Euthanasia - dying with dignity?

In the euthanasia debate, there is much talk of “dying with dignity.” In Switzerland, one of the organisations that assist the seriously ill to commit suicide is even called Dignitas. But is not the notion of a dignified death somewhat oxymoronic? Just how many people are afforded dignity in death?

A close friend of mine recently lost his wife to bone cancer. As her body slowly became engulfed by the invasive and aggressive tumours, her life force was just gradually snuffed out. In life, she had been vibrant, funny and an incredibly strong woman. She had borne and had helped to raise three lovely children and had provided support to countless others through her work as a teacher of children with learning difficulties.

In fact, if anyone was deserving of dignity in death, it was my friend's wife. But as her closest friends would observe, dying from cancer can be a long and painful experience. It was a grossly unjust and unfair end for an elegant and infinitely dignified woman.

In some respects, the terminally ill are able to face their death with much more introspection and consideration than many others, for whom death may come suddenly. And if dignity is afforded in their passing, in most cases it is not a word that typifies the nature of their illnesses.

Death is the antidote to the delusion of immortality to which so many humans aspire. Cosmetics companies, plastic surgeons, health spas and hair replacement clinics, regardless of the effectiveness or otherwise of their products, are in the business of selling ice to Eskimos. The only problem is that the ice caps are melting at a much faster rate than the ice can be sold and supplied. We might be able to slow down the ageing process, but in most cases that's where the illusion of control begins and ends.

As bleak as it may be, death and loneliness are arguably the two inescapable facets of human existence. Not everyone pays their taxes. Everyone dies, and most do not choose the time of their passing. In most cases, the concept of dignity is completely foreign. My Pa suffered a heart attack while taking my Nan shopping and fell into the gutter. Yet, his final undignified moments end the life of a gentleman about whom I still want to hear stories today, and from whom I have inherited my love of cars.

While my Pa died an undignified death, much less dignity is afforded to those killed by roadside bombings in Iraq. None for soldiers and civilians who are killed in conflicts around the world. Despite their growing cultural legend, many of the Anzacs died incredibly futile and undignified deaths. And perhaps most perversely, there is no dignity for those children who die malnourished in the developing world.

If the loudest argument for euthanasia is motivated by a desire to afford dignity to those who are losing the war of attrition with their illnesses, then perhaps we should consider whether others are worthy of such dignity also.

If, as a society, we care whether a wealthy person dying from a motor neurone disease in Australia can choose an early and “dignified” end, then perhaps we should ask whether we care as much when a toddler dies derelict in an African village overrun by poverty, aids and famine. Perhaps we should then ask why the Howard Government has over-promised and under-delivered on aid commitments under the Millennium Development Goals to halve global poverty by 2015.

Human life should be no more valuable in the developed world than in the developing world. Yet it is perhaps surprising that the euthanasia debate is not prominent in the developing world, where mortality rates are so high. It's also worth noting that terminal disease takes a more direct course in the developing world precisely because of the lack of, and the cost of medical alternatives. Without access to life preserving drugs, death is more swift and thus the case for euthanasia is not as strong.

Where death is such a constant reality, maybe the only option is to cling to life, but only for the duration of its natural course. Whereas in the developed world, we have more options than we can possibly exercise. The best doctors can diagnose and treat illnesses, many drugs can prolong life, though none indefinitely, and euthanasia advocates argue that hastened death should be also be an option for the dying.

Perversely, euthanasia may be a more humane option in the developed world than drugs that will extend life for the suffering.

Yet, so often in the West, death is that of which we so often avoid speaking, much less consider. Perhaps it's no surprise that we find ourselves speechless when confronted by death. Eight years ago, I was diagnosed with cancer at the age of 19.

It was during three successive diagnoses and respective chemotherapy regimen, an incredibly invasive treatment, that I devoted considerable time to thinking about the meaning of my existence. One of my resolutions was to write a will, yet despite my surviving cancer, I have still not written my last will and testament. Perhaps it is because my personal wealth is not much higher than the probate solicitor's and executor's fees.

However, the unpreparedness of civilisations to consider death is a perverse delusion. There is no reason to consider the meaning of life if we never intend to die. Slavoj Zizek, a Slovenian philosopher, describes the gap between that which we know and that which we experience as the parallax view. We all know that we will one day die and yet we live as though we will never die.

Climate change, poverty, inequality, injustice and exploitation are facets of our existence that deserve no consideration if our desire is to only to live well. On the other hand, perhaps considering these challenges is in fact the only way to live well. Maybe in the discussion of euthanasia, more consideration will be given to dying well, regardless of the cause of death.

One only has to encounter the miracle of birth to recognise the fragility of life. In many cases the membrane which separates life from death is a lot closer, and much less impervious than we would like to imagine. But in my experience, the questions which arose during my consideration of death, though complex, were not devoid of hope.

Who or what is God? And if God exists, does this change our philosophy toward others? Is there a meaning to life, and if so what's mine? What, if anything, comes after death? And in this life, what lasting legacy will I leave behind when I am gone, when only those who knew me will be able to tell my stories?

In Monty Python's unforgettable Meaning of Life, the dinner party who sup upon the poisoned soup ask the Grim Reaper if they should take their cars. To my mind, this articulates the attitude most people take towards their inevitable end. Everyone loves a bargain, but negotiations with the Grim Reaper are always going to be somewhat unfair, sometimes grossly so.

Perhaps, the notion of dignity and choosing the time and means of one's passing are just part of this process. But however you choose to look at it, and however it comes, for most people death is life's final indignity.