Question:
Mr. O’Connor is a 35-year-old man who has lost higher-brain functioning (the ability to think, experience emotions, or perceive sensory information). He has been in this condition for 10 years. He is able to breathe on his own, but depends on a feeding tube for nutrition and hydration to stay alive. He has left no information in writing as to what his wishes would be in such a situation. At least in theory, the basic options are: (1) prolong his life as long as possible, (2) prolong his life using tube feeding, but do not attempt to save his life in the event of cardiac arrest, life-threatening infection, etc. (3) do not prolong his life (stop the tube feeding) and (4) cause his death by an overdose of medication. Which options are permissible? Which options are permissible? Which are good or bad? Are any of them morally required or morally prohibited? (Leave legal considerations out of your discussion, for the time being.) Is there anything else you would like to know before you could make your decision?

Answer:
Before entering into the ever ongoing debate of euthanasia, we need to ponder over some concerns that have surfaced in my mind. Who decides when a life no longer has any value? Is it the doctors, patients, spouses, parents or the insurance companies? What if there are differences of opinion? Are doctors ever motivated by cost factors? Are patients sometimes in an emotional state that makes good judgment unlikely? Are parents ever motivated by unreasonable hope, spouses by an understandable need to move on? Might insurance companies possess a narrower view of what “value” means than most of us would be comfortable with? These are questions that affect not only end-of-life issues, but also quality-of-life issues for persons with disabilities in general.

In my opinion, it is about placing the lives of the weakest among us in the hands of people other than themselves who often have self-serving agendas. Once society gives a group of people the right to end life, our right to life disappears behind red tape. The value of life diminishes when it can be taken away by others.

Considering the above factors, in my opinion, the only person who has a right to decide if a life no longer has any value is the person whose life is in question. At this point, there is a fork in the thought process: A case when the person is conscious of his/her plight and has the mental ability to take a decision about his/her life and another, when the person is in a vegetative state.

The main reasons for a person who consciously wants to end his/her life are unbearable pain, a relief of emotional trauma for the loved ones and in general, the right to choose a better way to go. Lets us consider those reasons in moderate depth.

The question of unbearable pain: In my opinion, the question here is about the competency of medical technology and knowledgeable doctors to contain the pain. Does every bout of uncontrollable pain find a solution in death? Is it really that difficult to contain pain in the modern era where mankind is making giant leaps in medical technology? The solution here, might lie in exploring ways to contain the pain. The solution here is to make sure that no stone is left unturned in administering pain killers to the patient. The solution here is to make sure that doctors or insurance agencies have not tried to slant the truth in a effort to contain medical expenses.

Pondering about the mental trauma that loved ones go through, are we sure that decisions are being taken in an illogical manner without letting people decide in a fit of emotional excitement? There are a lot of cases of depression where medications and counseling are employed to make the patients life more enjoyable. Are we sure that the loved ones might not change their stance when such methods are employed for them? Are we sure the loved ones and relatives are the best judge about the patient’s life? The solution here is to explore ways of helping loved ones cope with the trauma.

Considering the right of the patient to choose a better way to die, how many of us make rational decisions when in pain or trauma? The solution here is to alleviate the pain and kindle hope for positive thinking.

When a person is in vegetative state, there is no question of pain. This is more pertinent to Mr. O’Conner’s case. The only motive for euthanasia is to end the emotional trauma for the relatives and to cut down on medical costs thus taking a laid back attitude which culminates eventually in giving up. Who gives the right to the loved ones to decide about the life of the patient? What use do the billions of dollars spent on medical research come to when doctors give up on a challenge? When billions of dollars are spent on wars, why would the cost of medications be an issue? Who knows what a patient in vegetative state might have wanted for himself? Has technology advanced to an extent where doctors can delve into the minds of the patients and see what they want? When there is even a slightest chance of hope, why should the innocent, unknowing patient not given a chance to cling onto it? In the era of rapid advancements of medical technology, how would anyone know how long it might take for a cure to the disease in question to be discovered? Who decides if the patient wants to wait for that long a time or not? A cure could be right around the corner, or it could take decades.

Options 3 and 4, I feel, should be ruled out until these questions are answered.

Option 2 suggests that special efforts should not be taken to save the patients life in the event of any complications. As put forward above, the only motive here is to facilitate nature to take its own course of action in an attempt to remove guilt from the minds of doctors and loved ones and save on medical costs. If we let nature take its own course of action, how is this society different from a prehistoric one? Almost all societies - even non-religious ones - for thousands of years have made euthanasia a crime. When pain control medicines and procedures are far better than they have ever been any time in history, why should our commitment towards nurturing life diminish?

Considering my points of view, Mr. O’Conner should be allowed to live and option 1 should be chosen, even if he were in immense pain and conscious of his disease. I would choose option 1 for Mr. O’ Conner, unconditionally.