LIVING, DYING

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Euthanasia (A Good Death) is a Fitting Climax to Euvivasia (A Good Life)

Va sa msi ji rna ni yatha viha ya
Nava ni grhna ti nar๓ para ni |
Tatha s ari ra ni viha ya ji rna ny
Anya ni samya ti nava ni dehi ||
Bhagwad Gita (stanza 22 of Ch. 2)

Tr.: Just as a person casts off worn-out garbs and puts on others
that are new, even so does the embodied soul casts off worn-
out bodies and takes on others that are new.
Dr. Radhakrishanan

The act of dying is the last positive act that only the living alone can
perform. So dying is the ultimate step in living. The person (Atman)
leaves, and her/his unatmic (anatomic, from an = not, and
atomic =atmic) body stays behind yet looking just the same person.
This act of shifting from being to nonbeing is an active one for it is
done by living person. So you do not die, but you cease to live, ceasing
being an intransitive verb connoting activity.

The etymology of to die, as a verb, is shrouded in mystery and
therefore claims to have too many sources. Amongst these two are
most appealing, namely, old Irish duine meaning man (subject to death;
a mortal), and the Gothic root diwans meaning mortal from un /
diwanei meaning immortality. Indians words connoting a living body
are more graphic and vivid. The word deha is rooted in dahan or
burning at cremation. The word sharir is more truly ksharir from
kshayate iti ksharirum implying that one that undergoes kshaya or
decay every moment is ksharir ( deha = ksharir = gross body).

When the lexicons try to explain the verb die , they use a series of
active intransitives, such as to pass, suffer, come, become, disappear
and so on, thus indicating something actively done. Dying or death
thus can be viewed as the final bow that the person offers to the world
before the curtain falls. Reverence for death and dying comprise the
ultimate respect one pays to the journey of living.

Indian thought has spiritually woven death as integral to living and
growing by evolving the concept of the Holy Trinity or Trimurti
comprising Brahma the creator, Vishnu the sustainer, and Shiva the
dissolver or the destroyer. The forgoing is uncannily incorporated in
DNA the molecule of life, D denotes development, N nuture and A
annihilation. In the epigraph above the Bhagwad Gita provides an
excellent metaphor.

The beautiful adage that "You owe yourself a good death" is pregnant
with the idea that you acquit yourself of your final duty while still
alive. Life seen as a brief stay between two heart beats, your first and
your last, makes being dead as but the obverse side of being born.

The commonest mode of death, that is, natural non-accidental, is
neither a blot of medical failure, loss of life, or a blow from a killer
disease but the final act that the living performs. The so-called process
of dying is needlessly synonymized with pathologies and diseases.
The journey called dying, whose destination is death, begins with the
act of living ushered in by the beating heart providing the first
evidence of the functioning and developing human being, in the
mother 's womb. The Lubb of the heart's contraction affirms Life and
the immediate sequential Dupp of the heart's relaxation stands for
Dying or Death. This duet continues for 4 billion times in a human
life of 100 years, during which the person uses a ration of one billion
breaths, each breath making the person first Inspire and then Expire.
Dying or death is thus nothing new to life. Death is medically declared
as arrived when there is no more dying either through the heartbeat
or the breath.

Each lubb of the heart and drawing in of air (inspiration) are acts of
affirmation of life. Equally, each dupp of the heart and exhaling of
air (expiration) are acceptance, or non-denial, of death. Such a
thoughtful, mindful spiritual sequence makes for a ceaseless play of
good life (euvivasia), and a good death (euthanasia). The final active
act of good living is good dying that brings the hitherto ceaseless
duet to an end.

If living and dying are physiologically recurring lubb/dubb, inspire/
expire sequences, then the process of dying and the ultimate event of
death when there is no more dying, are all integral to human
development. The eminent Harvard biologist Dobzhansky has averred
that the animal trajectory, from conception to cremation, as growth,
development, aging and senescence is a natural phenomenon. In fact,
the one function of human life that has maintained its pristine
physiological status of precise timing is death under natural
circumstances. The banal, ordinary truth that the healthy do not always
survive, and the diseased do not always die, dissociates disease and
death from the assumed cause and effect sequence. Disease and
diseasing are functions of the body, whereas death is the function of
time. That is why Lord Krishna declares in the Gita that "I am Time"
(and not disease) designed to bring human life to an end. Life is so
strong that it manages to disregard a museum of diseases in a single
man whose prayers to the Lord to deliver him from his mortal frame
prove of no avail. Death is so precisely timed that it could not care
less for a ten star hospital equipped by fifteen star equipment and run
by a horde of twenty star doctors. The most chastising part of the
superspecialty hospital culture is the serenity with which death
dominates the scene.

