Good Quality End-of-Life Care Removes the Need for Euthanasia - Essay Example

Discuss the Claim That Good Quality End-Of-Life Care Removes the Need for Euthanasia Table of Contents Introduction 3 Moral Arguments in Favor and Against of Euthanasia 4 Limitations of End-of Care 8 Conclusion 11 References 13 Introduction In medical terms, as mentioned in Gallagher & Wainwright (2007), euthanasia is also denoted as ‘assisted suicide’. The common motive argued as persisting behind such a practice is to relieve oneself from excessive pain and medical sufferings. This kind of practices is considered illegal in many countries based on moral and legal grounds. However, certain exceptions to such rules also exist around the world (Cooney & et. al., 2012). As apparent, the practice of euthanasia presents a pessimistic moral view to the care-giving obligations when treating patients suffering from unbearable pain due to incurable disease or any form of chronic illness. On the other hand, the end-of-life practice can be regarded as an optimistic ideology used in medical practices in order to continue caring for patients in their final days/hours, offering them temporary relief from the physical pain. . In the current times, multiple end-of-life treatment processes, such as palliative care and curative care among others are commonly enacted as an alternative step to euthanasia, which faces frequent ethical obligations (Rachels, 1975). Indeed, the practice of end-of-life care and euthanasia diverges into opposite directions, where the former operates with an optimistic view and the latter is strongly influenced by the pessimistic opinion that it is better end the life of the patient through ‘assisted suicide’ permanently in order to give him/her relief from unbearable pain and suffering. Debates emphasizing the moral correctness and injustice associated with such practices have also been astounding in the field of healthcare since the 19th century. In this study, emphasis has been laid on depicting the morality of practicing euthanasia along with reflecting on the limitations of end-of-life care, with the aim to justify whether practicing good quality effective end-of-life care practices can mitigate the need for euthanasia. Moral Arguments in Favor and Against of Euthanasia When justifying the ethical correctness of euthanasia, Dowbiggen (2003) argued that during the late 19th century, a situation had occurred when a significant proportion of American population felt the need of legalizing euthanasia. During that time, this voluntary killing process was completely sighted on the basis of religious beliefs and values, signifying human life as highly precious to be ended without the God’s will (Gielen & et. al., 2009). However, these religious views on euthanasia were ultimately superseded by the scientific thoughts provided by Herbert Spencer, who during the 19th century, provided a partial support towards the concept of euthanasia, not from religious sighting but through empathizing the importance of human life. According to Spencer’s moral justifications, the right to self-killing for individuals lacking the capability of undergoing chronic pain and/or being instable psychologically, should be considered justified as an act of sympathy to help them get relief from the suffering. According to Dowbiggin (2003), the process of active euthanasia got its approval as an acceptable policy in 19th century, wherein the active participation from Herbert Spencer played a pivotal role. Gradually, by the 20th century, this ‘mercy killing’ process became a public health measure in the wider framework to progressivism (Dowbiggin, 2003). By that time, people started understanding the differences about whether to terminate a patient’s life depending on the facts that the patient will show no sign of recovery owing to his/her terminal disease and will continue to endure the pain or to keep the patient alive by any means necessary based on the religious belief that human life is precious to be ended without the ‘will of God’ (Gielen & et. al., 2009; Dowbiggin, 2003). As mentioned above, the practice of euthanasia has long been debated by medical practitioners, wherein paramount significance has been delivered on the moral principles associated with the decision of ending the patient’s life at their will, voluntarily. To be noted in this regard, whether euthanasia is morally just depends largely on its meaning as referred by medical professionals when arguing in context of its legalization. In order to define euthanasia in precise, the European Association of Palliative Care (EPAC) Ethics Task Force determined that euthanasia must be a voluntary action where the medical practitioners decide to end the sufferings of their patient to relieve them from their sufferings due to incurable chronic disease, at their will and complete free consent (Cartwright, 2011). It will be vital to mention in this regard that ending one’s life without their consent is equivalent to murder and must be punishable under the applicable criminal law provisions. Valuing a similar perspective, various legal provisions have been enacted in order to guide the medical practitioners regarding their limit of power and guiding principles for practicing end-of-life care as a measure to mitigate the need for euthanasia. In this context, referring to the ‘doctrine of double effect’ and the Suicide Act 1961 will be crucial. The ‘doctrine of double effect’ is commonly used in weighing the moral and legal implications of any act that may have both positive and a negative effect and have been extensively referred to in the practice of end-of life care in accordance with the practice of euthanasia. The doctrine in this regard affirms the good effect of euthanasia as to end the sufferings of the patient through terminal sedation and providing