Euthanasia is but a symptom of a materialistic society that is
spiritually poor. There is much confusion between euthanasia,
physician assisted suicide and the advance medical directive. Terms
like active and passive euthanasia also further confuse the difference
between euthanasia and end of life care that is based on common sense
and compassion.
The objective of the advance medical directive is NOT euthanasia but
to ensure that doctors will not carry out FUTILE medical interventions
against the wishes of the patients who are at the end of life.
Euthanasia or physician assisted suicide is the ACTIVE termination of
a life in a patient who is NOT at the end of life on the pretext of
ending suffering. This is no difference from a person committing
suicide to end his or her emotional suffering. However,
discontinuation of futile medical treatment is NOT passive euthanasia.
It is important to recognize the psychosociospiritual dimension of
dying. It is foolish to put our faith in doctors only to cure our
diseases instead of seeing them as our fellow and fallible human
beings who can use their medical skills to relieve our physical
suffering so that we can live our final days with meaning, dignity and
grace.
When my 15 year old dog was dying, she would cry out whenever I leave
her side and would be quiet when I stayed by her side and stroke her.
I learnt the lesson that putting her to sleep is more for my
convenience than for the relief of her suffering. I relieved her pain
with morphine and she died a natural and peaceful death two days
later. I had chosen to give my dog hospice care rather than to end her
life by euthanasia. This made it easier for me to go through my grief
of losing my beloved dog.
The dying has been my teachers of how to die well so that one can live
our lives with meaning and love each day. One of my patients was
suffering from metastatic cancer of the prostate. When I first saw him
he was ambulant and able to look after himself. He was asymptomatic
and was struggling with his prognosis as the doctors in hospital had
told him that he cannot have any more chemotherapy. I encouraged him
not to see the bad news that there is no further treatment as a death
sentence but as a reminder to live his life more fully.
He was encouraged to attend a hospice Day Care Centre which he did for
two months. Unfortunately, he developed an urinary obstruction and had
to use an indwelling urinary catheter. He then stopped going to the
Day Care Centre but he remained independent and was able to care for
himself at home.
Four months later, the cancer spread and caused an intestinal
obstruction. He then had to have a colostomy. In spite of all the
above complications, he was able to live an independent life at home.
He was understandably demoralized and depressed by his condition but
we encouraged him to live one day at a time.
Unfortunately, 2 months later, as he was walking to his favourite
hawker stall one morning, he was knocked down by a car and suffered a
fracture of his right hip. But he was able to walk after his hip
operation and died at home after another 3 months.
It was not an easy time for him and his family. He had expressed a
desire for death a couple of times. If euthanasia had been permitted
by law, I would have to make the choice to encourage him to find
meaning in his suffering or to assist him in ending his life.. But
choosing euthanasia would have deprive him and his family the last few
months of his life which gave them an opportunity to resolve issues
and to complete unfinished tasks – to express love, forgiveness,
gratitude and to say goodbye in a human way,
The answer to suffering is not to end life but to see it as a
challenge to love and to care more. The evil of euthanasia is that it
is a symptom of a materialistic society that measures life only in
terms of wealth and health. But such a society is spiritually poor as
well as evil for evil is the absence of compassion and love.
