Euthanasia

A considerable size of society is in favor of Euthanasia
mostly because they feel that as a democratic country, we as free
individuals, have the right to decide for ourselves whether or not it
is our right to determine when to terminate someone’s life. The
stronger and more widely held opinion is against Euthanasia primarily
because society feels that it is god’s task to determine when one of
his creations time has come, and we as human beings are in no position
to behave as god and end someone’s life. When humans take it upon
themselves to shorten their lives or to have others to do it for them
by withdrawing life-sustaining apparatus, they play god. They usurp
the divine function, and interfere with the divine plan.


Euthanasia is the practice of painlessly putting to death
persons who have incurable, painful, or distressing diseases or
handicaps. It come from the Greek words for ‘good’ and ‘death’, and is
commonly called mercy killing. Voluntary euthanasia may occur when
incurably ill persons ask their physician, friend or relative, to put
them to death. The patients or their relatives may ask a doctor to
withhold treatment and let them die. Many critics of the medical
profession contend that too often doctors play god on operating tables
and in recovery rooms. They argue that no doctor should be allowed to
decide who lives and who dies.

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The issue of euthanasia is having a tremendous impact on
medicine in the United States today. It was only in the nineteenth
century that the word came to be used in the sense of speeding up the
process of dying and the destruction of so-called useless lives. Today
it is defined as the deliberate ending of life of a person suffering
from an incurable disease. A distinction is made between positive, or
active, and negative, or passive, euthanasia. Positive euthanasia is
the deliberate ending of life; an action taken to cause death in a
person. Negative euthanasia is defined as the withholding of life
preserving procedures and treatments that would prolong the life of
one who is incurably and terminally ill and couldn’t survive without
them. The word euthanasia becomes a respectable part of our vocabulary
in a subtle way, via the phrase ‘ death with dignity’.


Tolerance of euthanasia is not limited to our own country. A
court case in South Africa, s. v. Hatmann (1975), illustrates this
quite well. A medical practitioner, seeing his eighty-seven year old
father suffering from terminal cancer of the prostate, injected an
overdose of Morphine and Thiopental, causing his father’s death within
seconds. The court charged the practitioner as guilty of murder
because ‘the law is clear that it nonetheless constitutes the crime of
murder, even if all that an accused had done is to hasten the death of
a human being who was due to die in any event’. In spite of this
charge, the court simply imposed a nominal sentence; that is,
imprisonment until the rising of the court. (Friedman 246)
Once any group of human beings is considered unworthy of
living, what is to stop our society from extending this cruelty to
other groups? If the mongoloid is to be deprived of his right to life,
what of the blind and deaf? and What about of the cripple, the
retarded, and the senile?
Courts and moral philosophers alike have long accepted the
proposition that people have a right to refuse medical treatment they
find painful or difficult to bear, even if that refusal means certain
death. But an appellate court in California has gone one controversial
step further. (Walter 176)
It ruled that Elizabeth Bouvia, a cerebral palsy victim, had
an absolute right to refuse a life-sustaining feeding tube as part of
her privacy rights under the US and California constitutions. This was
the nation’s most sweeping decision in perhaps the most controversial
realm of the rights explosion: the right to die…


As individuals and as a society, we have the positive
obligation to protect life. The second precept is that we have the
negative obligation not to destroy or injure human life directly,
especially the life of the innocent and invulnerable. It has been
reasoned that the protection of innocent life- and therefore,
opposition to abortion, murder, suicide, and euthanasia- pertains to
the common good of society.


Among the potential effects of a legalised practice of
euthanasia are the following:
“Reduced pressure to improve curative or symptomatic
treatment”. If euthanasia had been legal 40 years ago, it is quite
possible that there would be no hospice movement today. The
improvement in terminal care is a direct result of attempts made to
minimize suffering. If that suffering had been extinguished by
extinguishing the patients who bore it, then we may never have known
the advances in the control of pain, nausea, breathlessness, and other
terminal symptoms that the last twenty years have seen. Some diseases
that were terminal a few decades ago are now routinely cured by newly
developed treatments. Earlier acceptance of euthanasia might well have
undercut the urgency of the research efforts which led to the
discovery of those treatments. If we accept euthanasia now, we may
well delay by decades the discovery of effective treatments for those
diseases that are now terminal. (Brock 76)
“Abandonment of Hope”. Every doctor can tell stories of
patients expected to die within days who surprise everyone with their
extraordinary recoveries. Every doctor has experienced the wonderful
embarrassment of being proven wrong in their pessimistic prognosis. To
make euthanasia a legitimate option as soon as the prognosis is
pessimistic enough is to reduce the probability of such extraordinary
recoveries from low to zero.


“Increased fear of hospitals and doctors”. Despite all the
efforts of health education, it seems there will always be a
transference of the patient’s fear of illness from the illness to the
doctors and hospitals who treat it. This fear is still very real and
leads to large numbers of late presentations of illnesses that might
have been cured if only the patients had sought help earlier. To
institutionalize euthanasia, however carefully, would undoubtedly
magnify all the latent fear of doctors and hospitals harbored by the
public. The inevitable result would be a rise in late presentations
and, therefore, preventable deaths.


