Contents:
Lifting the Weight of Misery
Animals and Medical Science: Vision of a New Era
As a Man Thinketh: Effects of the Media
Woman on the Threshold
On Capital Punishment
Physician Assisted Suicide: Questions and Answers
Physician Assisted Suicide
by Alan E. Donant
Dr. Jack Kevorkian, populist exponent of physician assisted suicide, was asked in an interview by William F. Buckley Jr., whether he had read any writings of Buddhism, Lao-Tzu, Confucius, Plato, or the Bible. Dr. Kevorkian responded he had never read any such books. It was a perceptive question that puts the argument squarely where it belongs. Without a broad philosophical and spiritual component to the discussion of euthanasia, the argument can only limp along in a materialistic fashion, where politics and the courts become arbiters without depth or inner sanctity. Listening to the current debate we should not be surprised to feel there is something lacking. Even discussion of current medical practices are limited largely to the capacity artificially to prolong life or to end it.
When God was pronounced dead in the 60's, an inevitable reexamination of beliefs began. Ever since, there has been an ongoing questioning about the deepest issues of life: birth, death, and divinity. In the long run, the struggle to understand these issues may be fruitful only when we consider the wealth of philosophical and spiritual perspectives available. Moreover, without a new inner sense, new words, concepts, and methods are as meaningless as the old. There has been significant change in people's perceptions of death and noteworthy discussions of near-death experiences. Yet, reincarnation and karma remain a small part of the public debate. When these subjects are brought up, they are often misinterpreted or maligned. It is possible that until these concepts take deep root in public thinking, it may be difficult to reach any meaningful insights into the deeper issues of life.
All religions are unanimous in the belief that our essence does not die, nor are we our body. What, then, is the argument about? A very real part of our apprehension is over the pain and suffering with which we must occasionally deal. Another part seems to concern who is in charge at the moment of transition: the state, the church, the doctors, or the patient. When industry, church, and state have first say, where does one find dignity when suffering? As theosophists, we acknowledge that our decision-making self is, all too often, our personality, the temporary aspect of our being, not our inner self. The issue is: what do we, the daily mask, know of the laws of nature? Is our personality competent to make such far-reaching, irrevocable decisions?
Euthanasia, “good death,” in the form of physician assisted suicide has been legalized in the Northern Territory of Australia and is currently under debate in their federal government. It is tolerated in The Netherlands. In the United States it has been on ballots in California, Washington, and Oregon. In 1994 Oregon approved the first law in the world in favor of assisted suicide, the constitutionality of which has been challenged in the lower courts. A ruling by the Supreme Court is expected in July of 1997.
Discussion of euthanasia requires an ever-awakening understanding of what life is. What insights can be gained by applying reincarnation, karma, evolution, the sevenfold structure of nature, cycles, and other theosophic themes to the subject of euthanasia? Given these, we realize that death does not begin, nor is it complete, with shedding of the physical form. It is an ongoing inner process
— initiated by the higher self. Then, like the death of the cosmos, the cohesive forces are withdrawn and the bodies on each of the lower four levels of the septenary constitution decay. The reincarnating ego is indrawn into the inner core of being where it resides until necessity compels it to embody once again. No mere isolated inconvenience, death is a universal process where every manifestation is an aspect of the Unknowable, where every divine spark passes through every event and elemental form of the phenomenal world — thus ascending through all the degrees of intelligence, from the lowest to the highest Manas, from mineral and plant, up to the holiest archangel.... The pivotal doctrine of the Esoteric philosophy admits no privileges or special gifts in man, save those won by his own Ego through personal effort and merit throughout a long series of metempsychoses and reincarnations. -- H. P. Blavatsky, The Secret Doctrine, 1:17
What, we may ask, are the implications for the reincarnating ego of a forced transition? What events and understandings may be left unfulfilled, and what effects are set in motion? Death in its entirety is considered by few; of the principles that make up our sevenfold being, only the physical body is recognized by modern science.
What if premature exit through death's portals becomes the norm? Like all events in our life where the artificial takes precedence over the natural, there may be consequences we cannot foresee. The euthanized being, physically bodiless, yet not dead, may be temporarily trapped, swept along in the astral and/or magnetic currents of earth-life without the protective restraints of the physical body for the remaining period of what would have been the natural life.
The metaphysics of death must be an ongoing consideration throughout life, not one confined to moments of pain and suffering, nor even to diagnosis, though this is better than nothing at all. Because we have not delved into dying as a lifelong experience we come to these moments with fear, which intensifies pain and suffering on the mental and/or emotional level. As shown in The Netherlands, only 2.3% of the terminally ill consider euthanasia. Yet, fear currently drives the argument as though it applied to all deaths. In fact, over 97% of these deaths occur without unbearable conditions.
What cases are ruled inappropriate for euthanasia? People who think they will suffer and therefore are suffering mentally? People diagnosed with a life-threatening illness but who show no symptoms of unmanageable pain? The depressed? None of these is currently grounds for physician assisted suicide. Nor is withdrawal of life support, when no hope remains, judged assisted suicide. Rather, we are considering the rare cases of conscious physical suffering beyond the tolerance of the patient to withstand. Recognizing that pain and dignity are most often given as justifications for euthanasia, too seldom is hospice, built around death with dignity, part of the equation. Rarely are successful means of pain management applied. And for good reason: few people are well informed, few facilities and knowledgeable professionals exist to provide these services as most medical schools fail to train in these areas, and too little research is done in pain management. Bearing in mind that our medical system emphasizes disease and focuses little upon well-being, one must ask just how far, once a doctor becomes proficient at euthanasia, this practice will go? How early in so-called terminal illness will it be applied? Or under what circumstances will it become “cost effective”?
My experiences with death and my study of theosophy have shaped my opinions. I have been with friends, my own family, and families I did not know when death approached. In each case, though pain was present due to the illnesses, the person was not wracked in agony. Hospice care and management of pain were performed well. In the experiences I have had, people died comfortably, though it surely would have been otherwise had not the goal early on been to be aware of dying easily and naturally without suicide or physician assisted suicide. These events allowed a greater sharing of the meaning of life to take place in wonderful ways I would not have wanted to miss.
In their book Final Gifts the authors, both hospice nurses, confirm the great value and intimacy of death. They tell of the remarkable inner workings they called “near death awareness,” which came forth even when the patient seemed to be unconscious, and the meaningful effects these had on the dying and those remaining here on earth.
The Supreme Court decision on physician assisted suicide will, whatever the ruling if history is any indication, only increase the excitable and visceral responses of the public. It is essential to remind ourselves, without minimizing the importance of the subject, that a very small percentage of deaths is of a nature that would lead a physician, any other assistant, or the patient himself to consider prematurely ending a life. Pain is manageable. Yet the hysteria that develops reinforces the belief that a natural death must be a painful process, an unnecessary and unjust way to end our manifested existence, with little meaning. The vast majority of deaths are not this way at all. Rather than enemy, death speaks with the kindness of a close and loving companion. Death is, after all, nature’s process for the rest and the renewal necessary for the continuation of life.
