When starving a loved one to death is an act of love

DEBORAH says:

07:30am | 01/10/09

Tory, you say there was selfishness.  However, I would say it was empathy.  Who has ever walked into a nursing home to visit a loved, and walked out saying to themselves “I’m looking forward to this lifestyle?” 

One of my grandmothers was 96 when she passed away earlier this year.  In the early stages of living in the nursing home, she wasn’t too bad.  But, after suffering a couple of strokes, her memory had terribly deteriorated.  Eventually, the only people she could remember were her immediate children, she could not remember her grandchildren.  And, it used to frustrate her greatly if grandchildren went in to visit her.  For years Gran kept telling her children that she wanted to go and be with God.

My other grandmother is also 96 and still alive.  However, she has had a few heart attacks.  She is still living in her own home, even though she spends most of her time in bed.  Her biggest passion was her garden, but she can’t attend to that anymore.  She is also waiting for her time to go.  The doctors will continue to prescribe her with medication, but they will not operate if she has another heart attack because of her age.  The doctors have told her that.

Therefore, is it more selfish to help a loved one end their life? Or, is it more selfish to keep the person alive to suffer?

John A Neve says:

07:49am | 01/10/09

We claim to be a democratic and civilised country, but are we? When a person cannot choose the time and method of their own death, where is our democracy? I don’t fear death, but I tremble at the thought of being trapped in a wheel chair or bed, being spoon fed and having some one wipe my ass.

Neill says:

09:17am | 01/10/09

maybe I see things too simply – when the right-to-life lobby dictates that the only way we can allow people who have ‘had enough’ [and I mean really had enough] to die is to starve them to death however if I did the same thing to my very old and demented cat I would be prosecuted by the animal welfare lobby. We live in a mixed up world – all I want is to live in a society that will allow my family and physician to treat me with the same dignity as I afforded my cat.

Meghan says:

10:00am | 01/10/09

Neill, if your cat is in terrible pain and is no longer able to live a fulfilling life then you have the option of euthanasing it.  This is currently not the case with humans and therein lies the reason for taking measures (such as starvation) which would, certainly, be seen as inhumane were they applied to animals.  Comparing animals and humans in this debate is flawed.

Darin says:

10:27am | 01/10/09

Tory, I have the up most sympathy and empathy for your situation, and that of your grandmother. The suffering and indignity involved can be very painful.

I would say though, that for many people, it is not the Christian Rossiter’s that we worry about, but the faceless thousands of other people who are elderly or disabled or facing a terminal illness that would choose euthanasia not because they want to ease their suffering, but rather, they want to end the suffering or burden on those around them.

I do find this issue very conflicting. on the one hand I believe that individuals should have final say over their own life and death. But equally, I am concerned for the vulnerable and powerless that could be unduely pressured or even potentially exploited by legislating for a ‘right to die’.

In 1997 the Australian Parliament, and the wider community, debated this issue extensively, as part of a process that led to the overturning of the Northern Territory’s euthanasia law. I don’t think it is fair to say that politicians waver or don’t have guts to address this issue. The issue is more complex than that.

The 1997 debate brought out many views along a wide spectrum, but highlighted the complexities of the issue that go beyond simply allowing an individual to die at the time of their choosing. Determining the level of consent, how it would be administed, safeguards, who could qualify for doctor assistance, and how one draws a line to place on one side the easing of suffering and on the other the sanctioning of the suicide of a physically healthy person. Is it just for the terminally ill who our sound of mind? Should an aged person with impaired mobility and mental incapacity be able to end their life? Does the right to die extend to young and physically healthy members of our society?

The issue of a right to die is very complicated, and charged with emotion and for many people real pain at witnessing the suffering of loved ones. However, I believe there must also be compassion for the vulnerable, and I am unsure if we could ever devise a system that would adequately afford them protection.

Stephen Pickells says:

10:32am | 01/10/09

Much as I support the choice of voluntary euthanasia, I can’t stand the thought of somebody starving to death, even on morphine. There must be a quicker more humane way to do it.
I was in hospital recently and I was on morphine which was administered by intra-muscular injection. I asked the nurse why it couldn’t be delivered through the canula, and I was told that the hospital cannot legally give more than two mils at any one time with IV.
I was well and truly away with the pixies, but I still felt some pain. Imagine how much worse it would be if your body was slowly folding in on itself due to lack of nutrition.
I believe a terminally ill patient has as much right to a dignified and painless death as a woman has a right to abortion, which has certainly been covered this week on The Punch.

Eric says:

10:42am | 01/10/09

Stephen, there is a quicker and more humane way—just increase the dose of morphine.

