Euthanasia
A considerable size of society is in favor of Euthanasia
mostly because they feel that as a democratic country, we
as free individuals, have the right to decide for ourselves
whether or not it is our right to determine when to
terminate someone's life. The stronger and more widely held
opinion is against Euthanasia primarily because society
feels that it is god's task to determine when one of his
creations time has come, and we as human beings are in no
position to behave as god and end someone's life. When
humans take it upon themselves to shorten their lives or to
have others to do it for them by withdrawing
life-sustaining apparatus, they play god. They usurp the
divine function, and interfere with the divine plan.
Euthanasia is the practice of painlessly putting to death
persons who have incurable , painful, or distressing
diseases or handicaps. It come from the Greek words for
'good' and 'death', and is commonly called mercy killing.
Voluntary euthanasia may occur when incurably ill persons
ask their physician, friend or relative , to put them to
death. The patients or their relatives may ask a doctor to
withhold treatment and let them die. Many critics of the
medical profession contend that too often doctors play god
on operating tables and in recovery rooms. They argue that
no doctor should be allowed to decide who lives and who
dies.
The issue of euthanasia is having a tremendous impact on
medicine in the United States today. It was only in the
nineteenth century that the word came to be used in the
sense of speeding up the process of dying and the
destruction of so-called useless lives. Today it is defined
as the deliberate ending of life of a person suffering from
an incurable disease. A distinction is made between
positive, or active, and negative, or passive, euthanasia.
Positive euthanasia is the deliberate ending of life; an
action taken to cause death in a person. Negative
euthanasia is defined as the withholding of life preserving
procedures and treatments that would prolong the life of
one who is incurably and terminally ill and couldn't
survive without them. The word euthanasia becomes a
respectable part of our vocabulary in a subtle way, via the
phrase ' death with dignity'.
Tolerance of euthanasia is not limited to our own country.
A court case in South Africa, s. v. Hatmann (1975),
illustrates this quite well. A medical practitioner, seeing
his eighty-seven year old father suffering from terminal
cancer of the prostate, injected an overdose of Morphine
and Thiopental, causing his father's death within seconds.
The court charged the practitioner as guilty of murder
because 'the law is clear that it nonetheless constitutes
the crime of murder, even if all that an accused had done
is to hasten the death of a human being who was due to die
in any event'. In spite of this charge, the court simply
imposed a nominal sentence; that is, imprisonment until the
rising of the court. (Friedman 246)
Once any group of human beings is considered unworthy of
living, what is to stop our society from extending this
cruelty to other groups? If the mongoloid is to be deprived
of his right to life, what of the blind and deaf? and What
about of the cripple, the retarded, and the senile?
Courts and moral philosophers alike have long accepted the
proposition that people have a right to refuse medical
treatment they find painful or difficult to bear, even if
that refusal means certain death. But an appellate court in
California has gone one controversial step further. (Walter
176)
It ruled that Elizabeth Bouvia, a cerebral palsy victim,
had an absolute right to refuse a life-sustaining feeding
tube as part of her privacy rights under the US and
California constitutions. This was the nation's most
sweeping decision in perhaps the most controversial realm
of the rights explosion: the right to die...
As individuals and as a society, we have the positive
obligation to protect life. The second precept is that we
have the negative obligation not to destroy or injure human
life directly, especially the life of the innocent and
invulnerable. It has been reasoned that the protection of
innocent life- and therefore, opposition to abortion,
murder, suicide, and euthanasia- pertains to the common
good of society.
Among the potential effects of a legalised practice of
euthanasia are the following:
"Reduced pressure to improve curative or symptomatic
treatment". If euthanasia had been legal 40 years ago, it
is quite possible that there would be no hospice movement
today. The improvement in terminal care is a direct result
of attempts made to minimize suffering. If that suffering
had been extinguished by extinguishing the patients who
bore it, then we may never have known the advances in the
control of pain, nausea, breathlessness, and other terminal
symptoms that the last twenty years have seen. Some
diseases that were terminal a few decades ago are now
routinely cured by newly developed treatments. Earlier
acceptance of euthanasia might well have undercut the
urgency of the research efforts which led to the discovery
of those treatments. If we accept euthanasia now, we may
well delay by decades the discovery of effective treatments
for those diseases that are now terminal. (Brock 76)
"Abandonment of Hope". Every doctor can tell stories of
patients expected to die within days who surprise everyone
with their extraordinary recoveries. Every doctor has
experienced the wonderful embarrassment of being proven
wrong in their pessimistic prognosis. To make euthanasia a
legitimate option as soon as the prognosis is pessimistic
enough is to reduce the probability of such extraordinary
recoveries from low to zero.
"Increased fear of hospitals and doctors". Despite all the
efforts of health education, it seems there will always be
a transference of the patient's fear of illness from the
illness to the doctors and hospitals who treat it. This
fear is still very real and leads to large numbers of late
presentations of illnesses that might have been cured if
only the patients had sought help earlier. To
institutionalize euthanasia, however carefully, would
undoubtedly magnify all the latent fear of doctors and
hospitals harbored by the public. The inevitable result
would be a rise in late presentations and, therefore,
preventable deaths.
