Euthanasia. Do Czechs care?


Euthanasia - in the original Greek the word means help in suffering, both medical and in the mind. The word now applies to the highly controversial issue of enhancing death on the request of a patient. Illegal in the Czech Republic, euthanasia became a topic of discussion and a political issue some ten years ago. Ever since then it has faded into the background, overshadowed by other events seen as more urgent. Talking to a few citizens of Prague about their opinion on euthanasia, I had the impression that many Czechs remain undecided.

"If I think about my dog I would let him die if he was very sick. I am not able to say the same about people. I am not sure."

"I can't imagine a situation when I would want to give up a chance to get better one day."

"I think yes, I would go for it. If it was an untreatable illness I would do it. We have a blind and mentally disabled relative and it is very difficult and tiring for the whole family.

"I am not sure I would have the courage. Are you not scared of death? I think that everyone tries to postpone it as much as it goes. If I had a seriously ill child I would just hope for a miracle and watch him suffering."

Supporters and opponents of euthanasia among professionals agree in one point. They both want to help dying patients. While supporters would prefer to do so by putting suffering and pain to an immediate end, opponents opt for palliative care, not trying to keep the patient alive artificially, but trying to alleviate their suffering as much as possible. Under this approach, patients are given painkillers and provided professional care at home, in hospitals or hospices.

Pavel Bocek
Pavel Bocek worked at Paediatric Clinic of Oncology at the Motol Faculty Hospital for thirteen years and has always been interested in trying to improve the quality of life of his terminally ill patients. He agrees with euthanasia but only under certain circumstances.

"If we are talking about euthanasia we should only talk about adult patients. I was seeing a patient who was suffering from one kind of cancer. He had numerous metastases in his body but his brain was clear. He was able to think about the quality of his life and he was in great pain although he was getting some anaesthetics. He was asking us, very directly, to stop his life because he could not bear to see himself in such a mess and he did not want to see the cancer win. He wanted to be the winner. From my point of view, we have first to ask the patient himself, because he is the one we are talking about. We have to focus on patients who want this to be done, who have a clear mind, and who have this very specific request."

What would your feeling be if you were to do it? Would you not still have some doubts?

"No, it might sound very aggressive or strange but no. If I am going to be the person who is going to fulfil the patient's last wish and he has asked for it many times my conscience will remain clear. If they are going to die they want to have the power to stop a miserable life. There must be many people involved in this process, at least two or three doctors who will agree and sign an agreement saying that a patient is suffering and there is no hope for him."

I suppose you have got into a discussion with people opposing your opinion for religious reasons. What were their main arguments?

"The main arguments were that doctors cannot decide that this patient is going to die or not. But my opinion is that it is not the decision of the doctor. A doctor is only a person who provides that."

Says Pavel Bucek once nicknamed "doctor death" because of his views. He makes clear that he would support legalisation of euthanasia but not before through discussion. Euthanasia, just like the death penalty, is irreversible and it is necessary to rule out its misuse. People on the streets seem to fear the same.

"I am against because I am not sure that someone would not misuse it."

"I think I would be for euthanasia because I personally would use it if it came to me."

"I would not be against it but it is difficult to be sure that a person really wants it. If there was some kind of a document saying so I would give the person the opportunity to decide for himself."

"I am not sure if I would be for or against. There is the danger that someone might use it in the wrong way. This is a country you where that can happen with everything."

Many opponents of euthanasia cite religious reasons. Vojtech Cinkrle the archbishop of Brno says the main reason for euthanasia is psychological. It is a result of the kind of life we lead today - individualistic, selfish and rejecting family values.

"I am against it. Life is a gift, it is something sacred so we can't take it away. Fans of euthanasia say that people have the right to do it. I would look a bit further than that and ask why people request euthanasia. Then you will find out that it is needless. It is common to say that people who request it are in unbearable pain but that is to be dealt with by doctors and they should be ashamed when their patients suffer. I think it is mainly because people feel that they are not useful and they are good for nothing. They very often don't want to bother anyone and have a feeling that no one loves them and no one cares. Consequently they request euthanasia."

The Czech population is ageing, doctors are increasingly complaining of a lack of money and the treatment of an increasing number of elderly and sick people is putting an ever greater strain on budgets.

"There is a need to talk about this question. The situation is different than fifty years ago. Thanks to social pressure and the media euthanasia is often viewed as something good. Something that can have many advantages - for example it can save money from the state budget. On the other hand we have to be reasonable and not try to keep a person who is dying artificially."

Coming from a family where - as so often - women outlive men, both my grandmothers are now in their mid eighties, I used to look forward to a long life. But as I watched many of the old and helpless patients of Zdenek Kalvach at the geriatric department of one of Prague hospitals I began to doubt whether I would really like to live to such an old age. Zdenek Kalvach.

"I can say that there is no case of a serious request for euthanasia. Sometimes people say: 'I would like to die,' but it is just a conversation. The most dying patients are not prepared to talk about their problems and their feelings. There is a psychological mechanism that makes them suppress it. They say: 'I don't understand it, I don't like to think about it, I don't like to discuss it.' It is our experience. I have tried to open a discussion with our patients several times but it was impossible. The only thing they were willing to discuss was a technical approach to illness: 'Oh, it is horrible, it is a cancer. What are we going to do with it?' They did not say: 'Oh, it is horrible, I am dying.'"

According to a survey euthanasia is now considered acceptable by almost 50 percent of Czechs. Would the number increase if the issue got more attention? Zdenek Kalvach again

"Maybe it is possible that as euthanasia gains more support, some people might think: 'Oh, yes it is not my own idea, but many people say it is not a bad idea, so maybe I should consider it.'"

And finally a few more views from the streets of Prague. My question was "Do you think that Czechs care about euthanasia?"

"It is not absolutely ignored. It is the same with homosexual couples for example. It is not a common issue so it is about 50: 50. I would say."

"Czechs don't care about anything apart from pork chops and social benefits. There are more important issues and no one cares. I think that euthanasia is not an issue that should be discussed at this stage."

And it certainly seems to be true, that while people talk endlessly about the price of pork chops in the shops, I don't think I've ever overhead a conversation about the rights and wrongs of euthanasia.