Facts and Ethics Behind Euthanasia
Euthanasia is defined by The American Heritage Dictionary as "the action of killing an individual for reasons considered to be merciful" (469). Here, killing is described as the physical action where one individual actively kills another. Euthanasia is tolerated in the medical field under certain circumstances when a patient is suffering profoundly and death is inevitable. The word "euthanasia" comes from the Greek eu, "good", and thanatos, "death," literally, "good death"; however, the word "euthanasia" is much more difficult to define. Each person may define euthanasia differently. Who is to decide whether a death is good or not? Is any form of death good? All of these questions can be answered differently by each person. It is generally taken today to mean that act which a health care professional carries out to help his/her patient achieve a good death. Suicide, self-deliverance, auto-euthanasia, aid-in-dying, assisted suicide -- call it what you like -- can be justified by the average supporter of the so-called "right to die movement" for the following reasons: The first reason is that an advanced terminal illness is causing unbearable suffering to the individual. This suffering is the most common reason to seek an early end. Second, a grave physical handicap exists that is so restricting that the individual cannot, even after due care, counseling, and re-training, tolerate such a limited existence. This handicap is a fairly rare reason for suicide; most impaired people cope remarkably well with their affliction, but there are some who would, at a certain point, rather die. We say that there is a second form of suicide; justifiable suicide, that is a rational and planned self-deliverance from a painful and hopeless disease which will shortly end in death. I do not think the word "suicide" sits well in this context but we are stuck with it. Suicide is the taking of one's own life. Why does the term euthanasia even exist? Is euthanasia not suicide? A differentiation must be made between the two. Suicide is condoned by society as being unacceptable but euthanasia is viewed as moral and acceptable in most instances. The term "self-deliverance" is difficult to understand because the news media is in love with the words "doctor-assisted suicide". This is because the news media is dissecting the notion of whether or not doctors, who are supposed to preserve life, should partake in euthanasia. The media is failing to look at the actual issue of euthanasia, but instead, they are looking at the decision of whether or not doctors should assist in euthanasia. Also, we have to face the fact that the law calls all forms of self-destruction suicide. There are ethical guidelines for euthanasia. If the following guidelines are met, then euthanasia is considered acceptable. The person must be a mature adult. This is essential. The exact age will depend on the individual but the person should not be a minor who would come under quite different laws. Secondly, the person must have clearly made a considered decision. An individual has the ability now to indicate this with a living will (which applies only to disconnection of life supports) and can also, in today's more open and tolerant society, freely discuss the option of euthanasia with health-care professionals, family, lawyers, etc. The euthanasia must not be carried out at the first knowledge of a life-threatening illness, and reasonable medical help must have been sought to cure or at least slow down the terminal disease. I do not believe in giving up life the minute a person is informed that he or she has a terminal illness. Life is precious, you only live once, and it is worth a fight. It is when the fight is clearly hopeless and the agony, physical and mental, is unbearable that a final exit is an option. The treating physician must have been informed, asked to be involved, and his or her response been taken into account. The physician's response will vary depending on the circumstances, of course, but they should advise their patients that a rational suicide is not a crime. It is best to inform the doctor and hear his or her response. For example, the patient might be mistaken. Perhaps the diagnosis has been misheard or misunderstood. Patients raising this subject were met with a discreet silence or meaningless remarks in the past but in today's more accepting climate most physicians will discuss potential end of life actions. The person must have a Will disposing of his or her worldly effects and money. This shows evidence of a tidy mind, an orderly life, and forethought, all things which are important to an acceptance of rational suicide. The person must have made plans to die that do not involve others in criminal liability or leave them with guilty feelings. Assistance in suicide is a crime in most places, although the laws are gradually changing, and very few cases ever come before the courts. The only well-known instance of a lawsuit concerning this is the doctor-assisted suicide of Dr. Kevorkian. The person must leave a note saying exactly why he or she is taking their life. This statement in writing removes the chance of misunderstandings or blame. It also demonstrates that the departing person is taking full responsibility for the action. These are all guidelines for allowing a euthanasia to take place. By this, I mean the doctor is involved in the patient's decision and actively performs the euthanasia. I believe that passive euthanasia would show a lack of interest on the doctor's part. Simply allowing a patient to die does not require a doctor's presence. Passive euthanasia should not even exist. Euthanasia is defined as "the action of killing..." James Rachels states in his "Active and Passive Euthanasia" that "The important difference between active and passive euthanasia is that in passive euthanasia, the doctor does not do anything to bring about the patient's death. The doctor does nothing and the patient dies of whatever ills already afflict him. In active euthanasia, however, the doctor does something to bring about the patient's death: he [actively] kills him" (1024). Is allowing a patient to die considered to be an action? Rachels states "...the process of being allowed to die can be relatively slow and painful, whereas being given a lethal injection is relatively quick