QED

Yet Again, the Banality of Evil

The promoters of the Voluntary Assisted Dying Bill (VAD) currently before the NSW Parliament have no idea what they are dealing with. They may feel they are addressing a human rights issue or that they are seeking to ease the terrible pain suffered by the terminally ill. However, they appear to have no awareness that what they are proposing merely further facilitates a very dangerous cultural shift in attitudes towards death that is underway in modern society. While this new view of death might appear superficially to enhance human rights, it has a more sinister potential to expose vulnerable people to exploitation and further reduce human beings to the status of mere components and functions within medico-technological-economic systems that can be administered according to abstract rules and that have no capacity to address the needs of individual human lives, as we will discuss below.

Of course, it may be that the promoters of VAD know exactly what they’re doing and are fully aware of the  dehumanising impact their proposals will have. This regrettable explanation seems quite possible given the opportunistic manner in which the VAD Bill has been brought before parliament in the midst of the COVID pandemic. This lamentable act has been highlighted in a full-page advertisement taken out by a large group of health professionals to protest the unseemly haste (Sunday Telegraph, 17/10):

It is extraordinary that Independent MP Alex Greenwich would choose this moment to introduce a Voluntary Assisted Dying Bill into the NSW Parliament. We are especially concerned about the fundamental impact and effects of such a far-reaching, unsafe and unexamined bill [on] an already stretched system … The ambiguities and distress it will add to healthcare systems cannot be underestimated.

The thoughtful and heart-felt statement goes on to highlight the concerns of highly qualified physicians, academics and other health professionals directly involved in the treatment of terminally ill patients, those in palliative and aged care, as well as those folk approaching the last days of their lives and increasingly apprehensive about what awaits them. These professionals describe the anxiety these folk already feel with the Covid threat, and lament the added stress this Bill imposes on all concerned. One, a consultant geriatrician, points out that:

The recent Aged Care Royal Commission showed that older people are a vulnerable group, sounding the alarm on elder abuse, poor care and reliance of ‘quick fixes’.

Many frail elderly will be targeted under the provisions of the VAD Bill and made to feel that they have become a burden and a nuisance to the system, so that “the ‘right’ to die becomes the ‘expectation’ to die.” He concludes: VAD is the wrong idea at the wrong time.”

However, there is another even more profound issue beyond this grim and immediate danger to the vulnerable. This concerns the cultural shift in attitudes towards death that began in the 20th Century and that now largely shapes the paradigm (i.e., the world-view, or mental framework) within which proposals concerning euthanasia and VAD are formulated, evaluated, judged, legislated, and implemented. Proponents of VAD may think they are acting in good faith, but it seems they are unaware of the unspoken and unconscious cultural factors that now determine how they and modern society conceive of human death. 

In fact, the 20th Century saw the emergence in the West of a new paradigm of death that fundamentally revolutionized values relating to mortality and life, displacing traditional principles derived over millennia from religious, philosophical, mythological and traditional sources. This new paradigm has its origins in the unprecedented cultural trauma of the ‘death of a generation’ in the Great War, followed by the horrendous death-toll registered in subsequent wars, civil wars, purges, atrocities, and genocidal acts of later decades. This was accompanied by the subsequent medical revolution in the middle of the century that vastly enhanced public health and made the collective well-being of the citizenry a principle responsibility of the State. Consequently, the paradigm now takes two major institutional forms: the militarization, and the medicalization of death. Both ensure that death is administered on an industrial scale and in accord with institutional and bureaucratic imperatives and values, with ‘administer’ being understood in its twin senses of ‘to manage’ and ‘to dispense’ – the two characteristic orientations towards death in contemporary society.

This cultural shift can be illustrated by considering some of the main iconic images of the 20th Century.  Some images strand out, e.g., the blue planet earth seen from the moon, the double-helix of DNA, the Nuremberg rallies under the Swastika, and the mushroom cloud of the atomic bomb. The first two images are iconic in the traditional sense that they serve as windows onto the mystery of life; while it might be said that the latter two images play an anti-iconic role, serving as a window, not onto the mystery of life, but rather onto its negation through the enormous human capacity for hatred, destruction and death.

