DUCK SOUP: We Need a Terminator, Too

Visiting my family over the holidays I heard a troubling story about one of their neighbors. She had returned home from work recently to find her father dead, a suicide. Suffering from a painful terminal cancer he had reached the limit of his endurance and elected to shoot himself in the head. He had set his affairs in order, and even spread a plastic tarp on the floor to minimize the mess, but I don't envy her that last memory of a parent, and I am angry that our laws gave him no other option to end his torment.Presently we are awaiting the first Supreme Court decision about physician assisted suicide. Observers guess the Court may sidestep the issue for now and hand the question back to state legislatures. Doctors are divided about whether helping someone die violates the Hyppocratic Oath, which states, "First, do no harm." Civil libertarians argue for individual rights while social democrats say the state has the obligation to protect people from the possibility of wrongful death. Disabled persons fear that doctors permitted to assuage death could be subtly pressured by insurance companies or H.M.O.s to encourage the exit of expensive patients.The compelling argument I see involves the right of a person to avoid suffering. Every animal reacts to hurt by going somewhere else. What could be a more natural right than avoidance of pain? In recognition of this idea, when a government tortures a prisoner we say it violates a human right, and under our Constitution we are protected from "cruel and unusual punishments." In effect, the medical technology that keeps sick people alive longer these days makes them prisoners of the health care system and forcing prisoners to endure protracted pain fits the definition of torture.I can understand the reluctance expressed by many physicians concerning their role in such cases, and the obvious solution is to create a new profession. Maybe we can call them Terminators. What I have in mind is more a Kubler-Ross character than a Schwarzenegger. A Terminator would hold degrees in pharmacology and psychology with emphasis on counseling and the study of death and dying. Specifically, a Terminator would not be a doctor.When a patient's physicians agree that a condition is terminal, the person could choose to discuss options with the Terminator. As a death and pharmaceutical expert, such a professional could discuss the patient's future in meaningful terms: how painful the dying process might be whether caused by disease or medication, how pain killers will affect mental processes, and most important, how the whole issue of death and dying fits into the patient's spiritual framework. Then the patient could make an informed decision.It is not as if current law actually prevents therapeutic suicide. All we do now is make it difficult. There have always been proverbial elderly Eskimo's who walk out on the ice when their useful days are over. There are those who illegally obtain pills, and others who own and use guns. A year ago, the writer Helen Nearing, whose husband Scott had starved himself to death when he was ready to die, tidied up her business affairs and drove her car head-on into a tree. Did she lose control or act while she still had control of her life? I believe it was the latter and admire her courage.The situation is apt to get a lot worse in the near future. Medical science may soon discover cures for numerous cancers and other diseases. Paradoxically this could make old age more miserable instead of less.According to recent studies, a seventy year old American woman now has a life expectancy of fifteen years, twelve of independent living, and three years in which she requires total care. If all cancers disappeared, it would add fourteen months to her life, half of which would require total care. Thus, even a miracle cure adds to the days we are likely to be sick, drugged, miserable and a huge financial burden to families or society.When I reach that bridge, whether the law says yeah or nay, I will find a way out. I hope I will be able to seek the help of a trained and caring Terminator to facilitate a dignified exit, and not have to gamble on do-it-yourself guessing games when I crave surcease from pain.