Who is the Dean of
Death?
Alex. Evans
Living life at age twenty-eight is
an amazing adventure. People are at
their prime – being active and living life to the fullest. However, for Nancy Cruzan, a terrible car
accident took that all away. One night,
driving on a quiet road in Missouri, Nancy’s car rolled off the road and into a
ditch. For twenty minutes she lay there
alone and lifeless. Then, a paramedic
car drove by and saw the car in distress.
They pulled Nancy out, and miraculously revived her back to life. However, she had damaged her cerebral cortex,
the vital end of the brain that gives humans all motor functions, senses, and
communication. Nancy was left in what is
called a persistent vegetative state (PVS), which “is a legal term defined in 765.101
(12) Florida statutes as: ‘a permanent and irreversible condition of
unconsciousness in which there is – a) the absence of voluntary action or
cognitive behavior of any kind; and b) an inability to communicate or interact
purposefully with the environment.” (Snow 3).
Many people refer to this state as being a “vegetable.” After contemplating the situation for a long
while, Nancy’s family decided that it would be best to remove the feeding tube
that was focibly keeping her alive. However, Nancy had no living will or health
care power of attorney which was needed by law to remove the tube. Does her family have the right to make the
decision to end her life, when she cannot make that decision herself? Who does have that right? Do people have the
right to die?
This incident started many people
thinking about what they believe about the issue of the right to die and
physician assisted suicide. The story of
Nancy Cruzan is only single scenario out of many that people have to decide
where they stand on the issue. There are
so many other possible cases and situations that there is no way this can be
defined as a ‘black and white’ issue.
People are all over the board in their approach to the issue of the
right to die. There are many factors that affect one’s approach to this issue - their
occupation, religion, experience with the issue, their values and morals,
etc. There are three main approaches to
the issue of the right to die and physician-assisted suicide. First, a religious or moral approach that
deals with people arguing their side because of their beliefs or values they
hold in high regard. Second, a political
and legal approach that deals with what the laws state and the reasons behind
them. And third, a personal approach
that explains peoples’ opinions who have dealt with the issue.
Although grouped together as having
the same approach, not all religious people and those who argue their opinion
based on their moral beliefs, have the same stance on the issue. These people look at the right to die and
physician-assisted suicide in the same way, but they do not see the same
thing. There are many people coming from
a religious or moral approach who have a strong commitment to preserve life. They believe that above all else, life should
be valued, and that our actions as humans should exemplify that. Some trace this back to their faith in a
creator, and argue that s/he is the one who gave people life, and so only s/he
should have the power to take it away.
People need to let their bodies and others’ bodies take their natural
course in death. The gift and
preciousness of life needs to be valued and upheld in the actions humans take,
and people do not have the right to end their life when they please. (The
Perspectives 1)
Other religious people, however,
disagree. There are many people who
believe that when someone is in a PVS, such as Nancy Cruzan, there is no real
life to hang on to. A writer for the Tampa Bay New Times, Constance Snow,
gives the reasoning, “without a functioning mind and body we lack consciousness
as we know it. Human consciousness is
the mechanism by which we know our creator, recognize spirit and embody and
express that which is holy.” (Snow 1)
There are many who agree and believe that at this state, there is no
point in keeping someone alive. There is
no room for spiritual growth or action, and without that, many religious people
say that it is time to let that person pass on.
There was a theological study done in 1950 called “The Duty of Using
Artificial Means of Preserving Life,” written by Jesuit moralist Fr. Gerald
Kelly. This Catholic priest researched
this subject in many Catholic teachings to look for a religious answer to the
case of Hugh Finn, a case similar to Nancy Cruzan’s, in which he was in a PVS
and being forcefully fed by a tube.
Father Kelly found that “no remedy is obligatory unless it offers a
reasonable hope of checking or curing a disease.” From this, he concluded that taking away Hugh
Finns feeding tube would not be actively killing him and therefore not be
against the teachings of the Catholic Church. (Paris 2) Not all people in the Catholic Church would
agree with this, just as there is dissention among religious people on the
issue of the right to die. There are
arguments from all sides in the religious and moral approach.