"Difficulties of oversight and regulation". Both the Dutch
and the California proposals list sets of precautions
designed to prevent abuses. They acknowledge that such are
a possibility. The history of legal "loopholes" is not a
cheering one. Abuses might arise when the patient is
wealthy and an inheritance is at stake, when the doctor has
made mistakes in diagnosis and treatment and hopes to avoid
detection, when insurance coverage for treatment costs is
about to expire, and in a host of other circumstances.
(Maguire 321)
"Pressure on the Patient". Both sets of proposals seek to
limit the influence of the patient's family on the
decision, again acknowledging the risks posed by such
influences. Families have all kinds of subtle ways,
conscious and unconscious, of putting pressure on a patient
to request euthanasia and relive them of the financial and
social burden of care. Many patients already feel guilty
for imposing burdens on those on those who care for them,
even when the families are happy to bear the burden. To
provide an avenue for the discharge of that guilt in a
request for euthanasia is to risk putting to death a great
many patients who do not wish to die.
"Conflict with aims of medicine". The pro-euthanasia
movement cheerfully hands the dirty work of the actual
killing to the doctors who by and large , neither seek nor
welcome the responsibility. There is little examination of
the psychological stresses imposed on those whose training
and professional outlook are geared to the saving of lives
by asking them to start taking lives on a regular basis.
Euthanasia advocates seem very confident that doctors can
be relied on to make the enormous efforts sometimes
necessary to save some lives, while at the same time
assenting to requests to take other lives. Such confidence
reflects, perhaps, a high opinion of doctor's psychic
robustness, but it is a confidence seriously undermined by
the shocking rates of depression, suicide, alcoholism, drug
addiction, and marital discord consistently recorded among
this group.
"Dangers of Societal Acceptance". It must never be
forgotten that doctors, nurses, and hospital administrators
have personal lives, homes and families, or that they are
something more than just doctors, nurses, or hospital
administrators. They are citizens and a significant part of
the society around them. We should be very worried about
what the institutionalization of euthanasia will do to
society, in general , how will we regard murderers? (Brody
89)
"The Slippery Slope". How long after acceptance of
voluntary euthanasia will we hear the calls for
non-voluntary euthanasia? There are thousands of comatose
or demented patients sustained by little more than good
nursing care. They are an enormous financial and social
burden. How long will the advocates of euthanasia be
arguing that we should "assist them in dying".
"Costs and Benefits". Perhaps the most disturbing risk of
all is posed by the growing concern over medical costs.
Euthanasia is, after all, a very cheap service. The cost of
a dose of barbiturates and curare and the few hours in a
hospital bed that it takes them to act is minute compared
to the massive bills incurred by many patients in the last
weeks and months of their lives. Already in Britain, There
is a serious under- provision of expensive therapies like
renal dialysis and intensive care, with the result that
many otherwise preventable deaths occur. Legalizing
euthanasia would save substantial financial resources which
could be diverted to more "useful" treatments. These
economic concerns already exert pressure to accept
euthanasia, and, if accepted, they will inevitability tend
to enlarge the category of patients for whom euthanasia is
permitted...
"Do not tolerate killing". Now is the time for the medical
profession to rally in defense of its fundamental moral
principles, to repudiate any and all acts of direct and
intentional killing by physicians and their agents. We call
on the profession and its leadership to obtain the best
advice, regarding both theory and practice, about how to
defend the profession's moral center and to resist growing
pressures both from without and from within. We call on
fellow physicians to say that we will not deliberately
kill. 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)
On the other hand some people strongly feel that euthanasia
is not bad and should not be looked down upon.
Are there no conditions when life is meaningless and should
be quietly ended? If a person is subject to pain that won't
stop as a result of a disease that can't be cured, must he
or she suffer that pain as long as possible when there are
gentle ways of putting an end to life? If a person suffers
from a disease that deprives him or her of all memory and
makes him or her a helpless lump of flesh that may live on
for years.
If euthanasia were legalized,it should be admitted that
there might be some abuses of virtually every social
practice. There is no absolute guarantee against that. But
we do not normally think that a social practice should be
precluded simply because it might sometimes be abused. The
crucial issue is whether the evil of the abuses would be so
great as to outweigh the benefit of the practice. In the
case of euthanasia, the question is whether the abuses, or
the consequences generally, would be so numerous as to
outweigh the advantages of legalization. The choice is not
between a present policy that is benign and an alternative
that is potentially dangerous. The present policy had it's
evils, too.
