The recent case in South Africa in which Advocate Robin Stransham-Ford made a High Court Application to be afforded his constitutional right to human dignity respected and freedom to bodily and psychological integrity guaranteed has brought this issue to the forefront in South Africa. Rather than retrace the sanctity of human life versus the free will/ right to human dignity debate, the focus of this blog will highlight the human cost of not allowing euthanasia under certain rigorously controlled conditions.

The detractors of the dignity of life advocates base their opposition to assisted suicide on the principle of the sanctity of life. The medical profession in particular is incensed at this possible amendment to the Hippocratic Oath. Simply put, this tenet entrenches the right to life as being paramount to the exclusion of all other considerations including severe pain and imminent death.

In practice, doctors probably do assist patients to die with dignity. In these circumstances, their decision not to treat a patient will have the same effect as assisting a patient to die peacefully and rapidly except that in these circumstances, it was not at the express behest of the patient but rather that of the doctor alone. Therein lies the moral dilemma for the medical profession. They do not want to become the final arbiter of life or death

A frequently quoted objection to euthanasia is that it could be the prelude to practising eugenics covertly. In totalitarian societies this may well be a possibility but never in democratic societies. The world has already witnessed this phenomenon in action; the practitioners were the Nazi Regime. In this case, the victims were not some non-Aryan race but rather those individuals identified as Lebensunwertes Leben – “life unworthy of life.” In this case, it was not merely the terminally ill or feebleminded who were classified as such but also those whose people with congenital cognitive and physical disabilities (including feebleminded, epileptic, schizophrenic, manic-depressive, cerebral palsy, neuroatypicals, muscular dystrophy, deaf and the blind to name a few categories).

In his epic chronicle on the social and political implications of Nazism, Nazis – A Warning from History – Lawrence Rees interviews families where even semi-functional individuals were euthanised. A case in point is a blond haired blue eyed youngster of approximately 10 years of age who was able and willing to assist his mother in her daily chores but was ultimately euthanized. His death was recorded as chicken-pox and not a fatal injection.

The supporters of the assisted suicide debate will instead dismiss or discount the possibility that euthanasia will be akin to entering the slippery slope to eugenics. Instead they will in all probably muster examples both from personal experience and from the media to bolster their argument.

I will take certain examples from my private life to support the dividing line between when life is sacrosanct and when euthanasia should be permissible. All of these are drawn from acquaintances in the running fraternity.

Clearly the mere fact of feeblemindedness should never be a consideration for euthanasia. This category of impaired individual can place an immense strain on the family. The burden is usually borne by the wife who has to attend to this child 24 hours a day. In prior centuries and even today in backward societies, the female would have to carry the additional guilt by being unfairly blamed for the child’s condition.

On the running scene there is the example of George, a runner from Roodepoort Athletics Club. He can always be seen at races with his son in his teens. It is incongruous as George has the appearance of a boxer. Before the race he will stand with his arm around his son as if reassuring him whilst on the run they will run hand in hand. The other case is that of Margaret, Vreni’s daughter. Vreni will take her to races where she will happily hand out pamphlets.

Even if both of these people are a burden on their parents due to their feeblemindedness, neither should ever be a candidate for euthanasia based upon their diminished mental capacity. Both are able to function at a level sufficient to be classified as human albeit that they are deemed to be retarded and can never possibly lead a “normal” life.

One of the arguments advanced by the detractors of euthanasia is that palliative care is available to those in pain. The reality is that even morphine is insufficient to dull the pain experienced in many cases.

Take the case of Paul, a fellow runner. Paul suffered from cancer. In the terminal phase of the disease the pain was so intense and unremitting that he phoned many of his running mates in an endeavour to obtain some medication with which to kill himself. Even my father in the terminal stages of colon cancer experienced this excruciating pain.

This gives the lie to Aaron Motsoledi’s – South Africa’s current Minister of Health – contention that this pain can be mitigated during this terminal phase.

Then we can take the example of Neville, also a running acquaintance. Neville’s brother – let’s call him Frank – who is now 71 years old, experienced a number of inexplicable accidents. After the latest incident, it was found that he was suffering from “brain damage”. As he had worked for 40 years adjacent to a petroleum refinery in Durban, it is presumed that these fumes were the cause of the brain damage. Frank is now a resident of a 24/7 care facility as he is unable to take care of himself. The tragedy is that he is not even able to recognise Neville.