and painless" (1020). Disconnecting respiratory devices is not an acceptable method of euthanasia. It causes the patient to starve for oxygen and gasp for it, but when he/she cannot breathe, the body is starved of oxygen and suffocates. This is not merciful by any means. Rachels also states, "One reason why so many people think that there is an important moral difference between active and passive euthanasia is that they think killing someone is morally worse than letting someone die" (1022). The idea that a patient utilizes a medical device and has grown dependent on it for life is a grim one indeed; however, relieving a patient who relies on this machine for his/her life by simply cutting it off is not acceptable. Leon Kass states in his "Why Doctor's Must Not Kill," "Ceasing medical intervention, allowing nature to take its course, differs fundamentally from mercy killing. For one thing, death does not necessarily follow the discontinuance of treatment" (1034). This states my point exactly. Euthanasia is the physical action of putting someone to a painless death who is suffering tremendously. The passive nature of allowing someone to die is not euthanasia. This is not an physical action taken by a doctor to ease a patient's suffering and agony. The doctor should decide whether the ailment is curable and if it is not, he/she should decide whether the patient will live productively for months or even years to come. If the ailment is not immediately fatal, will it cause pain and suffering for the rest of the patient's life? How old is the patient? Will he/she live much longer anyway? All these factors should come into play when deciding whether a patient should be euthanized; however, the doctor's answers to these questions may differ from those of the patient and his/her family. It is up to the patient's doctor to decide whether the patient's ailment is indeed curable. The patient should be presented with the facts. The doctor should tell the patient exactly how it is and not project the false hope that the patient may recover. With this information, the patient can make an informed decision and feel that it is the best one. Sidney Hook states in his "In Defense of Voluntary Euthanasia" that "Each one should be permitted to make his own choice- especially when no one else is harmed by it. The responsibility for the decision, whether deemed wise or foolish, must be with the chooser" (1028). This is evidenced quite simply by the mere fact that everyone has civil rights and liberties. No one can decide who should die and who should not. Everyone is in complete control of his/her own life and; therefore, should be free to decide. Having considered the arguments in favor of auto-euthanasia, the person should also contemplate the arguments against it. First, should the person go into a hospice program instead and receive not only first-class pain management but comfort care and personal attention? Put simply, hospices make the best of a bad job, and they do so with great skill and love. The right-to-die movement supports their work, but not everyone wants a lingering death, not everyone wants that form of care. Today many terminally ill people take the marvelous benefits of home hospice programs and still accelerate the end when suffering becomes too much. A few hospice leaders claim that their care is so perfect that there is absolutely no need for anyone to consider euthanasia. While I have no wish to criticize them, they are wrong to claim perfection. Most, but not all, terminal pain can today be controlled with the sophisticated use of drugs, but the point these leaders miss is that personal quality of one's live is foremost to some people. If one's body has been so destroyed by disease that it is not worth living, that is an intensely individual decision which should not be swayed. In some cases of the final days in hospice care, when the pain is very serious, the patient is drugged into unconsciousness. If that way is acceptable to the patient, then so be it, but some people do not wish their final hours to be in that fashion. There should be no conflict between hospice and euthanasia, both are valid options in a caring society. Both are appropriate to different people with differing values. The other consideration is related to religion: does suffering glorify a person? Is suffering, as related to Jesus Christ's suffering on the cross, a part of the preparation for meeting God? Are you merely a steward of your life, which is a gift from God, which only He may take away. If your answers to these questions is yes, then you should not be involved in any form of euthanasia. Remember that there are millions of atheists, as well as people of differing religions, and they all have rights, too. Many Christians who believe in euthanasia justify it by reasoning that the God whom they worship is loving and tolerant, and would not wish to see them in agony. They do not see their God as being so vengeful as refusing them the Kingdom of Heaven if they accelerated the end of their life to avoid prolonged, unbearable suffering. A doctor should not be allowed to "play God" and decide who should live and who should die. In fact, even the patient should not be allowed to, but it is the patient's life and he/she has to live it. So, it is only logical to allow the patient, and no one else, to decide. Another consideration must be that, by ending one's life before its natural end, is one is depriving oneself of a valuable period of good life? Is that last period of love and companionship with family and friends worth hanging on for? Even the most determined supporters of euthanasia hang on until the last minute; sometimes too long, and lose control. They, too, gather with their families and friends to say goodbyes. There are important reunions and often farewell parties. Euthanasia supporters enjoy life and love living, and their respect for the sanctity of life is as strong as anybody's. Yet they are willing, if their dying is distressing to them, to give up a few weeks or a few days at the very end and leave under their own control. Ultimately, the decision lies with the beholder. It is the right of a person to make his/her own choice, with some limitations. It is the doctor's responsibility to provide the patient with an accurate prognosis so that the patient may make an educated decision.