Eve Richardson, chief executive of the National Council for Palliative Care and the Dying Matters coalition, argues that the government needs radically to improve end-of-life care in the UK, and makes several excellent suggestions about how that might be done.
I agree wholeheartedly, and would like to add a suggestion of my own: that end-of-life or terminal care should be a medical specialization not restricted to hospice care. Hospice care involves merely the palliation of patients’ symptoms (where such palliation is possible – sometimes, as in cases of advanced cancer, for example, pain cannot be controlled, and patients are left to die in agony). Such care should include voluntary euthanasia as a possible intervention. What might we call such a specialization? I suggest telostrics (telos being the ancient Greek word for end).
Of course, I am assuming that such euthanasia would be legal. But as it certainly should be, and quite probably soon will be, my suggestion here is not out of place.
It might be thought preferable that a loved one – a friend or relative – administer the fatal dose. That might indeed be best, but there may well be cases in which there is no suitable person available, or in which the patient would be concerned about the potentially traumatic effect it might have on that loved one.
What about an ‘ordinary’ medical practitioner? Why do we need a specialism that includes euthanasia? Again, this may work in some cases. But there is still a danger of trauma, and choosing what’s best for any particular patient may itself be difficult. Further, the issues surrounding end-of-life decisions, both for patients and their relatives, are complicated, and experience in them will often be beneficial for all concerned.
But aren’t doctors trained to sustain life? And won’t they be naturally traumatized by their killing others, just as most of us would be? Not all doctors think this way. Some of them see their role as making the lives of their patients as good as possible, and this may involve bringing that life to a less agonizing conclusion. Such doctors might, if my proposal were adopted, choose to become telostricians.
“Beauty is a greater recommendation than any letter of introduction.” – Arthur Schopenhauer, Aphorisms on the Wisdom of Life
As our wealth increases, more and more of us undergo cosmetic surgery: From tummy tucks, breast enlargements and nose jobs to hair transplants and face-lifts: You name it—and pay—they fix it.
Even though cosmetic surgery has grown to become a multi billion-dollar industry, it is looked at with some suspicion. Many feel that there is something superficial and, perhaps, slightly desperate about undergoing surgery for aesthetic reasons. In academia, at least, although a hair transplant and a teeth bleaching might pass, chances are that a breast enlargement would raise eyebrows.
It is not be unlikely, however, that the eyebrows in question would be both plucked and colored—for we already do quite a bit to enhance our looks. We work out, try to dress well, shave, and go to the hairdresser. We make sure we get tanned during summer. Some of us are on a diet, wear make up, or dye our hair.
Matthew Rallison is a sixth-form student who is visiting the Oxford Uehiro Centre for Practical Ethics for his work experience placement.
Sir Terry Pratchett’s documentary, “Choosing to die” and the recent deaths of Ann McPherson and Jack Kevorkian (inventor of the Mercitron) have recently raised the debate of the legalisation of euthanasia, alongside criticism of the BBC’s bias favour towards the subject.
The latter of these issues is, to an extent, accurate as the programme echoes Pratchett’s support of euthanasia. Yet the conclusion of the programme, for me, offered personal reflection, rather than an affirmation that euthanasia (or assisted suicide) is morally correct. Watching, on screen, the death of Peter Smedley was not a compelling argument but humbling. Peter was unassuming as he fell out of consciousness. “A good death,” as Pratchett describes it. The scene offered a powerful impression of human dignity and spirit, rather than promoting death, or suicide. It supported virtue in life (or in leaving it). I reject the ex-Bishop of Rochester, Michael Nazir Ali’s claim that it the programme depicted “glorified suicide.” It did not.
Matthew L Baum
Round 1: Baltimore
I first heard of the Malleus Maleficarum, or The Hammer of Witches, last year when I visited Johns Hopkins Medical School in Baltimore, MD, USA. A doctor for whom I have great respect introduced me to the dark leather-bound tome, which he pulled off of his bookshelf. Apparently, this aptly named book was used back in the day (published mid-1400s) by witch-hunters as a diagnostic manual of sorts to identify witches. Because all the witch-hunters used the same criteria as outlined in The Hammer to tell who was a witch, they all –more or less- identified the same people as witches. Consequently the cities, towns, and villages all enjoyed a time of highly precise witch wrangling. This was fine and good until people realized that there was a staggering problem with the validity of these diagnoses. Textbook examples (or Hammer-book examples) these unfortunates may have been, but veritable wielders of the dark arts they were not. The markers of witchcraft these hunters agreed upon, though precise and reliable, simply were not valid.
On Sunday, scientists at the Harvard Dana-Farber Cancer Institute announced that they had succeeded in reversing age-related decline in mice, using genetic engineering techniques. The scientists created transgenic mice with a gene for telomerase expression that could be switched on and off with a chemical signal.
Written by Roman Gaehwiler
Reconstructive plastic surgery to correct ravages of disease and injuries as well as gross physical abnormalities constitutes a core medical practice. Reconstructive procedures, however, lie along a continuum, without any clear boundary between therapeutic reconstructive surgery for diagnosable problem and purely cosmetic surgery.
by Alexandre Erler
Technologies meant to help extend the human lifespan, such as cryonics, or the procedures investigated by gerontologist Aubrey de Grey under the name “Strategies for Engineered Negligible Senescence”, are increasingly an object of discussion, including in the popular press. A recent example of this is John Walsh’s piece in The Independent earlier this month. He is one of several authors who find it worth telling us that they wouldn’t want to live forever, even if they could. At times his article appears to aim merely at being entertaining and polemical, yet his central idea has been put forward by respected philosophers such as Bernard Williams, in his famous essay The Markopulos case: reflections on the tedium of immortality. In short, the idea is that living forever would just be atrociously boring.
Should we draw normative conclusions from such pieces about the development and use of life extension technologies, regarding them as superfluous or even downright undesirable? I want to argue for a negative answer to that question.
In the news today – scientists have identified a cluster of longevity genes. From the Daily Mail
A genetic test which tells whether you will make it to your century has been developed by scientists.
The computer program will give individuals their odds of reaching the age of 100 – and tell them whether their chances are higher or lower than average.
Its inventors, from the respected Boston University in the U.S., say it will allow those not blessed with the cocktail of 'centenarian genes' to make changes to their lifestyle to maximise the time they have.
Professor Julian Savulescu, an Oxford University ethicist, said: 'I believe it is highly in your interests to have this information because even if there is nothing you can do about it, it can help you plan your life.
What do you think? Is it a good thing to know if you are predisposed (or not) to long life?
What if this discovery led to many of us being able to live to 100? Would that be a good thing?
other reports: New York Times
There is no end to human suffering. There is a distinct end to the amount of money that governments will spend on reducing it. Someone has to make decisions about healthcare resource allocation. I am very glad it’s not me.
Many tools are used in the decision-making process. Not many emerge well from a viva with a philosopher.
Individual clinicians use intuition, experience, NICE
guidelines, the fear of hospital accountants and, no doubt, prejudice and the
tossed coin. But policy makers do not have the luxury of being able to account
only to their consciences and the local man in a suit. They have to say something in the minutes about the
reason for funding procedure X but not procedure Y. The real reason might be:
‘My grandma, whom I loved very much, had procedure X, and it did her good’, but
they can’t say that.