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I got back to Japan last night, so I’m feeling a bit like a zombie today. I knew it would be hot when I got back, but not this hot! It has been a horrible shock to my system.

Since someone brought this topic up recently, I thought it would be interesting to talk about the case of Tony Nicklinson, a courageous British man who died in hospital last week. Mr Nicklinson suffered a stroke in 2005, and following that, he became paralysed from the neck down. Talking through a computer that he controlled with his eyes, he described his life as a “living nightmare” and said that he wanted his doctors to help him to die. His family supported him because they could see how miserable he was. Because he was unable to use his body, Mr Nicklinson asked the British courts to say that it was okay for doctors to help him to end his life. The case went on for several years, and it was big news in the UK. Everyone sympathised with Mr Nickinson, but many people thought that it would be dangerous to change the law to allow doctors to kill their patients. The biggest worry is that pressure might be put on old people to end their lives even when they don’t want to so that relatives and/or the government do not have to pay for their care. The judge in the case said that although he had a lot of sympathy for Mr Nicklinson, only the government has the power to change the law. When he heard that, Mr Nicklinson felt that his only option was to starve himself to death, so he started refusing food. He caught pneumonia a few days later, and he died last week.

As many people pointed out, if Mr Nicklinson had been an animal, any loving owner would have had him put down by a vet. Many people think it is strange that we show more compassion for our pets than we do for our fellow humans. The problem is that many old laws are no longer suitable for our modern society. Nowadays, doctors can keep people like Mr Nicklinson alive for many years even if their quality of life is very poor and they no longer want to live. I think I mentioned this before, but many British people go to a place called Dignitas in Switzerland when they want to end their life because it is not illegal for others to help them in that country. Of course, they can only do this if they are very sick and have no chance of getting better. This was not an option for Mr Nicklinson because he was not able to move.

Most people in the UK would like to have the right to choose to end their own life if living became unbearable, but the government is too scared to change the law because of all the problems it will cause with, among others, religious groups who believe that only God has the right to take a human life.

So what do you think? Should it be okay for doctors to help a person who wants to end their life because of a terrible illness? Should we all have the right to choose how and when we die if we get sick?

Look forward to hearing your thoughts.

14 Comments

  1. Anne on Monday August 27th, 2012 at 05:05 PM

    Hi David,

    Welcome back to hot and humid Japan!
    I didn’t expect that you put new entry today. Your explanation about this topic helps us to understand the gist of this case. Thank you! I’d like to write my thought later.

    Anne



  2. YU on Monday August 27th, 2012 at 06:46 PM

    Hi David,

    Welcome back!

    > I knew it would be hot when I got back, but not this hot!

    Hahaha…!! 🙂
    You must know that’s Japan’s summer!

    Hi everyone,

    > When he heard that, Mr Nicklinson felt that his only option was to starve himself to death, so he started refusing food.

    I read it in an article too.
    And I thought that he might already have decided to take “the option” if his claim was not accepted.

    > So what do you think? Should it be okay for doctors to help a person who wants to end their life because of a terrible illness?

    I think most people in Japane just commit suicide when they are very sick and have no chance of getting better, but Mr. Nicklinson couldn’t do that because he couldn’t move.
    To tell the truth, I’m not really sure if it should be okay, but it must be done very very rigidly if it were allowed, like the cases of “脳死判定”.

    The other day, I saw a report about “euthanasia” on NHK. It said that some NPO groups are against to change the law, because pressure might be put on people(not only old people) to end their lives even when they don’t want to.
    And I agree with them.

    Imagine, two people are suffering from the same serious disease.
    One wants to end his/her life, but the other still doesn’t want, just like my classmate I mentioned before.
    I don’t think we should ignore the people who want to live. They have right to live.

    > Should we all have the right to choose how and when we die if we get sick?

    I actually think so.
    About 17 years ago, my mother collapsed from an acute myocardial infraction(心筋梗塞) and was taken to hospital in a coma. The doctor said to us that there was no chance to return her place in society, and she could be “a vegetable”(植物人間) even the best.
    At first, both my brother and I thought that we wanted our mother to live as long as possible even she became “a vegetable”. But some days later my brother said to me, “Do you think what she would have said, if she were alive and could speak?”, and I thought that my mother would definitely say, “Let me die”.
    Finally she died two weeks later.

