The case of Terry Schiavo and arguments against legalizing the right to die

Anti) Right to Die

Science and technology has allowed humans to treat a myriad of diseases that were previously terminal. This is illustrated in the controversy over the case of Terry Schiavo, the Florida woman at the center of a right to die dispute between her husband and her parents.

Schiavo, who has been in a vegetative state for the past 13 years, brings a face to the legal question of when can a third party decide the fate of patients who cannot decide for themselves. According to Schiavo's husband, Terri would not want to live in her present state. Schiavo's parents, however, disagree (Stern and Goddard).

The conflict illustrates the lack of precedent regarding the legal status of patients like Terri Schiavo. There are many more like her, who are comatose, unconscious and with no hope of recovery. Science and technology has allowed humans to treat a myriad of diseases that were previously terminal. This is no longer a question of whether prolonging life is possible.

Instead, as Schiavo's case illustrates, physicians and scientists must grapple with a more difficult dilemma - whether life should be artificially prolonged in the first place.

This paper thus argues against legally recognizing a "right to die" as a solution to this dilemma. Furthermore this paper argues that proponents of the rights of the terminally ill should instead focus on other programs that will provide comfort and medical care.

The first part of this paper looks at the arguments for recognizing the right to die. The next part then examines the social costs of legal euthanasia or physician-assisted suicide, as seen in the experience in the Netherlands. This part also evaluates the possible consequences of legalizing euthanasia in the United States. In the conclusion, this paper looks alternatives to legalizing euthanasia, such as hospice care and pain management.

Arguments to legally recognize the right to die

Proponents of the right to die movement believe that their actions are a compassionate response to the pain of those who are terminally ill. Others add that euthanasia upholds the rights of many individuals, particularly the elderly, the ill and the handicapped. Many physicians thus believe that a case-to-case approach is necessary where, subject to strict regulation, physician-assisted suicide can be an option for the dying.

Polls in the United States as well as Canada, Great Britain, Australia and other parts of Europe show that 60-80% of people support legalizing physician-assisted suicide. Many of these supporters expressed fears regarding losing control of their bodies and their life decisions to the medical care system. Others who have watched loved ones agonize through the final stages of cancer or multiple sclerosis argue that end of life choices rightly belong to patients and their families (Girsh 208).

In addition, right to die activists argue that experience of countries like Switzerland, where the right to die is legally recognized, belies any fears that allowing physician-assisted suicide will foster a "culture of death." In Switzerland, an estimated 120 people die annually through medical assistance. There is no deluge of patients waiting to be put out of their misery nor are there unscrupulous physicians waiting to take advantage of suicidal people. Even the notorious Dr. Kevorkian has averaged 14 assisted suicides since 1990 (Girsh 208).

Currently, the United States recognizes that people have the right to seek medical treatment for a host of ailments. The law also allows physicians to assist terminally ill patients by disconnecting life support of by prescribing medicine for pain. However, right to die activist argue that both patients and physicians are prohibited from taking the logical next step - medical assistance to produce a death free from pain and protracted agony.

Consequences of legal recognition of right to die: the Dutch experience

In February 2001, after two decades of being practiced underground, the Dutch government enacted a law legalizing physician-assisted suicide.

The law had popular support and, like the health workers who worked with AIDS patients, it had the best intentions. Strict criteria were put in place, limiting physician-assisted suicides to terminally ill patients who possessed adequate mental capacity to decide and make an explicit request for a physician-assisted suicide.

This decision was hailed as right to die activists as an example of how the system should work. They argue that the Dutch system allows a compassionate response to the needs of the elderly and those who are terminally ill.

Since then however, the law has been bent, stretched and expanded beyond its original strict criteria. As Hendin observed, Dutch society progressed from physician-assisted suicide to euthanasia. Eventually, recognizing the right to die for terminal ill patients gave rise to euthanasia for the chronically ill. Then people with psychological problems - many treatable - availed of physician-assisted suicide. This eventually led to physicians practicing involuntary euthanasia, "terminat (ing) patients without specific request." (Hendin: 23).

People who sought physician-assisted suicides included an HIV-positive man who has no symptoms of AIDS. He was not classified as terminally ill. He may have lived long enough to await a cure or he could have lived a full, productive life until the onset of symptoms.

Finally came the most chilling result of a policy that all but legalizes euthanasia. A government-commissioned Remmelink Report found more than 1,000 cases where health workers performed physician-assisted suicides even without the patient's request. These physician's reasons range from the impossibility of treating a patient's pain to the "low quality of life" to "all treatments were withdrawn but the patient did not die." (Hendin: 75-76).

The Dutch experience shows how, even with strict guidelines, the practice of physician-assisted suicide and euthanasia is virtually impossible to regulate. The result was a steady slide towards "involuntary euthanasia," a glaring contradiction in terms. When stripped of its euphemistic language, the practice of terminating a patient's life without a specific request is simply another way to describe a murder.

Conclusion

In summary, the debate over granting legal recognition for the right to die centers around the question of how to best alleviate the pain and discomfort of the terminally ill and the dying. Both sides frame their arguments in terms of compassion.

For advocates of euthanasia and physician-assisted suicide, recognizing the right to die offers those in pain a more dignified way out. However, recognizing a legal right to die can have detrimental consequences for society, as we as for the sick individuals. As seen in the case of the Netherlands, even the strictest physician-assisted suicide laws can be bent to include patients who have treatable illnesses.

This paper has argued that in addition to this social danger, the focus on legalizing the right to die takes away from the true needs of the terminally ill, namely pain management, subsidized home health care services and a wholistic approach to hospice care. Since many chronically or terminally ill patients fear pain more than anything, palliative care would help to reduce the call for a right to die. Subsidizing the health care of sick patients would also help overwhelmed families, and remove the onus from patients who feel like a burden to the ones they love.

Finally, even those who point to the need for a "death with dignity" would agree that a hospice care system with an aggressive approach to pain management, a fully-trained staff and other programs to address a patient's spiritual and other needs would be the best way to ensure this.

There are many, more enlightened alternatives to the right to die, ones that address the needs of the terminally and chronically ill in more wholistic ways.

Rather than focusing on the right to die, society should focus on these methods as a compassionate response to the needs of patients in pain.