[NOTEBOOK]Passive Euthanasia and Dignity of LifeLast week a row erupted at a hospital when family members of a patient in intensive care were discovered trying to remove the artificial respiratory apparatus that was keeping the patient alive. The family was aware of the harsh penalties for killing a patient. However, the family's bill from the hospital care for the patient had reached 16 million won ($12,300). the relative had been in a coma since January due to cerebral infarction. The family still owes 14 million won for the treatment.
The hospital is aware of the family's circumstances, but doctors must try to remain detached: According to a precedent set in Boramae Hospital in 1998, doctors can be charged with murder if they carry out a family's request to remove a terminally ill patient from life support.
Similar tragedies are played out every day across the nation. It is no surprise to see the families of patients in intensive care grabbing doctors by the lapels in anger. Hospital employees often have to resort to violent means to prevent families from taking patients home. And because comatose patients often occupy the sickbeds in intensive care for more than a year, patients requiring urgent treatment are left waiting in general wards.
Melvin Konner, an American ethnologist, wrote a book about Nancy Cruzan － a patient at the center of a famous medical storm. The title of the book is "Medicine at the Crossroads: The Crisis in Health Care." In 1983, Nancy Cruzan, then 25 years old, was involved in a near-fatal car accident. She was left in a persistent vegetative state. Her life depended on the nutrition and hydration supplied through tubes. If she had received continuous medical care, she could have survived for more than 30 years. Her parents, however, appealed to the law to have the tubes removed. They weighed her daughter's vegetative life with a peaceful death while visiting her at her sickbed for several years.
The lower court accepted her parents' argument, but the Missouri Supreme Court reversed the decision, underscoring the dignity of life. Removing supplies of food and water is virtually tantamount to starving a person to death, the court recognized.
Yet, time passed and the laws of the state court eased. In 1991, eight years after her accident, Ms. Cruzan's feeding tube was removed. Her parents must have felt both liberation and intense grief seeing their daughter slowly die, shielded from pain with regular injections of tranquilizers. The state court decision was made with consideration of her family's agony as well as the huge economic burden of medical expenses. The state had contributed an annual sum of $130,000 for the preservation of Ms. Cruzan's life. After Ms. Cruzan was allowed to die, this money was available to assist other patients.
Financial drain and familial agony － these are some of the very real consequences of maintaining what is technically a life. Yet, in our society, we often neglect to consider the pain of relatives and that this money could be better spent elsewhere, giving priority to "dignity" of preserving life. But can lives that depend on medical devices really be considered dignified? And does plain survival have more value than a graceful and peaceful death?
There is an ambiguous zone between life and death. Owing to rapidly developing science, this gray area has become wider. Advanced medical equipment and care provides us with the opportunity to live longer, but they also compel us to pay higher medical treatment costs and postpone the painful time when we say farewell to loved ones. Maybe we are getting too accustomed to leaving our souls with science and valuing the extension of life above all else.
Passive euthanasia, removing life support from terminally ill patients with no hope of returning to life, must be approved. Observing the recent controversy over passive euthanasia, I venture to say that medical science should be devoted to the living and those who can live.
The writer is deputy information and science news editor of the JoongAng Ilbo.
by Ko Jong-kwan