Tuesday, March 23, 2010

Euthanasia Essay

Essay on Euthanasia

The answer to this question I feel must be entirely based on opinion. The issue of Euthanasia is itself highly controversial, and has become an increasingly contentious issue in contemporary society. There are so many conflicting views in existence that there can be no ultimate right or wrong answer. In this essay I will be looking at the differing opinions of those for and against, but will also offer my own thoughts and understanding of the difficult subject.

To this day the European Commission and Court of Human Rights, have not considered the question of Euthanasia, Voluntary or involuntary. In fact Euthanasia is not a word known to English Law. It is a Greek word derived from those for "good" or "Well" and "Death". According to the Oxford English Dictionary, it was first used in English to simply mean a quiet and easy death, then the means of procuring this, and then the action of inducing it. The last meaning, being perhaps the most common in use today.

As law stands at the moment, the patient and/or the immediate family can stop the use of extraordinary means to prolong the life of someone when biological death is imminent. The American Medical Association (AMA) policy statement, states that euthanasia is "intentional termination of the life of one human being by another" but denies that the cessation of treatment is "intentional termination of life". "It is permissible at least in some cases, to withhold treatment and allow a patient to die, but it is never to take any direct action designed to kill the patient" (James Rachels: 1990: 1). This is the view accepted by most doctors and endorsed by the House of Delegates of the American Medical Association (AMA) in 1973.

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This is what is legally justified in terms of "letting die", however, there are many different types of, or should I say circumstances in which the act of euthanasia may occur. I shall take this first part of the essay to describe the various cases. It is these types of killings that are held up for moral questioning.

Euthanasia is often referred to in the media as Mercy killing, this is the term given to the intentional termination of the life of one human being by another. However, euthanasia can then be split into categories of active, passive, voluntary and involuntary.

Voluntary euthanasia is essentially assisted suicide, where the patient asks a doctor to help them die. Non-voluntary euthanasia, is along the same lines as voluntary euthanasia, however in this case the patient cannot be asked for consent. For example if treatment was withdrawn from a patient in a deep coma, or persistant vegetative state, but for their own benefit.

Involuntary euthanasia on the other hand occurs in the circumstance where the patient is killed "supposedly" for their sake, but without having given their consent.

Active euthanasia is when somebody purposely brings about the death of a patient, so that for example the patient would die of say a lethal injection rather than the cancer that ailes them. Passive Euthanasia however, would be an example of where the actual illness such as the cancer is the eventual cause of death, but this death is made possible by the conscious cessation of treatment from doctors, which if continued could have lengthened the patients life. So while passive euthanasia is when a doctor does nothing to bring about the patient's death and the patient dies of whatever ills already affect them, active euthanasia is when the doctor does something to bring about the patients death i.e. giving a lethal injection to a cancer patient. As it stands however active euthanasia is clearly forbidden by the law.

In favour of euthanasia, is the view, held by many in fact, that if a patient in terrible agony is going to die anyway, the continued use of treatment would only serve to needlessly prolong their suffering. In opposition of passive euthanasia is the argument that simply withholding treatment would mean more pain for the patient in the long term as it would then take them longer to die. It is therefore proposed that a lethal injection or immediate death of some means would be a more humane method. Where being allowed to die is relatively slow and painful, having oneТs life terminated would be quick and painless. It is this humanitarian impulse which prompts some to decide not to prolong life in the first place.

There are many arguments as to whether euthanasia is justifiable in any of these circumstances, but they all mainly refer to terminally ill, and dying patients. The main justification of any is to relieve the pain of the powerless and dying. In my reading however, I discovered a significant amount of writing on another justification for the use of euthanasia, on people who aren't in fact dying or even necessarily in pain. There are in fact those who view euthanasia as a means of unburdening society of all those considered to be unfit. As far back as in ancient Sparta not just those who were regarded as incurable, or physically unfit, but all who were deemed useless to the state were killed, or permitted to die. (McFadden: 1962: 208). This idea is not by any means restricted to the thoughts of those in ancient Sparta, however, it is in actual fact a view that has been harboured throughout the twentieth century.

Doctor Foster Kennedy in 1939, advocated the legalisation of euthanasia, so that "we might be allowed legally to grant a dreamless and unending sleep" and to "relieve of living the young person or child who should never have lived at allТ. It is this sort of view which, I can not help but find morally unjustifiable. Kennedy is referring to those who are born with what he calls Сa hopelessly damaged brainТ or "defective children". Kennedy feels justified to judge the quality of life available to these individuals and seems to want to "dispose of" children born with mental and physical handicaps and disabilities from society. If indeed "mercy killings" of those Kennedy suggests were to be carried out, the benefit would be entirely on behalf of the parents and guardians who feel burdened by their child, and not, as I believe it should be, at the consent of, and to the benefit of the person whose life is being considered. Kennedy even recommends that action be considered up until as old of the ages of five and above. At which point he believes that should someone "decide that the defective has no future nor hope of one" it is a merciful and kindly thing to relieve that defective - often tortured and convulsed, grotesque and absurd, useless and foolish, and utterly undesirable - of the agony of living" (American Journal of Psychiatry, 1942-1943, Vol. 99, p13). This is however a somewhat extreme view and the general consensus on euthanasia is that it is used for the relief from a painful and unbearable existence.

