Theologians and Jurists' Opinions on Merci Killing - Coursework Example

Introduction Life is very precious because all of us have only one life to live. Once we die, there is no coming back for a second chance at life unless one believes in reincarnation. This is why most religions favor the continuance of life under almost all circumstances. The overall belief is that only our God can take away life since it was God who gave life in the first place. Man cannot take away life, whether his own life or that of others. Once he does that, he commits a very grave mortal sin in the eyes of God and committed murder in the eyes of man. In other words, man cannot simply play God by making decisions on a weighty issue like this. However, today's medical advances have now allowed man to prolong life beyond what is biologically possible under certain conditions. With medical technology comes related problems of medical ethics called bio-medical ethics. In many situations, there are no clear-cut ways to decide on who has the right to live and right to die. The debate about euthanasia had been shrouded due to the controversy surrounding eugenics (Appel 611). There are many complex issues that doctors and relatives of seriously ill patients have to face whether they like it or not. Examples of complex medical issues that defy a moral or an easy ethical solution are only now cropping up because of new medical techniques. Good examples of ethical issues in the medical profession include abortion, brain death, surrogate motherhood, organ transplants and euthanasia (mercy killing). Because of the rapid advances in medicine, people today have the power in their own hands to prolong their lives if needed by some artificial means. On the other hand, people are becoming more activist and assertive about their rights, including the right to die (that is, their right to die with dignity). Background - euthanasia is defined in plain and simple language as mercy killing. The great Oxford English dictionary gives three meanings for “euthanasia”: the first, “a quiet and easy death”; the second, “the means of procuring”; and the third, “action of including a quiet and easy death.” (OED, 2010). An issue closely related to euthanasia is assisted suicide and these two issues put many in the medical profession in a moral and ethical quandary (both appear to be the same but there is actually a slight difference). The distinguishing factor that separates one from the other is the last act. If the dying person was the one who performed the last act prior to dying such as swallowing an overdose of pills given to him by someone else, pushing a switch to turn off the ventilator or pulling the plug on the life-saving machine, then it is assisted suicide (ITF, Jan. 2010). Euthanasia literally means “a good death” in Greek and this is the generally-accepted definition we have used today in connection with a terminally ill patient or those who have an incurable medical condition where further interventions are now useless. Euthanasia had been discussed by the early Greek philosophers (Mystakidou 97). Terri Schiavo - a case about euthanasia that attracted a lot of media attention and even reached to the highest levels of the government (it reached the Supreme Court) was unusual case of Terri Schindler Schiavo. She was born Theresa Marie Schindler on December 3, 1963 to her loving parents Robert and Mary Schindler in Montgomery County, Pennsylvania. She had worked as an insurance clerk and life seemed normal and beautiful. She met her very first romantic interest and future husband Michael Schiavo at the age of 21 while still studying at the Bucks County Community College. Everything was fine and in 1986 the married couple moved to Pinellas County in sunny Florida. Her parents eventually followed them to the Sunshine State some three months later. Life was perfect until she suffered a sudden seizure of cardiac and respiratory arrest at her home due to what doctors suspected to be electrolyte imbalance as a result of her extreme dieting habits of drinking only liquids (mostly iced tea). Terri collapsed at their St. Petersburg apartment at about 4:30 a.m. on February 26, 1990 and was never able to recover full consciousness due to severe brain damage from the lack of oxygen because when emergency paramedics arrived, she had no pulse and was not breathing at all. Her condition after a few months turned to worse from being in a comatose state to a persistent vegetative state (Edelstein & Sharlin 447). The media attention soon led to many politicians and pro-life advocacy groups getting involved in her case. From the time she became unconscious in 1990 to her death in 2005 when her life support was disconnected, she was institutionalized in various hospitals for a total of 16 years. Her legal case also took seven years to be finally decided by a local court after going through 14 appeals in various courts. A key issue in Terri's case was who had ultimate decision to stop a life support system as she was not in a position to state her own express wishes. As she was unconscious, there was no way she could give voluntary consent and the legal struggle was more or less between her husband Michael (who has the legal authority being the married spouse) and her parents who objected to a discontinuance of ANH (artificial nutrition and hydration) support for Terri on the belief that she was still conscious somehow at that time. Michael wanted to end the life of Terri as he believed there was no more hope of recovery or living a normal life for her. Advance Directives – her case highlighted many important issues associated with both assisted suicide and euthanasia. Among these crucial matters include advance directives (living wills), disability rights, right-to-life, pain control and end-of-life issues like religion and empathy. If only Terri