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Euthanasia Debate: Are we playing God?

By Paul Titus

The issue of euthanasia is once again in the public eye.

Introduction of the Death with Dignity Bill to Parliament and the New Zealand visit of Australian assisted suicide campaigner Dr Philip Nitschke have put the spotlight on the issue.

Proponents of euthanasia stress quality of life, the individual's right to choose, and the completely voluntary nature of death under carefully defined circumstances.

Opponents argue modern medicine has largely eliminated the pain associated with terminal illness, a decision to end a life always involves more people than the individual, and to have doctors involved in euthanasia would compromise their traditional role as healers and relievers of suffering.

President of the Voluntary Euthanasia Society, Wellington Frank Dungey says his organisation supports the bill now before Parliament. It allows the terminally or incurably ill to request assistance from a medical professionals to end their lives in a humane and dignified way.

"The essential issue is quality of life. For some people the quality of life can become so very poor they would sooner be dead. If someone is terminally ill and their remaining days are only anguish some would prefer to omit them.

"Euthanasia should not only be confined to the terminally ill, however. It is not the nearness of death but the quality of life that is the criterion. A tetraplegic may face 40 years lying on his back and should have the right to end his or her life as well."

Frank says in addition to pain there are other factors that can affect quality of life - breathlessness, nausea, and feelings of helplessness. If patients are in their right mind, and of mature, adult years, then the Voluntary Euthanasia Society feels their wishes about how they deal with those situations should be respected.

Some opponents of euthanasia argue it will create a "slippery slope". Once it is legal, people who do not wish to end their lives may be pressured to do so. Frank dismisses such arguments.

"People with terminal illness do tend to feel useless as their mental and physical powers decline. That's part of the human condition. If someone feels they are not doing any good, I don't see why they should not be able to go. It is a selfless, noble attitude."

He believes the law will ensure pressure from relatives is not allowed. The decision to die must be the sustained and unbiased decision of the patient. Doctors oversee the process and they would be aware of any pressure.

And people will be allowed to change their mind at any stage. There is no reason that just because they signed a paper that they have to stick to it.

Some of the strongest opponents of euthanasia are involved with the hospice movement. Hospices use interdisciplinary teams of physicians, counsellors, physio-therapists, and spiritual carers to relieve suffering and improve the quality of life for people diagnosed with terminal illnesses.

The policy of the hospice movement is to neither hasten nor prolong life against the wishes of the patient. Hospice workers believe individuals have the right to refuse treatment that might keep them alive but not to seek help to end their lives.

Palliative care specialist Dr Anne MacLennan works with the Mary Potter Hospice in Wellington. She says legalising euthanasia would devalue human life, and she calls it the ultimate abandonment.

"People should always be cared for and the most appropriate form that takes can differ at different times. A lot of pain is easy to manage now with drugs but terminally ill people also experience social, psychological, and spiritual pain. It is important to understand the type of pain people experience and respond to it.

"Terminally ill peoples' attitude about whether the want to live or die can change day by day, week by week. A lot of people can find relief and control pain at an acceptable level.

"Sometimes family and health care workers feel helpless in the face of pain and euthanasia offers an appealing solution. But euthanasia tells patients we are no longer willing to be beside them and accompany them," Anne says.

Unlike Frank, Anne is concerned about the slippery slope. She says Netherlands has assisted suicide and there are cases of people deciding relatives should be eased out. The disabled activist group 'Not Dead Yet' worries that eventually people with severe abnormalities could be threatened if society decides they have no value.

North shore Hospital chaplain Rev Roy Alexander says there are a number of issues that society must work through on the issue. One is that individual rights must always be balanced with community rights. The decision to end a life involves not only the person but also the family and the medical people who carry it out.

Another is that while we all uphold the sanctity of life, most of us have mixed attitudes about it. Some of us oppose war but support abortion, for example.

"Some people experience little physical pain but suffer enormously over existential issues of meaning and purpose. That is not necessarily bad because resolution can come from wrestling with the issues.

"As a community we have a lot to do to understand the issues of spirituality surrounding death, however spirituality might be defined. Meaning and suffering are community issues. We have to support people by being there, listening, and taking their issues seriously. It does not always mean we can fix things up."

Roy says this may mean the community should put more resources into the hospices and other support services for the terminally ill. And while he does not feel comfortable with the idea, he is open to the possibility of euthanasia if adequate safeguards are in place.