| Summary: | Assignment (MPhil)--University of Stellenbosch, 2000. === ENGLISH ABSTRACT: This study was undertaken to evaluate whether a mentally competent mature
human being, who is suffering an intolerable, irremediable existence resulting
from an incurable agonising or devastating paralysing disease; has a moral,
personal and civic right to end that life or have it ended by requesting assistance
in meeting death in a humane, compassionate and dignified manner.
~ The righteousness of such assistance can only be gauged if it follows the
repeated and voluntary request of someone who is presently not suffering from
any psychiatric disorder, is presently mentally competent or had made such a
written or verbal witnessed advance directive while mentally competent to do so.
~ This study will not deal with assistance in dying either active or passive which is
performed on severely mentally and physically handicapped new-born babies
with scant prospect of survival; nor with euthanasia for the relief of malignant or
paralysing disease in those with life-long [anoxic, congenital, inflammatory or
traumatic] mental incompetencies who have never had decision-making capacity.
~ This study will not address issues of aid-in-dying for mentally incompetent
persons suffering from senile dementia, Alzheimer's disease, or permanent
vegetative states due to brain pathology following anoxic, circulatory, infective,
malignant or traumatic events, who have not made advance directives and who
had never stated preferences concerning assisted euthanasia. The aim of this study is to outline the moral case advanced by those in favour of
legalising Voluntary Assisted Euthanasia [VAE] also called Assisted Euthanasia
[AE] and to develop ethically sound and practical proposals for policy and actions
contributing towards the resolution of the moral dilemma faced daily by doctors
when asked by mentally competent patients suffering from irremediable
malignant or paralysing diseases or the agonising symptoms of end-stage
Acquired Immune Deficiency Syndrome (AIDS) for assistance to end their lives.
}ii> This study will cover and discuss the more important objections of those opposed
to the legalising of assisted suicide for mentally-competent terminal patients who
are irremediably suffering in their bodies or from dehumanising incurable endstage
paralysing diseases and are near to an inevitable death.
}ii> The insights of philosophers, theologians, physicians and sociologists on the
subject of suicide and aid-in-dying, have been researched in the extensive
literature that exists (both in print and in cyberspace) on these subjects and are
presented with the study.
}ii> The study tries to show that a competent adult in certain grim circumstances
should have an inalienable human right, if not a constitutional one, to request
assisted euthanasia or aid-in-dying or assistance in ending their lives.
}ii> Such assistance must be subject to peer review, after careful assessment by a
multidisciplinary team in the healing [both physical and spiritual] professions This paper will try to determine whether the actionalisation of voluntary assisted
suicide or assisted euthanasia is murder or an act of compassion and empathy
performed out of respect for a fellow human being's autonomy and in deference
to their right to self-determination and self-realisation.
~ The relevance of this situation is that aid-in-dying is becoming one of the major,
moral, religious, philosophical and bio-medical dilemmas at this time.
~ The author's position is that it is neither just nor ethical to prevent a mentallycompetent
human being, who is tormented by agonising, incurable terminal
physical or irremediable paralysing disease, from deciding to chose to die when
he/she can no longer bear the torment and asking for professional assistance to
effect this. This relief should be given not only to those who are able to make an
enduring, informed contemporaneous decision, but also to those who [when they
still had decision-making capacity] had previously made a considered informed
advance directive about the use of ordinary and extraordinary medical methods of
sustaining a life that had become merely an existence. === AFRIKAANSE OPSOMMING: Die studie is onderneem om te evalueer of 'n bevoegde, volwasse mens wat 'n
onverduurbare en ongeneesbare bestaan het a.g.v. 'n ongeneesbare, folterende
of vernietigende siekte, 'n morele, persoonlike of burgerlike reg het om daardie
lewe te beeïndig of hulp te vra om dit te laat beeïndig, ten einde die dood op 'n
menswaardige wyse tegemoet te gaan.
~ Die regverdigbaarheid van bogenoemde hulp kan slegs bepaal word as dit volg
op die herhaalde en vrywillige versoeke van iemand wat nie, wanneer hy/sy dit
versoek, ly aan 'n geestessiekte nie, wat bevoeg is of wat so 'n geskrewe of
mondelinge versoek, met getuies, gemaak het terwyl die persoon kompetent was.
