History and Pros and Cons of Euthanasia - Essay Example

?Running Head: EUTHANASIA School: Topic: Lecturer: presented: Euthanasia Euthanasia is commonly referred as ‘mercy killing’ or a ‘good death’. It entails bringing about the death of a patient in belief that the existence of the patient is so bad that he or she is better off dead than alive. According to Manning (1998, p.1), euthanasia is “a death free of anxiety and pain brought about through the use of medication or deliberately putting an end to someone’s life in order to spare the individual from suffering”. Euthanasia is therefore believed to be beneficial to the person on whom it is brought about because it spares him or her from enormous pain and suffering at the end-of –life where death is inevitable. The practice began with the Greeks and Romans who believed that there was no need to preserve life at all cost hence if no relief could be offered to the dying and the disabled, suicide was acceptable. The choice to die is made by competent patient who does not value his or her life as worth while with the assistance of the doctor or choice is made through an existing living will in case the patient is not competent at the end –of –life. Euthanasia can be active or passive and voluntary or involuntary or non voluntary. Manning (1998) describes passive euthanasia as the avoidance of extreme measures to prolong life for example, by withdrawal of medical treatments whereby the illness is terminal and it results in pain and suffering for the patient. According to McMahan (2002), the patient is allowed to die through withdrawal or withholding of life-prolonging treatments. Active euthanasia I whereby the death is brought about by another person other than the patient himself/herself thus McMahan considers it as an act of killing which is not morally acceptable. Voluntary euthanasia is whereby a competent person makes an enduring request to be helped to die whereas in non voluntary euthanasia, the person is incompetent to make a request hence the decision to end life is made on his /her behalf. Involuntary euthanasia on the other hand, is whereby death is brought about without the consent of the patient. Where the physicians provide patients with a means to end their lives but are not involved in the killing, then it is a physician-assisted suicide which is prohibited by the law (Keown, 2002). The euthanasia debate has been going on for decades as to whether it should be legalized and the morality involved in the process. Some people advocate for proper palliative care as opposed to euthanasia and physician- assisted suicide while others view palliative treatment as causing unnecessary pain and suffering to patients whose life is not worth saving as they would eventually die. They thus advocate for a painless death or what they call a ‘good death’ by allowing patients to choose whether their lives are worth living or not (Keown, 2002). Euthanasia is rejected especially by religious groups on moral grounds as it results to killing and everyone has a right to life as set out by the international convention on human rights. However, the churches do not advocate for prolonging of life either hence patients should be allowed to die. Some others view legalization of euthanasia as a slippery slope to other forms of suicide hence should not be allowed while others see the law as inconsistent in dealing with suicide hence ineffective. The autonomy of the individuals in deciding whether their lives are worth living or warrant termination is also the choice and no clear guidelines to be followed in determining competency hence doctors can misuse their position while performing euthanasia. There is also debate on living wills, the Hippocratic Oath and healthcare spending among other issues which will be explored in this paper but first it is important to understand the history of euthanasia so as to make informed opinions. History of Euthanasia The concept of euthanasia began with the Greeks and Romans according to Young (2007). The early Greeks and Romans allowed suicide as a relief for the disabled and those suffering unbearable pain. Cavan & Dolan (2000) argue that the word euthanasia is derived from two Greek words; Eu meaning good or easy and Thanatos meaning death hence euthanasia is used to refer to a ‘good death’ (10). The difference from modern day euthanasia is that the action was directed at the way in which one died rather than acts aimed at enhancing the death or shortening one’s life. The death was supposed to be as painless as possible and to give the sufferer peace of mind hence the circumstances surrounding the death were very important (Manning, 1998). It was thus permitted to arrange the circumstances surrounding the death which included measures aimed at shortening one’s life. For example, in Athens the magistrates kept a supply of poison to give to anyone who wished to die hence euthanasia was not considered as suicide (7). The stoics on the other hand emphasized the importance of not evading ones responsibilities by taking advantage of euthanasia thus those affected had the responsibility to weigh the options and ensure