Take another example from Neville. Sue – not her real name – was bedridden and unable to look after herself. For 12 years, her husband dutifully looked after her and changed her nappies. Days before her death, her husband was praying for her release and early death. After her death, he immediately repainted the house and gave all her possessions to the Salvation Army. This was not to deny her memory but rather to start a new life with this burden removed.

This is common response after the persons passing. It is not indicative of callousness or inhumanity but rather the removal of a joint burden of suffering and caring to which they selflessly devout their lives knowing that in most cases they will never be rewarded.

South African born Tania Clarence who now lives in London, faced this dilemma. With three of her four children suffered from a rare, life-limiting muscular disorder. Tania had given up her career as a graphic designer to become their primary caregiver. At some point she could no longer emotionally cope with the 3 handicapped children and experienced some form of mental breakdown. This was understandable given the fact that Tania felt overwhelmed by the enormity of the responsibility placed upon her and by the fact that the care-giver’s role entailed her devotion and attention 24/7.

Tania Clarence

In her mental anguish there was no other solution but to murder all three afflicted children. One by one she stood over them, each one in turn, and pressed a pillow over their face until their fragile bodies stopped convulsing. The lifeless bodies of the twins – Max & Ben – and their elder sister Olivia had commenced their eternal sleep, a sleep of innocence and peace. Having suffocated all three, Tania then took another drastic step. She attempted to take her own life, to commit suicide. It was a failure.

In her mental state, Tania had relieved herself of the physical need for a life time of care-giving. One burden would be replaced by another; she will be afflicted by an encumbrance of guilt. Notwithstanding the vanquishing of one burden, a mother’s grief and remorse will forever scar her psyche in spite of ultimately being released from detention in a secure hospital. The loss of a child even if it removes a Sisyphean Task like constant care, often compels that person to contemplate suicide.

Home of Tania Clarence

My running mate on Saturday morning’s 25km Jackie Meckler in Thaba Tshwane – formerly known as Voortrekkerhoogte – unceremoniously pointed to a non-descript badge on his running vest. Let’s call the person Marie-Clare for convenience sake. Apparently this name was that of Neville’s grand-daughter now deceased. When his daughter was six month’s pregnant, tests revealed that the foetus suffered from severe complications. For religious reasons, the aborting of the baby was not considered to be an option. Instead it would be carried to term. The prognosis on birth was that the baby – a girl – would not survive long.

A quote was obtained on the costs to keep this child alive. This amounted to one million Rand per month. Discovery Medical Aid was approached to obtain an understanding of what or if the Medical Aid would assist with the child’s treatment. Without hesitation, Discovery consented to cover the cost of treatment.

From the outset there was no hope of survival yet the family poured all their hopes and efforts into this child.

After 3 months Marie-Clare died. The family was devastated.

For many, this episode would cast grave doubts on their religious convictions. This line of enquiry would take the stance of “why do bad things happen to good or innocent people.” I am unaware whether of what effect it had on the family but being a compassionate person, I could well imagine the hurricane of destruction that it wrought emotionally.

From the plethora of examples provided, I know what I would have elected in these cases – euthanasia. Having said that, when one of the family pets reaches the end of its life and is barely able to function any longer, the decision to put them down is traumatic. Similarly in many of these instances the affected parties are aware that the sufferer’s quality of life is poor at best, yet many will resist the rational notion that they should be euthanised like an animal would be.

Against the howl and din of complaints from the detractors of euthanasia, it is senseless to prolong human life merely for the sake of a religious or moral ideal.

Nothing in life can be an absolute right including the sanctity of life.

The relieving of the unbearable pain and suffering purposely inflicted not only on the sufferer but also the friends and family is also an inalienable right.

The consent of the sufferer, if not comatose, and the family if comatose including a review panel of medical experts should be the final arbiter and not some antiquated moral or religious injunction.

In conclusion, I am a fervent advocate of euthanasia in strictly controlled conditions. Not to do so, one imposes  unnecessary suffering in a terminal situation which is unconscionable.

A fitting epitaph would read, “Your Life. Your Choice.”