Legal Perspective on Euthanasia - Term Paper Example

Legal Perspective on Euthanasia Introduction It is apparent that there are various opinions about euthanasia. Besides the cultural, social, moral, bioethical, and medical elements of such end-of-life subject matters, there are political and legal components to take into account as well. Many have gone through legal proceedings in an effort to resolve these problems legally. Issues associated with euthanasia wind up in court because the people involved are not able to agree on a proper course of action and they appeal to the legal system to resolve the disputes. Nevertheless, even the issue of going through legal proceedings becomes contentious in several instances because some individuals think that the ‘right to die’ must be decided personally (Devettere 70). Even though individuals with these thoughts may seek advice from medical professionals or spiritual counselor, the concept of a legal resolution is detested because the act of placing the decision on another person meddles with a person’s rights to liberty and freewill. Numerous legal cases concerning euthanasia use the U.S. Constitution to support their judgments. They refer to privacy and liberty rights, protected by the Constitution, as the basis for a person’s right to decide how and when death should take place. Numerous individuals and groups supporting euthanasia claim that the reasonable step to take in the future is to constitutionally guarantee the ‘right to die’ (Keown 89). Even though legal decisions that support euthanasia somehow set precedents which advocates can eventually use in future cases, making euthanasia legal would offer stronger protection under the constitution. Critics of euthanasia, in contrast, assert that euthanasia must not be legalized. This essay critically analyzes the legal perspective on euthanasia. Euthanasia: An Overview When patients and their loved ones see misery and intolerable pain, disagreement usually occurs between patients and their families, who want to put an end to misery, and medical practitioners, who are instructed to save human lives. This disagreement focuses on the notion of euthanasia and its value in the contemporary period. The issue of euthanasia forces an individual to face the greatest fear of human beings—death. The legal system has confronted it and has made progress in establishing certain rules to help decision makers in this issue; unfortunately, there is still a long way to go. Society should be safeguarded from the undesirable possibilities related to allowing the taking out of life-support mechanisms. Society cannot permit the complicated matters related to this issue to be underestimated to the point where it is simply recognized that life can be subjectively or instinctively terminated. The law should make sure that the patient’s constitutional rights are protected, while preserving society’s concern for life, and strengthening the integrity of health care professionals. During a medical emergency, it is impractical to instruct a health care provider to first check the patient’s clinical record for prior instructions before addressing the patient’s urgent needs (Pozgar 124). Ultimately, the limits of patient’s rights are still quite vague. Over time, euthanasia has become a subject matter with opposing moral, medical, and legal repercussions. Today, there are passionate campaigns supporting dignified death, which prohibits tubes, monitors, machines, and other technical equipment (Biggs 15). Even the definition of ‘euthanasia’ has evolved over time. Euthanasia is generally defined as “the mercy killing of the hopelessly ill, injured, or incapacitated” (Pozgar 124). In the 1870s, literature on euthanasia started to surface, mostly in the United States and England. Even though this literature was written, primarily, by ordinary people, medical professionals and the public started to pay attention to the issues posed by euthanasia (Biggs 25). During that time, euthanasia is viewed as “the act or practice of painlessly putting to death persons suffering from incurable conditions or diseases” (Pozgar 124). Basically, it was defined as the sympathetic termination of untreatable pain. Nevertheless, by the twentieth century, there were still no definite rules or principles concerning the application of euthanasia. Not like in earlier times when society in general advocated or criticized euthanasia, various sectors of contemporary society use different definitions of the concept, creating more ambiguities (Dworkin 110). Some argue that euthanasia is intended to facilitate a painless death when a person goes through an untreatable illness. Others view euthanasia as a tool to assist only dying patients in ending their suffering by terminating their lives with as little or no pain as possible. According to current reports, “of the 2 million Americans who die each year, 80% die in hospitals or nursing homes, and 70% of those die after a decision to forgo life-sustaining treatment has been made” (Pozgar 124). Even though these choices are subjective in nature and rooted in personal moral principles, they should conform to the laws related to the delaying of death. Courts have summed up the ways in which the state is permitted to take part in the process of decision making. However, the misunderstandings and absence of a decisive path concerning the processes and rules have led to broad inconsistency among jurisdictions, both in judicial resolutions and policymaking. Hence, judges, policymakers, the American Bar Association, and the American Medical Association are vigorously trying to develop and implement decisive rules in this controversial, philosophical, and not yet completely understood issue (Pozgar 124-125). To guarantee adherence to the law while addressing patients’ needs, it is important for medical professionals to be informed