This anti-iconic realm is represented above all by other terrible images: of thousands of emaciated and naked corpses being bulldozed into open graves at Nazi death camps, and of soldiers mown down by machine guns, entangled in barbed wire, crushed under tanks, and buried in mud amongst the trenches of the Great War. Arguably, it is these images that are the archetypal representations of the 20th  Century, not just because they represent the horrors of total war and genocide replicated throughout our era, but because they represent the transformation of death into a large-scale technical and industrial process with human beings coming to figure anonymously as mere resources for warfare, labour, experimentation and even recycling (as was done at Auschwitz,  in the case of hair, tallow, tooth fillings and skin, etc.), before being disposed of as refuse – also on an industrial scale.

Sadly, it has been necessary to dwell for a moment on such awful scenes to illustrate not only the extensive processes of dehumanization that have taken place over the past century, but also to emphasize the accompanying demystification, desacralization and banalization of the singular value of human life that now characterise the culture of modern mass society.

This shift has been noted by many commentators in various ways. For example, it was first identified by Sigmund Freud in 1915 as he recoiled in horror at the terrible losses in the trenches. In his study of ‘Our Attitude Towards Death’ he attributes

our present sense of estrangement in this once lovely and congenial world [to] the disturbance that has taken place in the attitude which we have hitherto adopted towards death.” He observed that “the bewilderment and the paralysis of capacity, from which we suffer, are essentially determined … by the circumstances that we are unable to maintain our former attitude towards death, and have not yet found a new one.

The conventional attitudes towards death, which were conceived in terms of the individual, had been swept aside by the total mobilization of the Great War and the ‘massification’ of death:

Death will no longer be denied; we are forced to believe in it. People really die; and no longer one by one, but many, often tens of thousands, in a single day.

Indeed, the catastrophe of the war “strips us of the … accretions of civilization,” and reveals mass death to be an outcome of remorseless dehumanising forces that had broken through the restraining veneer of European civilization. A century later, it is these forces that are being served by the proponents of the VAD Bill in their misbegotten mission to routinize the bureaucratic killing of human beings.

For a time it was the existentialist tradition, with its roots in the work of the Danish theologian Soren Kierkegaard, that opposed this shift and the reduction of the irreducibly particular lives of individual people to the status of mere components or functions within a great, overbearing social collectivity. This resistance first found expression in the early philosophy of Martin Heidegger, who termed this particularity, Dasein. In Being and Time (1927), death is shown to be the primary determinant of Dasein, its presence looming before us all as the ultimate, unavoidable termination of the unique singularity of being human. This situation is, above all, non-relational, i.e., of its very nature, it can only be encountered alone. According to Heidegger, as he contemplated the massification of death unleashed in the War, the great defining characteristic of being human is that human death is pre-eminently a singular event in a life. It is this that a bureaucratised society like ours has great difficulties dealing with.

As Heidegger emphasised, in bringing the life of a person to a close, death both totalizes and individualizes that person, i.e., it determines eternally who that person is. Moreover, Heidegger insists, human beings have an inherent, pre-reflective, pre-philosophical awareness of this situation and this constitutes the Urgrund (i.e., the foundational ontology) of being human. It is this pre-reflective awareness of the bedrock nature of things that prompts the revulsion people spontaneously display at the wanton or gratuitous ‘snuffing out’ of a life, and that no doubt motivates much of the opposition to VAD.

