Asunción Álvarez – For a better end
A new group that defends the right to decide the end of life (in general those groups are known as right-to-die societies) has been founded in the United Kingdom. Its name is NINETY PLUS, “ninety” meaning the years of age. The coordinator of this group will be Michael Irwin, who has been the president of Dignity in Dying, of the United Kingdom, as well as of the World Federation of Right to Die Societies and who will turn 90 in two years.
The historical background of this association lies in the organization Society for Old Age Rational Suicide or SOARS, also established by Irwin in 2009, precisely on December 10, considered the day of human rights. Later, the organization changed its name to the current one, My Death, My Decision. On the one hand, this change was due to the interest of extending its objectives beyond the “old age” and, on the other, to avoid using the word “suicide” that usually brings to mind a violent, lonely and tragic death that has nothing to do with the one that the organization champions, namely, a rational and chosen death, with medical assistance so that it passes off in peace and without pain. Although this association also encompasses the old age topic, it seems that NINETY PLUS wants to address expressly this life condition once again and to make physician-assisted death an option for competent people 90 years old and older who have reached a stage of “life complete”.
How can a “life complete” be defined? Of course, it is something that each person must define personally, and those definitions differ considerably. When we consider whether it would be valid to help those people die with the benefit of a legal framework, we take it for granted that they must be mentally competent elderly people who have a chronic health problem or a combination of problems (loss of mobility, sight, hearing; fatigue, apathy, incontinence) causing them an increasingly unbearable and irreversible suffering, plus the additional loss of independence, dignity and meaning in their lives. For them it is preferable to die than to continue living, especially because they fear the future that awaits them. Of course, there are people suffering from any number of health problems who are grateful to be alive; obviously the “life complete” doesn’t apply to them.
We must point out that physician-assisted death (euthanasia or physician-assisted suicide) is prohibited in the United Kingdom, even in those cases where a person suffers from a terminal illness (the condition that is a requisite in the majority of jurisdictions allowing it). In recent years there have been several failed attempts to pass a legislation allowing physician-assisted suicide. This is a surprising issue because one would think of the United Kingdom as a liberal society, more willing to support the right of people to make decisions about their own lives, including to terminate it, and receive the medical assistance required to carry it out in the best conditions. I have conveyed my surprise at this fact to British persons who explained me that in fact their country’s legislators and judges are quite conservative. The result is a huge gap between what society wants concerning physician-assisted death (according to surveys, close to 80% are in favor of legalizing it) and what it gets from its government. It’s possible that things will start to be different due to the recent change that has taken place in the standpoint of the Royal College of Physicians that for the first time has adopted a neutral posture (instead of an adverse one) towards the physician-assisted death in the United Kingdom.[1] To put an end to one’s life is a decision that the person in question must take and, therefore, the permit to provide such assistance to die is a matter that concerns society and not the medical profession. However, since the intervention of doctors is indispensable, as they are the ones providing the assistance (at least it is the way in which it has been discussed and legislated up to now in all the countries, except Switzerland), the posture of medical organizations influences political decisions on the subject.
For many years, physician-assisted death has been discussed in the Netherlands for persons with a “life complete” (this expression was considered preferable to those previously used: “suffering life” and “tired of life”). It was Huib Drion, a professor of law and vice-president of the Supreme Court of that country, who addressed the issue for the first time in 1991, when his article, “The voluntary end of life of elderly people”, was published in the Dutch newspaper NRC Handelsblad. In it he reflected on the suffering of those people and the great serenity that would mean for many of them to benefit from an acceptable way of quitting life the moment they decided to do so.[2]
The main reason why this issue is still under deliberation is because in Holland the two main legal criteria for helping someone to die are: 1) the person is mentally capable to make a voluntary request, and 2) the person suffers intolerable pain caused by a disease or a medical condition. This second criterion is not met by people with a “life complete”; their situation is very different from that of a patient who asks for help to die because he suffers an intolerable pain due to a terminal illness, for example.
