People involved in the caring of the sick and dying have a tradition of concern about moral issues and the application of ethics to the decision-making process. This tradition is due, in part, to the tenets of the Hippocratic oath. Most people die in acceptable degrees of comfort but for some, dying is a most distressing experience. The things that can make dying so distressing include physical pain, mental distress, and the knowledge that the suffering is pointless in the sense that it has to be borne without hope of subsequent improvement in health or relief in suffering.
This remains to be one of the longest running debates among various sectors of society, which has been carried on from the past to the modern world, is the issue of euthanasia. Euthanasia has elicited intense debates among people. Ambivalence is the name of the game when it comes to the question of whether a person has the right to take the life of a patient who is terminally-ill. The debate is not as clear as black and white as there are opponents of euthanasia who are willing to give in to certain situations that could justify mercy-killing.
This paper argues that euthanasia must not be legalized based on three points which the paper shall be dwelling into: 1) Euthanasia has a certain way of changing the public conscience; 2) Euthanasia violates accepted codes of medical ethics and 3). Euthanasia denies the patient the final stage of growth. Issues on euthanasia The word euthanasia is taken from the Greek word for “easy death” (Dowbiggin xi). Euthanasia is generally classified into either passive or active euthanasia, depending on the actions undertaken by the attending physician.
However, some groups opposing euthanasia of whatever form provide no distinction between the two because of the argument that in both ways, men, more particularly physicians, act as God. According to Ian Dowbiggin, “for centuries, euthanasia had normally been understood to mean the process whereby the relief of pain for the dying was the best way to ensure an easy death” . 1. Euthanasia has a certain way of changing the public conscience All values must be kept under constant scrutiny to ensure that they are worthy, in fact to be regarded as standards against which man’s conduct should be judged.
History is full of examples of traditional values which have been employed to defend activities which are absolutely indefensible. Heated debates usually accompany the discussion of euthanasia, more so of active euthanasia. Euthanasia is like opening a pandora’s box; opening up the matter could bring to intense debates among people. Generally, active euthanasia in the form of physician-assisted suicide is undertaken to patients who suffer from diseases causing deterioration of his capacities and abilities as a person such as those suffering from unbearable pain or finding their lives to have turned into agony.
In the Netherlands, for instance, the law allowing euthanasia is restricted “to terminal patients suffering unbearable pain with no hope of improvement, and who request to die when they are of sound mind” (Associated Press). Recent case in the USA was that of Terri Schiavo- although seemingly a case of passive euthanasia- where the courts allowed her feeding tube to be removed (Grossman). Associated Press reported in early 2005 that euthanasia has been legalized in countries like Belgium and Netherlands, in the state of Oregon in the USA and, is undergoing debates in France.
There are instances, however, that the patients themselves request that their life be cut short due to the extreme pain and suffering from their disease. The opponents are not ready to give in to this request though. According to Rizkalla, these kinds of request might have been made due to the variability of human emotions. They do not abandon the possibility that a patient, who has decided to undergo euthanasia, might, on the next day, reconsider and realize the value of life. The variability of human emotions as well as environmental and situational effects to a patient is neglected by euthanasia.
Take the case of Dianne Pretty suffered from motor neurone disease that left her paralysed from the neck down. Mrs Pretty was in need of 24-hour care and faced an unpleasant death. Unable to end her own life, she wanted her husband to help her die without being prosecuted. Dianne Pretty’s court case to try to get permission for her husband to help her die failed, and she died without any assistance in May 2002. Euthanasia has a certain way of hardening people’s hearts and taking people’s lives for granted.
For example, in the case of infants with Down’s syndrome who need operations for congenital defects unrelated to the syndrome to live. Sometimes, there is no operation, and the baby dies, but when there is no such defect, the baby lives on. An operation such as that to remove an intestinal obstruction is not prohibitively difficult. The reason why such operations are not performed in these cases is clearly, that the child has Down’s syndrome and the parents and the doctor judge that because of that fact it is better for the child to die.
But when one looks deeply at this situation, it seems quite absurd, no matter how one thinks of these babies. In this case, the matter of life and death is decided on irrelevant grounds. It is the Down’s syndrome, and not the intestines, that is the issue. The matter should be decided, if at all, on that basis and not be allowed to depend on the essentially irrelevant question of whether the intestinal tract is blocked. What makes this situation possible is the idea that when there is an intestinal blockage, one can “let the baby die. But when there is no such defect there is nothing that can be done, for one must not “kill” the infant. The fact that this issue can be quite delicate and can have a sneaky way of changing views of people and can lead to such results as deciding death on irrelevant grounds is another good reason why the doctrine would be rejected. It is important to realize that euthanasia is condemned not merely as illegal but as “contrary to that for which the medical profession stands,” which brings me to my second point. 2. Euthanasia violates accepted codes of medical ethics.
