Saturday, March 7, 2009

Euthanasia

Euthanasia raises many questions in morality, medical ethics and the law. There is an ongoing struggle to make euthanasia legal. Advancement in technology has also contributed to the debate of euthanasia and physician-assisted suicide. Bloyd describes euthanasia as meaning "good or happy death." It involves allowing or helping a terminally ill person to die, for the sake of relief from suffering (15). Supporters of voluntary euthanasia argue that it is all right to help someone end his or her life, as long as that person has a good reason for doing it. However, other people think that it is wrong to legally kill and take away an innocent life.

According to Faye Girsh, the Hemlock Society and the majority of polled Americans believe that providing physician-assisted dying to a terminally patient who requests it, is a humane and compassionate option that should be legalized. She points out that it will be "cruel, even barbaric to make a suffering person, whose death is inevitable, live longer than he or she wishes." As part of their job, doctors are there to help all patients in any possible way. In the case with the terminally ill, only physicians can prescribe some medication to help with suffering, and in doing so, fulfil certain patients' wishes. A physician may also aid in the dying process, when prescribed substances cannot control suffering. The patient would also have a better state of mind, knowing that they have options when the pain becomes unbearable, instead of having "the anxiety of not knowing how much longer one would have to suffer and watch the family suffer," which also adds to the burden of the illness (69-76; ch. 2). With added stress and worrying about when the final day will come, a person may get more sick, and develop unnecessary symptoms. Kohl and Kurtz believe that "society has no genuine interest or need to preserve the terminally ill against their will and that the right to beneficent euthanasia, with proper procedural safeguards, can be protected against abuse (236).

On the other hand, many people believe that Euthanasia should not be legalized, for it will harm the society. Instead of terminally ill patients having a "right to die," they will see their illness as a burden to family members, which leads to their "duty to die" (Torr 72). As a result of euthanasia becoming legal, there would be many deaths of people who want to die, and even those who do not, but they were just told by the physician or a family member that that is the best available option. Not only would one individual be affected, but the society as a whole, because people may choose euthanasia even if they are not terminally ill, but instead have depression or some curable disease. In such a case, those are the people that need hospice care (where someone is on call for the patient at all times), not euthanasia, or an easy way out to committing suicide.

In many countries, Euthanasia is legal and accepted. Some of these countries include the Netherlands, Switzerland, Germany, Uruguay and Norway. Holland's policy may work for that country, but it may not be successful if applied to the United States. For the United States, the "New Oregon Death with Dignity Act" was passed in 1994, marking just a beginning. Derek Humphry argues that euthanasia is justifiable and ethical. A person should not be allowed to suffer if he or she does not want to. In the later days of the illness, a person may be given so much drugs to ease the pain that they loose consciousness, but their "quality of life" lowers, affecting loved ones around them (17-22; ch. 1). John Shelby Spong believes that, "We are aware that life can today be prolonged by managing pain with pain-killing drugs, but that relief is sometimes achieved at the price of the destruction of the patient's mind of the loss of the patient's capacity to relate to other human beings in a meaningful way." Every person has their individual rights, so they should also be granted that right of choosing their death, under the right state of mind (41, 44; ch. 1). Due to the advancement of medical technology, Spong also thinks that euthanasia does not violate Christian and other religious beliefs. Although the church could have taken a firm position on the topic in the past, the present brings about new changes and views. Due to the advances of modern medicine, God cannot only control death (The Ethics Of Euthanasia 30-34).

Although individuals may have the right to make decisions concerning the welfare of their lives, they had no control over their birth, therefore their death is not up to them. Based on Judea-Christians beliefs, one of the fundamental values includes not killing or taking the life of someone else, even voluntarily (Meilaender 31-33). Among the traditions that oppose euthanasia, the three main ones are Judaism, Roman Catholicism and Protestant (Childress 121; ch. 6). In Ronald Otremba's point of view, it will be unethical to legalize euthanasia because life is valuable. The practice will also lead to the death of many others, for example, once one terminally ill patient requests euthanasia, the handicapped may follow, along with others who do not need it. According to Otremba, the value of life is based "on the principle that God is the sole creator of life and has sovereign authority over life and death" (21-23). The value of life should not be judged merely by the physical, emotional and social characteristics, but instead, on the whole as being a human and having life. Good judgment does not necessarily portray morality. In such a corrupt society, people think about themselves and not how they may harm or benefit society as a whole.

