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"Should individuals, especially terminally ill people in excruciating pain, be able to end their lives? If so, may they hasten their deaths only by refusing medical treatment designed to sustain their lives, or may they take active measures to kill themselves?" (LaFollette, p. 19) These are the fundamental questions behind any discussion of Euthanasia. However, as the discussion develops, other relevant questions arise: for instance, "if they can take measures to kill themselves, can they ask others to assist them? Who can they ask?" (p. 19) All of these questions were examined during the seminar.
The crucial question to be examined first is, of course, should individuals be allowed to end their own lives? With this, comparisons can be made to the issue of suicide, but important differences must be established. Suicide involves an independent act by the person; whereas euthanasia requires acknowledgement and acceptance by the medical experts involved in the treatment of the patient, and either passive or active involvement in the act. A scenario that links the two is that of resuscitation of the individual. If the suicide attempt failed, but the patient needs treatment in order to survive, medics could adopt passive euthanasia by not administering the necessary treatment and therefore allowing the patient to die. However, arguments against this action being adopted by doctors are numerous: most notably, that the doctor's Hippocratic oath dictates that their role is to save lives and ask questions later, not to ascertain the true wishes of the unconscious patient -a suicide attempt is often a cry for help, not a genuine desire to end life.
Although suicide is a tragic issue, resuscitation is really the only link between that and euthanasia. In general, the debate regarding euthanasia focuses on the individual's right to end their life, or decide on the time when another should end their life. Voluntary euthanasia is the name given to the act when it is performed at the request of the patient. Non-voluntary euthanasia occurs when the patient is unconscious or too ill to communicate, and therefore another makes the decision. Most people, though certainly not all, accept that there are some cases in which voluntary euthanasia can be undertaken. In particular, it is seen as a humane act to grant the wishes of a terminally ill patient for who there is no hope, and who experiences excruciating pain. However, there are still some caveats to consider before even this is accepted. Firstly, modern medicine is forever advancing, and it must be proven that the patient is suffering from an illness from which they will die before any new medical developments occur that will save, prolong, or radically improve the patient's life: for when a human life can be saved, it must be attempted. Secondly, the rights and needs of the patient's family must also be considered: especially any young children dependent on the sufferer. If the patient is not too far advanced in their terminal illness, and can still perform the role of parental protector to their children for the forthcoming future, then they should be encouraged to withhold their request for euthanasia for the sake of their dependents. This may appear to be denying the rights of an individual to end their life, but it is more a matter of trying to balance the rights of the child against the rights of the patient. Of course, once the illness develops, and the patient's pain increases and quality of life decreases, then the rights of the patient becomes the dominant factor as they become the one dependent on others.
Another reason for delaying euthanasia is the likelihood of the patient's desire being triggered and controlled by depression. Upon first being diagnosed with a terminal illness, the patient's depressive state may immediately consider a quick, painless death to be suitable to a drawn-out, painful death. However, once the initial shock is over, the patient often appreciates their remaining time, until life becomes too painful to endure. Therefore, whilst many people accept euthanasia for those suffering from a painful terminal illness, they are wary of the patient's depressed state and are more inclined to leave the final judgement with the medical experts.
If euthanasia was introduced for terminally ill patients, could it be introduced for other types of patients? The most likely figures would be those suffering from paralysing diseases, or those that have become irreversibly brain-damaged to an extent that removes all of their capabilities to perform as a functioning person. In the first instance, there would be cases of both voluntary and non-voluntary euthanasia, as it is common for a paralysed person to still possess the mental abilities to make the request for euthanasia. In the second instance, it would inevitably be an act of non- voluntary euthanasia, requested by the patient's family or the doctor. Argument's to support euthanasia in these instances may focus on the lack of quality in such a life, and the mental torture experienced by a competent mind trapped inside a paralysed body. They may conclude that a person in such a state has a right to end their undignified life with a dignified death. Arguments against would suggest that if the patient is not suffering any physical pain, or is unable to request euthanasia for themselves, they should be kept alive in the hope that a cure can eventually be discovered. They may counter the suggestion of no quality of life by citing an example such as Stephen Hawking. He has suffered from a progressive nervous disease since his early twenties, which has left him paralysed and unable to speak; yet he has become a leading physicist.
If it was decided that euthanasia was to be legalised, how far should it extend and who should perform it? The dilemma would be between voluntary and non-voluntary euthanasia for the patient, and between active and passive euthanasia for others involved in the case. The main opposition towards euthanasia is that man does not have the right to take life. However, there are many who fall short of holding this fixed view, and merely express certain concerns: for instance, that patients will lose trust in doctor's if they possess the power to take as well as save lives. In order to avoid such problems, it would be wise for the doctor administering active euthanasia to be a specialised doctor, and not a regular GP or a typical hospital surgeon.
However, it will be necessary for the patient to visit their own GP at the onset of their illness, and a plan of action must therefore be arranged to distance local doctors and surgeons with the application of euthanasia. One possible way is to introduce small legal and medical tribunals, with the responsibility of judging the individual's rights to euthanasia on a case-by-case basis. The only role of the GP would be to alert the attention of the tribunal to the individual asking for euthanasia or, in the case of non- voluntary euthanasia, the individual involved. All the key factors of the case -the health of the patient, the extent of pain being suffered, and whether they have anyone dependent on them -would then be examined by the tribunal. If euthanasia were to be carried out, a specialist would undertake it, in order to preserve other patient's trust in their GP. This would allow almost all doctor's to maintain the Hippocratic oath. Some may claim that a partner or family member should perform euthanasia, as this would remove all doctors from the actual act, and the dying patient may prefer a loved one to grant their wishes and remove all their suffering. However, it is more likely that the partner or family member may suffer mental anguish at some point in the future upon recalling that they terminated the life of a loved one, whereas a specialised doctor is more likely to remember that death was inevitable, and what they actually did was to terminate the patient's suffering. Finally, some may complain that the time taken for the tribunal to make their judgement unnecessarily prolongs the suffering experienced by the patient, however it is a necessary procedure to ensure that it is in the patient's best interests to grant their wish of euthanasia.
To conclude, it has been decided that it would be acceptable to perform voluntary euthanasia in certain cases, most notably in the final painful stages of a terminal illness. Non-voluntary euthanasia is a more complicated matter, as rather than grant the right's of an individual it can be argued that it ignores their right to life. However, if it is the wishes of the patient's family, and it is the opinion of the medical experts, then non-voluntary euthanasia may be acceptable if the patient is deemed to be in an irrevocable condition.
Bibliography:
LaFollette. H, editor, 'Ethics in Practice', Blackwell Publishers Ltd, 1999.
Phil
Created 21:02:04