responsibility to others. The Pythagoreans were against euthanasia as they believed it disrespected human life. According to them pain and suffering were punishment from God for their sins hence one needed not to evade the punishment by shortening or ending his/her own life. Aristotle and Plato also had different views regarding suicide. For Aristotle, suicide deprived the state of useful members whereas Plato was of the view that the terminally ill and the disabled were a burden to the state hence ending their lives was essential. The suicide was for alleviating pain but later was used for economic reasons due to the widespread idea of survival for the fittest promoted by Charles Darwin (Manning, 1998, p. 11). Cavan & Dolan trace the history of euthanasia to 1968 when doctors at Harvard medical school proposed ‘brain death’ to be included in determining the end of life. Those who suffer mental illnesses or damaged brain are a responsibility to the society as they can’t depend on themselves and cannot make rational choices hence are better off dead or death is beneficial to them and the society as a whole. In 1976, living wills and advance directives were accepted by eleven states as consent to end an incompetent patient’s life. A terminally ill person therefore can make his or her wishes known in the event of death in case at that time the patient is incompetent to make voluntary and informed choices and persistently hence request for aid in dying. The supreme court of Netherlands also legalized voluntary euthanasia in 1984 (Young, 2007). It was agreed that there were to be no prosecutions of physicians for assisting the patients to die but strict guidelines were to be followed. These included; patient’s competence, unbearable suffering and a second opinion from another physician. This would ensure physicians did not end patient’s life involuntarily. Australia legalized voluntary euthanasia in 1990 but overturned the decision in 1997. The Supreme Court also gave constitutional rights to competent adults to refuse medical treatment if they presumed it would prolong their suffering or would not improve their well-being. The Oregon state passed the Death with Dignity Act in 1994 allowing for physician assisted suicide and according to Cavan & Dolan (2000), fifteen patients used the Act to commit physically assisted suicide in 1998. The idea of euthanasia was also strongly supported by Dr. Jack Kevarkian who helped patients to die by use of lethal injections. Euthanasia is therefore not a new phenomenon and continues to stir a lot of debate on its morality. Conditions Needed For Euthanasia Certain conditions need to be met in order to justify euthanasia otherwise the act or omissions could be used by doctors unethically or by any person who wants to shorten his/her life to avoid responsibilities. First, the patient need to be suffering from a terminal illness thus death is inevitable. Not any patient can decide to end life as that would be committing suicide as medical treatment can make the person worthwhile or improve the quality of his/her life. If any person with unbearable pain ended his or her life then euthanasia would lack meaning and the slippery slope argument would hold. The international convention on human rights grants all human beings the right to life and the government has a right to ensure all people are protected from harm. Such an offense is unlawful except where the law demands termination of life as a result of capital punishment. The second condition to be met is that the patient illness is so bad that a discovery of a cure is unlikely to benefit him/her. For example, an old person suffering from dementia or a person at a late stage of an incurable disease or even if the person survived, he/she would be a burden to others for the rest of his/her life hence making life worthless (Lewis, 2007). The act has also to be as a direct result of the illness. The illness can result to a lot of suffering for the patient and unbearable pain or it can render the patient unable to depend on themselves hence burdensome to others. The patient should also be competent or able to make voluntary and informed decision to die. Besides being competent, the patient should have shown persistence in his/her wish to die or has an advance directive upon being rendered incompetent or has a living will which is recognizable by law (Griffiths et. al 1998). The last requirement is that the patient should be unable to commit suicide without assistance. The patient may request removal of a respirator to hasten death but can’t do so without the assistance of a doctor. The doctor can also provide medicine that shortens the life of the patient, gives directions on how to take but does not take part in its administration. The doctor can also withdraw the treatment if it’s not helping the patient but only adding to the suffering due to prolonged death. The intention is not to kill but to let the patient die by shortening life. Pros and Cons of Euthanasia Euthanasia is advocated by those who feel that even if individuals have a right to life, people should be allowed to choose how they want to die or end their