Contemporary medicine is typically obliged to expand the boundaries of life, and the Hippocratic oath in itself is dedicated to the preservation of life. However, perhaps It shouldn't always be our prime motive to keep people alive. In doing so we may actually be inflicting and prolonging unnecessary pain, and denying good quality of life.

Killing has always been portrayed as evil, particularly in the media. We therefore instantly regard it as wrong. However, when it comes to debates about euthanasia, death can be seen as something positive, a sort of release from a pain filled life. Advances in technology and medicine mean that it is no longer necessary to die in pain. In fact death can be instant and painless.

This proves to be an increasingly popular view, as the number of those in favour of Euthanasia has risen in the last decade, as the subject has been brought into the public consciousness. It seems many people believe that we, should have the right to retain control over our lives, including the right to live or die. It is also seen to be important that we are able to retain our personal dignity to the very end of our lives. The Voluntary Euthanasia Society (VES), founded in Britain in 1935, found that one of the most cited reasons for joining the society was to be able to control ones self in the circumstances of one's own death. This sort of "Humanitarian" view is today shared by increasingly more doctors and organisations, who clamour for the legalisation of Euthanasia. In 1937 a poll by the institute of public opinion reported that the medical profession itself was so much influenced by the arguments for euthanasia that 53 per cent of the doctors polled favoured "mercy killing". (p 209). Doctor Frederick Bancroft, member of the New York City Cancer Committee for example, was quoted as saying "I do not see why a person should be condemned to agony; I do not see why we should not give humans the same treatment we accord to animals". (McFadden: 1962: 206)

As I say, the call for the legalisation of euthanasia is mainly to put an end to the pointless pain and impersonal indignity suffered by many people dying slowly, everyday of terminal and incurable illnesses. Something which it seems today, is not exactly rare, "As people live longer, so they are more likely to die of cancer and to need institutional care." (Lee and Morgan: 1994:108). For some, this quality of living is so unbearable that death is preferable. In this case the argument is that death is surely no more wrong than the patient's continued painful existence. Though it sounds an unpleasant to say, in some circumstances people believe that their life is so bad, that they would be better off dead.

Unfortunately there things are not this simple and It is possible that not all acts of euthanasia would be carried out in the person's interest. This could be said to be particularly true if there are others who stand to benefit from the person's death, such as family members involved in a will. The act of euthanasia is supposed to be to the benefit of the person whose life is being terminated and not to the person who commits the act of termination. Although for Doctors there is seemingly no personal gain, in their killing of a patient.

So although I do find euthanasia in many cases to be morally justifiable I do acknowledge the problems that could arise in the event of its legalisation. For example, if euthanasia were permissible, what if it were to be abused and mistakes were made. It could cause people to disvalue life, and the old and ill to fear medical treatment, for concern that their wishes were not respected. The elderly could be killed against their wishes, but with euthanasia as a an easy reason to justify their deaths. It begs the question, would legalising euthanasia makes tragic murders, like those carried out by Dr Harold Shipman, easier and more common? On the other side of things, you could say that those who are critically ill, often being treated by drugs etc, may not be in the right frame of mind to make such an important life or death decision. In both instances, no matter how desirable an option euthanasia may seem in some cases, we have to think about what could happen to the vulnerable, if there was this loophole in the law. We must think of the safety and the protection of all lives.

Hale neatly summarises some of the key issues of the Euthanasia debate, when she cites her three principles, a) autonomy - individual freedom of choice, b) Paternalism - what others think will be best for the individual and c) Value - a transcending respect for the sanctity of life (Hale: 1996: 89). One side of the argument is that the individual should have the right to live or die. However, there is the worry that the individual's best interests are not being protected as decisions on their lives are being made. Finally many feel that the value and sanctity of life is being lost.

Most people think that there is an important moral difference between active and passive euthanasia, they think that killing someone is morally worse than letting someone die, but is killing and letting die, really morally different? You may let someone die for humane reasons so why may one not kill for humane reasons?

Another of Hale's points which I found particularly poignant was; "On the face of it, the choice of when and how to end one's life involves only oneself. We do not owe a legal duty to anyone else to keep on living indefinitely." (Hale:1996:87). It is this notion that compels me to view euthanasia on the whole as morally justifiable. I strongly believe in the freedom of the individual, and the choice to live or die should be ours alone, and as we are all going to die at some point, anyway, why should we not have the opportunity to decide how and why?

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