by Rooptaz Sineh Sibia. Medical Student . Medical Collece. University. Miami. FL

Sikhism’s Response to Withholding Care

Now that a better understanding Of Sikh history, life, and ideas has been established, the case of withholding or withdrawing treatment with respect to Sikhism may now be dealt with, Sikhism believes in using medicines and surgery if necessary The line between trying to save a life and unnecessarily prolonging its stay on car this very narrow in Sikhism, as it is in most religions. The Sikh Gurus tackled the problem of sickness and suffering by providing medical relief and alleviations of pain. One of the Gurus built a leprosarium and others established hospitals. Medical training was highly regarded. If a patient was in a situation where treatment was completely futile and death inevitable, Sikhism would not encourage the withholding or withdrawing of care, but would allow it.

At the death bed of a Sikh, the relatives and friends console themselves and the departing soul by reading a portion of the Guru Granth Sahib known as the Sukhmani Sahib (The Psalm of Peace). The Sukhmani Sahib is a source of comfort to a Sikh’s soul in time of trouble. Much of the meaning and strength of the Sukhmani Sahib is lost in translation but here is one verse that particularly deals with death: Re member God. By remembering thou shalt attain peace and efface from within the body strife and anguish … There is peace within the mind of Lord’s Slaves (Sukhmani 11).

After reading this verse it would appear that Sikhism encourages a peaceful death. By withdrawing of care death will take its natural course. Death should be peaceful and as dignified as possible, Here is another quote: By Lord’s Medilation, the torture of death flees, By Lord’s Meditation, death is removed (Guru Granth Sahib 496)

This verse shows that death is not to be feared and a faith in the Lord makes it easier to accept. The mortality of man is also dis played in the following lines;

Neither kings remain, nor beg gars, Neither the rich, nor the poor When one’s tum comes, nothing is there to help (Guru Granth Sahib 936).

Active Euthanasia: Pro and Con

Active voluntary euthanasia is a case in which a clearly competent person makes a completely voluntary and persistent request for aid in dying. The case for euthanasia is based on two central claims (Singer 1881), These claims are individual self-determination or autonomy and an individual’s right to wellbeing (Brock 11), By autonomy it is meant that people should be able to make important decisions about their lives for themselves based on their values or conceptions of a good life, and being able to act on those decisions (Brock 1 1). These rights, though, “must be balanced against the rights of other people and the values of society” (Singer 1882). Autonomy is valuable because it allows people to live according to their conception of a good life and allows people to take responsibility for their own lives. Being able to control one’s own life is a central aspect of human dignity, This concern about dignity extends to a person wanting control over his or her last stages of life, For those persons near death some of the most important issues become “maintaining the quality of one’s life, avoiding great suffering, maintaining the quality of one’s dignity, and insuring that others remember us as we wish them to” (Brock 11).

The second central argument for voluntary active euthanasia is a person’s right to individual wellbeing. When a person decides to forego treatment, he or she has decided that the best life possible with treatment is of poor quality and that it is worse than no further life at all, Life is no longer considered a benefit, but rather a burden to that person (Brock 1 1), Active euthanasia would be an act of com passion because it would relieve that person’s suffering (Pellegrino 95),

Critics of active euthanasia argue that the argument for a person’s autonomy and dignity is suspect. “When a patient opts for euthanasia he uses his freedom to give up his freedom” (Pellegrino 96). Furthermore, when a person chooses to end his life “he loses control over a whole set of options, all of which cannot be fore seen and many of which would be of importance if life the basis of freedom, had not been foregone” (Pellegrino 96),

The argument for a person’s right to individual wellbeing also faces criticism, “Critical times force us to reveal and confront the inner self’ (Pellegrino 97), Accepting euthanasia deprives individuals of experiencing these inner insights, Suffering may serve some purpose. “The lives of many of the handicapped, the retarded, and the aged teach us much about courage and personal growth” (Pellegrino 97),

In summary, these are the arguments for active euthanasia. Euthanasia can lessen the emotional and psychological hardships which include the loss of independence, the feeling of hopelessness and the basic fear of death. The fears about how and when death will occur are also eliminated, Euthanasia also gives a person control over the process of dying. These benefits of euthanasia must be weighed against the potential harms of euthanasia (Singer 1882). One of the most commonly cited arguments against allowing active euthanasia is that it will lead to policies which would lead to a “subtle coercion of other powerless to choose death rather than become burdens to society or their families” (Quill 1383) This argument is known as the slippery slope argument Once you start down the slope you don’t know where it will end. “There could be a gradual erosion and ultimately a break down in our respect for life (Parakh and Slesnick 48), Allowing euthanasia could lead to involuntary euthanasia, The first is crypthanasia Which literally means secret euthanasia, Vulnerable patients may be euthanized without their consent. The second way is through encouraged euthanasia, “chronically ill or dying patients may be pressured to choose euthanasia to spare their families financial or emotional strain” (Singer 1882). The third way “surrogate euthanasia, incompetent patients may be euthanized on the basis of substituted judgments (Singer 1882). The fourth is discriminatory euthanasia in which vulnerable groups such as the poor, the elderly, the disabled, and minority groups may be pressured into re~ questing euthanasia (Singer 1882),

Those who argue for euthanasia claim that with procedural safe guards, such as those in the Netherlands, where euthanasia is not prosecuted, the fall into the slippery slope will not occur. The Criteria for euthanasia in the Netherlands include: (i) that the patient’s request must be persistent, conscious, and freely made (ii) the patient’s suffering, including but not limited to physical pain, cannot be relieved by any other means (iii) the attending physician must consult with a colleague regarding the patient’s condition and the genuineness and appropriateness of the request for euthanasia

(iv.) all options for alternate care: have been exercised (Wachter 23),

To be Continued.

Article extracted from this publication >>  October 29, 1993