Choosing Death from Despair: The System Calls It Progress

Empathy Replaced by a Pavulon Injection: The Rise of Death on Demand

The number of countries where euthanasia, or death on demand, is legal and regulated by various legal frameworks is slowly but steadily increasing. This trend reflects how states are adapting their legislation to meet a continuously growing demand for such services. Western European nations have long observed Switzerland, where assisted suicide was legalized as early as the 1940s. This involves providing individuals with lethal means and tools, which they can then consciously use themselves.

With an increasing number of people seeking “trips” to specialized Swiss centers like Dignitas and Exit, countries in the Benelux region, among others, decided to align their laws with this ultimate trend. The Netherlands legalized euthanasia in the early 2000s, followed by Belgium and Luxembourg. Germany and Spain have also amended their legislation on this matter, while the United Kingdom and France are seriously considering introducing euthanasia. Outside Europe, Canada is the most advanced in this regard, and in the neighboring USA, four states have followed a similar path.

Death on Demand: Why No One Asks “Why?”

Dr. Matthew Doré, a palliative medicine consultant at institutions including the Royal Victoria Hospital in Belfast, emphasizes that none of the proposed legal acts concerning assisted suicide contain a single provision that would compel a profound question: “Why are you doing this?”

According to Dr. Doré, “the primary reason for requesting one’s own death is the simplest human emotions: suffering and fear. Fear for oneself, fear for others, and fear of losing control. Furthermore, fear of uncertainty, fear of suffering, fear of not coping. Fear of losing identity due to dementia, or simply despair over the loss of what once was.” Dr. Doré points out that this is a normal reaction to terrible news, but the tragedy lies in when this reaction becomes a justification for killing a patient. In such cases, a pretext is sought “instead of addressing suffering and fear, symptoms, and psychological turmoil.”

Assisted Suicide as an Escape from Despair

In 2021, in Canada, where legal euthanasia is euphemistically termed “Medical Assistance in Dying” (MAiD), less than seven percent of over 10,000 cases were referred to a psychiatrist for an assessment of their motivations. During the same period in Oregon, USA, only 2 out of 383 patients underwent similar evaluations. Simultaneously, three-quarters of individuals requesting assisted suicide reported feeling lonely, and over half suffered from clinical depression. In the Netherlands, the most frequently diagnosed mental disorders were linked precisely to depressive moods.

Matthew Doré draws the logical conclusion that “we are not recognizing mental health as a causal factor in these patients.”

Read more: First Intuition, Then Culture

Freeing Loved Ones from the “Burden”

Even if the aforementioned multi-layered fear can be overcome, other concerns remain. According to a study conducted four years ago in Oregon, over 50% of people using assisted suicide services did not want to be a burden on their loved ones. Interestingly, ten years prior, this number was more than half lower.

The feeling of being a burden on others is pervasive, regardless of how caring one’s family may be. The patient remains under immense pressure, manifested, for instance, in suicide notes: “You’d be better off if I wasn’t here.” In such a state, the patient is particularly susceptible to suggestions and imagined or real expectations of being freed from the “burden” they represent for their loved ones or even for society. In such cases, the mere existence of euthanasia clinics creates the possibility of a wrong, premature, and ultimate choice. The situation further escalates when the option of assisted suicide or other forms of euthanasia is no longer just a choice, but rather a command.

Death on Demand: A Relief for the System

In Canada, euthanasia legislation is systematically evolving. Initially, Medical Assistance in Dying (MAiD) was limited only to cases of “grievous and irremediable suffering” with “a reasonably foreseeable natural death.” This requirement, however, was removed in favor of “reasonably foreseeable death.” Yet, even this did not last long, as lawmakers decided to completely remove the concept of death from the regulations. This, they argued, would open the door “for people with chronic problems that do not lead to death, i.e., disabled people.” It is not precisely specified how far the disability, both physical and mental, should extend.

In reality, the right to euthanasia is being exploited to exert inexplicable pressure on vulnerable individuals. In November 2020, Canada’s Standing Committee on Justice and Human Rights heard testimony regarding 45-year-old Roger Foley, who had been suffering from spinocerebellar ataxia, a very rare genetic disease, since birth, but one with which it is possible to live relatively long.

