Birth, aging, illness and death are inevitable parts of the human experience. Yet, living well does not necessarily mean dying well. For those who have a chronic illness or cancer, or are bedridden due to significant injuries or disabilities, the remainder of life can be a torment for themselves and a hardship for their caregivers. Even if they wish to end their life with dignity, they are not allowed to do so.
Bih Liu-ing (畢柳鶯), former superintendent of Chung Shan Medical University Hospital, introduced the practice of Voluntary Stopping of Eating and Drinking as an alternative to assisted dying, which remains illegal. However, due to the physical and emotional toll associated with such self-enforced fasting, her proposal received limited support within the medical community.
Surveys indicate that up to 86 percent of the public supports assisted dying for terminally ill patients, highlighting a stark contrast between public sentiment and the cautious stance of many medical professionals.
Despite widespread public backing, the question of legalizing assisted dying remains unresolved, entangled in complex ethical and legal debates. Among the most disputed issues is the question of who should carry out the act.
If a patient ends their life by their own hand, it is considered suicide; if done with the help of a medical professional, it becomes assisted suicide — a concept fraught with legal and moral ambiguity. This fundamental dilemma continues to hinder consensus between medical ethics and legal frameworks.
A friend of mine has a father who became paralyzed following a cervical spine injury. According to my friend, his father remains fully conscious and aware of his surroundings, yet is unable to communicate. It is heartbreaking, he said, to watch his father try to speak, but fail — tears welling up in the corners of his eyes.
“If the government can decriminalize same-sex marriage and adultery, why can’t it allow patients who are suffering so immensely to pass away peacefully?” he said.
The friend was not trying to dismiss his father’s right to live, he simply could not bear the agony of watching his father contort his features in frustration at not being able to communicate, unable to speak or move. The profound suffering experienced by patients and caregivers leads only to torture for both.
Similarly, former sports commentator Fu Da-ren (傅達仁) had endured a long and painful battle with cancer. He pushed for the legalization of assisted dying, but in vain. Fu ended up having to pay his way to Switzerland to fulfill his final wish of parting the world in peace and on his own terms.
What is even more heartbreaking is that to free their bedridden patients from eternal suffering due to illness, some caregivers would suffocate their patients with pillows or plastic bags — an act of kindness that is dismissed and misrepresented in prevailing ethical norms. The rigidity of the law does not tolerate mercy killings. However, their circumstances nonetheless evoked sympathy among people.
Faced with long-term bedridden patients who struggle to live, and yet are not permitted to end it all on their own terms, should we legislate to help them find relief or let them struggle on in pain until their final breath? The government can no longer look the other way — it must propose a solution.
I ran into a retired colleague when doing my morning exercise one day. He joked that it was pure luck he was still alive. He had been diagnosed with prostate cancer and had gone through chemotherapy, but he had come to terms with it.
“I exercise every day now — it’s actually so I can leave this world more peacefully in the future,” he said. “Life is uncertain; no one knows when their time will come, but sooner or later, we all have to go. I just hope that when my time comes, I can go peacefully, without pain or attachments. I don’t want to be kept alive with tubes and electric shocks — that only brings suffering to myself and sadness to my family.”
He did not want to burden his children or make things complicated for his spouse. I was impressed in terms of his open-mindedness and optimism of wanting a “good death” when facing the end of life.
People in modern society no longer regard “death” as a taboo and can make practical considerations such as exempting oneself from the suffering of illness, burdening family members or taking up medical resources unnecessarily.
Acknowledging that there has been a rational and open-minded awareness of a good death, the Ministry of Health and Welfare should start taking the matter seriously and provide terminally ill people with the option to come and go as they please. Perhaps for both the family and society, it might well be a kind of relief.
Shiao Fu-song is a lecturer at National Taitung University.
Translated by Jiang Wen-qing
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