It's a very difficult time for the family of a terminally ill patient under any circumstances, and it is even more difficult if that same family is called upon by doctors attending on the patient to take the final call on whether the patient should be allowed to continue suffering or take the option of letting that patient go- slowly but surely..
All these thoughts as well as so many others crossed my mind some years ago as I stood inside Medanta, the Medicity in Gurgaon, India, (after my mother had been through a minor surgery and was being discharged that same night) and listened to a conversation between some doctors as well as the family of what was clearly a terminally ill patient.
I heard one of the sons tell the doctor how he didn't want to come back home from work in the evenings because he was faced with the sight of his ill father groaning in pain, day after day. At that point, a friend of theirs chipped in with the comment that despite all that was wrong with that older gentleman, it was their duty to ensure his life was prolonged as long as possible.
“‘To what avail,’ asked his older daughter, “when all my father can do is look at us from his hospital bed and ask all of us, 'Why are you crying'?”
And that really was the crux of their dilemma to hold on or to let go? Not something that many of us are even prepared to think about as it seems so far away. And if I might add, far fetched as well, until it impacts one directly.
(Image source-http://www.catechism.ca/the-bible-and-euthanasia/)
But Mark Twain once said, “The fear of death follows from the fear of life man who lives fully is prepared to die at any time.” And I agree with him completely! Ten years ago a British man with terminal cancer travelled to Switzerland and drank a lethal solution of barbiturates to end his life, with his son and daughter by his side.
He was the first of more than 180 Britons to be assisted to die at Dignitas, a Swiss organisation founded in 1998 which helps people with terminal and incurable illnesses to end their own lives.
While euthanasia and assisted suicide are illegal in the UK, other countries, like Switzerland, do permit assisted suicide in specific circumstances and Dignitas is the only Swiss facility to accept foreigners.
Dr MC Mishra, the former Director of the All India Institute of Medical Sciences, while talking of passive euthanasia says "We doctors encounter this dilemma when we are faced with terminally ill patients, when we know that it is an exercise in futility to use resources to keep the person alive. In such cases, we talk about passive euthanasia with the concurrence of family members. Passive euthanasia is partly permitted and implies withdrawing life support when a person is not mentally alert. Mental alertness is assessed by the Glasgow Coma Scale (GCS) score, which tells us the level of consciousness. In normal individuals, the score is 15, and for those who are brain dead, it is three. A GCS score of less than eight means that the patient is not conscious, her airway is threatened, and her chances of recovery are less. But if the GCS score is three, the possibility of recovery is practically zero unless there is a miracle. I have not seen such miracles happening in clinical practice.
On the other side, the right to life is an old debate. When the Supreme Court heard the challenge to the imposition of Emergency, it rejected the argument that in India, the right to life available to a citizen flows from Article 21 of the Constitution, and that if such an Article were to be deleted or suspended, the citizen would have no right to his life under law.
As far as I’m concerned, this is an extremely personal decision and choice and I can understand that some people with a terminal illness might be tempted to use this route.
Then again, many others would definitely have exactly the opposite point of view. I am not there to sit in judgement either way. Suffice it is to say that each family knows what is best at any given point in time.
And the debate over euthanasia- to do or not to do, will probably go on and on...
(NB-These are excerpts taken from my piece in the Muscat Daily Oman.)