The intellectual burden of the foregoing is to dissociate an advanced
state of disease from the immediacy of death. The label of particular
"killer" disease medically foisted on to the patient can not be the guide
to the so-called euthanasia tragically synonymized as mercy killing .
The most incurable disease in fact is life for it always ends in death.
Let us forthwith dissociate disease from suffering and death from
disease. A man with advanced inoperable cancer, as happens even to
many a cancer specialist, may be fully at peace, unaware of the disease
(i.e. diagnosed "too late") because of the oft-observed fact of the
absence of any accompanying dis-ease or lack of ease. Dispensing
with disease as causing death robs euthanasia-enthusiasts of the
pathological prop to their movement. Let us question the whole
concept of death, needing disease as a cause. To accept death as a
physiologic event is to sublimate thanatology and to free medicine-
n-mankind of a lot of fear, frenetics, and foolhardiness.

Euthanasia: A Semantic Error
The lexicographic error is to define euthanasia as 'mercy killing,' a
classical example of the bad use of a good word. An editorial in The
Medical Journal of Australia,1976, pointed out that by conventional
standards and by the law as it is, euthanasia means murder: 'Behind
this is the blunt fact that euthanasia, for all the mildness of its root
meaning, in current usage means the active and deliberate ending of
a life - that is killing.' A British Medical Journal editorial, 1975,
written in a similar vein concluded that what now connotes euthanasia
had better be replaced by the concept of assisted suicide . The
conundrum is traceable to the fact that, as a cover for our conceptual
inadequacies, euthanasia has been forced to mean the monstrous
hybrid called mercy killing.

The internet biography of Viktor Frankl, by George Boeree, has a
significant statement: "He made many a false diagnosis of his patients
in order to circumvent the new policies requiring euthanasia of the
mentally ill." So, it transpires that, in the Nazi Concentration Camps,
and in the WWW of today, euthanasia continues to be mercy/merciless
killing. The real-meaning of euthanasia – a good death – would allow
Hitler and his cronies to say that they gifted millions of Jews a good
death, for which, to say the least, the Jewry and the thinking world
should be grateful to them. The practice of "euthanasia" as a part of
Hitlerian Final Solution - Endl sung – should, now, deter us from
misusing the term euthanasia.

Huxley, in The Perennial Philosophy , has asserted that many a thought
is unthinkable without appropriate vocabulary and a frame of
reference. Let us use Huxley's statement to clear the seemingly
insoluble confusion and to return to euthanasia its pristine benignity
and glory. Towards this, we may also be helped by Apley who pointed
out that we indispensably need new words to keep abreast of new
ideas. The intellectual cycle of new concepts spawning new terms
that in turn beget newer ideas is the heartthrob of the expansion of
mental horizons.

Eu - as a prefix clearly implies 'good' or 'well'; thus we have eupep-
sia, euphoria, eugenics and so on. Euthanasia then means good death,
and not, as the British Medical Journal erroneously assumed, an 'easy
death'. What the so-called euthanasia or mercy killing purports to
provide is a swift end to the process of dying, a quick death that could
logically be called tachythanasia ( tachy meaning 'quick' or 'rapid').
When Sigmund Freud suffering at 83 from an obstinate oral carci-
noma for 17 years was injected with four centigrams of morphine by
his physician-friend Max Schur, he was not euthanatized, but
tachythanatized. Tachythanasia could be defined as a medically-eased/
expedited-death.

It is a paradox of modern times that medical men are busy prolonging
the lives of diseased, senescent individuals, while destroying, quite
lawfully, nascent fully-formed fetuses. It is equally paradoxical that
the Japanese, who pioneered the free abortion movement soon after
the Second World War, should have recently prosecuted and punished
a helpless father who felt compelled to put an end to the life of his
desperately handicapped son. Sir Theodore Fox, as the editor of The
Lancet , 1965, declared that ' Life is not the most important thing in
life.' If heart attack, stroke or cancer takes away a human being in a
split second by engendering what may be called a 'guillotine- death',
then each of these very diseases, as a necessary polar-opposite, makes
itself a protracted affair, wherein the soul of the patient looks like a
suffering prisoner of the irremediably ailing soma.

