The Issue of Euthanasia - Research Paper Example

The Issue of Euthanasia Introduction The topic of euthanasia cannot leave anyone indifferent. Currently, the question of euthanasia is one of the most painful, urgent, and widely discussed topics. In medicine, euthanasia is seen as the opportunity of a person suffering from a fatal disease to make an independent choice between painful life and premature death (“Euthanasia”). If the patient cannot take such a decision because of his/her physical condition, the choice can be made by his/her relatives. The question of permitting or prohibiting euthanasia is associated with constant and never-ending disputes. Despite the fact that in some countries it is permitted, there is still no consensus on the matter in the world. Unfortunately, even given the high level of its achievements under the influence of scientific and technological progress, modern medicine cannot save mankind from death and physical suffering. The fact that the issue of euthanasia is particularly important in modern medicine is also associated with a departure from the principle of medical paternalism to the principles determined by contemporary bioethics. Euthanasia and Principles of Modern Medicine To begin with, for centuries, medical ethics had changed markedly. Previously medicine relied on Hippocratic Oath, the basic principle of which is as follows: “do whatever you like, but do no harm” (Hulkower 41). The ethics of Hippocratic medicine was an example of paternalism where the doctor was endowed with limitless powers in relation to the patient (McClenaghan 10). Today, medical ethics is based on four ethical principles that demonstrate a departure from medical paternalism. None of them is leading, since they are all equivalent (Varelius 377-380): • Autonomy. It suggests the implementation of the human right to control over their own life, health, and death; • Beneficence that is the duty to act in the interest of the patient; • Non-maleficence. It is based on the principle of "do no harm"; • Fairness suggests that all patients have equal rights to receive medical assistance. The History of the Term "Euthanasia" Translated from the Greek the word "euthanasia" means a "good death." (Ardelt 424) The term appeared in the 16th century. The English philosopher and scientist Francis Bacon identified the following main features of euthanasia: easy and painless dying and a strong belief that to die is the greater good than to feel pain and sufferings in life. Francis Bacon believed that the doctor should help the dying patients, so they were not so scary. He "discussed euthanasia as a fair, easy passage" (Pridgeon 49). After almost three hundred years, a modern meaning of the term had appeared. Euthanasia began to be understood as an attempt to help person experiencing unbearable suffering escape from life that is to show compassion towards him or her. Shortly after, the term was forgotten, and at the end of the twentieth century, the issue of euthanasia became rather disputable. There is a question of why medicine raises the notion of a good death. In fact, it is possible to observe two main trends. Firstly, as mentioned earlier, in medicine there is a shift from paternalism to patient’s autonomy. In addition, one needs to note a change in the medical approach to the dying patient. If several decades ago the doctor was not engaged in his/her patient’s dying, the XX century is marked by the emergence of a hospice movement, which develops the idea that even the dying people deserve attention and help from their doctors. Over the years, causes of human death have changed greatly, as well as life expectancy. One can observe a variety of technologies that prolong life. People have learned to replace the huge number of body functions with artificial ones. Nevertheless, this in turn creates its own problems. There are endless debates is if is reasonable to formally allow euthanasia, and how it will be a humane solution. Types of Euthanasia In addition to the known classification of active and passive, euthanasia is divided into voluntary and involuntary. Passive euthanasia is the cessation of therapy, which supports the patient’s life. From the point of view of doctors, the second type that is active euthanasia (or a physician-assisted suicide) is less responsible in moral and professional aspects. Active euthanasia is performed by actions aimed to interrupt the patients life by giving him/her a certain drug. The active form has the following variants: 1. Euthanasia, performed out of sympathy when the patients condition is rather serious. It can be applied without the request and consent of the patient. 2. Voluntary euthanasia. This variant requires not only the consent of the patient, but also his/her request for relief from suffering. 3. Suicide with the help a doctor. The doctor gives the patient the drug, which the patients takes him/herself. It is of interest to estimate the passive and active euthanasia from the philosophical point of view. In particular, the American philosopher, James Rachels states: An important distinction between active and passive euthanasia is that in passive euthanasia, the doctor does nothing, and the patient dies because any disease already struck him. In active euthanasia the doctor does something that leads to the death of the patient, i.e., he kills the patient. The doctor who gives the cancer patient a lethal injection, becomes the cause of his patient’s death. However, if he will simply stop the treatment, cancer will became the cause of death is (79). The Practice of Euthanasia in the World The first country in the world which legalized active euthanasia was the