The Ethics of Euthanasia in the US - Research Paper Example

? The Ethics of Euthanasia Euthanasia is a topic that has gained much ethical ambiguity and debate over a long period of time (Bartels and Otlowski, 2010). Various forms of euthanasia have been identified but they have been subject to a host of controversies. They include assisted suicide, active voluntary euthanasia and physician-aided suicide. In essence, these terms describe the ending of one’s suffering via termination of their life often via drugs administration. Today, Patients Rights Council (2012) reveals that assisted suicide is considered illegal in 47 U.S States apart from Washington, Montana and Oregon which support physician-assisted suicide. This is a reflection of the status quo of a majority of countries although some permit the act under given circumstances. This article defines euthanasia and related terms in order to elicit the key arguments of opponents and proponents of euthanasia. In addition, the paper also takes a look at the legal framework of euthanasia in the U.S. The Ethics of Euthanasia Proponents of euthanasia are of the view that every person has the right to make their own choices with respect to death (Bartels and Otlowski, 2010). They believe that the act intends to lessen the pain and suffering experienced by terminally ill patients; hence referred to as mercy killing. Such arguments are heavily contested by opponents of the act who claim that euthanasia is equal to murder as it is an abuse to human rights and self-government. In addition, the group argues that with proper palliative care, the act of euthanasia can be eliminated (Walsh et al., 2009). Definition of Terms Euthanasia – the term euthanasia can be traced back to Greece where it means good health (Kerridge, Lowe and Stewart, 2009). In its common use, however, the term refers to the termination of one’s life so as to bring to an end a prolonged period of suffering, usually from a terminal condition, hence the name mercy killing. Dignity – the value held by a human being out of living freely and not based on another person’s actions or property (Kerridge, Lowe and Stewart, 2009). Palliative care – This involves emotional, spiritual, psychological and or medical care given to an ailing individual aimed at lessening the pain and suffering of the person rather than cure the condition (Walsh et al., 2009). Passive euthanasia – this is where a patient dies out of omissions of certain prescriptions, for instance the withholding or withdrawal of medical treatment of a person to aid in the death of the individual (Adams et al., 1992). Voluntary euthanasia - this is a situation where the patient requests for their life to be terminated (George, Finlay and Jeffrey, 2005). Active euthanasia – involves a person causing direct and deliberate death of a patient (George, Finlay and Jeffrey, 2005). Early History The early years of the twentieth century gave birth to the efforts towards legalization of euthanasia in the United States. A 2004 article by Jacob Appel that appeared in the Bulletin of the History of Medicine documented the extensive political debate perpetuated by Anna S. Hall, a 1906 social activist that took place in Ohio and Iowa aimed at legalization of physician-aided suicide (Kerridge, Lowe and Stewart, 2009). Another instance of euthanasia is an article called "It's over Debbie “documented in the Journal of the American Medical Association 1988 issue describing how an unidentified doctor aided in the death of a woman ailing from ovarian cancer (Anonymous, 1988). This was followed by a group of ten doctors from top hospitals declaring that "it is not immoral for a physician to assist in the rational suicide of a terminally ill person" (Wanzer et. al., 1989). In 1990, Dr. Jack Kervorkian used a suicide machine to aid an Alzheimer's disease patient die. According to Quill (1991), the patient was only one of the twenty patients assisted by the doctor in committing suicide in a period of three years. This act was later followed by a move by the Hemlock Society who published a manual entitled Final Exit on how to commit suicide (Kerridge, Lowe and Stewart, 2009). In 1994, Oregon became the first US state to legalize physician-assisted death when the Oregon Ballot Measure 16 established the Death and Dignity Act to legalize the act (Euthanasia, 2012). The approval of the Act was based on the 8 November 1994 general election where 51.3% voted in favor of the Act as opposed the 48.7% against it. According to Euthanasia (2012), several attempts have been made since then to overturn the law but the US Supreme Court ruled in favor of the law following arguments presented by the Gonzales v. Oregon case. Oregon State was followed by Texas in 1999 when it passed the Texas Futile Care Law where hospitals and physicians within the state can withdraw life support or treatment on a terminally ill patient (Kerridge, Lowe and Stewart, 2009). Passive Euthanasia and Active Euthanasia Advocates of euthanasia argue that passive euthanasia is morally worse than active euthanasia. From a utilitarian point of view, Rachels (1975), an advocate of euthanasia believes that killing and letting die are no different as both have similar intentions. He further argues that passive euthanasia is less humane than active euthanasia as it is relatively slow hence a painful death. He points out that active euthanasia can be a lethal injection that can be quick and less painful or totally painless in terminating one’s life. On the other hand, opponents of euthanasia are of the view that active and passive euthanasia have a moral distinction that is very clear (Walsh et al., 2009). Letting one die from a terminal illness is viewed by this group as allowing the disease to naturally cause the death of a patient without moral guilt. Walsh et al. (2009) point out that palliative care significantly postpones the death of a patient. Withholding or withdrawing of these interventions means the patient dies of the underlying illness. This view has been endorsed by some countries, for instance, Australia where physician-aided suicide and voluntary active euthanasia are strongly opposed whereas death caused by withholding or