Is my death only mine?


Thank you to MP for your comments and questions on Linkedin. This is my answer.

When I claim that euthanasia is not admissible in any country in the world, I am not doing a comparison, but I am referring to the intrinsic value and nature of life per se. What euthanasia suggests is the devaluation of life with which we are all born and with which we should all die regardless of our latitudes and differences of any kind. Because we are living until the last second, we die alive, we do not die without life. Therefore, if we automatically shorten life, we are devaluing it.

When opting for Palliative Care and not for euthanasia I am not doing an antiquity, but the way in Portugal is setting this situation, leads one to believe so. To clarify: Palliative Care involves a basic philosophy and euthanasia implies another conception.

In choosing Palliative Care I do not choose euthanasia and I decide to live until the end of my life with all possible dignity and being assisted by professionals who can provide me with necessary medical, psychological, spiritual and social skills. Unfortunately, Portugal is far from this possibility. Thus, euthanasia becomes, for many people, an option they consider inevitable. It makes no sense to me, therefore, that being able to choose life until its last minute, patients choose euthanasia because they do not have access to Palliative Care.

In the Netherlands, Palliative Care already existed on a large scale when they implemented the possibility of euthanasia. In this particular country, people decide to shorten their lives, especially when Palliative Care is not fully accessible or lacking the necessary security. When asked why people choose this option (evidence says), a large extent of the Dutch responded "because the disease took away my dignity." So the question is: if lack of dignity is what makes people shorten their lives, what is the point to implement euthanasia rather than create a system in which dignity is increased?

As for free will, a matter of great complexity, I can briefly mention: life of each one of us is a life of relationship, with our inner self and with the other. Life has been given to us by biological mechanism set in motion between father and mother (and now is not the time discuss the question transcendence matter). We were not responsible for our own lives. Throughout our existence, we support this life (that is, we do it for our own responsibility and care), but always in relation to each other, to the world. We need the other to subsist biologically (we feed ourselves on other beings); we need others to exist psychologically and ontologically. There is no completely lonely, nonrelational being.

This seems to be an inevitable cosmic, psychological, and ontological reality - the world being composed of me and others in constant relational circularity. It cannot be otherwise: we are always in relationship with each other.

If so, why is the person alone who decides when he/she wants to die? Does it make sense that in the name of a concept called "free will" the person is given the power to die, failing to recognize this structuring relationship with others? Your-others do not have a word in that choice? Society do not have a word in dignity of this self-chosen death? Is it only a self decision determination?

Because, if we refer to free will when we are talking about the human right to all possible conceptually choices at all times, then this is not free will. It is not free the person who believes that anything is possible all the time, but is free the person to whom the choice is made by determining:

(a) first, what is impossible for him to choose,

(b) followed by an assessment of what is convenient and possible,

(c) and followed by the evaluation of what is appropriate and possible in relationships with others.

The person who chooses, without limits, without self-determined and ex-determined criteria, is not free. He/she would choose in the midst of chaos, without context evaluation, at random, without any ordering of the elements under analysis or determination of values, for himself (and for others, by the very definition of Self above mentioned).

Finnaly, there is no such thing as terminal illness patient without palliative care. Let me say diz by other words: in Portugal there are and very much suffered patients indeed, but there are also all means (medical and psychological, among others) to avoid pain. There are Palliative Care for all moments, even for the most painful suffering . Unfortunately, a minority in Portugal have access to this care, despite the great efforts of health care professionals working in the area.

Studies have already confirmed that for terminally ill patients, despair, fear of pain and hopelessness are important clinical markers pushing for suicidal ideation. So, from my point of view, allocate euthanasia as an option, is very much inconsistent.

Once again, I am thankful for the opportunity of this debate which is so sensitive and important. We need everyone's reflection, a serious and careful reflection.

Chochinov, H. (2001), Final Days for Final Words, Oxford  

Chochinov, H., Wilson, K., Enns, M., Lander, S., (1998), Depression, Hopelessness, and Suicidal Ideation in the Terminally Ill, Psychosomatics; 

McCune, L., Living Beyond the Other, Pastoral Psychol (2013) 62:461-471