When I qualify as a Doctor in many years, I will have to make decisions about life and death. In my current work, people are in the final stages of their life whether it’s cancer or merely old age. The question of end-of-life care and the proper way of easing people into their final moments whether young or old, cancer or pneumonia is a very tricky subject. I believe that prolonging life in the absence of quality (or very little quality) of life seems cruel. Maybe I’m wrong, but morally it seems like we’re prolonging suffering rather than easing it.
On the other hand, you could help end a person’s life prematurely. This road is fraught with moral complications like ‘Is the person mentally capable of making this important decision?’, ‘Is it absolutely necessary or morally justifiable to assist suicide?’ or ‘Is this really the person’s own choice, of others?’ And sometimes, the painkilling medication given to terminal cancer patients has this effect of easing pain but at the cost of shortening life.
Supposedly in between is letting a person die ‘naturally’. But what does it mean to die ‘naturally’? I guess in it’s pure form, it means letting a person live the final stages of their life without treatment (if that is their choice), without painkillers.
I know this seems unrelated but I compare this morally to capital punishment, which I see as immoral. If you kill a murderer (as a mob or an agreeing party), what does that make you? I believe killing others is uncivilised and unnecessarily cruel. But getting to the point, how do you make a decision or situation intrinsically human? To be civilised, you adhere to the ideals of humanity and you reject your non-reasoning animal roots.
So, on this thought - prolonging life is the opposite of ‘natural’. But I think honestly, what makes us innately human is reasoned choice. Choices of what to do, what to eat, when to live, when to die according to personal moral and social reasoning is what makes us human. So giving a person choice about their last moments, I believe is the best (but by no means foolproof) approach and it doesn’t make anyone feel better about death but it’s progress.
I remember one moment in outpatients where I was observing, an elderly man in a wheelchair with his daughter. He was on the maximum legal dose of morphine possible to ease the pain he experienced (I believe from cancer) and was also taking medication to combat the side effects of opioids. After a long period on morphine, people gain resistance and the painkiller becomes less effective. This was the case for the old man. And the process of even getting close to the maximum legal limit of morphine takes many months, even a year of steadily increasing the dose and in most cases, weaker opioids are used before the transition to morphine - which is the last resort. When I think about it now, I feel sad and I wonder how he is. A man in his situation is unlikely to get better. I think about his family and how they suffered with him. Our lives are full of life and death decisions, however indirect and distant, but unavoidable. Careful and caring thought must be given. No matter the problem.