Right to Die: The Issues of Euthanasia - Essay Example

14 June Right to Die Concept Medical technology has advanced tremendously, enabling medical professionals to prolong life using life sustaining treatments for greater lengths of time (Capone 764). It is now possible to keep a person alive by the use of life support machines with certain death if the machines are removed. At this state, many people are choosing death and would not want their bodies undignified by the use of these machines. Some people are against the legalization of choice to die even if medical technology can prolong life. The opponents of the right to die include governments, Christian churches and organizations, who argue that no one has the right to decide when to live or die. They are against organizations and people who believe that everyone has an intrinsic right and autonomy to choose life or death under any circumstances especially in the face of emotional and physical suffering. People who choose to end their lives under any circumstances have a choice of being euthanized in hospital settings or seek the help of physicians to commit suicide. Euthanasia is the compassionate killing of an individual painlessly. This service is obtainable for people who have terminal, painful and debilitating diseases or handicaps with death being the only hope for them. People who choose death can choose active euthanasia, refuse life prolonging treatments or choose to be assisted to commit suicide. The governing of these services is through various legal requirements including the patient’s state of mind and reasons why they choose to die. Active euthanasia is the deliberate act by a doctor to end a person’s life by use of lethal medicines; passive euthanasia is the withdrawal of life saving treatments and nourishment that sustains life. Euthanasia is voluntary and must be requested by the patient orally or through written requests. Immediate family members or people bestowed with power of attorneys by patients may also request for the service if the patient is mentally incapacitated, clinically brain dead, or in a persistent vegetative state (PVS). There is persecution of doctors and physicians who administer euthanasia or assist patients who have chosen death over treatment by some sections of the society even in countries that have legalized euthanasia. Some have had their licenses revoked and further punished by jail terms without the consideration that euthanasia takes place on compassionate grounds. Background People are increasingly choosing to die, when medical conditions become unmanageable and they suffer too much emotional and physical pain. Communication for this choice is through both oral and written requests when one is fully competent. Alternatively, through pre- written wills by competent people who direct that they be put to death in the event that they lose their mental faculty due to disease or accidents. People who write advance directives may give instructions on what should be done in case a disease or accident makes them incompetent. Thus, they can refuse life prolonging treatments using life support machines or request for active euthanasia when their diseases make them incompetent, incapacitated or virtually dependent on people for survival. A person may choose death driven by the hate of helplessness and dependence that makes the quality of life poor. When in this state, many people refuse treatment, food and some attempt suicide where euthanasia is not legal. Where euthanasia is legal, it is often the moral responsibility of the family and patient’s physicians to heed the patients requests, upon meeting all legal requirements in which a person has the right to choose to die. Normally, it is only the patient’s doctors and close family members who may decide if the person’s wish to die has any merit, based on medical prognosis, emotional status, mental competence and degree of physical pain. People against the right to choose death believe that causing death on compassionate grounds is wrong. Thus, this service should not be legalized under any circumstances as death is not the solution to suffering. The legalization of the right to choose death on compassionate grounds is appropriate, but it also has many loopholes which can be exploited for selfish reasons. The death of people may be a factor for various organizations, including insurance companies, and also relatives of the deceased, of an entitlement to numerous monetary benefits and hence should be strictly regulated and monitored. Argument In this paper, I will argue that everyone has the right to choose death only under exceptional circumstances caused by: Unmanageable medical conditions that result in unbearable pain, dependence on others and mental incompetency. Conditions that lead one to be in a permanently vegetative state; being clinically dead with life being maintained by life support machines. Everybody has the right to die painlessly and with dignity (McArdles 7) and this right should be respected at all times. It is our duty and responsibility to reduce the pain and suffering, through death on compassionate grounds, of other people especially when they are suffering from unmanageable and extreme pain. Pain degrades the essence of life for an individual and causes insurmountable pain and the suffering, too, for loved ones and friends, witnessing the suffering. It is especially cruel to allow a person to suffer helplessly with no way of reprieve. We are obligated to assist such a person to die painlessly and humanely if they willingly choose to die. The right to die is a personal prerogative and should be respected by all as this is self determination. We are free to make resolutions and