Mercy killing is a term that has long been used to justify euthanasia, when the perpetrator is considered to have acted out to free another from suffering. There is conflict over whether those accused are mercy killers, deserving of compassion from the Courts or whether they are murders who should be prosecuted and convicted.
Many ethicists would justify such actions since the ultimate motive was a good one but others say that the while the ultimate motivation may have been to stop the suffering of the other person, no-one has the right to kill to achieve that end.
Mercy killers and their victims usually fall into one of the following categories:
- Killing terminally/chronically ill, disabled or elderly spouse
- Parents killing disabled child
- Children killing elderly, sick or disabled parent
- Nurses killing a patient
- Doctors killing elderly, sick or disabled patient
- A lover (or friend) killing a terminally ill or disabled ‘other’
Disability rights activists object to the typical media coverage of such cases. US organisation Not Dead Yet, responding to the coverage of a 74 year-old woman who was shot in her hospital bed by her husband issued a press release:
Not Dead Yet and other national disability rights groups have been watching with growing anger and horror as the murders of disabled people of all ages have occurred with what seems like ever-increasing frequency. The news coverage of these tragedies is also a cause for deep concern. Accused murderers of disabled people are often portrayed by reporters as loving, caring individuals acting out of compassion. The Chicago media coverage of the Harrison murder is no exception to this trend.
Specifically, the coverage in the Daily Southtown and the Chicago Sun-Times has been disturbing to read. From the very first story in the Southtown, the speculations of unnamed police officers, neighbors, and a member of the clergy were quoted — all suggesting that Shirley Harrison was “suffering” and that her murder could be described as a “mercy killing.” The Sun-Times published quotes from unnamed police sources that suggest reporters may have actually suggested that police label this murder a “mercy killing.” The Sun-Times recently published a series of articles on elder abuse and should know that it’s unwise to rush to label murders of old, ill or disabled women as “mercy killings.”
In fact, according to the prosecutors, Shirley Harrison did not ask to die. She did not complain of suffering or pain. Her condition was expected to improve.
Domestic violence is all too common in our culture. If the victim of that kind of violence happens to be old, ill or disabled, that’s no reason to assume the violence was an act of mercy. Shirley Harrison’s last moments were spent looking at a gun pointed at her by a person she thought she could trust. It’s hard to imagine a more horrible way to die. The murders of old, ill and disabled people need to be treated in the same way as any other murders — labeling these murders as understandable or excusable can encourage such killings — and deprive all other potential victims of the equal protection of the law and, perhaps their lives. 1
The geriatric Romeo and Juliet scenario
Professor Donna Cohen, who is based in Florida and has led many of the world’s homicide-suicide studies, says the geriatric Romeo and Juliet scenario is the most poignant and palatable explanation for grieving survivors, and for a society that routinely devalues disabled people and the elderly ? except that it’s hardly ever true.
“These are not acts of love. They are not compassionate homicides. They are acts of desperation and depression, other forms of psychopathology, or domestic violence.”
Dr Cohen’s research indicates that older men ? who almost always initiate the acts ? routinely proceed without their wife’s knowledge or consent. She says true pacts occur in perhaps one half of 1 per cent of elder homicide-suicides.
“Kindly elderly husbands are now one of the world’s fastest growing groups of killers” she says. 2
Pointing out that most men are task-orientated, Cohen suggests that they come to the decision to kill their wives because they can’t face the fact that they are unable to care for them. These men are reluctant to have the wife put into a rest home, and in fact imminent hospitalisation of a spouse, a sense that they are losing control of the situation, may be a factor in the homicide-suicide decision.
“There is little awareness that those in 24 hour caring roles could have mental health conditions that may lead to homicide-suicide. If a young and fit couple say to one another, kill me if I become sick or disabled, this can become a license to kill in later life ? and an argument for social and legal sympathy that has proved quite successful in New Zealand.”
“Describing every case as a mercy killing masks the health factors and also trivializes the risk to sick and disabled New Zealanders who have no opportunity to change their minds about comments they may have made when they were young and healthy.” 3
Parents who kill their children
Parents, often out of despair, desperation or simply burnout as caregivers, having killed their disabled or terminally ill child, are usually portrayed sympathetically by the media and often are not convicted, or receive minimal sentences.
