Is Euthanasia Justified in Certain Patients?
It is 1998, Thomas Youk, 52, is in his final stages of Lou Gehrig’s disease. He is in constant pain because of his illness. He is administered a lethal injection, which he consents to by Dr. Jack Kevorkian to end his life. Dr. Kevorkian is later charged and convicted of second-degree murder for Youk’s death and is sentenced to prison (“Kevorkian Charged With Murder”, 1998). Was the act performed by Dr. Kevorkian really considered murder or was it an act of mercy? The practice of intentionally ending the life of a patient in an effort to relieve their pain and suffering is known as euthanasia (also referred to as assisted death or physician-assisted suicide). The topic of its use is controversial worldwide. Some say euthanasia is the matter of choice, even when it comes to choosing death. Others claim that doctors should not be empowered to suggest death as an option for patients who may not realize the decision they are making. Every country where euthanasia is legal has its own specific provisions on how it is used. Nevertheless, it is an ethical dilemma faced by many health care professionals. In the United States, several states have introduced the Death with Dignity Act. This Act “allows qualified terminally-ill adults to voluntarily request and receive a prescription medication to hasten their death.” Currently, there are only a few states that enacted the Death with Dignity statutes: California, Colorado, District of Columbia, and Hawaii. Before the end of 2019 Maine, New Jersey, Oregon, Vermont, and Washington will also legalize assisted death in their states (“How Death with Dignity”, 2019). Regardless if state legislations permit it, I believe euthanasia should be illegal. Again, this raises the question of whether assisted death is murder or mercy.
Euthanasia and physician-assisted suicide
Euthanasia and physician-assisted suicide violate the Hippocratic Oath- an oath taken by physicians to “do no harm.” It would require physicians to breach their general duties and to act in the patient’s best interest. It fundamentally goes against the role physicians have as healers. The Oath clearly states, “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; …” (Smith, 2002). Oftentimes, patients who express their wanting to die by euthanasia is actually a cry for help. First, there is the rising cost of health care. Patients opt for life, empirical evidence shows that even in their darkest moments patients yearn to live. Patients opt for life especially in situations where they are Muslims catholic and Jews. As humans, we possess zeal of life, in situations where the wishes of a patient are unclear as humans we should always ensure that we opt for the life of the patients. Only a few patients express their wishes to die and family members would like their person live again.
Patient autonomy occurs in situations where physicians lack proper training on how to assess and treat the suffering of a patient. There is a need to put emphasis on improving care for patients. Provision of good quality care for a patient translates to the reduction of life-threatening illnesses throughout different stages of a disease. Physicians should be in a position to provide inter-professional guidance in palliative care (Math, & Chaturvedi, 2012). Further, these patients are able to benefit from palliative care and can also be physician comfortable. Patients should also be provided with pain management strategies instead of euthanasia. Currently, patients lack pain management options due to fear of addiction and overuse of Opioid. Physicians should also focus on improving and symptom management for patients. Also, they should not depend on patient subjective complains as they are undergoing mental suffering which in most cases results in diagnostic uncertainty, misdiagnosis and is-diagnosable and treatable depression and other disorders.
Proponents of euthanasia complain about the issue of quality of life improvement. Quality of life, in this case, is used by individuals to advance their comfort and their status and for tranquility purposes. Also, the term quality of life in medicine refers to physiotherapy, rehabilitation, and palliative care and psychology. Proponents of euthanasia use the term in a negative sense as opposed to a positive manner, in this case, they do not improve the patient’s quality of life but end it. Quality of life in their sense is justified by the termination of a patient’s life. Some ethicists such as Ronald Dworkin argue that the term quality of life acts as a mischievous term. Dworkin argues that the quality of one’s life is in terms of felt experience and pleasure and how pleasure is being felt. Quality is a subjective idea and is determined by an individual’s personal life and their circumstances. Also, the idea of leaving a patient to determine their quality of life is not a good concept ( Sprung, Somerville, Radbruch, Collet, Duttge, Piva, & Ely, 2018). Physicians should distinguish those situations that patients are left to decide for their lives. Also, those situations that nurses, physicians, hospital managers, and ethicists justify in terminating the life of a patient should be critically considered. No one should conclude that the life of a patient is meaningless whenever they find some value in such life. The same way that no one prolongs the life of an individual no patients should be forced to end their life.
