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The Question of Euthanasia Is It Ethical

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The Question of Euthanasia Is It Ethical essay

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The applied ethical issue of euthanasia, or mercy killing, concerns whetherit is morally permissible for a third party, such as a physician, to end the life of a terminally ill patient who is in intense pain. The euthanasia controversy is part of a larger issue concerning the right to die. Staunch defenders of personal liberty argue that all of us are morally entitled to end our lives when we see fit.

Thus, according to these people, suicide is in principle morally permissible. For health care workers, the issue of the right to die is most prominent when a patient in their care is terminally ill, is in intense pain, and  voluntarily chooses to end his life to escape prolonged suffering. In these cases, there are several theoretical options open to the health care worker. First, the worker can ignore the patient’s request and care can continue as usual.

Second, the worker can discontinue providing life- sustaining treatment to the patient, and thus allow him to die more quickly. This option is called passive euthanasia since it brings on death through nonintervention. Third, the health care worker can provide the patient with the means of taking his own life, such as a lethal dose of a drug. This practice is called assisted suicide, since it is the patient, and not technically the health care worker, who administers the drug.

Finally, the health care worker can take active measures to end the patient’s life, such as by directly administering a lethal dose of a drug. This practice is called active euthanasia since the health care worker’s action is the direct cause of the patient’s death. Active euthanasia is the most controversial of the four options and is currently illegal in the United States. However, several rights to die organizations are lobbying for the laws against active euthanasia to change. Two additional concepts are relevant to the discussion of euthanasia. First, voluntary euthanasia refers to mercy killing that takes place with the explicit and voluntary consent of the patient, either verbally or in a written document such as a living will.

Second, nonvoluntary euthanasia refers to the mercy killing of a patient who is unconscious, comatose, or otherwise unable to explicitly make his intentions known. In these cases it is often family members who make the request. It is important not to confuse nonvoluntary mercy killing with involuntary mercy killing. The latter would be done against the wishes of the patient and would clearly count as murder. Like the moral issues surrounding suicide, the problem of euthanasia has a long history of philosophical discussion. On the whole, ancient Greek thinkers seem to have favored euthanasia, even though they opposed suicide.

An exception is Hippocrates (460-370 BCE), the ancient Greek physician, who in his famous oath states that “I will not prescribe a deadly drug to please someone, nor give advice that may cause his death.” The entire oath is presented below, which places emphasis on the value of preserving life and in putting the good of patients above the private interests of physicians. These two aspects of the oath make it an important creed for many heath care workers today. In medieval times, Christian, Jewish, and Muslim philosophers opposed active euthanasia, although the Christian Church has always accepted passive euthanasia. During the Renaissance, English humanist Thomas More (1478-1535) defended Euthanasia in book Utopia (1516). More describes in idealic terms the function of hospitals. Hospital workers watch after patients with tender care and do everything in their power to cure ills.

However, when a patient has a torturous and incurable illness, the patient has the option to die, either through starvation or opium. In New Atlantis (1627), British philosopher Francis Bacon (1561-1626) writes that physicians are “not only to restore the health, but to mitigate pain and dolours; and not only when such mitigation may conduce to recovery, but when it may serve to make a fair and easy passage.” Types of Euthanasia Apart from the above classifications three types of euthanasia may be identified, depending upon the sentience of the individual. Voluntary euthanasia This is the truest and fullest form of euthanasia wherein the individual requests euthanasia – either during illness or before, if complete incapacitation is expected (coma would be an example). Non-Voluntary euthanasia Where an individual lacks sentience (in a coma, for example) and hence cannot decide, or distinguish, between life and death. Famously notable as “turning off life-support”, it is often done when resusitation is not expected, or after severe brain damage. Involuntary euthanasia Where an individual may distinguish between life and death – and may fully realise the difference between them, but who death is imposed upon.

