It is nearing the end of 2020, and those of us following the waves of the Covid 19 pandemic are well aware of how New Zealand has distinguished itself on its timely and efficient response to the coronavirus.
It launched what are referred to as “successful non pharmaceutical interventions”,which resulted in the lowest death rate in the developed world, roughly 4 per a million people, 49 times lower than the OECD average. Therefore, it seems rather incongruous that a country lauded the world over for saving lives, is now considering legalising euthanasia, or the termination of life by the deliberate action (or inaction)of a physician.
Euthanasia is not the same as ‘assisted suicide’,where the doctor prescribes, but does not administer a lethal dose of medication, or ‘mercy killing’ performed by a patient's family or friends. Active euthanasia is the direct intervention of a physician, while passive euthanasia is the decision to relinquish life sustaining treatment. It is argued that the phrase ‘passive euthanasia’is a contradiction in terms, as wil ful (in)action itself does not directly cause death, and therefore is not a form of euthanasia at all.
If we were to examine euthanasia from the Islamic perspective, we need to first understand what exactly the termination of life is. It is death, or the separation of the soul and the body and the beginning of the afterlife, not merely the cessation of breathing or falling into an irreversible coma.
In Islam death is predestined, and therefore suicide or taking one’s own life is unacceptable. Active euthanasia is tantamount to killing a person, as are assisted suicide and mercy killing; passive euthanasia is riddled with ambiguities and debates because of the advances in technology which have rendered an exact determination of a medical death uncertain. There is also concern that a precipitous declaration of death could sanction organ harvesting for transplantation, and thereby violate the sanctity of saving life.
In the non-Islamic societies, euthanasia itself is a contentious issue. It is supported by those who believe that mentally competent patients have a right to control their own medical treatment and this includes the right to request and receive what is viewed as a ‘voluntary euthanasia’ in the case of unbearable pain and suffering or a terminal condition.
The proponents against euthanasia argue that legalising it would lead to the vulnerable or mentally incapacitated being euthanised without their consent, or the elderly or chronically ill being encouraged or pressurised to consent to end their lives to reduce the burden of financial or emotional strain on their families or carers, that voluntary would stealthily become involuntary. They maintain that euthanasia could be a dangerous discriminatory tool against racial minorities, and could become a mandate to take away the lives of the defenceless and the disabled.
From a medical perspective, the fundamental core of the Hippocratic Oath is the total commitment to saving lives, and euthanasia is a complete contradiction of physicians as healers, and medicine as a healing profession. Furthermore, it diminishes the importance of end – of - life care.
Then why at this stage, with the onset of fatalities in the second Covid 19 wave is New Zealand considering legalising euthanasia? Possibly because the subtext of saving lives is efficiently saving lives and/or conserving the means to saving lives.
The coronavirus demonstrated how health systems can quickly become overwhelmed,how with limited medical resources physicians make choices as to which lives to save, how exposed medical staff are to infections, and how palliative or old age care comes undone in the face of contagion. It reduced human beings to in, out, and intensive care patients, and stripped death of the dignity of rituals. A deceased is now a number, Covid or non-Covid, and end of life is mired in calculations and statistics, and discussions of termination of life, be it active or passive, can now be had without any hysteria. Whatever the reasons, with no end to the pandemic in sight, we may soon be hearing a lot more about euthanasia, and not just from New Zealand.
Chintamoni grew up in Dhaka, where she will always belong, but never quite fit in. She is an enthusiastic traveller, a compulsive procrastinator, and a contumelious raconteur.