about the policies developed for this continuously evolving arena. The Legal Issues To resolve the vital issues about whether life-support mechanisms can be denied or removed from a hopeless patient, it is important to understand first the rights a competent patient has. Case law and constitutional law have provided multiple perspectives and guidelines (Devettere 76). Some courts refer to common law and the previous Schloendorff v. Society of New York Hospital case to strengthen their argument about a patient’s right to freewill. As proclaimed by the Schloendorff court (Devettere 76): Every human being of adult years has a right to determine what shall be done with his own body; and the surgeon who performs an operation without his patient’s consent commits an assault for which he is liable for damages. In In re Storar, the right of freewill was highlighted when the court proclaimed that all competent, adult human beings have the right to decide on matters concerning their own body (Pozgar 125). The Quinlan case originally tackled the issue of whether euthanasia must be allowed when a person is incurably sick. The Quinlan jury proclaimed that the legal privacy right safeguards a patient’s right to freewill. The jury emphasized that privacy right “is broad enough to encompass a patient’s decision to decline medical treatment under certain circumstances, in much the same way as it is broad enough to encompass a woman’s decision to terminate pregnancy under certain conditions” (Dworkin 115). The Quinlan jury, in making its judgment, used an assessment evaluating the interest of the state in sustaining and protecting the value of life against the privacy right of Karen Quinlan (Dworkin 115). It made a decision that, particularly with regards to the prognosis, the interest of the state did not validate intrusion with her right to decline treatment. At the same time, the Superintendent of Belchertown State School v. Saikewicz case was resolved. The court backed up the counsel of a court-designated guardian that it would be best to terminate the chemotherapy treatment of Saikewicz. Saikewicz was suffering from mental retardation and leukemia (Pozgar 125). The court discovered that the prognosis was dismal, and although a ‘normal’ individual would perhaps have opted for treatment, it permitted Saikewicz to die with no treatment to alleviate him of the affliction. Even though the court adhered to the decision of the Quinlan case to grant the right to a hopeless patient to decline treatment, the court still deviated from Quinlan (Pozgar 125). It disregarded the Quinlan model of delegating a decision regarding the prolonging of life to the patient’s family, guardian, doctors, and a medical ethics group. The Saikewicz jury claimed that although a judge may view the judgments of medical professionals, doctors, or medical ethics groups useful in the decision-making process, there must be no obligation to ask for guidance (Meisel & Cerminara 3-81). The court concluded that issues of life and death as regards a hopeless patient must be the courts’ obligation, which would perform objective but thorough examinations. The court assumed a “dim view of any attempt to shift the ultimate decision-making responsibility away from duly established courts of proper jurisdiction to any committee, panel, or group, ad hoc or permanent” (Meisel & Cerminara 3-81). This major disparity between the Quinlan and Saikewicz cases brought about the formation of two distinct rules on the hopeless patient’s right to decline treatment. One group of cases has adhered to Saikewicz and backs up court authorization before medical professionals are permitted to deny or remove life support (Meisel & Cerminara 3-81). Supporters of this argument believe that it is more reasonable to hand over the decision to an impartial court than to extend the privacy right of a patient to several involved individuals, as in the case of Quinlan. They criticize the Quinlan approach as being a privacy judgment accomplished by public choice (Pozgar 125-126). However, the Massachusetts Appeals Court restricted court involvement by concluding that ‘no code’ directives are legitimate to prohibit the application of artificial resuscitative procedures for incurably sick patients (Pozgar 126). The court was confronted with the case of an old woman who had Alzheimer’s disease. It was discovered that she was comatose for good at the time of legal proceedings. Moreover, the court concluded that Saikewicz-based legal processes should occur only in instances where therapy may provide a valid possibility of providing a short- or long-term treatment of the sickness (Dworkin 117). The Massachusetts Supreme Judicial Court tried to explain its Saikewicz-based reasoning. It claimed that various aspects as the patient’s medical prognosis and his/her mental disability with or without therapy should be taken into account before legal consent is needed to deny or remove treatment from an incapable patient (Pozgar 126). What is lacking in these cases is definite guidance as to precisely when the court’s authorization of the withdrawal of life support would be required. The discrepancies shown by the Massachusetts cases have encouraged courts since the latter part of the 1970s to adhere to the limits established by Quinlan, calling for legal interference. In instances where in doctors have verified the permanence of a patient’s comatose condition, an ethics group could officially confirm the patient’s incurable neurologic disorder; afterward, a guardian would be allowed to choose the legal measures needed to withdraw the life support (Biggs 91-92). The primary rationale for the designation of a guardian is to guarantee that incapable patients preserve their right to decline treatment. The law specifies that since a patient has the legal right of freewill, those taking steps on behalf of the