Saturday, December 11, 2004

"If only people would recognize their duty to end it all..."

Medpundit points to a Sunday Times interview with Baroness Mary Warnock, Britain's "philosopher queen." Her fireside chat with an awestruck reporter resulted in this headline: "Better for old to kill themselves than be a burden, says Warnock." After reading the interview, I think this headline is misleading, and that the Baroness would object. But it's clear that she thinks she, herself would rather die than be an unacceptable burden to her family. And she would understand if others felt that way too. Here are some quotes:
"In an interview with The Sunday Times, she said: 'I know I'm not really allowed to say it, but one of the things that would motivate me [to die] is I couldn't bear hanging on and being such a burden on people.
'In other contexts, sacrificing oneself for one's family would be considered good. I don't see what is so horrible about the motive of not wanting to be an increasing nuisance...'
"...(N)ot only does she now think assisted suicide should be legal...she also feels the very frail should slink away, like elephants, to die quietly. She reckons doctors, when asked to assist in this, bang on too much about their consciences rather than their patients’ interest.
"Oh, and she suggests that if parents want to keep premature babies with unviable lives life-support machines, they should stump up the cost. Gulp..."
I should probably give the Baroness the benefit of some doubt. This article has just appeared, and she hasn't had a chance to respond. But here are some more quotes:

“...'Maybe it has to come down to saying, ‘Okay, (non-viable babies) can stay alive but the family will have to pay for it.’ Otherwise it will be an awful drain on public resources.' But wouldn’t this offend against doctors’ desire to keep us alive? “I don’t see why the rest of us should be sacrificed to the scruples of the medical profession. Some say, ‘But we wouldn’t like to do it.’ Of course they wouldn’t like to do it, but maybe they should,' she intones with the cut-glass determination that sent young men off to do their duty in the trenches.
"Warnock suggests saving life for its own sake has become a fetish. She tells me of a gruesome story she heard from New York where a poor mother gave birth prematurely. 'Nurses were desperate to break a record (and save the baby). The over-effort was all sentimentality, really. The mother didn’t want the baby, she knew she couldn’t cope, and within days of going home it was found dead, eaten by rats.'

Note how her tone changes when she's asked if she would have helped her terminally-ill husband commit suicide.

"...Her husband, Geoffrey, was saved at the last from (a) gruesome death by what Mary considers a doctor’s mercy in upping his painkillers.
“He had, in the nicest possible way, been written off. He had an absolute horror of suffocation, of gradually being denied air and turning blue...

"The doctor’s actions saved him from that. If it had been necessary, would she personally have helped him into the night? She struggles to answer: 'Killing someone is very difficult. If I had been able to get hold of a tremendously large number of sleeping pills, I think I would have been prepared to put them in his reach. And if he’d had them I think he would have used them.'

I blog today in a state that has twice voted in favor of assisted suicide. The arguments for and against were complex. They dealt with patient autonomy and choice. We considered mental capacity to make decisions. We considered psychiatric factors contributing to hopelessness and suicide. We argued about inadequate pain control in end-of-life care, and measures to improve it. We discussed the value placed on living, suffering, and dying; the problem of defining a terminal condition; and the problem of determining when further attempts at cure are medically futile. And we were especially nervous about social pressures to kill oneself, once assisted suicide was legalized. These issues are barely considered in the interview. (There was no vote in Oregon concerning non-viable babies.)

When to finally say, "enough of treatment, enough of life?" The Baroness's answer boils down to this: when one feels like it, and when it's too expensive to do otherwise, and preferably if someone else takes responsibility for performing the troublesome part, like actually ending a life. Neither the interviewer nor the Baroness did justice to the issues. The Baroness has more explaining to do. These issues, I'm afraid, are more than a nuisance.
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