Holding a glass bottle of barbiturates, Angel Hernandez asked his wife one last time if he wanted to die before handing her the deadly poison. “The sooner the better.” She replied. Maria Carrasco, already crippled by multiple sclerosis, struggled to swallow poison, forcing it down with the help of a straw.
Carrasco’s death in 2019 created a storm of public opinion in Spain. The investigating judge initially assigned the case to a court that specializes in violence against women. Prosecutors sought a six-month prison sentence for Hernandez, who was 70 at the time. In June of that year, however, Spain enacted a law allowing people “suffering from a serious or incurable disease” and “suffering from chronic illness or inability to live a normal life” to seek help to end their lives. Hernandez was acquitted 12 days later.
In recent years, much of the Western public has embraced euthanasia. In 2002, 60 percent of Spaniards supported active euthanasia, rising to 71 percent in 2019. The weakening of religious restraint and increasingly enlightened social values undoubtedly laid the groundwork. Personal experience also plays a role, especially among the post-World War II baby boomers, who witnessed their parents’ agonizing deaths and fought harder for the right to die.
Change ensued. Up to now, more than a dozen countries have declared euthanasia legal or not punishable, and many of the remaining countries have carried out legislative discussions to legalize euthanasia, or there are doubts about the court’s decision to criminalize euthanasia. In November 2021, Portugal’s parliament passed a bill allowing “persons suffering from a serious illness that is incurable and cannot be improved” to end their lives with the help of others. Other Catholic countries, such as Chile, Ireland, Italy and Uruguay, are also moving towards legal recognition of the right to die. In Belgium, Colombia and the Netherlands, governments have even extended legal permission for euthanasia to terminally ill children. As the number of countries that allow euthanasia grows, so does the fear. Change snowballed as activists in different countries learned from each other’s experiences.
Euthanasia has changed people’s understanding of death.
Is easier than to implement | | legislation
In 1997, Oregon passed the Death with Dignity Act, which allows patients to take lethal drugs if they are conscious and have less than six months to live, after being confirmed by two doctors. Drugs must be given to patients themselves (physician-assisted death), not injected by doctors (active euthanasia). In all, some 2, 000 people have died this way, none of them reported as illegal deaths.
With appropriate modifications, Oregon’s rules were accepted around the world. Since 2017, when Victoria became the first Australian state to pass a similar law, there have been proposals in support of euthanasia in five Australian states. New Zealand’s “Oregon Bill” takes effect on November 7, 2021.
Some activists opted to give up persuading conservative lawmakers and fight directly for the court’s decision. In 2011, the European Court of Human Rights ruled that people have the right to decide when and how they die. The nonprofit Organization Dignitas Germany began helping people commit suicide in 2020 after the Country’s highest court declared that helping others repeatedly to end their lives was no longer unconstitutional. In February 2021, a Peruvian court ruled that the ministry of Health violated the “dignity” and “autonomy” of a woman suffering from degenerative polio by refusing to help her end her life.
However, even if the legislative and judicial authorities open the door, euthanasia is still difficult to implement. Victorian law has a further 68 “safeguards” to turn away those who seek help. In addition, state law prohibits doctors from mentioning euthanasia to patients, leaving many unaware of the option. Colombia legalized active euthanasia in 1997, but until now there have been many restrictions.
The number of euthanasia patients is small, and the vast majority are cancer patients. Even so, we cannot deny that euthanasia has changed the human understanding of death. In some countries euthanasia is carried out for people with mental illness, dementia or even the elderly who are tired of life. Secret societies sharing methods of suicide have flourished among baby boomers. The consternation is causing even euthanasia supporters to worry that things are getting out of hand.
The only way out for | |
In 2015, the Supreme Court of Canada declared that euthanasia was no longer unconstitutional, and that canadians suffering from chronic diseases or physical disabilities had the right to apply. Canada plans to extend euthanasia to the severely mentally ill by 2023. Questions have been raised about whether patients who choose to die have tried all available treatments when the medical and social understanding of mental illness is so rudimentary and mental health services so inadequate. Mona Gupta, a Quebec psychiatrist and bioethicist, points out that most people underestimate the severity of intractable psychosis. People often see psychosis in pop culture but never in real life.
John Sculley, who has battled major depression and post-traumatic stress disorder for decades, would certainly agree. Late at night at his home in Toronto, Sculley, 80, was still haunted by the horrific images he had seen as a war correspondent: bodies torn apart by vultures and ak-47s fired at him. Physical torture did not pass him by either. “There is no cure.” He said. Six psychiatrists, 19 shock treatments and countless drugs failed to drag him out of the mire. He regarded euthanasia as his “last straw”. In his view, having attempted suicide twice, the choice was far more dignified and less hurtful to his family.
Gupta, like most bioethicists, believes we should treat mental disorders the same as other chronic conditions that cause suffering. From a doctor’s point of view, she said, the criteria for euthanasia for both conditions are basically the same: is it a spur of the moment choice or a deliberate decision? Does the applicant have the ability to judge for himself? But it is rare for a mentally ill person to be approved. In 2020, only 88 mentally ill patients in the Netherlands had their requests approved by euthanasia clinics.
