Pulling the Plug or Never Plugging In
The key considerations in determining if it is morally acceptable to either not implement or discontinue the use of various treatments or services are:
1. The current condition of the patient in being able to receive such treatments or services.
2. The likelihood of any benefit from a treatment or service.
3. Whether or not a new cause of death will be introduced by doing X or Y or Z (or refraining from doing X or Y or Z).
Accordingly, if a decision is made to not implement or discontinue the use of a feeding tube and/or hydration IV and/or ventilator, etc., …or to not resuscitate a patient, and this causes a person to die of dehydration (lack of feeding also brings about dehydration), and/or suffocation, or heart failure, etc. instead of his/her underlying pathology,…another cause of death is brought about, and this is frequently (not always) a form of euthanasia.
In certain circumstances, there are a few exceptions to the approach set forth above, and this is where a good Priest well-versed in Catholic morality should be consulted to help determine if a patient is in such a condition so that specific treatments can be discontinued or bypassed even where another cause of death may be foreseen and possibly come about. In these situations, the underlying pathology is essentially preventing numbers 1 and/or 2 from being beneficially engaged.
A precise application of the Rule of Double Effect (see my post of April 1, 2012) is oftentimes required in end-of-life decision-making.
“Liberty and Autonomy” in Choosing Euthanasia or Physician-Assisted Suicide
What liberty or autonomy is being enjoyed when a person is deprived of the one thing that makes it possible to enjoy liberty and autonomy – his or her life?
Euthanasia as a “Dignified Death”
All human beings have dignity in virtue of their being human. If we truly love and respect our fellow human beings, it shouldn’t matter what they look like or what state they are in. They do not lose their dignity because they can no longer function like they used to, or because they are physically incapacitated in one form or another. Those who make such false claims about “dignity” only appreciate the value of human beings based upon whether or not they can perform certain functions. Where is the real love and respect?
A human being can never be a vegetable. It is most regrettable that some people view others this way because of their severe incapacitation. Such a view manifests a tremendous disrespect (intentional or unintentional) for the suffering person by considering him or her to be less than human and a mere member of the plant community.
Others Distress From Observing a Suffering Patient
This is understandable. However, please consider the following: Should not our compassion for the person suffering from a major illness/injury override our own feelings of mental distress from witnessing the effects on the loved one or others? If we truly love someone in significant physical distress, should we consider our own mental suffering and/or the mental anguish of others a significant factor to take into account in making the most important decisions impacting the life of another human being?
The Meaning of Suicide and Asking Doctors to Assist
Always keep in mind that suicide means self-murder. To bring somebody else into the act like a physician is to make them an accomplice to murder.