Euthanasia? All life is terminal!

While I appreciate that the Hippocratic Oath in effect stipulates physicians should  “do no harm”, this is not the end of the matter.

To only allow (or disallow) a “terminally” ill person to decide when they wish to end their life is looking at this problem from the wrong end. It is not if they are ill, terminally or otherwise, but a person’s quality of life – their perception of that quality, which should be the main issue.

Recall and understand that all life, repeat ALL life, is terminal – we cannot escape the end. It is terminal! Sooner or later we all die – ill or not. Palliative care, however well administered, will not halt this process. Furthermore it is impossible to accurately determine the exact time or date in the future as to when a person will die. So to stipulate a time or date (following the Victorian “model”, six months is suggested), sometime in the future which may determine whether or not a person is “allowed to die” is regrettable, to say the least. 

Furthermore, why should anyone have to “live” according to another person’s expectations? We have no “right” to interfere. It is not our life; it is not our choice.

We, and by “we” I include all humans, were presumably born to live in the world. Now if a human being decides, because of the status of their health, that the life he or she is currently experiencing in the world is not a “quality life”, who is to say they are wrong? We, you or I, cannot experience that person’s view with all the emotional, stressful or painful events they may have suffered or endured during their life to date. How can anyone, other than the person concerned, determine what level of “quality” is acceptable or unacceptable? 

We can have no idea how this expression of life plays out; or how life events (particularly their health) affect a person’s outlook, towards themselves or others – no one can “know” this except the person concerned. They make a choice based on such experience – good, bad or indifferent. It is their decision. You or I are in no position to say they are wrong. 

Similarly, what evidence, what insight do we have such that we can proclaim that a particular person’s view or expression of life (as currently experienced) is wrong and that we (or at least the “experts”) alone know better? We may not like or approve of their view but - so what! 

Likewise, what evidence is there for the “experts” to state that those who wish to end their life may be suffering from a “mental disorder” (hence the proposed requirement - for a totally subjective - psychiatric assessment on any person wishing to end their life). Disordered from what? From “normal”? As far as I can determine there is no accepted definition of “normal”. Possibly those considered “mentally disordered” react to life’s trials and tribulations differently from those around them. Are they “wrong”? Or are those who condemn euthanasia just being intolerant and lacking in understanding, compassion or empathy? 

Then there is widespread over prescription of antidepressant and antipsychotic medications (remember that, allegedly, one in five people (1 in 5) will, allegedly, suffer from a “mental illness” in their lifetime). There are many reasons why all concerned should be critical about psycho-pharmaceutical drug treatment, such as uncertainty regarding the causes of mental disorders, the problematic accuracy of the few diagnostic tools available, poor understanding regarding the mechanism of drug actions and their many side-effects together with the related problem of publication bias. Then there is commercial conflict of interest, [Note:The reanalysis of the – originally ghost written - GlaxoSmithKline Study 329 relating totheir antidepressant drug formulation paroxetine,Paxil, (also known as Serotax or Aropax) provides an illuminating, if unfortunate, example of these issues]. 

Also there is extreme pain. Anything that results in an actual or perceived loss of personal control will (possibly) bring about a loss of dignity and of “hope” - those most subjective attitudes of mind.

Furthermore for some to say that only God can decide when any person dies is surely a gross over assumption – how do they know? What special insight do they possess? Is it not possible, because (I assume) God gave us free will, that God may have already decided to allow a person who wants to die, to die?

Then what about those who say that the legalization of euthanasia would see the end of compassion? Surely it would be more compassionate to allow someone who wishes to end their life to do so in a private setting of their choice, with (possibly) family and friends in attendance?

Far rather this than, to get their way, forcing a person to take extreme actions – starving, drinking or drugging themselves to death; shooting themselves; jumping off a high rise building or cliff; driving at high speed into the support column of a freeway overpass or into a tree on a country road; consume rat poison or drink some corrosive liquid (such as ammonia) and take four days, in agony, to die.

