Impact of Euthanasia on the Family

An issue that is often overlooked in the debate over legalisation of euthanasia and assisted suicide (EAS) is the many ways that EAS could affect other family members.
  • Family members may not all agree that it is the best course of action for a loved one to choose EAS, causing conflict and a possible family split.
  • There may be pressure from family to choose EAS for economic and inheritance reasons.
  • Family members and caregivers may be unable to cope with what they see as the suffering of the loved one.
  • While thinking EAS the right thing to do at the time, some may regret their decision at a later date leading to unresolved grieving.
  • EAS may send signals to other family members that choosing death is an acceptable action, and lead to suicides.
Euthanasia and assisted suicide - EAS - doesn't just affect the individual. What hasn't been discussed very much, at least in the media, is the effect it can have on the family of the patient.

In the normal course of an illness, loved ones, friends and family are all going to be involved in the dying process.

Having to watch a loved one's symptoms get worse, sometimes over a long period of time, can be very harrowing.

In his book Death as a Salesman - What's Wrong with Assisted Suicide, anti-euthanasia activist Brian Johnston says:

"In addition to their own emotional needs, it is the family and friends, more than anyone else, who will influence the mood and mindset of the patient. They may, even unwittingly, reinforce negative thoughts and attitudes.

"...the gravely ill are emotionally vulnerable, and depressed family members may unconsciously reinforce, or even suggest 'suicidal' thoughts. 1 Sometimes it is the family members who are in even greater emotional need than the patient." 2

If assisted suicide and active voluntary euthanasia were legal and readily available, opponents are concerned that those who are chronically or terminally ill and the elderly, might feel obligated to opt for death, so as not to be a burden on relatives or other caregivers.

Unbearable suffering
Unbearable suffering is one of the most frequent reasons used by EAS advocates to justify legalisation. On the subject of pain medication given to terminally ill patients, a study in the Journal of the American Medical Association said:
"Surprisingly the drugs were given nearly as often "for the comfort" of the patient's family as they were give to reduce the suffering of the patient themselves... [Additionally] in four out of every five cases, nurses who had discretion in administering drugs said that they were treating the patients for the comfort of their loved ones." 3
Family conflict
Conflict often arises due to differing opinions and beliefs of various family members. A family member or friend with an Enduring Power of Attorney, or who has been appointed Guardian, may face battles about continuing, withholding or withdrawing medical treatment.

When decisions are made and carried out without family consultation and/or agreement, the resulting bitterness may split a family apart, sometimes forever. 

Financial pressures
The ageing of the New Zealand population means that the number of older people needing treatment and support will continue to increase unless older people are healthier in the future. The proportion of people over 65 in the population will double in the next 40 years.

Families, it is feared, may pressure patients to choose assisted suicide to avoid spending money that the patient otherwise could leave to the family. Or, family members may exert pressure because they are spending too much of their own money. Patients themselves may opt for assisted suicide to save money as a duty to their loved-ones. 

Later regrets
While many family members who have had a loved one die by euthanasia or assisted suicide have said how they feel at peace with the decision, there are some who find it hard to live with it.

After Rebecca Badger, one of Dr Jack Kevorkian's 'clients', killed herself her daughter Christy discovered the diagnosis of Multiple Sclerosis was wrong. The autopsy showed that her mother did not have MS and, if she had sought a second opinion instead of assisted suicide, might still be alive today. Christy describes the Kevorkian-suicide experience and what has followed in one word: "Overwhelming." 4

Family members of assisted suicide patients have found that neighbors and coworkers sometimes react callously to this controversial kind of death.

Another of Kevorkian's clients, Linda Henslee arrived in Michigan a few days early to spend more time with her daughters. Encamped in a motel room, the women made videotapes, sorted old photographs, organized a family scrapbook -- and enjoyed their favorite foods: champagne, strawberries, shrimp and chocolate eclairs.

In spite of it all, Dawn Henslee said, the aftermath has been "the most horrifying experience that I've ever been through."

While Henslee found the invasion of reporters disturbing - she found the callous responses of other people just as troubling.

"For months, we didn't have time to grieve properly -- and people didn't treat us like we were grieving, either," Henslee said. "The guy who came to pick up the hospital bed that mother had used, told us: 'Normally, I would say I'm sorry, but I guess this is what she wanted.' He didn't think this was a loss for us."

Sending a negative message
Many EAS opponents believe that establishing an option of assisted suicide or euthanasia would have negative consequences not only for patients who receive assisted dying, but for many others.

Some fear a general reduction of respect for human life if official barriers to killing are removed, citing high youth suicide figures. They believe that grieving and/or depressed family members may kill themselves at a later date.

A report published by the UK Voluntary Euthanasia Society (VES) on 9th September 2003 , stated “30% of suspects in reported mercy killing cases end up committing suicide.” The chief executive of VES, Deborah Annetts is quoted as saying, “Behind the statistic of 30% of mercy killers going on to commit suicide, there lies a huge amount of suffering.” 5

Ms Annetts' interpretation of the statistic is that 'mercy killers' commit suicide because they are fearful of prosecution. 

The fear of prosecution is unlikely to be uppermost in their minds, because it is a known fact that the Courts more often than not tend toward leniency in ‘mercy killing' cases. It seems just as likely that the person who has assisted a loved one to die may have begun to suffer guilt, remorse and despair.

References:
  1. Margaret Pabst-Battain, "Manipulated Suicide," Bioethics Quarterly 2 (1980), pp. 123, 134.
  2. Brian P, Johnston, "Death as a Salesman - What's Wrong with Assisted Suicide," Ch. 2 p. 17
  3. K.M. Foley, "The Relationship of Pain and Symptom Management to Patient Request for Physician-Assisted Suicide," Journal of Pain and Symptom Management 6 (July 1991) 290.
  4. Death stuns relatives who expected a conclusion
  5. www.ves.org.uk/newsstory