By Ogova Ondego
Published April 25, 2018
When a former First Lady of United States of America died on April 17, 2018 ‘after deciding to discontinue medical treatment for her declining health’, her death sent tongues wagging in Kenya concerning ‘Death with Dignity’, ‘Mercy Killing’ or ‘Euthanasia’.
Though a secular state, Kenya’s religiosity—it is 47.7% Protestant Christian; 23.5% Roman Catholic Christian; 11.9% Other Christian; 11.2% Muslim; 1.7% African Traditional Religion; 1% Bahá’í; 0.3% Buddhism and 2.0% Other religions according to the national census of 2009—appears to hold sway on how human life begins and ends in this conservative East African country of 40 million people that revolves around what is known as traditional African rural values.
That was why the decision of Barbara Pierce Bush to discontinue ‘medical treatment for congestive heart failure and lung disease after consulting with her family and friends’ elicited, and continue to elicit, mixed feeling in Kenya. This prompted me to go back to the interview I held with various Kenyan experts and people on the street on Euthanasia almost two decades earlier.
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Then, medical sources told me, euthanasia was used clandestinely in Kenya in dealing with patients suffering from terminal illness, incurable illnesses or conditions which are accompanied with unbearable pain that is expected to result in the death of the patient within a short time.
These illnesses, I was told, paralyse their victims, robbing them of human dignity and making them a burden to themselves and their relatives. Such people, I learnt, may be on life-supporting machines or expensive drugs which prolong their lives but without curing their ailments.
Medics who supported Euthanasia gave examples of Jacqueline Kennedy-Onassis, another former US First Lady who asked to be removed from life-supporting machines so she could die; Félix Houphouët Boigny, the first President of Cote d’Ivoire who requested that he be unhooked off the machines and a clinically dead Hussein, a former Jordanian king who had remained on machines for a long time until his family asked he be removed from artificial life-sustaining machines, as justification for euthanasia.
So what do Kenyans think about euthanasia and did the three people cited above die as a result of euthanasia?
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S Patel of Nairobi said there can be no excuse for terminating human life on the pretext off relieving their pain.
“There is nothing like mercy in killing. All murderers will have to explain their action to God,” she said.
She explained that the human body is designed to bear whatever amount of pain and that anyone who interferes with this process by attempting to play God commits a sin.
“People who terminate life are selfish and do not care about the people they claim to be merciful to. How can you kill your loved ones in the name of euthanasia?” she posed.
Nathan Kimani , also of Nairobi, argued, “Life is given by God and only He can take it. People who justify withholding or withdrawal of treatment to a dying person as an excuse to save costs are murderers.”
Fred Nyabera, a pastor, said euthanasia is playing God and that it should never be allowed in Kenya as it is murder. He said removing clinically dead people from life-support systems is not euthanasia.
“Hooking such a person on machines interferes with nature. It is playing God,” Nyabera said. What is objectionable, he argued, is administering something to kill the patient.
When Kiraitu Murungi , then a Member of Parliament, suggested in 1996 that people suffering from AIDS be allowed to undergo euthanasia, Basil Criticos , an Assistant Minister, said what Murungi had asked for was unconstitutional in Kenya.
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Richard Barasa, then chair of the Medical Practitioners and Dentists’ Board (MPDB), told me that euthanasia was illegal in Kenya and that ‘trying to legalise it in a country like ours where the rule of law is shaky would be dangerous’.
“If this is allowed at this time, it could tempt some doctors to just kill people,” he said. “Under no circumstances would I justify euthanasia.”
Dr Barasa said it is common for doctors to withdraw or withhold treatment when it is clear the patient is dying no matter what they do.
Defining euthanasia as the practice of directly killing someone or killing someone out of sympathy for the suffering one may be undergoing, Barasa said Kenyan doctors are at times forced to practice what they refer to as Do Not Resuscitate (DNR) where the heart of an incurably ill person stops or the patient gets a fatal stroke. Dr Barasa, however, stressed DNR is not synonymous with euthanasia. He said that where death is imminent, doctors should not keep patients in Intensive Care Unit (ICU) or on expensive drugs.
“Doctors have no right to decide who lives and who dies. Our duty is to preserve life and to alleviate suffering,” Dr Barasa concluded.
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Prof David Ndetei, a consulting psychiatrist and lecturer at the University of Nairobi’s School of Medicine, said: “Patients and their relatives are always asking for euthanasia.”
Revealing that some doctors are now compromising and giving in to such requests, Prof.Ndetei said: “Like abortion, doctors keep these requests to themselves. The Hippocratic Oath, patients’ requests for euthanasia and the shifting emphasis from length—t o quality—of life are putting us in a dilemma. How do you prolong life making the patient to suffer more and how do you turn down requests for euthanasia without appearing to be insensitive?”
Saying there are two types of euthanasia—active (direct) and passive (indirect)—Prof Ndetei said in the passive – which he said is common in Kenya – doctors either withdraw or withhold treatment leading to the death of a patient while in the former they give something to the patient which hastens their death.
The psychiatrist said there are instances where doctors recommend euthanasia to patients or their relatives. He stressed it may be inappropriate to refer to withdrawal of treatment as euthanasia.
“This practice needs a new name,” said Ndetei.
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Like Barasa, Ndetei said euthanasia is a societal dilemma and that doctors just happen to be at the centre of it.
“The only way forward is for people to begin discussing the problem openly,” said Prof Ndetei.
Saying euthanasia has moral, religious, medical and technological implications, Prof Ndetei said doctors should not just agree or refuse requests for euthanasia without explaining their position as this leaves patients devastated and thinking that the doctor is devoid of any human feelings.