“Difficulties of oversight and regulation”. Both the Dutch and
the California proposals list sets of precautions designed to prevent
abuses. They acknowledge that such are a possibility. The history of
legal “loopholes” is not a cheering one. Abuses might arise when the
patient is wealthy and an inheritance is at stake, when the doctor has
made mistakes in diagnosis and treatment and hopes to avoid detection,
when insurance coverage for treatment costs is about to expire, and in
a host of other circumstances. (Maguire 321)
“Pressure on the Patient”. Both sets of proposals seek to
limit the influence of the patient’s family on the decision, again
acknowledging the risks posed by such influences. Families have all
kinds of subtle ways, conscious and unconscious, of putting pressure
on a patient to request euthanasia and relive them of the financial
and social burden of care. Many patients already feel guilty for
imposing burdens on those on those who care for them, even when the
families are happy to bear the burden. To provide an avenue for the
discharge of that guilt in a request for euthanasia is to risk putting
to death a great many patients who do not wish to die.


“Conflict with aims of medicine”. The pro-euthanasia movement
cheerfully hands the dirty work of the actual killing to the doctors
who by and large , neither seek nor welcome the responsibility. There
is little examination of the psychological stresses imposed on those
whose training and professional outlook are geared to the saving of
lives by asking them to start taking lives on a regular basis.
Euthanasia advocates seem very confident that doctors can be relied on
to make the enormous efforts sometimes necessary to save some lives,
while at the same time assenting to requests to take other lives. Such
confidence reflects, perhaps, a high opinion of doctor’s psychic
robustness, but it is a confidence seriously undermined by the
shocking rates of depression, suicide, alcoholism, drug addiction, and
marital discord consistently recorded among this group.


“Dangers of Societal Acceptance”. It must never be forgotten
that doctors, nurses, and hospital administrators have personal lives,
homes and families, or that they are something more than just doctors,
nurses, or hospital administrators. They are citizens and a
significant part of the society around them. We should be very worried
about what the institutionalization of euthanasia will do to society,
in general , how will we regard murderers? (Brody 89)
“The Slippery Slope”. How long after acceptance of voluntary
euthanasia will we hear the calls for non-voluntary euthanasia? There
are thousands of comatose or demented patients sustained by little
more than good nursing care. They are an enormous financial and social
burden. How long will the advocates of euthanasia be arguing that we
should “assist them in dying”.
“Costs and Benefits”. Perhaps the most disturbing risk of all
is posed by the growing concern over medical costs. Euthanasia is,
after all, a very cheap service. The cost of a dose of barbiturates
and curare and the few hours in a hospital bed that it takes them to
act is minute compared to the massive bills incurred by many patients
in the last weeks and months of their lives. Already in Britain, There
is a serious under- provision of expensive therapies like renal
dialysis and intensive care, with the result that many otherwise
preventable deaths occur. Legalizing euthanasia would save substantial
financial resources which could be diverted to more “useful”
treatments. These economic concerns already exert pressure to accept
euthanasia, and, if accepted, they will inevitability tend to enlarge
the category of patients for whom euthanasia is permitted…


“Do not tolerate killing”. Now is the time for the medical
profession to rally in defense of its fundamental moral principles, to
repudiate any and all acts of direct and intentional killing by
physicians and their agents. We call on the profession and its
leadership to obtain the best advice, regarding both theory and
practice, about how to defend the profession’s moral center and to
resist growing pressures both from without and from within. We call on
fellow physicians to say that we will not deliberately kill. We must
say also to each of our fellow physicians that we will not tolerate
killing of patients and that we shall take disciplinary action against
doctors who kill. (Chapman 209)
On the other hand some people strongly feel that euthanasia is
not bad and should not be looked down upon.


Are there no conditions when life is meaningless and should be
quietly ended? If a person is subject to pain that won’t stop as a
result of a disease that can’t be cured, must he or she suffer that
pain as long as possible when there are gentle ways of putting an end
to life? If a person suffers from a disease that deprives him or her
of all memory and makes him or her a helpless lump of flesh that may
live on for years.


If euthanasia were legalized,it should be admitted that there
might be some abuses of virtually every social practice. There is no
absolute guarantee against that. But we do not normally think that a
social practice should be precluded simply because it might sometimes
be abused. The crucial issue is whether the evil of the abuses would
be so great as to outweigh the benefit of the practice. In the case of
euthanasia, the question is whether the abuses, or the consequences
generally, would be so numerous as to outweigh the advantages of
legalization. The choice is not between a present policy that is
benign and an alternative that is potentially dangerous. The present
policy had it’s evils, too.


We spend more than a billion dollars a day for health car
while our teachers are underpaid, and our industrial plants are rusty.

