Death and Dignity

- V. Manickavel, M.D.
College of Medical Sciences-Nepal,
Kathmandu University, Bharatpur, Chitwan, Nepal
Eubios Journal of Asian and International Bioethics 9 (1999), 116-117.

In these modern times, death is fast becoming a point of popular interest but, being dealt with as an alien aspect of life. As more and more modern technologies are applied in the treatment of various diseases, death has started to come into direct conflict with another important aspect of discussion, namely dignity.

In this paper some of these issues will be discussed. However before the discussion on death and dignity can be done, there is a need to endeavor to define the eternal question. "What is life?" There is understandably, a plethora of definitions and answers to this question, each backed by its own set of explanation. However, it is beyond the scope of this paper to go into that discussion and so, we will attempt to broadly define life, from the biological aspect. It can be defined as the ability of an organism, either plant or animal, to sustain its form and reproduction constituting the struggle for maintaining the continuity of germplasm. These two points are considered as vital to define life in the biological sense.

It is hard to imagine anything in this world which is not changing, except may be man made materials such as plastic. In life sustainability and reproductivity is in a continuous state of change. Death plays an integral part in the sustenance of life and must be remembered not as opposite but an aspect of life. In short, life could not go on if there was no death. There is no immortality without mortality. Various antagonistic features maintain this phenomenon.

Reproduction as it plays a part in establishing immortality by conveying the germplasm from one generation to another is also subjected to inevitable changes, due to time and space. This influence of time and space is unavoidable, and so reproduction in fact is not reproduction in the true sense but the act of producing something altogether, new every time. Be it an amoeba or a plant, the so called reproduction is only the act of producing variants, as more clearly seen in other organisms, such as butterflies, fish and birds. Now, immortality in relation to reproduction is not tenable. The fact that the passing of germplasm is subjected to changes of time and space, and thus continually diversifying from the original. The governing force behind this parameter of nature is motion or continuous change. Life thus may be arbitrarily divided as genesis, expansion and nihilism or "spent". If genesis may be referred to as birth, then the stage of nihilism or spent may be referred to as death. Thus we see that, birth and death are different, even opposite but on the whole belong to the same cycle of existence. In one branch of Hinduism the three aspects of life are represented through the trinity, that is creation (Brahma), sustainability (Vishnu) and destruction (Rudra). This trinity is only one whole aspect of god and personified in the poetic form of dancing Shiva "Nataraja" in Tamil Saivism.

With this particular background knowledge on life, death is often misunderstood to occur in the stage of nihilism only. But in reality, death does not wait for the stage of nihilism. Death or transformation from one form to another can and does occur at any time. It can occur in the expansion stage and even in the genesis stage.

In this continuous cycle of life and death cessation of one form is speeded up by other factors present in this Universe. There are special breeds or organisms which perform these functions, while others participate in the speeding up of the transformation by bringing on death viz. by infecting and bringing death in the form of diseases through microorganisms. In other words, "normal death" as it is commonly understood, like the end which a star meets after spending its energy and gets sucked into a black-hole or an extinguished oil lamp when the oil is used up does not occur in nature.

The signs of distress, can appear at any stage of life in an organism due to malformation, disease or any other reason and there are other forms (partners of the bio-cosmos) which act on the distressed organism and consequently end the struggle and aid in the transformation of life to death. The cessation of struggle in aiding the transformation is observed even in plant forms. For example, fungus growing on a dying tree actually speeds up the death of the tree and kills that tree. Similar observations show that distressed animals in their final struggle for life leave their "fate" to other animals and organisms to bring on death. Such is observed in nature, among ants attacking crushed, but still-living insects or small animals and bringing on death by murder or "euthanasia". This has been noted even in larger animals like elephants. These distressed organisms which may be invalid due to old age, malformed on wounded, wait for scavengers or carnivores to finish them off. It is probable it also occur in microorganisms as well. These observations all point to the fact that death often does not occur naturally but is brought on. If death is brought on, then what it should be called, because of lack of a better word, is murder.