had given advance instructions to her husband or someone else in her immediate family like her parents or siblings, the issue would not have been so difficult or complicated. A lack of prior instructions left both Michael and her parents at cross purposes. What the court used to settle the issue was the legal concept of substituted judgment in which a person's judgment is assumed whenever that person is unable to give a competent decision. Discussion Euthanasia and assisted suicide are accepted in some form or degree by some cultures in other parts of the world. For example, the early native Americans would mercifully kill a fellow warrior if they think that warrior cannot survive his wounds sustained in combat and it is thought that he will just suffer a slow and painful death. A wounded warrior often asks his tribesmen to kill him quickly with a short thrust to the heart to end the suffering. Examples of mercy killing also abound in early Japan where a warrior class known as the samurai was in control for the most part of those early centuries. The samurai had a strict code of honor that is called bushido (the way of the warrior) and its Western equivalent is chivalry. Anyway, the principal concept of bushido is “honor unto death” and a samurai back then would commit an honorable way out by a ritualistic suicide known as seppuku (disembowelment) if he had ever committed a dishonorable act like cowardice, disloyalty to his lord (shogun) or failed in duty. A colleague is always nearby if he becomes weak to finish his final act and kill him instantly. However, ritualistic mercy killings were resorted to in the past when most nations had engaged in various armed conflicts. The point or reasons of warriors committing suicides are many like to evade capture, avoid torture if captured or escape shame by a formal execution. In today's modern and more civilized societies, these practices are no longer acceptable and a new attitude is towards the preservation of life at all costs if possible to the very last moment. But there are many situations today where death is sometimes more preferable than continued living such as those people who suffer from a terrible terminal illness that puts great pain. The hospitals' geriatric departments, for example, contain many elderly patients who are suffering daily due to some disease like cancer or Alzheimer’s that causes a slow and painful death. The situation has put ethicists and medical practitioners very often on a collision course on what is the proper course of action to take especially in palliative care (Hartocollis 2). One of the fastest-growing fields in medical practice, palliative care involves focus on some key areas in a patient's life such as telling patients to confront the reality of their ills, put their affairs in order before finally kicking the bucket, accept inevitability of death and most importantly, ensure their last weeks and days are not spent in unbearable pain or in suffering. Palliative care came about as a counter-reaction to the impersonal health care and as backlash against the highly-medicalized death process prevalent in most hospitals today. The argument for palliative care is to somehow alleviate all the anxieties caused by the ambiguity of death and let terminally-ill patients enjoy their last moments on earth free from pain and worries. Euthanasia is a Crime - patients who are still physically active and mentally lucid or alert want an active part in how they are cared for and reject the impersonal care they received from doctors and nurses who attend to several patients at the same time and cannot give them personal attention they crave. People today want to take charge of their lives whenever it is possible even down to the last moments of life. All persons want the best possible health care available to them and this extends to both the basic human rights to live a decent life and to die a dignified death. In most instances, people do not want to prolong their agony. Against Medical Ethics - doctors and nurses are often put into difficult situations about patient preferences on their manner of treatment and how they want to die. The Hippocratic Code forbids taking away life in although there might be some rare exceptions. For example, the Nursing Code of Ethics with Interpretive Statements (ANA, 8 Dec. 1994) do not condone euthanasia and assisted suicide because these contradict with ethical goals and traditions. The taking away of life violates its covenant (sacred contract) with society to promote life and not take away life. Nurses are to provide complete and comprehensive standard medical care and promote compassionate end-of-life care by giving comfort and take away pain. Doctors also strongly opposed this controversial issue and had taken a stand in favor of life (AMA, 2010). Religions against Euthanasia - religions oppose euthanasia and its very first usage was around 1771 in relation to religious beliefs. Western philosophic attitudes towards euthanasia was a result of utilitarianism that in turn led to hedonism. This latter aspect emphasized idea of getting for someone a gentle death to prevent suffering (Council of Europe, 141). Many of the world's religions responded differently to advances in biotechnology such as medically-assisted procreation (test-tube babies, artificial insemination by donor or AID), the taking of organs from the dying or the dead (organ transplants) and even abortion (when does life start). However, the three major religions of the world are similar in their opposition to euthanasia. For Jews, Christians and Muslims, human life is meaningful only in the sense the human body contains the human soul (nefs in Arabic and nefesh in Hebrew). Jews and Christians oppose euthanasia because they consider life as very sacred. The Muslims also are against euthanasia for the reason they believe