Choosing Death: Aid In Dying Gains Support

“That is a decision the individual has to make. It is wrong for the law to take away that option…” Stephen Hawking

Excerpts, Forbes – “…Over the past 40 years, according to Gallup, public support has grown from 53% to 70% for a doctor “being allowed to end a patient’s life by some painless means if the patient and his or her family requests it.” But when the phrase “doctor-assisted suicide” is used, support is only 51%.

Assisted Suicide Vs. Aid In Dying

“Aid in dying and assisted suicide have nothing to do with each other,” says Barbara Coombs Lee, an attorney and president of Compassion & Choices, the group dedicated to expanding and protecting the rights of the terminally ill. “One is a medical practice and the other is a felony.” In Montana, Oregon, Vermont, Washington and one county in New Mexico where right-to-die is the law, assisted suicide is outlawed.

“It’s like calling surgery a stabbing or chemotherapy poison,” says Coombs Lee, co-author of the nation’s first death-with-dignity law in Oregon.

Just as boomers have been central to the civil rights, women’s rights and gay rights movements, they are now driving the aid in dying effort. Coombs Lee says there’s a reason: “It’s the boomers’ personal experience with the deaths of their parents that has opened their eyes, awakened them to the harm [of not having the choice to end your own life, if you’re terminally ill]. And because of that, they are starting to think of their own end-of-life plans.”

A Watershed Moment

Historians may look back at July 2014 as a watershed moment for aid in dying.

Advocates like Coombs Lee have their eyes on the British House of Lords, where a major debate is underway on a bill allowing doctors to prescribe a lethal dose to terminally ill patients judged to have less than six months to live.

It has attracted high-profile religious support from no less than South African Nobel Laureate Desmond Tutu and the former Archbishop of Canterbury George Carey, who dropped his long-standing opposition to aid in dying, saying that by opposing reform, the Church “risks promoting anguish and pain, the very opposite of a Christian message of hope.”

The Movement Now

Where is the assisted dying movement in this country in 2014?

Coombs Lee says even though progress is being made, “it’s like the early days of the women’s movement when women would meet at the kitchen tables of America and talk about their experience…we’re still in the consciousness-raising mode.”

Full Article on Forbes

Put My Dignity First, Kindly

It is selfish to stare at me plugged into machines with no hope of recovering, even if you stare with tears rolling down your cheeks.

Put my dignity first, kindly.

Excerpts, The Star -“Johannesburg – The fact of our existence is a mystery that can drive an overactive mind nuts. Little wonder, then, that some of us take a philosophical leap into the arms of God.

I sometimes wish I could abandon my commitment to evidence-sensitive belief, and become a believer too. It just might help soothe anxieties about existence, life’s meaning and how to live well.

But I suspect I will fail. Outsourcing my personal yearning for answers to a mysterious being won’t satisfy me emotionally or intellectually.

And, at any rate, even believers find themselves all-too-human when life throws certain challenges in their direction.

This is precisely what I realised when I asked my listeners on Power Talk the other day what their views were on Archbishop Emeritus Desmond Tutu’s support of assisted suicide or euthanasia. Many identified as Christian, and yet, even so, their reflections on dying, and death, transcended our differences about deities.

It became clear to me that there must be a near universal desire to not die in an undignified manner, if possible. This yearning isn’t dependent on specific moral codes or beliefs about our place in the universe. It is a basic desire…

…So, why do we not have laws that allow for active euthanasia even? Let’s disentangle the issues.

First, and most importantly, I support euthanasia, both so-called passive and active euthanasia, on the basis of valuing someone’s autonomy enough to respect his or her desire to die.

It is strange that we can place enormous value on the individual in liberal democracies, from which we derive a range of fundamental rights like the right to freedom of expression and the right to dignity, and yet we are prepared to ignore a rational being’s considered view about how they want to die and under what circumstances.

It doesn’t make sense, and probably reflects the powerful, sometimes silent, influence of religion on public policy, more so than being a policy position that is supported by argument independent of religious influence.

But we need to be honest. Life – existence – isn’t intrinsically worthwhile, intrinsically valuable. Unless you draw a quick line from God’s wishes and intentions to every human being.

But that view, I’m afraid, will have to deal with the enormous philosophical challenges religious belief continues to struggle with, metaphysically and morally…

…And this isn’t about “playing God”, as some casually and lazily retort, very often. It is about a medically informed decision about the quality of life of the dying person, and their prospects of recovering.

If we accept this principle of respecting people’s autonomy, and the right to die in a dignified manner, which must include the hastening of death itself, then the real public discussion must be about what policy to choose to uphold these principles. And that is where I wish the debate would move, quickly.

Passive euthanasia simply means withholding any life-prolonging medical interventions, which hasten the dying process.

Active euthanasia is a little more controversial, referring to medical interventions that speed up the dying process, such as a lethal injection.

I do not understand why there is a sharp distinction drawn between these. If the principles are the same – respect my autonomy, and respect my desire to die in a dignified manner – then public policy must allow for both passive and active euthanasia.

We need a policy that can give further expression to respecting my autonomy, and my desire to die with as much dignity intact as possible.”

Full (Outstanding) Article Here on The Star

Prolonging Life At Any Cost?

On Mandela Day on Friday we will be thinking of a great man. On the same day in London, the House of Lords will hold a second hearing on Lord Falconer’s bill on assisted dying. Oregon, Washington, Quebec, Holland, Switzerland have already taken this step. South Africa has a hard-won constitution that we are proud of that should provide a basis to guide changes to the legal status of end-of-life wishes to support the dignity of the dying.

