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Duty to Live

04/15/02 12:00AM By Cheryl Hanna

(Host) Commentator Cheryl Hanna has been following a legal case that raises some profound questions about life and death, rights and obligations.

(Hanna) Every so often, a legal case comes along that is tragic beyond description. The case of Miss B. is just such a case. She is a 43-year old British woman, single, with no children, who led a fulfilling life as a social worker until a blood vessel burst in the neck and left her paralyzed from the neck down, with no hope of recovery. After spending more than a year confined to a hospital bed and dependent on machines and government caregivers for survival, she demanded that her doctors remove her from her ventilator. They refused.

So Miss B. sued, and just a few weeks ago, a British court ruled in her favor. To be clear, this was not a case of physical assisted suicide. Miss B. could not have demanded that her doctors affirmatively end her life, such as by administering a lethal injection. Only in Oregon and the Netherlands, can a doctor hasten the deaths of some terminally ill patients.

Removing someone from life support is altogether different, however. In both England and the United States, as long as a patient is mentally competent, as Miss B. clearly is, a doctor must respect her decision about medical treatment, even if that decision will undoubtedly lead to death. Just as a doctor can't force a cancer patient to undergo chemotherapy, she can't force a paralyzed woman to stay on a machine.

So the legal questions in this case are easy. But the emotional issues are hard. Everyone in the hospital, even the judge, found her to be a remarkable woman who still has much to offer the world. Was there anything, the judge asked, that would change her mind? "I think, really," said Miss B., as she lay in a hospital bed, gasping for breath, "the only thing that probably would make a difference to my decision is if I had children. I would have had a much stronger duty and obligation to stick around."

We often talk about the right to die, but what does it mean to have a duty to live? It's a deeply personal question. I would like to think that if I were Miss B., I could still find meaning in my life, as so many people with disabilities do. And as someone who is also single and childless, as so many people are, it's profoundly sad to me that she may have felt the world needed her less because she had no family of her own. Then again, she was alone, and I can understand why a dignified death might be preferable to a dependent life.

The court was right to respect her wishes. But it breaks my heart that such a brave and far-too-young woman has spent some of the last few days of her life by herself convincing a court, and her country, that she should be allowed to die a natural and peaceful, death because she felt no duty to live.

This is Cheryl Hanna.

Cheryl Hanna is a professor at Vermont Law School in South Royalton, Vermont.
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