Euthanasia, Dysthanasia, Tachythanasia
The foregoing has now brought us to the intellectually ripe stage of
discussing the art of dying . Dying is the final, active act of the living
and therefore it is a mere climax to the sustained, uninterrupted art of
living, of savoring joie de vivre , of feeling happy within and without,
in communion with whichever God you believe in, or choose to deny.

To die when you are fully fit to live, when you are manifestly in
compos mentis et somatis , to die without an identifiable cause rightly
so because you were born without any identifiable reason, is to die
actively, abjuring the body as an act of programmed will of the body,
your final bow to the global audience before, like Rabelais, you
jestfully declare: "Let down the curtain, the farce is over." Put
clinically, you euthanatize, you die well when you foreknowingly die
even when your own doctor felt that you were fully fit to live. Three
hundred years before Christ, Aristotle summed up euthanasia
succinctly: "It is best to quit life, just as we leave a banquet, neither
thirsty, nor drunken."

The distinction between euthanasia and tachythanasia is in order.
Euthanasia is self-earned, self-willed dignified departure unsullied
by any medical intervention or condescension. Tachythanasia is a
medically offered facility that helps to expedite the task a patient is
already engaged in - protracted dying. It should be clear that
tachythanasia is not assisted suicide. Jumping into the Thames or off
the Eiffel Tower also is not tachythanasia. It is suicide. Dysthanasia ,
a bad death, on the other hand is, in the opinion of many, a common
sin of modern medicine. Medical technology has made dying lonely,
gruesome, dehumanized, mechanical, obscene and immensely
troublesome and expensive. The fact that modern medicine has chosen
to distort euthanasia to suit itself, and has not bothered to label as
dysthanasia much that it does, speaks of the current intellectual crisis
in medical thinking.

Where Do We Go From Here vis-a-vis Euthanasia?
The current concepts and movements of Dying with Dignity , Exit (as
in the U.K). Living Will (as in the USA) or the general idea of
euthanasia which being medically accelerated death is not euthanasia
but tachythanasia, are as much rooted in relieving human suffering
permanently, as also in the paranoia that medical men have inflicted
on mankind with such epithets as "Killer disease" number one (heart
attack) number two (cancer) and number three (stroke) and then
number n ….ad nauseum . The presence of all the three, and more in a
single person neither inflicts unbearable suffering nor inevitable death.
The moral of the story is that in the presence of these killers the
reasonably good ease that the patient is enjoying or can be provided
abolish medical diagnosis as a consideration for advising or promoting
tachythanasia. There was a report from the USA of a lady accidentally
diagnosed to have breast "cancer" (which as well could have been a
benign lump), jumping to death. And now there are reports coming
from world over about a fully healthy person declared HIV positive
either killing himself or herself or being hacked to death in the name
of public safety. Medically foisted paranoia must part company of
tachythanasia-activists subjectively and objectively.

Most killer diseases are in the fact integral to human growing and are
far more kind than the human traits of anger, aggression, avarice, rank
cruelty to the human species in particular and rest of the biokingdom
in general. The second important reason is that critical studies have
failed to reveal the killer diseases as invariably denying long peaceful
and creative life. Thirdly, when human suffering does arise from
whatever reason, it behooves that the bearer develops and sustains
fortitude and the people around kindle within themselves concern,
care, and company for the sufferer from a sense of altruism as also
the realization that one day they may be at the receiving end. Most
religions see suffering as a prayer, a penance, a lesson of the
ephemerality of human existence and the worthlessness of all gold
and silver. The healthy and young at home must witness the drama of
suffering that spares no age to evoke in them the ability to understand
and accept sickness and suffering and the need to rise to the occasion
to make light of a serious event. Mishaps and tragedies fall to all to
serve as great philosophic teachers.

Tachythanasia does have to have a place in the scheme of living and
dying. A decerebrate person, medically declared brain dead and
proving to be a huge drain on the average family, hospital, or the
state could be tachythanatised. Unbearable pain in cancer is the
aftermath of aggressive cancer surgery and more so chemotherapy
and radiotherapy wherein the ravaged soma tortures the soul despite
all the anodynes that the medical man can marshal. This is the path
Sigmund Freud, the father of modern psychiatry chose after the 33rd
surgery for a 17 year old jaw cancer. A person with gross cirrhosis of
the liver, or, cardiomyopathy rendering him breathless, restless,
bloated and at unease 1440 minutes of the day could be helped to die,
albeit , with his or her desire and consent. Put generally, tachythanasia
is the last refuge of the desperate where all the dignity of living has
departed, and death is refusing to oblige. Such an approach can provide
an easy merger into eternity, thus obviating heroic and costly measures
that divest the dying persons from home and family, and living behind
the latter in state of debt and penury.