Awareness of these facts about the irreducible nature of the human situation has deep ethical implications, according to Heidegger. Above all, such awareness has the capacity to radically intensify the person’s subjective apprehension of their life, alerting them to the singular value of the time they have on earth, and calling upon them resolutely to live authentically in that time. This conclusion inspired many subsequent existentialists, who explored its demands in innumerable works, e.g., Jean-Paul Sartre in Being and Nothingness (1943) and his many plays; Albert Camus, in all his works, but especially The Outsider (1942) and The Myth of Sisyphus (1942); and John Fowles in The Magus (1965). Ultimately, this existentialist vision of Dasein as ‘being towards death’, with its demand for authenticity, placed what was experienced as an unbearable burden on those who sought to live by it. Consequently, it fell victim to the anti-humanist revolution in thought that set in around 1970 and radically devalued the human subject. This was exemplified by Foucault’s famous declaration in The Order of Things (1966) of ‘the death of man’, and was implemented by structuralism, post-structuralism, and postmodernism, all of which are culturally relativist and have no place for metaphysical mediations or ‘heroic’ notions of Dasein. It is this ideology that shapes Progressivist support for VAD.

Heidegger’s analysis also profoundly influenced his one-time lover, Hannah Arendt, especially in Eichmann in Jerusalem (1963), where she showed how a powerful Nazi bureaucrat could rationalise the extermination of vast numbers of people. They did this by claiming that their allegiance to a ‘higher’ moral imperative, i.e., the legitimacy of laws and orders, overrode any residual concern for humanitarian issues. It is the victory of such abstract, allegedly ‘universal’ principles, and the dismissal of the singular existential dimension of death that produced what Arendt identified as ‘the banality of evil’, exhibited by Adolf Eichmann in his confidence that he was ‘doing the right thing’ in administering the Final Solution.

This attitude proved to be a key defining characteristic of the new paradigm of death, of which the VAD Bill is a primary example. (It is also the underlying rationale behind the repeated refusals of our Chief Health Officers to approve humanitarian requests for exemptions from cross-border restrictions on people seeking medical care or opportunities to visit sick or dying relatives; these CHOs are convinced they are doing the ‘right thing’ and that the universalistic principles that they implement have priority over the particular needs of individuals.)

These foreshadowing insights of Freud and Heidegger were inspired by the trauma of total war, which initiated the paradigm shift in attitudes towards death. Its completion was dependent however upon the mid-century revolution in medical science, which delivered into human hands previously undreamt powers over life and death and forced a fundamental bureaucratic and philosophical reappraisal that verged on the Promethean. As Philippe Ariès observed in 1974 in Western Attitudes Toward Death,

in our day, in approximately a third of a century, we have witnessed a brutal revolution in traditional ideas and feelings [about death] – an absolutely unheard-of phenomenon.

A new discourse appeared, exemplified by various best-sellers and literary prize-winners, including Norman O. Brown’s Life Against Death (1959), Jessica Mitford’s The American Way of Dying (1963), Jacques Choron’s Death and Western Thought (1963), Geoffrey Gorer’s Death, Grief and Mourning (1965), Elizabeth Kubler-Ross’s On Death and Dying (1969), Ernest Becker’s The Denial of Death (1973), and Philippe Ariès, Western Attitudes Toward Death (1974). This was accompanied by the rise of the new field of thanatology, death education and counselling, bioethics, the hospice movement, and growing enthusiasm for VAD and other forms of euthanasia.

In order to grasp the implications of the new paradigm and the VAD Bill that seeks to implement it, it is necessary to grasp the profound ways in which humanity’s religious conceptions had previously shaped the understanding of death throughout history. Prior to the advent of the new paradigm, the world’s religious systems were (and remain) the primary repository of all the symbolic resources and meaning that humanity has been able to construct around the brute fact of death. These invariably locate death in grand schemas and narratives, making death a defining moment of life, or even making life a preparation for death or its transcendence. One’s individual fate acquired a cosmic dimension that far transcended one’s physical passing-away. Although sometimes bleak in their implications, the grandness and richness of such perennial visions highlights the radical departure represented by the core tendencies of the new paradigm and the abrupt rupture with tradition that it involves.

