Who's Choice?

"We all must die. But if I can save someone from days of torture,
that is what I fell is my great and ever new privilege. Pain is a
more terrible lord of mankind than even death itself."
Albert Schweitzer

It's easy to imagine how best we would want to die: at home, at peace, tended by loving family members, and without pain. But for many Americans, the hard reality is that they die in the hospital, often isolated and in pain, while constrained to a frightening display of life supporting equipment. Others die unattended in nursing homes alone and scared with no family members at their side. Because of the first nationwide public debate to change the care of the dying and to alter the legal right to die for the terminally ill; public leaders of the nation's medical establishment have acknowledge that the medical health care often fails to provide the best decision when to allow a patient to die. Whether it is the patient's wish, family members or just by medical discretion there is no clear medical answer.

When pain is part of a terminal illness, people need and deserve effective relief. Yet study after study reveals that doctors usually under treat pain. They often use mild, ineffective drugs when morphine or another drug would be appropriate. The reason often given is fear of scrutiny or discipline from state and federal authorities. The laws in some states deter physicians from providing their dying patients with strong medications in sufficient quantities. And in every state doctors perceive a medical licensing board keeping close track of the quantity of so-called "controlled substances" they prescribe. Many patients with terminal illnesses, including cancer; suffer needlessly because they do not receive drugs or other medication that would relieve their pain. An unfounded concern about addiction prevents doctors from prescribing stronger medication. Yet there is wide agreement among experts that fear of addiction should play no role in treating the pain of the terminally ill. The "correct" amount of medication is whatever is required for relief.

Families who support doctor-assisted suicide believe that it is inhuman to allow a patient with hopeless and painful illness to suffer. It should be the wishes of the ill to have the "right of choice" to end his or her life. Providing for the terminally ill with compassion and dignity is and every day struggle and the cost of medical care can become a hardship. Medical care requires monitoring and adjusting pain medication and the endless task of feeding or cleaning people who cannot control their natural body functions. Whether a patient is not aware or is aware of his burden to his caregiver, he or family should be given the right to choose his or her fate. It may require talks with family members about their fears, their image of life and what happens after death. Ending a person's life by assisted suicide, along with the added consolation that it will be quick and painless, is much easier than the constant physical and emotional care that is needed for survival. If there is a way to eliminate pain and suffering during your loved one's last days, assisted suicide would not be a difficult choice to make. We must be wary of those who are too willing to end the life of someone who does not wish to die. If we ever decide that a poor quality of life justifies ending that life, we have taken a step down a slippery slope that places us in dangerous choices. There is a difference between allowing nature to take its course and actively assisting death by murder.

For every case that is brought to the public's attention, there are many more, which take place quietly in hospitals, with no public notice or debate. Most victims are old or very ill, so their deaths might be attributed to a cause other than passive euthanasia, the denial of food and water that actually killed them. While it is illegal to kill someone directly, for example with a gun or knife, in many cases the law has put a "stamp of approval" on causing the death by withholding this type of care needed for survival. It is a horrible death to undergo and to watch. Health care professionals