If, for example, a man is going to experience severe agony and does not consent to death, euthanasia may be imposed upon him. In Nazi Germany the term “euthanasia” (Euthanasie) referred to the systematic killing of deformed children and mentally ill adults under the T- 4 Euthanasia Program. This has tainted the word in German-speaking countries; the alternate term is “Sterbehilfe”, which means “help to die.” Arguments for and against euthanasia Proponents of euthanasia state that people should be allowed to decide that they do not want to live any more, and that terminally ill patients are respected more by having their suffering end than by being kept alive against their will. Philosopher Peter Singer has been one of the most outspoken proponents of euthanasia, arguing from a utilitarian philosophical point of view. Arguments from opponents of euthanasia can be divided in two main categories: religious and prudential.

Many religious people, primarily Christians, object that it is not loving to kill someone, and that pain medications are good enough that suffering is preventable if doctors have the will. Many religions also regard one’s life as from God and that either it is His (not yours), or throwing it away insults Him. The second type of argument against euthanasia is that it is not prudent to advocate it; that eventually we all may be suffering, and if we think ahead, we may think it better if the doctors on whom we depend are not tempted to perform euthanasia. If euthanasia were to be allowed, it is feared by some, doctors might press people into euthanasia to reduce medical costs, or because their family wants them to die. It should be noted that doctors routinely and legally provide medical treatment to the terminally ill involving the use of large quantities of pain-killing drugs, primarily to relieve the patient’s pain, but in doses that may suppress bodily functions and thus shorten the life of the patient.

However, as the goal of the treatment is the relief of suffering rather than the shortening of life (even if that is a known consequence) doctors who oppose euthanasia argue vigorously that such treatment is not euthanasia. It should be noted that in about a quarter even of the medically supervised euthanasias there are ‘complications’, like respiratory paralysis that make the death anything but pleasant. Legislation and national political movements Australia Euthanasia was legalised in Australia’s Northern Territory, by the Rights of the Terminally Ill Act 1995. This law was soon however made ineffective by the an amendment by the Commonwealth government to the Northern Territory (Self-Government) Act 1978. (The powers of the Northern Territory legislature, unlike those of the State legislatures, are not guaranteed by the Australian Constitution.) Three people had already been legally euthanasied, however, before the Commonwealth government made this amendment. Belgium After an extensive discussion the Belgian parliament legalised euthanasia in late September 2002.

The new legislation, however, institutes a complicated process, which has been criticized as an attempt to establish a bureaucracy of death. Nevertheless, euthanasia is now legal and its proponents in the country hope that it will stop many illegal practises (it is said that several thousand illegal acts of euthanasia have been carried out in Belgium each year). The Netherlands In The Netherlands the Reviewing Termination of Life on Request and Assisted Suicide Act has taken effect from April 1, 2002. This legislation has wide support among the liberal Dutch. According to the new legislation, euthanasia and assistance with suicide will continue to be criminal offences, except if all conditions are fulfilled, and it is carried out by a physician who follows the correct procedures.

The law states that euthanasia is only allowed when the patient has asked repeatedly, when the patient’s suffering is unbearable and desperate, and when the doctor has prior to the act consulted a colleague. The doctor must also report the cause of death to the municipal coroner in accordance with the relevant provisions of the Burial and Cremation Act. A regional review committee assesses whether a case of termination of life on request or assisted suicide complies with the due care criteria. Depending on its findings, the case will either be closed or brought to the attention of the Public Prosecutor. Finally, the legislation offers an explicit recognition of the validity of a written declaration of will of the patient regarding euthanasia. Such declarations can be used when a patient is in coma or otherwise unable to state whether they want euthanasia or not.

From the time that euthanasia first came to be widely practiced in the Netherlands, it was formally subject to review by boards of doctors in each hospital. The law as created basically made official what had already become unofficial law by judgments in the courts. The Netherlands has an excellent health care system and one of the world’s highest expected life lengths. The right to euthanasia is supported by a majority of the traditionally libertarian Dutch people.

United States In the United States, the most common form of euthanasia is withholding tube-feeding to elderly and incapacitated patients. This is generally considered an abuse when the patient might recover. These patients die protracted deaths by dehydration. However, it is so common in some areas that the family must actively prevent it, or it will occur. Contrary to the rest of the United States, Oregon residents have twice voted for the legalization of assisted suicide.