The second main approach to the
issue of the right to die is the political and legal approach. The people who take this approach either use
law as support for their stance or are people looking towards others to make
laws concerning the issue. The people
who use law as their support have many court cases they look to, to find
official rulings that judges have handed down on the numerous circumstances
they’ve been presented with. Each state
has different cases and rulings to support a variety of opinions on the
issue. Many people look to the story of
Nancy Cruzan and the court case dealing with her situation for support in
arguments. The Cruzan case came to be
known as the right to die case. There are also the many lawsuits and cases
against Dr. Jack Kevorkian, a medical doctor who has helped people commit
suicide in Michigan, which people look to for legal back-up. Laws are the backbone of our country, so
taking an approach from a legal standpoint is a very valid way to look at the
issue of the right to die.
Also taking a political and legal
approach are lawmakers and those involved with legalization of
physician-assisted suicide. In summary,
there are four main arguments in support of legalization of physician-assisted
suicide. One, “the mercy argument,”
which says that it is inhumane to make people suffer immense pain when they
would rather end their life. Two, “the
patient’s right to self-determination,” which argues that people own their
lives and they should be able to treat themselves the way they want to. Three, “the economics argument,” which
discusses the high cost of keeping someone alive whose physical state will
never change for the better. And four,
“the reality argument,” which says, ”let’s face it, people are already doing
it.” There are many arguments to the
contrary of this legal debate as well.
“Medical doctors are not trained psychiatrists. How will physician-assisted suicide be
regulated? The ‘slippery slope’ argument
(is strong as well as) the sacred view of life.
What about the doctors who don’t believe in killing?” (Newman Part Five 1) These are all common
arguments against the legalization of physician-assisted suicide. There are lawmakers on both sides of the
legalization issue as well as citizens who support them. Many lawmakers are concerned with up-holding
the value of life in law because that is the one place where the answers are
concrete and stand for what Americans believe.
At the same time though, there are many lawmakers interested in the
rights of the people, and believe that included among the other freedoms is the
right to die. There is much contention
in the political and legal approach as well. Not all
people, even with the same purpose, hold the same view on the issue.
The third approach to the issue of
the right to die and physician-assisted suicide is one of personal experience
or attachment to the issue. This
includes family members who have dealt with the issue first-hand, the people
who have terminal illnesses, and the doctors who care for them. First, a man named Derek Humphry
“helped his wife commit suicide at age 42 during the last stages of her battle
with breast cancer. Five years later he
founded the National Hemlock Society, an organization dedicated to the cause of
legalizing doctor assisted suicide for the terminally ill.” (Newman Part Three 1) After seeing his wife’s suffering, he
understood her desire to end her life and supported her decision. Humphry is still in
support of this, and argues that people should not have to unnecessarily suffer
and that they should have the choice to decide for themselves what they want to
do about their life and their death. The
people that are making the laws aren’t the ones suffering, so they shouldn’t be
able to tell those people who are in pain what they can and can’t do. The Cruzan family is a good example of people
in a slightly different situation, but who agree with Humphry
in his stance on the right to die. Just
as he saw his wife suffering with cancer, the Cruzan family saw Nancy suffering
in a PVS. They both chose the same route
of wanting to end their loved one’s life.
Not all family members of people who have chosen to die agree with Humphry and the Cruzans. There are many who believe that taking their loved
one away is a mistake, mostly because there could be some miracle that could
save their life and keep them around longer.
But for the most part, family members who have experienced making this
decision, seem to support the right to die and physician-assisted suicide.
Meg Green is a 75 year-old cancer patient
and “is glad that the option exists.”
