Murder or mercy killing? One story that dominated headlines this week raised that question in a particularly dramatic fashion: An Ohio man is accused of shooting to death his ailing wife of 45 years, possibly as part of a "death pact" promise to prevent her from suffering.
In the coming years, many other Americans will be wrestling with similar questions about how, and when, to end their own lives or the life of a loved one.
"This is going to become one of the great social challenges of the next 20 years," predicted Arthur Caplan, one of the nation's foremost bioethicists and director of the division of medical ethics at NYU Langone Medical Center.
Many Americans agree that people should have greater say over end-of-life decisions in cases in which they've been diagnosed with a terminal illness, are in great pain and are expected to live only a few days or weeks, Caplan told the Los Angeles Times.
But the Ohio case underscores what can happen when the scenario is less cut-and-dried, Caplan said.
John Wise, 66, of Massillon, Ohio, allegedly walked into his wife's room at the Akron General Medical Center on Saturday and fired a single gunshot at his wife of 45 years. He was still at her bedside when security arrived, and he was taken into custody without incident. Barbara Wise, 65, died the following day.
Law enforcement authorities have so far declined to publicly detail Barbara Wise's medical condition and diagnosis other than to say she was suffering from a "very serious medical condition."
But a family friend has said that she had recently suffered a triple cerebral aneurysm, and Wise's attorney, Paul Adamson, told the Los Angeles Times that her condition before entering the hospital had deteriorated so much that "there was a feeling she was never going to recover to any quality of life."
That may be enough for some people to conclude that end-of-life measures were warranted. (Although no one suggests using a gun.)
But taking someone's life to end their suffering -- and doing so without a doctor's diagnosis of a terminal illness -- raises thorny issues, Caplan said.
So do many other scenarios.
"What if you are just chronically ill or terribly debilitated" but nonetheless have many, many years of life ahead of you, Caplan asked. Should you or someone else in that condition be allowed to choose death?
"What if you have Alzheimer's but are not in severe pain?" Caplan asked. And what if you've told your family and friends in no uncertain terms that you do not want to live in such a state?
Americans increasingly will have to face such uncomfortable questions, in part because baby boomers are entering their later years. And just as their generation has transformed every other part of our culture, the boomers are expected to redefine death on their terms as well.
Caplan said that medicine has made improvements in the area of palliative care, and some states allow for physician-assisted suicide. (Oregon, Montana and Washington are among them; Massachusetts will vote on the Death With Dignity Act in November.)
Nonetheless, many Americans still live in fear that they'll have no control over pain and suffering in the face of death.
The Los Angeles Times has been at the forefront of an effort to discuss end-of-life issues, with our columnist Steve Lopez leading the way. On Thursday, Lopez hosted a Google+ Hangout with Dr. Judy Epstein, clinical director of the Compassion & Choices organization's End-of-Life Consultation Program, and Kathryn Tucker, director of legal affairs for Compassion & Choices, which advocates for patients' rights on end-of-life issues.
As for Wise, the Summit County Grand Jury is likely to decide by Aug. 22 whether he'll face a charge of murder for taking the life of the woman who was once his teenage sweetheart.
If he does face a murder charge, Caplan said, there is plenty to suggest that a judge and jury will be sympathetic if the evidence points to a mercy killing.
"People who prosecute these cases have a very tough time," Caplan said. "Judges and juries have sympathies for the circumstances in which these kinds of killings take place."
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