Via Dignity South Africa – “During all my years of pastoral care, I have never had the privilege of being with someone when they die. I’ve visited dying colleagues and friends at St Luke’s hospice, Cape Town, in the last period of their lives; I’ve witnessed their being cared for beautifully – but I’ve never been there at the exact moment of passing. I’ve been asked why I consider it a privilege to be present when temporal death takes place. It comes from my belief system. It is the wonder of a new life beginning, the wonder of someone going to meet their maker, returning to their source of life. In some ways, death is like a birth; it is the transition to a new life.

I am myself now closer to my end than to my beginning.

Dying is part of life. We have to die. The Earth cannot sustain us and the millions of people that came before us. We have to make way for those who are yet to be born. And since dying is part of life, talking about it shouldn’t be taboo. People should die a decent death. For me that means having had the conversations with those I have crossed in life and being at peace. It means being able to say goodbye to loved ones – if possible, at home.

Recently I discussed my wishes with my youngest daughter, Mpho: my choice of the liturgy, the hymns, and who should preach. I’d like to lie overnight in St Mary’s Cathedral in Johannesburg. It was such an important place in my life; it’s where I became a deacon, where so many important things happened. I would like to be cremated; some people are not comfortable with that idea. I’d like my ashes to be interred at St George’s Cathedral, Cape Town.

There are certain African traditions I am not comfortable with: the turning of photos to face the wall, the clearing of furniture from the bedroom and placing of straw mats for the women to sit on for days. I am comfortable that on my passing these traditions should not be followed. It concerns me how people get into debt at funerals, buying expensive caskets, slaughtering animals they can ill afford to pay for. I want to role model modesty. I would like a simple coffin, the one of plain wood, with the rope handles. I would like modest refreshments after my funeral. If people want to slaughter an animal as part of traditional ritual, I’d be happy with a sheep or a goat – it doesn’t need to be a big animal. My memorial stone should also be modest. My concern is not just about affordability; it’s my strong preference that money should be spent on the living.

This takes me to the question of what does it mean to be alive. What constitutes quality of life and dignity when dying? These are big, important questions. I have come to realise that I do not want my life to be prolonged artificially. I think when you need machines to help you breathe, then you have to ask questions about the quality of life being experienced and about the way money is being spent. This may be hard for some people to consider.

But why is a life that is ending being prolonged? Why is money being spent in this way? It could be better spent on a mother giving birth to a baby, or an organ transplant needed by a young person. Money should be spent on those that are at the beginning or in full flow of their life. Of course, these are my personal opinions and not of my church.

What was done to Madiba (Nelson Mandela) was disgraceful. There was that occasion when Madiba was televised with political leaders, President Jacob Zuma and Cyril Ramaphosa. You could see Madiba was not fully there. He did not speak. He was not connecting. My friend was no longer himself. It was an affront to Madiba’s dignity.

It is important for all of us to talk about death and our dying. A survey was done of doctors in the UK in 2008. As many as two-thirds of them said they had difficulty discussing end-of-life care with their patients. Physicians were once healers of life and easers of death. In the 20th century the training for the latter has been neglected.

Death can come to us at any age. The clearer we are about our end-of-life preferences, the easier it will be for our loved ones and our doctors. I am coming to understand the importance of having a living will or advance directive, as some people call it. I do not want artificial feeding or to be on an artificial breathing machine – I don’t want people to do their damnedest to keep me alive…” Full Article on Dignity South Africa

Let’s Talk About It

Desmond Tutu Speaks Out In Support Of Assisted Death With Dignity

“Dying is part of life. We have to die. The Earth cannot sustain us and the millions of people that came before us. We have to make way for those who are yet to be born. And since dying is part of life, talking about it shouldn’t be taboo.

“People should die a decent death. For me that means having had the conversations with those I have crossed in life and being at peace. It means being able to say goodbye to loved ones – if possible, at home.”

Excerpt, Voice of Russia – “Tutu wrote: “Death can come to us at any age. The clearer we are about our end-of-life preferences, the easier it will be for our loved ones and our doctors. I am coming to understand the importance of having a living will or advance directive, as some people call it. I do not want artificial feeding or to be on an artificial breathing machine – I don’t want people to do their damnedest to keep me alive.” Full Article on Voice of Russia 

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Excerpts, iafrica – “South Africa’s Anglican archbishop emeritus Desmond Tutu on Sunday said he supported assisted dying for the terminally ill, the day after the Church’s former leader backed a bill to legalise it in Britain.

But the Church remains officially opposed to the legislation and has called for a public inquiry into the issue.

Writing in Britain’s Observer newspaper, Tutu explained that he had been convinced by the case of Craig Schonegevel, a 28-year-old South African who suffered from neurofibromatosis and ended up killing himself because doctors were unable to end his life.

“Some people opine that with good palliative care there is no need for assisted dying, no need for people to request to be legally given a lethal dose of medication,” said the Nobel Peace laureate…

…He revealed that he had asked his family not to prolong his life artificially, and slammed the treatment of former president Nelson Mandela during his final days.

“What was done to Madiba was disgraceful,” he wrote.

“You could see that Madiba was not fully there. My friend was no longer himself. It was an affront to Madiba’s dignity.”

Full Article on iafrica

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“I have been fortunate to spend my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying. I revere the sanctity of life – but not at any cost.”

Excerpts, BBC – “Writing in The Observer he (Tutu) said he reveres “the sanctity of life but not at any cost”.

He also suggested that prolonging the life of Nelson Mandela had been an “affront” to his dignity.

His comments follow a U-turn by former Archbishop of Canterbury Lord Carey, who also said he would support assisted dying for the terminally ill.

The Church of England (CofE) has called for an inquiry into the issue.

In his column the 82-year-old retired Anglican Archbishop of South Africa said: “I think when you need machines to help you breathe, then you have to ask questions about the quality of life being experienced and about the way money is being spent.“

Full Article on BBC