In New Zealand in May 2004, a Nelson man was found with the dead body of his five-month old daughter who had been diagnosed, on the day of her death, as having a rare brain disorder – lissencephaly.
During the trial the father admitted holding his hand over his daughter’s face until she stopped breathing. It seemed a clear case, yet it took an eight-woman, four-man jury only 47 minutes to find the baby’s father not guilty of murder or manslaughter.
Disability and child advocacy groups expressed alarm at the verdict, feeling it could erode the rights of severely disabled children and pave the way for them to be killed indiscriminately. 4
Dr Dick Sobsey, Ed D., of the University of Alberta, Canada, in an article Altruistic Filicide: Bioethics or Criminology? considers the difference between those who kill a disabled child out of ‘compassion’ and those who kill a non-disabled child for the same reason:
Resnick’s (1969) classic American study of parents who killed their children found that about 50% rationalized their actions as altruistic. A more recent Canadian Study of 10 fathers who killed their children also classed 50% as altruistic filicides (Marleau, Poulin, Webanck, Roy, & Laporte, 1999).
Not surprisingly, a majority of parents who commit other forms of child abuse also rationalize their behavior as justified (Dietrich, Berkowitz, Kadushin, & McGloin, 1990), often as beneficial to the child.
While only a few parents who kill their children rationalize their behavior on the basis of disease or disability, others kill their children because they want to spare them from poverty, family breakup, discrimination, exploitation, or a wide variety of other real and imagined social ills.
In most cases, the rationales are distorted and irrational. In some case cases, the parents have clear psychopathology but sincerely believe their rationalizations which are often influenced by societal attitudes and beliefs. 5
Killing a parent
A study in the Journal of the American Medical Association points to the fact that the family of a dying or severely disabled person often find it very distressing to watch their loved one. According to the study:
“Surprisingly the drugs were given nearly as often “for the comfort” of the patient’s family as they were give to reduce the suffering of the patient themselves… [Additionally] in four out of every five cases, nurses who had discretion in administering drugs said that they were treating the patients for the comfort of their loved ones.” 6
People who are gravely ill are very vulnerable emotionally. ‘Suicidal thoughts’ and requests for euthanasia or assisted suicide may be unconsciously reinforced by family members who are distressed by the condition and perceived ‘suffering’ of a loved one. 7
In New Zealand we had the prominent case of Lesley Martin, a former intensive nurse who attempted to kill her mother, then wrote a book justifying her action. The book, To Die Like a Dog led to her arrest and eventual conviction. She said her mother had told her she didn’t want to die “inch by inch” and she had promised her mother not to let that happen.
Martin’s lawyer based his evidence on the fact that Martin was stressed and tired and should never have been responsible for the care of her own mother. Better palliative care for her mother was an option for Joy Martin in the last days of her life but Lesley had declined the offer.
Part of her defense rested on the fact that she in writing the book, although she thought she was writing things as they happened, she may in fact have been suffering from ‘cognitive dissonance’, or memory distortion.
At the trial Professor Roderick MacLeod of the University of Otago Medical School and a specialist in care of the terminally ill stated that it was quite normal for dying people to feel “scared and frightened. And when they ask me to kill them, which they do, I talk about that with them and basically the vast majority of them are saying they don’t want to live like this, which is entirely different from saying they want to be dead.”
Martin was sentenced to 15 months in prison and served half the sentence. 8
Angels of mercy/ angels of death
The Hospice Patients Alliance (HPA) is concerned that some physicians, nurses and even family members are administering overly high dosages of narcotics, sedatives or antidepressants when the patient has no need for them, as a form of euthanasia or mercy killing. They say:
“Lynching” (“hanging” for those who don’t know their history) the elderly and disabled would be a shocking thing to do. But merely “euthanizing” the elderly or disabled, at least to some, doesn’t seem to sound so bad.” 9
Australia’s Dr Philip Nitschke, stated that, “assisting suicide can attract a life sentence in jail” so, he says, “the best advice is to do it and say you didn’t.” Any “angels of mercy” taking heed of Dr Nitschke can, if accused of killing a patient simply say, “it was out of mercy;” that they killed the patient or “I wanted to relieve the patient’s suffering.” 10
In 2001 a Swiss nurse, having previously confessed to the ”mercy” killings of nine elderly women, admitted responsibility for 18 deaths of old people in nursing homes and hospitals. The man Swiss media dubbed the “Angel of Death” told investigators he had put his victims – mostly old women — out of their misery by injecting them with drug overdoses or smothering them with plastic bags and towels.