    I hear more and more people leave a record how and when they want to die if they get sick. For example, if they need life-prolonging cares. But I’m not sure if all of them are accepted by the current Japanese laws…

    Look forward to hearing your thoughts.



  3. rinko on Tuesday August 28th, 2012 at 02:22 PM

    Hi David.
    Welcome back to Japan!
    I hope you will overcome this heating summer!

    Hi Everyone.
    Since David mentioned this topic last week,I’ve been thinking about this and found it’s still difficult to get an answer for it.
    I can’t deny the idea of “euthanasia” because I personally think it’s just torture to bear the pain of disease and medical treatment despite that there is no hope to get over.
    But the case of Tony Nicklinson, it’s a bit different from this.
    Having read the article of him,I strongly felt sad and pity for the hardship that he had gone through after he became paralysed.And also thought no one could imagine and understand how hard and painful his life had been. But when I saw a picture of him with his wife and daughters,my feeling was a bit saved. He was not going to be dead and still could communicate with his family, and seemed happy in that picture.So if I were the one of his family ,I don’t think I could support his idea of right-to-death.
    I know it’s quite selfish opinion but it’s just what I think about this theme.

    Hi YU
    I’m very sorry about your mother.
    It must have been really hard for you.

    >One wants to end his/her life, but the other still doesn’t want, just like my classmate I mentioned before.
    I don’t think we should ignore the people who want to live. They have right to live.

    I agree with you.
    I saw the news of NHK,too. It also said that the families of handicapped people were very worried about leagalization of “Living Will” and against it because of the reason that YU mentioned.

    Well..it’s quite difficult topic to describe in my poor English. When I sort out my idea,I’ll write a comment later.

    Have a nice day everyone!

    rinko



  4. Miho on Tuesday August 28th, 2012 at 09:41 PM

    Hi, Mr.Barker.
    Welcome back.
    Yes, it’s still very hot here. But August will end soon and the season of autumn leaves is coming. Anyway, I hope you feel better soon.

    In my opinion, I think that the active euthanasia should be legalized under certain circumstances.

    In Japan, there is a judicial precedent that defines that active/passive euthanasia could be allowed under some conditions. However, doctors are reluctant to conduct euthanasia because it hasn’t been legalized yet and there is a possibility that they could be convicted of murder.

    My grandfather collapsed from cardio-respiratory arrest. He was 86 back then. It was supposed to be a natural death. But a doctor saved his life by the electric shock to his heart and inserting the oxygen tube.

    His brain stem was completely damaged and he was in vegetative state. I had lived with him for long time and I knew that he always wanted the natural death. Therefore I asked the doctor if he could withdraw the oxygen tube but the answer was, of course, No. The doctor asked us to sign the paper. It was agreement on further medical treatment such as inserting the feeding tube. I questioned the doctor if we could reject his proposal. He answered “You may reject it. But do you want to see him dying from starvation?” In the end, I gave up the euthanasia since my aunts opposed to it. The feeding tube prolonged his life for a whole year.

    Because of the experience above, I always thought that the law should obligate every person to have the living will. (I don’t mean that everyone should be euthanized. I mean we should have the chance to think about our death/organ donation/funeral at certain time in one’s life.) But after doing some research on this issue, I found out that there are critical problems. “The right-to-die” could be replaced by “the right-to-kill”.

    Still, in Mr.Nicklinson’s case his mind fully functioned. I can’t even imagine how hard it had been for him and his family.

    I assume that it would have given Mr.Nicklinson some hope if the court ruling was different.
    It is always good to have options and I believe it would have made his quality of life much better if he had the option to end his life with dignity.

    He was extraordinarily brave man. Rest in peace for Mr.Nicklinson.

    Miho



  5. Anne on Tuesday August 28th, 2012 at 10:06 PM

    Hi David and everyone,

    As the title of this week’s entry “The Right to be Killed” shows, this week’s topic is a difficult and sensitive one. Situation is a bit different from the case in the UK, but in Japan some of the Diet members are working for enacting the legislation of “withdrawing life-prolonging treatment.” If I remember correctly, feeding by gastrostomy is included in this.

