Of Euthanasia.

BEFORE I read a recent article as to the state of euthanasia or 'assisted dying' in Holland I was a decided advocate of it. Although I always doubted as to whether the proper use would enable improper use or malpractice, nevertheless due reflection on the pain of certain cancer patients I had read of convinced me that it was a decent and civilised thing, such as we would never for a moment spare for a beloved pet. For I know there are some virulent forms of cancer and other terminal illnesses which cause so much pain that not even fentanyl, the most potent of all painkillers, can for a moment relieve it. In such circumstances I cannot but think that it would be a blessing and a mercy to offer strong barbiturates to the patients concerned, which should gently quietly and caressingly terminate their agonies with their lives, as in the case of beloved pets: but my opinion has changed.

   The cases of Lauren Hoeve and Zoraya ter Beek of the Netherlands have convinced me that euthanasia of human beings cannot be legitimately permitted in society, for risk of its inevitable abuse. These two women above named had no justification for euthanasia, they were not in a state of irremediable agony and torment due to disease, they were only low in spirits and suffering with mental afflictions such as I have had along with many others, autism, depression, or fatigue. There can be no tolerable argument for these women being referred for euthanasia, but in fact they and their doctors make a mockery of those for whom it was originally legalised.

   So grievous are the possibilities of abuse in the case of euthanasia that its original ratification into law is to be totally discouraged. I believe this is why it has always been so stalwartly resisted in the British Kingdom. Yet what of the dire cancer sufferers? They must not be allowed to suffer unduly either. Of course this is acknowledged, and I believe in Britain there is already an awareness that palliative care should lessen the pangs of extremely painful deaths at all costs. I do think that there should be no limit on anxiety medications for the distressed dying, as long as they are not resistant to their use. If benzodiazepines will not suffice barbiturates should be employed, so that intolerable consciousness is not allowed. This is almost euthanasia by another name, except the doses should be justified and harnessed for the purposes of pain alleviation and the soothing of anxiety.

   I do have a number of particular points to make in regard to this palliative course however. For example, when a dearly remembered relative of mine was dying and she was put on a daily regime of morphine she began to be constipated, and this led to a very uncomfortable bowel obstruction. I pleaded that she should be given a PAMORA drug, and I could not understand why the doctors would not prescribe her one instead of seemingly useless laxatives. In the end she had to be taken to hospital in an ambulance because of this constipation. I believe that the PAMORA drugs are not well known, but certainly they should be employed in almost all cases of terminally ill patients to avoid a horrible and dangerous constipation. I am aware that they can cause some side-effects but surely these may be alleviated by a concomitant increase in dose of the relevant opioid.

   I feel very strongly that terminally ill sufferers of the worst kinds of pain should have every palliative put before them, and that by gradation the palliatives should be used until a serenity is reached or, failing serenity, a peaceful sleep achieved whilst the natural process of dying is continued. However I am now, with the examples of these Dutch women, firmly resolved against the pronounced existence of euthanasia clinics. For the most difficult cases even enforced comas, enforced with every necessary consent of course, would be preferable to these euthanasia abuses. Naturally there should be all manner of checks in every health system to see that all is conducted in a proper fashion, mannerly, orderly, decent, religious if wished, and civilised.