The investigating magistrate Orvo Nieminen said in a statement, “As far as his motive goes, he is sticking to his previous comments that he acted out of sympathy, compassion, empathy and salvation of the people involved.” 11
Lying on the bed of a super specialty hospital in New Delhi, suffering from incapacitating physical disorder, a frail figure, entangled in the mesh of drips, implored the doctor to help him die with dignity. The patient none other than D L Reddy, the renowned U S- based businessman, was suffering from prostrate cancer and wanted the doctor attending on him to relieve him of the racking pain. “It is better to die than live like a vegetable,” he pleads.
For the protagonists of mercy killing, this is perhaps the right cause and the perfect time to allow the patient to embrace death and put an end to his unbearable pain for an eternal peaceful abode.
If human beings have the freedom to live with dignity should they be deprived of their right to die in dignity? After all as an individual, you decide where to marry, you decide where to work, and at the last hurdle of your life, you should be allowed to choose how do you want to end your life.
Euthanasia or mercy killing is the bringing about of the gentle death of a patient in the case of a painful, chronic and incurable disease. It is a practice of ending the life of a person or animal in a painless or minimally painful way for merciful reasons usually to end the suffering of a patient before death.
Euthanasia, an ancient Greek word literally mean “Good Death”
Terminally ill patients, be it cancer, AIDS, accidental or traumatic coma, The children, old women and men afflicted with the diseases undergo excruciating pain In such a situation, if death is not imminent but sure, the question arises why not the patient be artificially induced for a “good death”, of course medically
PROPOSALS FOR ITS LEGALISATION
Proposing legalisation of mercy killing, the Kerala Law Reforms Commission (KLRC) had stated that mercy killing could be considered in cases where death is the only salvation as preservation of life would be medically impossible and visited with insufferable physical or mental pain.
Apart from the miserable pain, that the patient goes through, the trauma and the emotional turmoil of his relatives is starking. To see your close ones suffering is not an easy situation to handle. Why must a family suffer as a loved one slowly and perhaps painfully wends his or her way to a “natural” death?
The essence of human life is to be able to live a dignified life but when some law forces you to live in intense pain and humiliation, there seems to be something wrong with our society. You wish the laws could be changed.Who are we to prolong the life of one who is suffering when he has himself decided to end his life?
The Indian Law Commission has asked the government to consider if a legislation can be enacted under which life-support systems can be withdrawn in the best interests of terminally ill patients. The commission has submitted its report to the Law Ministry, further sent to the Health Ministry.
CHOICE BETWEEN DEATH AND LIVING HELL
Legalizing mercy killing will help freeing a person from shackles of life worse than death. Sometimes incurable medical condition makes life of a person and his near and dear-ones a living hell.
The KLRC recommended that mercy killing should be legalized on humanitarian grounds. Solace, compassion, justice and humanism make euthanasia a legally permissible farewell to life in its misery and desperation.
CRITICISM
However, the issue of legalizing euthanasia has been a bone of contention throughout the world and will continue to do so due to fear of its misuse and/overuse. Critics have cited examples in cases where the patient is pressured by family members to give consent to the ending of their lives. But this should not be an excuse for the law makers to take a backseat on this burning issue. Criticism is bound to pour in for every bold step you take. That does not mean that every enterprising move should come to a grinding halt.
STEPS TO TACKLE ITS MISUSE,IF ANY.
Stringent laws and strict vigil by the administration in implementation of euthanasia should ensure safeguards against such a situation, and other instances of coercion and fraud
Every case will have to be carefully monitored taking into consideration the point of views of the patient, the relatives and the doctors. This decision is based on the patients’ rights and dignity, doctors’ rights, religious beliefs, society’s views ,morality and other resolutions available.
Obviously legalization of euthanasia should not include anyone wanting to end their life at the flimsiest of excuses. Taking this into account the Kerala Law Reforms panel suggested that mercy killing should be carried out with the written sanction of three state-recognized doctors certifying that the patient under consideration is a fit case for euthanasia.
