Illegal Active Euthanasia - Essay Example

Active euthanasia should stay illegal At present active euthanasia is illegal. There are many arguments on both sides for and against active euthanasia. Those who argue that active euthanasia should be allowed are often those who have been diagnosed with a terminal illness or have a loved one that has been diagnosed with such an illness. Their mindset in pushing for the legalisation of active euthanasia is based on wanting to prevent their loved one or themselves from further pain and suffering, but should this be a sufficiently good reason for allowing them to opt for this form of treatment? In this paper I propose to put forward arguments why I believe that active euthanasia should not be legalised. To do this I will look at countries where active euthanasia has been allowed and examine the dangers inherent in allowing the legalisation of this practice. I will also examine individual cases where the patient or the family of the patient has attempted to persuade the court to allow active euthanasia including tracking such cases as Diane Pretty who took her case to the European Court of Human Rights and lost. The starting point for this discussion is to differentiate between active euthanasia and passive euthanasia. Active euthanasia involves a member of the medical profession from administering medication that would bring about the early death of the patient. By contrast passive euthanasia is where a member of the medical profession stops treatment of the patient. This could be by removing feeding tubes so that the patient starves to death or by the removal of ventilation equipment that assists the patient in breathing thereby causing the patient to die from lack of oxygen. The removal of essential drugs to combat infection could also be a form of passive euthanasia as the patient may die soon after the treatment is discontinued. The essential difference between the 2 forms of euthanasia is that with active euthanasia the doctor has to give the patient a form of treatment that will bring about their death whereas with passive euthanasia they are removing an element of the treatment that is sustaining life. The ethics behind the two is based on the principle that a patient is entitled to refuse treatment that might save or prolong their own life but they cannot insist on a treatment that will bring about their premature death. Having looked at the different forms of euthanasia discussed below is a number of reasons why I believe active euthanasia should remain illegal. Firstly as suggested by Brock 1989 there is likely to be a “reduced pressure to improve curative or symptomatic treatment”. (Brock p 76). Brock argues that if euthanasia had been legal 40 years go there would be no hospice movement today. He argues that the improvement in terminal care is a direct result of attempts made to minimise suffering. He suggests that if that suffering is extinguished by extinguishing the patients who bore it then the medical profession would not have made any advances in the control of pain and other associated symptoms of dying. He also argues that some diseases that were described as terminal a few decades ago can in fact now be cured by new treatments. If euthanasia had been in practice the urgency to find cures for certain ailments would be diminished and less of the now curable diseases would remain incurable due to lack of research on finding a cure. A further reason why active euthanasia should be discouraged from being made legal is that a doctor could use active euthanasia to cover his own mistakes. This might occur if the doctor makes a wrong diagnosis of an illness or orders a form of treatment that is harmful to the patient. In an attempt to avoid a claim against him for malpractice or criminal charges for gross negligence a doctor might encourage the patient into wanting to seek active euthanasia to bring a swift end to their suffering or might just administer an increased dosage himself to bring about the patients death. Maguire 1984 believes that the families of a terminally ill patient might also apply pressure on their loved one to seek active euthanasia where the patient is wealthy and there is an inheritance at stake. In countries where medical treatment is paid for out of medical insurance doctors might encourage patients to seek active euthanasia if the insurance is due to expire (Maguire p 321). Active euthanasia can cause problems for those in the medical profession who would be expected to carry out the administration of the medication that would take the persons life. Brody, 1988 spoke of his fears that those required to carry out the procedures might be ostracised from society and regarded as murderers by those opposed to euthanasia. He stated that for those involved in administering the treatment there was the “dangers of societal acceptance” (Brody, p 89). The same principal was supported by Chapman, 1984 who thought that the medical profession should defend its moral principles and repudiate any and all acts of direct intentional killing by doctors and their agents. Chapman called upon his fellow physicians to say that we will not deliberately kill and we must say also to each of our fellow physicians that we will not tolerate killing of patients and that we shall take disciplinary action against doctors who kill. (Chapman, 209) The whole notion of active euthanasia goes against the Hippocratic Oath which instructs doctors not to prescribe a deadly drug and not to give advice causing death nor to procure an abortion. This same notion was voiced in the Declaration of Geneva by the World Medical Association in 1948 where it was stated I will maintain the utmost respect for human life from its beginning. This ‘right to life was incorporated into the Canadian Charter of Rights and Freedoms and is also enshrined in the European Convention on Human Rights stating ‘Everyone’s right to life shall be protected by law.  No one shall be deprived of his life intentionally…’ In 1806 a German physician by the name of Christoph William Hufeland wrote:  ‘It is not up to [the doctor] whether life is happy or unhappy, worth while or not, and should he incorporate these perspectives into his trade the doctor could well become the most dangerous person in the state.’  (quoted in WJ Smith, 2003)  The UK Association for Palliative Medicine & the National Council for Hospice and Specialist Palliative Care Services voiced their fears in 2003 on the subject of euthanasia and assisted suicide. It was their opinion that ‘Euthanasia, once accepted, is uncontrollable for philosophical, logical and practical reasons.  Patients will certainly die without and against their wishes if any such legislation is introduced.’  In 3 surveys that were carried out over a 10 year period by Dutch researchers the results showed that in Holland where euthanasia has been legalised at least 1,000 patients every year are killed through euthanasia without consent or request. The first report which was published in 1991 showed that in 1,000 cases physicians had administered drugs with the explicit purpose of ending the life of the patient without an explicit request by that patient. The second 2 reports were published in 1996 and 2001 and had similar findings. (Van der Maas PJ et al1991; Van der Maas PJ et al, 1990-1995; Onwuteaka-Philipsen BJ et al, 1990, 1995, and 2001). Only half of all cases of euthanasia are reported to the authorities by Dutch doctors. Between 1990 and 1995 the notification rate rose from 18% to 45% and rose again to 54% by 2001. Most doctors gave the reason for not reporting such cases described the process of reporting as burdensome and time consuming. (Onwuteaka-Philipsen, BD et al, 2005). The data shown from Holland and Belgium demonstrates what is described as the ‘slippery slope’. Smith, 2003 said of the Dutch doctors that they ‘have gone from killing the terminally ill who asked for it, to killing the chronically ill who ask for it, to killing the depressed who had no physical illness who ask for it, to killing newborn babies because they have birth defects, even though, by definition, they cannot ask for it.’  (Smith.  p 111.)  By legalising euthanasia immense pressure can be put on those who are ill and especially those who feel that they are a burden to others because of their illness. An example of a case in Holland demonstrated just this point. In this case a 65 year old woman was discharged from hospital suffering from incurable cancer. Her GP discussed euthanasia with her, but she objected on religious grounds. As the cancer progressed she became concerned that she was a burden for her husband and so she requested euthanasia and died. (Dr Peter Hildering, President, Dutch Physicians League in a presentation given at the House of Lords, London, UK, May 7th, 2003). Sometimes terminally ill patients may consider euthanasia due to the financial burden they are causing relatives or others (Emanuel EJ et al., 2000). Physician assisted suicide was legalised in Oregon in 1997 and a survey conducted in 2001 found that the percentage that had died through this form of treatment because they considered themselves to be a burden rose from 12% in 1998 to 26% in 1999 and further increased to 63% in 2000 (Sullivan AD et al, 2001). By legalising euthanasia the doctors are being given the right to kill their patients. This would alter the relationship between the doctor and the patient leaving patients wondering whether ’the physician coming into my hospital room is wearing the white coat of the healer ... or the black hood of the executioner.’ (British Medical Association statement – End of life decisions, 2000).  The conclusion that can be drawn is that although for those with a terminal illness the option of euthanasia may seem an attractive alternative to the pain and suffering they are experiencing the reality is that it would have a profound effect on society and people’s attitude towards death and illness. Euthanasia is difficult to control as can be seen from the Dutch experience and could lead to patients being killed without request or consent. There is a great danger that the use of euthanasia would spread from those with terminal illness to those with disabilities as highlighted in Holland were euthanasia has been used on babies who are unable to make the choice to die (Vrakking A et al, 2005). There could be increased pressure on those who consider themselves to be a burden to opt for euthanasia as a way of relieving their families of the burden. It could become the norm that it is cheaper to kill rather than cure and therefore the use of palliative care would lessen. The loss of trust between doctor and patient would be irrevocably lost. Bibliography A, Vrakking, A. van der Heide, B. Onwuteaka-Philipsen, I. Keij-Deerenberg, P. van der Maas, G. van der Wal, Medical end-of-life decisions made for neonates and infants in the Netherlands. 1995–2001. Vol 365 Lancet, 2005;1329-1331  A, Vrakking, A. van der Heide, B. Onwuteaka-Philipsen, I. Keij-Deerenberg, P. van der Maas, G. van der Wal,, Medical end-of-life decisions for children in the Netherlands. Vol 159: Archives of Pediatrics & Adolescent Medicine 2005; 802-9  Brock, Dan. Deciding For Others. Cambridge: Cambridge University Press, 1989. Brody, Baruch. Life And Death Decision Making. New York: Oxford University Press, 1988. Chapman, Carleton. Physicians,Law,& Ethics. New York: New York University Press, 1984. Emanuel EJ, Fairclough DL, Slutsman J, Emanuel LL, Understanding economic and other burdens of terminal illness: the experience of patients and their caregivers.  Vol 132, Annals of Internal Medicine. 2000; 451-9. Maguire, Daniel. Death By Choice. Garden City: Doubleday & Company, 1984. Onwuteaka-Philipsen BD, van der Heide A, Muller MT, Rurup M, Rietjens JA, Georges JJ, Vrakking AM, Cuperus-Bosma JM, van der Wal G, van der Maas PJ, Dutch experience of monitoring euthanasia. Vol 331, British Medical Journal 2005; 331: 691–3 Onwuteaka-Philipsen BD, van der Heide A, Muller MT, Rurup M, Rietjens JA, Georges JJ, Vrakking AM, Cuperus-Bosma JM, van der Wal G, van der Maas PJ, Euthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001.  Lancet online 17 June 2003 Smith, W J, Forced exit.  Dallas 2003.  p 111 Sullivan AD, Hedberg K, Fleming DW, Legalized physician-assisted suicide in Oregon, 1998-2000.  Vol 344, New England Journal of Medicine  2001; 605-607. Van Der Maas PJ, Van Delden JJ, Pijnenborg L, Looman CW, Euthanasia and other medical decisions concerning the end of life. Vol 338, Lancet 1991;  669-74 Van Der Maas PJ, Van Delden JJ, Pijnenborg L, Looman CW, Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990-1995.  Vol 335, New England Journal of Medicine, 1996; 1699-705 Read More