Wednesday, April 22, 2009

Survival Instinct

Humans and animals are born with the survival instinct. They have some sort of pre-programmed mechanism in the brain to do whatever it takes to preserve life. Of course they are some people who'd commit suicide, but the vast majority of the human race will try to remain alive no matter what.

Take the playboy for example. He abuses his body—overeats, smokes heavily, hardly any physical exercise; and if he can help it, he'd not take his medications too. When we children try to advise him to go easy on his food intake, or stop smoking, or take his medications, his response has always been the same: "I'm already in my mid-sixties—if I can't do the things that I enjoy doing, there is no point for me to continue living; I don't mind dying!"

And so he'd continue to overeat, including all the high-cholesterol foods even though that's partly what caused him to suffer 2 heart attacks before. The overeating does not help with his diabetes situation too. And of course he smokes heavily whenever he's out of the house (we merely pretend not to know that he smokes).

Yet, on both occasions when he suffered the heart attacks, he said he wasn't ready to die—that he wanted very much to continue living. He said there're many things he set out to do which still remained undone. Suddenly, all those talks that he'd rather die were gone.

Always, it's so easy to say that you'd rather die, yet when you're really at death's door, you suddenly realise that you don't want to die just yet. Well, he fought really hard to remain alive. And now, after his successful heart surgery, he's back to abusing his body again. And again he says the same thing whenever we try to advise him about his unhealthy lifestyle—that he doesn't mind dying.

The survival instinct is a very powerful inbuilt programme in the brain.

Not too long ago, I was having a yam-cha with Eric one afternoon. And we were having some empty talks. This topic, that topic—and then we eventually talked about euthanasia. Both of us agreed that if we ended up being a vegatable in a coma with no hope of being cured, and we're living on life-supporting machines, we would prefer someone to pull off the plug and let nature take its course.

My reasons for the above are quite similar to Eric's. If there is no more hope for a cure, is there any point to remain alive in that condition? And it becomes quite a tricky question whether being in a coma hooked onto life-supporting machines can really be considered as "still alive"? We may be still "alive" in the technical sense, i.e. heart still pumping and brain still in good order; but in the practical sense the rest of the body is no longer "alive".

Apart from that, strictly from the medical point of view, it gives rise to ethical questions—whether is it ethical to continue occupying the life-supporting machines when there is only a very remote chance of getting a cure, yet depriving other patients who might have a better shot at living, provided that they get to use those machines? The point is that by occupying the bed and machines on a hopeless case will surely deprive other people with a more promising chance of survival.

But now we come to a very significant question: By requesting to remove the life-supporting machines (say before going into a coma), does that amount to committing suicide? And here things can become very complicated. Most religions consider suicide as a big sin. Apart from that, many countries have laws against euthanasia. There have been cases where the sick person had to go to court to seek the permission to die. Furthermore, even if it is allowed, would it mean that the person who actually pulls the plug is committing a murder?

And finally, what if before the health deteriorates we can request for painless death, but when we become paralysed (but still conscious and no longer able to communicate) suddenly the survival instinct kicks in? Might we change our mind but by then unable to reverse the request to die?

A lot of questions, yet when we were happily talking in the coffeeshop, it seemed such an easy decision to make.

I can't even remember who brought up this topic anyway. I must ask Eric who did. If it's him, I will want to kick his ass for bringing up a topic that can never have clear-cut answers!

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