only the Creator (Allah) has a power and authority to recall or get back the soul (nefs) and euthanasia is anathema to the real practice of medicine which is to promote life. Muslims believe the secondary causes of death such as accidents, sickness and disasters should be controlled and mitigated by his appointed vicars (representatives on earth as imams or khalifa). Euthanasia therefore is against common sense and is unthinkable on both religious and rational grounds of logic (ibid. 142). Islam against Euthanasia – it is the giving of death instead of the giving of life. Even Avicenna (Ibn Siña in Arabic), the greatest Islamic physician (he was a Persian polymath or a genius), argued for medical knowledge and understanding to battle bodily illnesses better and find cures for diseases. In Islamic religious tradition (hadyth), prophet Muhammad teaches the proper attitude in cases where medicine cannot offer any hope or cure is to put the patient into the hands of God (Islam) because it was Allah who created the disease (da), a remedy (dawa) and the cure (shifa). The idea is to provide active care as suffering is a reality. Once a Muslim dies, people prepare the body by washing and perfuming. The funeral prayer is then performed and the deceased is buried in a graveyard without a coffin, simply laid in the earth and covered. The deceased is informed of what is happening, as Muslims believe that the deceased can still hear and understand what is being said. Muslims believe the dead person is not always aware of the transition, and so the one giving instructions informs the deceased that he or she has died, is being laid in the grave, and that two angels known as Munkar and Nakir will soon come into the grave to ask three questions. To the first question, "Who is your Lord?" the deceased is instructed to reply, "Allah." In answer to the second question, "Who is your Prophet?" the deceased should say, "Muhammad," and the correct response to the third question, "What is your religion?" is "Islam." If the individual passes this first phase of the afterlife, the experience in the grave is rather pleasant and he or she is given glimpses of the pleasures of paradise. If however, the deceased does not pass this phase, then the grave is the first stage of chastisement. Allah takes men's souls upon their death and each soul must taste what death is like. Only at that point that He passes a judgment. However, there are some difference between Islam and the other religions. In Islam, a doctor will go to great lengths to preserve and prolong life as long as possible because care is required by religious doctrine. Any doctor who evades the responsibility of providing active medical care under the pretext of compassion (by either euthanasia or giving assisted suicide) is guilty similar to a warrior who ran away from a battlefield because he was afraid of dying. In the Islamic system of medical ethics (bioethics), no one has the power over another on the matters of life and death. Although no one is infallible, each patient is evaluated individually because each person is unique when facing the event of death. Muslims will always try to help anyone who is sick on the best of their ability without any discrimination on religious, racial or other grounds. For Islam, passive euthanasia is an abuse and active euthanasia is a crime. Near death experiences (NDE) in Islam – the religion accepts NDE as a glimpse of an afterlife. The Qur'an (Koran) contains several stories and anecdotes in which the characters want to return to earthly life to warn their relatives about the truth of what happens in the next life and what awaits them there. In a practical sense, those who tried to commit suicide but were not successful happened to experience NDE and so they now have an idea of what the next life will be. The rule in Islam is that if it is not yet time, the dead will revive. Arguments for Euthanasia – proponents of euthanasia argue that it is needless to let a patient suffer when there is no more hope of a recovery. It means all type of medical treatment have been exhausted and there is nothing more doctors can do except wait for death to come. People may suffer from incurable disease (cancer) or progressive illnesses like Alzheimer’s or dementia causing its sufferers to ramble incoherently, lose their memory and in general unable to perform the normal activities of daily living (ADLs). It means people in terminal care need constant medical attention but can be quite expensive on the family. Islam does not allow for financial or economic considerations to discontinue or withdraw medical treatment. Others try to quantify how much pain a person is suffering to allow the use of euthanasia. Some religions view humans the same as animals who suffer when dying and it is therefore legitimate to kill them to cut short and end their suffering. Emotional Pain – some family members cannot bear to watch their loved ones in last stages of their lives undergoing so much physical pain. Watching and caring for a close family member like a grandfather or ones' own mother suffer also imposes emotional pain on family members who watch over them and care for them. Many diseases cause a lingering and often very painful death. This sad situation is played out in most hospitals daily and it is very tough on family members watching sweet old grandma coughing, convulsing, vomiting and losing control of bodily functions. It leaves emotional and psychological scars for quite some time. Dying with Dignity – it is precisely this concern when death is near that people want to leave advance directives (instructions) on what to do in case they cannot make these decisions themselves. This is contained in a living will which is a legal document that contains wishes at these end-of-life situations. Proponents for euthanasia argue living wills also