Compassionately eliminated

Gonzalo Herranz.
Published in La Razón (Madrid), 17 March 2007.

Inmaculada Echevarría has died. I am unable to evaluate her case, both for lack of clinical data and due to an excess of media information, inevitably loaded with improvisation and sentiment. With the few data available, it could be argued that this is a case of euthanasia or a legitimate suspension of futile treatment. In recent days there has been a clear division of opinion among reasonable people.

Spanish society is thus once again confronted with discussion regarding the legalisation of euthanasia. Before getting to grips with it, we should wait for the emotional shock that this death has caused to dissipate. It is therefore time to take a critical, incisive look at important issues for this discussion: what is euthanasia, what are the aims and limits of medicine, what do we mean by the words we use, what are the intellectual and moral components of medical compassion.

This opportunity must be seized. Because a society's capacity to withstand repeated doses of dramatic and extreme cases is limited. We have already had a few (Ramón Sampedro, Jorge León, Madeleine Z, now Inmaculada Echevarría), all of them activated by the activists of death with dignity, programmed to numb our good judgement and turn us into a tender-hearted people.

I am well acquainted with the pro-euthanasia movement. I am amazed by their almost magical ability to twist language, to blur concepts, to dramatise cases, to act as prophets of an emancipated humanity. They no longer invoke physical pain for compassionate death, for palliative medicine has won them that battle. They want to free us from technological abuse, as if medical futility were not strongly forbidden.

Their banner today is euthanasia so as not to live dependent on others, for existential fatigue, abandoned loneliness, or being a burden to others. They are not right in any of these proposals. We have to thank them, however, for reminding us that either we stop being a society of selfish people, or we are heading for a cruel society in which the weak will be mercifully eliminated.

Commentary on the case of Inmaculada Echevarría.

Antonio Pardo.
summary sent to Europa Press, 16-III-07.

At department a thesis was run some time ago on acute care, and when to implement or withdraw it.

The conclusion he reached is simple rules that are easily understood and practical.

The first thing is that the medical treatment is useful for something. What is not useful for nothing should not be applied.

Secondly, this useful treatment must be bearable for the patient, i.e. it must not be disproportionately bothersome or unbearable for any reason whatsoever subject.

And thirdly, that it is not disproportionately expensive (this, of course, varies with the location, or the financial capacity of the patient; however, it is the last thing to be considered and is not usually the problem).

Secondly, a patient can reasonably refuse to accept a treatment which, for the little benefit it will bring him, involves a great deal of discomfort (for example). And this, even if he will die immediately if the treatment is not given (this is an issue that the moralists of the Salamanca school in the 16th century dealt with at purpose on the obligation to eat).

This is different from stating that one has the right to refuse treatment in general: it is only ethically correct for us to refuse things that contribute almost nothing and, above all, cause additional discomfort.

Inmaculada's case is strange: she remembers that she finds it unbearable to live after ten years of illness, in an institution famous for its care of the chronically ill. Everything suggests that the members of the Right to die with dignity society have convinced her to want to die, although I suppose it would be difficult to prove. It would be a crime of inducement to suicide.

I think that, according to the medical status that was shown in the reports, the patient did not seem to suffer particularly: she smiled, spoke and communicated well, read and turned the pages of a book by herself... but, in any case, without having spoken to her, it is not possible to know if status was really unbearable for her.

If so, the respirator, which is a patch to their problem, would produce more disadvantages than benefits, so either it should not have been fitted or it can be removed (ethically it is the same).

Euthanasia is deliberately causing the death of the patient: this does not seem to be the case. All the time there has been talk of withdrawing treatment, without there being any will to kill on the part of the care team (although the superiors of the Order of St John of God have refused to allow this to be done in their hospital, as it would be a betrayal of the spirit of the Order: the logical thing for them to do would be to have been at the forefront of palliative care, which includes making this subject of patients who want to die see the meaning of life).

In short: the issue has been muddled, dressing up the withdrawal of unhelpful and perhaps unbearable (?) care that we are masters of our lives and other falsehoods along those lines.

These borderline cases and grey areas that are not very clear are always played with to promote the pro-euthanasia opinion.

subject So, although the principles are clear, it is not clear what has happened to this poor woman and what influence association for the right to die with dignity has had on her.