them comfort, while on the other hand it reduces the life span of the patient that might have been longer if the decision is made on the contrary to practicing euthanasia. Although, the decisions for euthanasia have been stressing much on the good effects of such practices as per the doctrine, it has been proved that at often instances, the bad effect of shortening the life span of the patients through terminal sedation (Allmark & et. al., 2010; Randall & Downie, 2009). As per the UK law, the doctrine relies much on the distinction of foresightedness of the medical practitioners to recognize the probable life span of the patient and their intention to end the life span of the patient. This further raises the moral liabilities of the medical practitioners, further raising certain conflicting arguments concerning the legitimacy of euthanasia. It is fundamentally because law fails to recognize such moral distinctions between the practitioner’s foresightedness and intention, making the legalization of euthanasia grounded on weak rationalization and moral justness (Allmark & et. al., 2010). Further adding to the complexities in the meaning of euthanasia, the enactment of Suicide Act 1961 in the UK also played a major role in bringing the debate into limelight in the modern society. As per this Act, although the survivor of a suicidal attempt is no more to be considered liable for legal prosecution, persons who act in support of such actions are deemed to be legally answerable in the Court of Justice. As per section 2(1) of this Act, “A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years” (Ligislation.gov.uk, n.d.). Such a prosecution has undoubtedly been acting against the practice of euthanasia, which makes the medical practitioners liable to be prosecuted and even barred if found guilty. Considering the moral implications of this particular, it can further be asserted that by restricting practitioners to conduct assisted suicide through euthanasia, this Act performs contrary to the good effect of such practices, i.e. ending the patient’s sufferings as emphasized in the ‘doctrine of double effect’ (George & et. al., 2005). Based on similar moral grounds, Keown (2002) argued that government should not pass the legislation of approving these sorts of voluntary killing, termed as euthanasia, as it might provoke immoral medical practices shadowing illegal killing. A practical understanding to such situation shall advocate against the reliability of the evidences on obtaining free consent of the patient while deciding in favor of euthanasia, which again hinders the morality of euthanasia (Keown, 2002). Ethical arguments against euthanasia has also been emphasizing that promoting such practices by legalization is quite likely to hinder the inviolability and respect of life within the society, hampering the overall social interest in the long-run. Consequently, practicing euthanasia may also hinder the value of human life, especially for those suffering from chronic incurable diseases or disabilities caused due to ageing, making the morality of the entire society suffer discrimination practices. Given the fact that evidences of voluntary euthanasia and involuntary killing of a patient witness limits in terms of their reliability and distinguishability, chances of involuntary euthanasia may increase substantially within the society. Ultimately, it might risk social stability and best interest of the people concerning their demands for healthcare and safety (Chappell & Connally, 2012). In addition, concerns were also raised regarding the moral effectiveness of euthanasia considering the aspect that its literal meaning in medical practices also refers to the assisted suicide of patients suffering from psychological illness, which makes their voluntary consent void, both ethically and legally. Hence, emphasizing this particular anti-euthanasia argument, it can also be asserted that euthanasia might not necessarily be in the best interest of the patient (Hall, 2012). Hence, a major influence of the complexities associated with the correct interpretation of the meaning of euthanasia can be witnessed as stimulating the moral arguments against and on behalf of such practices (Chappell & Connally, 2012). Anti-euthanasia arguments have also been focused on the alternatives of such voluntary killing, where maximum stress has been delivered on good quality effective end-of-life care. Arguments have often been centralized to the notion that effective end-of-life care can play a key role in temporarily ending the sufferings of the patient from terminal disease or illness. According to Sanson & et. al. (1996), euthanasia offer undue power to the medical professionals, which can be limited by increasing their obligations of delivering effective end-of-life care services. Such services are further credited to limit the power of the practitioners to end the patient’s life voluntarily or involuntarily, along with reducing the sufferings of the patient (Cohen-Almagor, 2009). Limitations of End-of Care The literal meaning of end-of-life care is to deliver moral, psychological as well as medicinal support to a patient of terminal disease or illness, during his/her final days. Examinations reveal that such practices play a major role in minimizing the patient’s suffering and making them psychologically stronger to bear the pain. Relating to euthanasia, end-of-life practices may also decrease or completely mitigate the need for deciding in favor of euthanasia; thus, acting as a restrictive measure to the ongoing debate concerning morality of assisted suicide (Doerflinger & Gomez, n.d.). As per Izumi & et. al. (2012), currently this concept is based on medical models and mostly follows the codes of nursing ethics as its guiding framework to identify the individuals who deserve end-of-life care. This