America prides itself on the liberty of its citizens however the liberty to choose to end your life several weeks or months before it would inevitably end anyway is one that that groups calling themselves "Right To Life" are trying to deny US citizens (it is one that Australia also denies). The option, known as Oregon's Death With Dignity Act, has been legal in Oregon since November 1997 and is taken primarily by terminally ill cancer patients.

The Green Man thinks that these groups should, perhaps be renamed "Obligation To Life" groups after all a "right" is something that you can choose to forego. In the the US for example, if you are over 21, you have a right to drink alcohol but you don't find many groups protesting over those who choose not to comsume it.

Recent studies have shown that people choosing to end their lives

- are not depressed
- seek assistance only after a deliberative and thoughtful process rather than on impulse

This has not detered those that The Green Man, somewhat unkindly, refers to as "those right wing fundamentalist loonies" from seeking to trapple on the rights of those of their fellow citizens who find themselves in a situation that, it is fair to say, we all dread. Weakened by cancer and chemotherapy, they are near death and with a life expectancy that is counted in days, it is entirely reasonable that these people want to have power over the one thing that is left for them, their death.

The Bush Administration has tried to turn this right into an obligation in the past. John Ashcroft, then the attorney general, announced in November 2001 that the Administration had reversed the response to the Oregon law espoused by Janet Reno, the attorney general in the Clinton administration which stated that

The federal government's pursuit of adverse actions against Oregon physicians who fully comply with that state's Death With Dignity Act would be beyond the purpose of the C.S.A. (Controlled Substances Act)

In summary the Bush Administration went the doctors under this act because they claimed that suicide is not a "legitimate medical purpose" under regulations of the federal Controlled Substances Act. They failed.

It is now back on the agenda and once more terminally ill patients and those that care for them are faced with an onslaught from those who would deny them their liberty to choose to end their lives a month/week/day earlier than it might otherwise end.

When the patient is a child the emotion and the ethical dilemma is magnified immeasureably. St Judes, a hospital in the US that specialises in pediatric cancer and palliative care of children (how sad that we need such a facility), and Sydney Children's Hospital in Australia have found that child cancer patients as young as 10 years old who are aware that their disease is incurable have the ability to participate meaningfully in discussions of their own end-of-life care with family members and the health care team. They say

These children identified their deaths as an outcome of their decisions to end or limit treatment, understood that they were participating in decisions about the end of their own lives, and recognized the consequences of their decisions.

Staggeringly, faced with all of their troubles and their awareness of their own limited life expectancy, these children and adolescents were motivated more by their concern for others than by their own needs. Entering into a trial of a drug from which she would gain little or nothing one 14-year-old girls said

If I can help someone else, that's wonderful, I think

another said

If I don't take it, my family would support me, but they don't want me to quit. Grandpa said he would worry himself to death if I don't try it. My boyfriend wants me to take it for him. I don't want to do it but for my family.

A parent, of course, will do anything and everything they can to try an cure their child and it takes great courage to withdraw treatment to allow your child respite from the tortuous regime of chemo and radio therapy. A 15-year-old girl with acute lymphoblastic leukemia said

We decided not to go with chemo because I don't want to be sick the rest of my days, and it's not like it is going to cure me, so I just said, 'We'll go home and take it from there.'

These children know they are shortening their lives but they want to actually enjoy the few days that they have left as best they can. They will inevitably, and often quickly, reach a stage where they are in complete agony and are finished with life; they will wish to die. The situation is tragic and far more complex than the simplistic scenario that is painted by the "Right To Life" extremists.

Source New York Times and here St Judes Research here.