The new paradigm has displaced and marginalised such traditional attitudes towards death, which has been stripped of any metaphysical or spiritual dimensions. We are now integrated into an economic system dominated by the ersatz, hyper-transient, and commodified ‘values’ of consumer culture, and a political system dominated by the imperatives of an increasingly intrusive administrative State upon which we are fervently encouraged to depend. In such a system, it seems ‘life’ and ‘death’ may be purchased and consumed, valued and depreciated, managed and administered in a fashion entirely consistent with any other commercial or bureaucratic transaction, i.e., with ever-increasing superficiality and lack of lasting meaning or significance. In this new regime, whatever broader meaning death possesses will increasingly be associated only with problems arising from technical, economic and utilitarian considerations. And these will be contingent upon the cost-benefit calculations associated with the transition of people from being producers and consumers in the economic system to being cost-centres and burdens within the health system.

And so, here we are in 2021, on the other side of a revolution in our attitudes towards death that set in a century ago. Generally, this has proven to be firmly atheistic and even anti-religious (e.g., ‘Church has no moral authority over assisted dying’, SMH, 16/10), expressing a militantly secular view of death and an annihilationist view of the afterlife. For example, as Peter Singer enthused in his very influential book on Practical Ethics (1993), “when we reject belief in a god we must give up the idea that life on this planet has some preordained meaning. Life as a whole has no meaning.” It seems that Friedrich Nietzsche was only too prescient when he concluded 130 years ago in The Will to Power: “What does nihilism mean? That the highest values devaluate themselves. The aim [of existence] is lacking; ‘Why?’ finds no answer.”

Ominously, as Nietzsche lamented as he looked forward to  the history we now inhabit, humanity has never previously lived in full comprehension of this ultimate nullity of the human condition – and it cannot be expected to do so in an unproblematic fashion. Nevertheless, this is what the proponents of VAD are prescribing. It is for such reasons that any further consideration of the VAD Bill should be postponed until the COVID crisis has passed and the Bill can receive the proper consideration it demands.

27 comments
  • Stephen Due

    Why is the word ‘Voluntary’ in there? One might imagine variations on the theme of ‘Involuntary Assisted Dying’. Socrates comes to mind. On the other hand, one might imagine the more traditional practice of ‘Voluntary Unassisted Dying’. But now it seems we expect governments to step in and cater to our needs – on a purely voluntary basis of course (unlike the Covid vaccination).
    Christianity stood firm against suicide until well into the nineteenth century. The moral law “Thou shalt not kill” applied as much to self-murder as to the murder of someone else. Legal sanctions were applied. But during the 1800s being of ‘unsound mind’ gradually became a way of avoiding the legal and social consequences of an act that was widely regarded as shameful, and contemplated with horror.
    Now something very sinister is afoot. Not merely the impersonal State, but also pharmacists and doctors as agents of the State, are being co-opted in an enterprise that is deeply suspect. The health professions have traditionally regarded human life as sacred. But now death is to become just another therapeutic option, and presumably the appropriate drugs will be listed in the standard pharmacopoeias.

  • ianl

    @Stephen Due

    >”Why is the word ‘Voluntary’ in there? ” [your comment]

    Because it is.

    The usual scaremongering about unscrupulous greedy relatives is trotted out, even though the State is the most greedy about the domestic assets of the elderly. It’s a cowardly excuse – cowardly in the sense that it avoids revealing the real reason you oppose the idea of legal assistance in relieving terminal agony.

    If a person in terminal agony voluntarily chooses to end that with, say, legally supplied Nembutal, why is that any of your business ?

    Just answer the question.

  • maxpart27

    To have read all the negativity referred to in this article must be extremely depressing but the point of the Voluntary Assisted Dying Bill is missed. Modern medicine keeps our bodily functions working when in past times we would have died. Consequently we can be a heap of flesh breathing and with blood flowing but with zero engagement by the brain. In other words we can become the flesh equivalent of a potato, cucumber or daffodil. All have as much humanity as my Aunt Pauline had lying on the floor being fed. It was disgusting. This will probably generate responses from like minded people to the author but I hope they are far less depressed than he must be to have read all the writings he refers to.

