Tag Archives: Euthanasia

Transdermal patches for a rational voluntary death?

James Park is one of our favourite contemporary philosophers, and like us he is a proponent of the right of people to decide on their own death. However, Park is seriously concerned about what he calls irrational suicide, that is people making an end to their life for futile reasons such losing a job or being rejected by their love, but if they had not chosen to die they would be able to recover from these setbacks and be able to live a happy life.

The problem, according to Park, is that most methods for voluntary death only require one decision: yes or no. And once the decision to commit suicide, a point of no return has been passed. It would be better in his opinion if people who want to die should use a method which would require multiple decisions. This would force people to consider whether their original desire for a voluntary death is actually what they want.

Park therefore proposes voluntary death by dehydration as a method for a rational voluntary death, i.e. the refusal of drinking water by a person with the intent of ending one’s life. Because death in this fashion is not instantaneous and require a period of at least several days, during which the person has to consistently to refuse water, this method precludes its use in an impulse suicide.

He then puts forward several arguments in favour of this method. First this method does not depend on doctors, and that it could be used by everyone. Also he states that no change of law is required, but this depends on the jurisdiction where one lives and in many countries doctors will put you on intensive care if you has lost your consciousness (but not yet your life) in this way.

But most important is his claim that this method is relatively painless. But this claim is highly questionable, and evidence suggests that voluntary dehydration does cause great suffering. But given that most people will agree with Park’s concern about irrational suicide, could we design a humane but slow method of voluntary death?

I think the answer might be found in transdermal patches. Unlike pills or potions, transdermal patches are designed to administer low doses of a drug to the body over a longer period of time. A well-known example of such devices are nicotine patches, but another example are contraceptive patches and there are several other applications.

What properties should the drug used in this type of transdermal patch have? First, the drug should be able to permeate through the skin into the blood stream. Second, the drug should have a long biological half-life, i.e. the rate in which the body removes this drug should be lower than the rate in which it is administered and hence enables a build-up of the drug in the body. Third, the drug should have a high lethal dose. This means that a large amount of drug should be present in the body before death will occur, this will prolong the time between the attachment of the patch and ultimate death.

A fourth but very important property would be that until the lethal threshold level is reached, the drug should have no or only minimal side effects. And as fifth and final property, is that if the patch is removed before the point of no return, total recovery is possible.

These properties together will ensure that the use of transdermal patches as a method for voluntary death, will not lead to irrational suicides.

In order to guarantee a responsible distribution of these patches, we propose that these devices will only be available through a thanatologist (a medical profession proposed by A. C. Grayling, specialized in euthanasia in order to free other medical personal from this practice). People should be certain that patches provided by licensed thanatologists are save and reliable. An additional benefit is that when a person requests a patch, the thanatologist can have a conversation with this person on why one wants put an end to his or her life, and whether this is the only solution.

Assisted Suicide

Yesterday a Dutch court found Albert Heringa guilty of assisting his step-mother with committing suicide. Though the judges were convinced of his guilt, they refused to punish Heringa for his actions, because he acted out of love.

We of Republic of Lagrangia believe that people should have to right to determine whether they should live or not, and as such we believe that assisted suicide should be legal, albeit with the necessary regulations.

Of course, this case has opened a controversial issue, as is demonstrated by the comments beneath the news article. One of those commenters remarked that allowing assisted suicide would set open the door to “Nazi eugenics“. This comment clearly shows a certain ignorance. First, euthanasia or assisted suicide as such have nothing to do with eugenics, which is the systematic improvement of human genotypes. Secondly, what they Nazis did with their Aktion T4 can described at best as involuntary euthanasia, which is fundamentally different from voluntary euthanasia or assisted suicide. The latter are done at request of the person who will be killed, whereas involuntary euthanasia is nothing else than murder, which will and should remain prohibited.

An other objection raised, is that this would lead to elder abuse and manipulation by (greedy) relatives. The last problem is easy to solve if, as we have proposed, a progressive inheritance tax would be levied. With such a tax, people will only inherit only little wealth, so a strong motive for manipulating one’s relatives to commit suicide will be removed. The abuse of the elderly is a severe problem, and will not be solved by banning assisted suicide. Tackling this issue is a complex matter, and proposing simplistic solutions will not necessarily help anyone.