Theo Bohr, a Dutch ethicist who once supported euthanasia in his country, thinks Canada has gone the wrong way. Since Dutch doctors pushed for euthanasia to be legalised 20 years ago, active euthanasia has gradually moved from “a last resort to avoid dying in disgrace” to “a last resort to avoid living in disgrace”, he said. Pohl claims that active euthanasia is a shortcut to death, just as c-sections are a shortcut to birth. On average, one in 25 deaths in the Netherlands is due to euthanasia, and in some cities the figure can be as high as one in seven.
In addition, dementia patients’ willingness to die is often the most difficult to grasp. In 2016, an Alzheimer’s patient in the Netherlands woke up during a euthanasia procedure and struggled so badly that her family had to hold her down. Her wishes were given priority by doctors after she had made a written request for euthanasia long before she was delirious with dementia. In 2020, the Supreme Court acquitted doctors and issued a judicial interpretation that they could not be sued for euthanizing a patient with advanced dementia, even if the patient no longer expressed a clear intention to die during the procedure. In the Netherlands, such cases average about two a year.
Bert Katz, a geriatrician who has carried out some of the Netherlands’ most controversial euthanasia cases, was also disturbed by the court’s decision. Generally speaking, euthanasia should be carried out with the consent of the patient, the doctor and the family. If the patient has dementia, it means “the central figure of the whole thing has been removed”. The implication of the court’s decision is that a person’s past is more worthy of credence than their future — in other words, the patient’s desire to live in the present is being taken away.
| | ahead in the face
Some people who are tired of life or unwilling to tolerate decline take action. Don Waskuper, 76, had only minor ailments but refused to accept what was already his destiny: the pain of having his ears cleaned with syringes, the indignity of swimming with an ostomy bag and the trouble of being immobile as his arthritis worsened. She said, “I don’t want to die, but I can’t live like this.” In October 2021, she left her home in The UK for an industrial area on the edge of a forest in Switzerland, where she died after hearing Nick Drake sing The Remains of the Day.
Katie Engelhardt, author of Inevitable, put it simply: “Many people want to end their lives before they can wait for the law to pass.” According to her, people, fed up with laws and doctors’ restrictions, secretly buy poisons from the Internet. Their desire to die often stems from mental pain rather than physical torture, such as loss of purpose, fear of being a drag, fear of losing dignity.
Euthanasia is rewriting the culture of death. British anthropologist Naomi Richards says euthanasia is being discussed so much that a play has been written on the subject. Death is becoming something that can be arranged, managed and even avoided. Ellen Webby, a Canadian doctor, said she had helped people die “on the beach, in the forest and at parties”. Compared with the traditional scene of death, confined to a bed, and given the millions of people dying alone in a hospital during the pandemic, this approach seems particularly appealing.
For those who remain, euthanasia can be a blessing or a curse. Angry that his mother had been taken away prematurely, Tom Mortier took his case to the European Court of Human Rights. But most find comfort there. Heather Cook’s son, who had metastatic colon cancer, died last year at the age of 42. Although She suffered the loss of her only son, Cook took comfort in the fact that he died peacefully at home and with his family around him. “Euthanasia is a gift to us,” she said, “but I understand why people are afraid of it.”
[Compiled from The Economist and The Washington Post]
Editor: Want yuan
Suicide capsule
People in Switzerland who want to end their lives will soon have access to a new euthanasia tool — a 3D-printed suicide capsule. The capsule, called Sarco, was developed by the non-profit Organization Free Way International. At the press of a button, Sarco will release nitrogen, rapidly reducing the oxygen level in the cabin, and the user will lose consciousness within a minute, but will not suffocate or suffer, but will die of hypoxia after falling asleep, according to Philip Nitschke, founder of the group. In theory, Sarco can be placed anywhere. According to Nitschke, it’s a “stylish and elegant” way to die. “Sarco’s look has a ritualistic feel to it that it’s something I want to do,” he says. He also stressed that the use of suicide capsules would not violate Swiss euthanasia laws.
However, since Nitschke introduced the “suicide capsule” concept four years ago, the criticism has never stopped. Critics say its appearance is the biggest problem. Daniel Sulmasi, director of Georgetown University’s Kennedy Institute for Ethics, says the capsule’s sleek, car-like appearance “glamorizes suicide.” He also objected to Nitschke Posting instructions for the capsules online, which he feared would lead to an epidemic of suicides.
Even euthanasia supporters have concerns. Writing in the Independent, disability campaigner Stephen Warkworth said: “There should be more choice at the end of life and we should strive for it, but safety should be a priority. Sarco has very serious safety concerns: what happens if a delirious person gets in it? What if it’s a child? Could the capsules be used to torture others? If it doesn’t bring a quick, quiet death, what about the people inside, left alone and helpless?”
Nitschke explained that suicide capsules are not dangerous, but only a painless death. He carried out the trial at a clinic in Switzerland and said: “Just a few repetitions should clear it up.” Responding to accusations that it could be triggering a suicide epidemic, Nitschke said: “Free International has published specific guidelines for the use of suicide capsules. It says they should only be used by people over 50 who are mentally sound or seriously ill. We want this information to be freely available to reasonable adults.”
Nitschke’s main reason for developing Sarco is that he wants to help older people who are “tired of life.” Nitschke said he also uses Sarco at the end of his life, feeling that death should not be “shrouded in pain and gloom” but a time to “celebrate”.
Ethicist Surmasi strongly disagrees. “Death is sometimes a means of release for people, but it is never something we should celebrate.” “When one of us dies, we lose someone special,” he said.