Values are enduring but dynamic beliefs held by a person or members of an organization about the worth of something. Values motivate behavior. Judgments about right and wrong or good and bad are moral judgments based on values. In the course of human interactions there are many situations in which it is difficult to make a decision because values come into conflict. Conflict between moral values results in an ethical problem. Major influences on moral decision making on the dying are personal, personal. Clarification comes from serious, thoughtful consideration of the effect decisions have on others.
An individual must engage in values clarification to develop a personal decision-making process that fosters ethical behavior. Decisions that deal with morality are decisions that have significant social importance in terms of the way they affect the welfare of others. Moral decisions are those which are correct according to philosophical principles. Introspective consideration of one’s value hierarchy leads to a personal ethic. Ideally, a person can make morally correct choices by following a decision-making process which involves contemplation and weighing the effects of each choice according to ethical principles.
Dr. Jack Kevorkian, upon request of his patient suffering from amyotrophic lateral sclerosis, performed active euthanasia by injecting poison to stop the heart of the latter (Dowbiggin xi). According to Dowbiggin, the procedure shown in a CBS television program was not the first for Dr. Kevorkian who had performed the same procedure for several patients resulting to various criminal charges of assisting suicide against him from which he was acquitted except to the last one shown on CBS arguably for him crossing the line (xi).
It has always been contrasted with the most accepted euthanasia- the passive euthanasia- whereby active euthanasia, as the name implies, needs the active participation of the doctor to hasten the death of a patient in an agonizing pain while passive euthanasia is more of letting the patient die his natural death by switching off life support machines (Anonymous). In active euthanasia, “drugs are (prescribed) or (administered) to patients who are not in life support system” (Anonymous).
However, this violates the principle of the Hippocratic oath that a physician should never do anything that is not in the best interest of his patient. It is the fundamental basis of the unwritten contract between the patients and physicians. Keeping a patient alive, when dying has become a better option for the patient than living, is not in the patient’s best interests. The American Medical Association has made the pronouncement that “Physician assisted suicide could undermine the trust that is essential in the doctor-patient relationship by blurring the time-honored line between healing and harming. Physicians also cannot heal all the time, and it is their responsibility to use his/her best skills in the best interests of the patient, whatever those happen to be—to heal when possible, to comfort always, and when neither healing nor comforting is possible, to do then whatever is in the patient’s best interests. 3. Euthanasia denies patients the final stage of growth Good palliative care can manage pain and other physical problems, although sometimes at a high cost from the patient’s point of view, and loving care can usually keep existential problems within a tolerable range.
But even the best palliative and supportive care cannot always make life tolerable and at the end of their lives, some people simply want to bring their useless suffering to a close. In order to support this argument, some say that they are in favor of active euthanasia since they be giving terminally-ill patients the dignity until the end of their lives. Active euthanasia gives patients the chance to die with dignity instead of prolonging their lives but degrading their being a person.
However, one argues that there is real growth even during the last moments of one’s life. Polls indicate that most requests for assistance in dying come not from the least privileged members of society but from the most privileged. Perhaps the privileged are more accustomed to being in charged and in control of their lives. The poor may be better at tolerating dreadful conditions because they have more experience of having had to do that. People are still concerned with having dignity until their last days and having control with their own lives (Brock 11).
When patients are put into a life-support system or whose lives are only sustained by medical technology, most of them are becoming worthless relative to what they had been before they were struck by these deadly diseases. According to Dan Brock, “the central aspect of human dignity lies in people’s capacity to direct their lives” hence, once terminally-ill patient losses his capacity to take responsibility for his life, he, in effect loses his dignity as a person (11). The dying person is denied the final phase in his growth if one legalizes euthanasia.
Suicidologists tell us that at least 95 percent of physically healthy people who are suicidal may be depressed, as claimed, and therefore, mentally or emotionally incompetent to make life and death decisions, but that is no reason to infer that 95 percent of terminally ill people who wish to terminate their suffering are in the same category. Some experts like Bednarz argues that one of the most important aspects of being human is the person’s autonomy that is, which is the modern feature of physician-patient relationship.
Others claim that technologies are available to ease pain in majority of the cases, and that therefore suicide due to uncontrollable pain is unnecessary (Balch and Waters). However, this is flawed and still depends on a case to case basis. Conclusion Allowing the practice of euthanasia is like opening the medical world into possible abuses not just of medical practitioners but also of the patients and their relatives. Once euthanasia is given as an available option, people and medical practitioners might make this an easy option or worse, an escape from their responsibilities to the patients.