allow for dying with dignity at a time when most people will eventually lose their decision-making capacities (Chen 1) and it is important they document their wishes in a legal document to avoid a legal controversy like Terri Schiavo. It is also important to leave specific instructions about the type of medical care for the patient (whether limited medical care or comfort care only – avoid or alleviate pain) because our health care system today is very fragmented. There is no assurance that the same doctor will be the one to attend to the same patient. Passive euthanasia is worst form of a moral act because dying people are left with no choice about how to die (Kuhse & Singer 393) in the dignified way they had wanted. Arguments Against Euthanasia – besides the religious, moral or ethical arguments that opponents use, there are some practical considerations why they oppose euthanasia. The first argument is that a cure might ultimately be found in the near future and so there is hope for a patient to continue living some more. Opponents cite cases of abuse in applying euthanasia such as those not legally capable of making a right decision about it (like mentally retarded or even underage patients). Another is when there is a mistake in the diagnosis that could lead to a person to end his or her life erroneously. In fact, there have been cases like these such as that about a paralyzed man who lived more than what his doctors had predicted (O'Brien, 2005.). Another reason is a potential for abuses in which voluntary euthanasia is simply transformed into involuntary (without consent) euthanasia very easily through physician-assisted suicides (PAS). It is easy to go from ideological acceptance to action like what happened in Germany during its Nazi regime using eugenics, social Darwinism and scientific racism (all are false). Euthanasia against the Laws – at present, only three countries have allowed a limited form of euthanasia (voluntary that requires patient consent) which are Luxembourg, Belgium and the Netherlands. In the U.S., only the states of Oregon, Washington and Montana allow it for some medical reasons. The potential for abuses like unscrupulous doctors helping patients with a temporary problem like depression get euthanasia is always present although majority of doctors are very ethical and strictly adhere to the Hippocratic Oath. In England and Wales, it is illegal; their citizens are asking for a review of laws to make clear those circumstances which will spark legal action from the government (Mayer 1). To help prevent abuses from being committed, the following conditions will put people in jail (up to 14 years) when they assist someone to commit suicide: if deceased was below 18 years old, or mentally incapable or had no clear wish to die or to commit euthanasia (ibid.). Conclusion It is clear there is still a need to engage in more meaningful debates about euthanasia. People are conflicted on what side they will be because it is a very sensitive issue for them. It is clear the laws on euthanasia need updating and clarification. This update should include the arguments for and against it in bioethics discussions. Suicide which is the deliberate act of a person to end his or her own life when that person is healthy is surely criminal in nature when someone helped to do it but not when a person is terminally ill and suffering in great pain. In all honesty, both those for and against euthanasia have strong valid arguments. It is a fact that many people die “bad deaths” each year such as those in comatose conditions. Scientists are not decided on what really constitutes consciousness (Carey, 5 Feb. 2010) while theologians liken it to something like a long sleep. Opponents of euthanasia and assisted suicide produced an award-wining video called Euthanasia: False Light (ITF, 2009). However, a compromise can certainly be found such as crafting laws with enough safeguards to prevent abuses. Works Cited American Medical Association (AMA). AMA: Anti-Euthanasia, Pro-Pain Control. 2010. Web. 21 April 2010. . American Nurses Association (ANA). Ethics and Human Rights. 2010. Web. 21 April 2010. . Appel, Jacob M. “A Duty to Kill? A Duty to Die? Re-thinking the Euthanasia Controversy of 1906.” Bulletin of the History of Medicine 78.3 (Fall 2004): 610-634. Print. Also available at: . Carey, Benedict. “The Riddle of Consciousness.” The New York Times. 05 Feb. 2010. Web. 21 Apr. 2010. . Chen, Pauline W. “Making Your Wishes Known at the End of Life.” The New York Times. 15 April 2010. Web. 21 April 2010. . Council of Europe. Euthanasia: Ethical and Human Aspects. Strasbourg, France: Council of Europe, 2003. Print. Edelstein, Sari and Judith Sharlin. Life Cycle Nutrition: An Evidence-based Approach. Sudbury, MA, USA: Jones & Bartlett Learning, 2009. Print. Hartocollis, Anemona. “Months to Live: Helping Patients Face Death, She Fought to Live.” International Herald Tribune. 03 April 2010. Web. 21 April 2010. . International Task Force (ITF). “Euthanasia: False Light.” Narrated by actor Joseph Campanella. 15-mins. Video. 2009. Web. 21 Apr. 2010. . International Task Force (ITF). Euthanasia and Assisted Suicide: Frequently Asked Questions. Jan. 2010. Web. 21 Apr. 2010. Kuhse, Helga and Peter Singer. Bioethics: An Anthology. Malden, MA: USA: Wiley-Blackwell, 2006. Print. Mayer, Catherine. “A TV Confession Re-ignites Britain's Euthanasia Debate.” Time Magazine. 17 Feb. 2010. Web. 21 Apr. 2010. . Mystakidou, Kyriaki. “The Evolution of Euthanasia and its Perceptions in Greek Culture and Civilization.” Perspectives in Biology and Medicine 48.1 (Winter 2005): 95-104. Print. Also available at: . O’Brien, Lauren. “Opposing Legalization of the Right to Die.” Emmitsburg Area Historical Society. (2005). July 9, 2009 Web. 21 April 2010. Oxford English Dictionary. Euthanasia. 2010. Web. 21 Apr. 2010. Read More