Euthanasia Background Essay

* What’s Euthanasia? * The Pro-Life Alliance defines it as: ‘Any action or omission intended to end the life of a patient on the grounds that his or her life is not worth living.’ * The Voluntary Euthanasia Society looks to the word’s Greek origins – ‘eu’ and ‘thanatos,’ which together mean ‘a good death’ – and say a modern definition is: ‘A good death brought about by a doctor providing drugs or an injection to bring a peaceful end to the dying process.’ * Three classes of euthanasia can be identified — passive euthanasia, physician-assisted suicide and active euthanasia — although not all groups would acknowledge them as valid terms.† * What is physician-assisted suicide/physician aid in dying? * It is descriptively accurate and carries with it no misleading connotations. * Other contributors to this volume prefer the synonymous term physician-assisted suicide because it is technically accurate, and still others prefer physician aid in dying because it is relatively neutral. * Although suicide can be considered heroic or rational depending on setting and philosophical orientation, in much American writing it is conflated with mental illness, and the term suggests the tragic self-destruction of a person who is not thinking clearly or acting rationally. Pros: * Everyone has the right to die * The right of a competent, terminally ill person to avoid excruciating pain and embrace a timely and dignified death bears the sanction of history and is implicit in the concept of ordered liberty. * The exercise of this right is as central to personal autonomy and bodily integrity as rights safeguarded by this Court’s decisions relating to marriage, family relationships, procreation, contraception, child rearing and the refusal or termination of life-saving medical treatment. * In particular, this Court’s recent decisions concerning the right to refuse medical treatment and the right to abortion instruct that a mentally competent, terminally ill person has a protected liberty interest in choosing to end intolerable suffering by bringing about his or her own death. * Patient suffering should be able to end their life. * At the Hemlock Society they get calls daily from desperate people who are looking for someone like Jack Kevorkian to end their lives, which have lost all quality. * Americans should enjoy a right guaranteed in the European Declaration of Human Rights — the right not to be forced to suffer. * It should be considered as much of a crime to make someone live that with justification does not wish to continue as it is to take life without consent. * What about palliative (end-of-life) care? * The evidence for the emotional impact of assisted dying on physicians shows that euthanasia and assisted suicide are a far cry from being ‘easier options for the caregiver’ than palliative care, as some critics of Dutch practice have suggested. * We wish to take a strong stand against the separation and opposition between euthanasia and assisted suicide, on the one hand, and palliative care, on the other, that such critics have implied. There is no ‘either-or’ with respect to these options. * Every appropriate palliative option available must be discussed with the patient and, if reasonable, tried before a request for assisted death can be accepted. * What about living wills? * Living wills can be used to refuse extraordinary, life-prolonging care and are effective in providing clear and convincing evidence that may be necessary under state statutes to refuse care after one becomes terminally ill. * A recent Pennsylvania case shows the power a living will can have. In that case, a Bucks County man was not given a feeding tube, even though his wife requested he receive one, because his living will, executed seven years prior, clearly stated that he did ‘not want tube feeding or any other artificial invasive form of nutrition. * A living will provides clear and convincing evidence of one’s wishes regarding end-of-life care. * Healthcare * Even though the various elements that make up the American healthcare system are becoming more circumspect in ensuring that money is not wasted. * The cap that marks a zero-sum healthcare system is largely absent in the United States. * Considering the way we finance healthcare in the United States, it would be hard to make a case that there is a financial imperative compelling us to adopt physician-assisted suicide in an effort to save money so that others could benefit. Cons: * There will be a slippery slope to legalized murder. * In a society as obsessed with the costs of health care and the principle of utility, the dangers of the slippery slope†¦ are far from fantasy. * Assisted suicide is a half-way house, a stop on the way to other forms of direct euthanasia, for example, for incompetent patients by advance directive or suicide in the elderly. So, too, is voluntary euthanasia a half-way house to involuntary and nonvoluntary euthanasia. * If terminating life is a benefit, the reasoning goes, why should euthanasia be limited only to those who can give consent? Why need we ask for consent? * The Hippocratic Oath and Prohibition of Killing would make it impossible. * The prohibition against killing patients†¦ stands as the first promise of self-restraint sworn to in the Hippocratic Oath, as medicine’s primary taboo: ‘I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect’. * In forswearing the giving of poison when asked for it, the Hippocratic physician rejects the view that the patient’s choice for death can make killing him right. * For the physician, at least, human life in living bodies commands respect and reverence–by its very nature. As its respectability does not depend upon human agreement or patient consent, revocation of one’s consent to live does not deprive one’s living body of respectability. * The deepest ethical principle restraining the physician’s power is not the autonomy or freedom of the patient; neither is it his own compassion or good intention. Rather, it is the dignity and mysterious power of human life itself, and therefore, also what the Oath calls the purity and holiness of life and art to which he has sworn devotion.† * There is also Government involvement in end-of-life decisions. * Cases like Schiavo’s touch on basic constitutional rights, such as the right to live and the right to due process, and consequently there could very well be a legitimate role for the federal government to play. * There’s a precedent–as a result of the highly publicized deaths of infants with disabilities in the 1980s, the federal government enacted ‘Baby Doe Legislation,’ which would withhold federal funds from hospitals that withhold lifesaving treatment from newborns based on the expectation of disability. * The medical community has to have restrictions on what it may do to people with disabilities – we’ve already seen what some members of that community are willing to do when no restrictions are in place.Healthcare spending implications will shut it down. * There would be healthcare spending implications. * Savings to governments could become a consideration. * Drugs for assisted suicide cost about $35 to $45, making them far less expensive than providing medical care. * This could fill the void from cutbacks for treatment and care with the ‘treatment’ of death.† * Social groups would also be at risk. * It must be recognized that assisted suicide and euthanasia will be practiced through the prism of social inequality and prejudice that characterizes the delivery of services in all segments of society, including health care. * Those who will be most vulnerable to abuse, error, or indifference are the poor, minorities, and those who are least educated and least empowered. * This risk does not reflect a judgment that physicians are more prejudiced or influenced by race and class than the rest of society – only that they are not exempt from the prejudices manifest in other areas of our collective life.