Tired of life?
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When
the soul suffers, so does the body.
Paracelsus,
Swiss physician and philosopher (1493-1591)
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Strides
in medicine may allow people to live longer, but the result is not always a happy
one. In the Netherlands, euthanasia is now legally available–but just how far should
we go?
Is a human body worth
less in the Netherlands than elsewhere? Does it lose its meaning here once it gets
old and decrepit? One might think so, for this European country of 16 million people
is the only nation in the world where doctors, in accordance with the law, are able
to end patients’ lives.
In April 2001, the Dutch senate gave the new law on euthanasia the green light. The
decision grabbed international attention, although it was the predictable outcome
of a debate that has lasted a quarter of a century. The law only established what
was slowly becoming normal procedure: that doctors are no longer punishable if they
carry out euthanasia as long as they strictly conform to certain requirements of
due care. For example, they must be satisfied that the patient is, according to medical
criteria, suffering unbearably and incurably, and has made the choice to end his
or her life without any outside pressure.
With the new law’s approval, the glorification of suffering–a once pervasive streak
in the Christian tradition–seems to have been consigned to the country’s past. As
Dutch theologian Annelies van Heyst recently put it in Trouw, an ordinary life brings
enough suffering as it is. She nevertheless went on to regret that along with the
glorification of suffering, the common rituals and comforting symbols of Christianity
had also been swept away: “Our culture is focused on success and self-development.
Fast, flashy, healthy–and when a problem comes up, this is felt as if life is taking
you for a ride.”
“Degrading” and “humiliating.” With these words euthanasia was justified from the
very first lawsuits in the 1970s and 1980s. Degrading meant, in the first place,
physical decay, such as terrible bedsores, incontinence and loss of mobility. A culture
that places increasing emphasis on a flawless and beautiful body is increasingly
unable to cope with such ailments: this might be one explanation for the support
for euthanasia, albeit rather a cynical one.
Advocates of euthanasia instead speak of self-determination and compassion. They
feel that it’s a doctor’s duty to mitigate suffering, and the ultimate consequence
of this duty is death at request. An oft-heard argument is that doctors themselves
cause a lot of suffering in their efforts to repair the old, sick body. In the past,
elderly people would often die as the result of a short and fierce infection, such
as tuberculosis. These days, they have to live for years in a body that slowly gives
up before finally dying after a wasting disease. Everybody has the right to go on
to the very end, those in favour of euthanasia say, but nobody should be obliged
to do so.
Many European countries might share the same demographics, but they’re not necessarily
ready to follow in Dutch footsteps. The law is the fruit of a unique set of circumstances.
First, it required an influential organization, the Dutch Voluntary Euthanasia Society,
which counts around 100,000 members, including many prominent names. Second, a small
group of influential politicians, who had been trying for years to get euthanasia
legalized, garnered support within the present left-liberal government coalition.
Dutch doctors, finally, had long been seeking to be treated as integrated medical,
psychological and social workers. Euthanasia–literally “a good death”–fit this holistic
description to a T.
This particular alliance of doctors, politicians and patients, however, is now threatening
to fall apart. Doctors see the new law as the final conclusion–“no further than this.”
But the Dutch minister of national health care, Els Borst, let it be known that she
wants to initiate a debate over giving elderly people who are simply tired of life
the means of putting an end to it, even if they are not terminally ill. The minister
has the full support of the Voluntary Euthanasia Society. Again, the magic word is
“humiliation.” What if a person, after a rewarding social life, has to spend the
rest of his or her years in total solitude after everyone around has passed away
and every new day adds only more torment? Is this not just as humiliating as the
last phase of cancer, with all the pain and loss of decorum that accompany it?
Over 80 percent of the Dutch population are in favour of euthanasia carried out by
a doctor, on condition that all the legal demands about due care are met. There is
much less enthusiasm for a more or less easily available suicide pill for those who
are old and weary of life. According to a recent poll, 46 percent of Dutch people
are against this, of which a significant number are over 60. Doctors doubt that the
right to self-determination should go this far. Psychiatrist Frank Koerselman argued
recently that “autonomy is an ideology, even a relatively fanatical one, to which
the boundaries between life and death are being subordinated.”
In the mid-1990s, Dutch doctors actively ended about 3,200 lives a year, representing
about 2.6 percent of all deaths. The ageing of the population and developments in
medical science will undoubtedly increase the demand for euthanasia, but not without
limits: it has become clear that doctors refuse two out of three requests. Most do
not regard being tired of life or “not wanting to be a burden to others” as valid
reasons to carry out this procedure. Euthanasia mainly concerns cancer patients in
their last days, and this is likely to remain the case in years ahead. When questions
about terminating life are raised, doctors tend to fall back on familiar territory:
the body. “They are there to help when there are biological functional disorders,”
wrote Koerselman. “To do this, they have instruments such as pills and psychotherapy.
Suffering is only what brings people to the doctor. That the doctor can sometimes
alleviate this suffering is a fortunate circumstance.” |