life so as to maintain their dignity in death. However, others argue that it is immoral to kill or assist in committing suicide due to sanctity of life and there is no life which is not worth living. Life is inherent in human beings and should be used to flourish their well being and not to end it (Keown, 2002). Some therefore feel that euthanasia should be legalized while others are against. Those who are for legalization argue that the death of the patient would be of benefit to him/her and the society since the one’s life affects the others. According to Keown (2002), there are three competing views about the value of human life which includes; vitalism, sanctity or inviolability and Quality of life. Vitalists argue that it is morally wrong to shorten or fail to lengthen life regardless of the pain and suffering the patient is undergoing through. Life is thus to be preserved at all costs (39). According to this school of thought therefore, euthanasia should not be legalized as it does not give absolute moral value to life. Euthanasia is aimed at shortening the life of the patient to end suffering hence does not allow lengthening of life as advocated by vitalism. According to this view, it is wrong to withdraw or withhold medical treatment on the basis that it results in more suffering for patients due to prolonged life or because it adds to health expenses. They thus advocate for palliative care and hospice care. However, advocates of euthanasia would argue that getting the best palliative care involves trial and error and harmful consequences thus should be avoided (Young, 2007). Hospice care is also available only at the last stages of life and to a few patients hence it is ineffective. It also diminishes the patient’s will or desire to die a decent death or on their terms and conditions hence patients are unwilling to get palliative care. There are those who advocate sanctity or inviolability of life. These hold the view that individuals are created in the image of God hence have a dignity to be protected and a right to life (Keown, 2002 p. 39). It is thus wrong to intentionally kill a person because they are disabled or don’t have the abilities required to make rational choices needed to make life meaningful. They argue that all human beings have capacities which can develop into abilities to help them live a worthwhile life. They thus follow the Hippocratic Oath which prohibits intentional killing of innocent people. However, as opposed to vitalism, life should not be preserved at all costs hence it advocates for euthanasia. The doctors can withdraw or withhold treatment if it is not beneficial to the patient in prolonging his/her life. The intention is not to shorten the life of the patient but to allow the patient to die thus it is morally right. The overall aim of this is to assess the effectiveness of treatment on the patient and withdraw if it is not beneficial but not to assess the worth of the patient. Every one has a right to live hence no life is not worth living (41). The other view is Quality of life. This is used to determine whether it is beneficial for the patient to die rather than live and continue suffering or being a burden to others. Determination is made on whether life is worth living or patient would be better off dead. It is therefore right to intentionally shorten or end the life of the patient if his/her life is not worthwhile (Keown, 2002). The patients thus request for death or the view advocates for voluntary euthanasia and involuntary euthanasia whereby the doctor ends the life of an incompetent person if his/her life is of low quality and not worth living. Involuntary euthanasia is prohibited by the law. Opponents would argue that choices patients or doctors make should be consistent with moral values and it is also difficult to ascertain whether the requests by patients to end their lives are competent or are true due to lack of procedure or guidelines for directing competent behavior. This can lead to involuntary euthanasia and thus the practice should not be legalized (Young, 2007). The slippery slope argument is of importance to euthanasia debate. Opponents of euthanasia believe that allowing voluntary active euthanasia could lead to other forms of euthanasia which are harmful hence euthanasia should not be legalized. This is because there are no clear procedures to ensure that the acts or omissions are carried out only after a patient voluntarily, competently and persistently requests for an end to his/her life with or without assistance from the doctor (Manning, 1998). It is argued that even if the guidelines existed there is no way of proving that the requests are genuine or to monitor the process. The doctor cannot also detect if the patient is requesting for euthanasia willingly or due to pressure from outside hence uninformed and incompetent decisions. If the opinion of second doctor was to be sought, there is n o way of telling whether the second opinion is genuine or compromised and the second doctor does not also have all the facts to conclude whether the euthanasia decision is competent and voluntary. There is also no way of determining