From a friend who is a surgeon –

In my pracice, in which I saw a new cancer of the lung every week day, over half of these patients would die, but on only oneoccasion did I have a patient ask for help to die. They all ask for help in dying, but not my help to end their lives.

He writes:

Response to the Euthanasia Debate.

Hippocrates was concerned a lot with dying patients. He was concerned with the stature of the profession. His words embodied in the Oath then, are still applicable now.  ¢â‚¬Å“I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan. ¢â‚¬ 

And yet Eugenic Practice is being practised today with abortion, infanticide, ethnic cleansing. Should we add another component ?

Euthanasia is an ambiguous term. In the Greek it means a  ¢â‚¬Ëœcomfortable death ¢â‚¬â„¢, and as such has many aspects. Personally I believe in euthanasia as helping dying patients, but not helping patients to die with the liberal translation  ¢â‚¬Å“mercy killing ¢â‚¬ . May I explain ?

There are many cconsiderations in the care of dying patients, which are part of our understanding of euthanasia

1. Not using life support systems

2. Withdrawing life support systems

3. Patient refusal of treatment

4. Withdrawal of life sustaining medication

5. Symptom control with life threatening effects, eg. Morphine to relieve pain.

These are all aspects that may be considered in the care of patients when death is inevitable, and prolonged. In these five considerations, the patient actually is dying from their disease, and are part of good medical care at the present time. All of these considerations are legal, and properly practised at the present time can support a comfortable death.
However there are two distinct emphases that proponents are seeking to add to this selection.

The proposed law would add to these the following –

6. Facilitating death by overdose of drugs

7. Terminating life by lethal intervention.

However, in the case of the latter two, the patient does not die of his disease, he / she dies at the hand of the physician. This is killing, seemingly approved as  ¢â‚¬Ëœmercy ¢â‚¬â„¢ killing. It is not legal, nor is it in keeping with the highest principles of the community or the profession, nor consistent with our concern for those entrusted to our care.

There is deception involved in the arguments justifying this perception of mercy killing. Many of the arguments advanced in its favour are expressed in the concerns of 1  ¢â‚¬“ 5., all of which at the present time have legislative approval. In this case, the protagonists are using the total concept to justify a particular aspect of their philosophy. In the words of Solzhenitsyn – all forms of violence to life are inextricably bound up with the language of deception.

In any form of assisted suicide or therapeutic killing, the question is whether we are happy with the moral cost to society, and loss of life among vulnerable patients as a result of reclassifying the freedom to die to the right to be killed.

The history in other nations is significant. In the United States, Jessie Helms has stated  ¢â‚¬Å“No nation can maintain moral leadership, when it has embraced a doctrine of death. In France, Jean Rostan – in  ¢â‚¬ËœHumanly Possible. ¢â‚¬â„¢ has written  ¢â‚¬Å“Measure the society ¢â‚¬â„¢s degree of civilization by the vigilance it places upon itself out of sheer respect for human life ¢â‚¬ . Prof. Kubler Ross has written a book  ¢â‚¬Å“Dying is the final stage of growth ¢â‚¬  outlining this title, but not supporting mercy killing.

 ¢â‚¬ ¢ In Germany  ¢â‚¬“ Euthanasia was practised on a massive scale before and during World War II. Martin Niemoller ¢â‚¬Ëœs comment is a challenge to us and to our politicians,  ¢â‚¬Å“Evil triumphs when good men do nothing. ¢â‚¬ 

 ¢â‚¬ ¢ In Holland – The Remelink Report found that 1 in 7 people had neither signed for voluntary euthanasia, nor had the proper certification of their agreement. The report clearly demonstrated that any suggestion that this proposed legislation supports the sick population as a whole is misleading. Any legislation will be abused as in the Dutch practice and reporting.

What is the Answer ?

 ¢â‚¬ ¢ Understanding of dying, of pain, of loneliness, of cancer.

 ¢â‚¬ ¢ Managing patient ¢â‚¬â„¢s symptoms and concerns, as well as their disease, and pain relief should be possible.

 ¢â‚¬ ¢ Teaching of all involved in care, not just the palliative care physician. For the physicians we must learn that N.F.R. is not the withdrawal of care, that it is not failure for a patient to die, but that we are concerned about them, and that we have time for them, to listen, to care and to ensure a  ¢â‚¬Ëœcomfortable death ¢â‚¬â„¢ .

All of these do not require legislation, but rather education and concern.
The challenge to us all in the presence of human suffering is in caring. For the patient, that the suffering is eased as much as is possible; for the family and friends to provide support, care and kindness, and just being there; to the health community to provide the best care possible to the patient and the family; and to the politicians, that they will understand the significance of such a law as evidenced by the experience in other countries, and not be guided by expedience or convenience.

Making this proposed legislation legal and politically correct, does not make it ethical, or right.

September 2010