Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Floridian compassion
- Mark Struthers (9 April 2005)
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Doctors Shy away from discussing death
- Sandip Raha (10 April 2005)
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What is a 'bad death'?
- Associate Professor Niyi Awofeso (15 April 2005)
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Roman Catholic attitudes to suicide and voluntary euthanasia.
- Colin Brewer (27 April 2005)
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Mark Struthers, General Practitioner Bedfordshire, UK. mark.struthers@which.net
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Glen Ocha, 47, was executed in Florida on 5 April. Remorseful at the murder of a young woman in 1999, he dropped all legal appeal against capital punishment and volunteered for death. As Montaigne would have it, Glen Ocha was booted, spurred and ready to go. He’d exercised his choice, had made an advance directive and secured a legal right to die. And then the pope died. At this sad time we are reminded that humankind’s attitudes to dying are a bit muddled – especially so the American variety. Jeb Bush, governor of Florida is a Roman Catholic and like his brother, is a champion of the sanctity of life and the inalienable human right to live it. He considered postponing the death sentence out of respect for Pope John Paul 2 but decided against. "I have a duty to carry out the law, and in this case I actually was prepared to delay the execution out of courtesy for and respect for the pope's passing," Bush said. "But I also have a duty to have sympathy for the victims." Competing interests: None declared |
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Sandip Raha, Physician Bridgend, Wales
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I deal with many elderly patients every day with terminal disease as well as severe disability. Medical Training all over the world teaches doctors to preserve life but very little teaching is done to discuss death or its process with patients and family. I vividly remember early in my career a patient with terminal cancer asked me "How soon I will die doctor? will it be painful? am I going to be conscious all the way? Is lord going to stand beside me? What will be last feeling and symptom"? I could not answer any of them. Now 20 years later discussing death with my patients and family members I don't shy away from it. It is not a failure of Medical treatment. Dying and "good dying" are as important to many patients and family as is getting better. I don't support euthanesia or assisted dying (although we unknowningly do it) but to help those who are dying with their symptoms, psychology and thought process is also a duty of any good doctor. Competing interests: None declared |
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Associate Professor Niyi Awofeso, Public Health Surveillance Officer New South Wales Justice Health, Sydney, Australia.
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A major controversial issue relating to ‘dying with dignity’ is that the health professionals’ community uses as its starting point the concept of a ‘good death’.1 The ‘good death’ concept has its roots in the flawed perspectives of St. Augustine’s “City of God” essay (~4CE).2 Building on this Christian perspective to define what ‘dying with dignity’ is may further complicate an already polarised issue. Perhaps an approach that starts with what a ‘bad death’ is might prove more instructive. Attributes of a ‘bad death’ might be defined to include issues such as death following prolonged unnecessary pain and suffering, death following persistent vegetative state, dying as a suicide bomber, keeping a terminally ill individual alive against her/his written wish to be allowed to die, death from torture, and death from prolonged hunger. Consensus on what constitutes a ‘bad death’ is potentially more likely to be achieved compared with that on what constitutes a ‘good death’. I realise that as the list lengthens, it would stretch into controversial grey areas. However, the current approach that ‘dying with dignity’ should implicitly derive from St. Augustine’s ‘good death’ perspective has so far proved unhelpful, being coloured more by religious considerations than concerns for individual autonomy, views of a dying individuals’ loved ones, and/or the evidence-based decisions of health professionals. References 1) Smith J. A good death, or a public one? BMJ 2005; 330: 7495.0 2) Burry JN. Darwinian Original Sin. Adelaide, SA, 2004. Competing interests: None declared |
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Colin Brewer, retired SW1W 9NP
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Roman Catholic attitudes to suicide and voluntary euthanasia.
Dear Editor Grayling’s no-nonsense editorial rightly equates voluntary euthanasia with assisted suicide. While we wait for the new Pope to pronounce on these matters, it is interesting that the Vatican seems to have discreetly changed its attitudes to suicide in the past century or two. Notably, when the Bishop of Karachi, John Joseph, shot himself through the head in May 1998 outside a Pakistani courthouse in protest against the trial for blasphemy of a young Pakistani Christian parishioner, Ayyub Masih, who faced a death sentence. It seems from contemporary accounts that though his suicide came as a great shock, Bishop Joseph had told several people that he intended to protest against the trial and the blasphemy law in some unusual and striking way in the hope that it might help Ayyub. He was right about that but according to long-standing Catholic doctrine, the reward for his courageous, altruistic and clearly well-planned sacrifice is eternal damnation. Theologically, suicide is among the most dreadful of Catholic sins, arguably worse even than murder because of the impossibility of subsequent confession and absolution. It is not an Old or New Testament sin and did not become a Catholic sin until, in 562 AD, the Council of Braga denied funeral rites to all suicides.(1) Yet Rome did not dishonour Bishop Joseph by insisting on burial in unconsecrated ground and posthumously excommunicating him, which it no longer does. Neither did it get round the problem (thus devaluing his suicide) by proclaiming, as is sometimes appropriate, that he must have been mentally ill. Bishop Joseph’s martyrdom probably did save Ayyub’s life. It provoked no outbreak of religious tolerance among Islamic militants but what about the Vatican? If it can so comprehensively overturn one 1400-year-old doctrine, why can't it do the same for contraception and abortion, which were much more recently anathematised? Incidentally, a few centuries ago, Bishop Joseph’s episcopal predecessors were being even nastier to blasphemers than today’s Islamic extremists. The mullahs may be a bit old-fashioned but they don’t have their victims burned alive. I really resent lectures on the sanctity of life from the spiritual heirs of Torquemada. Yours etc. Colin Brewer
Competing interests: None declared |
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