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| Article
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10824 |
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Section : |
MODERN THOUGHT
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| Issue
Date : |
3 / 1993 |
1,800 Words |
| Author
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Stephen G. Post
Stephen G. Post is assistant professor of medical humanities
at the Center for Biomedical Ethics, Case Western Reserve
University School of Medicine, Cleveland, Ohio. |
Chris Hackler raises and quickly dismisses the objection that most hospice physicians (about 90 percent) emphasize with respect to mercy killing: that this alternative to pain control and comfort care will "take the pressure off the movement to perfect pain control." Hackler asserts that just the opposite is true, since adequate guidelines would require that all pain control efforts be used before mercy killing is offered. This is certainly an interesting turn of argument. But, in my view, both physician-assisted suicide and mercy killing tend to work against the hospice ideal and the development of technologies to alleviate pain. Mercy killing is antithetical to hospice, and for this reason hospice workers oppose it.
Hackler does well to underscore that, given advances in pain control, the mercy killing option is less relevant to those who are dying of cancer or some other terminal illness than it is to patients confronting protracted diseases that strip the self of quality of life and even of selfhood. Alzheimer's disease is an example of an irreversible dementia that, in its severe stages, leaves the self a shell of what it was. The temporal glue that holds together the self's sense of connectedness between past, present, and future seems to flake away. Even loved ones are eventually no longer recognized. Thus, many might prefer preemptive suicide or mercy killing to this downward spiral into oblivion.
On the other hand, I worry that such preemptive strikes against a natural death (if all life-saving technologies from antibiotics to artificial nutrition and hydration are avoided, as I believe they should be) will spill over to strikes against senility in general and even against aging in a society that wrongly worships youthfulness. Yet, caring for dementia patients is a huge responsibility for family and society. Mercy killing, if requested by those diagnosed with early probable Alzheimer's disease, is obviously cheaper than creating state-of-the-art Alzheimer units in nursing homes.
So, while I find Hackler's comments thoughtful and articulate, I would simply urge him to reflect again on the relation between killing the decrepit of mind or the imminently dying and the momentum to provide a better quality of life for such persons.
Ronald P. Hamel is especially helpful because he focuses on the deeper underlying existential questions that inform the movement to preempt a natural death. At bottom, the questions of suffering, finitude, dependency, and meaning that he points to are the essential ones. Along with
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