FREE ESSAY ON EUTHANASIA

EUTHANASIA

Ethics in Euthanasia and Physician-Assisted Suicide
There are numerous controversial issues that currently affect the evolving field of
psychology. Unsolved issues on human experimentation, abortion, genetic testing, animal
rights are a few examples of themes that arouse conflict and contention. Euthanasia and
Physician-Assisted suicide is yet another controversial issue that has particular
relevance to the field of psychology because of the apparent moral and ethical dilemmas
involved. Euthanasia, by definition "a happy death," implies an easy or painless death.
The purpose of this procedure is usually to end suffering analogous to the phrase "mercy
killing," the practice of putting to death a persons suffering from incurable conditions
or diseases. This subject brings to discussion one of the oldest and most controversial
issues in the practice of modern medicine. 
On one side of the argument, Euthanasia would appear to be contradicting the Hippocratic
oath, which proscribes inducing death, even if it is requested by the patient. On the
contrary, medicine could be referred to as the practice that not only prevents death, but
enhances the quality of life through prevention of suffering. The issue of assisted
suicide also stimulates the debate of legality versus situation ethics. Should jurors, in
physician-assisted suicide cases involving Dr. Jack Kervorkian, vote on grounds that
empathy and compassion takes precedence over the letter of the law? Antithetically,
should the juror take the conventional or legalist perspective and enforce the law as not
allowing room for such compassion? 
Is it is morally permissible for individuals to end their lives when they no
longer wish to go on living or suffering? This central question of assisted suicide
directly relates to the worries of how society would be impacted if Euthanasia were to be
legalized. In addition to the societal impact of legalizing such a procedure, does this
violate the ethical codes of the practice of medicine? These are some of the obvious and
reoccurring questions in the controversial ethics pertaining to Euthanasia. 
The controversial issues of Euthanasia have direct relevance to the field of psychology
in the judgment of whether or not an individual is "competent" to make such a
determination to end their life. For an example, clinical and counseling psychologists
often are consulted by physicians regarding DNR (Do Not Recesitate) orders to examine the
psychological stability of the patient to make a life ending decision. Additional
parallels that relate psychology to Euthanasia are an individual's moral development and
how it effects their decision making process' in relation to moral dilemmas in the law.
Everyone is put in situations where they are forced to form an opinion that potentially
goes against an accepted or legal policy. Psychology examines and theorizes how people
may react in such a situation as well as analyzes the varying factors that may lead up to
an individual's decision in such a predicament.
Examples of this, relevant to Euthanasia, would be jurors sitting in on an assisted
suicide case such as those obtaining to Dr. Jack Kevorkian. In this situation, the jurors
were faced with the psychological decision to either declare that it is wrong to assist
in one's death because it is legally prohibited. Or, on the contrary, that the suffering
and pain of a terminally ill patient was ended allowing the patient to die in a peaceful
manner; delineating that the action should be deemed honorable due to its inherent value
rather than its consequences. 
There are various types of Euthanasia that must be explained before further discussing
the topic. If the act is undertaken at the explicit request of a competent patient, it is
defined as voluntary euthanasia. Involuntary euthanasia is when this action is carried
out without the explicit request of the individual, also known as murder. 
Those who argue against physician-assisted suicide primarily base their justification on
the moral probity of the medical profession. There are many worries that go along with
the legalization of euthanasia. In the Netherlands, euthanasia has already been legalized
and is being practiced. Some of the frequent concerns are the possible pressuring of
patients into consenting, especially those without health insurance or financial support.
Economic and financial hardships could potentially play a major factor with the unjust
persuasion of an individual into such a procedure. The Netherlands, indeed, finds itself
having an alarmingly high rate of involuntary euthanasia, which is unequivocally
impermissible. 
