Death with dignity

MY FOUR CENTAVOS By Dean Andy Bautista (The Philippine Star) | Updated November 8,
2014

“No person shall be deprived of life, liberty or property without due process of law” is arguably
the most important provision in all of Philippine law. It represents the most fundamental of human
rights as it protects an individual’s right to life, liberty (which includes privacy) and property from
the arbitrary interference by the State.

But if a person’s right to life is enshrined the Constitution, is her right to die protected as well?

***

This column was not precipitated by last week’s Undas commemoration nor by the first year
anniversary of Typhoon Yolanda. Rather, it is a brief commentary on the “suicide” of Brittany
Maynard. Unlike the Jack “Dr. Death” Kevorkian cases in the 90s which usually involve adults in
their 70s, Brittany was a 29-year-old female who was suffering from terminal brain cancer and
was given six months to live. She moved her residence from California to Oregon to avail of the
latter’s Death with Dignity law. As NYU’s Arthur Caplan observed, she “changed the optics of
the debate.” She reached a younger generation of Americans who may view physician-assisted
suicides (PAS) differently from their ascendants.

Montana, New Mexico, Oregon, Washington and Vermont allow PAS but only the latter three
have passed Death with Dignity laws. They provide several end-of-life care options including
allowing mentally competent, terminally-ill adult residents to voluntarily request and receive
prescription drugs that would hasten their death. These laws seek to ensure that the patients are
protected and in control of the process.

Hence, the patient must:

• verbally request the prescription medication from the physician twice with the second request
being made at least 15 days after the initial request

• provide a written request to the physician that is witnessed by two individuals who are not family
members or primary care givers

• notify her next-of-kin of the prescription request

• wait for 48 hours before picking up the medicine

• be able to self-administer and ingest the drugs

These laws further provide:

• the patient can rescind the request at any time

• the attending physician’s diagnosis must be validated by a consulting physician

• both physicians need to certify that the patient is mentally competent to make and communicate
health care decisions

• the attending physician needs to inform the patient of alternatives, including palliative care,
hospice and pain management options

Physicians and hospitals are not obligated to participate but those who comply are protected from
criminal prosecution.

***

Euthanasia is a much debated issue that stirs the deepest of emotions within certain groups and
individuals. The term is derived from the Greek words “eu” (meaning good)
and “thanatos” (meaning death), which combined means “good death” or “dying well.” It was
the Roman historian Suetonious and philosopher Francis Bacon who coined the term.

Certain definitions of euthanasia manifest the deep divide. The Pro-Life Alliance defines it as “any
action or omission intended to end the life of a patient on the grounds that his or her life is not
worth living.” On the other hand, the Voluntary Euthanasia Society sees it as a “good death
brought about by a doctor providing drugs or an injection to bring a peaceful end to the dying
process.” Euthanasia can either be voluntary or involuntary. Voluntary euthanasia which refers to
cases involving mentally competent individuals can be further subdivided into passive euthanasia
(e.g., refusing to eat), active euthanasia (e.g., asking that a life-support machine be switched off)
and physician-assisted suicide.

PAS is ethically challenging for doctors because of their Hippocratic Oath. Written between 400
and 300 BC, the Oath, among others, states: “To please no one will I prescribe a deadly drug nor
give advice which may cause his death.” The dilemma was probably best described by Dr.
Kevorkian: “I did not do it to end a life. I did it to end the suffering the patient’s going through.
The patient is obviously suffering – what’s a doctor supposed to do, turn his back?”

There are several arguments for and against euthanasia. The American Civil Liberties Union
believes that “the right of a competent terminally ill person to avoid excruciating pain and
embrace a timely and dignified death bears the sanction of history and is implicit in the concept
of ordered liberty.” Dr. Jasper Emmering thinks that “the moral distinction between abstaining
from life-saving treatment, palliative sedation and euthanasia is very murky, for me it doesn’t exist
at all. Therefore it makes no sense that the first two are legal while the third is not.” Physicist
Stephen Hawking simplistically argues: “We don’t let animals suffer, so why humans?”

On the other hand, those who oppose euthanasia believe that “there is no such thing as a life not
worth living. Every life holds promise, even if disadvantaged by developmental disability, injury,
disease, or advanced aging.” Dr. Sissela Bok argues that “no society has yet worked out the
hardest questions of how to help those patients who desire to die, without endangering others who
do not.” Those particularly at risk are the impoverished and who have limited access to good
medical care. Peter Kavanagh thinks that “there would be other long-term consequences of
legalizing euthanasia that we cannot yet envisage.”

For sure, euthanasia is a complex, multi-faceted issue. It has objective and subjective components
which straddle scientific, religious, ethical, societal and practical concerns. Our responsibility is
to be properly informed so when our, or a loved one’s time comes, we are able to decide
intelligently.

Source: http://www.philstar.com/opinion/2014/11/08/1389242/death-dignity