  • Katzenjammer

    @maxpart27
    I suspect you’d find the same people who are against killing the diseased elderly and also against artificially prolonging a life of suffering.

  • lbloveday

    Another telling people what to do, demanding an answer! “Just answer the question” – ianl
    .
    Reads like a parent speaking to a child or a judge to a witness.

  • lbloveday

    maxpart27 – “Modern medicine keeps our bodily functions working when in past times we would have died”.
    .
    How I admire Einstein’s attitude “It is distasteful to prolong life artificially. I have done my share; it is time to go. I will do it elegantly”.

  • STD

    @ianl “why is that any of your business”?
    So long as yourself and Maxpart27 don’t object to actually carrying out the dirty work ,regardless of the psychological consequences to your health and well being in the long term.
    Best if we let the doctors get on with patient care and leave them completely out of the murderous equation all together ,and just let them consciously care for their patients according to good conscience and character that accomodate medical practice’s that accord with the Hippocratic Oath.
    Leave this the next growth industry ( the assisted suicide industry)to be managed by listed investment companies, who can train the executioners conducting the executions- maybe all that is needed to qualify and be competent is a certificate 3, in execution ,specialising in voluntary assisted suicidal execution.
    Long term industry growth prospects aided by the lobbying of government by assisted suicide lobbyists such as the brains behind triple M’s Doug Murray, one Andrew Denton and the Emeritus Physician ,now Professing assisted suicide Phil-lip Nitschke ( adjunct) could lobby progressive MP’s on both sides of the house to move motions aimed at the resurrection of state sanctioned penal execution, whose KPI’s for performance are solely figured on economic growth.
    The long term horizon looks bright, with industry lobbying already in train to lower the bar for capital punishment from murder and rape to politically incorrect non progressive views that lay well outside the bounds of both irrational thought and the prowess of subjective powers of reasoning .
    Welcome to the culture of death, a big cheer resounded from the chamber as honourable MP’s on both sides of the house congratulated each other on the passing of two important landmark bills ,that of alive late term abortion ,up to and including birth of the embryonic blastocyst universally and historically defined as a baby, and finally after many years groundwork and preparation and much hand on heart insincere vacillation the passing of the assisted suicide executions act – both bills requiring a con-science vote in accordance with peer pressure and mutual esteem.
    It is rumoured and is thought to be the undying hard work and persistent efforts by Greens member Alex Greenwich on behalf of the Labor party and rusted on progressive’s inside liberal circles that ultimately got both bills over the line.

    *The mission of the medical Profession.
    FIRST DO NO HARM : “I will abstain from all intentional wrong-doing and harm”.

    EXTRACT FROM THE HIPPOCRATIC OATH:I will use those dietary regimes which will benefit my patients according to my greatest ability and judgement and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so , nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art.

    The inverse is the intent of Alex Greenwich.

  • Stephen Due

    @ianl. I used to work on the same building with a Palliative Care team. They were not calling for VAD – quite the reverse. They were highly skilled, qualified medical specialists, fully committed to compassionate terminal care. Certainly from their perspective there was a big difference between VAD and the ethical standard of care they offered. Since the time of Hippocrates, doctors have always had a sacred trust to affirm and preserve life. As a society we depart from this standard at our peril, it seems to me.

  • Katzenjammer

    The reasonable question of how does it effect anyone else –
    It defines life itself as a comodity that’s subject to governmenmt decree,. That re-defines a fundamental aspect of the whole of history, and of our millennia of philosophies about human existence, and of our estimates of possibilities for human society into the distant future, That’s the simple reason why it effects everyone else.

    PS – Note, no recourse to anything related to religion, and no whimpy excuses that it makes someone uncomfortable.

  • maxpart27

    STD and Stephen Due
    About those doctors.
    A comment on their criteria:
    “intentional wrong-doing and harm” = doing harm by keeping alive those who will be better off dead.
    “benefit my patients” = should be letting them die and assisting them to do it with least pain.
    My Aunt Pauline was no better than a vegetable which is why that descriptive term is used for humans in that condition. For the doctors to think they are doing well when they keep such humans alive merely means they lack any humanity at all.