Euthanasia is also seen as being a serious distraction to physicians and others in the
medical field because of the potential luring of doctors away from the improvement of
pain control, suffering and terminal care. In addition to this, frequent practice of
euthanasia could very well negatively affect the trust entailed in the patient-physician
relationship with doctors who are known to actively practice assisted suicide. All
practitioners in the medical field take the Hippocratic oath stating the following, "...I
will follow that system of regimen which, according to my ability and judgment, I
consider for the benefit of my patients, and abstain from whatever is deleterious and
mischievous. I will give no deadly medicine to any one if asked, nor suggest any such
counsel..." 
The Hippocratic oath strongly implicates that participating or approving of
physician-assisted suicide could very well destroy the legitimacy of the medical
practice, with direct regard to the value and sacredness of life. Additional views
against such procedures claim that most pain and suffering in terminal illnesses are
controllable using current medical technology, thus suggesting the nonnecessity of
Euthanasia. There are many dangers that can be presented by the misuse of assisted
suicide. Without proper guidelines and precautions established, euthanasia could easily
become a dangerous hazard. A misunderstanding could easily transpire in regards to what
level of pain the patient should be in for assisted suicide to be offered. Moreover,
guidelines must be set as to determine whether or not the patient is psychologically
competent to make the decision to end their life. I feel that there is a crucial
difference in the manner that Euthanasia should be permitted. I feel that a physician
should not convince an individual the worthiness of life; however, I feel that euthanasia
should be allowed because of its reverence for a person's judgement on his or her own
quality of life provided that all other medical options have been considered.
One of the greatest dangers is to ignore or deny lessons learned from world history. Nazi
Germany actively had programs to eliminate the weak and vulnerable, moreover in this
movement euthanasia was frequently meditated. Hitler focused on this topic and legalized
the assisted suicide for all those who were mentally retarded as well as anyone who was
"incurably sick by medical examination." By1941 in Nazi Germany had euthanized 70,000
patients in mental institutions. For Hitler, this act was merely an advancing step
towards a better social hygiene. The power of the state rather than the empowerment of
the individual with respect to euthanasia displayed the danger of such practice. What the
Nazi's did was purely murder for the good of the state; however, the possibility for
legalized euthanasia to once again become such a hazard must be recognized. 
There are five commonly excepted ethical reasons for those against physician assisted
suicide. The first is that the American Medical Association has ruled out any "mercy
killing, which is defined as " the intentional termination of the life of one human being
by another." They argue that a physician's duty is to prevent medical suffering in the
first place as laid out in the Hippocratic Oath, an oath that all physicians take upon
completion of medical school. "Western medicine has regarded the killing on patients,
even on request, as a profound violation of the deepest meaning of the medical
vocation...Neither legal tolerance nor the best bedside manner can ever make medical
killing medically ethical."
The next argument recognizes the slippery slope that could easily develop as did with
Hitler in Nazi Germany upon the legalization of assisted suicide. The opposition also
fears that more and more physician's will become insistent in their roles with assisted
suicide, and begin to offer and urge it on patients who have become not only depressed
about their circumstances, but also a burden to themselves and to others, even an
economic burden.
They also feel that the doctor-patient relationship depends solely on trust, and if the
public begins to mistrust the profession of medicine, because its unhealthy participation
in death-dealing, then the profession of medicine itself will suffer irreversible losses.
They also see the potential for physician's having the ultimate power of life and death
in their hands as being an instigator to infringement and control over an individual's
life. Lastly, the opposition feels that more often than not, euthanasia would be offered
before all moral, political and social ramifications have been considered.
On the contrary, there are many that argue in favor of euthanasia and assisted suicide.
In fact, euthanasia is commonly practiced legally throughout the Netherlands. Euthanasia
can easily seen as a method allowing an individual to die peacefully and painlessly if
they are suffering from an incurable sickness. In 1991 an estimated 516,170 Americans
died from cancer. If 5% of these people died suffering with severe pain, this surmounts
to 25,809 people dying a painful death that could have been eased with assisted suicide.
