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Euthanasia and physician assisted suicide
Euthanasia and Physician Assisted Suicide
Euthanasia care is a new and controversial topic that needs to be addressed. Most people end their lives in pain and suffering without their desires towards treatment options met. One study found that "more often than not, patients died in pain, their desires concerning treatment were neglected, after spending ten days in an intensive care unit (Horogan, 1)". Euthanasia originated from the Greek language eu, which means "good" and thanatos which means "death". One definition given to this term is "the intentional termination of life by another at the explicit request of the person who dies" ( religious tolerance,1 ) . Briefly this states that the person who wishes to commit suicide must request the death. In recent years the number of patients that have been facilitating the intensive care unit for periods of time, generally leading to a painful and uncomfortable death, has been on the up rise. Unfortunately most states and medical providers have failed to recognize this. Doctors and physicians are being addressed on their knowledge of palliative care and their readiness to successfully meet the needs of their patients before the time of their death. Despite increasing public sympathy for euthanasia, there is widespread confusion as to what it signifies. Many terminally ill patients turn to physician-assisted suicide not because they cannot be cured, but because they cannot bear the thought of physical pain. Terminally ill patients should be allowed to end their lives with dignity, physician assisted suicide idividual has dominion over their body and should be allowed to decide when to end their life." (Murphy, Jan. 00) "To achieve that end, with dignity and without pain, doctors should be allowed to aid terminal patients by providing necessary doses of drugs." (Murphy, Jan. 00) The choice lies solely in the hands of the patient; no outside force has any control over the decisions and steps that you take towards the care of your body. Since the law was finally approved in 1997, forty-three people have taken advantage of the opportunity to spend their last moments of life in a carefree, peaceful state. The patient is in complete control of the drugs, the doctors are not allowed to administer the substance, they are only allowed to prescribe a lethal dose. This law rests on a thin line. Many say that patients experiencing extreme pain are not competent enough to make a clear-minded decision whether they want to live or die. When life becomes unbearable, quick death can be the answer. If a patient that spends every day in excruciating pain and is given the ability to take it all away at the switch of a button and give up on the fight for life the majority would utilize this. If living persons become so ill that they cannot tolerate the pain, they have a right to die to an escape from torment.
It is not morally acceptable to commit suicide in our society. Though it has been recently legalized many believe that one should not hold the power to kill themselves and take away the life that God has given them. Christians and many other faiths argue that "Life is a gift from God and each individual is its steward, only God can start a life and only God should be allowed to end one. God does not send us any experience that we can not handle." (Religious aspects, 4) Unfortunately with the day and age that we live in this statement is unreasonable. Because of modern medicine and health care benefits people are now able to enhance the conditions of their lives and control debilitative diseases. Religiously speaking, yes God did give life to us, but he also gave us the freedom to do what we want with it. You control your life and the actions that you take. God made man and man made the world and society that we live in. We were placed in this world and left to establish our own means of survival. If God is the only one to control life and the time that you spend here on earth then there are millions of people playing God everyday. People suffering from incurable diseases or injuries that would have died are being kept alive on machines. The initial purpose of a doctor is to save lives and improve the quality of life for those in pain. Prescription medicines, life support machines, organ donations and all other medical practices are intervening with the natural cycle of life. Why then is assisting someone that can not be helped by any of these resources to die without experiencing the pain they have endured for an extensive period of time wrong? Because our medical technology has improved so much, we are literally able to postpone death. Why would you keep a human being alive when they are no longer able to function on their own and control their own physical actions. Those who are victims of debilitative diseases have learned to adapt into the m!
edical world and trust the decisions of their physician. With regard to medical procedures, a large percentage of palliative-care professionals agree that it is ethical to stop or forgo medical procedures at the request of a terminally ill, mentally competent patient if the illness is progressing and there is very little chance of halting its progress or restoring the health of the patient. After a disease has ran its course and there is no hope of recovery a suffering individual deserves the right to make the choice of whether they want to live or die.