withdrawal of treatment is not considered as physician-aided suicide or euthanasia (Bartels and Otlowski 2010). U.S Laws on Euthanasia: Death with Dignity in Montana, Washington and Oregon The general homicide laws in the US federal government, the District of Columbia and all fifty states are against euthanasia. Due to the absence of assisted suicide laws in the federal government, the state level is charged with the responsibility of handling these laws. Three states- Oregon (1994), Washington (2008) and Montana (2009) – have legalized physician-assisted suicide (Euthanasia, 2012). The State of Oregon was the pioneer of the Death with Dignity (DWD) Act approval; dating back to 8th of November 1994 following a referendum initiated by citizens. However, the implementation of the law came later on the 27th day of October in 1997 after a series of interventions that saw legal challenges filed against using the law (Euthanasia, 2012). The DWD Act allows patients with terminal illnesses to request for lethal medication. Before proceeding with the act, the patient must submit a fully witnessed written request to back the initial step of two verbal requests. In addition, two doctors have to concur with respect to the diagnosis of the patient, h/her prognosis as well as the capability of the patient. However, administering of the lethal medication is done by the patient in person. The Washington and Oregon laws are strong opponents of euthanasia, an act they define as involving a different party rather than the patient in administration of the lethal medication. Washington’s Ballot Initiative 1000 DWD Act stated that: "An adult who is competent, is a resident of Washington state, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication that the patient may self-administer to end his or her life in a humane and dignified manner" (Euthanasia, 2012). The State of Montana was the latest of the three in implementing the DWD Act in a 2008 court ruling of a case involving a 76 year old lymphocytic leukemia patient’s request for terminating his life with the help of a physician. This ruling was in favor of the patient with the judge citing that a competent patient with terminal illness has a legal right to death with dignity as stipulated by the Montana Constitution under Article II, sections four and ten. This includes the use of help from physicians in obtaining of the lethal medication that the patient self-administers when s/he decides to end his/her life. This protects the medical practitioners from any criminal liability by the consent of the patient. In Oregon, the DWD legislation is reported on every year by the Department of Human Services (Euthanasia 2012). Among the reported end-of-life concerns include the loss of dignity, a reduced or diminished aptitude in participating in life-enjoying activities, and the loss of autonomy (Euthanasia, 2012). i. Abuse of human rights and autonomy – most proponents of euthanasia use autonomy in their arguments but it has been raised as a concern by those against it. According to Bulow et al. (2008), the autonomy principle is against the voluntary termination of conditions that are vital for autonomy. This only happens when one’s life is brought to an end by another individual. In addition, many argue that the euthanasia requests made by patients are hardly autonomous since most patients suffering from terminal illnesses may no be of a rational mind. On the other hand, opponents of euthanasia state that the act is a contradiction to the right to life. They believe that one has no right to death thus justifying suicide in any case (Bulow et al., 2008). ii. The sanctity of life – the society’s view of life is that it must be respected and preserved at all costs (Bulow et al., 2008). Proceeding with euthanasia in any given circumstances is viewed by Christians as disrespecting the gift of life from God. Similarly, Bulow et al. (2008) reveal that the Islamic faith is of the view that it is the role of God to give and take away life and not human beings. iii. Loss of dignity – the view of society is that euthanasia is wrong as it is an act with a primary objective of killing despite approval by the patient. According to Callahan (1992), active voluntary euthanasia is consenting the killing of an adult. iv. Rights of vulnerable patients – legalization of euthanasia is believed to give rise to situations undermining the rights of certain patients (George, Finlay and Jeffrey, 2005). A suitable example is where patients under costly medication can be compelled into accepting physician-aided suicide or euthanasia. Conclusion It is clear now that the issue of euthanasia is contentious. The legal status of the act in the 47 US states is that of manslaughter charges or conferring to murder as stipulated under the common law. However, the many arguments for and against euthanasia are only but a glimpse of what controversies surround the topic of euthanasia. References Adams, R. et al. (1992). ‘Physician assisted suicide and the right to die with assistance.’ Harvard Law Review, 105, 2021-2040. Anonymous. (1988). ‘It’s over Debbie.’ Journal of the American Medical Association, 259, 272. Bartels, L., & Otlowski, M. (2010). ‘A right to die? Euthanasia and the law in Australia.’ Journal of Medical Law, 17(4), 532-555. Bulow, H. H., Sprung, C. L., Reinhart, K., Prayag, S., Du, B., Armaganidis, A. et al. (2008). ‘The world’s major religions’ points of view on end-of-life decisions in the intensive care unit.’ Intensive Care Med, 34(3), 423-30. Callahan, D. (1992). ‘When self-determination runs amok.’ Hastings Cent Rep, Vol. 22(2), pp. 52-55. Euthanasia (2012). State Laws on Physician-Assisted Suicide. Retrieved from http://euthanasia.procon.org/view.resource.php?resourceID=000132 George, R. J., Finlay, I. G., & Jeffrey, D. (2005). ‘Legalized euthanasia will violate the rights of vulnerable patients.’ British Medical Journal. 24(331), 684-5. Kerridge, I., Lowe, M., & Stewart, C. (2009). Ethics and law for the health professions. New South Wales: Federation Press. Patients Rights Council. (2012). Assisted suicide laws in the United States. Retrieved March 14, 2013 at . 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