Sir, - Recent developments in the euthanasia debate, both in this country and abroad, have tended to focus increasingly on the case of those patients who despite adequate pain and disability control, and the presence of strong family or other support, still wish to have their lives ended. Supporters of legalised physician assisted suicide would argue that these patients have a right to assess the value of their own life, and that the physician has an obligation, not simply to approve, but to facilitate the termination of that life at their request. There are those who would say that the doctor has no right to withhold those means which would precipitate death.
Our society has grown accustomed to the language of rights. It is the prism through which the moral value of our actions is seen: do I have the right to do this? Do you have the right to stop me? Do I have the right to stop you?
Rights are claimed and duties are imposed without reference to the reason behind them, because in fact it is no longer a question of reason but of personal decision.
Viewed from this perspective, the question of whether an action is ethical or otherwise becomes subject to distinctly arbitrary parameters. Recent legislation in the US has declared that doctors need not be present at state executions. By contrast, in the state of New York, for example, it is permissible for doctors to assist in the death of their patients. The reason one action is deemed correct and the other not so is the fact that one life is being ended against the will of its owner (as in execution) while the other is ended with its owner's consent (physician assisted suicide). The doctor's actions are deemed ethically correct or otherwise by virtue of the fact that he does, or does not do, what the patient wants.
This is a philosophy which, if universally accepted, would undermine the foundations of medical practice and patient care.
Doctors and health care professionals have a duty to respect their patient's wishes and not to impose therapeutic measures against their will. However, it is naive and illogical to draw the conclusion that an action which is wrong in one instance can be made right in another, simply because the patient wishes it. Were that the case, it could be considered ethically permissible for a doctor to prescribe heroin to drug users or "ecstasy" tablets to teenagers.
The language of rights is an inappropriate medium for ethical debate on the care of terminally or chronically ill patients. The establishment of a "right to die" would be a clear statement from society that there are human lives which are so devoid of value that it is better for them not to exist at all. That a human being would freely, take that decision is a reproach to the society which claims to care for them. That a doctor would subscribe to such a collective nihilism by actively co operating in the termination of a patient's life is the ultimate capitulation. - "L'enjer, c'est les autres". - Yours, etc.,
Queen's Park,
Monkstown,
Co Dublin.