    >Everyone sympathised with Mr Nicklinson, but many people thought that it would be dangerous to change the law to allow doctors to kill their patients.
    —-I totally agree with this. My heart goes with Mr Nicklinson and his family, however, how and where do people draw the lines between “a murder” and “assisted suicide”? In his case, he and his family had a clear decision, but situation would be different depending on each person or family. I wonder if this law is enacted, doesn’t it cause patients drive into this choice when they can’t bear the burden of their families? As YU said, whether or not he/she feels his/her life unbearable differs depending on each person even though he/she is in the same situation.

    >Nowadays, doctors can keep people like Mr Nicklinson alive for many years even if their quality of life is very poor and they no longer want to live.
    ——-My father-in-law ended his life in a health care facility for the elderly; he stayed there for several months and before that he had to move one hospital to another a couple of times. In the meanwhile, he got the operation of “gastrostomy.” We talked a lot about it and other treatment before that. Whenever I visited him, I thought what the quality of life was. Visiting him who couldn’t speak anything was really sad and made me feel down. As you know, you often hear about the terminal care; you can choose how and where to end or live your life at the last stage even though it’s not enough. It’s different from “assisted suicide.”

    >Should it be okay for doctors to help a person who wants to end their life because of a terrible illness?
    —-It’s difficult to answer, but I don’t think so. I have mixed feelings, but it’s not the time now(or at the moment?) to legalize killing by doctors, and we need a lot more to move into next stage.

    >Should we all have the right to choose how and when we die if we get sick?
    —–Yes, we should.
    By the way, according to an article from The Telegram(20 Jun 2010..it’s a bit old,though..), the number of the people who was killed by euthanasia in 2009 in Holland amounted to 2636; rose by 13 per cent in a year.
    Here’s the link of the article:
    http://www.telegraph.co.uk/news/worldnews/europe/netherlands/7841696/Euthanasia-cases-in-Holland-rise-by-13-per-cent-in-a-year.html

    Furthermore, I came across another eye-catching( does the use of the word here make sense?) article concerning euthanasia in Holland:
    http://www.dutchnews.nl/news/archives/2010/02/tired_of_life_group_calls_for.php

    It says, “A group of older Dutch academics and politicians have launched a petition in support of assisted suicide for the over -70s.”
    This is also the article in 2010, so I’m not sure how the things go, but I sometimes talks about our future jokingly with my friends, and say “I want to die peacefully when I get old.”, but I can’t believe this kind of topic is put on the table.

    Hi YU,
    I’m sorry to hear about your mother. It must have been the tough decision for you and your brother.

    Bye for now,

    Anne



  6. Fumie on Tuesday August 28th, 2012 at 10:40 PM

    Hi David,

    Welcome back! It’s still scorching hot during daytime but morning and nighttime are cooler.

    About Mr.Nicklinson’s case, I think what he did was a very brave thing. In my opinion, people should be allowed to decide whether he/she choose to live or end one’s life if they had no chance to recover. In case of someone’s condition is really bad and can’t show one’s will, his/her family should decide what to do. But it might be dangerous because they might choose his/her death even if he/she want to live, as David mentioned. So to avoid these unfair things, anyone should tell what he/she want them to do his/her life if something happen to him/her even if he/she is healthy to his/her family when he/she reaches the age when he/she can decide his/her life: 18 or 20. Nobody knows what will happen tomorrow. In conclusion, the law should be revised that one has the right to choose how and when we die only when he/she can tell one’s will.

    Hi YU,

    I’m so sorry about your mother. That must have been so hard for you and your family.

    Fumie



  7. Anne on Wednesday August 29th, 2012 at 05:59 AM

    訂正;
    >so I’m not sure how the things go, but I sometimes talks about our future jokingly
    —–so I’m not sure how the things went, but I sometimes talk about our future jokingly

    Hi Miho and Fumie,
    >, I always thought that the law should obligate every person to have the living will
    > anyone should tell what he/she want them to do his/her life if something happen to him/her
    —I agree with both of you as we discussed it when we talked about organ transplant.