At present doctors are afraid to openly discuss end-of-life decisions with patients due to absence of any legislation. This prevents an open and honest relationship between doctor and patient in which the doctor can discover the patient’s wishes regarding his/her own life and death.
In brief mercy killing should be legalised because :
1) The patient is near his or her end.
2) The patient has unendurable pain.
3) All possible ways to avoid the pain have been attempted but are useless.
4) The patient expresses his or her own will to accept mercy, they are never forced.
SCENARIO IN INDIA AND OTHER COUNTRIES
While in India the debate continues,Netherlands was the first European country to legalise euthanasia in 2002, Belgium passed a law permitting voluntary euthanasia and assisted suicide in May 2002, according to Alan G. Williams, JD, Reviewer Physicians Medical Legal Prevention, LLC, as detailed in JAMA (Journal of American Medical Association)
The state of Oregon in the USA has a ‘Death with Dignity’ law, which has been in place for almost 10 years. It has allowed terminally ill patients to take legal, proscribed medication to end their suffering. Under The Death with Dignity Act in Oregon, doctors signed only 96 prescriptions for lethal doses of medication from 1998 through 2000. By, comparison, physicians already euthanise roughly 4000 Dutch each year.
Polls show that the euthanasia law is popular in Europe, and other countries may follow.
In the Doctor NDTV Opinion poll, 67 % people in India voted in favour of euthanasia.
GROWING NUMBER OF APPEALS FOR MERCY KILLING
Appeals for legalising euthanasia are pouring in from different states of the country.
Recently, a family in Rajasthan, suffering from an undiagnosed disease, has sought the president’s permission for mercy killing. Six members of the family, including two women, are on an indefinite hunger strike in Sheopur area of Jaipur district to highlight their plight Vaishani Devi, 65, has had the disease since she was 10. The disease was passed on to his sons and her daughter. One of her sons died. This is not a solitary case.
A year ago, the case of Aruna Shanbag hit headlines when writer Pinki Virani approached the court to win Aruna the right to die after she was left in a vegetative state. Aruna who was working as a nurse in Mumbai’s KEM hospital, was sexually assaulted and sodomised in Nov 1973 by a ward boy. The rapist strangulated the then 24-year old Aruna with a dog chain cutting off blood supply to her brain, leaving her blind, paralysed and speechless.
Euthanasia has gained significant human interest in the Indian society and even Bollywood of late is catching up on the trend.
Bhansali’s latest release Guzaarish has touched the sensitive issue of mercy killing. Euthanasia is illegal in India and laws governing it are vague and Guzaarish attempts to bring the issue to the forefront. The film shows Hrithik Roshan, a magician left immobilised from the neck down after an accident and his struggle to end his life with dignity. The movie is inspired from the Spanish flick The Sea Inside, which showed the real life tale of sailor Ramon Sampedro, paralysed after a diving accident. Sampedro was bedridden for 28 years and struggled to earn his right to die.
EXPERT VIEW
Dr K Subbha Rao, an experienced radiologist, who has returned to India after serving over four decades in the United States says, “I propose, I second and support mercy killing. I do not find a reason for providing expensive treatment to those who are terminally ill, have no scope for survival and who are merely surviving on somebody’s mercy.” Even after knowing fully well that all efforts would prove futile, doctors continue to carry out surgical operations on terminally ill patients in the name of treatment.
Though most of the medical practitioners endorse the idea of euthanasia, only a daring few practice it and reveal it.
At the end there seems no real distinction between killing and letting die.
References:
- Not Dead Yet Press Release
- “Mercy killing” debate shrouds health risks for older men carers
- Ibid
- The killing of Baby C
- Dick Sobsey, Ed.D., “Altruistic Filicide: Bioethics or Criminology?” Health Ethics Today Volume 12, Number 1, Fall/November 2001
- K.M. Foley, “The Relationship of Pain and Symptom Management to Patient Request for Physician-Assisted Suicide,” Journal of Pain and Symptom Management 6 (July 1991) 290.
- Margaret Pabst-Battain, “Manipulated Suicide,” Bioethics Quarterly 2 (1980), pp. 123, 134.
- The Lesley Martin story
- Hospice Patients Org.
- A practical guide to suicide Sydney Morning Herald: 12/2/2002
- The Daily News