Then is murder the norm? Is murder the rule? If murder is the rule, why different in humans? Socially, humans are considered to have acquired some qualities, which distinguish "humanness" from the rest of the biomass. The point here that these qualities are merely distinct attributes. The idea that humans are unique may be attributed to anthropomorphic arrogance, the same tendency that categorizes "higher" life forms and animals of "lower" strata. However all these qualities are not unique to humans and may be present in varying degrees and organization in other animals/plants. Some of these qualities, are what Aristotle referred to as "Virtues or values unique to humanness."

Love, compassion, justice, mystical transcendence or ethical nature is some of the unique qualities on which humanness built on. These qualities or virtues are responsible for treating death differently among humans than other life forms. It is out of love and compassion that distressed people are allowed to part on their own in their last struggle for life rather than be relieved by some external forces. It is for this same reason that a murder, human or otherwise, is not approved by the society and considered as in human. It is that compassion for fellow beings, good samaritanism and ethical medical practice, which relieves symptoms of infection by treating against those microorganisms which, debilitate, a suffering human being. It is because of human justice that no human allowed to do away with oneself, whatever his physical, mental or material restrictions may be. It is the mystical transcendence of human death that often deigns a certain respect to those humans who have passed away. It is out of respect and dignity for that 'person', though she/he no longer exists as such, various rituals of disposing the dead have evolved. It is that transcendence of the departed members of humanity, is remembered and revered.

The ritualistic sacrificial killing of humans in some simpler societies, where, there is no alienation of death in life, often looked down on as animalistic and barbaric. Similarly, in some other uncomplicated societies, distressed persons who suffer some malady due to age or other reasons are left alone to be relieved by their fellow cosmic organisms or by their relatives. This is often referred to as barbaric on cannibalistic.

In animals, distress noted on grounds of fitness result in elimination during the very early stage of life which in turn results in fit members of their groups, always perfect to the definition of 2 wings, 2 legs and one beak or 4 limbs, one tail and two eyes. Thus, when infants are killed for the fitness reason or for the reason of sexual preference, it is called animalistic behavior.

The unique virtues of love, compassion, ethics and transcendent values mentioned earlier are seemingly not expressed in the former examples and humanness often condones them. However, a few questions remain.

If part of the duties of the medical profession involves relieving symptoms of the suffering out of compassion, then why is euthanasia regarded as being wrong, even though the main struggle of the suffering victim, often intensified by of their intervention? Is it because death should not be brought on by other organisms or any other means, that modern medical technology intervene? Should this intervention be at the expense of the dignity of the suffering patients, whose condition may be no better than an utter vegetable in a comatose condition?

If compassion is the reason for not allowing selective infant killing, why millions of medical pregnancy terminations done?

If justice is the reason for not allowing malformed infants to be killed, why cloning and genetic manipulation done?

If transcendence is the reason for condemning the ritualistic killing of humans, then why, in the name of the law, hanging and execution done?

Is it animalistic traits and lack of ethics that propagates large scale of murder in the name of racial supremacy, religious majority and holy war?

Is it the animalistic instinct in us that impels us to murder in the name of justice in the form of communal riots and civil war?

Is it those traits, that still present in humans and allows global "absolute poverty" to continue?

Is it because of this animalistic behavior of lack of ethics (bioethics) that global ecological disasters planned and executed in an organized manner in the name of progress/development in southern natural resource rich countries?

Is it the animalistic tendency in us that prevents from having the compassion to live with the malformed or sub-intelligent, but prompts us to promote cloning in an effort to produce 'better' and 'perfect' species?

Is it that killing instinct in humans that causes nations to develop nuclear arms in the name of defense?


The author would like to thank the College of Medical Sciences-Nepal for the support and to Prof. R. Ramaswamy for his enthusiastic encouragement and to International Society of Medical Education (Reg. USA) for the financial support.


Maciver, R.M., 1960, Life: Its Dimensions and its bounds. Harper & Brother pub. New York.

(Presented in IAB4, the Fourth World Congress of Bioethics, 04th Nov., 1998-07th Nov., 1998, Tokyo, Japan).

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