As of 2002, it is estimated that nearly 100 terminally ill patients have committed doctor assisted suicide since the law went into effect in 1997. It is difficult to determine accurate figures, since doctors are not required by law to report when they have granted the patient’s request. Oregon’s law has been attacked by various organizations, and federal government parties that support those organizations, ever since it was first enacted. (See Oregon Ballot Measure 16 (1994), Oregon Ballot Measure 51 (1997).) Euthanasia and the Law A severely handicapped or terminally ill person should have the right to choose to live or die.

The right to live; the right to choose to live or die should not only be a right allocated for bodied individuals of sound mind but for all human beings. Euthanasia is a controversial issue which encompasses the morals, values and beliefs of our society. Euthanasia, literally defined means “good death”. There are two types of euthanasia, active and passive. Active euthanasia is the intentional killing of a person by medical personnel either by a lethal injection or by denying ordinary means of survival.

The act of euthanasia called “passive euthanasia”, is committed by denying or withholding ordinary medical care to a patient. Currently, under Canadian law euthanasia is prohibited. In Holland euthanasia has been accepted, in principle for terminally- ill patients, on request. It comes to be seen as practice for those whose “quality of life” is judged by themselves as worthless. Even though euthanasia is not yet legal in Holland, it is legally tolerated.

Doctors are rarely prosecuted and even more rarely convicted. If euthanasia were to be decriminalized in Canada certain restrictions would have to be put into place, to ensure that a patient’s rights are not infringed upon. A living will should be made when the patient is of lucid mind. Also, a council should be selected and outlined in the living will. The council should be chosen by the patient, when the patient is of sound mind and is able to make decisions.

The council might consist of the patient’s family, doctor or any other he or she feels have the same view or perception of life. Presently in Canada a living will is not a legally binding document. A living will is a document prepared and sighed in advance of illness, in which a person may specify which treatment or care is to be withheld or withdrawn from him or her in certain situations. It is extremely general, trying to cover a wide range of accidents or illnesses and possible treatments. Living wills are created to protect the individual who is unable to participate in decisions regarding their medical care.

In Canada, even with a living will in many cases any decisions on the removal of medical care must be passed through the court system. This system must be amended. The living will should be made a legally binding document. In the United States, living wills have become legally binding documents, in most states.

The recognition of the living will as a legally binding document is one of the first necessary step required in the legalization of euthanasia ant the recognition of ones right to their own life. Every person has the right to choose to live or die. This statement is a reality for most individuals, but for many terminally ill or permanently disabled patients this right cannot be exercised. Many patients lose control of the function of their arms and or legs and become completed dependent.

The question then becomes, “When does ones quality of life reach such a low level that life then becomes not worth living?”. A person, at any time, should be able to make this decision. Under the existing law Canadians are not granted this right, the right to their own life. An example of the absence of the “right to die”, can be seen through the examination of a case from 1990. A woman named Michelle Frenette wanted to be disconnected from the respirator which was keeping her alive.

Her doctors refused to disconnect her from the respirator without a court order. Michelle’s family could not afford to go to court, and legal aid does not provide assistance in such cases. So, Michelle lay there, for two years until her eventual death. She should have been able to end her life, without having to obtain a court order, when she felt that her quality of life had been reduced to such a level that it was no longer worth living.

In this particular case the law prevented and discriminated against Michelle and her inherent right to freedom of choice. When a person decides wheth… Euthanasia In Canada There is considerable debate today, both among the public and the politicians, about euthanasia. While the government is hesitatant to venture into morals and ethics, it appears that euthanasia is gaining more press coverage, in light of the Sue Rodriguez and Robert Latimer cases.

Indeed, the issue is difficult to resolve, and despite few advances, the government has enacted penalties in the Criminal Code to punish assisted suicide. Without reservation, euthanasia is illegal in Canada. An increasing number of people are turning to doctor-assisted suicide. As a result of a more liberal political arena, more people are agreeing that some form of euthanasia must be acceptable in specific circumstances.

