When Karen Ann Quinlan suffered cardiopulmonary arrest in the spring of 1975, a new concept entered American culture regarding death and dying; it's now know as "the right to die." Karen's father petitioned the courts for guardianship and permission to stop the ventilator that was thought to be maintaining Karen's life. In the meantime, the New Jersey Supreme Court ruled that there was a distinction between the unlawful taking of a life and the termination of artificial life support. With great misfortune, the doctors won out when the court ruled against the family. The outcome was many more years of legal battles while the parents watched their child wither in a deep vegetative state.
We move so very slowly but it would seem that the issues of refusal and withdrawal of treatment are relatively settled and an individual now has the right to seek or refuse treatment. Signing some kind of living will will usually handle these issues if or when they arise and one is unable to speak for themselves.
What is far from settled at this time is what may seem to some to be the next logical step: physician assisted suicide and euthanasia. Whether we as Americans agree with Dr Jack Kevorkian, he too is an American living in a free country. The numbers of laws and court challenges to move against him illustrate that we as a society are still struggling with the ethics of rightful death. So, for those of you who see Dr Kevorkian as nothing short of a maniac wielding death with solutions of potassium chloride, consider this: why is it that so many individuals facing what we all will eventually face choose to do so in this manner? The leading cause of suicide in this country is depression many times brought on by chronic illness and intractable pain. So, the focus that at first fell on Dr. Kevorkian, unnecessarily, is now where it needs to be dealing with chronic pain and depression.
Unrelenting chronic pain robs an individual of clear objective thought and the faith that there will be a better day ahead and indeed there may not be better days ahead. This leads the individual to believe there are few, if any, ways out other than death by suicide. When the pain is lessened, these kinds of desperate feelings usually dissipate, allowing the individual to return to thoughts of how they might like to spend the last of their time mending fences with loved ones, finishing one final project, time in self reflection and forgiveness, or just being with those they love and cherish.
Assisted suicide is accepted practice for the hopelessly ill in many European countries. The individual with family and friends at their side and the support of their physician is allowed to peacefully end their life. It is understood by all that this is not something to be taken lightly and repeated interviews are done with family and patient to determine that this is not a temporary wish.
The interesting part: most individuals, when allowed freer reign over their pain medications, find that ending their life is not what they really want. They simply are sick and tired of the pain.
Physicians are beginning to manage chronic pain more fully. With new delivery systems via the skin and surgically implanted devices, they're finding their patients living a more full life without depression and continued thoughts of ending it all. Some studies even indicate that with relief of pain that not only is the quality of life improved but sometimes extended.
Painful as it may be for us as a nation to grabble with issues such as the right to die, no one needs to suffer the wages of intractable pain.
Till next time, Rebecca.