preferences that affect our own lives, including dangerous activities that can lead to death and hence have the same right to choose death and how we die. The medical fraternity fully recognizes and accepts that there are instances where terminally sick people have conditions that cannot be fully managed by use of existing treatments rendering patients’ lives meaningless (Gurney 10). Some diseases and medical conditions make people lose their dignity and autonomy. According to Kantian philosophies, dignity is bestowed on individuals by virtue of their rational nature and dignity is what makes human beings invaluable (Kant 102). The inability to perform the day to day tasks with premeditated actions makes a person lose their dignity. Additionally, medical treatments that prolong the life of people who are clinically dead also make them lose their dignity. Everyone should have the right to die with dignity, which is through choosing euthanasia rather than subjection to protracted and futile medical treatments. This right gives a person the dignity one deserves and also gives loved ones pleasant memories of a productive life rather than traumatic memories when a person’s life is maintained by machines. Medical advancement has made it possible to keep the body functioning even when the brain is clinically dead. Patients in clinically proven cases of persistent vegetative state and brain dead patients have no hope of ever making a decision in their life. Their life depends on life support machines and they would naturally die if the technology were unavailable. These people have lost the capacity to think freely and act on the premises of their thoughts independently and hence have lost their autonomy and it should be freely accepted then that other people can make decisions for such a person with the best interests of the person so as to maintain the dignity a human being deserves. Living in such a way is undignified where family members and friends undergo a lot of emotional suffering and pain. With no hope of living, these people should be allowed to die peacefully for the benefit of their loved ones. Medical practitioners are bound by the Hippocratic Oath that requires all doctors to heal their patients regardless of rank, age or sex (Hypocrisy and the Hippocratic Oath 2). Doctors have the ability to discern the prognosis of a patient and gauge the treatment progress at all instances. They should act in the best interests of the patient and should correctly give advice where euthanasia is the only solution to alleviate the suffering of patients. They should also listen to the wishes and desires of their patients, as the era where doctors made unilateral decisions about patients’ treatment options are long gone. Majority of members of the public and citizens support euthanasia on compassionate grounds (McCormick 124) and other sectors of the government should follow suit. The British Columbia Supreme Court was informed that the legalization of euthanasia or physically assisted suicide does not lead to increased cases of physician assisted deaths (Gurney 10). Many legislative bodies oppose the legalization of these services on these grounds and there is disapproval of these through experience from countries that have already legalized them. These experiences have shown that euthanasia reduces suicide cases in areas where physician assisted suicides are legal, this is due to the openness and transparency accorded to the phenomena, which serves to facilitate getting professional help to people contemplating suicide. Evidence Some countries have legalized the right to choose death under some unique medical conditions. They allow euthanasia only if the patient had previously chosen to die through euthanasia through written directives. Competent individuals have to orally request for euthanasia for it to be administered only when they abide by the legal requirements. The world has seen the increased acceptance and use of advance directives where individuals give written directives and instructions on future medical care. Countries such as the Netherlands give these directives legal recognition (De Boar et al. 989). Depending on individual wishes, some directives expressly refuse treatment while others request active euthanasia when a person health status reaches a certain level that makes one incompetent and utterly dependent on others. The Netherlands, Belgium and Luxembourg have pioneered legal, active euthanasia for incompetent patients (De Boer et al. 256) and the legalization has been well handled with minimal drawbacks. Various sections of the society, including medical professionals, are demanding the legalization of euthanasia for all people suffering from severe debilitating diseases with no positive outcomes, but I would advocate for more conclusive data on the effects of such policies before their implementation. Euthanasia is a voluntary choice by mentally competent people who would want to die a quick, painless and dignified death. Existing regulations state and govern the conditions under which euthanasia requests may be accepted with the law providing that all applicants must be mentally sound and understand euthanasia fully (Hume 8). In some countries, doctors are required to consult with at least one other colleague before being legally bound to administer euthanasia on compassionate grounds in hospital settings. This ensures that only deserving applications are accepted and enables correct decision making (De Boer et al. 990). Many medical doctors, patients and the public are in support of euthanasia purely on compassionate grounds. It would be wrong for anyone to overlook the possibility of doctors and patients abusing pro-euthanasia and