Physician-Assisted Suicide Kathleen M. Foley, author of Competent Care for the Dying Instead of Physician-Assisted Suicide, believes doctors should develop treatments for the physical and psychological problems of dying patients rather than helping them commit suicide. Available data suggests most physicians do not receive training in the care of dying patients. Dying patients experience physical symptoms such as pain, psychological problems such as anxiety and depression and existential distress (described as the experience of life without meaning.)(1) many of the physical and psychological problems can be treated. Furthermore, legalization of physician-assisted suicide may deter physicians from developing treatments that could enhance the dying patient’s quality of life.
Euthanasia by definition means “a gentle and easy death”, “the good death of another” or “mercy killing.”(2) There are two types of euthanasia currently recognized, active and passive euthanasia. Active euthanasia is the taking of one’s own life, or being killed, for example, by lethal injection. Passive euthanasia is taking one’s life with the assistance of another or just being allowed to die. In passive euthanasia we simply refrain from doing anything to keep the patient alive, for example, refusing to perform surgery, administer medication, give heart massage or use a respirator and let the patient die from whatever illness is already present. It is important to understand the difference, because many people believe that active euthanasia is immoral and passive euthanasia is morally all right. They believe that we should actually never kill patients, but sometimes it is all right to let them die.
The main issue then is it morally permissible to kill or let someone die who is going to die soon anyway, at the person’s own request, as an act of kindness? Throughout history, many people have thought that the distinction between active and passive euthanasia is morally important: and many of those who condemned active euthanasia raised no objection against passive euthanasia. Even by people who believed killing to be wrong, allowing people to die by not treating them was thought in some circumstances to be all right. Even before Christ, Socrates was quoted as saying, ” ..bodies which disease had penetrated through and through he would not have attempted to cure..he did not want to lengthen out good-for-nothing lives.”(3) In the centuries that followed, both the Christians and the Jews viewed allowing to die in circumstances of hopeless suffering, morally permissible. It was killing that they adamantly opposed. The Pope, stating the position of the Catholic Church, said “it is acceptable to allow the patient who is virtually already dead to pass away in peace.”(4) In a statement published in 1982, the American Medical Association echoes the feeling of the Catholic Church saying, ” we remain firm on our stand against mercy killing, but allowing patients to die (in some circumstances) is all right.”(5) So it seems, there is widespread agreement that passive euthanasia is morally all right (in at least some cases), but active euthanasia is much more controversial.
In essence what we seek is whether euthanasia active or passive is moral, or whether it is immoral. To discover the truth we must examine the arguments or reasons that are given for or against it. If the arguments in favor of euthanasia are persuasive and the arguments against it can be rejected, then it is morally acceptable. And likewise, if after careful analysis we find a strong case against euthanasia, we would have to conclude it to be immoral. I think this is true not only of euthanasia, but of any moral issue. The single most powerful argument in support of euthanasia is the argument of mercy.
The main idea of this argument is simple. Terminal patients sometimes suffer pain far beyond our comprehension. This suffering can be so terrible that we cringe at the descriptions of such agony. The argument for mercy says: Euthanasia is justified because it puts an end to that. It is not important to give gory details of the suffering of the terminally ill, but it is important to keep these visions vividly imprinted in our minds so we can appreciate the full force of the argument for mercy. If a person prefers and even begs for death as the only alternative to lingering on in this kind of torment, only to die anyway after a while, then surely it is not immoral to help this person die sooner.
As Stewart Alsop (a respected journalist) stated prior to his death from a rare form of cancer in 1975, “No human being with a spark of pity could let a living thing suffer so, to no good end.! ” (6) In the case of voluntary euthanasia, great suffering is eliminated, and since the patient requests it, there is no question of violating that individuals human rights. If an action promotes the best interests of everyone concerned, and violates no one’s rights, then that action is morally acceptable. In some cases, active euthanasia promotes the best interests of everyone and violates no one’s rights. Therefore, in at least some cases active euthanasia is morally acceptable. First and most important is the interest of the patient.
If chosen, euthanasia would provide the individual with an easier, better death, without pain. Secondly, the interests of the family members should be considered. Their misery, helplessly watching their loved one suffer, must be almost equal. Thirdly, the interests of the medical staff must be considered. Their attentions would be better focused on patients that can be helped. Lastly, other patients would benefit as medical resources wo! uld no longer be used for the pointless maintenance of a terminally ill patient. Considering all this, how can active euthanasia in this case be wrong? How can it be wrong to perform an act that is merciful, benefits everyone concerned, and violates no one’s rights? The Golden Rule states, “Do unto others as you would have them do unto you.”(7) The basic idea is that moral rules apply to everyone without exception; therefore, you can not say you are justified in treating someone in a certain way unless you are willing to be treated that way if the positions were reversed.
How does this apply to euthanasia? Someday we will all die, although we do not know when or how. For the sake of this argument suppose you were told you would die in one of two ways and had to choose between them. First, you could die quietly and without pain by lethal injection. Or secondly, you could choose to die from a disease that caused excruciating pain and reduced the body to a point were it was unrecognizable while your family watched helplessly. It is hard to believe that any sane person, confronted with these possibilities, would choose to have a rule applied that would force the to take the horrible death. Then if we would not want a rule which ex! cludes euthanasia applied to us, we should not apply it to others.
And what happened to our unalienable right to “life, liberty and the pursuit of happiness?” Each dying patient should be free to choose euthanasia or reject it, simply as a matter of personal liberty. The government should not have the right to tell another what choice to make. If a dying patient wants euthanasia, that is a private matter. Being the life belongs to the individual, the individual should have the right to decide. People should be free to live their lives as they think best.
Of course liberty is not without restrictions. For example, we should not be free to murder, rape or steal. So why are certain restrictions placed on our freedom while others are unacceptable? The answer is simple: personal freedom should be limited when it causes harm to others. Terminally ill patients should have the right to choose active euthanasia as a morally acceptable and legal choice. The morality of euthanasia is supported by such maxims as the Golden Rule.
Euthanasia (in some cases) serves the interests of everyone concerned: it is mercy to the patient, relieves emotional strain on family and friends and conserves finances and medical resources. If doctors are forbidden from providing a painless death to their terminally ill patients who request it, this is an unjust restriction on the patients personal freedom. These ideas are hard to accept, but deserve consideration. The idea of deliberately killing someone goes against the very core of our morality. I am not suggesting that the value of life be taken lightly, nonetheless, I believe in the most tragic cases euthanasia should be permissible.
References 1. Foley KM. Competent Care for the Dying Istead of Physician-Assisted Suicide. The New England Journal of Medicine. 1997; v336: 54-57. 2 .
Lane B. Euthanasia: the Debate Continues. 26 June 1996. http://www.mala.bc.ca./www/ipp/ethanas.htm (25 February 1997). 3-6. Rachels J.
Euthanasia. http://www.lcl.cmu.edu/..intro/part3/Rachels.txt (9 March 1997). 7. Hannigan, J. (1986). As I Have Loved You.
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