An abhorrence for the taking of life

By RICHARD RANDERSON*

News that a plastic "exit bag" has been imported by a member of the Voluntary Euthanasia Society opens a sensitive debate on the termination of human life which has become devoid of quality or hope.

Moral denunciation that fails to address the human distress involved in long and painful illnesses seems cold and clinical. On the other hand, brave-new-world scenarios leading to the premature ending of life may be equally inhuman.

The sanctity of human life is a principle with which few would disagree. It is enshrined universally in legislation, statements of human rights and in the values and belief systems of most.

Yet life is more than just physical existence. As Father Neil Vaney so movingly expressed in a Dialogue article, there is a time for giving back the gift of life, especially when its wonder and joy have worn away.

No one who has sat beside the bedside of someone enduring extended pain and discomfort can fail to ask the question about the value of life so devoid of obvious quality. I once ministered to a family in which one of its members was in a coma for months, and eventually died without ever regaining consciousness. Was such prolongation justified?

Or what of when a loved one is afflicted with Alzheimer's disease, as in the recent tragic case when a man was so distressed that he killed his wife of a lifetime?

In such circumstances people often say that this is no longer the person they once knew, or even that there is no real person there at all. Physical existence remains, but life is also about meaning and purpose, enjoyment and relationships. When such things have gone, is there still life?

The active prolongation of life at all costs is not a principle many in the Church would embrace. There comes a time when the withdrawal of hospital life-support systems is a human thing to do. Life comes to a natural end. Heroic procedures to extend it have no place. Likewise, the palliative use of medication to relieve pain, even if life is shortened in the process, presents no moral difficulty.

But active intervention to terminate life, such as with the new exit or suicide bag, poses a different dynamic. There was a time when suicide was condemned by the Church. The 1662 Church of England Prayer Book, for example, carries an instruction that the funeral service is not to be used for "any who have laid violent hands upon themselves". Suicides often had to be buried outside the hallowed ground of the churchyard. Today the dynamic of suicide is better understood.

Dr Philip Nitschke, the Australian euthanasia advocate who launched the exit bag, previously offered to assist people in Darwin to end their lives by means of a patient-controlled computer which delivered a toxic mix of drugs when the patient had three times pushed a "yes" button. Legislative changes compelled him to end this programme.

The availability of the exit bag opens up new dimensions. Unless the user retained a reasonable degree of physical and mental capacity, might use of the bag require help from another, and hence no longer be suicide? And even if intended only for voluntary use, might not the very fact of its existence put pressure on sufferers to do it?

Pressure to end one's life, whether by a suicide bag or other means such as the administration of drugs, can take several forms. Older people, vulnerable and confused, and feeling a burden to their family, might think they should do the decent thing and take the cocktail.

I have experienced situations in which decisions about the care of ageing parents were determined by the impact the costs would have on the next generation's inheritance, rather than on the needs of the parents. These are invidious and compassionless situations for anyone to be in.

Other pressures could result from an ageing population requiring a bigger slice of public healthcare funding. Public attitudes could be easily manipulated into the acceptance of euthanasia for those who have already had a good innings. A choice between preventive care for the young and prolonging life for the old or sick is a difficult one.

As a nation we should ensure that funding allocation is not cast in either/or frameworks of that sort.

Were euthanasia to be legalised, what situations would qualify? It is easier to understand the case when someone is in the final and distressing stages of a terminal illness, but what about in the case of Alzheimer's? Or those who are physically or mentally impaired? Or the deeply and chronically depressed?

Should it be left to the individual to decide, or should there be some external reference point for approval?

At the personal level, the decision to terminate a life evokes in me many of the same feelings I have when contemplating a judicial execution. Taking the life of another has a natural abhorrence for most.

There are foreseeable negative consequences. Family and friends, perhaps doctors and nurses, may feel post-event emotions of distress or guilt.

By contrast, the slow ebbing of life in the presence of friends, with the comfort of pain-relieving medication, avoids the coldly clinical decision to terminate.

Clergy and others who minister to the dying know the extensive pastoral and spiritual benefits which can emerge in the last days of life. Broken relationships with family members and friends are often restored, thoughts and feelings from the past expressed, spiritual depths discovered and loose ends of life tied up. The foreshortening of this process can rule out much of the final richness of life.

Those who have experienced hospices speak highly of the competent palliative care offered, the atmosphere of compassion and the pastoral and spiritual support, all of which make a huge difference to patients, family members and friends in times of distress.

The ending of life is a topic that affects us all. The interplay of human need, shared values and official policy requires careful and sensitive debate.

* Richard Randerson is dean of Holy Trinity Cathedral in Parnell and assistant bishop of Auckland.