Skip to main content

What is the purpose of prolonging life in painful terminal diseases?

Let us examine the problem from the point of view of rational ethics based on anthropological grounds. By rational, I mean a discourse whose statements are not contradictory among themselves, and by anthropological grounds, I mean a non-transcendental valuation of life, a human axiology. Particularly, I will use two anthropological ethic principles:
P.1 Principle of life preservation: We have to preserve human life.
P.2 Principle of primacy of the public interest: the life of the group has preference over the life of the individual. Human individual life is conditioned by the life of the group and subsumed to its needs. Not only my actions are rightful when they do not imply any sort of harm to others, but they cannot be autonomous when there is an urgent need of the society: we work and die for the group whenever is needed. And since the needs of society are always urgent, life preservation is limited by public interest, as has always been the case with wars.

In relation to our question, we can imagine, at least, the following scenarios for a dying patient in pain:

1   I.  The patient is sustained by public funds.      
           a. Society denies further sustenance for it is an incurable disease and cannot benefit from the situation. 
      b. Society agrees to sustain the patient despite the non-economic benefits of the situation.
1.   The community wants the person to live longer in pain.
2.  The community wants the person to live longer but not in pain.
3.  The community leaves the choice to the individual.
2      II.  The patient is self-sustained.
a.   Still the society wants to exercise control.
1.    Society wants the individual to suffer.
2.    Society wants the individual to live longer but not to suffer.
b.  Society declares the case to be a private choice.

In case I.a, when the patient is sustained by private funds and society denies further sustenance, we are dealing with a rational choice according to principles 1 and 2, for P1 cannot be enacted (is a terminal disease), and there is nothing positive for the patient (supposing that s/he is driven by the principle of avoiding pain) in the situation. The rational action is assisted death.

The second choice (I.b) has, in turn, three scenarios. The first one, I.b.1 is not as rare as it would seem. Such is the case with criminals or by religious motives in which the valuation of pain extends beyond this life to other worlds. There are religious ethical values that consider suffering as a way for purgation in the context of otherworld scenarios. In this case, is not the principle of life preservation that is at work, but a principle of punishments and rewards on a transmundane scale. This is contrary both to any anthropological principles and to the structure of most of our legal systems. Since this punishment does not serve any practical purpose for the community, beyond sadistic morbid satisfaction, it obeys only non-rational valuations, therefore are not part of rational ethics.

The second scenario of the second choice, I.b.2, when the community wants the person to live his/her final days without pain, does not affect the principle of life preservation, for life cannot be preserved in this case, and also conforms to the public interest principle, which in this case is to alleviate the patient’s pain. The rational action is the alleviation of pain whether by the increase of medication for relief or by the shortening of the condition of pain. If pain cannot be alleviated, the rational outcome of the scenario is assisted death, for since P1 cannot be accomplished and the choice is not to suffer, it can only be obtained by shortening the duration of pain.

The third scenario, I.b.3, is to leave the choice to the patient, which will decide therefore either to continue his/her suffering to the very end or to suicide. None of these decisions is contrary to the ethical principle of life preservation nor to the one of public interest, for life cannot be prolonged and the community has passed the choice to the patient, i.e., has given the ownership of life to the individual. This case is equivalent to II.2.b, and both are rational actions.

Case II.a. 1, when the patient is self-sustained and society still wants to control the life of the individual for it wants him to suffer (for whatever ethical or metaphysical reasons) is equivalent to the 1.b.1, and therefore, is not a choice of rational ethics. On the other hand, case 2.a.2, is analogous to 1.b.2, and represents a choice of rational ethics which developed to its consequences leads to assisted death.

Therefore, pain can only be prolonged in terminal disease cases under non-rational ethical principles, whether those corresponding to the personal choice of the individual or the group.
Labels:

Comments

Post a Comment

Please write here your comments

Popular posts from this blog

Limen et Continuum

  Existence is Encounter. Meeting at the limen. In the limen, the masks disappear, that is, the basic intuitions of identities, such as the identity that I feel and think in relation to the tree that I see in front of me. The identity of the tree is a projection of mine: the unity of my process of perceiving the tree generates a mask in me, the ghost of a limited unity separated from everything else. The simplest form of intuitive understanding of masks and limen is given to us by numbers. Numbers intuitively express the liminal tension that is Existence. A little etymological note. Rythmos in Greek means flow. Arythmos (number) is what does not flow, what remains solidified. Numbers express the liminoid, and flow, rhythm, expresses the liminal. A rhythm becomes liminoid when we can trace patterns in it, that is, when we can construct masks of identities. Mathematics has spoken of flow using the Latin word “continuum”, the continuous. All modern science, since Leibni...
Post a Comment
Read more

Ritual, Scientific Experiment and Truth

 Human rituals have their roots in animal behavior, and the animal pattern has its roots in the need for repetition of living organisms, in the cyclical structure of physiological actions. At the human level, ritual behavior involves a delimitation of space and time, as well as a different meaning of both with respect to the spaces and times of everyday experience. From the ritual ceremonies of cold societies, we observe the care and thoroughness of the shaman to determine with precision the spaces, times and elements that intervene in the rite. Sacred space delimits the world, not only as a place of action, but also the scope of meaning of the things contained in that space. It is a space loaded with meaning: there is an order in things. Time itself acquires its meaning in relation to this order of things, and cyclically closes the space in the “tempo” of the rite, a tempo that is a symbol of the tempo of the World. What is not in the rite or is not referable to the rite has no re...
Post a Comment
Read more

What do we marry?

  The narrative tradition of India contains true gems of fantastic literature that give rise to the most entertaining ethical and metaphysical speculations. In the collection of stories from the 11th century Katha-Sarit-Sagara ( The Ocean that Contains Streams of Stories ), which collects traditional stories from India, the loquacious ghost of a corpse taken down from a gallows tells the king who took him off the macabre swing a very interesting tragicomic tale. Two friends undertook a pilgrimage to a sacred spa of the goddess Kali, and there they saw a beautiful girl. One of them fell ill with passion, stopped eating and sleeping, and was sure that he would die unless he could have that girl as his wife. His friend contacted her father and explained the situation. The father, hurriedly, went to the girl's parents in order to organize the wedding. Shortly after the hasty marriage, the young couple and her friend left for her parents' house. On the way, they ca...
Post a Comment
Read more