physician assisted suicide laws. Doctors can use euthanasia legalization to put to death unpleasant and troublesome patients while patients may kill themselves without proper reasons. There is a likelihood that some people can use social criterion to decide who dies and who lives based on status, social importance and usefulness in the larger society if the right to die is legalized (Fenigsen 57). However, this is not often the case with many qualified applicants having their requests turned down. According to a research done by De Boar et al. (2011), advance directives for euthanasia are rarely complied with in the Netherlands, especially for people with dementia due to various circumstances, despite the law allowing them to comply with them. One of the aspects contributing to this is that elderly care physicians had difficulty ascertaining the unbearable suffering of their patients, as there is no universally accepted criterion for determining their agonizing afflictions. This was further complicated by the absence of clear wishes by patients with dementia although the prewritten wishes are meant for incompetent people. Some of the patient’s wishes also changed during their health care periods, indicating some positive outcomes for the treatments. In some cases, there were disagreements between the relatives on the way forward with some elderly physicians limited by their religions. Advance directives are only complied with when there is absolute proof that the patient is suffering with no positive impact or any benefits from the life sustaining treatments and all parties involved must come to a consensus on the futility of treatment of incompetent patients. This should allay the fear the public has of advance directives on care and treatment as there are strict conditions to be followed with no valid proof. Their research helps to dispel all claims that legalizing euthanasia would lead to various groups of people being discriminated against and euthanized. There is no proof that doctors would cause the death of the handicapped, poor, elderly and senile by passive euthanasia. They, too, are human beings with feelings and euthanasia is a choice made independently by a competent person. However, the right to die is a delicate issue and requires the establishment and enforcement of strict laws and policies to ensure that it remains voluntary all over the world. All policies and guidelines should be harmonized all over the world to close all loop holes that can be exploited. The establishment of these laws needs to borrow from the already functioning laws and policies which govern euthanasia in Oregon, the Netherlands and other places and countries that have legalized it. Their laws have been successful in ensuring that only the deserving patients have their applications accepted. The laws stipulate that all patients must undergo qualifying tests that include assessment from qualified and vetted psychologists. Psychologists determine whether the patients have the right mental capacity to correctly make a valid euthanasia request. All euthanasia applicants must be provided with adequate information about euthanasia, the types of euthanasia and physician assisted suicide available so that they can make the right choices and choose the most dignified way to die. Clear-cut guidelines are used to determine the qualified and unqualified applicants, which minimize decision making burdens. Adequate documentation allows the review of each and every case when necessary and serves to help with follow up and review of euthanasia situation in those countries. This shows that euthanasia is carried out professionally and doctors accept requests from individuals whose conditions merit assistance to die. To ensure the autonomy of euthanasia decisions is maintained and respected, physicians administering euthanasia should have specific roles that would limit involuntary euthanasia. In euthanasia, the doctor should be tasked with the responsibility of administering the lethal medication necessary to cause painless death to the patient whose written or oral requests have been accepted. For physician assisted suicide, the law stipulates that only patients who have less than six months to live due to terminal diseases with medical proof and consensus of two doctors can be granted their wish to die. This clearly shows that physician assisted suicides would not be used on the most vulnerable members of the society as most would not qualify. Research on the trends of suicide and euthanasia cases in countries that have already legalized euthanasia shows no increase in suicides in the society (Hume 11). There is also no evidence to show that the vulnerable members of the society that include the elderly, disabled or mentally ill are more likely to receive euthanasia or that its legalization increases the number of deaths in a country. The research showed the opposite happening on the ground with requests for euthanasia from the elderly people, over 80 years, being granted less often (Hume 13). Euthanasia institutions in these countries refused to grant permission for euthanasia to people suffering from psychotic illness and people suffering from depression (Riddle 4) as they are severely limited in making the correct decisions refuting claims that euthanasia would lead to more deaths if legalized worldwide. Euthanasia legalization has other positive benefits to the society as it removes the stigma associated with death in the general population; people are able to talk more openly about suicide and physicians can correctly treat and counsel many people willing to commit suicide due to unfounded concerns. This has been experienced in Belgium when dialogue between patients and