Politicians, and the courts, claim that the country is not yet ready for such a climate. The characterization of pro-euthanasia advocates by their counterparts as selfish, taking the easy way out, diserespectful of life, and challenging human dignity is misconstrued. Pro-euthanasia groups advocate self-dignity, personal choice, economic well-being, happiness, family support, and individual rights. The word euthanasia simply means good death, but has come to mean causing death with intent, whether by doing something (commission), or by omitting something(omission). Euphemisms of the pro-euthanasia movement, include “right to die”, and “death with dignity”.

The term “passive euthanasia” is often applied to the withdrawal of useless treatment that is onlyprolonging the dying of a person. This needs to be differentiated from withdrawing of something that is actually keeping them alive, the withdrawl of which actually causes their death. It has been pointed out that the pro-life lobby will be split and discredited if there is an insistence by some that all technological means must be used whenever possible to prolong life. No ethical doctor insists on the use of burdensome, ineffective of futile measure, commonly called ‘disproportionate’, when refused by the patient or family.

Doctors must necessarily in all patients discontinue curative or therapeutic efforts at the time when death is imminent and inevitable. Patients may request all measures to be attempted if they desire but it cannot be demanded that life always be prolonged as much as possible, without fuelling the “right to die” movement. Allowing death to occur when the patient specifically refuses further therapy is to acknowledge the natural limit of autonomy. This does not extend to refusal of basic care and does not mean the withdrawal of comfort measures.

In 1991, the BC Royal Commission concluded that “the person who is dying should have the right to determine the form and time of death…There is a right to commit suicide, and a physician should be allowed to assist a person who chooses to exercise that right.” The Right to Die Society in Canada, based in Victoria, “Affirms the right of any mature individual who is chroniclally or terminally ill to choose the time, place, and means of his or her death. Suicide and euthanasia are a legitimate response to the declining quality of life which many individuals experience as they growq older, or whicfh they suffer as a result of accidents or congential disabilities.” This society actively lobbies politically for active euthanasia, and provides counselling to every member who wishes to know about assistance-in-dying. Similarly, the Canadian Medical Association has run a series of articles on euthanasia. Eike Kluge, the former CMA ethicist, is outspokenly pro-euthanasia.

A recent article published as a discussion article stated, “What a strange world we live in, that we are kinder to our animals than we are to human beings.” His colleague, Ethics Committee Chairman, Dr. Arthur Parsons, asked “Who is going to get into the lifeboat? Is it better to keep a severely retarded person alive, or spend your tight resources on bypass surgery for a father of four?” This brings up two important issues, the first, that euthanasia is still used for animals, despite being called “putting to sleep”, and secondly, the issue of money and the costliness of keeping a person alive. Research shows that the most expensive term of care for a patient is the final six months prior to their deaths. The financial burden for a seemingly hopeless case is unbearable, not just for the family, but for the patient as well.

The patient, in their last few days, should not have to worry about being a financial burden, but the truth is, healthcare is expensive. As Dr. Parsons argued, it may be better to supply those crucial healthcare dollars to the father of four who requires surgery because the chances of success are phenomenally better than the comatose or terminally ill patient. Current euthanasia advocates have erealized that active euthanasia is too difficult to push through Parliament.

They have elected to go through assisted suicide which opens the door to active euthanasia. Svend Robinson has proposed Bill C385 which would amend the Criminal Code to allow doctors to assist in the suicide of a patient who is terminal and requests this. In 1972, suicide was decriminalized in Canada, keeping with the understanding that suicide is not a rational act and these people need help, not incarceration if the suicide attempt was unsuccessful. The BC Commission into health care costs stated that suicide is a right and that physicians should be empowered to assist patients who choose to exercise that right.

