Original link: https://www.skyue.com/22092521.html
Recently I read a book “The Euthanasia Scene” and a movie “Eternal Sleep”.
The former is written by Japanese journalist Miyashita Yoichi. He interviewed many patients, family members and doctors in countries where euthanasia is legal and illegal, and personally witnessed some of the euthanasia scenes. It is a very good first-hand information, you can see the status quo of euthanasia in different cultures and societies, as well as people’s views on euthanasia.
The film is based on a Spanish case mentioned in the book (euthanasia was not yet legal when it happened). It was released in 2004 and won the Best Foreign Language Film at the 77th Academy Awards.
This article attempts to sort out the relevant content.
Definition of Euthanasia
Broadly speaking, euthanasia can be roughly divided into the following four categories:
- Active euthanasia: A doctor administers a drug to a patient, causing the patient to die.
- Assisted suicide: The patient takes his own life with the lethal drug given by the doctor.
- Passive Euthanasia: Termination of life-prolonging therapy. For example, those who rely on various equipment and medicines to hang their last breath, turn off the equipment or stop taking medicines.
- End-of-life sedation: The act of administering sedatives to terminally ill patients that ultimately shortens their lives.
When discussing “euthanasia” in the daily context, it generally refers to the two categories of 1 and 2, both of which are subjectively requested by the patient (the family member of the unconscious patient) to end their life in advance, but the execution method is different. Euthanasia mentioned in this article refers to 1 or 2.
The difference between the two ways
Active euthanasia and assisted suicide have different psychological effects on patients and doctors.
In voluntary euthanasia, the doctor directly performs the operation, and there is the psychological pressure of “killing”, but assisted suicide is better. There are also patients who prefer assisted suicide, so that the final death is completely under their own control, without artificial hands.
euthanasia conditions
This section is for countries that have legalized euthanasia.
First of all, euthanasia must be voluntary , there is no doubt about this, otherwise it is a crime of homicide. Secondly, not all people who want to die can be euthanized. Generally, two objective conditions need to be met:
- have unbearable pain
- no hope of cure
That is, it only targets specific patients. These two conditions, although objective conditions, are actually very difficult to quantify.
What is ” unbearable pain “? For physiological diseases such as cancer, although there are physiological indicators to assist, it also depends to a large extent on the patient’s willpower, and the doctor’s opinion can easily affect the patient’s psychology.
What is even more difficult is mental illness. In the communication with experts, the author summarized three points:
- From teenage years, to the mental hospital many times, and not cured
- Have had multiple suicide attempts
- have a biological problem with serotonin deficiency
These three points, when implemented, are actually not easy to quantify.
” There is no hope of cure ” is more of a probability issue in many cases, and different doctors may have different opinions. Patients who are actively euthanized often have months or even years to live, and with the development of medicine, there may also be hope for a cure.
” I am voluntarily ” may also be doubtful. Is the patient completely following his own heart, or is it a decision made by external pressure?
In short, the approval of conditions for euthanasia is not easy to implement, and there is room for subjective judgment, which is also an important aspect of euthanasia controversy .
At present, countries that have legalized euthanasia have set up mechanisms such as “certification of multiple qualified and unrelated doctors” in the approval process, “joint review by a committee composed of doctors and lawyers”, etc., all to reduce the risk of individuals Subjective misjudgment.
Physician’s Responsibilities
The book tells the story of a patient in Oregon (the first legal state for euthanasia in the United States), Janet. After she was confirmed to have cancer, she wanted to choose euthanasia, but under the persuasion of the attending doctor Stevenson, After receiving radiation therapy, he was miraculously cured and is still alive (more than ten years).
Janet said afterwards: “It wasn’t the pain that bothered me, it was the fear.”
This is that the physical intolerable pain has not yet come, and the spiritual fear of the future has become intolerable .
The importance of this case is that when euthanasia becomes a legal option, the different attitudes of doctors may affect a person’s life and death .
The patient’s wishes are important, but the patient’s professional knowledge is limited. When making an impulsive decision in fear, the doctor can make a sufficient and objective judgment.
patients and families
Another important controversy in euthanasia is family ethics, that is, the relationship between patients and their families. To put it bluntly: Is death an entirely personal matter?
Much of the book is devoted to interviews with family members of patients, including the family of the protagonist of “Eternal Sleep in the Deep Sea”. This case is particularly explanatory, and here is the introduction:
The protagonist is called Raymond, who was paraplegic in a high position due to an accident in his 20s, unable to move below the neck. The local religion and culture do not allow euthanasia (nor does the law allow), and his brother and sister-in-law have been taking care of him, which can be said to be hard-working. Maybe it was because he had been in bed for too long, and he wanted to be euthanized, but his family didn’t agree. He applied to the court to legalize euthanasia, and the lawsuit hit the Supreme Court for a time, but it was not passed. Eventually, he got a copy of cyanide with the help of a friend and committed suicide in front of the camera. The footage was later made public.
