Euthanasia

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Euthanasia


Every society is faced with many issues that require sensitivity and understanding. One such issue is the debate over euthanasia, the practice of mercy killing. The need for society to act in a socially responsible manner of this moral issue is critical. Euthanasia is literally a life or death question, creating strong feelings on all sides. That is why there are medical, legal, and moral needs in the United States for society to recognize the right of terminally ill patients or their representatives to direct medical caretakers to withdraw or withhold life sustaining treatment.


There are several medical arguments to be made in favor of euthanasia. In the past, euthanasia was not as open to public debate. This was mostly due to the fact that many terminally ill patients died in their homes without making the public knowledgeable of how their deaths took place. However, as more people move from dying in their homes to dying in hospital beds, doctors become armed with the medical knowledge and technology to prolong a dying person’s life. For this reason, the euthanasia issue is receiving considerable attention in the world of modern medicine.


There are two forms of euthanasia. One being passive euthanasia, where treatment is withheld and the patient is simply allowed to die. The second being active euthanasia and for the sake of the arguments presented in this paper, active euthanasia will be defined as taking some direct action to end a patient’s life. This form of euthanasia is currently illegal in the U.S. except in Oregon. In Oregon there is what is known as the, “Death with Dignity Act,” where a patient can choose to terminate their own life.





According to hospital administrator Larry Larson, “American Medicine is supposed to operate in the best interest of the patient, and by prolonging a life of incurable wretchedness turns that standard upside down” (1). Larson also points out that death is inevitable and because of this, the medical profession should offer a “quick and merciful” medical option to end the life of a dying patient (16). In other words if death is an inevitable product of life, then why should the terminally ill be forced to continue living an existence that does not offer them the qualities that distinguish a vital and functional being from a dead body or inanimate object? Furthermore, Dr. Christian Barnard states, “I believe often that death is a good medical treatment because it can achieve what all the medical advances and technology cannot achieve today, and that is to stop the suffering of the patient (Larson 16).


There is the classic example presented by James Rachels. The patient is dying of incurable cancer and he is experiencing terrible pain, which can no longer be alleviated. He will die within a few days, and the pain is unbearable. So he asks the doctor to end it, and his family agrees with his decision. If the doctor went with the passive form of euthanasia, and agreed to withhold treatment as the current doctrine says he may. However, if the treatment is withheld it may take the patient longer to die and he would suffer more than if direct action were taken. This shows that, once the decision has been made not to prolong his agony, active euthanasia would be preferable to passive euthanasia. To say otherwise would endorse the option that leads to more suffering rather than less (Pojman).


These statements suggest that the physician’s primary goal should be relieving pain and suffering. Yet due to medical technology, as many as 10,000 patients are kept alive through life-sustaining medical treatment (Brennan 6). In order for this situation to change, society must hold the beliefs of medical professional, such as Dr. Bernard, to be true in order for there to be a universal acceptance of the need for medical caretakers to provide relief from pain and suffering.


In addition to sound medical reasons to support active euthanasia, there are also cogent legal issues to support it. Today, it is common for social issues to originate in the courts. For this reason, the legal system--our courts as well as legislatures--is determined to play an active role in deciding the outcomes of the debate over euthanasia. As lawyer James Podgers notes, “News media coverage of decisions in key cases triggers public debate that evolves into consensus, translating finally into legislative action” (60). As long as the courts are destined to decide the fate of our lives, it is important for society to be aware of the legal principles involved with euthanasia.


Central to most arguments for euthanasia is the principle of self-determination. As suggested by critic Daniel Callahan, people are presumed to have an interest in deciding for themselves how they will conduct their lives (5). Just as we have the right to choose our lifestyles, we should also hold the right to decide whether we should continue to live or die. Such a decision can be reached by rationally evaluating the benefits of continued living against the suffering involved. In doing so, we have preserved our own basic right as individuals to direct our lives according to our own principles and morals.


Unfortunately today the involvement of the legal system makes it more difficult for our own wishes to be carried out. Supreme Court Justice William Brennan emphasizes this struggle by stating, “When the courts decide a persons own evaluation of the dying process, they have ignored her values and deprive her of the right to a decision” (6). In addition, Rev. John Paris effectively stresses the need for a person’s self-determination to be respected in regard to the dying process, “In our determination to prolong life at any cost, we have forgotten that dying is a part of the process of living.” These people’s bodies are telling them there really is no purpose in going on, and yet we make them go on. (Larson 18).


In discussing the need for euthanasia, we must consider the moral arguments that society faces today. To begin with, society must distinguish between the act of killing an innocent person and that of euthanasia. Moral philosopher, Richard Brandt, argues that killing human beings ordinarily injures them and violates their preferences. In cases of euthanasia, when both of these conditions are lacking, the killing could be allowable” (4). Richard Brandt also feels that if we are no longer able to be injured we are free to withdraw life sustaining measures while taking positive steps to terminate life; he feels we are morally bound to do this ().


The fact that one person kills another does not automatically make euthanasia wrong. James Rachels is a professor of philosophy at the University of Alabama. He argues that killing someone is not morally worse than letting someone die. If a doctor lets a person die for humane reasons, he is in the same moral position as if he had given the patient a lethal injection for humane reasons (Pojman 1). The same result comes from both decisions, and if the same result is intended in both cases than morally there is no difference. Therefore by following Rachels argument it can be said that active euthanasia is not morally any worse than passive euthanasia.


