Tuesday, 11 November 2014

Is assisted suicide brave?

Brave: Ready to face and endure danger or pain; showing courage.

- Oxford Dictionary

Last week saw the passing of two chronically terminally ill people in starkly contrasting ways. 

Brittany Maynard was 29 when she "died with dignity" via assisted suicide. Diagnosed with grade 4 astrocytoma (a form of brain cancer) in April this year, she was given six months to live. She subsequently moved from California to Oregon in order to utilise Oregon State Law that permits assisted suicide. She died seven months later.

Professor Nicholas Tonti-Filippini was 58 when he died after a lengthy battle with a chronic auto-immune disease.
 He was diagnosed with the illness at the age of 20 and was given only a few years to live. He died thirty eight years later.

Maynard and Tonti-Filippini were polar opposites with regard to their positions on voluntary euthanasiaMaynard, prior to aiding her own death, set up the Maynard Fund which seeks to legalise assisted suicide in US states where it is currently illegal. Tonti-Filippini was an avid defender of life and established himself as one of the world's leading bioethicists and human rights defenders. 

In 2010, Andrew Bolt blogged a letter Professor Tonti-Filippini wrote to South Australian Premier Mike Rann, explaining why voluntary euthanasia should remain illegal. I encourage you to read that here.

In the wake of Maynard's death, pro-euthanasia advocates claimed the taking of her own life exemplified bravery. In what I'd call bad taste, they championed Maynard's death as a means to promote the supposed bravery of ending one's life at one's discretion. In fact, her decision to die was backed by activist group Compassion & Choices which says her death will inspire others worldwide.

It is a sad day when an activist group piggy backs off the death of a terminally ill person in order to inspire others to kill themselves. 

With all respect to Brittany Maynard, and based on the definition of "brave" in the Oxford Dictionary, I struggle to see how ending one's life constitutes a brave choice. Given the definition of brave is the readiness to endure pain and danger, her decision to bypass pain and suffering and choose death as a favourable alternative would seem like anything but brave. 

Maynard's death has reignited the public debate regarding "dying with dignity". Many people hold the view that ending life on your own terms, pain free, is a dignified way of dying. Personally, I think this is a problematic philosophy as it essentially writes off any sick person as undignified and proposes the notion that human dignity is contingent on whether you are healthy or not. 

In his letter to Premier Rann, Professor Tonti-Filippini discussed the idea of dying with dignity: 

I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability.   
Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living,”
For many terminally ill people, assisted suicide is an appealing proposition not only to put a end to the insufferable pain, but to avoid becoming a prolonged burden to family. Professor Tonti-Filippini also addressed this issue in his letter:
"If euthanasia is a legitimate option with a determined structure... then life for the chronically seriously ill would become contingent upon maintaining a desire to continue in the face of being classified as a burden to others. 

Essentially the Bill [a voluntary euthanasia bill] involves setting up a category for people whose lives may be deliberately ended. Their protected status as a member of the South Australian and Australian communities depends on a contingency."

If anyone was an ideal candidate for voluntary euthanasia, it was Professor Tonti-Filippini. Over the course of thirty eight years, he battled a combination of renal failure, advanced ischaemic heart disease and rheumatoid auto-immune disease. He was dependent on haemodialysis and palliative care, and at the time of penning his letter to Premier Rann in 2010, had undergone fifteen angioplasty procedures and the placement of eight stents to attempt to recover blood flow after the failure of coronary bypass surgery.  His rheumatoid disease caused chronic pleuropericarditis. In his own words, he was no stranger to pain and suffering and knew the limitations of palliative care.

However, despite this, and over a period of almost four decades, he became a living definition of true bravery to become one of the most respected people in his field and an inspiration to his pupils and those that knew him. 

In the face of suffering, Professor Tonti-Filippini excelled himself and became the Associate Dean and head of bioethics at the John Paul II Institute for Marriage and Family in Melbourne. In 2009 Pope Benedict XVI made him a Knight Commander of the Order of St Gregory the Great and he was also a Knight in Obedience of the Sovereign Military Order of the Knights of St John of Jerusalem, Rhodes and Malta. He had published four volumes on bioethics and was due to publish a fifth.

While I am not in any position to condemn Maynard for her decision, I cannot help but contemplate what might have been and what she could potentially have done with the unknown time she had remaining had she not elected to take her own life. Interestingly, in his letter to Premier Rann, Professor Tonti-Filippini provided an insight into one of the problems with the assisted dying law in the eventual place of Maynard's death.
"It is distressing to note that in the US State of Oregon in 2009, none of the patients who wee lawfully killed at their own request were referred for formal psychiatric or psychological evaluation. It is also distressing to note that two thirds of people lawfully killed under euthanasia laws, in those jurisdictions that permit it, are women."
The Age is currently running a poll on whether you believe terminally ill people should be given the right to decide when and how they die. Interestingly, at the time of publishing this article, 64% of voters believe people should not be given that right.

The sad aspect of the whole debate is how easily our society is willing to give in. While I cannot dream of understanding the pain and suffering those with terminal illnesses go through, many assisted dying advocates, who also do not know what it is like, make death sound trivial. If there is pain, why not simply die?

Wouldn't a more constructive and positive step be to increase our efforts to advance palliative care so that we can provide our suffering relatives and friends with peace of mind and as much comfort as possible in their final days? Rather than the morbid and negative decision to simply die?

Wouldn't it be more humane to say to your loved one, "I'm here for you through your suffering and will aid you in your palliative care. Your life is as valuable as mine and you deserve to live as much as I do", rather than adding pressure, or not eradicating pressure, on the terminally ill's potential feelings of being a burden?

Touch wood, if any of my family become terminally ill, I will be there to support them in their brave struggle and will make them feel as valuable as those assisting them.

My thoughts and prayers are with Brittany Maynard and Professor Nicholas Tonti-Filippini and their families.

All the best,
Dom Meese

Picture courtesy of www.topnews.ae

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