we know, what you postulated might already hve happened, Minerva! That’s the sad thing.

    I much rather people be more hnoest instead of dressing up “dying with dignity” as a favour to the very sick and needing 24-hour care. I believe it’s mostly the dignity of the care-givers they are thinking of, even tho no family care-giver with any streak of decency wld admit to such callousnes!

  9. Minerva: No doubt that you are probably right that in some cases people who have signed a directive do change their minds at the very last minute, but who is to know? One can only assume that anyone, least of all one such as your eg (rich, has immediate family who stands to benefit from his death), would have had the mental capacity, reason, and presumably enough legal advice to think things through before actually making an advanced directive. It is certainlly not a document that is written, or can be written on the spur of the moment.

    Lucy: Giving a dying person a dignified death doesn’t (need to) mean euthanasia, as you know :) It just means giving them medications to make them comfortable and not let them suffer with pain or breathing difficulty in their final hours, so that they can rest in peace, and their loved ones don’t have to see them writhing in pain in bed with an awful rattle of secretions in their chest, hooked up to tubes left right and centre. Hardly callous at all I would have thought.

  10. I know the scenrario u describe Areya. Abt 20 years ago, a young nephew of abt 5 was exactly as u describe, in the communicable disease centre, writhing in excruciating pain, tho without any tubes in him (if I remember correctly). He lasted abt a week in that condition, unable to take liquid, unable to accept intravenous feeding or sedatives. He was suffering fm Steven Johnson’s syndrome and yes, every bit of his body (inside or out) was burnt by the severe drug allergy. Bits of flesh just fell off. All the grown ups could do was watch in horror, praying and hoping against hope. But note, no one thought of asking the doctors to put the little tyke out of his misery. If euthanasia was an option, I hope his parents won’t ask for it, because whenever we want to put the other party out of pain, it is our own pain that we want to end first n foremost. And if euthanasia was available and his parents asked for it for their child, I wonder whether they could continue to live with themselves after the event?
    That’s why I salute all doctors who have to watch and vicariously experience untold (and untellable) pain all their lives, yet less than 0.000000000001% are mad enough to hasten their patients’ end. Legalising euthanasia would push them to do something 99.99999999999% don’t want to. Yes, by all means provide comfort to the suffering — and let them live, I rpt live, in dignity. Not die dignified!

  11. Ah, but please do not misunderstand or believe that the only way to alleviate suffering is to kill them with a drug.
    You agree that they at least should be relieved of pain and suffering? It doesn’t mean that they should be given something to kill them – just painkillers and sedation, and if they have secretions in their chest, something to dry up their secretions. Dignified death also means, to me, and to my colleagues, dying naturally without suffering, surrounded by people you love, in the comfort of a private room, without the pain, the writhing, the bits of flesh falling off, lying in a soiled bed because there is no way to excrete without leaving it etc etc etc. My condolences to your poor nephew – no one, least of all little children, should be allowed to suffer in that state, and i wonder if the drs then did give him anything to help his pain.

    http://gigomole.blogspot.com/2008/11/euthnasia-3-good-death.html
    :)

  12. Ooh, I left a comment but it didn’t show. Basically just wanna clarify that I’m not pro Euthanasia – I don’t think people in my field should be, and neither do I think it should be ‘legalised’ in that it can be freely asked for and given. Also wanted to clarify that to alleviate suffering does NOT mean choosing to end their life, and that dying with dignity doesn’t mean choosing to have someone kill you while you’re suffering. Dying with dignity means – to us – keeping the suffering comfortable, pain free, surrounded by their loved ones in a private room, with clean sheets (because they are too immobile to go to the loo to excrete), and going in peace when time is up.

    As gigamole wrote here: gigomole.blogspot.com/2008/11/euthnasia-3-good-death.html
    :)

    My thoughts are with your little nephew, as well as my condolences. I only hope that the drs at that time have given him the comfort he needs.

  13. Areya yr comment was corralled by Askimet which thought it was spam because of the gigomole link.
    I’m not sure what the drs were able to do for my nephew except that they had difficulty getting needles into his flesh and fluids into veins. I knew he cried till he was hoarse n dry, as did his parents n grandparents. Other relatives were shocked to bits because we initially didn’t know what it was all about. It was a very traumatic experience but that was about 20 years ago.
    What we took away from that is all with blood ties to the little boy, including me, now avoid Batrim and all sulphur based drugs. We inform every doctor we consult.
    Since that incident, I’ve come across two episodes, one leading to death and the other a close shave, after the patients were given sulphur-based antibiotics. I’m surprised such drugs aren’t banned.
    Completely agree with you that the very sick be kept comfortable in every way possible but not to the extent of “accidentally” OD with morphine, as mentioned in Gigomole’s blog. That’s “mercy” killing and a murder from whatever perspective.

  14. Hi all,

    Guess I should pop up and say something since a number f you visit my blog and read my thoughts on this…. :)

    It’s really not an easy issue to deal with. It’s not a solution that can be applied to all. Yet there are occasions when the end is in sight and the suffering unbearable. Sometimes palliation can help bring the patient in reasonable comfort to the end. Sometimes it just can’t. Sometimes the comfort of prayer works, and the patient remains strong. Sometimes not. We are not talking about doing things against the patients will, but of situations where the patient opts for a route of exit, knowing full well the consequences of his/her actions…and desiring to depart at an appointed time when all goodbyes have been said and in the company of loved ones…instead of having a fatal seizure or haemorrhage in the middle of the night in a lonely cubicle of the hospital ward, when no one is around.

    I must say it is quite understandable for a terminal patient to not to want to go in that lonely and horrific fashion. I find myself asking if at times like that, being dogmatically correct is what our humanity compels us to be, or should we be merciful at the expense of being ‘incorrect’?

  15. Some doctors may rationalise what they do as dispensing mercy; such as deliberately ODing the patient in unbearable pain. Hence the term mercy killing.
    Each of us must live according to our conscience and according to the laws of the land; hence this latent fear in many that the current discussion led by the Govt may be the thin end of the wedge to prise loose from as many as possible their antipathy against expediting death for the very sick, and who knows once the line is crossed, perhaps even for the so-so-sick and then the troublesome but not-so-sick…
    The laws are to keep wobbly conscience on a tightrope. Once the law does sanction executintg the very sick for their own good, like you would put down a badly injured animal, then I guess humankind will be debased to the level of animals.

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