process of ending an individual’s life in order to end his/her suffering is quite complex although and argumentative too, as it deals with the critical aspects of the family member’s emotional conditions (Center for Bioethics University of Minnesota, 2005). Arguments in favor of palliative care as a method of end-of-life care have also been emphasizing the motive of such practices, which is to eradicate the sufferings of the patient and can be possible by alternative means rather than killing the patient. However, end-of-life practices may also posses certainly limitations. At the foremost, good quality end-of-life care deliverance depends largely on the ability and moral conscience of the medical practitioners as well as the friends and family members of the patient. Considering another important facet of euthanasia, it can be apparently observed that it not only aims at sufficing the rights of the patient but also the representatives of the patients, i.e. their family members and people who are involved in care-giving apart from the medical practitioners (Streeter, 2010). In the similar context, it can be observed that deliverance of end-of-life care is largely dependent on the abilities of the nurses to communicate messages with an optimistic view and the patience of the care-givers to avoid deciding for euthanasia. This further limits the applicability of end-of-life care as an effective tool to mitigate the need for euthanasia in the practical context (Morris & Corbett, 2011). Limitations in the end-of-life care are fundamentally identifiable with regards to the fact that its effectiveness depends largely on the decision-making abilities of the practitioners as to whether the act of euthanasia should be withhold or the life sustaining sources must be withdrawn to assist voluntary suicide of the patient to relieve him/her from the sufferings. These sorts of decisions are made depending on the chances of the patient’s survival and sometimes even on patient’s request. Conflicts on moral grounds occur when the decision in favor of end-of-life care is jeopardized due to the pessimistic interference of the representatives of the patient, which makes the decision in the interest of the care providers rather than in the best interests of the patient (Cicely Saunders International, n.d.). Additionally, considering the vagueness in the concept of good quality end-of-life care, such limitations become more prominent. The limitations of end-of-life care can be better justified with empirical evidences based on two recent occurrences, i.e. the case of Baby Joseph and Al Barnes. The landmark case of Baby Joseph attracts the attention of the debaters arguing on the basis of the limitations of end-of-life care towards the practical shortcomings of such health support (Burkle & Benson, 2012). As argued in context of this case, end-of-life support may prove to be quite costly and ineffective to minimize the terminal pain even though pharmaceuticals. Under such circumstances, it is likely that the patient’s representatives might find it more logical and convenient as per their economic status to take off the life support from the patient and permit medical practitioners to commit euthanasia. Such cases are mostly observed when involving minors or elderly patients, who are legally not considered to be independent decision-makers (Streeter, 2010). Apparently, the scope of moulding the ethical responsibilities as per the convenience of the medical practitioners, often with a motive to save medical resources and also the patients’ representatives, limits the effectiveness of end-of-life care practices to mitigate the need for euthanasia (Centre for Bioethics University of Minnesota, 2005). In a similar case of Al Barnes, a court order was allowed to practice euthanasia; however it was observed that the patient, who was an elderly, expired prior to the court’s permission, which raises noteworthy questions regarding the moral obligations of the care-givers to continue giving life-support to the patient as an end-of-life care giving procedure (Burkle & Benson, 2012). As observable in both these cases, the high probability of immoral interferences from the medical practitioners and/or patient’s representatives hinders the effectiveness of end-of-life care, which in turn fails to mitigate the need for euthanasia. Rather, in most instances, it raises the need to take off the life support of the patient in order to give him/her relief from the unbearable terminal pain. Conclusion With reference to the above-discussion based on the moral correctness and wrong in ending one’s life in complete consciousness either voluntarily or non-voluntarily, it can be observed that the fundamental point of disagreement embarks on the complexities of the meaning of euthanasia. In consequence, such vagueness in the meaning limits the legal identification of the distinctions between the ethical righteousness and immorality associated with such practices. In the similar context, while attention may be provided to alternatives of such practices through end-of-life care, it was also observed that such notions still lack specific principles and distinctive assumptions that can assist medical practitioners identify their moral obligations towards delivering terminal care to the patient and accordingly, differentiate between their intention and ethical duty. Owing to such fallacies, the concept of good quality end-of-life care becomes vague, which further defies the claim propounding the effectiveness of such alternatives in mitigating the need for euthanasia. Hence, to be concluded, it can be argued that it is necessary to define good quality end-of-life care based on specific guiding principles in order to determine if it practically abolishes the need for euthanasia. 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