Euthanasia as Assisted Suicide - Essay Example

Society’s Response to Requests for Euthanasia or Physician Assisted Suicide This paper will explore society’s response to Ramon Sampedro’s request for Euthanasia or Physician Assisted Suicide (PAS). I will be discussing the moral implications of Euthanasia or PAS for the characters surrounding Ramon Sampedro in the movie, Sea Inside, by talking about the various philosophers’ notions of autonomy. Also, I will be touching on how we can decide if one’s “quality of life” is enough reason to request for such procedure. I believe that it is one thing to want death for yourself but it is another thing to ask someone else to help you die. Each person has different perspectives on what their life should be. Each person has their own sense of moral responsibility. However, most of society generally does not condone the taking of another’s life. In conclusion, I will discuss the reasons why society should also consider the effects of Euthanasia or PAS on both the patient and those requested to help out before making a response to such requests. In laymen’s terms, Euthanasia is mercy killing; that is, a person, usually a physician, lets or causes a patient to die as a sign of mercy. Euthanasia can be passive, if no act was done since death is inevitable, or active, if an act was done to cause death. It can also be voluntary or involuntary, depending on the patient’s cognitive & decision-making skills. Physician Assisted Suicide, on the other hand, is different since the patient does the act, not the physician. The latter just supplies the patient with what he needs for the deed. In all cases, there are always 2 major roles – the one who is killed & the one who does the killing. Pro-life advocates look down on euthanasia, saying it is morally wrong for a physician to kill or let people die if saving them can be done. Supporters of Euthanasia say that it would be morally wrong not to do it since it is just right to grant a person his death if he so wishes. How can we tell if an ailing person’s life needs to end? Does it suffice when the patient says he doesn’t consider his life worth living; that for him death is a better alternative to living? A key component of the debate on euthanasia is the patient’s ability for self-determination. As Callahan (2002) puts it, “the self-determination in that case can only be effected by the moral and physical assistance of another. Euthanasia is thus no longer a matter only of self-determination…” There is something morally wrong in allowing one person to decide another’s fate. It also seems immoral for a person to be that powerful when it comes to another’s life. For competent patients like Ramon Sampedro, doctors are suggested not to overrule the patient’s determination (Kluge 2002). As long as, in a language the patient can understand, they have advised the patient of the modes of treatment, given their opinion & their recommendation, doctors usually feel their professional obligation has been fulfilled. A competent person has autonomy and self-determination. It is only his body that fails him & not his mind. Whatever he decides, he does with full employ of his cognitive skills. We can employ this theory in studying Ramon Sampedro’s office assistant, Genè, the 2nd lawyer, Marc, & Ramon’s nephew, Javi. In the film, they were never seen contradicting Ramon’s wishes, even if they’ll be taking an active part in the deed like supplying the poison (Genè). On the other hand, where the patient is incapable of rational thought the decision of whether his quality of life is too poor that death would prove to be a better choice than living is left to the hands of the doctors & his family. It was decided in Reibl vs. Hughes that quality of life can be decided objectively or subjectively. Objectively is when the “assistants” think of what a sensible similarly incapacitated person would do. I think this was being practiced by Padre Francisco when he wanted to visit Ramon to talk some sense into the latter. In contrast, deciding quality of life subjectively would be something like how the lawyer Julia started to think. She wasn’t keen on helping Ramon die. But toward the end of the movie when her bad health started to limit her freedom of movement, she began to fully empathize with Ramon’s situation. According to John Keown (2002) though, there is a danger in deciding too subjectively. Using a study made in the Netherlands, even with the set guidelines by the Royal Dutch Medical Association there were still cases of undisclosed voluntary & non-voluntary euthanasia. Also, for incompetent patients, it is logically impossible to determine exactly what the person is feeling. Suffering & pain are relative. Each individual has their own pain threshold. However, since the incompetent patient is still a person & should be treated as such. Kluge suggests forming co-efficients by comparing said patient’s life & a competent person’s that is influenced with the same type and degree of inability (Chahal, n.d.). That should form as a baseline Kluge suggests (2002) in determining what a cognitively-impaired person would want with his life. Margaret Battin, however, says euthanasia should be allowed under the principles of mercy, autonomy & justice (2002). People have the moral duties of 1) not causing further pain & suffering and 2) acting to end such, even if this