Netherlands (Ardelt 428). In the Netherlands, euthanasia can be applied to patients aged at least 12 years and ​​only at the request of the patient, if it is proved that his/her suffering is unbearable, the disease is incurable, and doctors cannot help anything. In this case the law requires the re-consent of the patient. The decision should be made by at least two doctors, and in case of doubt, it will be considered by the Prosecutor. Doctors also fall under the control of special committees of experts in medicine, law, and ethics. Belgium became the second country in the world where the government legalized medical assistance to terminally ill death. The relevant law came into force in September 2002 (Almagor-Cohen 192). According to the law, a doctor might have right to apply euthanasia in case if his/her patient is experiencing constant and unbearable physical or mental suffering as a result of accidental illness or an incurable disease, because of which he/she is in a desperate medical situation. The doctor must be sure that his patient is an adult capable of making his/her own decisions. The request for euthanasia must be formulated voluntarily, deliberately and repeatedly. Luxembourg became the third EU country to legalize euthanasia. The relevant law came into force in March 2009. In the United States, a strong supporter of the legalization of euthanasia was Jack Kevorkian, better known by the nickname Dr. Death. Kevorkian came to believe in the ethics of euthanasia in cases where the patient can no longer be assisted, and his sufferings are unbearable. In 1989, he designed a "suicide machine" or “thanatron” that was “a homemade machine designed to assist in the termination of a patient’s life through a series of lethal injections” (Orlando 7). The first patient, who suffered from Alzheimers disease, committed suicide with the help of this machine on 4 June 1990. Kevorkian’s ideas were protested by medical community and the government of the United States. In 1991, he was deprived of his medical license and arrested. In the United States, euthanasia is officially permitted in the states of Oregon and Washington. In Oregon, euthanasia was legalized in 1998, in Washington - in 2009. In both cases, the decision was made in referendums. Terminally ill patients are prescribed poison that they have to take on their own. Attempts to adopt similar laws in other 13 states have failed. In Oregon and Washington, there are strict requirements for wishing to resort to euthanasia. At least two independent physicians must confirm that these people are terminally ill. Patients wishing to die need to declare their wish to die in the presence of witnesses. After 15 days, the request can be repeated. Physicians have an obligation to inform such patients about all possible alternatives. In recent years in the United States there have been attempts to introduce euthanasia into the framework of the federal legislation. In 2001, the Attorney General of the United States signed the directive, which established that the doctors who help terminally ill people commit suicide, will be prosecuted in the context of the law, which regulates the handling of poisons. In 2006, the United States Supreme Court has recognized this directive illegal. In Switzerland, euthanasia is prohibited, but the doctor can help hopelessly ill person to die. He may give the patient a drug that he/she should introduce him/herself. The existing Swiss legislation on euthanasia is rather simple and liberal. Euthanasia is allowed is the doctors do not have any personal interest in the death of the individual and do not receive material profit from it. The absence of a more detailed and strict law on euthanasia is usually attributed to the fact that in Switzerland there is an idea the decision to leave a life is a personal matter, and the state should not interfere with it. Various countries (Germany, Israel, France, Sweden) allow passive euthanasia. This type of euthanasia was first legalized by ​​the Supreme Court of California (Schicktanz 364). The same law according was adopted in in France. In December 2006, Israel adopted a law allowing terminally ill people to refuse artificial life support. The law is applied to patients who, even with proper treatment are not able to live more than six months. Such patients have the right to forbid their doctors to take perform actions aimed at medical assistance (electroshock, surgical intervention, etc.). If the patient is not able to express his/her will, the decision can be made based on his/her testament or relatives’ desire. In April 2010, the Ministry of Health in Sweden stated that patients in Sweden may require disconnection from life-support machines. In June 2010, an appeals court in Germany ruled that the disconnection of devices that support the life of the dying patients, with their personal agreement, is not a criminal offense. Moral Aspects of Euthanasia Considering the physical side of death, one might see that it is the termination of life of a living organism. Despite the fact that each person lives his/her own life, he/she is a mortal being and death is an inevitable fact. However, no one knows when it will happen. Even those who try to commit suicide cannot be completely sure that the outcome will be fatal. No one can guarantee that a suicide attempt will not end with severe. One can find a lot of cases and historical facts, when a man remained alive even after taking a large dose of a potent poison. It makes sense to consider a doctor’s calling. According to medical ethics, the doctor’s mission is to treat diseases or prevent them and do everything possible to prolong the patients life. Many