“When you can’t function, what’s the use of living? Or if the pain gets too great, what’s the use
of living? And I think you have a right
to the final say,” she said. Author of Compassion in Dying, Barbara Coombs Lee
says that physician-assisted suicide is good way to go. The whole thing is self administered by the
patient, the people requested can be there, and all the good-byes are said. She realizes the difficulty of the situation
for the family, but also sees it as liberating for them that not only the
physical suffering for the patient is over, but also the family’s own emotional
suffering. One hospice nurse, Steve Sehm, who witnessed an assisted suicide said of the
patient, “‘He never wavered, never once, with all the people whom he
interacted. He was always very clear.’
He remembers the man smiled as he drank form a coffee cup a bitter
prescription flavored with cherry. In 30
seconds, the man was asleep.” (Hochberg 1)
It seems to be that many people taking a personal approach to this issue
believe that people do have a right to die and that physician-assisted suicide
is a good option. There are many family
members and doctors who wouldn’t feel the same, but for the most part, people
who have already had personal experience with the issues support it.
There are many ways of approaching the
issue of the right to die and physician-assisted suicide. Using the story of Nancy Cruzan, people can
look at it from an ethical standpoint and say a variety of things. Some people would argue that it is the moral
thing to keep her alive and wait for nature or a higher being to take her when
it’s ‘her time.’ Other people would
argue that the right thing to do would be putting her out of her misery and
removing the feeding tube that was sustaining her life, which wasn’t really a
life anyway. The fact is though, what
was to be done about this case is a legal issue, another important approach and
component to this issue. The Cruzan
family took the issue to trial. There
was a statute in the state of Missouri that said no assisted suicide. At the trial court, the Cruzans
won, and the court ordered that yes, the tube could be removed. The appeal to the Missouri Supreme Court
reversed that and said no, there is absolutely no right to die. The case went one appeal further to the
United States Supreme Court. Here, the
ruling was once again over-turned, and based on the 4th Amendment –
the right to liberty - people do have the right to die. However, there must be a doctrine of informed
consent. This meant that the patient had
to understand the situation in its entirety and consent to the action. In a persistent vegetative state (PVS), such
as in Nancy’s case, there needed to be a living will or health care power of
attorney. Nancy did not have
either. However, in the state of
Missouri, a living will or health care power of attorney was “clear and
convincing evidence” stating the patient’s desire to die. The Cruzan family took the case back to trial
court and gave testimony from friends and family saying that Nancy would want
to die in this situation. The judge
found this to be sufficient “clear and convincing evidence,” and ordered the
removal of Nancy’s feeding tube once and for all.
Although, there is law regulating the
right to die in America and in each state, the issue does not end there. People are always entitled to their opinions
in America even if it goes against law.
Every action that government takes, there will always be someone who
disagrees or has a different opinion.
With the issue of the right to die, there are many different opinions
and approaches, all valid in their own right.
There is no right or wrong answer to such a complex and individual
question.
Works Consulted
Dororquez, David.
“Cruzan and the Right to…”
(2001). <http://www.doroquez.com/arts/tesp01.htm>
Hochberg, Lee. Interview with various players. Rec. 24 November 1998. Video.
Right to Die. Public Broadcasting System, Oregon.
Newman, Ed. “Part Five: Making The Final Choice: Should
Physician-Assisted Suicide Be Legalized.”
The Truth Seeker 121.5 (1992).
15 October 2002
<http://www.cp.duluth.mn.us/~ennyman/DAS-5.html>
Newman, Ed. “Part Three: Local Perspectives on the Right
to Die Debate.” Detroit Free Press FREEP 15
October 2002 <http://www.cp.duluth.mn.us/~ennyman/DAS-3.html>
Paris, John. “Hugh Finn’s Right to Die.” America
(1998). 15 October 2002 <http://www.americapress.org/articles/ParisFinn.htm>
Snow, Constance. “The Right to Die?” Tampa
Bay New Times May/June (2000). 23 October 2002 <http://www.altnewtimes.com/e03csn.html>
“The Perspectives in Brief.” Public
Agenda Online (2002). 13 October 2002 <http://www.publicagenda.org/issues/debate_brief.CFM?issue_type=right2die>