Platform : Assisted Suicide: ‘Medicalizing Killing’

GARY COSTA

Person living with HIV and executive director of Being Alive, People with HIV / AIDS Action Coalition

I’d like to relate my own personal experiences. I’ve assisted four good friends and two acquaintances in their own deaths. Some of them I helped administer the lethal injection or obtained the pills. When my day comes as a person with HIV if I feel it’s time for me to check out, I already have plans in place, good friends who will assist me if I become incapacitated and can’t do it myself.

It took AIDS to make me realize that this is an ongoing problem. I remember my grandmother dying of cancer back in 1974. She was in so much pain. Our whole family suffered through that. The doctor’s goal was to keep her alive and she was in pain. Nobody was benefiting from her prolonged death.

Then shortly thereafter, I would take food every night to my grandfather’s home because he lived next door to us. I was a 12-year-old little boy and my grandfather would beg every night, “Gary, poison me. Please poison me. I don’t want to live anymore. Grandpop’s old. He wants to die. Please, help me.” And that always stuck with me--will I, will people, actually get to a point where they want to die and can’t?

Once HIV and AIDS became an epidemic, I started seeing so many of my friends, close friends especially, begging the same way, begging me to help them end it all. We lose our dignity and we lose so much that the last thing that we need is to be a rotting carcass begging to die and have nothing or no one in place that can assist us legally. So, if a person feels it’s time to go, I’m all for systems in place.

KATHLEEN DRACUP

Professor of Nursing, UCLA School of Nursing

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By virtue of their profession, nurses share the intimacy of patients’ struggle with their physical and emotional illnesses. That makes the issue of assisted suicide a particularly poignant one.

Nurses very strongly believe that the goal of care is, whenever possible, to help someone achieve a cure; and, when that’s not possible, to provide a symptom-free death--meaning a death without pain, without suffering, an important goal very often lost in our society.

I’ve been a nurse for almost 30 years, much of that in critical care. I have never had the issue of assisted suicide come up and yet I’ve had hundreds and hundreds of cases where people have not made plans for these last days. There was no durable power of attorney or living will and therefore conflict about what the patient wanted, what the family wanted and what physicians and nurses felt was in the best interests of the patient.

In some ways the assisted suicide debate is a sign of that failure of communication.

However, I don’t think that acceptance of death necessarily means our society and medical institutions become passive. What we’re talking about here is a society which, in the best sense, walks a middle line. Many treatments are currently thought of in terms of prolonging life that also help the patient have a more comfortable day.

As we move into a health care system where treatments mean dollars. If the treatment doesn’t mean survival, just pain management, will the payer be willing to pay?

Assisted suicide is just one aspect of a much more important discussion.

BONIFACIO BONNY GARCIA

Attorney, Los Angeles

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I serve on on an archdiocesan Catholic Life Issues commission and I helped draft a Catholic durable power of attorney because we felt that really the problem was people were confusing pulling the plug with lethal injection.

One is allowing nature to take its course and letting go naturally. The other one is pushing people over the edge.

The Catholic notion of “extraordinary means” comes into play here.

There’s a complication in this--what is the role of pain killers like morphine? If you get too much morphine it will kill you. And the distinction there is that it always permissible to give morphine to ease pain even if it’s shortening life and the intention is not to terminate life, [but] ease the pain.

But if you gave the morphine for the purpose of killing the person then that’s the intention of homicide. And that’s not permissible.

I think that this debate arises because doctors really don’t understand [the range of] pain medications available. They’ve come a long way and doctors don’t realize that.

I think the answer is that if you can take away people’s pain you’ll take away a lot of the pressure for assisted suicide.

REX GREENE

Physician specializing in oncology, Pasadena

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Suicide is a rare event, slightly less common [among terminal patients] than in the general population. But such as suicide is an issue in that setting, it has the same meaning as suicide in non-terminal patients; it is a reflection of depression and other issues, including family issues, deep concerns over dependency and abandonment and so on.

It needs to be dealt with as a problem, not by killing the patient but by dealing with the underlying causes.

My personal opinion, is I [that] mankind has gone a little crazy at the end of the 20th century and has confused dying with killing. I think that we’re at the end of a protracted blood-bath and we have just lost our focus. The medical profession has endured for over 2000 years and steadfastly resisted an erosion of the boundary between empowering physicians to help people who are dying versus actively killing. The [ancient] Greeks were very smart; they considered it madness to cross over that threshold and had no interest in allowing physicians to do that.

Now, we’re medicalizing capital punishment, medicalizing killing in all sorts of forms of which Mr. Kevorkian is the most extreme example. We’ve just lost our vision. I heard about a public opinion poll taken recently that found about 60% of physicians and the lay public think that assisted suicide is OK.

That horrifies me.