  • pgang

    Stephen Due I think you raise a critical point that is often missed. Palliative care is not about needlessly extending suffering, which is the one trick argument of those who want to legalise murder by our doctors and health system. Rather it is an ethical. caring and dignified response to managing the end of life.
    To bump off those who are suffering is an admittance that human life is utilitarian and only valued if it is useful, or easy. Perhaps it reflects the opposite end of the spectrum, in which unborn life is terminated if it is not considered to be convenient.

  • STD

    Maxpart27 I will refer you to William Shakespeare’s – Hamlet- the first Quarto- it is succinct. People’s lives are better sustained in hope ,even when living alongside perchance and prospect of death. Killing people is not the answer to restoring one’s sense of joy in simply just being. Hope is what keeps people alive and gives them the ‘will’ to keep living.
    “To be or not to be ,Ah there’s the point,
    To die to sleep ,is that all? Aye all:
    No to sleep, to dream,, aye marry there it goes,
    For in that dream of death, when we awake,
    And borne before an everlasting judge,
    From whence no passenger ever returned,
    The undiscovered country at whose sight
    The happy smile and the accursed damn’d,
    But for this the joyful hope of this,
    Who’d bare the scorns and flattery of the world,
    Scorned by the right rich , the rich cursed of the poor,
    The widow being oppressed, the orphan wrong’d,
    The taste of hunger , or a tyrants reign,
    And a thousand more calamities besides,
    To grunt and sweat under this weary life,
    When that he may his full Quietus make,
    With a bare bodkin, who would this endure,
    But for hope of something after death?
    Which puzzles the brain and doth confound the sense,
    Which makes us rather bear those evils we have,
    Than fly to others we know not of,
    Aye that, O this conscience makes cowards of us all,
    Lady in thy Orizons be all my sins remembered”.

  • STD

    Maxpart27 if you read my extract , specifically pertaining to the Hippocratic oath, when paraphrased this is actually acknowledging physiological treatment of the physical and in the same breath it is incumbent upon our good conscience to deliver hope as part of the healing process, alongside our impending death which awaits everyone of us. Can you see ,or at least recognise this parallel?

  • lbloveday

    maxpart27:
    .
    There is a vast difference between keeping “such humans alive” – which is what was happening with my father via nasogastric intubation feeding which he could not administer himself – and allowing them to die. He and my mother wanted the prolonging of his life by artificial means stopped, it was stopped (no-one had the right to force-feed him), he died naturally within 4 days, without anyone killing him or assisting him to kill himself.

  • maxpart27

    lbloveday
    So putting humans in a situation where they starve to death is humane?
    You don’t think a less painful approach would be more civilised?
    Western society has too many people not thinking of the result of their actions or inactions.

  • Stephen Due

    @STD
    My mother taught me this beautiful but deeply disturbing speech as a child.
    I think you may be inadvertently quoting from a ‘pirated’ edition of Hamlet.
    The standard text reads:
    “To be, or not to be: that is the question:
    Whether ’tis nobler in the mind to suffer
    The slings and arrows of outrageous fortune,
    Or to take arms against a sea of troubles,
    And by opposing end them. To die, to sleep–
    No more–and by a sleep to say we end
    The heartache, and the thousand natural shocks
    That flesh is heir to! ‘Tis a consummation
    Devoutly to be wished. To die, to sleep–
    To sleep–perchance to dream: ay, there’s the rub,
    For in that sleep of death what dreams may come
    When we have shuffled off this mortal coil,
    Must give us pause. . .

  • STD

    Thanks Stephen , you are correct but I chose this version simply because to those of us with dull minds, it makes it glaringly obvious that human beings need hope and it lays at the very core of our being. Your version is this hope encapsulated as what can only be described as a beautiful lamentation and melding of mind and heart.

