Responsibility of the kind I am contemplating, often indeed more obvious and definite, presses upon the obstetrician, and is met unreservedly. In embryulcia, one life is sacrificed in the hope and with the reasonable prospect of saving another more valued: this is done too sometimes where there is an alternative presented, the Cæsarian section, which destroys neither of absolute necessity, but subjects the better life to very great risk.
Patients themselves frequently prefer the prompter and more lenient motives of death which our science refuses to inflict. In summing up the motives of suicide in one hundred and thirty-one cases, whose causes are supposed to be known, Prevost tells us that thirty-four, more than one-fourth of the whole number, committed self-murder to rid themselves of the oppressive burden of physical disease. Winslow gives us an analysis of thirteen hundred and thirty-three suicides from Pinel, Esquirol, Burrows, and others. Of these, there were but two hundred and fifty that did not present obvious appearances of bodily ailment; and although it is not stated how many of them sought death voluntarily as a refuge from physical suffering, it would be unreasonable to doubt that this was the purpose with a very large proportion. I am far from advocating the propriety of yielding to this desire or gratifying the propensity; nay, I would, on the other hand, earnestly endeavor to remove or repress it, as is now the admitted rule.
I hold fully, with Pascal, that, according to the principles of Christianity, which in this entirely oppose the false notions of paganism, a man “does not possess power over his own life.” I acknowledge and maintain that the obligation to perform unceasingly, and to the last and utmost of our ability, all the duties which appertain to our condition, renders absolutely incompatible the right supposed by some to belong to every one to dispose of himself at his own will. But I would present the question for the serious consideration of the profession, whether there does not, now and then, though very rarely, occur an exceptional case, in which they might, upon full and frank consultation, be justified before God and man in relieving, by the efficient use of anæsthetics, at whatever risk, the ineffable and incurable anguish of a fellow-creature laboring under disease of organic destructiveness, or inevitably mortal; such, for example, as we are doomed to witness in hydrophobia, and even more clearly in some instances of cancerous and fungoid degeneration, and in the sphacelation of organs necessary to life, or parts so connected as to be indispensable, yet not allowing either of removal or restoration?
I have left myself scarcely time for a few remarks upon death, psychologically considered. How is the mind affected by the anticipation and actual approach of death? The answer will obviously depend upon and be influenced by a great diversity of contingencies, moral and physical. The love of life is an instinct implanted in us for wise purposes; so is the fear of pain. Apart from this, I do not believe, as many teach, that there is any instinctive fear of death. Education, which instills into us, when young, the fear of spectres; religious doctrines, which awake in us the terror of “something after death;” conscience, which, when instructed, “makes cowards of us all;” associations of a revolting character—
“The knell, the shroud, the mattock, and the grave—
The deep, damp vault, the darkness, and the worm;”
these startle and appal us.
“Man makes a death that nature never made,
Then on the point of his own fancy falls.
And feels a thousand deaths in fearing one.”