How would you prefer to die?

“Dogs do not have many advantages over people, but one of them is extremely important: euthanasia is not forbidden by law in their case; animals have the right to a merciful death.” — Milan Kundera (born 1929) Czech writer of “The Unbearable Lightness of Being.”

A recent article about 45-year-old identical deaf twins in Belgium who were granted their wish to be euthanized — both had a genetic defect causing increasing blindness and other undisclosed medical problems — has renewed the controversy regarding this practice in the United States and worldwide.

Discussion of such a controversial and complicated subject cannot be resolved in a short column. This is a sensitive topic because of religious, moral and cultural prohibitions. But it is an inescapable one. We all know that death is inevitable and we cannot be like Woody Allen who said, “I am not afraid of death; I just don’t want to be there when it happens.”

A good start to reading about many facets of this topic is to Google “pro and con about euthanasia.”

Euthanasia is defined as “performance of the last act by a third party whereas assisted suicide is the performance by the individual himself or herself, but the means has been provided by another.” Dr. Jack Kevorkian was a champion of terminal patients’ rights to assisted suicide but he unfortunately was convicted of second-degree murder for his beliefs in 1999.

He had many other contentious ideas such as allowing prisoners who were to be executed to consent to donate their organs.

The end of life by whatever means has always been one of the most important functions that all religions deal with. The majority of religions are against euthanasia (and by extension suicide) and the Catholic religion in particular strongly opposes the practice. Most religions believe that their superior being mandates “thou shalt not kill” and also that God gave us life and only he has the right to end it. This moral quandary is a major obstacle for the acceptance of how to end life in many cultures.

Advances in medical science and changes in secular morality have led to attempts at legalizing euthanasia. Euthanasia is presently legal under strict guidelines in Belgium, Luxembourg and the Netherlands. France is debating whether to also legalize this practice. Places that allow assisted suicide include Oregon, Vermont, Washington and Switzerland.

Drafting legislation for allowing euthanasia or assisted suicide can be difficult. Should it be allowed only when a condition is deemed terminal? Does this nebulous term mean one is expected to die in a day, a month or a year? Physicians are put in the difficult position of determining when this imprecise date will occur.

In the Netherlands, it is allowed for unbearable suffering of a physical or mental nature without requiring any time determination.

Modern medicine has the means to prolong life but is it really just prolonging death? Needlessly delaying death may cause increased anguish for those close to the terminal patient, not to mention increased costs for the patient as well as society. The decision should be left up to the individual’s personal wish.

Physical suffering can be treated. Compassionate doctors might use higher than usual doses of a drug such as morphine. Doctors will usually only do so after consultation and agreement by the patient and family to inform them of this fact. Hospitals provide forms for those who wish not to be resuscitated.

In Nevada there are provisions for an advance medical directive consisting of three parts:

1. Power of attorney for health care decisions that allows you to name an agent who can make decisions when you are no longer able to do so.

2. Nevada Declaration that is the state’s living will and allows you to express your wishes regarding cessation of life-sustaining treatment.

3. Signature and witnesses procedure to make your wishes legal. For such an important document, legal consultation is recommended. In addition, not only should you give a copy to your agent, copies for yourself and stored in more than one location, but Nevada also maintains an Advance Directive Registry. Complete information can be found at www.livingwilllockbox.com.

Stating your medical wishes in advance in such a legal form will make decisions much easier for your loved ones to carry out but complete estate planning is also part of end-of-life preparation and definitely requires legal consultation. Be sure to include information on how to access your electronic accounts with log-on names and passwords.

I asked a friend how he wanted to die and he replied he wanted to die peacefully in his sleep like his grandfather, and not screaming hysterically like the passengers in the car his grandfather was driving.

Glenn Nakadate is a Boulder City resident and can be reached at bcpebble@yahoo.com