Physician-assisted suicide must be permitted

Imagine that you are 85 years old. You have been in good health, but suddenly you suffer from a stroke that leaves you a prisoner inside your body. Aside from being able to move your right index finger, you cannot move. You cannot hear. You look straight ahead at the clock on the wall and, in a rough way, chronicle your condition. Days pass. Weeks pass. As best you can figure, you've been lying in your prison body for three months. But now you notice, or you think you do, that you sleep more than before. After a while you sleep, in a coma, and notice nothing.

Fortunately, there is a clever Emory doctor who comes to your rescue. He has invented Infusion 1-1. He tells your family about his invention. He also tells them that Infusion 1-1 has been approved by Emory's Human Investigations Committee. He presents your family with a consent form. It explains that if he uses the infusion on you, your hearing, speech and reason will be restored and, strangely enough, so will your control over you right index finger. Unfortunately, the restoration will last for only one hour and, the consent form adds, the infusion can only be used once per person. Efforts to use it a second time on subjects in his experiments have simply had no effect. Aside from the benefits the infusion might bring, the consent form explains the risks. There is a small chance the infusion will kill you. Indeed, so far, although 18 infused patients have been restored, two have died. After reading the consent form carefully and talking still more with the clever Emory doctor, your family decides to let him use his magic restorative on you.

Amazingly, it works as promised and you are restored. Understandably, what follows is pretty emotional. You and the people around you both cry and laugh. But after a while serious conversation begins when someone asks, "What has it been like with you since...? You are anxious to tell them. "Sometimes I am in pain. It comes and goes. But worse than pain is the discomfort of just being there, wanting to move, but being unable to. Sometimes I am too cold. Other times too hot. Sometimes I feel I can't breathe, and other times I am choking. All the time I feel this sense of fatigue and helplessness. I look forward to sleep, but it does not come easily. After I do sleep, I awake and realize that the new day brings the same discomforts, feelings of hot and cold, fatigue and sense of weakness, and the same frustrated feelings of wanting to go to sleep. Time drags. I also feel restless and despondent. More than that, I feel dismay. I know what is happening and know also that no one can help me. I feel humiliated being there, in bed, in such a helpless and ugly condition. I feel a sense of degradation. I don't want to think of myself the way I am, and I certainly don't want people to see me the way I am and then, later, to remember me that way. In short, I've been miserable."

Time passes. There are only 15 minutes left. Someone asks: "What do you want us to do?" You reply: "Had I been able to say so, I would have asked you to end my life before I went into a coma. Back then I had enough of pain, discomfort, fatigue, degradation and all the rest. Now you tell me that I am in a coma.

If that's so, I ask you, `What's the point of keeping me alive?' Besides, being in a coma is just as degrading as it was when I was conscious of what was happening to me. If you don't want to end my life, help me do the job. Arrange a Kervorkian-like machine quickly, and I will use my finger to finish the job myself by pulling the `trigger.'" Those around you can't agree on what to do. Time passes, and the effect that Infusion 1-1 has had on you ends. You lapse back into a coma.

Should your family and your doctors have assisted you to end your life? You bet! Not to help is to go counter to your strongest personal wishes not to continue your suffering. It is also to go counter to an important principle in our Western tradition that an individual should be allowed to have his/her wishes satisfied when others are being hurt only marginally or not at all. You are the one who is suffering and so you should be our main concern in deciding what to do. If you wanted them to help you die because your life is permanently miserable or pointless, then they ought to have assisted you. Since your doctors and your family can't do anything to help improve your health, the least they can do is to ease you out of your misery.

Nick Fotion is professor of philosophy and is a center scholar for the Ethics Center. He was part of a panel discussion on physician-assisted suicide sponsored by the Ethics Center in early November.

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