Finlay promotes life and death with dignity - Coombs Lee considers life to be a prolonged imprisonment

By Alex Schadenberg

Rarely do you read two articles published on the same day that promote an opposite point of view. Today (July 15, 2009) those two articles came up in my inbox, one from the UK and one from America.

The first article was written by Barbara Coombs Lee who is the leader of the Compassion & Choices suicide lobby group in America. Her article - Healthcare Reform and the Price of Torture
promotes a pessimistic point of view about life, one that would lead one to consider death as preferable to growing old, living with disability or living with chronic or life-limiting medical conditions.

The second article was written by Baroness Finlay, an independent member of the House of Lords in the UK and a Professor of Palliative Medicine at the University of Cardiff who wrote an article titled - Don’t fear death. Enjoy the setting sun.

My first reaction to the Coombs Lee article was how the concept of Choice with connection to euthanasia and assisted suicide is an illusion. The suicide lobby wants you to believe that legalizing euthanasia or assisted suicide would grant choice and freedom for people to have their life ended based solely on autonomous decisions for competent people.

For instance Coombs Lee states:

"Standard routine is to torture those in the process of dying by inflicting upon them a host of toxic chemicals, invasive machinery and painful surgeries. It's the American way of dying --- agonized and prolonged imprisonment in an intensive care unit, pinned down under a maze of tubes and machines, enduring one medical procedure after another, unable to hold or be held by loved ones."

If end-of-life care in America is based on torturing people who are dying, then it is far more reasonable to find your nearest veterinarian and be "put to sleep."

Coombs Lee continues by stating:

Oncologists entice their dying patients into bearing one more, experimental round of chemotherapy almost certain to intensify toxic symptoms without extending life. Surgeons repair the fractures and amputate the limbs of people clearly only a few weeks from death. The newest medical specialists, "hospital intensivists" deftly thread tubes into failing hearts and attach ventilators to decrepit lungs. Much of the pain they inflict does nothing but monitor the chemistry and pressures of internal crevices and gather the information necessary to thwart a body trying to shut itself down.

Coombs Lee seems to view physicians as the enemy. She describes them as being primarily concerned about invoking extra-ordinary burdensome interventions with no hope of benefit. With Coombs Lee description of care one would have to conclude that physicians are no better than sadistic warriors from another time.

Does Coombs Lee believe that physicians intentionally invoke pain on their patients because physicians generally oppose assisted suicide?

But Coombs Lee has the answer for medical care in America. She is suggesting that health care reform can end the torture by promoting assisted suicide. She states:

“Like all cultural shifts, it must start with the people. The people --- you --- deserve to be able to choose a healthcare plan driven by what patients need, not what profit demands. You deserve a system that pays your doctor to talk with you about peaceful endings when death is imminent. One that pays for hospice care in the home as readily as it pays for intensive care in the hospital. 

“Raise your voice. Make your views known. Talk to your own doctor and to your family. Take action with calls to members of Congress and letters to local news outlets. Ask for healthcare reform to include payment for your doctor to talk to you about your end-of-life wishes. We make it easy for you. Tell them you reject torture at the end of life for yourself and you resent the needless torture of others. Joining together, let's change the American way of dying.”

Notice how Coombs Lee never mentions that she is actually promoting assisted suicide. If she were truly concerned with caring for people who would otherwise be tortured, she would clearly state that she is lobbying government to legalize assisted suicide.

She also doesn’t tell you what assisted suicide is. Assisted Suicide isn’t about choice, or freedom or autonomy, it is giving physicians the right to be directly and intentionally involved with causing my death.

Coombs Lee is saying that the way to get healthcare reform in America is by legalizing assisted suicide. She does say:

"You deserve a system that pays your doctor to talk with you about peaceful endings when death is imminent"

Doctors can already speak to you about end-of-life options, but they cannot speak to you about assisted suicide (directly and intentionally causing your death).

How does giving physicians the right to be directly and involved with causing your death give you choice. It only gives your physician more choice.

Baroness Finlay presents a positive view of life, of aging gracefully and dying with real dignity. She starts her article by stating:

“So why are we increasingly fearful of growing old? People can consider longer working lives to contribute actively to society, precisely because health is better than ever. They can share their wisdom, accrued over years, with others. The trick in being an inspirational older person is perhaps in attitude rather than in physical performance. Of course, none of us wants to be a burden or to feel lonely. However, the future for our connectedness with others, maintaining our role in life and independent living, has never been greater.”

Notice the difference in attitude. Finlay recognizes that life is improving for the elderly whereas Coombs Lee presents life as a type of trap.

Finlay continues by stating:

After spending much of my life treating people who are very seriously ill and dying, I have come to be in awe of death and to realise the amazing uncertainties of life. I have been privileged to be part of a revolution — it’s nothing short of that — in the way that people are treated.

Finlay then extols her experience with the current medical system by stating.

It is paradoxical that, at the same time as we have seen ground-breaking advances in the treatment of serious illness, we see increasingly strident demands for euthanasia. The pressure seems to come from fear of tomorrow rather than from the reality of today. Those who commend euthanasia usually frame their proposals around terminal or chronic illness. But in reality they base their case on personal wish alone and see assisted suicide as another “end of life choice”.

She then explains why the attitude and philosophy of Coombs Lee would not create new choices but in fact exploit people in their most vulnerable condition and eliminate end-of-life choice. She states:

Their demands assume that everyone who is seriously ill can say without difficulty whether they want to be cared for or to end their lives and that no one ever comes under pressure to “do the decent thing”. The real world isn’t like that. Among the thousands of seriously ill patients I have treated, the vast majority are vulnerable to influence. Most people getting old are aware that death is approaching; they want to talk about dying. They often seek reassurance that they are still of value and worth, that they can contribute to society. Very few wanting to talk about dying actually want to die.

Finlay concludes her comments by stating:

We should remember that what we read in the papers and see on TV, whether it is a death from swine flu or a suicide in Switzerland, is the exception rather than the norm — it wouldn’t be news otherwise. And, when we feel inclined to pessimism about the future, we should reflect on what earlier generations had to cope with and ask ourselves how much of our gloom stems from our own changing expectations.

She ended her article with these comments:

It is great to able to grow old. So perhaps we should enjoy the glory of the setting sun.

I choose to follow the direction of Finlay over Coombs Lee. Finlay is about caring for people until they die with dignity whereas Coombs Lee wants us to fear death and give physicians the right to directly and intentionally cause your death.

I believe in Caring not Killing.