See also: Empathy vs. Fear. The Timeless Psychology of Power

Care is a Luxury; Death is Standard in the “Package”

The patient described the “care” system he was subjected to. “I was abused. Because I am disabled, I was told my care needs were too much of a burden. I was coerced into assisted death through neglect, lack of care, and threats. For example, when I wanted home care, a hospital ethicist and nurses tried to force me into assisted death. They threatened to charge me $1,800 a day or discharge me without the care I needed to live. […] Hospital staff did not provide me with essential means of survival. I was hungry and thirsty for 20 days. I had severely acidic body. An expert who examined my case found gross negligence,” testified Roger Foley.

The patient began to investigate the MAiD system himself. According to his observations, the care for people like him is geared towards death, not toward helping them live difficult lives. “I discovered that the entire assisted dying system is based on false propaganda, bias, conflicts of interest, blindness, and the fact that the law does not protect me,” he accused.

Quite a Party: Death on Demand with Balloons and Cake

On the other hand, legal euthanasia is taking on the form of a well-marketed product: death on demand. Online, one can find descriptions of professionally organized “death parties,” complete with balloons bearing the inscription “life sucks.”

Meanwhile, the Swiss clinic Exit, which specializes in assisted suicide, has even developed a special 3D-printed euthanasia device called the Sarco capsule. The person who has decided on suicide comfortably lies inside. After a series of questions and answers to ensure the decision is conscious and irreversible, the person can press a button. This initiates the process of dying, technically by introducing nitrogen. Within 30 seconds, as oxygen levels drop, the person is said to experience disorientation and even mild euphoria. They then lose consciousness and, as brochures advertise, die painlessly. This description sounds more like an interesting trip into the unknown than a process of dying. Perhaps this is partly why “suicide tourism” is often discussed.

Recommended: Trivializing of Euthanasia. Truly A Remedy for a Burning Planet?

Life Ceases to Be Sacred: Death Has an Easy Procedure

Most materials advocating for the choice of euthanasia heavily feature the word “dignity.” Indeed, choosing the moment of departure “on one’s own terms” seems appealing. Many consider independence from the inevitably approaching time to be a dignified death, freeing one from suffering that strips away dignity.

Dr. Matthew Doré, mentioned earlier, views this differently: “Dignity is not something you can assign to yourself (…). Dignity is given to you through a caring, respectful environment. For example, the Queen is the most dignified lady I can imagine because we have bestowed respect and honor upon her.”

Illness can indeed deprive a person of a dignified posture, appearance, or even logical thinking. However, well-managed palliative care can somehow restore this dignity. It’s worse when institutions established to help are not interested in their charges. As late as 2015, the UK was ranked by the consulting firm Economist Intelligence Unit as the best country in the world for palliative care. However, the President of the Association for Palliative Medicine, Dr. Sarah Cox, states bluntly: “This is no longer current. We are not receiving the funding we need.”

Quoted by the BBC, the doctor also admits that the problem is not merely a lack of money. The institutions established for this purpose do not cooperate with each other. Allocated funds are misused, and doctors and nurses are usually unavailable in the evenings or on weekends. Consequently, patients spend their last days in hospital corridors.

Doctors Concerned About “Moral Complexes”

British medics acknowledge that such a situation does not exist in other medical specializations. Why, then, is palliative medicine becoming increasingly marginalized? According to Dr. Matthew Doré, this is partly a result of aggressive cultural changes occurring in passively yielding societies in the name of “progress.”

Morality is now understood differently, particularly concerning the fundamental medical principle: “first, do no harm.” Doctors who advocate for the superiority of palliative care over euthanasia and assisted suicide are, as Doré writes, “increasingly perceived as being more concerned with their own moral complexes than with the patient’s well-being.”

It is certainly difficult to unequivocally persuade someone to forego an option that might spare themselves or their loved ones suffering. However, wherever systemic solutions emerge, organizations quickly appear that marginalize original goals, seeking to replace them with economic considerations. In doing so, they ensure their intentions are given the status of higher aspirations.

Polish version: Wybierają śmierć z rozpaczy. System nazywa to postępem

Sources:
“Assisted suicide a 20th century problem, Palliative care a 21st century solution” Dr. Matthew Doré’a
The 2015 Quality of Death Index: Ranking Palliative Care Across the World (2nd Ed.) Report “The 2015 Quality of Death Index” (Economist Intelligence Unit)
https://www.ourcommons.ca/DocumentViewer/en/43-2/JUST/meeting-6/evidence Roger Foley Justice and Human Rights November 2020