Our friends across the pond have their own concerns and controversies over issues relating to the end of life, and the ending of life.
The Guardian has published a very personal commentary discussing the end of life issues when the person involved is conscious and fully capable of making life and death decisions, but unable to act upon them unassisted.
A brief quote to encourage reading the entire article:
What kills you in the end if you have cancer or other terminal diseases? Not often the cancer itself. Nor the morphine that people innocently imagine will one day waft them away on a cloudy pillow of dreams to some opium-fuelled nirvana. What people actually die of, like Terri Schiavo, is dehydration when they can no longer swallow enough water to live – and it takes time. Enough morphine to die quickly is very rarely administered these days. Instead, cautious doctors, extra wary after Harold Shipman, give just enough morphine to kill people by degrees. It is enough, in the very end, to render them unable to drink so they die, semi-conscious, of thirst. Hospices don’t put up drips to keep people alive, but they don’t give out death-dealing injections either. The legal compromise is death by dehydration or sometimes slowly and gasping for breath by morphine-induced chest infection – “old man’s friend”. That is the great unspoken truth.
The other unspoken truth is that morphine – the only existing, effective pain-relief – is a cruel drug whose main side-effect is such acute constipation that final months are spent in far greater agony from cemented bowels punctuated with bursts of uncontrollable diarrhoea than from the original disease. The indignity of bowel-obsession is no way to end up. Nor does morphine ease anxiety: on the contrary, frightening hallucinations are frequent so patients need anti-depressants as well, but those have their own side-effects. Morphine causes nausea, requiring anti-sickness medication. Nor does it take the away the terminal sense of a body crumbling and falling apart.
Many, like my mother, thought signing a living will to refuse intrusive treatment would be enough. But she, like so many others, was left begging everyone and anyone for a quick release from an intolerably drawn-out, inevitable end. It is one of the law’s cruelties that a healthy person can kill themselves or an irrational person can deny themselves life-saving treatment, while the terminally ill close to death are forced to linger on beyond what they can bear.
In reading the piece, remember that it is written for a domestic audience in Great Britan; however, the questions raised apply to us all.