Although the act of euthanasia is quite simple, there are two different types: active and passive. Active euthanasia is when life is ended directly by administering a drug of lethal dose. Passive euthanasia is administered by the withdrawal of life-support devices, medications, and even fluids (Barnard, 27). Active euthanasia is illegal and has been debated in the courts while passive is generally left up to the physician and the family. Many people argue against euthanasia saying that life should be preserved at all costs. Doctors, for example, take an oath to preserve life and ease pain. There are many cases when the doctor of a critically ill patient is requested by the family to stop the medical treatment and let the patient die. The doctor either refuses or delays the act prior to the miraculous recovery of the patient. It is extremely hard to decide without a doubt that a patient cannot recover. If the doctor had acted on the request of the family, then it truly would be murder. There is also the case in which a terminally ill patient has not relayed his wishes and is incapable of doing so in his condition. It is impossible to make the judgment on what the patient really wants at this point. Is it justified for the family to make the decision to let their loved one live? It is too easy to let other motives influence that type of decision. The family very well could decide on the life of their loved one based on the burden of doctor bills or even the need for the inheritance instead of the well being of their beloved. It is also shown that "80% of relatives preferred to have their terminally ill loved ones die in the hospital, while 80% of dying persons...said they would prefer to die at home" (Barnard, 21).
In the fall of 1994 a Saskatchewan farmer killed his 12-year-old daughter with the exhaust from his pickup truck. The death of the girl, a longtime sufferer from severe cerebral palsy, resulted in the man's being convicted of second-degree murder. Yet many people, seeing the father's action as compassionate, approved of what he had done and called for a change in the law. The girl's life was not worth living, they said, and the man was to be applauded for deciding on her behalf that this was so. His conviction is currently under appeal.
In 2001 a case involving a woman with motor neuron disease was denied her right to "die with dignity at the time of her choosing with her husbands help" (British Med J., 953). She argued that "the right to life also included the right to choose to end one’s life" ( British Med. J, 953 p. 4). This woman was diagnosed in 1999 and now has no movement from her neck down and is fed through a tube. Euthanasia treatments were denied to this terminally ill victim who in turn was forced to spend her last weeks of life in a vegetative state, unable to function and end her life in peace. She would suffer for the last moments of her life as the disease ran its course. This woman did everything that she could to control and improve the condition of her illness, there was no further medical practices that could be done to save her life. She left this world as a rotting corpse absent of a soul able to pass on in peace. In this case along with many others death was
inevitable, yet the victims were forced to suffer and live out their lives against their will.
If a person is suffering terribly and has no hope of recovering, should their death still be postponed as long as possible? In many cases, it is impossible to relieve suffering while preserving life. With our medical advances, we can delay death even long after the brain stops functioning. Is it right to use our technology to keep a person alive as long as possible even if he can't tolerate the anguish? (Trubo,57). "The Brain is the organ that determines the quality of life, and the individual dies when his brain dies" (Barnard 7). In the many cases in which euthanasia is argued, the patient would have died long before without medical treatment in the first place. Because of the doctors' intervention, there is only a person in pain being kept alive by machines. In all of our great medical advances, we have forgotten that people still have to die. We must draw the line and decide that when a patient will not recover, is in great pain, and he or his families wish it, then the patient must be set free. Euthanasia may seem like a terrible thing, but it goes along with the advances that man has achieved and it must be accepted.
Back in 1990 a study was held in the United States, called The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatments (SUPPORT). They hypothesized that " improved communication between the patient, physician and their families would lead to improved situations and more nourishing and earnest decision making for end-of-life patients, less pain and discomfort and a decreased need for the intensive care units and hospital resources (........)" . The results showed that most individual died in the ICU without consideration paid to the victim’s choice of their care options and often in severe pain. Since this study was undertaken organizations have been developed in more than half of the states to increase the attention paid to end-of-life issues, better care is being taken towards pain management and further ways to overcome the strong financial barriers.
Legislatures have recently turned their attention towards the important issues of end-of-life care. Doctors and families are beginning to make strong efforts to understand the pain and suffering that patients experience throughout the course of their illnesses along with their time of death. Preparation towards physician’s ability to respond to the needs of patients and their families is being taken. Any aid that is given to suffering patients will decrease distress and help improve the length and quality of their life. It is important that doctors are not only experienced in saving lives but are also prepared to provide sufficient medical resources to alleviate the pain when death cannot be avoided.
1998 the Supreme Courts nine justices rejected claims previously made on physician-assisted suicide. They denied " that assistance by physicians in suicide is a constitutionally protected right of terminally ill person’s and their physicians (America, 16 )". This statement and ruling affects those who advocate physician-assisted suicide to those at the end of their lives. Both sides need to take into perspective the need for enhanced access to palliative medicine and hospice care in order to more thoroughly meet the needs of the terminally ill. The chief justice believes that physicians assisting their patients in death is both legally and morally different from the treatments of medical practice. What is different? The initial service that doctors are supposed to provide is improved quality of life for their patient. When they can no longer do this the patient deserves the right to decide what steps they want to take in order to alleviate their pain.