We spend more than a billion dollars a day for health car
while our teachers are underpaid, and our industrial plants
are rusty. This should not continue. There is something
fundamentally unsustainable about a society that moves its
basic value-producing industries overseas yet continues to
manufacture artificial hearts at home. We have money to
give smokers heart transplants but no money to retool out
steel mills. We train more doctors and lawyers than we need
but fewer teachers. On any given day, 30 to 40 percent of
the hospital beds in America are empty, but our classrooms
are overcrowded and our transportation systems are
deteriorating. We are great at treating sick people, but we
are not that great at treating a sick economy. And we are
not succeeding in international trade. When you really look
around and try to find industries the United States is
succeeding in, you discover that they are very few and far
between.(Lamm 133)
There is no way we are going to come to grips with this
problem until we also look at some of these areas that
aren't going to go away . One of the toughest of these is
what Victor Fuchs called "flat-of-the-curve medicine"-
those medical procedures which are the highest in cost but
achieve little or no improvement in health status. He says
that they must be reduced or eliminated. We must demand
that professional societies and licensing authorities
establish some norms and standards for diagnostic and
therapeutic practice that encompass both costs and
medicine. Wer'e going to have to come up with some sort of
concept of cost-effective medicine.
Individuals have the right to decide about their own lives
and deaths. What more basic right is there than to decide
if you're going to live? There is none. A person under a
death sentence who's being kept alive, through so called
heroic measures certainly has a fundamental right to say,
"Enough's enough. The treatment's worse than the disease.
Leave me alone. Let me die!". Ironically, those who deny
the terminally ill this right do so out of a sense of high
morality. Don't they see that, in denying the gravely ill
and suffering the right to release themselves from pain,
they commit the greatest crime?
The period of suffering can be shortened. If you have ever
been in a terminal cancer ward, It's grim but enlightening.
Anyone who's been there can know how much people can suffer
before they die. And not just physically. The emotional,
even spiritual, agony is often worse. Today our medical
hardware is so sophisticated that the period of suffering
can be extended beyond the limit of human endurance. What's
the point of allowing someone a few more months or days or
hours of so-called life when death is inevitable? There's
no point. In fact, it's downright inhumane. When someone
under such conditions asks to be allowed to die, it's far
more humane to honor that request than to deny it.(Barry
405)
People have a right to die with dignity. Nobody wants to
end up plugged into machines and wired to tubes.
Who wants to spend their last days lying in a hospital bed
wasting away to something that's hardly recognizable as a
human being, let alone his or her former self? Nobody. The
very thought insults the whole concept of what it means to
be human. People are entitled to dignity, in life and in
death. Just as we respect people's right to live with
dignity, so we must respect their right to die with
dignity. In the case of the terminally ill, that means
people have the right to refuse life-sustaining treatment
when it's apparent to them that all the treatment is doing
is destroying their dignity, and reducing them to some
subhuman level of humanity.
The reasons just stated in favor of euthanasia are often
over looked due to the following arguments that are against
euthanasia.
The way you talk you'd think people have absolute right
over their bodies and lives. But that is obviously just not
true. No individual has absolute freedom. Even the
patient's Bill of Rights, which was drawn up by the
American Hospital Association, recognizes this. Although it
acknowledges that patients have the right to refuse
treatment, the document also realizes that they have this
right and freedom only to the extent permitted by law.
Maybe people should be allowed to die if they want to.But
if so, it's not because they have an absolute right to
dispose of themselves if they want to.(Brock 73)
Only a fool would minimize the agony that many terminally
ill patient endure. And there's no question that by letting
them die on request we shorten the period of suffering. But
we also shorten their lives. Can you seriously argue that
the saving of pain is greater good than the saving of life?
Or that presence of pain is worse than the loss of life? Of
course, nobody likes to see a creature suffer, especially
when the creature has requested a halt to the suffering.
But we have to keep our priorities straight.
Pro euthanasianists make it sound as though the superhuman
efforts made to keep people alive are not worthy of human
beings. What could be more respectful of human life, than
to maintain life against all odds, and against all hope?
All of life is a struggle and a gamble. At the gaming table
of life, nobody ever knows what the outcome will be. "
Indeed, humans are noblest when they persist in the face of
the inevitable. Look at our literature. Reflect on our
heroes. They are not those who have capitulated but those
who have endured. No, there's nothing undignified against
being hollowed out by a catastrophic disease, about
writhing in pain, about wishing it would end. The indignity
lies in capitulation".(Buchanan 208)
Bibliography
Friedman,Emily. Ethics Issues For Health Care Professionals.
Baskerville: American Hospital Publishing, 1986.
Maguire,Daniel. Death By Choice. Garden City: Doubleday &
Company,1984.
Reich,Warren. Quality Of Life. New York: Paulist Press,
1990.
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.
Maestri,William. Choose Life And Not Death. New York:
Library Of Congress,1986.
Low,Charlotte. Euthanasia - Opposing Viewpoints. San Diego:
Greenhaven Press,1989.
Brock,Dan. Deciding For Others. Cambridge: Cambridge
University Press,1989.
Barry,Vincent. Moral Aspects Of Health Care. Belmont:
Wadsworth Publishing Company,1982.
Current,Richard."Death".The World Book Encyclopedia,1986 ed.
Gibbs,Nancy. "Dr. Death Strikes Again" TIME, 54 (November
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