A life that lacks certain distinguishing circumstances such as consciousness, human dignity, self-responsibility and other features such as suffering and pain does not necessarily mean that life lacks quality. A patient who is undergoing suffering is likely to complain that their life lacks human dignity. Also, other patients can think that they have dignity even while undergoing suffering. People perceive their life’s differently. Some patients can view life as a way of developing human abilities, discovering experiences, thrills, and achievements (Strinic. 2015). When individuals are denied the ability to enjoy their life’s the way they deemed they are likely to choose death as the only means to execute their suffering. Patients should be treated in a manner that their worth on earth is felt and should feel that there is always a meaning to life as opposed to suffering.
Effects of patient assisted suicide
Patients assisted suicide is detrimental to the patient-doctor relationship. In situations where a physician is involved in euthanasia, the relationship that exists between the clinician and patients is weakened. Further, the dying patient may not also be in a position to make informed decisions. Mostly, patients recover in situations where they have been written off by their doctors. A patient can also propose euthanasia in situations where they are not near death.
Pain and suffering in the life of an individual can be controlled in most cases to a level that is satisfactory to the patient. That patient whose pain may not be adequately controlled to a level that satisfies the patient does not call for euthanasia. Sedation can be used to alleviate patient suffering in situations where the pain can no longer be controlled. Also, the government should support patients suffering from chronic diseases by providing them with easy accessibility to palliative care. Legislative and procedural frameworks that are required for a patient to enter palliative care should be abolished.
Terminally ill patients cannot also impose a physician to take an immoral action, this is because they believe that it can result to murder hence a physician should not end the life of a patient without their consent. Physicians are not required to suggest for assisted suicide but the patient should ask for such assistance (Sprung, Somerville, Radbruch, Collet, N. Duttge, Piva, & Ely, 2018). When a physician initiates such discussions it is likely to undermine their relationship. Patients would also feel that their life is meaningless as their doctors have already given up on them. It also undermines the patient’s willingness to live and may avert further treatment.
Furthermore, the decision to end and terminate life should basically remain as an opinion of a patient when they are able to express themselves. Nonetheless, the liberal state should help preserve the life of a patient. Further, it should insist on prolonging the life of a patient that believes that euthanasia negates their dignity. Patients’ autonomy should be observed especially in situations where a patient is mentally ill, unconscious and young because they lack the autonomy of expressing themselves. If patients had states ending their lives through audio and video then their opinion should be respected (Cohen-Almagor, 2015). Also, in circumstances where a patient had initially stated that on reaching a particular situation in their life they prefer to die but when the situation arises they portray that they want to cling on to their life their choice should be respected. In situations where it is impossible to determine the patients present and past desires, and where there are no signs of the patient continuing with their life. In this case, decisions should be made by a group of physicians and close members and friends of the patient. Physician-assisted suicide is not a natural death and should not be upheld by humanity just as the comic presents.
In life, people should respect other people’s lives. The culture in our society teaches us not to inflict harm on others. We also ought to show concern on an individual’s life as an individual defines what is best for them. Being concerned in this case means respecting the autonomy of a patient. Diligence and care are paramount when it comes to matters of death. Necessary measures that serve the interest of a patient should be served and all the mechanisms in place should prevent harm on a patient. Euthanasia has detrimental effects as it affects the patient and physician relationship. Also, it infringes against the wishes of a patient.
Strinic, V. (2015). Arguments in Support and Against Euthanasia. Journal of Advances in Medicine and Medical Research, 1-12. https://pdfs.semanticscholar.org/f23b/91effa0238fea69bbf12ced8e7abde54f43c.pdf
Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: the right to life vs right to die. The Indian journal of medical research, 136(6), 899. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612319/
Sprung, C. L., Somerville, M. A., Radbruch, L., Collet, N. S., Duttge, G., Piva, J. P., … & Ely, E. W. (2018). Physician-assisted suicide and euthanasia: emerging issues from a global perspective. Journal of palliative care, 33(4), 197-203. https://www.ncbi.nlm.nih.gov/pubmed/29852810
Cohen-Almagor, R. (2015). An argument for physician-assisted suicide and against euthanasia. Ethics, Medicine and Public Health, 1(4), 431-441.
The graph depicts the number of terminally ill Oregonians that were administered terminally ill dose medications. Deaths represent the number of individuals subjected to DWDA prescriptions.
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