We are often reluctant to talk openly about the prospect of death or our preferences regarding end-of-life care and spend enormous resources, often with little or no measurable benefit to the dying.
With advancement of life-supportive technologies for delaying death, patients now receive therapeutic care, cardiopulmonary resuscitation, ventilator support or ICU care even when death is imminent and it is not necessarily in the individual patient’s best interests or for any human or humane benefit.
Although our laws respect and acknowledge the principle of the sanctity of life under Article 26 of the Constitution, the right to life is not absolute.
We should not pursue it to the point at which it becomes almost empty of real content or involves the sacrifice of other important values, such as human dignity and freedom of choice.
Maintaining life alone may not be in a patient’s best interest if the treatment does nothing to improve their condition.
And while life-supportive measures may help to assuage feelings of helplessness on the part of families and caregivers, no one should be denied the right to a dignified death.
Many state laws acknowledge “best interest” analysis in making treatment decisions for incapacitated patients or those in constant and unbearable physical or mental suffering that cannot be alleviated.
In Kenya, euthanasia and/or assisted suicide is illegal and a medical practitioner who conducts it is liable of manslaughter or murder, depending on the circumstances, under Section 21 3(d) of the Penal Code, whether the person requested it or not.
Denying people the right to make decisions concerning their bodily integrity and medical care violates their freedom of liberty.
And by making them to endure intolerable suffering, it impinges on their security of person.
One’s response to a grievous and irremediable medical condition is critical to their dignity and autonomy.
Life is sacrosanct. However, withdrawing life support is not “killing” the patient but rather allowing them to die of the underlying disease or injury which led to it in the first place.
Courts in some jurisdictions have taken the position that “a view that life must be preserved at all costs does not sanctify life”.
Kenya should legalise euthanasia and/or physician-assisted suicide for deserving cases. Without legal guidance, it is difficult to know when to cease life support if a patient’s condition will not improve.
Possibly, most people would prefer not to receive life-sustaining treatment if they are in too much pain and with no chances of ever recovering, or if they are confirmed to be in permanent vegetative state and surrogate decision-makers face the dilemma of whether to continue life support with no hope of recovery.
“Best interests” should be interpreted to include not only medical interests but also the patient’s wishes, values and preferences.
If we truly value autonomy, our laws and the end-of-life practices that operate within them must do more to protect incapacitated patients’ choices from those who may, by default or deliberation, impose their personal views about the sanctity of life on others.
Indeed, all reasonable steps which are in the person’s best interest should be taken to prolong their life — unless, of course, treatment is futile, overly burdensome to the patient or where there is no prospect of recovery.