Too bad it’s illegal.

iansand says:

11:35am | 01/10/09

Darin@10:27 THe irony is that the NT legislation provided for just those types of checks and balances.  2 non-treating doctors certifying that the illness is most likely terminal and that remission is unlikely.  Psychologists or psychiatrists certifying that the decision is, in reality, voluntary and that there is genuine understanding of the consequences and desire to die.  But that was overturned and we revert to this hole in a corner charade of “palliative” care, or starvation.

I know where the compassion lies.  I know which system is most likely to be abused.

S says:

12:31pm | 01/10/09

I’m consistently shocked by how poorly understood the legal framework for medical treatment is in this country, particularly when it comes to the issue of ‘euthanasia’. Stephen, your nurse is a classic example of the misinformation about law that pervades the health-care industry. There is no proscription, statutory or otherwise, against delivering specified amounts of IV morphine. There are laws against administering any amount of any drug kills a person, however one suspects that in the vast majority of cases the ordinary laws against manslaughter that apply to all people - medicos and lay-people alike - are uncontroversial.

Christian Rossiter /always/ had the right to refuse medical treatment. That peg-feeding is a medical treatment has been legally uncontroversial for years, and the law has long recognised that all adults are presumed capable of refusing medical treatment (the exceptions are enunciated by statute and most often include forced treatment of communicable diseases like TB, or in rare cases some palliative care). Rossiter’s legal team asked the WASC for declarative relief, that is a declaration of what the law was, and in a move that was wholly unsurprising to anyone with even a passing acquaintance with the legal issues relating to medical treatment, the WASC affirmed the position that a hospital or care facility is not liable for a patient’s refusal of medical treatment. This is not new law, nor even a clarification of a previously contentious position; it is merely an uncontroverisal statement of what the law has been for a long time, played out against a contentious factual scenario.

Conflating the refusal of medical treatment and ‘euthanasia’ is an astonishingly dangerous road to travel down. Rossiter did not euthanaise, he refused medical treatment, just as basically any adult person - and many children - are entitled to do. There is a clear practical and conceptual distinction between on the one hand removing or withholding life-saving treatment, and on the other taking active steps to prematurely end a life.

When we conflate these two issues we risk doing serious damage not only to the debate, but also to the practice of medicine. If we draw no distinction between active steps to end a life and refusal of medical treatment, might we reasonably require those making any end-of-life treatment decisions to be psychiatrically assessed, as were patients who were euthanised in the NT? If we go down that route it is a short path indeed to allowing the medical profession to overrule a person’s autonomy and forcibly treat patients - I for one can think of very few things more damaging to human dignity.

We must take care to understand the existing legal framework, and draw clear distinctions between issues of treatment decisions on the one hand and euthanasia on the other. The consistent failure of commentators to draw such clear distinctions invites serious intellectual error on both sides of the debate which risks jeapordising whatever slim chance exists for community consensus - whatever that consensus is - to prevail.

lantana says:

12:32pm | 01/10/09

We are all mortal, and we should all have the right to decide to go to sleep permanently if we are facing unimaginable torment and suffering as the end of our life nears.

Comparing animals and humans in this context is not at all flawed, since the law requires us to put down animals that are suffering.  In the case of humans, it would not be somebody else who made the decision, it would be the person themselves.

The over-riding principle of legally recognising the need to avoid unnecessary suffering, by allowing termination of life when the person knows that is what they want, is exactly the same.

Vicki PS says:

01:28pm | 01/10/09

Thank you, S, for your lucid explanation of the current law and practice.  I have always understood that ‘letting nature take its course’ was the accepted, and acceptable, thing when a person’s condition was such that even eating and breathing were beyond them.

However, I am very distressed when I hear of nutrition being withheld from people with severe disabilities or in persistent vegetative states.  There have been a number of well publicised cases where individuals who did not require parenteral nutrition or respiratory support—just ordinary feeding and care—were starved to death without their consent.  Family members in these cases who declare that he or she (the patient) would want to die, when the person concerned has never expressed any such wish, seem to me to be speaking more of their own inability to tolerate the situation.  There is a real danger in courts allowing too much weight to be given to the wishes of family members when the true desire of the patient cannot be known.

Roland says:

08:24pm | 07/10/09

I think family members invariably know the stance of their parents when it comes to wanting to die.
If death came peacefully, via nitrogen gas or some-such, where you simply drift off to sleep, and if precautions are in place to ensure that no-one is being pressured to do it, I cannot see anything more humane.
People who put compassion aside in favour of the assumed wishes of imaginary beings have no right to force others into extended torture with their screwed-up logic.