Another source of public confusion has to do with pain control. Many people have a horror of being kept alive in a state of intolerable pain. Many people support the legalization of euthanasia for this reason alone. Yet health professionals tell us that only in very rare circumstances should it be necessary for a dying patient to suffer uncontrollable pain.
When it comes down to giving physicians the power and access to drugs that are used to numb the patient both physically and mentally many obstacles and doubts arise. Are the doctors working on a completely professional level, or are they taking in personal opinions and feelings of success due to the requests of the ill? They have many paths that they can take towards the care of the terminally ill. " Doctors may administer drugs to relieve not just physical pain but the mental distress associated with the final stages of a severe degenerative disease, even if it shortens the patients life ( British Med. J., 956)".
Much of the informed opposition to legalizing euthanasia and assisted suicide flows from a practical concern about the abuses that will almost surely arise, and about the real difficulty of distinguishing compassionate mercy killing from murder.
Everyone has the right not to be subjected to any cruel and unusual punishment
In part this is because our culture emphasizes choice and self-determination. All of us face the inevitability of death, and all of us fear the debilitation and dependency of crippling disease.
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The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient’s failing lungs and medicines can sustain that patient’s physiological processes. For those patients who have a realistic chance of surviving an illness or accident, medical technology is science’s greatest gift to mankind. For the terminally ill, however, it is just a means of prolonging suffering. Medicine is supposed to alleviate the suffering that a patient undergoes.Yet the only thing that medical technology does for a dying patient is give that patient more pain and agony day after day. Some terminal patients in the past have gone to their doctors and asked for a final medication that would take all the pain away— lethal drugs. For example, as Ronald Dworkin recounts, Lillian Boyes, an English woman who was suffering from a severe case of rheumatoid arthritis, begged her doctor to assist her to die because she could no longer stand the pain (184). Another example is Dr. Ali Khalili, Dr. Jack Kevorkian’s twentieth patient. According to Kevorkian’s attorney, “[Dr. Khalili] was a pain specialist; he could get any kind of pain medication, but he came to Dr. Kevorkian. There are times when pain medication does not suffice”(qtd. in Cotton 363). Terminally ill patients should have the right to assisted suicide because it is the best means for them to end the pain caused by an illness which no drug can cure. A competent terminal patient must have the option of assisted suicide because it is in the best interest of that person.
Further, a dying person’s physical suffering can be most unbearable to that person’s immediate family. Medical technology has failed to save a loved-one. But, successful or not, medicine has a high price attached to it. The cost is sometimes too much for the terminally ill’s family. A competent dying person has some knowledge of this, and with every day that he or she is kept alive, the hospital costs skyrocket. “The cost of maintaining [a dying person]. . . has been estimated as ranging from about two thousand to ten thousand dollars a month” (Dworkin 187). Human life is expensive, and in the hospital there are only a few affluent terminal patients who can afford to prolong what life is left in them. As for the not-so-affluent patients, the cost of their lives is left to their families. Of course, most families do not consider the cost while the terminally ill loved-one is still alive.When that loved-one passes away, however, the family has to struggle with a huge hospital bill and are often subject to financial ruin.Most terminal patients want their death to be a peaceful one and with as much consolation as possible. Ronald Dworkin, author of Life’s Dominion, says that “many people . . . want to save their relatives the expense of keeping them pointlessly alive . . .”(193). To leave the family in financial ruin is by no means a form of consolation. Those terminally ill patients who have accepted their imminent death cannot prevent their families from plunging into financial debt because they do not have the option of halting the medical bills from piling up. If terminal patients have the option of assisted suicide, they can ease their families’ financial burdens as well as their suffering.
Finally, many terminal patients want the right to assisted suicide because it is a means to endure their end without the unnecessary suffering and cost. Most, also, believe that the right to assisted suicide is an inherent right which does not have to be given to the individual. It is a liberty which cannot be denied because those who are dying might want to use this liberty as a way to pursue their happiness. Dr. Kevorkian’s attorney, Geoffrey N. Fieger, voices the absurdity of curbing the right to assisted suicide, saying that “a law which does not make anybody do anything, that gives people the right to decide, and prevents the state from prosecuting you for exercising your freedom not to suffer, violates somebody else’s constitutional rights is insane” (qtd. in Cotton 364). Terminally ill patients should be allowed to die with dignity. Choosing the right to assisted suicide would be a final exercise of autonomy for the dying. They will not be seen as people who are waiting to die but as human beings making one final active choice in their lives. As Dworkin puts it, “whatever view we take about [euthanasia], we want the right to decide for ourselves . . .”(239).