As it stands now, Section 241 of the Criminal Code states that it is illegal to counsel or assist someone to commit suicide. Section 14 presently reads “no person is entitled to consent to have death inflicted on him”. These laws exist to protect the vulnerable, and people open to coercion. It also recognizes that suicidee is not a rational act, being an act of desperation and depression out of hopelessness and helplessness. Because something is not illegal does not make it a right. In other words, your right to suicide is my obligation to assist your suicide.

This obligation clearly does not exist as Justice Melvin found in the Sue Rodriguez case. Sue Rodriguez, a 42 year old woman who has Amyotrophic Lateral Sclerosis, commonly known as Lou Gehrig’s disease, appealed to the Supreme Court of Canada to strike down the section of the Criminal Code that makes aiding suicide illegal. A graphic article published in The Globe and Mail, September 1992, written by John Hofsess, the director of the right to Die Society, describes her plight with this progressively paralysing disease as “condemned to die”. Her future is described as a “helpless, drooling, physically atrophied captive of this disease, dependent on other people and machines for an ever attenuated form of mere biological exsistence”. Her lawyers argued that Section 241 of the Criminal Code, which makes it an offence to assist aqnyone to commit suicide, violates Section 7 of the Charter of Rights, which guaratntees liberty and security of the person. The Justices stressed the significant difference between palliative care nad physician-assisted suicide, saying Rodriguez failed to show her right to fundamental justice is infringed by the existing criminal law.

University of Manitoba law professor Barney Sneiderman says charges are rarely laid because the Crown recognizes that juries generally sympathize with doctors who end the agony of dying patients. Some doctors fear that even providing a patient with the means to commit suicide, for example, prescribing enough pills that might be hoarded and used for an overdose, would constitute aiding or abetting the action of euthanasia. But Sneiderman argues that the courts would likely requrie prosectors to prove intent. A doctor might suspect a patient was harding pills, but because the ipills were not prescribed for thepurpose of aiding a suicide, the doctor would probably have a good defence. For illustration, Sneiderman says an Edmonton doctor was charged under Section 217, saying a person has a legal duty to perform an act if not doing it would endanger life, and Section 219, which defines criminal negligence and includes both acts and omissions that wou Justices Proudfoot and Hollinrake, both agreed with Justice McEarchern, the sole dissenter, that the legality of physician- assisted suicide is a matter for Parliament to decide. Euthanasia, practice of mercifully ending a person’s life in order to release the person from an incurable disease, intolerable suffering, or undignified death.

The word euthanasia derives from the Greek for “good death” and originally referred to intentional mercy killing. When medical advances made prolonging the lives of dying or comatose patients possible, the term euthanasia was also applied to a lack of action to prevent death. Active euthanasia involves painlessly putting individuals to death for merciful reasons, as when a doctor administers a lethal dose of medication to a patient. Passive euthanasia involves not doing something to prevent death, as when doctors refrain from using an artificial respirator to keep alive a terminally ill patient.

In voluntary euthanasia, a person asks to die (by either active or passive euthanasia). Nonvoluntary euthanasia refers to ending the life of a person who is not mentally competent to make an informed request to die, such as a comatose patient. Euthanasia differs from assisted suicide, in which a patient voluntarily brings about his or her own death with the assistance of another person, typically a physician. In this case, the act is a suicide (intentional self- inflicted death), because the patient actually causes his or her own death.

Euthanasia has been accepted in some forms by various groups or societies throughout history. In ancient Greece and Rome helping others die or putting them to death was considered permissible in some situations. For example, in the Greek city of Sparta newborns with severe birth defects were put to death. Voluntary euthanasia for the elderly was an approved custom in several ancient societies. However, as Christianity developed and grew powerful in the West, euthanasia became morally and ethically abhorrent and was viewed as a violation of God’s gift of life. Today most branches of Christianity, Judaism, and Islam condemn active euthanasia, although some permit restricted forms of passive euthanasia.

Following traditional religious principles, Western laws have generally treated the act of assisting someone in dying as a form of punishable homicide (unlawful killing). However, in modern times laws have become more secular. Those who wish to legalize euthanasia have argued that, under principles of individual liberty (such as those expressed in the Constitution of the United States), individuals have a legal right to die as they choose. Most countries (including the United States), however, have not fully adopted this position and retain restrictions on euthanasia. The first organizations to promote the legalization of voluntary euthanasia in the United States and Great Britain formed in the 1930s. For several decades these organizations remained small and had little impact.

