physician-assisted suicide?

So I had a pretty interesting discussion in my The Body and Literature Honors seminar today about physician-assisted suicide. According to the New York Times, Washington state joined Oregon after Tuesday's election as the second state to allow physicians to administer lethal injections to terminally ill men and women who are ready to die.

I'm sure you remember the Terri Schiavo case...it was a huge issue and very heavily publicized when her husband was finally able to pull the plug. The Washington state proposition barely passed, just 51 to 49, which shows that the nation continues to be divided. There are several safeguards in the proposition to prevent people from rushing into the decision, according to nytimes.com.

"Patients requesting this assistance must be mentally competent, residents of the state, have six months or less to live according to two physicians, wait 15 days after their initial request and then repeat that request both orally and in writing. They must be capable of administering the lethal medication themselves and agree to counseling if their physicians request it. In addition, these patients also must be informed by their health care providers of other feasible alternatives."

The Times article also talked about reasons why assisted suicide is technically already happening. It's rare, but some patients who are suffering from intractable pain receive treatments so intense that they actually hasten death. Also, we tend not to question "a
patient’s right to forgo life-sustaining therapies or discontinue them once begun."

This includes not only feeding tubes and ventilators, but also chemotherapy, insulin or antibiotics.

And as my seminar teacher Sibbie reminds us, we all have a right to control what is done or not done to our own bodies.

But what if we are not conscious to make that choice?

The Washington Post ran an article today about a 12-year-old Jewish boy on life support at a D.C. hospital, who is brain-dead and technically deceased, that doctors want to take off life support. His parents are fighting vehemently to keep him on it, because they say that "their faith does not define death as cessation of brain function alone." Basically, his heart and lungs are still functioning thanks to a ventilator and various other machines, but he is brain is 100 percent dead in both higher and lower functioning, so if there was not a machine there to pump the heart and expand the lungs, his body would be in the morgue by now.

It's a Maryland law that physicians have the right to declare a body dead if it has no brain activity, which they did on Tuesday for this boy. According to the Post, "In filings, the hospital extended its sympathy to the family but said the boy should no longer be on its equipment, saying that "scarce resources are being used for the preservation of a deceased body.""

So who's correct? There are many reasons that make both situations problematic, but I tend to agree with the doctors in both cases. I'm not talking about Dr. Kevorkian or anything like that - but if someone is in so much pain that they are willing to end their own life, chances are they will find a way to do it somehow on their own. Other than that, I'm not going to touch that topic.

But as for the brain-dead child, he's been in a vegetative state for a long time, and once he is brain-dead he's not coming back. There is no functioning, the nerve cells have died, and nerve cells in the brain do not regenerate. A beating heart and moving lungs are literally the highest functioning his body will ever be able to perform again, and that is only because they are being forced to do so by machines. Honestly, at this point it seems to be selfishness and grief on the part of the parents that is keeping him alive, more than Jewish law. If they want their son to move on if he hasn't already, the compassionate thing to do would be to accept his death and stop trying to force life into a dead body. The hospital is right; the machines being used to keep him alive could be serving...not a better purpose, I suppose, but a more pressing one.

Of course, I can say this stuff all I want, but I can never imagine the amount of suffering these parents must feel at the loss of such a young son to a debilitating brain tumor. Their attorneys are also right in that the grief of the parents and their religious beliefs should be respected. But for how long? He is never going to come back, and he can't be kept on life support indefinitely. Eventually his organs will not function as well, and his body will deteriorate from lack of nutrition and exercise, and his body will die like all bodies. How long can a body without a functioning brain be kept a live?

Sadly, however long his parents fight to keep him on life support, it's not a matter of if he will be taken off, it's a matter of when, because one way or another, his body is going to die. But this situation does raise an important question: If we can control it, when should we let go of life?


The Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2008/11/05/AR2008110504602.html

The New York Times: http://newoldage.blogs.nytimes.com/2008/11/06/at-the-end-of-life-a-delicate-calculus/