In order to ensure that euthanasia or assisted suicide only happen voluntarily, proper regulations has to be designed. For instance, a video will could be required before any life-ending decision could be made.

See also

Euthanasia and capital punishment

Euthanasia and capital punishment

The participation of medical professionals in both euthanasia and capital punishment is controversial. Lethal injection is a common procedure in both practices, but it requires trained skills to perform it properly. Ideally, either physicians or anaesthetists should carry out the injections. However, traditional medical ethics (the Hippocratic Oath) prevents medical practitioners from administering people lethal substances.

British humanist philosopher A. C. Grayling argued for the introduction of thanatologists: medical professionals specialized in human euthanasia. Though Grayling does not point out a specific method of euthanasia, it’s reasonable to assume that he is thinking about either some kind of lethal injections or some pill (“Pil van Drion” in Dutch). However, they are other possible methods for euthanasia.

Canadian-American philosopher James Park argues for the abolition of the death penalty around world, and to replace it with imprisonment for life. However, Park agrees with Peter Moskos that:

the sadism inherent in long-term imprisonment, especially solitary confinement, should give pause to all who have the slightest bit of human empathy. Is anything worse than being entombed alive? (Moskos p. 50, 2011).

Imprisonment, life sentences in particular, have been described by many as a kind of torture. For those criminals sentences to temporary prison sentences, Moskos has proposed to offer the condemned a choice between either a several years in prison or to be flogged instead (with subsequent release). But Moskos has to accept that some criminals (including murderers, serial rapists, child molesters and terrorists) are so dangerous that they have to be kept away from society, for ever.

However, if we accept that imprisonment is a kind of torture, than life-imprisonment becomes a serious moral problem. This argument is used in favour of the death penalty, since some supporters of the death penalty see it as a more humane alternative for life-imprisonment. (Conversely, some opponents of the death penalty are using this to describe the death penalty as too soft.)

In order to solve this moral dilemma, James Park has proposed to offer those condemned to life without parole the option of voluntary execution. In his proposal, the prisoner will select the date of his or her execution (at least a year into the future). During the time up to the execution the prisoner can reverse his or her decision. Further the prisoner who desires to be executed, has to make twelve requests for it to be sent to trusted person outside the prison system. Park also proposes several safe-guards to ensure that the decision to be executed is made voluntarily by the prisoners (i.e. without pressure from the authorities).

Additionally Park argues for giving prisoners the option to donate their organs after their (voluntary) execution, which could save the lives of up to seven persons. This requirement severely restricts the number of execution methods which can be used. Although Park mentions brain death as an execution method, he does not say how to induce brain death in people. But there is an execution method which is both humane and leaves the organs suitable for donation.

This method is inert gas asphyxiation. As explained on Wikipedia:

Inert gas asphyxiation is a form of asphyxiation which results from respiration of inert gas in the absence of oxygen rather than atmospheric air (a mixture of oxygen and the inert nitrogen). The painful experience of suffocation is not caused by lack of oxygen, but because carbon dioxide builds up in the bloodstream, instead of being exhaled as under normal circumstances. With inert gas asphyxiation, carbon dioxide is exhaled normally, and no such pain experience occurs.

Therefore inert gas asphyxiation is a relatively humane way to cause death. This method works also quickly, unconsciousness within fifteen seconds and death within a minute. As method for euthanasia, it has the additional benefit of causing a state of euphoria in the person dying in such manner. What way of dying is better than dying in euphoria?

However, this aspect is reason for some supporters to oppose this method for executions. But since this method only requires a bottle of nitrogen, a tube and a mask, inert gas asphyxiation does not depend on the use of medical skills. This fact makes it suitable for use by Grayling’s thanatologists. With a simple and fast method for euthanasia, thanatologists can focus on counselling their patients and their loved-ones.

References

Moskos, Peter 2011. In defense of flogging. Basic Books, New York.

How to kill a human being, part 5. BBC Horizon. 2008.