In our society there continues to be a controversy about the right of an individual to end their own life when living becomes emotionally and physically unbearable for them. This may be the case when a medical problem leads a person to lose everything they feel necessary to continue a dignified, meaningful life.
It is not uncommon for people in the end stages of catastrophically disabling neurological illnesses, such as Amyotrophic Lateral Sclerosis (ALS) or Huntington's Disease, to desire a controlled and painless end to their existence. In other cases, loss of function coupled with unbearable disfiguration due to cancer, trauma, neurofibromatosis, or other conditions leads a person to feel that no form of meaningful, acceptable existence is possible. For others, it is never ending, intractable, excruciating pain that makes existence unbearable. For too long we have forced human beings to suffer under the primitive religious notion that it is "God's" decision and not our own to end life.
The subtext of the notion that it is "God's" decision to end life tormented by suffering has always been that suffering is meaningful, and that God has a purpose for it. Few would argue against the common understanding that adversity ennobles the mind. Loss, disappointment, pain, defeat, and failure are the great teachers of humanity. They lead us to seek the comfort and guidance of others. We experience consolation, and we learn to give such consolation to others. We learn that to persevere through pain and defeat can bring rewards far sweeter than they might have been had they been more easily and less painfully achieved. Pain and adversity teaches us patience, humility, empathy , grace, courage, and hope. It teaches us what it means to be one among other human beings. Indeed, it may be the basis if not the prerequisite for love in its most mature form. However, on what basis do we force an individual to continue to suffer an excruciatingly painful existence in which there is no longer any hope, comfort, or meaning?
Some argue that to allow people the right to end their life when and as they choose is the first step down a road to nihilism and wholesale suicide. However, experience shows that this is not the case. Where physician assisted suicide is legal, such as in my own home state of Oregon, those who have successfully pursued access to medications to end their life most often choose to go on living. The sense of control and choice they experience gives them the courage and peace of mind to see it out a little longer. There is also an unfounded concern that allowing an individual to take their life under such circumstances is a slippery slope to encouraging or compelling people to take their own lives. However, aside from being unfounded, this concern easily resolved. We must simply prohibit encouragement and compulsion!
There are some who argue against assisted suicide because they are under the impression that modern medical science is capable of treating and relieving all forms of physical pain. This, unfortunately, is untrue. There are forms of physical pain that do not respond to medication. People who suffer pain resistant to medication are sometimes helped by pumping pain medication directly around their spinal cord. Others are helped by surgery that cuts pain pathways in their brain, or by implantation of electrodes that alter brain function. But for some people not even those extreme measures bring relief from pain. No matter what is done, some human beings continue to suffer unrelenting, unbearable pain. They should not be forced to endure it.
A final and perhaps more complex question is on what basis would we establish criteria to define the conditions and forms of suffering that might justify suicide. Clearly, there is a possibility that people might choose suicide due to frivolous, temporary, or easily resolved problems. Safeguards are written into the Oregon law to prevent an individual who is psychiatrically ill from making an ill-conceived and irrational decision to end their life. There is also a waiting period to prevent rash or precipitous actions. Common sense dictates that we rule out conditions that are likely to be reversed by treatment.
The current law in Oregon is based on the confirmation of a terminal illness, and not necessarily for intractable pain or loss of meaningful existence. I believe the law would be more humane by allowing for individual variation and personal choice. Whereas Stephen Hawking, through his magnificent life of the mind, has found a means to live a meaningful and productive life with ALS, not everyone with the illness can do so. Nonetheless, Oregon's law is a good one and, for most states, allowing an individual with unmitigated suffering in the context of an terminal illness to seek a physician's help to end their life would be a major step forward.
The argument against physician assisted suicide and the right to die is almost entirely a religious one. There are many reasonable religious individuals who see that a just and loving God would forgive any mere human being for finding a peaceful, painless way out of unmitigated misery. I applaud them. On the other hand, for those of us who do not believe in a sugar-coated God that makes all things right in the end, the notion that one should be forced to persist in a painful, unbearable existence, without respite or hope of remedy is cruel, barbaric, and pathological. It is time that our society grows up and grants the right to die.
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