However, in the late 1970s the pro-euthanasia movement gained significant momentum after a highly publicized incident in the United States. In 1975 a 21-year- old woman named Karen Ann Quinlan suffered a respiratory arrest that resulted in severe and irreversible brain damage and left her in a coma. Several months later, after doctors informed them that their daughter’s recovery was extremely unlikely, Quinlan’s parents requested that artificial means of life support be removed. The hospital refused this request.

After a lengthy legal battle, in 1976 the Quinlans obtained a court order allowing them to remove the artificial respirator that was thought to be keeping their daughter alive. The New Jersey Supreme Court ruled that the Quinlans could disconnect the device so that the patient could “die with dignity.” This decision spawned increased discussion of the scope of patients’ rights to control their death. (Although the respirator was removed in 1976, Quinlan began to breathe on her own. She lived until 1985 without ever regaining consciousness.) In the early 1990s the decision of Nancy B.

v. Hotel-Dieu de Quebec in Canada played a similar role in promoting public awareness of the issues surrounding euthanasia. In this case, a young woman paralyzed as a result of the rare disease known as Guillain-Barr syndrome wished to have the artificial breathing mechanism that kept her alive disconnected. Concluding that such refusal of treatment was permissible, in January 1992 a Qubec superior court judge authorized the woman’s physician to remove the respirator. |III||Laws| |Print Preview of | |Section| As laws have evolved from their traditional religious underpinnings, certain forms of euthanasia have been legally accepted.

In general, laws attempt to draw a line between passive euthanasia (generally associated with allowing a person to die) and active euthanasia (generally associated with killing a person). While laws commonly permit passive euthanasia, active euthanasia is typically prohibited. |A| |In the United States| | | |and Canada | Laws in the United States and Canada maintain the distinction between passive and active euthanasia. While active euthanasia is prohibited, courts in both countries have ruled that physicians should not be legally punished if they withhold or withdraw a life-sustaining treatment at the request of a patient or the patient’s authorized representative. These decisions are based on increasing acceptance of the doctrine that patients possess a right to refuse treatment.

Until the late 1970s, whether or not patients possessed a legal right of refusal was highly disputed. One factor that may have contributed to growing acceptance of this right is the ability to keep individuals alive for long periods of time-even when they are permanently unconscious or severely brain-damaged. Proponents of legalized euthanasia believe that prolonging life through the use of modern technological advances, such as respirators and kidney machines, may cause unwarranted suffering to the patient and the family. As technology has advanced, the legal rights of the patient to forgo such technological intervention have expanded. Every U.S.

state has adopted laws that authorize legally competent individuals to make advanced directives, often referred to as living wills. Such documents allow individuals to control some features of the time and manner of their deaths. In particular, these directives empower and instruct doctors to withhold life-support systems if the individuals become terminally ill. Furthermore, the federal Patient Self-Determination Act, which became effective in 1991, requires federally certified health-care facilities to notify competent adult patients of their right to accept or refuse medical treatment.

The facilities must also inform such patients of their rights under the applicable state law to formulate an advanced directive. Patients in Canada have similar rights to refuse life-sustaining treatments and formulate advanced directives. Only one U.S. state, Oregon, has enacted a law allowing physicians to actively assist patients who wish to end their lives.

However, Oregon’s law concerns assisted suicide rather than active euthanasia. It authorizes physicians to prescribe lethal amounts of medication that patients then administer themselves. In response to modern medical technology, physicians and lawmakers are slowly developing new professional and legal definitions of death. Additionally, experts are formulating rules to implement these definitions in clinical situations-for example, when procuring organs for transplantation. The majority of states have accepted a definition of brain death-the point when certain parts of the brain cease to function-as the time when it is legal to turn off a patient’s life-support system, with permission from the family.

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