patient can use that right when making their paramount decision regarding how the patient would claim the right. This principle of ‘substituted judgment’ (Biggs 92) may be justified in cases where a guardian has the right to exercise the legal rights of another person when that guardian’s interference is required to safeguard the other’s legal rights. According to Keown (2002), the decision of the guardian is stronger if it is grounded on prior directive of a patient who was capable before falling into comatose. A prior directive is a compelling proof of an incapable patient’s desires. An incapable patient can be a guardian and according to the conditions of a living testament. A court may order the involved physician to officially verify that a patient is in irreversible coma before a guardian or a family member can call for a removal of a special medical treatment (Pozgar 129). The guardian would try to determine the actual wishes and intentions of the incapable patient. Court intervention would be allowed only to designate a decision maker in one of the following circumstances (Pozgar 129): Family members disagree as to the incompetent’s wishes Physicians disagree on the prognosis The patient’s wishes cannot be known because he or she has always been incompetent Evidence exists of wrongful motives or malpractice No family member can serve as a guardian Almost all cases about euthanasia raise the obligation of a doctor to determine if a patient is either incurably ill or in a permanent coma. Historically, the description of death used by the courts has been in reference to the Black’s Law Dictionary: “cessation of respiration, heartbeat, and certain indications of central nervous system activity, such as respiration and pulsation” (Pozgar 129). Nowadays, though, science has the ability to maintain vital functions of patients in permanent comas. Technology can prolong respiration and heartbeat of those incurably ill. It is now widely recognized that permanent brain death amounts to death (Keown 97). Ethicists who support arguments against euthanasia believe that “where death is imminent and inevitable, it is permissible to forgo treatments that would only provide a precarious and painful prolongation of life, as long as the normal care due to the sick person in similar cases is not interrupted” (Pozgar 129). Today, most states determine brain death by law or legal resolution. The legal system has never espoused ‘vitalism’— physicians have never been obliged to sustain life whatever means possible (Keown 59). The law did not traditionally embrace the ‘quality of life’ perspective—that only individuals with ‘meaningful’ or ‘sensible’ lives have a right to live. Instead, the law has historically embraced the ‘inviolability’ doctrine (Keown 59). Specifically, it has constantly been murder for a physician vigorously and deliberately to speed up a patient’s demise. It is murder, regardless of the intention of the physician and the medical state or directives of the patient. Nor is it a justification for a physician to implore that ending the patient’s life was a rational and just way of protecting a greater good acknowledged by the law, or that s/he was forced to end the patient’s life by severe injury or possibilities of death. Nor is the law focused only on the punishment of ‘active’ murder. Even though there is, in general, no legal responsibility for an omission to sustain life, it is widely accepted that it is murder to omit to fulfill an obligation to sustain life with an intention to take a life (Meisel & Cerminara 3-84). The law also reprimands helping or pushing another person to kill him/herself. The doctrine of inviolability forbids action aimed at shortening life; action which is expected to curtail life may or may not be blameworthy, depending on the situation. The criminal law also differentiates ‘foresight’ from ‘intention’ (Keown 59-60). Intentional taking of a life is considered murder, but action which predictably curtails life is manslaughter and could be totally legal, depending on the rationality of the physician’s action. A physician who conforms to rational medical guidelines in giving palliative medication to a fatally ill patient, thus trying to lessen pain, behaves legally, even though the medication speed up death as an unintentional consequence (Keown 60). To associate an attempt to end suffering with an attempt to take the life of a patient is erroneous ethics which generate erroneous law which can simply hold back proper and ethical medical practice. Conclusions The issue of euthanasia creates philosophical, ethical, medical, and legal perspectives. These are exactly the sorts of issues where in public involvement is essential, and courts or the larger legal system are obviously not prepared to carry out the form of thorough, comprehensive trials at which professionals and witnesses on all parties to the dispute would confirm the wider policy implications of forming and controlling a right to euthanasia. As far as the legal perspective is concerned, the issue of euthanasia remains a slippery slope. Works Cited Biggs, Hazel. Euthanasia: death with dignity and the law. Portland, Oregon: Hart Publishing, 2001. Print. Devettere, Raymond. Practical Decision Making in Health Care Ethics: Cases and Concepts. Washington, DC: Georgetown University Press, 2010. Print. Dworkin, Roger. Limits: The Role of the Law in Bioethical Decision Making. Indiana: Indiana University Press, 1996. Print. Keown, John. Euthanasia, Ethics, and Public Policy: An Argument against Legislation. Cambridge, England: Cambridge University Press, 2002. Print. Meisel, Alan & Kathy Cerminara. The Right to Die: The Law of End-of-Life Decision Making. New York: Aspen Publishers Online, 2004. Print. Pozgar, George. Legal and Ethical Issues for Health Professionals. New York: Jones & Bartlett Publishers, 2012. Print. Read More