For "Life-Long" Dignity

Chieko Inoue
Waseda University ESS

The hospital is a place where countless precious lives are saved, but at the same time, it is a place where countless precious dignities are neglected, under the name of "treatment."

In the end of 1980s, my grandparents died of terminal cancer after weeks of life-prolonging treatment. The treatment was done although they pleaded the doctors not to. Their throats were cut open to pass the tubes through; their wrists and ankles were strapped so they couldn't pull the tubes out. Their tears and voiceless cries were totally ignored. Eventually, they died in isolation, with no one replying to their weak, but desperate appeals. For the first time, I learned that treatment can be a torture for patients if it is done against their will, especially for terminal patients who have lost every kind of physical freedom. Today, I'd like to discuss why and how the wills of terminal patients should be reflected.

As you know, death with dignity has been one of the social topics, but still, there is no legal system which enables us to actualize it. Death with dignity medically means to choose not to receive life-prolongation beforehand. The doctors cannot practice death with dignity without legal consent even if they are asked to, because it is concerned with life and they may be involved in legal problem afterwards. According to the data by the association of Living Will in 1997, over 90 percent of the life-prolongation is done without the agreement of the patients, although 75 percent of the people desire death with dignity. Still, terminal patients are dying like my grandparents, deprived of their dignity, in other words, respect toward their will and recognition as individuals. Many people are forsaken in the darkness where their wills are neglected and voices unheard, disregarded as if they don't exist.

To assure the right of terminal patients, in the United States, a law called Self Determination Act was framed in 1991. That is the law to oblige doctors to give a brochure about death with dignity. For the patients who will be hospitalized, the doctors must help the patients make a document according to their will, which indicates what kind of treatment they want to receive, and don't want to receive in their terminal stage. If the doctors don't do so, they will be punished. So, terminal patients in the United States are able to choose if they want to receive life-prolongation.

Then, why don't we have such a system like the United States? In fact, in 1994, The Science Council of Japan tried to establish a law similar to Sell Determination Act, but the guideline didn't draw a clear line between death with dignity and passive euthanasia. So, the proposal was turned down because passive euthanasia requires some kind of action to be taken to stop the life. But, not like passive euthanasia, death with dignity doesn't require any kind of third person's actions, and the patients can still live within the treatment they chose to receive. Although it is quite simple to distinguish death with dignity and passive euthanasia, the government didn't clarify the point.

Then here comes another question. If it wasn't so difficult, why didn't the government make more specific guideline after 1994? That was because there wasn't voice of the ordinary people who actually appealed to the government to establish the system. We don't understand the fact that legal system is indispensable; because we think blindly that death with dignity can be realized even without it, if we just say so when the time comes.

Although so many people desire death with dignity, why are we so unaware of the reality? We say oh yes, death with dignity sounds nice to me, but never think why it sounds nice seriously. Somewhere in our minds we still think it's somebody else's problem to care about. Ladies and gentlemen, now, please consider this problem carefully. I believe, that because we have a right to live with dignity, we also have a right to die with dignity. That means, until the very last moment of our lives, our will should be respected. I can understand the doctor's and families' feelings that they want the patients to live as long as possible, but it is nothing but a distress if we cannot decide over our own lives. Treatment should always be done under our agreement, because medical technology exists for us, and it’s never the other way around. Especially if your life is in the terminal stage, no mailer what you will do, it will be the last scene of your stage called "life". Even if you regret, you can't do it over in the next scene. We should face this problem now, because it is too late to fight to retrieve our dignity after we have lost it.

So, we must raise our voice while our voice can still be heard. We must demand the government to set clear definition for death with dignity and legalize the system. You might say that there is nothing we ordinary people could do, but in 1996, the Ministry of Health and Welfare opened the Health and Science Council, to listen to our opinions and make guidelines that meet our demand. We can express our opinions in the homepage of the internet, or by letters. We can also participate in the meeting. We shouldn't waste these opportunities, because nothing would ever change if we just sit back and wait. We must not leave it handing in midair like four years ago.

Ladies and gentlemen, even in speeches, this topic has been discussed repeatedly for this past decade. Still, I chose to talk about it today in my final speech contest because it is about time to make this speech the last one, and it is the best time to do so. I don't want you, or your loving family to suffer from undesired treatment like my grandparents. Because we have only one life to live, and only one death to crown that life, I believe, that we should never give up the right to hold our dignities until the very end, so we can live, and die as a "human" in a true sense.

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