The success of science and medical technology has led to medical brinkmanship, pushing aggressive treatment as far as it can go. But medicine lacks the precision necessary for such brinkmanship to succeed, and the resulting cycle of expectation and disappointment in technology has, in part, led to an increasing acceptance of euthanasia and assisted suicide, linked closely with advocacy for patient autonomy. At the opposite extreme lies medical vitalism, which refers to attempts to preserve the patient's life in and of itself without any significant hope for recovery.
Against the backdrop of ancient, mediaeval and modern Catholic teaching prohibiting killing (the rule against killing), the question of assisted suicide and euthanasia is examined. In the past the Church has modified its initial repugnance for killing by developing specific guidelines for permitting killing under strict conditions. This took place with respect to capital punishment and a just war, for example.
The historic or traditional Christian view of pain (suffering) and death, especially as preserved by the Christians East (i.e., the Orthodox), is radically opposed to the modern secular obsession with avoidance of pain. Everything about this life has its goal or aim in a mystical reality, the Kingdom of Heaven, for which earthly life is a preparation. While neither illness nor health are seen as ends in themselves, both are viewed as proceeding from the will of God for our benefit and have no ultimate meaning or purpose outside of eternal life.
In the author's experience most normal healthy adults would like to have the choice of medical help to die if they become incurably ill and find their suffering intolerable. The reasons for this are explored, based on ten years of listening and talking about the subject to a wide variety of people in many countries. The most familiar and common are the avoidance of futile suffering and the desire to retain autonomy. This paper concentrates on the dislike of losing independence and its closely associated wish to continue to behave altruistically.
We assume that a statute permitting physician assisted death has been passed. We note that the rationale for the passage of such a statute would be respect for individual autonomy, the avoidance of suffering and the possibility of death with dignity. We deal with two moral issues that will arise once such a law is passed. First, we argue that the rationale for passing an assistance in dying law in the first place provides a justification for assisting patients to die who are motivated by altruistic reasons as well as patients who are motivated by reasons of self-interest.
PURPOSE/OBJECTIVES: To explore the meanings and uses of an expressed desire for hastened death in seven patients living with advanced cancer. DESIGN: A phenomenologic inquiry. SETTING: Urban cancer research center. SAMPLE: Terminally ill patients with cancer who had expressed a desire for hastened death. METHODS: A series of in-depth semistructured interviews were audiotaped, transcribed, coded, and organized into themes.