This should not continue. There is something fundamentally
insustainable about a society that moves its basic value-producing
industries overseas yet continues to manufacture artificial hearts at
home. We have money to give smokers heart transplants but no money to
retool out steel mills. We train more doctors and lawyers than we need
but fewer teachers. On any given day, 30 to 40 percent of the hospital
beds in America are empty, but our classrooms are overcrowded and our
transportation systems are deteriorating. We are great at treating
sick people, but we are not that great at treating a sick economy. And
we are not succeeding in international trade. When you really look
around and try to find industries the United States is succeeding in,
you discover that they are very few and far between.(Lamm 133)
There is no way we are going to come to grips with this
problem until we also look at some of these areas that aren’t going to
go away . One of the toughest of these is what Victor Fuchs called
“flat-of-the-curve medicine”- those medical procedures which are the
highest in cost but achieve little or no improvement in health status.
He says that they must be reduced or eliminated. We must demand that
professional societies and licensing authorities establish some norms
and standards for diagnostic and therapeutic practice that encompass
both costs and medicine. Wer’e going to have to come up with some sort
of concept of cost-effective medicine.


Individuals have the right to decide about their own lives and
deaths. What more basic right is there than to decide if you’re going
to live? There is none. A person under a death sentence who’s being
kept alive, through so called heroic measures certainly has a
fundamental right to say, “Enough’s enough. The treatment’s worse than
the disease. Leave me alone. Let me die!”. Ironically, those who deny
the terminally ill this right do so out of a sense of high morality.
Don’t they see that, in denying the gravely ill and suffering the
right to release themselves from pain, they commit the greatest crime?
The period of suffering can be shortened. If you have ever
been in a terminal cancer ward, It’s grim but enlightening. Anyone
who’s been there can know how much people can suffer before they die.
And not just physically. The emotional, even spiritual, agony is often
worse. Today our medical hardware is so sophisticated that the period
of suffering can be extended beyond the limit of human endurance.
What’s the point of allowing someone a few more months or days or
hours of so-called life when death is inevitable? There’s no point. In
fact, it’s downright inhumane. When someone under such conditions asks
to be allowed to die, it’s far more humane to honor that request than
to deny it.(Barry 405)
People have a right to die with dignity. Nobody wants to end
up plugged into machines and wired to tubes.


Who wants to spend their last days lying in a hospital bed
wasting away to something that’s hardly recognizable as a human being,
let alone his or her former self? Nobody. The very thought insults the
whole concept of what it means to be human. People are entitled to
dignity, in life and in death. Just as we respect people’s right to
live with dignity, so we must respect their right to die with dignity.
In the case of the terminally ill, that means people have the right to
refuse life-sustaining treatment when it’s apparent to them that all
the treatment is doing is destroying their dignity, and reducing them
to some subhuman level of humanity.


The reasons just stated in favor of euthanasia are often over
looked due to the following arguments that are against euthanasia.


The way you talk you’d think people have absolute right over
their bodies and lives. But that is obviously just not true. No
individual has absolute freedom. Even the patient’s Bill of Rights,
which was drawn up by the American Hospital Association, recognizes
this. Although it acknowledges that patients have the right to refuse
treatment, the document also realizes that they have this right and
freedom only to the extent permitted by law. Maybe people should be
allowed to die if they want to. But if so, it’s not because they have
an absolute right to dispose of themselves if they want to.(Brock 73)
Only a fool would minimize the agony that many terminally ill
patient endure. And there’s no question that by letting them die on
request we shorten the period of suffering. But we also shorten their
lives. Can you seriously argue that the saving of pain is greater good
than the saving of life? Or that presence of pain is worse than the
loss of life? Of course, nobody likes to see a creature suffer,
especially when the creature has requested a halt to the suffering.
But we have to keep our priorities straight.


Pro euthanasianists make it sound as though the superhuman
efforts made to keep people alive are not worthy of human beings. What
could be more respectful of human life, than to maintain life against
all odds, and against all hope?
All of life is a struggle and a gamble. At the gaming table of
life, nobody ever knows what the outcome will be. ” Indeed, humans are
noblest when they persist in the face of the inevitable. Look at our
literature. Reflect on our heroes. They are not those who have
capitulated but those who have endured. No, there’s nothing
undignified against being hollowed out by a catastrophic disease,
about writhing in pain, about wishing it would end. The indignity lies
in capitulation”.(Buchanan 208)

Bibliography
Friedman, Emily. Ethics Issues For Health Care Professionals.

Baskerville: American Hospital Publishing, 1986.


Maguire, Daniel. Death By Choice. Garden City: Doubleday & Company,
1984.


Reich, Warren. Quality Of Life. New York: Paulist Press, 1990.


Brody, Baruch. Life And Death Decision Making. New York: Oxford
University Press, 1988.


Chapman, Carleton. Physicians,Law,& Ethics. New York: New York
University Press, 1984.


Maestri, William. Choose Life And Not Death. New York: Library Of
Congress, 1986.


Low, Charlotte. Euthanasia – Opposing Viewpoints. San Diego:
Greenhaven Press, 1989.


Brock, Dan. Deciding For Others. Cambridge: Cambridge University
Press, 1989.


Barry, Vincent. Moral Aspects Of Health Care. Belmont: Wadsworth
Publishing Company, 1982.


Current, Richard.”Death”.The World Book Encyclopedia, 1986 ed.
Gibbs, Nancy. “Dr. Death Strikes Again” TIME, 54 (November 4, 1991).