doctors about the death issues became more open once euthanasia legalization had been passed. Medicine’s primary objective is to help the individual who is ill and suffering and the public, legislatures and governments have always supported this noble profession and its professionals (Fenigsen 57). Doctors should always ensure that nobody suffers needlessly in the society due to unmanageable conditions. They should never at any moment change their loyalty and commitment to their patients (Fenigsen 70). I believe that euthanasia is crucial in the society in exceptional incidents, but it also has the potential to include eugenic principles where doctors sacrifice the individual patient’s well being for the society’s demands, which can lead to the elimination of certain human individuals deemed unfit and a burden to the society. We should never allow this to happen and we must ensure that doctors still obey their Hippocratic Oath. Conclusion In conclusion, there is a need to accept euthanasia in the society and allow the terminally ill people to die in relative peace devoid of emotional and physical suffering. Euthanasia is voluntary and must remain so for all times to come. A person must be allowed the right to decide on the future treatment and care if something catastrophic happens and it is the moral obligation of physicians and family members to respect an individual’s wishes when made on varied valid and compelling grounds. Euthanasia remains a contentious issue partly because many people are not thoroughly aware of the issues surrounding it. Despite being for the good of the terminally ill, there is a need to consider the varied concerns raised by anti-euthanasia advocates and make the necessary amendments and introduce safeguards to the legislative law to close all loopholes possible. There is an urgent need for internationally accepted and vetted guidelines on the correct methods and procedures of carrying out euthanasia with lists of legally acceptable medicines for use in the process and during physician assisted suicide. These laws should contain the procedures that patients and doctors should follow when accessing such medicines and administering compassionate killing services. There is a need for strong legislation of euthanasia coupled with strict monitoring of euthanasia cases to prevent embracing of eugenic principles in the medical profession. Strict penalties and jail terms ought to be legislated for to curb any misuse of euthanasia as it is intrinsically wrong to euthanize any individual without appropriate and medically proven facts. Medical practitioners should respect and follow the Hippocratic Oath in their institutions and nobody should be denied access to medical care to hasten their death without their clear wishes. The moral responsibility to choose life or death should be left to a competent person without legal interference; the law allows an individual to refuse treatment that ultimately leads to death and is a form of suicide but refuses the same person an opportunity to make plans for his pain-free and dignified death. Mercy killing should be an acceptable option as the patient may be persuaded to choose life over death. However, it is my opinion that involuntary euthanasia (where the patient has not actively expressed a wish to die through oral or written means due to a mental or physical incapacity) should not be allowed at all. It would be better if these people were allowed to die naturally from the diseases rather than from active euthanasia. This would hinder any members of the patient’s family who assume power of attorney for patients to hasten the death of their loved ones for ill motives especially where wealth inheritance is at stake. Involuntary euthanasia can also be used by questionable people and government regimes, which can eliminate certain groups of people due to any reason for their own political or economical gain. Works Cited Capone, John. Bartling v. Superior Court: The Final Transgression of a Patient's Right to Die? 35 Case W. Res. 764 (1985). Print. De Boar et al. "Advance Directives for Euthanasia in Dementia: How Do They Affect Resident Care In Dutch Nursing Homes? Experiences of Physicians." Advanced Directives, Patient Care, Euthanasia, Advanced Care Planning 6th ser. 59.989-96 (2011): 981-95. CINAHL. Web. De Boer et al. “Advance Directives for Euthanasia in Dementia: Do Law-based Opportunities Lead to More Euthanasia?” Health Policy 98 (2010): 256-262. Print. Fenigsen, Richard. "Other People's Lives: Reflections On Medicine, Ethics and Euthanasia:" Ethics, Medical Suicide, Assisted-Ethical, Physician's Role 1st ser. 27.51-70 (2011): 1-64. CINAHL. Web. Gurney, Matt. "Euthanasia a Right Long Denied; Quebec Report Suggests Legalized Option for Dying." National Post [Canada] 23 Mar. 2012, National Edition ed., NEWS; Pg. A2 sec.: 10-999. Print. Hume, Mark. "Experts Defend Right to Die Laws." The Globe and Mai [Canada] 6 Dec. 2011, Bristish Columbia News; Courts; Pg. S3 sec.: S.3. Print. "Hypocrisy and the Hippocratic Oath." Web log post. The Western Confucian. Web Blog, 2 Aug. 2011. Web. Kant, Immanuel. Groundwork of the Metaphysic of Morals. Trans. by H.J. Paton. New York: Harper and Row, 1964. Print. McArdles, Helen. "Give Terminally Ill Right to Die, Reports Urges MPs." The Heard [Glasgow] 5 Jan. 2012. 1 Edition ed., Hs-News sec.: 1. Print. McCormick andrew. "Self-Determination, the Right to Die and Culture: A Literature Review." Intensive Care, Right to Die, Social Case Work and Terminal Care 56.2 (2011): 119-28. EBSCOhost. Web. Riddle, Christopher. "Baseline Concerns about Euthanasia." National Post [Canada] 30 Mar. 2012, National Edition ed., Letters; Pg. A17 sec.: n. Pg. Print. Read More