On the other side of the issue, however, people who are against assisted suicide do not believe that the terminally ill have the right to end their suffering. They hold that it is against the Hippocratic Oath for doctors to participate in active euthanasia. Perhaps most of those who hold this argument do not know that, for example, in Canada only a “few medical schools use the Hippocratic Oath” because it is inconsistent with its premises (Barnard 28). The oath makes the physician promise to relieve pain and not to administer deadly medicine.This oath cannot be applied to cancer patients. For treatment, cancer patients are given chemotherapy, a form of radioactive medicine that is poisonous to the body. As a result of chemotherapy, the body suffers incredible pain, hair loss, vomiting, and other extremely unpleasant side effects. Thus, chemotherapy can be considered “deadly medicine” because of its effects on the human body, and this inconsistency is the reason why the Hippocratic Oath cannot be used to deny the right to assisted suicide. Furthermore, to administer numerous drugs to a terminal patient and place him or her on medical equipment does not help anything except the disease itself. Respirators and high dosages of drugs cannot save the terminal patient from the victory of a disease or an illness. Dr. Christaan Barnard, author of Good Life/GoodDeath, quotes his colleague, Dr. Robert Twycross, who said, “To use such measures in the terminally ill, with no expectancy of a return to health, is generally inappropriate and is—therefore—bad medicine by definition” (22).
Still other people argue that if the right to assisted suicide is given, the doctor-patient relationship would encourage distrust. The antithesis of this claim is true. Cheryl Smith, in her article advocating active euthanasia (or assisted suicide), says that “patients who are able to discuss sensitive issues such as this are more likely to trust their physicians” (409). A terminal patient consenting to assisted suicide knows that a doctor’s job is to relieve pain, and giving consent to that doctor shows great trust. Other opponents of assisted suicide insist that there are potential abuses that can arise from legalizing assisted suicide.They claim that terminal patients might be forced to choose assisted suicide because of their financial situation.This view is to be respected. However, the choice of assisted suicide is in the patient’s best interest, and this interest can include the financial situation of a patient’s relatives. Competent terminal patients can easily see the sorrow and grief that their families undergo while they wait for death to take their dying loved ones away. The choice of assisted suicide would allow these terminally ill patients to end the sorrow and griefof their families as well as their own misery. The choice would also put a halt to the financial worries of these families. It is in the patient’s interest that the families that they leave will be subject to the smallest amount of grief and worry possible.This is not a mere “duty to die.” It is a caring way for the dying to say, “Yes, I am going to die. It is all right, please do not worry anymore.” Further, legalization of assisted suicide will also help to regulate the practice of it. “Legalization, with medical record documentation and reporting requirements, will enable authorities to regulate the practice and guard against abuses, while punishing real offenders”(Smith 409).
There are still some, however, who argue that the right to assisted suicide is not a right that can be given to anyone at all. This claim is countered by a judge by the name of Stephen Reinhardt. According to an article in the Houston Chronicle, Judge Reinhardt ruled on this issue by saying that “a competent, terminally-ill adult, having lived nearly the full measure of his life, has a strong liberty interest in choosing a dignified and humane death rather than being reduced at the end of his existence to a childlike state of helplessness, diapered, sedated, incompetent” ( qtd. in Beck 36). This ruling is the strongest defense for the right to assisted suicide. It is an inherent right. No man or woman should ever suffer because he or she is denied the right. The terminally ill also have rights like normal, healthy citizens do and they cannot be denied the right not to suffer.
The right to assisted suicide must be freely bestowed upon those who are terminally ill. This right would allow them to leave this earth with dignity, save their families from financial ruin, and relieve them of insufferable pain. To give competent, terminally-ill adults this necessary right is to give them the autonomy to close the book on a life well-lived.
Barnard, Christaan. Good Life/Good Death. Englewood Cliffs: Prentice, 1980.
Beck, Joan. “Answers to Right-to-Die Questions Hard.”Houston Chronicle 16 Mar. 1996, late ed.: 36.
Cotton, Paul. “Medicine’s Position Is Both Pivotal And Precarious In Assisted Suicide Debate." The
Journal of the American Association 1 Feb. 1995: 363-64.
Dworkin, Ronald. Life’s Dominion. New York: Knopf, 1993.
Smith, Cheryl. “Should Active Euthanasia Be Legalized: Yes.” American Bar Association Journal April 1993. Rpt. in CQ
Researcher 5.1 (1995): 409.
--Esther B. De La Torre