  • lbloveday

    Quote: You don’t think a less painful approach would be more civilised?
    .
    Some comments from “experts:
    ****
    Studies have shown that for terminally ill patients who choose to die, deaths by terminal dehydration are generally peaceful, and not associated with suffering, when supplemented with adequate pain medication.
    ****
    At first, you will feel the same as you did before starting VSED. Hunger pangs and thirst may occur the first day, but these sensations are usually tolerable; discomfort can be alleviated with mild sedatives or other techniques such as mouth swabs, lip balm and cool water rinses.
    ****
    TD advocates assert that death by dehydration is a relatively gentle way to die. As dehydration sets in, the body releases certain chemicals (“esters” and “ketones”) that have the effect of dulling the senses. These chemicals act like an anesthetic, and the dying patient feels little pain.
    ****
    In a poll of Oregon hospice nurses asked to rank “death experiences” on a scale of 0 (a very bad death) to 9 (a very good death), the nurses gave terminal dehydration an 8.
    ****
    “The process of starving to death seems very barbaric but in actuality is very peaceful,” said Dr. Fred Mirarchi, assistant clinical professor of emergency medicine at Drexel University College of Medicine in Philadelphia.
    ****
    Quote 2: Western society has too many people not thinking of the result of their actions or inactions.
    .
    Strongly agree, and those who advocate Government-legalised killing of people are in the van of the non-thinkers

  • rod.stuart

    “‘the banality of evil’, exhibited by Adolf Eichmann in his confidence that he was ‘doing the right thing’ in administering the Final Solution.”
    This quote from Hannah Arendt is earily similar to Gladys insisting that volutarily submitting to the pathogens in the “vacccine” as “doing the right thing”.

  • andrew2

    maxpart27 Did your Aunt want to have her life ended by euthanasia? I have seen you mention her a number of times but haven’t seen you explain what she was thinking.

  • Elizabeth Beare

    Last September I sat with his adult children and watched my previously well brother die following a sudden major brain stem blood clot that appeared one night while he was watching TV and turned him into a totally blind and immobile being on a ventilator in ICU. Except that he was sentient. He was able to gently sqeeze one of his hands and he could hear us and agree or disagree via the number of squeezes he could make in response to questions. In this way we communicated to him that his life could continue for a few more weeks on ventilation till he succumbed to drowning in his own lung fluids, or he could face death without ventilation. He had no hesitation in opting for removal of the ventilator, which was infinitely more comfortable for him then, and we waited for him to die as we were assured he would, perhaps immediately or in up to three days time. As he was a strong fit man it took nearly three days, with no treatment except morphine to dull pain and help with the sense of breathlessness. His last struggling day and his final heart attack as he suffocated were dreadful for him and for us all. Once he was declarerd terminal, ICU staff were absent unless we pushed them for more morphine. I wish more medication of different sorts had been made available to ease his passing, without fear by medicos of ‘killing him’. It is always hard to ‘draw a line’, but one could have been drawn here. If situations like this were clarified then there would be no need for euthanasia laws which, as Mervyn says so well in his essay, have some vile cultural antecedents.

  • maxpart27

    andrew2
    Aunty Pauline was a vegetable. Not talking, thinking, moving, or any of the other characteristics of an animal. She did not care what happened. She did not think. It was the humans keeping her alive in that state that absolutely appalled me. How society can treat a fellow human in such a disgraceful manner is criminal.

  • Elizabeth Beare

    All our family ever wanted were some better drugs to assist my brother to smoothly fade away rather than pass away with massive involuntary gasping arching up in his death throes, for his death was inevitable given his brain stem injuries. He deserved more medicalised peace at the end than this. I am told that hospices can provide this. ICU’s should also be able to offer such peace via drugs not intended to kill but to relieve..

    As for medically assisted vegetative states, they are cruel. Death should come as it will when the body gives up and all means of easing distress should be used.

    To argue for relief in extremis and in the period of illness leading up to death in hospices is very different to arguing for voluntary euthanasia, in my book anyway.