In support of the moral rightness of euthanasia, Larry Larson points out that oftentimes the way we treat our aged and loved animals is better than we treat our aged and loved human beings (18). He furthers this analogy by making the following comparison


Having worked in a variety of medical settings, I have seen countless people suffer hideous deaths from illnesses like cancer, aids, cirrhosis, and end stage pulmonary disease. A dying animal is quickly “put out of its misery,” but no such consideration is offered to the terminally ill human (16).





A final point to be made is, just as there is a moral obligation to carry out a person’s wishes for disposal of his body and possessions after death, it would seem to be equally morally obligatory to respect his wishes in case he finds himself in vegetative state.


One of strongest arguments against euthanasia is the argument that there is the risk of an incorrect diagnosis. Yale Kamisar is one of the leading advocates against the legalization of euthanasia. He argues that by giving the medical practitioner wide discretion and trusting to his good sense is dangerous. “This, I submit, raises too great a risk of abuse and mistake to warrant a change in the existing law” (Pojman 177).


However, as seen with “The Death with Dignity Act” in Oregon, there is actually many safeguards to ensure there is no mistake when a person is euphemized. In 15 Oregon devised its own guidelines regarding assisted suicide.


1. The patient must be at least 18, terminally ill (having less than 6 months to live), and an Oregon resident.


. The patient must voluntarily make an oral request to the attending medical/osteopathic physician for a prescription for medication to end his or her life. A 15-day waiting period then begins.


. The attending physician ensures the patient understands the diagnosis and prognosis. The patient is informed of all options, including pain control, hospice care, and comfort care, as well as the risks and expected results of taking the medication.


4. The attending physician (a) determines whether the patient is capable of making health care decisions and is acting voluntarily; (b) encourages the patient to notify his or her next of kin; (c) informs the patient that he or she can withdraw the request for medication at any time and in any manner; and (d) refers the patient to a consulting physician who is asked to confirm the attending physician’s diagnosis and prognosis.


5. The consulting physician also decides whether the patient is capable of making the decision and is acting voluntarily. If either or both physicians believe that the patient is suffering from psychiatric illness or depression that causes impaired judgment, the patient will be referred for counseling.


6. Once the preceding steps have been satisfied, the patient voluntarily signs a written request witnessed by two people. At least on witness cannot be a relative or an heir of the patient.


7. The patient then makes a second oral request to the attending physician for medication to end his or her life.


8. The attending physician again informs the patient that he or she can withdraw the request for medication at any time and in any manner.


. No sooner those 15 days after the first oral request an 48 hours after the written request, the patient may receive a prescription to end his or her life. The attending physician again verifies at this time that the patient is making an informed decision (Pojman 4).





The Death with Dignity Law shows how through legislation, Oregon has taken steps to ensure there will be no mistakes in diagnosis when it comes to terminating a patients life. Although this is not the greatest remedy for the terminally ill, it is a start to dealing with the issue of euthanasia in a socially responsible manner. Also just because a practice can be abused does not mean that it will, or even that it should not be used at all. Like anything else in the field of medicine abuse can be a problem. However, euthanasia must be thought of as remedy. Similarly to the way penicillin is used to cure bacterial infections, euthanasia has to be accepted in society as a cure for the terminally ill who are suffering terribly.


Many advocates who fight against euthanasia argue that active euthanasia is “playing god and violates the sanctity of life” (Pojman 8). Many of these advocates feel that only god is allowed to take an innocent life. But if this rational is held than by prolonging life with life support medical practitioners are playing god. Taking antibiotics to cure bacterial infections, taking medicine to slow down the Aids virus, and even feeding the starving can all be seen as acts of playing god. If playing god means doing what will affect the chances of life and death, a lot of responsible social action does that (Pojman 8). We take life in self-defense and war, so why not in the self-defense against torture or great and irreversible suffering (8)?


Today, many people regard euthanasia as a dirty word. However, the root idea is that in euthanasia one undergoes a good death instead of a lingering and painful one. James Podgers argues in favor of euthanasia “Life is sacred, and death is a natural part of life. But just because life is sacred does not mean that death has to be feared, painful, or prolonged” (6). As long as society denies the need for its members to act in a socially responsible manner toward euthanasia, people will continue living life in a fearful existence. Once we accept that there is a medical, legal, and moral need for society to recognize the rights of terminally ill patients, or their representatives, society will have a better outlook on life and death. Works Cited


Brandt, Richard. “Is Euthanasia Immoral?” Taking Sides; Clashing Views on Controversial Moral Issues. Ed. Stephen Satris. Boston Dushkin Publishing Group, Inc., 10.


Brennan, William J., and William Rehnquist. “Can States Restrict the Right to Die?” Taking Sides; Clashing Views on Controversial Legal Issues. Ed. Ethan M. Katsh. New York Dushkin Publishing Group, Inc., 11.


Callahan, Daniel. “When Self-Determination Runs Amok.” Hastings Center Report Mar.-Apr. 1 5-55.


Kamisar, Yale. “Against Legalizing Euthanasia.” Minnesota Law Review 4 6 (May 158). Life and Death. Pojman, Louis P. Belmont, CA Wadsworth Publishing Company, 000.


Larson, Larry, and Alan L. Otten. “Euthanasia is Justified.” Death and Dying. Ed. Janelle Rohr. Minnesota Greenhaven Press, 187.


Podgers, James. “Matters of Life and Death.” ABA Journal, 78 May 1 60-6


Rachels, James. “Active and Passive Euthanasia.” The New England Journal of Medicine (175). Life and Death. Pojman, Louis P. Belmont, CA Wadsworth Publishing Company, 000.





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