    I read lots of comment in the BBC and Mail Online that Fumie show us, and as David mentioned,I found religion-related comments in there, but I don’t want to consider this from this point of view.

    Anne



  8. amo on Wednesday August 29th, 2012 at 12:51 PM

    Hi David,

    Welcome back:)
    Am sorry to say this but I don’t think I can have time to comments on this week topic, becourse I am in Okinawa now and I will be busy to prepare お盆 and meet my old friends this week. I know it’s really an interesting topic to discuss, so I wanted to join you. But anyway I have some time to read your comments.

    Bye for now,
    amo



  9. kattie on Wednesday August 29th, 2012 at 10:55 PM

    The euthanasia/right to die debate’s a really interesting and thought provoking topic. My mother died a couple of months ago, she was diagnosed with terminal cancer last September and my sister and I have talked about this many times over the last year. My sister strongly believes that people should have the legal right to have assistance with dying and this should include teminally and non terminally ill people.

    I worry about this a lot because I spent hours and hours with my mum in the last year and she never once said she wanted to die, she knew she was terminally ill but still wanted to have hope and she still had some quality of life until the last 2 weeks. However, she was also worried about being a burden and she worried about the financial side of her care – care is incredibly expensive in the UK (Although medical care is completely free under the NHS) and she only got government help in the last 10 days or so when she was completely bedridden, even though 24 hour care was absolutely necessary for many months beforehand. If she had known she could have had assistance with dying, I’m pretty sure she would have felt selfish if she had chosen to try and live on.

    Palliative care is increasingly effective and people can often live 2 years or even longer. I worry that there will be less emphasis on continuing to improve palliative care or even finding new cures, if the law is changed. In the UK, medics are currently allowed to give as much pain relief as is necessary to relieve pain, if this results in a person dying, then this is lawful, so to some extent we already allow euthanasia. The problem is that because people in the UK have become increasingly litigious, health professionals seem to be very worried about administering adequate pain relief and from our own experience, this can mean it is given too late – and too little. I understand that many people in the UK have raised this issue and it’s a particular problem when people lose their mental faculties and/or are unable to communicate how much pain they are in.

    On the other hand, people like Tony Nicklinson who have a very poor quality of life, no chance of recovery and who continually say they wish to die over a long period of time should probably be helped but then I have read that other people in a similar situation feel quite differently, so it would be really terrible for them to feel that they had to choose death. It’s easy to look at one case and make a decision based on that – we have an expression ‘hard cases make bad laws’. By the way, I heard an interview with Tony’s wife where she was asked why they didn’t go to Dignitas in Switzerland and she said it was because he wanted to die at home so I think it was a possible for him to go. If the law is changed I think it needs to be changed by parliament (not the law courts) because that way it will be properly drafted and will hopefully be limited to exceptional cases. I agree with Rinko this is a very hard topic…even for a native speaker!

    I am interested in what Yu said about most people in Japan committing suicide if they are really ill. I have known quite a few terminally ill people but I’ve never known anyone who has committed suicide (who was terminally ill). I suppose it’s because people still want to have hope (like my mother), or they people don’t know how to do it quickly and painlessly, or perhaps they are religious



  10. YU on Thursday August 30th, 2012 at 11:22 AM

    Hi everyone,

    It seems that I picked up a cold from my son.
    I was in bed with a high fever, but it got much better now.

    Hi Kattie and everyone,

    >I am interested in what Yu said about most people in Japan committing suicide if they are really ill. I have known quite a few terminally ill people but I’ve never known anyone who has committed suicide (who was terminally ill).

    In Japan more than 30000 people commit suicide yearly, and the most frequent reason is “health problem”(48%).

    > I suppose it’s because people still want to have hope (like my mother), or they people don’t know how to do it quickly and painlessly, or perhaps they are religious

    I suppose it’s because people lose all hope for their future when they hear that their disiase is incurable, and don’t want to be a burden to their families.

    I don’t know if that is a good way, but Japanese people normally don’t announce, “I’m commiting suicide from now, because I’m terminally ill” to other people. I guess it’s becasue they already know that they can’t have assistance with dying under the current Japanese laws. Of course, there must be more other reasons too, though.