if the suffering is unbearable for the patient as the patients pain may be as a result of the medicine taken to relieve pain and not as a result of the illness hence this condition cannot be fulfilled. Bearing this in mind the opponents of euthanasia have a strong case against legalization. Acceptance of voluntary active euthanasia leads to logical acceptance of non voluntary euthanasia according to Keown (2002). However, advocates argue that advance declarations can be used as evidence. They also argue that there principle difference between voluntary and non voluntary euthanasia hence no logical reason to conclude that voluntary euthanasia could lead to non voluntary euthanasia. Euthanasia should thus be allowed or legalized (Keown, 2002). The current laws are accused of being ineffective or hypocritical in dealing with suicide issues hence euthanasia should be legalized for the laws to be consistent. The law adopts the inviolability principle hence making it a criminal offense (murder) to actively and intentionally hasten the death of a patient. However, the law does not advocate for saving of life at all cost hence the doctor can withdraw treatment if it is not beneficial and this leads to unintentional killing by hastening death. According to Keown (2002), drugs meant for palliative care can hasten death through side effects but this is not considered unlawful hence in practice, euthanasia is prevalent. Euthanasia should be allowed in cases where someone leaves a living will. Such a person may state that if they ever become worthless, as a result of a terminal illness or an accident they do not wish to be put on life support machines. It is only fair to respect the wishes of such people instead of continued suffering due to preservation of their life. Opponents of euthanasia on the other hand, would argue that people do recover from vegetative states or from terminal illnesses hence they should be preserved. Euthanasia would therefore deny such people the chance of living longer (Lewis, 2007). Young (2007), advocates for the doctrine of double effect. Doctors should be permitted to act in ways foreseen to be of bad consequence if side effects are observed. The pain killers offered by doctors to alleviate suffering may have fatal results hence euthanasia should be allowed. However, others would argue that a difference exists between unintended consequences and deliberate actions hence euthanasia which is deliberate should not be allowed. Others argue that just as individuals have a right to life, they should have a right to die hence legalize voluntary euthanasia. It is not illegal to commit suicide according to the law. However, it is illegal for the physically handicapped to commit suicide. This is seen as discrimination against them and hence physician-assisted suicide should be allowed in such cases to avoid discrimination. On the other hand, allowing physician-assisted suicide would lead to abuse of power by doctors to eliminate some people who are viewed as utilizing medical resources for no just cause hence dangerous to allow such actions (Trevor, 1999). Trevor (1999) also argues that euthanasia enables doctors to get transplant organs from the patients instead of allowing them to go to waste by removal of life support machines and allowing them to die. On the other hand, the practice enhances exploitation of patients by doctors as they are used as medical resources. People should have the right to choose what they want when faced with an illness that is incurable. This is due to the fact that people view death differently and experience different levels of suffering at the end of life hence it is only logical to allow them to choose whether their life is worth living or not. Some people would also wish to die with dignity and without imposing unnecessary burdens on others and hence it is only fair to grant them their wish for the benefit of the individual and the society as a whole. Doctors should not be allowed to perform involuntary euthanasia as it is against the international convention on human rights and denies the patient the right to life. As an autonomous being with the capacity and the ability to make choices, a terminally ill person therefore has the right to choose what is good for him/her without interference from the government or medical practitioners. References Cavan, S., Dolan, S.,2000, Euthanasia: The Debate Over The Right To Die, New York: Rosen Publishing. Griffiths, J., A. Bood, and H. Weyers, 1998, Euthanasia and Law in The Netherlands, Amsterdam: Amsterdam University Press. Keown, J., 2002, Euthanasia, ethics and public policy: An Argument Against Legalization, New York: Cambridge University Press. Lewis, P., 2007, Assisted Dying and Legal Change, Oxford: Oxford University Press. Manning, M. 1998. Euthanasia and Physician-Assisted Suicide: Killing or Caring?, New Jersey: Paulist Press. McMahan, J., 2002, The Ethics of Killing: Problems at the Margins of Life, New York: Oxford University Press. Trevor, S., 1999, Pros and Cons: A Debater’s Handbook, UK: Routledge. Young, R., 2007, Medically Assisted Death, Cambridge: Cambridge University Press. Read More