researchers believe that euthanasia violates the medical principles as well as the Hippocratic Oath (Orlando 19). However, the present time makes its own rules. Life expectancy has increased, as well as the number of people who are experiencing severe and painful condition, to which their ancestors simply did not survive. In this case, an example with oncology can be used. Currently, thanks to treatment, people stay alive for a long time while the pain might become unbearable. For them, death is a blessing since it frees them from the torment. In general, one can identify the set of arguments for and against euthanasia. Arguments for Euthanasia Each person has the right to decide whether to continue sufferings or get rid of them. In this case, the emphasis is on the principle of patients’ autonomy: each person may chose the way of medical treatment and the need for its applying. In other words, “the Argument from Autonomy, briefly, claims that rational people have a fundamental right to the disposition of their bodies, and that, given the differing perceptions of “good” in a pluralistic society, they ought to have the freedom as patients to choose the timing and manner of death.” (Fernandes 16). However, those who do not support euthanasia, may say, "You know, there is also a physician autonomy. Doctors are not required to go against their principles. " Each person has the right to die. Such people free both themselves from suffering and their loved ones from the heavy moral and physical load. Euthanasia is an act of mercy. People who are in favor of euthanasia are not bad people, predators, or murderers. Euthanasia is the result of medical responsibility. One might say: "You, doctors, created the problem, and you decide how to solve it. You made ​​it so that people now live longer and live up to each of these diseases, which previously did not know. So you also need to help them get of the sufferings caused by diseases." Euthanasia is strictly controlled in order to prevent doctors’ and relatives’ frauds. Arguments against Euthanasia Euthanasia is contrary to the religious beliefs and moral foundations of society. Given that euthanasia is a kind of suicide, religion considers euthanasia as a sin which violates the principle of understanding life as a gift of God (Hui). In some countries, there is no way to strictly control the process and thus avoid the misuse (Sanson et al. 9). A doctor can make a mistake in the diagnosis, while the man may have had a chance to recover. A man tormented by severe pain is not always able assess his/her condition and prospects of treatment correctly. Euthanasia can be used for financial gain. Conclusion The issue of euthanasia remains controversial. There are a lot of opponents and supporters of euthanasia and each side has its own well-founded conclusions. The supporters of euthanasia make the emphasis on the fact that euthanasia is a way to facilitate the patients unbearable suffering caused as a result of serious illness or accident. Euthanasia is regarded as a humane way in cases where treatment may not help the patient. The arguments against euthanasia are based mainly on religious positions, as well as doubts that euthanasia is always can be under control. The opponents of euthanasia are convinced that it is practically impossible to prevent all cases of frauds in this matter that can cause increase in the number of murders. Despite the ambiguity of euthanasia, many countries have legalized either the active or passive types of euthanasia. This suggests that, despite its shortcomings, euthanasia is able to offer the most important advantage - namely, the possibility of relieving patients from the unbearable pain. Given that currently medicine is not able to provide an effective treatment for all diseases euthanasia has a special meaning. Works Cited Almagor-Cohen, Raphael. “Euthanasia Policy and Practice in Belgium: Critical Observations and Suggestions for Improvement.” Issues in Law & Medicine 24. 3 (2009): 187-218. Print. Ardelt, Monica. “Physician-Assisted Death.” Handbook of Death and Dying, Volume One: The Presence of Death. Ed. Clifton D. Bryant. Thousand Oaks, CA: Sage. 2003. 424-434. Print. “Euthanasia.” CARE. n.d. Web. 3 Sept. 2014. Fernandes, Ashley K. Euthanasia, Assisted Suicide, and the Philosophical Anthropology of Karol Wojtyla. Diss. Georgetown University, 2008. Print Hui, Edwin C. “Euthanasia: Secular and Christian Perspectives.” University of Hong Kong. n.d. Web. 2 Sept. 2014. Hulkower, Raphael. “The History of the Hippocratic Oath: Outdated, Inauthentic, and Yet Still Relevant.” The Einstein Journal of Biology and Medicine 2010: 41-44. Print. McClenaghan, Liz “Autonomy is the ruining principle of medical ethics.” Nucleus. 2011: 10-12. Print. Orlando, Stephen. “An Argument for the Legalization of Active Euthanasia.” Annual Celebration of Student Scholarship and Creativity. 2010: 1-10. Print. Pridgeon, J. Lucy. “Euthanasia Legislation in the European Union: Is a Universal Law Possible?” Hanse Law Review 2.1 (2006): 45-60. Print. Rachels, James. “Active and Passive Euthanasia.” The New England Journal of Medicine 292 (1975): 78-80. Print. Sanson Ann, et al. “Psychological Perspectives on Euthanasia and the Terminally Ill.” The Australian Psychological Society Ltd. 2008. Web. 2 Sept. 2014. Schicktanz, Silke, Aviad Raz, and Carmel Shalev. “The Cultural Context of Patient’s Autonomy and Doctor’s Duty: Passive Euthanasia and Advance Directives in Germany and Israel.” Medical Health Care and Philosophy 13 (2010):363–369. Print. Varelius, Jukka. “The value of autonomy in medical ethics.” Medicine, Health Care and Philosophy 9 (2006): 377–388. Print. Read More