    So, I wonder a bit why Mr. Nicklinson didn’t die
    silently at home from the beginning. He starved himself to death finally, right?
    Was he worrying about that his family might be suspected of murder? Or he just wanted to change the law for the people who are really ill like him?

    > I worry that there will be less emphasis on continuing to improve palliative care or even finding new cures, if the law is changed.

    Huuummmmmhh…..
    Isn’t it a bit strange that people now start rejecting them after we have been making efforts to improve medical science for a long time?
    I personally feel that it’s very cruel that you can’t take effective medicines in front of you. I know some don’t want them, but some want to live longer.

    I think this topic is discussed mainly in developed countries. And I have a feeling that it has something to do with the problems of the aging polulation and the low birthrate in those countries, which is very scary to think about, though…



  11. Fumie on Thursday August 30th, 2012 at 01:53 PM

    Hi Kattie,

    I’m so sorry to hear your loss. It must be so hard for you. Please accept my sympathy.

    >It’s easy to look at one case and make a decision based on that – we have an expression ‘hard cases make bad laws’.

    It’s so true. They should be think over each case and make a right decision based on each case.
    >If the law is changed I think it needs to be changed by parliament (not the law courts) because that way it will be properly drafted and will hopefully be limited to exceptional cases.
    I agree with the part “and will hopefully be limited to exceptional cases. (I’m not familiar with the UK situation so I can’t say if the law is changed by parliament or the law courts). They souldn’t decide the case based on the precedent.

    Before I read your comment, I totally agree with euthanasia if that’s the patient want to do. But I knew that his/her will doesn’t always be his/her true feeling. He/she might worry about the burden of the family and financial burden.

    Hi YU,

    Oh no, you caught a cold. Please take good care of yourself!

    Fumie



  12. Kattie on Friday August 31st, 2012 at 04:14 AM

    Hi Fumie,

    Thank you for your kind words.

    Hi Yu,
    >In Japan more than 30000 people commit suicide yearly, and the most frequent reason is “health problem” (48%)

    I wonder whether mental health problems are included in this figure. I tried to find out how many health related suicides there are in the UK but I could only find the annual suicide figure (about 6000) however I understand that a lot of people commit suicide because they are clinically depressed or suffer other mental health problems. I’m really not sure how many terminally ill people, or people who have very severe physical illnesses, commit suicide in the UK each year

    Kattie



  13. Anne on Friday August 31st, 2012 at 05:56 AM

    Hi Kattie,

    I’m sorry to hear about the loss of your mother.

    > I worry that there will be less emphasis on continuing to improve palliative care or even finding new cures, if the law is changed.
    —-I agree with you.
    I mentioned the movement above by some of the Diet members,and there are pros and cons for that; some groups said,”Patients should have the right to live as well as the right to be killed. We talked about the living will and I think it’s important to show our will,too. Having said that, our thoughts toward terminal care could change. I’m not sure if I am able to decide how I want to end my life when the time comes.

    Hi YU and Kattie,
    >In Japan more than 30000 people commit suicide yearly, and the most frequent reason is “health problem”(48%).
    >I understand that a lot of people commit suicide because they are clinically depressed or suffer other mental health problems

    I guess a lot of people commit suicide because of mental health problems. Actually, one of my husband’s friend did this spring and my husband was so shocked to hear the news.

    Hi YU,
    Hope you are feeling better now. Take care!

    Hi amo,
    Have fun with your family and friends.

    Anne



  14. YU on Friday August 31st, 2012 at 08:46 AM

    Hi Anne and Fumie,

    Thank you.
    I feel much better today! 🙂

    Hi Kattie and Anne,

    I think you’re right, but I found an article that describes about “causes of suicide”.

    http://www.47news.jp/CN/200806/CN2008061901000162.html

    According to the article, the TOP3 reasons are :

    1. mental health problem (うつ病)
    – 6060

    2. physical health problem (身体上の健康問題)
    – 5240

    3. multiple debts (多重責務)
    – 1973

    (annual suicide figure in 2008 = 33093)

    So, I think quite a lot of people commit a suicide because of physical health problems as well as mental health problems in Japan.



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