VIEWPOINT Is euthanasia the proper answer?

By Francesco D’Agostino

Compassion and clarity. The greatest compassion is called for when dealing with the case of a person who is suffering and wants to die, such as that of the Italian Piergiorgio Welby, who recently captured international headlines.
On the other hand, the most transparent clarity is required by a case that is political, as Mr. Welby himself desired his own case to be seen.

Silence, meditation and especially prayer, are befitting to compassion. Clarity, on the other hand, demands a capacity for analysis and discernment, detached reasoning and especially deep intellectual honesty.

It likewise demands that the profound and previous human value of compassion be kept separate from emotionalism, a psychological dynamics as deeply engulfing as it is generally transient and lacking in content.

The public debate, sparked by the letter Piergiorgior sent to President Napolitano [Italian Head of State] on 22 September 2006, asking that he be permitted a “gentle death”, was in the News Week after week in Italy and worldwide.

The discussion mixed different terms and sentiments obviously seeking to alter the deeply and instinctively hostile attitude to euthanasia prevailing in Italy and most places around the world.
It is too early to tell the results and effects of this media campign. But we can and must say from this very moment that a terrible and moving case has been unduly exploited.

Here are some aspects of the problem, which as we will see, are closely interwoven.
The figure, personality, suffering and actual image of Piergiorgio Welby have been exploited, if with his consent and perhaps also on his initiative (but even self-exploited, is always exploitation), to send a false, objectively death-oriented message to the public: that death is the only possible response to terribly invalidating degenerative diseases such as the one that afflicted Mr. Welby, and more generally, all diseases that have reached the terminal stage.
But the true message is exactly the opposite: the right response to all tragic situations of chronic invalidating diseases and illnesses that inevitably lead to death does not consist in the interruption of treatment (of which euthanasia is an extreme form), but in the therapist’s warm and compassionate closeness to the patient, understood as a true right that is part of the more general right to health, common to us all.

Palliatives, not sedatives
Palliative medicines, the true pride of medicine in recent times that are required by and can give every sick person the concrete hope of being able to live with his own, even terminal, disease in a dignified manner, are intentionally and unduly confused with practices of strong and irreversible sedation that obviously aim to do away with the sick person rather than alleviate his pain.

The most recent and extraordinary biomedical technologies have been denounced and demonized as true and proper forms of violent and unnatural manipulation of life, which unduly minimize the extraordinary therapeutic effect that has enabled them to save so many human lives, thereby neglecting to recall that manipulation should not be condemned because it is unnatural (if this were the case, even cooking food would have to be condemned), but only if it is incompatible with human good.

The use of artificial respiration equipment on which Mr. Welby depended for survival has been insistently described as aggressive.

That it was not aggressive but merely a beneficial form of treatment as a last resort is shown not only by an authoritative opinion expressed by the Superior Health Council, but also in the basic consideration (shared by all bioethicists) that for a treatment to be classified as “aggressive.

There must be an objective disproportion between the treatment to which the patient is subjected and the results the doctor desires to achieve by it.

In Mr. Welby’s case, the purpose of the mechanical respirator was not to provide his merely with a means of biological survival but to give him the possibility of an authentically and profoundly human survival that would enable him before all else to exercise his admirable role as a true and proper political leader (as members of his party tirelessly recalled).
The erroneous belief has been inculcated in people that one of the fundamental duties of doctors is to help their  patients die, carefully forgetting that the Hippocratic Oath – even before a religious vision of life – binds the doctor always and only to fight for life and not to hasten death.

Spin, to legalize euthanasia
The principle of the patient’s self-determination has been exalted as if it legitimized any demand the sick person might make of the doctor, even the extreme request for euthanasia.

This principle, however, which is fundamental to a correct attribution of full moral responsibility, acquires a far narrower effect in bioethics, for in order to legitimize any medical act, it is generally reduced to the obligation to acquire a patient’s fully informed consent should he be in command of his mental faculties.

Reference has been made to the Welby case to stigmatize the absence in our juridical system of a law recognising the validity of so-called “living wills”. (I prefer to call them Directives on Advanced Medical Treatment, following the practice of the Italian National Committee for Bioethics).

It is obvious, however, that even if there were in force in Italy a body of norms on living wills that addressed those situations where the patient has lost the capacity to understand and will, there still would have been no way that this could have been applied to the case of Piergiorgio Welby, who retained all his faculties until the end.

So how can this misinformation be explained?
In many cases, one can blame the bioethical incompetence of those who created it; but in other instances, it is possible to discover behind it an unequivocal intent to open a new front in order to legitimize euthanasia for the sick with impaired mental faculties.

More News...