Recall also that the British philosopher David Hume (1711 –1776) said, “I believe that no man ever threw away Life while it was worth keeping.” 

Finally I will repeat a quote, from the Indian sageJiddu Krishnamurti (1895-1986), who said, “It is no measure of health to be well adjusted to a profoundly sick society”. 

There we have it – in a nutshell! 

PTSD and those who suffer.

That people suffer the after effects of traumatic events is indisputable and very unfortunate for those experiencing the emotional and mental upheaval – whether or not they have had it diagnosed as Post Traumatic Stress Disorder (PTSD). Yet this condition – PTSD - was “created” by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) only in their1980 third revision – DSM III. Prior to this date – while people certainly suffered – it was not categorized as Post Traumatic Stress Disorder.

Traumatic and highly stressful experiences rob us of our belief that we can keep ourselves safe in the world and we wait anxiously for the next traumatic event and react nervously to every unexpected sound –compounding our fearful expectations. Whatever our traumatic experience it is important to remember that such events, though terrible, evoke responses that are ordinary human responses to extraordinary circumstances. Everyone going through such an “out of normal” and fearful experience needs comfort and support, just as we all need comfort and support when, for instance, we are injured, lose a close friend or someone we love. But to categorize our ordinary reactions to this fear or grief as a “mental disorder” both diminishes and demeans our experience. We have had this experience, which is outside our normal expectations, and we react by trying to master our memory of the event and the emotions that are evoked. The mind will often attempt to ‘retreat’ from unpleasant life circumstances. It will do so in the only way it can, by going to a place of refuge and shutting off the ‘hurt’. This can manifest in many ways – as ‘depression’, as apparently delusional thoughts or neurotic behaviour. Such reactions far from being an “illness” are but a desperate attempt to preserve our concept of self, our identity, which is in danger of being overwhelmed.

Since humans first evolved millions of people would have experienced highly stressful or traumatic events. People in antiquity, as far as I understand history, would have suffered the after effects of the trauma experienced in battles and ever present likelihood of being captured and taken into slavery. Similarly in their daily experiences with the natural world of their times – wild animal, floods, earthquakes, droughts, starvation and such like would have tested the resilience of the strongest characters.  

With the winding down of the military activities in Afghanistan many military personnel are arriving home with emotional and psychological scars which need to be healed. Assistance is available for those who wish to take advantage of what is offered.

What happens, however, to those Iraqis, Afghans or Sri Lankans who were caught in the middle – between government military and the Taliban, supporters of Al-Qaeda or militants fighting for their cause? Those people who lost their livelihood, family members or were themselves severely injured by Improvised Explosive Devices (IEDs) or who suffered revenge attacks because they happen to support the “wrong” side – what support do they get? Do they cry? Do they dull the pain with opium? Do they get drunk?

As in most wars it is women and children who bear the brunt of trauma; in all countries it is women and children who endure the effects of violence and abuse of any kind. What support do they get from anyone – anyone at all? What is of great concern about any traumatic event is the long term health effects, even generational health effects it may have on people – possibly even those not yet born.  

Drugs, except in the very short term, generally don’t help and are not a “cure” for PTSD. In any event the side effects of antidepressants and antipsychotics are quite severe. Furthermore to suggest chemicals can address the distressing flash-backs, the recurring memories and recollections, the guilt, the “what if …” or the “if only…” is plain wrong. All chemicals do is to help dull the pain and put a brake on the expression of any emotional response – they have the effect of “dumbing down” the sufferer. This may be good – in the very short term – to give a person time to gain strength but let it be known that there is no known test for a “chemical imbalance” in the brain. Let it be known, also, that no one knows how to measure the “chemical balance” for any person’s brain or to determine what such a “balance” should be.

What is needed is counselling and as much love and emotional support that the PTSD sufferer can get – and time, and sleep, that “knits the ravelled sleeve of care” (Shakespeare – Macbeth).