~ Die studie handel nie oor bystand-in-sterfte, aktief of passief, waar dit uitgevoer
word op fisies of psigies ernstig gestremde pasgebore babas met 'n skrale kans
op oorlewing nie; ook nie oor genadedood ter verligting van kwaadaardige of
verlammende siekte in diegene met lewenslange [anoksiese, kongenitale,
inflammatoriese of traumatiese] geestelike ongesteldhede, wat nog nooit
besluitnemende kapasiteit gehad het nie.
~ Die studie ondersoek nie gevalle van bystand-met-sterfte waar inkompetente
persone wat ly aan seniliteit, Alzheimer se siekte, of permanente vegetatiewe
toestande a.g.v. brein patologie n.a.v. anoksiese, sirkulatoriese, infektiewe,
kwaadaardige of traumatiese gebeure, nie direk gevra het vir genadedood of
nooit die voorkeur vir geassisteerde genadedood uitgespreek het nie. Die doel van hierdie studie is om die morele saak van diegene ten gunste van die
wettiging van Vrywillige Geassisteerde Genadedood, ook bekend as
Geassisteerde Genadedood, te stel en om praktiese sowel as eties
verantwoordbare voorstelle te maak vir beleid en optrede wat kan bydra tot die
oplos van die morele dilemma wat dokters daagliks in die gesig staar wanneer
hulle deur geestelik bevoegde pasiënte wat ly aan ongeneesbare, kwaadaardige
of verlammende siektes, of die folterende simptome van die finale stadium van
Verworwe Immuniteits Gebrek Sindroom [VIGS], gevra word vir bystand in die
beeïndiging van hulle lewens.
~ Die studie sal die belangriker besware van diegene aanspreek wat teen die
wettiging is van geassisteerde genadedood vir geestelik bevoegde terminale
pasiënte wat ongeneesbaar ly of van dehumaniserende ongeneesbare finale
stadium siektes en wat naby is aan 'n onafwendbare dood.
~ Die insigte van filosowe, teoloë, dokters en sosioloë oor bystand-met-sterfte en
selfmoord, is nagevors in die wye literatuur beskikbaar is (beide in druk en
kuberruimte) oor hierdie onderwerpe en word saam met die studie angebied.
~ Die studie probeer aantoon dat 'n bevoegde volwassene in sekere erge
omstandighede 'n onvervreembare mensereg, indien nie 'n konstitusionele reg
nie, behoort te hê om bystand tydens genadedood te versoek.
~ Sulke bystand moet onderworpe wees aan groepsevaluasie, na versigtige
ondersoek deur 'n multi-dissiplinêre span in die gesondheidsprofessies [beide
fisies en psigies]. Die studie sal probeer bepaal of die uitvoering van vrywillige geassisteerde
selfmoord of geassisteerde genadedood moord is, of 'n aksie van empatie,
uitgevoer uit respek vir 'n medemens se outonomie, sy/haar reg tot selfdeterminasie
en self-realisasie.
)lo- Die relevansie van hierdie situasie lê daarin dat bystand-met-sterfte besig is om
een van die belangrikste morele, religieuse, filosofiese en biomediese dilemmas
van ons tyd te word.
)lo- Die outeur se posisie is dat dit nie regverdig of eties is om te verhoed dat 'n
geestelik bevoegde mens, wat ly aan folterende, ongeneesbare terminale fisiese
of ongeneesbare verlammende siekte, self kies om te sterf wanneer hy/sy nie
meer die lyding kan verdra nie en vir professionele bystand vra om dit uit te voer.
Die verligting behoort gegee te word, nie net aan diegene wat in staat is om 'n
bindende en ingeligte besluit te maak nie, maar ook aan -diegene wat [toe hulle
nog besluitnemende kapasitiet gehad het] vroeër 'n oorweegde, ingeligte
vroegtydige versoek gemaak het aangaande die gebruik van gewone en
buitengewone mediese metodes vir die verlenging van 'n lewe wat bloot 'n
bestaan geword het.
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