Such a general outline is applicable in any country for it does not
demand some extraordinary wisdom or resources. India is a poor
country wherein family values and ties hold the very sick and the
caring healthy together often at a great cost and very little gain. Our
legislators who have failed at controlling the great killers in the shape
of polluted and infected water, pesticided food and fouled up air and
worst of all the exponentially increasing violent vehicles on the road,
should not strain at swallowing the gnat of tachythanasia or assisted
medical death after having swallowed the whole camel of the above
mentioned demons that maim and kill on an astronomical scale. If
there are a thousand procedural forms that a small businessman must
maintain, then surely the nation can put its medical, social, religious
and philosophical heads together to evolve a compassionate and a
nearly foolproof scheme to provide legal sanction to tachythanasia.

Euvivasia: A Good Life A Means to A Good Death
The balancing opposite of, and the highway to, euthanasia is euvivasia
- a good life, a yea-saying to life that ends with a yea-saying to death.
Describing euvivasia is too tall an order, but an attempt may be made
by weaving the theme around Schweitzer's concept - reverence for
life. The meaning of one's existence is to preserve unspoiled,
undisturbed and undistorted the image of eternity with which each
person is born. A genuine sense of reverence for the elements within
and around us, can help each one of us steer our life towards imparting
to our existence a meaning, towards living a good life culminating in
a good death.

Euthanasia: A Good Death
Euthanasia is climactic to euvivasia. It is difficult to spell out its
method. Humble inquiries into the lives of people around would reveal
for oneself the true death-story of many who died a good death,
without any medical tutoring. They could predict their end and
welcome it, as they would a friend. Some could even time it. Robert
Platt, the English physician and writer, relates the case of a vivacious
young Scandinavian with progressive pulmonary fibrosis, admitted
to an English hospital during the Second World War. One day he asked
a nurse what hour would a patient's death cause the least bother to
others. Next day, he was found dead, at the time he was apprised of.
A celebrated example, of yet a younger person, is of John Gunther
Jr., who, in the words of his father, died without any fear or pain. We
personally witnessed, recently, a robust, lively man of 88 suddenly
discovering that he had throat cancer. He said, 'My time is up.' For 3
months thereafter, until his death following a heart attack, he was a
picture of grace, gratitude and what is more, love and affection.

Amongst the deaths of the notables, two are worthy of mention here -
Haldane, and Einstein. JBS Haldane had cancer of the rectum, and
typical of him, he died after leaving behind an elegiac tribute to his
own cancer. 'Cancer' he wrote, 'can be rather fun/Provided one
confronts the tumour/With a sufficient sense of humour.' Of his death
from it, he admitted that 'I know cancer often kills/But so do cars and
sleeping pills.' Einstein's final hours have been described by his
daughter Margot: "I did not recognize him at first - so changed was
he by the pain and the lack of blood in his face. But his manner was
the same. He was glad that I was looking a little better, joked with me
and faced his own state with complete superiority; he talked with
perfect calm, even with slight humour about the doctors, and was
waiting for his end as if for an expected natural phenomenon. As
fearless as he was in life, so quietly and modestly he faced his death.
He left this world without sentimentality and without regret."

There are some gifted individuals who know the time of their death, a
kind of personal thanatognosis. An example close to the authors is
cited here. Mrs. K, who died at the age of 80, predicted her death 16
months earlier at a time when she was enjoying full health. On the
appointed day - Narsinhachaudash , a holy day amongst Hindus - all
her family members came and took her blessings. Her doctor-son, a
cardiologist in the USA, checked her in the evening and assured
everyone that she was perfectly normal. A little later, she requested
that she be left alone. She prayed, and died soon after. A veterinary
surgeon of Mumbai has described the willed death of a dog under
poignant circumstances. A dog was run over by a car that left him
severely injured, paraplegic and in shock. Admitted to the hospital,
the doctors said that he would not survive for more than a few hours.
The dog's master was in England, and his return to Mumbai took three
days. The dog lingered on. The master rushed from the airport to the
hospital. He took the dog's head in his lap, and while he was stroking
his head, the dog passed away.

Reverence for life is Schweitzer 's legacy to mankind which deserves
a balancing opposite, reverence for death. This dual concept in its
manifold sense, is a way towards still farther reaches of human nature,
and human soul. It is good, for man, to revere death so that he can
revere life.

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