Die with dignity

From the moment we are born, the single certainty we have in life is that we will die, sooner or later. For most people, the moment of death will come at advanced age. We simply have to accept the fact that we will age and eventually will die.

In some societies where people still live in a more natural way, these facts are incorporated in everyday life. Western societies have increasingly succeeded in turning ageing and dying into taboos which shouldn’t be talked about and should be kept hidden. Thanks to for instance cosmetic surgery the myth of eternal youth has taken on a preposterous form and is accompanied by the illusion of eternal life.

Burial ceremony in India where death is celebrated as well as birth. (© fothoss – Fotolia.com)

Burial ceremony in India where death is celebrated as well as birth. (© fothoss – Fotolia.com)

To age gracefully is all about letting nature take its course. Live as long and well as possible and then go through a rapid decline at the end of life. Successful ageing includes a low probability of disease or disability; a high cognitive and physical function capacity; and an active engagement with life.

People’s fear of ageing is often greater than needs to be. Everyone can make choices about how to age. The more active and involved older adults are, the higher their satisfaction with life. Instead of complaining about what they have lost, older people should focus on what they still can do, find ways to perform well, and compensate for any age-related loss. Doing things one finds meaningful and maintaining control over one’s life are very important factors in ageing well.

Right to die
Having aged gracefully, the decline unavoidable will come. Everybody hopes for the end to be painless and quick. But unfortunately for many people this is not the case. The dying process can be long and painful. The suffering can be so unbearable that the patient doesn’t want to live anymore and would like to die sooner than when nature takes its course.

Time passing man from birth till deathIn most countries, people do not have the right to die. Suicide is often frowned upon, even a crime still in many countries, and euthanasia is only legal in a handful of countries. Presuming people have the right to live in peace and comfort until death, they should also have the right to die. This means doctors should legally be able to help a patient die by administering a lethal dose of a drug or by providing the necessary drug that the patient can take on his own.

Euthanasia refers to the act of painlessly ending the lives of persons who are suffering from incurable diseases or severe disabilities. Withholding of available treatments allowing the person to die is called passive euthanasia. This may take days or weeks, which can be very difficult for the dying person and for family members.

Injecting a lethal dose of a drug to induce death deliberately is referred to as active euthanasia. The lethal agent is administered to the patient by another person, in most cases a physician. In physician-assisted suicide a physician provides the necessary means or information, but the patient performs the life-ending act himself.

“One should die proudly when it is no longer possible to live proudly.”
Friedrich Nietzsche, German-Swiss philosopher and writer

Passive euthanasia is a generally accepted practice. It is done quietly, but without legal protection for doctors. Active euthanasia on the other hand has been strictly prohibited until some years ago. After many years of unofficial acceptance, the Netherlands was the first country in the world to officially legalise active euthanasia. On 1 April 2002, the Euthanasia and Assisted Suicide Act took effect.

Dying has become far more complicated than it once was. People used to die at home of illnesses that medicine could not cure. Now, technology has created choices for dying patients and their families. Most people die in hospitals or institutions where the staff makes a valiant effort to keep patients alive.

Many people make their wishes for the end of their lives known in an advanced directive. (© Manfred Steinbach – Fotolia.com)

Many people make their wishes for the end of their lives known in an advance directive. (© Manfred Steinbach – Fotolia.com)

For many people, that is exactly what they want: fight death off as long as possible. For others, however, there may come a point where the fight no longer seems worth it. Since dying is a part of life, choices about the manner of their dying and the timing of their death are, for many people, part of what is involved in taking responsibility for their lives.

A dilemma occurs in the case of unbearable psychological suffering when there’s no physical suffering as part of a terminal illness. As more people reach older ages, more cases of dementia occur. The presence of dementia or some other such condition is not in itself a reason to comply with a request for termination of life or assisted suicide. For some people, however, the very prospect of one day suffering from dementia and the eventual associated loss of personality and dignity is sufficient reason to make an advance directive covering this possibility.

A next step would be for older people who are done with life and tired of living, to be able to obtain a suicide pill. It would be made possible for them to choose to die before experiencing the final stages of decline and dependence.

Former Dutch Supreme Court judge and professor of civil law Huib Drion made a plea in 1991 to provide suicide pills free of charge to old people who themselves wanted to put an end to their lives. He said: “It appears to me that many old people would find great reassurance if they could have a means to end their lives in an acceptable way at the moment that to them appears suitable.”

The famous Père-Lachaise cemetery in Paris, France.(© zatletic – Fotolia.com)

The famous Père-Lachaise cemetery in Paris, France. (© zatletic – Fotolia.com)

The topic of euthanasia has entered public debate in a growing number of countries. The advocates come up with objective arguments why euthanasia should be legalised. But there’s still a strong group of opponents, frequently from fundamentalist religious circles, who out of fear and based on subjective reasoning prefer terminally ill patients to suffer.

I think everyone should have the right to possibly choose and control the moment of their death. Doctors should not be prohibited by law from lending their professional assistance to those competent, terminally ill persons for whom no cure is possible and who wish for an easy death. Or, for that matter, to those who think they have lived life to its fullest and simply want to end it in a humane and dignified way.

“Death may be the greatest of all human blessings.”
Socrates, Greek philosopher


Newborn babies © tan4ikk – Fotolia.com
Cycle of life © rashadashurov – Fotolia.com

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