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April 30, 2007
Euthanasia among topics explored at ‘Changing the Way We Die’ forum

by carol clark

An elderly woman with Alzheimer’s is chained to a wheelchair so that she can’t fall out. She was a ballerina in her prime. Now she spends her days confined to a locked ward, smiling and pirouetting down the hall in the chair.

“There was genuine joy in her face,” recalled Timothy Jackson, associate professor of Christian ethics at Candler, who worked one summer in the facility where the woman was kept. “She was no longer autonomous, but she still possessed sanctity and, most fundamentally, was able to give and receive love.”
What if the woman, when she had still been lucid and knew what lay ahead, had been given the option of a physician-assisted suicide? Would that be moral?

The recent Emory conference, “Changing the Way We Die: Religion, Medicine and Improving the Dying Process,” opened with a euthanasia discussion between Jackson and Margaret Battin, distinguished professor of philosophy and adjunct professor of internal medicine at the University of Utah.

Jackson strongly opposed the notion of physician-assisted suicide, and used the case of the chained ballerina to underline his point. “A health care professional should not facilitate the death of a patient,” he said. “I fear that even if a consensual request is made, we’re harming that patient by breaching the sanctity of life.”

Battin countered: “Others will feel that to take someone whose life was about freedom of movement, and to see her reduced to being chained to a wheelchair in a nursing home, is to harm her.”

“Changing the Way We Die” was developed by the Emory University Initiative on Religions and the Human Spirit and the Office of the Provost. The two-day public event brought together a range of experts and community members to examine religious, ethical, historical, medical and legal questions related to the end of life.

Battles are raging throughout the developed world over euthanasia, said Battin, one of the nation’s leading defenders of physician-assisted suicide. The debate is driven by medical advances and the fact that about 70 percent of people in the developed world die of diseases with long, downhill courses.

The Netherlands, Germany and the state of Oregon are three examples of places that have adopted laws allowing physician-assisted suicide.

“Helping someone die can be an act of the highest moral character,” said Battin, arguing that a terminally ill person should have a right to choose the best death possible for them. “The principle of autonomy is active in all other parts of our adult lives. It should also be included at the very end.”

Jackson, however, said that active euthanasia, or physician-assisted suicide, is an immoral act, and that modern medicine offers good pain management and palliative care. “Autonomy is very important,” he acknowledged. “But acceptance, persistence and patience may be the highest virtues. I don’t want to deny that there is tragedy at the end of life. But we’re not here to remove all tragedy if it cannot be done without dubious measures.”

While he argued against active euthanasia, Jackson said he could accept the morality of “passive euthanasia,” or withholding artificial means of life support for a terminally ill patient that preferred to die, or a brain-dead patient. “There is a distinction between taking the action of killing the patient and withholding or withdrawing treatment,” Jackson said.

Battin asked if being in favor of passive euthanasia, but not active euthanasia, was hypocritical. “Isn’t it crueler to rely on the slow breakdown of bodily functions, the failure of organs, rather than the painless administration of a drug?”

During the Q&A session that followed, a physician in the audience asked if studies had been done on the number of doctors who give escalating doses of morphine, under the guise of a painkiller, knowing that the larger doses will result in death.

“You’re certainly right that it goes on,” Battin responded. “I would agree with you that it should be recognized as euthanasia. There’s no protection for this. No paperwork or vetting of whether the patient is competent. It just happens. That’s what we ought to be disturbed about.”

She said that it would be better to regulate the practice, so that people could discuss the matter openly with their physicians.

“No situation is so bad that it can’t be made worse with a bad law,” countered Jackson.

Another audience member asked, “Is it possible that in a secular, humanistic society this discussion would not be necessary?”

Battin agreed, but said, “I think that faith also has enormously positive things to bring to this.”
Jackson commented: “Religion is not great, but God is.”

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