An Abstract Discussion of a Concrete Issue. The extensive debate on euthanasia and assisted suicide has been surprisingly abstract. The actual deaths from euthanasia, the reality of death and of putting people to death, have almost never been mentioned. This has partly been due to the broad range of the discussion: stands have been taken by ethicists, theologians, lawyers, sociologists, journalists, citizens writing letters to the editor; very few of them have ever had the misfortune to see how people put a person to death, most have never seen a human being die, and many have never seen a dead body. The debate on euthanasia has been conducted in such a way that the reality of a person's death, and the way it is seen and experienced by those present, has never been revealed. A human being B though he be sick or paralyzed, but a living person, a unity of structure and function incomparable in its complexity and precision, a spirit capable of feeling, hoping, and suffering, reacting to everything in the world, a mind that knows no limits, a world unto himself and a world different from all others, irreplaceable, one of us, loving and loved, bound with innumerable ties to us all--ceases breathing, turns gray and blue, and is no more; after a few hours, cold, rigid, with red blotches on his back, he begins to decay.
After a lifetime of medical practice this is just as difficult to bear as it was at the beginning. There is the same sense of loss, guilt, self-doubt, and the recurrent questions of whether this had to happen, whether I had neglected or overlooked something. The fact that sooner or later we all must go down that road changes nothing, the fragility of human life makes it all the more precious, every day becomes precious, and every hour. Alas, I can no longer say the same about all my colleagues, but all doctors educated in the same spirit that I was feel the same as I do.
It was more than thirty years ago that I first heard of doctors who, motivated by logical reasoning and noble considerations, deliberately caused the death of their patients; but I still find it difficult to believe, despite the obvious evidence. I always have the impression (though I know it to be mistaken) that only genetic mutation can explain such deviant acts. Unlike many who have taken part in the debate, I have had the misfortune to see people being killed: In 1943, along with all the other soldiers in my infantry regiment, I was compelled to witness the execution of two so-called deserters. After that experience, for the rest of my life I have remained convinced that to deliberately put a defenseless person to death, regardless of the reasons, is the most terrible act that one can commit on this earth and the worst evil he can do to himself, to those who aid him, and to all helpless eye-witnesses.
The debate on euthanasia has avoided the specific realities of death and killing. Emotion should indeed be excluded from rational debate, thus images that rouse emotion must be excluded as well. But purely rational debate, excluding all emotions, is not the right way to solve all human problems. This is not the best way to decide to get married, for example; nor is it the right way to consider matters of life and death. We must also know when to trust our emotions. This does not rule out rational thought, but leads to lines of reasoning that differ from those purely abstract ones.
The Ugly Reality. Euthanasia has been praised as an act of charity governed by truth and wisdom. However, the reports from the country where euthanasia is practiced on a large scale do not confirm these claims.
Doctors are the ones who carry out euthanasia, and the medical profession, as any other, has its share of neglectful, intellectually inferior, amoral, or emotionally unstable members. In the past, such doctors now and again failed in their professional duties; but as long as a strong taboo and an absolute legal prohibition protected human life, they did not intentionally kill anyone. With the advent of euthanasia, these inferior doctors seem to have been particularly attracted to this new branch of medical practice.
A neurologist prescribed lethal increases of morphine injections to a 63 year old incompetent patient, had neither explained his intentions to the nurses, nor informed the doctor on duty or the patient's family, left for the weekend and could not be reached when the patient was dying. (652) The doctor who terminated the life of Mrs. H in "a sloppy way" (653) was a drug addict and had previously been disciplined for forgery and for administering treatments beyond his competence.
Doctor B, suspected of having killed twenty inhabitants of the De Terp home for the elderly in The Hague, (654) admitted having performed euthanasia on five persons without their consent or knowledge. (655) Witnesses testified that some of the victims were not even ill, but only senile and querulous, and that the doctor was impatient with older people, reluctant to treat them, frequently absent, and left many decisions to...