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to end a life

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deathbed MunchLast week I joined an on-line forum on the topic of “palliative sedation.” It refers to the medical treatment of “inducing and maintaining deep sleep for the relief of deep suffering … when all possible alternative interventions have failed.” Such treatment “of last resort” clearly differs in its intent from euthanasia or physician-assisted suicide! A person thus medicated would likely stay asleep until death arrives—usually for only a few days. It’s a complex topic on which to reach consensus: ethical, religious, legal, and personal quandaries demand attention.

As it’s unlikely that I’ll ever have to make the decision regarding a patient—except as a minor player on the care team—this conversation is mainly theoretical. Yet as I look deep into my heart I imagine that the vow to “be of service” and the precept “to alleviate suffering” and to “do good” would serve as my reference point … and would rub against the precept “not to take a life.”  Intention will most likely be the deciding factor: to kill, to hasten death, or to alleviate suffering.

In a café conversation this morning, I talked about this with a friend. The topic quickly moved from deep-sleep sedation to ways of ending one’s life. What if I were in extreme and uncontrollable pain, unable to do my own bathing, feeding, and toileting? Would I want to hasten my end? Could I ask/expect a friend to assist me in this? Would I be able to assist another person? Could I leave instructions to my designated decision-maker in case I’m unable to communicate my wishes regarding  uncontrollable pain, hopelessness, and indignities? What if that person was unable or unwilling to heed my wishes? What do you think?

image: At the death bed by Edvard Munch (1896).


2 responses »

  1. The role of a medical advocate is to speak on behalf of the individual (the patient). The role of the patient advocate is to make medical decisions that the individual would want and would have made if they were competent and able to make decisions for themselves.

    Therefore, anyone stepping into the role of an advaocate for another has a duty to the patient they are advocating for. The advocate’s role is to make decisions that the individual would wish and the decisons the individual would have made if they were able to make the decisions for themselves. The medical advocate is faced with the challenge of setting aside their own values and moral in the advocacy process to make the decision the patient would want and would have made were they able to make the decison at hand themselves.

    This is not an easy role. Often a biomedical ethics team may be brought on board to deliberate on difficult ethical-legal desicions such as those of cessation of medical treatment, in cases where the individual is incompetent and where it is difficult to determine what the individual’s wishes are or what they would be if the patient could make their wishes known.

  2. this is the ulitmate end of life dilemma which i find no answer for, yet think about it and wonder how i want to handle it for myself, for my family members – even friends. Pacts made with friends about what i don’t want to happen to me do not suffice in face of the medical system taking over…. it is a really good point to think about.


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