Euthanasia Essay, Research Paper
Euthanasia, also known as mercy killing, is enveloped as deeply in
medical and ethical controversy as abortion. Both issues involve the termination
of a life, and both conjure strong arguments for advocacy and opposition.
Pro-euthanasia arguments emphasize the right of patients to choose their own
death, the duty of the physician to end pain and suffering, and the ability of
legalization to establish guidelines which create lucidity on when and how
euthanasia should be performed. Anti-euthanasia arguments, on the other hand,
emphasize the sanctity of life, the commitment of physicians to save lives, and the
possible dangers of mistakes. These are all important considerations. However,
in determining the ethics of euthanasia: religious values, opinions of the morality
involved, and interpretations of physician commitments should take a second seat
to the consideration of whether pain and suffering is uncontrollable, whether a
patient has a chance of recovering, and the development of extensive guidelines
by which physicians can make better decisions regarding euthanasia.
The definition of euthanasia can be subdivided into two parts: active and
passive. Passive euthanasia, the version deemed more acceptable by most
anti-euthanasia advocates, means simply refraining from rendering medical
treatment to keep the patient alive. This could mean withholding of medication
or life-sustaining therapy, refusing surgery, or negating to resuscitate and letting
the patient die of his or her own affliction (Darley 1). The definition of medical
treatment has been recently expanded by the American Medical Association to
encompass intravenous feeding and hydrating tubes. These medical devices used
to be considered a part of human care, which cannot be withheld from a patient.
Now that they are considered medical treatment, they can (Smith 1).
As a result of this, a patient may now die from starvation or dehydration
because of lack of intravenous nutrition and water supply. This has raised issues
in euthanasia debates over the humanity of such practices. Tom Flynn, an editor
for Free Inquiry, wrote an account of his partner s grandmother which describes
how, after terminating medical treatment on his grandmother, Flynn and his
partner had to watch her slowly die over a period of two weeks. In a descriptive
account of the inhumanity of the situation, Flynn wrote how Occasionally a
nurse or a family member would squeeze a few drops of water into her parched
and crackling mouth, but aside from a continuing dose of painkillers, that was all
she received (Flynn 1).
Common sense regarding the treatment of this situation did not come into
play here. If the decision is made to terminate treatment with the intention of
letting the person die a dignified death, and to end prolonged pain and suffering,
then it seems only logical to make sure that the patient does in fact reach a fast
and painless end after the fact. However, passive euthanasia, by definition, does
not provide for intervention after medical treatment has been terminated. Oddly
enough, this method of assisted suicide is considered by many religious
conservatives and anti-euthanasia advocates to be the humane method of
physician assisted suicide (1).
The inhumane method has been designated as active euthanasia. By
definition, active euthanasia can be described as taking some action designed to
directly bring about the end of a patient s life (Cherny 1). Throughout history,
cases of active euthanasia have caused much controversy. Michigan, in
particular, has been the setting for a number of incidences where people have
come to legal complications in situations where they helped another end his or
her life. In 1920 the Michigan State Supreme Court upheld the murder conviction
of a man who placed poison within the reach of his dying spouse who was
suffering from multiple sclerosis. This case, known as the People v. Campbell,
went unrecognized as a precedent sixty-three years later by a Michigan appellate
court which dismissed a murder charge against a man who gave a gun to a person
who was talking of committing suicide, and subsequently killed himself
Michigan was also the setting for the notorious Dr. Jack Kevorkian, who
orchestrated the infamous suicide of Janet Adkins in 1990. Adkins was suffering
from Alzheimer s disease, and in anticipation of years of degeneration from the
disease, requested the help of the doctor. Kevorkian reported himself to the
police immediately after she died. The murder charges brought on Kevorkian as a
result of his actions were dropped two years later, again ignoring the precedent of
Campbell s case. This lack of both continuity between cases, and established
policy with which to act upon, is symbolic of the same lack within the medical
field regarding active euthanasia.
Arguments against active euthanasia revolve around the notions that
physicians cannot always know the wishes of the patient, especially when the
patient is comatose or unresponsive; physicians hold an obligation to save and
prolong lives, not end them; physicians cannot always accurately gauge how
much time is left; and also that physicians can misdiagnose and label a patient as
terminal when in fact he or she has good chances of survival (1). In a discussion
of this, Wesley J. Smith, an editor for National Review, reported in 1995 that:
According to a growing body of medical literature, misdiagnosis of the
persistent vegetative state is a real problem. A study published in the
June 1991 Archives of Neurology found that, of 84 patients with a
firm diagnosis of persistent vegetative state, 58 percent recovered
consciousness within three years. Moreover, researchers were unable
to identify objective predictors of recovery to differentiate between
those who would awaken and those who would not. (Smith 1)
The issue of misdiagnosis could be seen as reason to say that the practice
of euthanasia should not be accepted, and a patients right to a death with dignity
should be denied. However, interpreting the issue this way is also another way of
saying that a person must continue in his or her suffering, regardless of whether
the cause is to prolong his or her life. Instead, misdiagnosis should be interpreted
as a factor that contributes to the need for more extensive guidelines in physician
assisted suicide. Guidelines which provide for the amount of time a person
should remain comatose or in pain before euthanasia is considered, especially
when the duration of such afflictions is uncertain, are some that definitely need to
be established. Malcolm Dean, an editor for the British publication The Lancet,
commented in 1995 that Doctors have too little guidance in mercy killing
matters and there has been too little attention paid to the issue in medical
education and training (Dean 1).
Even if this void in medical treatment is remedied, still present is the
disturbing irony that some believe it is more humane to let a person die slowly of
starvation and thirst rather than give the person a remedy that will bring about a
faster, painless end. Realizing this irony would lead any logically minded person
to believe that the moral values regarding this issue are hypocritical and mundane.
The real focus should be on making sure euthanasia is done correctly, at the right
time, and is the best decision for the patient. With all the attention being placed
on sanctity of life, interpretation of the physician s oath, and legality involved;
policy and procedure are going to have a tough time being established with so
many barricades to battle through.
Cherny, Nathan I. The Problem of Inadequately Relieved Suffering.
(Psychological Perspectives on Euthanasia). Journal of Social Issues.
Summer 1996: 52, 2, 13.
Darley, John M. Community Attitudes on the Family of Issues Surrounding the
Death of Terminally Ill Patients. Journal of Social Issues. Summer
1996: 52, 2, 85. la.edu.
Dean, Malcolm. Politics of Euthanasia in the UK The Lancet. 18 March 1995:
345, 8951, 714.
Flynn, Tom. A Case For Mercy Killing. Free Inquiry. Summer 1993: 13, 3,
McCord, William. Death With Dignity. The Humanist. Jan.-Feb. 1993: 53, 1,
Smith, Wesley J. Killing Grounds: By Dehumanizing Brain Damaged Patients,
We Have Made It Acceptable to Starve or Dehydrate Themselves to
Death. National Review. 6 March 1995: 47, n4, 54.