He said the following in front of the camera:
“Judges, politicians, religious gentlemen, what does dignity mean to you? No matter what you think, it is not a dignified way of living for me. Today, at least I want to be dignified Die. (Abstract) The mind, which is to say consciousness, is my thing. As you can see, I have a glass of water with potassium cyanide next to me. Drink it, and vital bodily functions stop, and I I will die. It is a right to live, not an obligation like me. As an obligation, I have lived for 29 years, 4 months and a few days, and even if these are weighed on a scale, the word happiness cannot be found .”
Among the friends who helped him, an important person was his girlfriend, Ramona. Because of this, she was in the center of public opinion, and was always hated by the Raymond family (in the interview, her own statement).
The movie largely restores the story, but in the movie, the process of Raymond drinking cyanide to his death is simplified. According to Ramona’s description, Ramon struggled in pain for 30 minutes, unable to bear to look directly. If euthanasia can be done legally, this pain can be avoided .
In the book there is a dialogue between the author and Jose (Raymond’s brother) that left a deep impression on me:
I changed the point of entry and continued to ask.
“What would you do if you were bedridden and wanted to die but couldn’t?”
In an instant, the room was silent. After a few seconds, Jose said:
“I would choose euthanasia.”
I didn’t understand for a while, are you talking about euthanasia? Does Jose, who sees Ramona as a criminal, choose euthanasia? Jose shouted angrily again:
” I don’t care. But if it’s my family, I can’t do it! I can’t! “
Here, I would like to add another scene in the movie: when the younger brother proposed euthanasia, Jose was very angry, and expressed his inner pain, to the effect of taking care of you, I also gave up a lot.
Both brothers are suffering. The crux is: the relationship between personal death and relatives is not only limited to family affection, but also related to social ethics. Family affection is only an objective blood relationship, while ethics is an invisible hand. To live is a right and an obligation.
Ramona commented on Ramon’s family, they are selfish.
If it is pure family love, should you support the family’s decision? In most cases interviewed by the author in countries where euthanasia is legalized, the patients walked peacefully and happily, and most of their family members supported the patient’s decision. One of the patients even threw a party for his own death, and died in the company of relatives and friends after the party.
I can’t help but think of the brothers in ” Tian Dao ” about whether their father should be in a vegetative state or not. Ding Yuanying said, “If your filial piety is at the cost of your father’s pain, I don’t know what that is.” Then his brother retorted: “If your filial piety is at the cost of your father’s death, then I don’t know what it is.”
I don’t know who defines “filial piety”.
Characteristics of euthanized patients
Regarding the characteristics of euthanasia patients, Diane Coleman, president of the American Disabled Agency “Not Dead Yet”, put forward a statement called “4W”. which is:
- White
- Wealthy
- Worried
- Well-educated
Statistically speaking, it is said to be basically consistent, but from the book interview, there are two more fundamental reasons behind it:
- Patients have seen relatives or friends go through the pain of the same disease (people in Kochi often know what the disease means), further creating anxiety and fear. Some of the euthanasia patients in the book are doctors by profession.
- Want to take control of your life (Kochi, wealthy, successful people)
As for white people, I think on the one hand, it is a country where euthanasia is legal, and white people are in the majority in the highly educated + wealthy stage, plus the culture of individualism.
Switzerland is the only country that accepts euthanasia applications from foreigners. When foreigners go to Switzerland, they have to complete various euthanasia application procedures and certifications, which is not a small cost in itself.
The famous Taiwanese host Fu Daren went to Switzerland to perform euthanasia.
The deterrent of euthanasia
The so-called deterrent force of euthanasia, I understand that euthanasia can give patients a placebo effect.
There are many cases in the book. For example, a mentally ill patient became a lot more cheerful after being approved for euthanasia. He began to wonder if he could live for a few more days. In fact, it took a while to execute.
A little unexpected, but also reasonable. Knowing when you will die, or knowing that you can die at any time in a painless way, removes the uncertainty of the future.
Treat each day as the last day of your life, roughly.
at last
Let me talk about the opportunity to read this book. In August, I went to Zhejiang University to have an MRI. While waiting in the aisle, I saw several critically ill patients pushed past my eyes, some covered in blood, those with tubes inserted, and unconscious. Waking up, in short, gives a feeling of despair.
It happened that my leg was injured and I had difficulty moving. I was thinking, if one day I can’t take care of myself at all, or suffer from a terminal illness and the pain is unbearable, why don’t you give me a treat.
Live or die, refuse to be half-dead.
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