Legalizing euthanasia would not lead to involuntary killing. Defined in Euthanasia: moral and pastoral perspectives, Richard Gula states that involuntary euthanasia is killing a competent person for the purpose of relieving suffering without first obtaining their consent. With the proper safeguards in place, the abuse of legalized euthanasia can be prevented. The "slippery slope" argument is associated with Nazi Germany. Under the dictatorship of Adolph Hitler, many people were persecuted because of disabilities, the color of their skin or other stereotypes that would consider a person as not being "pure" for Hitler's society. In an essay by Gerald A. Larue, he states that the United States is a democracy and individuals are free, so the slippery slope pattern cannot develop in America. Human rights are protected, as long as "the government is of the people, for the people and by the people, and so long as the national ethic endorses the right to life, liberty and the pursuit of happiness for all citizens" (124-132; ch. 3).

Jack Kevorkian is a well known name associated with euthanasia and physician assisted suicide. Through his death machine called the "Mercitron," Jack Kevorkian has help to kill hundreds of patients. However, Torr stated that "Wesley J. Smith, a staunch euthanasia opponent, points out that 'approximately 80 percent of Kevorkian's victims were not terminally ill'" (85). This defeats the purpose of euthanasia, since it was meant to be for only those who are terminally ill. Such a case shows that the process can lead to abuses within society. Safeguards in preventing abuse might not be adequate enough. Euthanasia has been established in the Netherlands for some time, and it has moved from physician assisted suicide, to active euthanasia to involuntary killing (Torr 88).

Some terminally ill patients have tried to commit suicide. When unsuccessful, the patient can become more ill and try even harder, leading to violent attempts at times. With the help of a physician, the situation can be prevented. The Hippocratic Oath is the traditional vow made by most physicians. It states that physicians should "use treatment to help the sick, […] but never with a view to injury and wrongdoing" (Wekesser 100). The Oath also states that physicians should follow the method of treatment that would benefit the patient, based on his or her ability and judgment" (Bloyd 30). Patients depend on the advice and help of their physicians because they are the only ones who may be able to help them. Timothy Quill believes that the relationship between physicians and patients will improve if euthanasia is legalized (101; ch. 3). Terminally ill patients will feel better knowing that they have options available and if not in a total vegetative state (brain dead), they will be able to relate with medical professionals better also. At some point in time, some sick people often find it hard to take some of the prescribed medication, due to the method of taking it (for example, swallowing), or the high dosage (Bloyd 62). With the help of a doctor and euthanasia, a person may not have to go through all that torture and suffering. In helping a terminally ill patient, Timothy Quill proposed the following guidelines for doctors to follow:
First, the patient must, of his or her own accord, clearly and repeatedly request to die rather than continue suffering. Second, the patient's judgment must be clear. Third, the patient must have a condition that is incurable and associated with severe, unrelenting, unbearable, suffering. Fourth, the doctor must make sure that the patient's suffering and the request are not the result of inadequate treatment for pain, anxiety, and depression. And last, another doctor who is experienced in treating the pain, anxiety, and depression sometimes felt by the terminally ill should be consulted. (Bloyd 76)

These requirements would set a precedent as to whether euthanasia is being practiced for the right reasons; thus there would be no harm if it were to become legal. Physician, Ezekiel Emanuel points out that by doing the procedure over and over again, doctors would become more comfortable, and it would it help the purposeless lives of those suffering ("Whose Right to Die" 79).

Euthanasia is prohibited under the Hippocratic Oath in several ways. Even if the disease is formidable and the person is completely take over by the disease, the physician is still supposed to treat the patient. The Oath states that "I will not give poison to anyone though asked to do so, nor will I suggest such a plan" (Sulmasy 26; ch. 1). No matter how close a person may be to dying, physicians should not assist in their death. By taking one's life, physicians may be seen as "God" (Torr 47). Whereas some people think that the doctor-patient relationship may improve, the opposite might happen. Instead, the patient would be more afraid of the doctor, loosing their faith and trust in his/her practice, because the choice which he/she has given them, is death. The patient may not be ready to face such a challenge (Dougherty 70).

Hospice care is a program in which the dying person is cared for in the comfort of his or her home with family members and other caregivers providing support, care and counseling for the patient. Whereas in the hospital, the patient is only treated with drugs to cure pains, hospice provides everything else to ensure that a person's final days are well spent (Anderson 66-73). On the other hand, Vicki Brower argues that " hospices may not always provide the best care for the dying patients because of a lack of money, poor medical supervision, inadequate personal training and a rigid philosophy that compels people to "accept" death rather than embrace life" (74). Hospice is not for everyone. It may be a substitute to legalizing euthanasia, however, those that cannot benefit from such a program may want to have euthanasia as an option.

Each human being is different, therefore each death is unique in its own way. For some, the subject is very emotional, thus one's judgment is bias, but for others, they stand by their beliefs and morals, and not accepting change in the developing society. In conclusion, if euthanasia were to become legal, we would not know about the consequences or what problems would arise. However, if euthanasia remains as a debatable topic, we would not be able to face the challenges and deal with situations that would or would not have come up with such a topic.

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