Friday, November 7, 2008

Euthanasia #1 - views on life...and death -

Copyright © 2008 BBC, Jellyfish Pictures and Marco Iozzi.

I've been struggling with this. This recent spate of discussions about euthanasia has got me thinking, and it's really not an easy issue to wrap your mind around. The issue has been further clouded by a lot of emotive arguments..most of which not very rational. Often public positions have been deliberately hardened around extreme unrealistic situations, which do not help in advancing our understanding.

I'll try and put my thoughts down in a number of posts. I think they will eventually pan out into something rational...I hope. Meanwhile do bear with me. Your comments will help me see though the fog, so please feel free to input your ideas.

It is perhaps unfortunate that the line between life and death is really not something clearly definable other than by means of a empirical physiological measurement. A heart that has stopped beating. A silent EEG. Somehow we know these are inadequate.

As a doctor, we see more than our fair share of death. Perhaps more so than any other profession (possibly more than the clergy). I have seen more than I have wished to. The times I have witnessed death by the bedside have been sobering, humbling...sometimes traumatic moments. When we speak to relatives we use terms like.."(so and so).. has passed away." An euphemism for something we don't want to articulate. Somehow we feel it say the obvious..."he has died". But then, it's not really an euphemism to refer to a passing away of life, because somehow, witnessing death at such close range, it forces you somehow to recognize that there is something else not accounted for...that perhaps the patient has truly passed on to another existence. Another life.

Perhaps it is because of my christian beliefs, but cliched or not, death is not the end ... but a beginning. Notwithstanding this, it is heartwrenchingly painful.

Once I had to deliver an abortus. Seventeen weeks old, it was no bigger than a newborn puppy. I watched it die in the gynae ward sink. No...not die...because technically it wasn't alive, despite moving, gasping. That night, I wept. As a young houseofficer in a cold sterile ward of the old KKH, the sight of that abortus passing away from 'non-life' to death in the cold kidney dish, was far too much for me. That image has stayed with me all my professional life.

Later in my life, hardened by life, I have had to turn off numerous respirators, and watch life pass from lifeless bodies.

How do we draw the line between life and death? Somehow, the beating heart...flat EEGs...seem hopelessly inadequate. We use those only because we have no other means to demarcate that time of passing.

No comments: