suesEuthanasia can be considered one of the most prevalent problems when dealing with the ethics of patient treatment. Should people have the right to end their own lives when prolonging it will only cause them more pain? Should families who love someone so much, that they don’t want to lose them, cause them more pain by keeping them alive. What makes that more ethically correct then letting them die? The more you look into this issue the more you see how contradictory people are when it comes to making these decisions. This paper shows the issue in a more detailed manner, gives some background, shows the effects on modern society and explains briefly my standpoint on the subject.
The practice of euthanasia dates back as far as the dawn of civilization itself. In the past it was an easy subject to deal with because technology didn’t permit nearly as much life sustentation. When health problems, such as, diabetes and high blood pressure were causes of death, it wasn’t such a controversial issue in society. Now that we have the knowledge along with medical equipment to keep people alive, the issue has developed into a more difficult one to deal with. However, the issues surrounding euthanasia are not only of death, they are about ones liberty, right to privacy and control over his or her, own body. Currently under U.S. law, there are clear differences between the two different types of euthanasia. Extraction of life support, referred to by some as passive euthanasia has been exclusively upheld by the courts as a lawful right of a patient to request and a permissible act for a doctor to perform. Physician-assisted death, referred to by some as active euthanasia is specifically prohibited by laws in most countries and American states banning “mercy killings” and is condemned by the American Medical Association.
Active Euthanasia is thought of by most to be morally wrong and punishable by law. Yet, mercy has been held as a high moral by most civilizations in history. Now we punish anyone who assists someone else in suicide, out of their own mercy. During the 21-month trial period of a new law anyone assisting in a suicide can be sentenced to up to four years in prison and fined more than $2,000 (1). Physicians have been and will continue to be prosecuted for the murder of patients who seeked assisted suicide, a good example of this is Dr. Kevorkian. Jack Kevorkian was a well known physician who assisted over hundred-thirty people in their deaths before he was convicted for murder (2). He considered it merciful to assist patients with “terminal” illnesses. His definition of terminal, “any disease that curtails life even for a day” (3), didn’t convince the courts of his legal innocence. While people who have terminal illnesses sometimes wish to die, society punishes the people who assist them. In my opinion, punishing physicians in relation to this form of medical treatment is a moral contradiction.
The indirect killing of a person, referred to as “passive euthanasia”, is thought to be the lesser of the two evils. Despite the fact that it is more legal than “active euthanasia” it is still the termination of a human life. Through the removal of life extending treatments, the physicians are still causing the patients death. Many life-sustaining treatments and examinations may actually cause the individual more pain and suffering, without a worthy return. A good medical example of this, are burn victims in which their survival is improbable, sometimes debridement treatments are used, which can provide the patient no gain what so ever and are extremely painful. When dealing with patients who will die with or without treatment, most people consider euthanasia the most appealing procedure.
Legally euthanasia is broken down into those two categories, Active being illegal everywhere but Oregon and the Netherlands. In 1994 Oregon passed its “Death with Dignity Act” which legalized assisted suicide, making it the only place other than the Netherlands which condoned active euthanasia. In the Netherlands the law is a lot less strict, but still goes along the same basic principles. Even though most countries do not allow assisted suicide, there have been many proposals made to introduce laws in which physician-assisted death would be an accepted medical procedure. Due to the fact of the Dutch findings, in which 948 patients were terminated without their consent during 1990 (4), Washington’s proposition to legalize lethal injection and assisted suicide was widely opposed. As of July 1998, there were no laws ruling out physician-assisted suicide (5). The practice of allowing patients to refuse treatment has always been held up by the fact a doctor could be charged with assault if the patient didn’t wish to be treated.
These days all states have some form of living will legislation. In addition, the person who wishes to have such a will, may also assign a family member or friend as a proxy to make the decisions for him or her, should they be unable to make the decisions themselves. Some states also require the individual to sign a power of attorney to do so. In 1976, the New Jersey Supreme Court decided the parents of Karen Ann Quinlan won the right to remove her from a ventilator because she was in a persistent vegetative state (6). The justices unanimously ruled that this act was necessary to respect Quinlan’s right to privacy. Some medical ethicists warned then that the ruling was the beginning of a trend, which could lead to decisions to end a person’s life. Being made by third parties not only on the basis of medical condition but also on such considerations as age, economic status, or even ethnicity. In 1990, the Supreme Court case, Cruzan v. Missouri (7), recognized the principle that a person has a constitutionally protected right to refuse unwanted medical treatment. In 1983, Nancy Beth Cruzan lapsed into an irreversible coma from an automobile accident. Before the accident, she had said several times that if she were faced with life as a “vegetable,” she would not want to live. Her parents went to court in 1987 to force the hospital to remove the tube by which she was being given nutrition and water. The Missouri Supreme Court refused to allow the life support to be withdrawn, saying that there was no “clear and convincing” evidence Nancy Cruzan wanted that done. The U.S. Supreme Court agreed, but it also held that a person whose wishes were clearly known had a constitutional right to refuse life-sustaining medical treatment. After further proof and witness testimony, a probate court judge in Jasper County, Mo., ruled Dec. 14, 1990, that Cruzan’s parents had the right to remove their daughter’s feeding tube, which they immediately proceeded to do (8).
In a poll cited in a 1991 issue of USA Today eighty percent of Americans think sometimes there are circumstances when a patient should be allowed to die, compared to only fifteen percent who think doctors and nurses should always do everything possible to save a person’s life. It also showed that eight in ten adults approve of state laws that allow medical care for the terminally ill to be removed or withheld, if that is what the patient “wishes”, whereas only thirteen percent disapproved of the laws. Also seventy percent think the family should be allowed to make the decision about treatment on behalf of the patient, while another five percent think this is suitable only in some cases (9). Now to mercy killing, seventy percent asked think that it is justified at least sometimes for a person to kill their spouse, if they are suffering terrible pain caused by a terminal illness. Also about half the public thinks that there exists a “moral right” to suicide, if a person has an incurable disease or is suffering great pain with no hope of recovery (10). Numerous polls indicate that half of the medical profession would like to see euthanasia become law and seemingly, about fifteen percent of physicians practice it on justifiable occasions (10). When voluntary euthanasia was a official ballot measure, the percentages of people supporting it were 46 percent in Washington (1991), 46 percent in California (1992), and 51 percent in Oregon (1994) (12).
Personally, I believe it should be law, even though in some cases it’s not always clear as to what people who can not articulate want.
Since it is such a controversial subject many politicians can get themselves somewhere they don’t want to be, if they push too strongly one way or the other on this issue. There are so many opposing issues, that it makes it hard to discern how anyone feels exactly on the subject. Therefore making it hard for public officials to make decisions based on their personal preference or that of the people. You could say you opposed euthanasia all together, but when you actually looked further into the subject you would have to make decisions based on individual cases. Thus proving this issue is one which would have to be dealt with like many laws, on a case by case basis. There are many active groups who also try to get the people and politicians to make decisions based on their ideas and beliefs about euthanasia. Some on the most noted are American Society for Action on Pain, The Hemlock Society, CURE (Citizens United Resisting Euthanasia), International Anti-Euthanasia Task Force, and The American Medical Association. These groups fight for or against euthanasia by spreading their beliefs and getting bills sponsored into Congress. The Hemlock Society which was founded in 1980 is the largest and oldest right-to-die organization in the U.S. (11). Its funds go directly into legislative efforts to change law. Now on the opposing side, CURE, which was founded in 1981, defends the rights of patients to receive care even when a physician or family member decides it’s useless. These groups sometimes have a profound impact on how society views euthanasia, through scare tactics. They feed the media propaganda to alarm the public, but personally I think it is a matter of personal choice in the long run. If people want to die and it is against the law, will that be enough for them not to go through with it themselves? I don’t believe it would, because when a person has reached that point there usually isn’t a point of return. Politicians, in my opinion, should stay far away from the subject at least in their campaigns, if they wish to gain favor of the masses.
As I stated before euthanasia is a very controversial topic and there are many different views when dealing with it, now I will show some different views. This subject is one which is based on personal choice, therefore making it hard for some to decide until they are in a similar situation. First I will give some examples from a pro-choice perspective. Secondly, show examples from an anti-euthanasia standpoint. Then to finish it off give my views, which lean the same way I do with other similar human choice subjects, such as, abortion and homosexuality.
Prohibiting assisted suicide and active voluntary euthanasia are restrictions to liberty-patients are prevented from receiving the care they want and physicians from providing it-there is a case for legalizing those practices and it is up to their opponents to show why they should be forbidden (12). In some cases, a person’s dignity is at stake, when the loss of physical and mental functions commences or is apparent to soon, some wish to shield their loved ones from this sight. If passive euthanasia is allowed by law and active euthanasia isn’t then it would seem there would be a distinct difference between killing and letting die. The truth of the matter is there is no clear distinction between these two acts, in both acts the person’s death is brought on by the actions of another person. Therefore finding a morally sound difference between killing a patient and letting one die is a hard thing to do. Another issue which brings about confusion is that fact that suicide is legal, while assisted suicide and active voluntary euthanasia aren’t. If a person has a good reason to die-if, for instance, they are terminal and suffering-it would be unspeakable to interfere with their suicide. If the person doesn’t have the means by which to commit suicide is too weak to swallow a pill or inject themselves, they should be allowed to request and receive those services from someone willing to provide them. (12)
Allowing people the kill other people is just that, the taking of another person’s life and therefore it is morally unacceptable. Therefore both forms of euthanasia are morally wrong and should be punishable by law. If active euthanasia were to become legal, who knows if doctors would only administer it in voluntary situations? As proven in the Netherlands physicians have used euthanasia to get rid of patients who are, so to say, just taking up room. There is no law permitting voluntary euthanasia that could, even if implemented via complex measures, protect conscious and vulnerable people against subtle manipulation to request socially acceptable administered death when they would rather live and be cherished (13). Most times people suggest euthanasia as an escape from unendurable pain and suffering. In all reality with today’s advanced treatments and pain controlling medicines, this is just a falsified belief. Suffering is more than just the feelings of pain. Each persons suffering is as individuated, distinctive, and profoundly different from everyone else’s (13).
Personally I believe that euthanasia, like the two other human choices which are most profoundly debated in modern day society; homosexuality and abortion, is a matter of personal choice. While it is impossible to compare the three on any other level, they are in my opinion the most significant choice issues today. If a person has justified reason to die then they should be allowed to die, by what means they choose to. The only issue that is a part of this topic, which pressures me against it what so ever, is involuntary euthanasia to rid hospitals of patients who are just taking up room. It should be based on the person’s living will, if they wished to die a peaceful death through some form of euthanasia then so be it. If the family members do not agree with the patient, that is completely irrelevant. When dealing with persons who are in a persistent vegetative state, I believe that the individual should be euthanized. This situation is a sad one and families may wish for this person to continue living, but I think that it is morally wrong to make someone live in an intolerable existence without any manner of escape. Taking away the freedom to choose a dignified, pain-less and easy death is against all the basic morals that are held close to heart in American society. As quoted by Mark Twain, “Whoever has lived long enough to find out what life is, knows how deep a debt of gratitude we owe to Adam, the first great benefactor of our race. He brought death into the world.” (14).
-Ann Wicket, “The Right to Die: Understanding Euthanasia” (New York: Harper ; Row publishers, 1986)
-Samuel Gorovitz, “Drawing the Line: Life, Death, and Ethical Choices in an American Hospital” (New York: Oxford University Press, 1991)
-Pro-Life Infonet (prolifeinfo.org)
-Thomas Maier, “Death by Choice,” Newsday (November 6, 1997. p. A5)
-Henry Weinstein, “Assisted Deaths Ruled Legal: 9th Circuit Lifts Ban on Doctor- Aided Suicide,” Los Angeles Times (March 7, 1996. p. A1)
-Barbara Dority, “The Ultimate Civil Liberty,” Humanist (July/August 1997. p. 17)
-Euthanasia and Assisted Suicide: FAQ – http://www.iaetf.org/faq.htm
-Geoffrey Fieger, Letter to the Editor, Detroit Free Press (December 11, 1990)
-Herbert Hendin, “Physician-Assisted Suicide and Euthanasia in the Netherlands: Lessons from the Dutch,” Journal of the American Medical Association (June 4, 1997 p. 1720-1722)
-USA Today, 1998
-Matter of Quinlan (http://www.csulb.edu/jvancamp/452_r6.html)
-Cruzan v. Director, DMH 497 U.S. 261 (1990) (http://supct.law.cornell.edu/supct/html/88-1503.ZS.html)
-Exploring constitutional conflicts, “The right to die” (http://www.law.umkc.edu/faculty/projects/ftrials/conlaw/righttodie.htm)
-Colesanto, D, “The right-to-die controversy,” USA Today (May, 1991 pp. 62-63).
-Derek Humphry, Frequently Asked Questions; Right to Die. ERGO! (http://rights.org/deathnet/ergo_FAQ.html)
-About Hemlock (http://www.hemlock.org/about_hemlock.htm)
– Alister Browne, Understanding Euthanasia: Should Canadians Amend The Criminal Code? (September 26, 1994)
-David J Roy, When the Dying Demand Death; A Position Paper On Euthanasia, (Undated)
-Mark Twain – The Tragedy of Pudd’nhead Wilson and the Comedy of the Extraordinary Twins