3rd of November 2020
By Ruth Bushell
Last week we looked at euthanasia as a product of society’s aversion to the suffering of others and unwillingness to engage with anyone elderly or unwell. Now we will consider it more from the perspective of its victims.
The common image perpetuated by those in favour of euthanasia is of someone in unbearable, intractable pain. However, such cases of extreme pain being medically impossible to alleviate are actually fairly rare. Advances in palliative medicine have enabled people to die in more comfort than ever before. Sometimes these palliative treatments do have the effect of shortening life but they are not fatal in the same way that euthanasia drugs are. While the idea of pain is often what makes people sympathetic toward euthanasia, according to a peer-reviewed and respected journal JAMA, pain is not the main motivation for PAS (physician-assisted suicide). Jama reports that ‘The dominant motives are loss of autonomy and dignity and being less able to enjoy life’s activities.’ Loss of dignity is mentioned as a reason for 61% of cases in the Netherlands. What is ‘dignity’ in the sense it is being spoken of here? It’s a word I take to mean the state of being worthy of respect. It’s a value that should be ascribed to every living human being. In the case of those arguing that they have ‘lost’ their dignity due to illness or old age, no one has taken it from them, rather they have perceived a change in how they are viewed and treated by others. We as social beings cannot help but measure our dignity, our sense of worth by how those around us act. If everyone around you avoids you, if those paid to care for you rush to be away from you and your children and grandchildren rarely visit then it is inevitable that you will feel a loss of dignity. If we were less squeamish about disability and treated the elderly as people rather than problems perhaps their sense of their own worth and dignity could be regained.
Humans are incredibly fickle in how they view their fellow man and it is not true to say that we are always repulsed by suffering. Rather we find it hard to respect, value or love those whom no one else respects, values or loves. We can see this reflected in all those gooey Hollywood films about romantic couples where one partner is suffering from a terminal illness. In these films a huge amount of effort goes into making sure bucket lists are ticked off and affection is showered constantly on the patient. Now the suffering patient is valued above all others because they are loved by another healthy, beautiful person and they love in return. The ‘patients’ in these films are also entirely compus mentus, their supposedly deadly illnesses have little effect on their airbrushed beauty and much of their medical treatment looks like a spa procedure. Their suffering has been sanitised to the point of being unrecognisable and the real focus of these films is not so much their death but how the healthy partner responds to it. The humanity, worth and dignity of the patient is dependent on the affection of a healthy person. It is the healthy that are portrayed as the ‘heroes’ of these film and them (and not the person actually dying) that the audience is encouraged to sympathise with. 
The hierarchy of the healthy over the sick is thus perpetuated. Of course, to watch a loved one die is extremely difficult but imagine how much more difficult it would be to be dying without a doting partner, to suffer whilst being spurned by all those around you, to be told your life couldn’t possibly still be worth something. To cut man off from mankind is to deny a part of his humanity, and the less human someone feels the easier it is to accept the ‘easy death’ of euthanasia.
A common (mis)interpretation of dignity is that it is in someway connected to our independence, to our ability to survive with minimal assistance from others. We see ‘control’ as a key indicator in our life’s value. But all these things can change incredibly quickly without our essence as a person changing at all. Stephen Hawking did not become a lesser version of Stephen Hawking as his illness progressed and he relied on more people for his survival. Humans are desperate for control over their lives but history should have taught us by now that any control we do have is constantly liable to being undermined. Dr Burt Keizer, a Dutch doctor and proponent of euthanasia describes the procedure as ‘a bearable way of severing that link (between living and dead) ‘not by a natural death, but by a self-willed ending. It’s a very special thing’. To the doctor and the patient’s relatives it may well be more ‘bearable’ to watch a clean, quick death than a prolonged one. But for the patient a controlled, ‘self-willed’ death is still death. Dr Keizer’s assumption that a death one has ‘willed’ is in some way better has one fatal flaw. Humans are famously inconsistent. What we willed yesterday may not be what we will today, what we once thought of as unbearable suffering we may grow to bear, the death we once looked forward to we now fear.
A chilling example of this can be found by looking at Holland’s first euthanasia malpractice case. An Alzheimers patient had previously signed a document stating that they wanted to be euthanised when the ‘time was right’. The women involved had originally deemed this time to be before she needed to enter a care home. However, when the day came and her doctor prepared to administer a lethal drug, she resisted. Due to her condition it was difficult to explain the situation to the patient and the doctor was unable to get her consent. In accordance with her past choice, the family and doctor decided to go ahead. A sedative was given via the patient’s coffee but during the final stages of the process she woke up and resisted, resulting in her family holding her down while she was euthanised. When the case was taken to court the doctor defended her actions by saying the patient’s protests before her death were ‘irrelevant’ since she was suffering from Alzheimers and therefore not of sound mind. But was her mind any sounder when the patient decided to plan her own death? Most psychiatrists would deem thoughts of suicide to be in line with some form of mental disorder, so why is planning for euthanasia accepted as a liberated choice? Is it simply 
that it is more convenient for society to promise death than to provide care? When that patient originally made her decision about her death she did so to feel more ‘in control’, but in the end she died not in a calm or dignified manner but struggling to live while her loved ones restrained her. The control her past self had yielded was used to erase her current self.
Our birth and death are and should be beyond our control. Who we are between those two events may change to some extent but our essence as innately valuable human beings does not. To pretend that our deaths can be improved upon by bringing them forward and making them ‘self willed’ is a lie that diminishes our humanity and ultimately makes death harder for the dying and easier for the living.