  • STD

    Maxpart27 , murder is a criminal act. As far as I am aware palliative care is not listed on the statute books, therefore the intent could not possibly be murderous.
    As far as I am aware, there is a protocol in the medical profession to ascertain if someone is clinically brain dead- Palliative cares intention is not to prolong suffering needlessly or senselessly for the sake of our own vanity.
    The intent is what differentiates the differences between Euthanasia and Palliative Care. ( animals and humans).
    Example: my father had a little French bulldog who was ill with a tumour (mass) in his abdomen, instead of having him euthanised post haste, he asked the Vet to operate to see if anything could be done. The intent here was not to satiate the desire to kill, but to satisfy and bring the justice we find in loving intent.
    So the Vet removed a lot of the tumour, but he would of had to have removed a vital organ it was wrapped around ,to remove it completely.
    How was little mate going to get his head around having chemotherapy or radiotherapy or having daily injections to keep him alive ( by the way the dollars was and is not the issue here).
    I’m guessing here, but a dog might have trouble understanding the concept of making him feel sick in order to make him better. So the Vet rang dad from operating table and asked what do you want me to do- I think we will have to let him go – so you see the intent wasn’t to intentionally kill, the intent was to do the right thing ( palliative- to soothe)and in doing that ,we deliver justice.
    You see there is a difference between killing( euthanasia) , and simply accepting fate (palliative) and just letting go.
    In other words we let go of him with our hearts not our heads.
    As I see it Euthanasia is indeed a criminal act ( immoral act) as can be seen in statutes of law at the present moment, by changing the moral law, by creating a loop hole in criminal law to perform such barbarism- to kill with intent to kill- this is akin to what the Nazis did to the Jews in the concentration camps- here they weren’t worried about relieving the pain of malnutrition and or the psychological trauma and abuse inflicted upon their being- the intent of the heartless regime was to destroy the Jewish people and their capacity to live and die feeling loved.
    The medical and nursing professions can be thought of as a barometer of a good and just society- these people ,Doctors and Nurses, are ,and should be the embodiment of all that is good in civilised human nature, to tinker with that integrity is to undermine the foundations of the ethical society, and that my friend should not only be a criminal act, for surely it exposes the inhumaneness ( lacking compassion) and uncivilised potential that lays dormant in each and every one of us.
    The administration of morphine such as in palliative care, is done to relieve pain. If as a result of pain relief the respiratory and heart rate of the “patient” declines in a fashion commensurate with increased pain and its relief, that eventually leads to death, this is justice, death being a point along that line that restores justice when the human capacity for moral integrity has followed its proper course.
    THEREFORE RESTORING JUSTICE- RIP- pall-iative.
    By the way Maxpart27 because of the kindness of my father’s generosity that Vet and the Veterinary nurses got to exercise and impart the love of their profession- that is to help ,where possible ,make animals ‘feel’better.
    ****On a serious final note : I am not sure if you have taken this side of the human equation into account, The Veterinary Profession has one of the highest rates of Profession suicide – why do you think this might be- could it be caused by the moral nature of Euthanasia?
    Is that why suicide is considered a selfish act and palliative care and caring is selfless?

  • STD

    Ps , maxpart27, when I get some more free time I will endeavour to tell the stories of 3 people I cared for, who died a palliative death- I’m hoping this will place your idea and understanding of death and dying and palliation / nursing, on solid ground, bye for now.

  • andrew2

    Maxpart27, I’m struggling to understand you Aunt’s case. Euthanasia involves obtaining her consent to die but if she couldn’t respond she couldn’t give her consent. So isn’t hers a case of inappropriate palliative care and not euthanasia?

  • lbloveday

    STD,
    When “Dr Death” Philip Nitschke killed the NT man before Andrews’ (the good one, not the bad) bill overturned the NT euthanasia law, and the filming of execution was made public, my old footy team-mate, Paul Rofe (RIP), then SA Director of Public Prosecutions said, I paraphrase, but think it’s exact “What I have just seen is murder”.

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