Certainly, the legal criteria in the Netherlands, as in Belgium, are more open than in other countries and do not specify a life expectancy duration, as do the other jurisdictions permitting some kind of physician-assisted death. Therefore, in these countries, people with an intolerable suffering, due to a mental illness or a neurological illness with which people could live for many years, can be helped to die. The problem is that persons with a “life complete” lack a medical condition that, by itself, causes them an intolerable pain. To solve this problem, and not abandon persons who would want to put an end to their lives (and would be forced to do it by their own means, risking a violent death and even to fail in the attempt), it has been proposed that for those persons an equivalent criterion to the intolerable suffering caused by a medical condition could be the irreversible loss of dignity (something that, obviously, the persons themselves should have to express). For now, a “life complete” category that could include this criterion has not been legally passed, but assistance has been provided to persons in this condition, considering that the legal criterion is met when there’s an intolerable pain suffering caused by the sum of different medical conditions (none of which would be sufficient by itself). Regarding age, it’s always questionable to establish limits because in the end they are arbitrary, but at the same time necessary. Since he first spoke on the subject, Drion proposed that help to die requests based on a “life complete” criterion should be received after age 75, and that’s the age that has been considered since then. For its part, it seems that the NINETY PLUS group is proposing that age to be set after 90.
What about people who consider they already have a “life complete” but don’t have one single medical ailment? In the Netherlands (the country that has most discussed this topic), they cannot be helped. It must be recognized that whenever legal criteria are established, conditions and limits must be specified, which is why there will always be persons unjustly left outside the law; in this case one permitting a physician to help a person to die. As they don’t meet the legal criteria, people with a “life complete” who want to die are forced to end their lives without the help of a doctor, reason why, in the Netherlands as in other countries, some right-to-die associations advocate that these persons should have access to safe means to end their lives by themselves, without pain, when they so decide.
Switzerland has managed to help people with a “life complete” with more freedom. (That’s why, last year, the 104-year-old Australian scientist David Goodall went to die in that country). That’s because in that country suicide help is not legislated to be given within the context of medical care, as it happens in the countries where some kind of physician-assisted death is permitted. What has happened in Switzerland is that organizations offering assisted suicide (some even to foreigners) must satisfy certain guidelines established by the government. Although they cannot help anyone to commit suicide, they benefit from the broadest criteria of all the regulations that allowed them to help, not only single persons with a “life complete”, but couples whose two members state that they are in that condition and want to die together. In Holland, Oregon and Canada, it has also occurred that a couple is given physician-assisted death at the same time, but not for having a “life complete”, but because its two members meet the legal criteria due to the disease each of them suffers.
Life expectancy is increasing thanks to scientific and technological progresses and better health services, which means that population is aging at an accelerated pace. In some cases, people enjoy living longer, but in others, people are forced to live in such unacceptable conditions that they would prefer their life to finish sooner instead of adding years to a life that will keep getting worse. From such a perspective, it is understandable that many people want to have the assurance that, if they reach that situation, they will receive help to die safely and painlessly. We must not forget that there have always been traditions in which the decision of elderly people to die is accepted and supported. The film The Ballad of Narayama (Narayama Bushiko) [3] focuses on a Japanese tradition according to which the elderly who no longer have teeth go to die at Mount Narayama. For their part, the Jainistes in India still maintain an ancient ritual called Santhara that is practiced in case of old age or incurable disease with the permission of a religious leader to fast until dying.
As John Hardwig said in his article Going to Meet Death. The Art of Dying in the Early Part of the Twenty-First Century, [4] although some people fear dying prematurely, nowadays many others fear that their death could come too late. We must do something so that life can be enjoyed without the fear of being trapped in it and in conditions tainted by suffering or indignity.
Fuente: El Semanario
https://elsemanario.com/colaboradores/asuncion-alvarez-del-rio/313020/una-vida-completa-y-el-derecho-a-decidir-cuando-morir/
José de Teresa 253, Campestre Tlacopac, Álvaro Obregón, CP 01040, CDMX
AVISO DE PRIVACIDAD Copyright© DMD México | Cuarto Negro 2024