meant a more direct act than just allowing the patient to die, especially if death is the only means to give the patient peace. This second duty could be observed with Rosa because she was the one who gave the poisoned water to Ramon. She also wanted to alleviate her “loved” one of his pain, even it meant killing him. Battin believes that withholding life-prolonging treatment morally complies with the principle of mercy, one of the 3 main principles of euthanasia, especially if said treatment will just expose the patient to more pain & suffering. She also believes that killing to end pain & suffering is the moral thing to do. Furthermore, Battin says that we should also recognize the principle of autonomy since we can’t determine objectively if life for the patient is still a benefit. For her, life has benefit if a person can still get good things out of it. Now, ending a patient’s life by euthanasia if there is suffering & little proof of future benefit has now become the patient’s duty. Susan Sherwin says that if we truly recognize autonomy of ALL patients, “health care providers must learn to respond more appropriately to patients who are differently situated.” (2002) In relation to the topic, absolute autonomy requires equal treatment among all patients. Patients can do whatever they want, without regard to other people’s sense of morality. This can create quite a problem as it threatens our innate duty as human beings to help others or keep them from harm. Sherwin suggests using the relational approach which is more complicated as it calls for taking into consideration every relevant aspect of the patient, his condition and his environment. This approach gives value to each and every human being. This kind of approach can be observed in Ramon’s father, Joaquin. He kept wondering why Ramon wanted to die. Ramon had people who loved him, a big house and comfortable things. In the movie, Sea Inside, Ramon Sampedro, had been a fisherman so he could experience the world. He had been a vibrant man before his accident. Now a quadriplegic, with full cognitive skills as evidenced by his continuous poem writing; his appreciation for music & literature; and, his interaction with people, Ramon wanted to die. Since he had paralysis, he needed assistance to carry out his suicide. His brother, his sister-in-law and son & Ramon’s father lived with & took care of Ramon. He made new friends, Ramona (who ultimately hands him the glass of water with potassium cyanide) & Julia (the lawyer who helped him write his autobiography). They didn’t want to be a part in this quest of Ramon’s. It was their opinion that his life was okay and he should be happy to still be alive. Meanwhile, Ramon’s old & close friends supported his opinion. They actively searched for reasons as to why the first courts in Spain, which eventually wouldn’t give its acquiescence, should allow him to put an end to his life. They respected his opinion regarding the quality of his current life. It was his friends who helped him acquire the poison which caused his demise. Those who helped him die did so out of love. I think they weren’t even worried about the morality of their actions. They just wanted what Ramon did – to be free of the limits caused by his condition and finally “be at sea” again. It is ironic that his family held back from helping him because of their love for Ramon, too. I also think it had to do with them being brought up in the belief that it is immoral to kill yourself and to kill someone. In dealing with a request for assisted suicide, I think each and every aspect of the case should be considered. Since the concept of morality is different for each society & for the individual, the moral implications of being a part in assisted suicide, like in the movie, are then ruled by the person’s own sense of morality. There are already non-disclosed cases in real life of competent people who prefer not to go to the hospital & undergo treatment. There are also cases where families of patients on life-support systems either let death come to their loved one naturally or honor the patient’s pre-signed request not to prolong their life. This practice may not be legal, true, but as the adage goes not all things legal are moral & not all things moral are legal. References Callahan, D. (2002). When Self-Determination Runs Amok. In E. Boetzkes and W. Waluchow (Eds.), Readings in Health Care Ethics (pp. 385-389). Peterborough: Broadview Press. Case 12.2 Stephen Dawson: Should Retarded Patients Be Treated? In E. Boetzkes and W. Waluchow (Eds.), Readings in Health Care Ethics (pp. 269-273). Peterborough: Broadview Press. Chahal, S. (n.d.). An Analysis and Comparison of Proxy-Decision Making Approaches. Retrieved on April 12, 2009 from http://www.sorach.com/article/index.php?pg=1&page=article&article_id=23 Keown, J. (2002). Voluntary and Physician-Assisted Suicide: Beyond Control? In E. Boetzkes and W. Waluchow (Eds.), Readings in Health Care Ethics (pp. 390-394). Peterborough: Broadview Press. Kluge, E-H. W. (2002). After “Eve” Whither Proxy Decision-Making. In E. Boetzkes and W. Waluchow (Eds.), Readings in Health Care Ethics (pp. 147-153). Peterborough: Broadview Press. Sherwin, S. (2002). A Relational Approach to Autonomy in Health Care. In E. Boetzkes and W. Waluchow (Eds.), Readings in Health Care Ethics (pp. 73 – 88) Peterborough: Broadview Press. Read More