This statistic clearly proves that there are a considerable number of people that are
suffering painful deaths in areas that the medical field has been able to remedy. If a
patient is physically and emotionally competent and able to coherently understand their
dainty condition, the option of euthanasia and a peaceful death should rightfully be
presented. 
For patients that are suffering from terminal cancer and other incurable sicknesses, pain
is by no means the only cause of their suffering. Other common symptoms of terminally ill
patients are weakness, pain, anorexia, dyspnea, nausea/vomiting, confusion, pressure
sores, fecal incontinence, as well as offensive odors. Dr. Jack Kevorkian, a publicly
well-known advocate and practitioner of assisted suicide argues that in the current state
of law and medicine, individuals with degenerative diseases must decide either to take
their own life during the stage of their impairment when they are still capable, or
suffer the grim realities of a lingering decline. 
Individuals deserve the right to have control over their lives and to the autonomy they
are entitled to. Those in favor of euthanasia agree that it is an individual's
constitutional right to be offered a painless cure to their suffering. The principle of
respect for autonomy tells us to allow rational individuals to live their lives according
to their own autonomous decisions without any interference. If rational individuals
independently chose to die, then proper respect for autonomy will allow physicians to
assist them in doing so. The goal of medicine is to address the suffering of patients. As
the suffering increases intractable to relief, if requested by the patient, the medical
field should offer euthanizing relief if no other options are available. This by no means
delineates that a person should be forced into assisted suicide regardless of their
social, political or economic stature. Assisted suicide should merely be an option
mentioned to the patient, moreover would be permissible to execute upon a patients
request. 
Supporters also argue that the responsibility for technology should exist for these
individuals as well. Medical technology has made efforts to gain terminally ill patients
some additional time; likewise, medicine must recognize when they are unable to further
help such patients. Scientific research for cures in these areas should continue;
however, in the mean time technological methods to relieve the pain for those via lethal
injection should be offered. Furthermore, when science is able to find a cure, there will
be no need for the assisted suicide. Euthanasia is not trying to replace scientific
research, but it offers a relief to the incurable pain and suffering that research has
not yet corrected.
Addition concern should be devoted to the individual's autonomy. The personal decision to
end ones life whether it is because of terminal pain or merely faced with old age,
suicide should be honored. However, a firm criteria for this must be established to
prevent abuse. The following are some of the few guidelines The patient must fully
understand their current medical condition and must be mentally aware that assisted
suicide is an irreversible action; moreover, the patient must request assisted suicide on
their own will. The patients suffering must also be validated by a physician as not being
caused from inapt care. A second, non-affiliated physician should make consultation, thus
ensuring that the patient's judgement is not distorted. 
The rise of "patient's rights" in current medical ethics debates will undoubtedly bring
euthanasia closer to being legalized in the United States. Those who support autonomy in
biomedical ethics have been promoting the right for patients to ask for assistance in
death. The supporters of assisted suicide have established numerous reasons as to why
euthanasia is a morally and legally legitimate practice. These supporters have also
instituted particular safeguarding procedures preventing against abuse. Specific
committee review boards have been devised to examine the patient's competence, the
voluntariness of the request, and the terminal condition in which the patients suffers
from. 
The euthanasia committees would consist of interdisciplinary panels of clinicians,
ethicists, lawyers, as well as laypersons. With a diversified professional panel, the
committee will effectively be able to analyze the patient's competency levels as well as
the severity of the individual's suffering. Corresponding interviews will be conducted
assuring the patient's genuine desire to carry out the procedure, and that he or she is
not suffering from a mental or psychological impairment. The committee's purpose is not
to agree or disagree with the patient's decision in whether or not to proceed with
assisted suicide; rather it determines the patient's psychological ability to make such a
decision. This does not impose euthanasia, but it morally and legally sanctions the
procedure because it is of the individuals own will. 
Now that both sides to the Euthanasia controversy have been described. I feel that I am
prepared to present my perspective on the issue. As an undergraduate student studying to
go into the medical field. I am an avid supporter of medical research to find cures for
terminal diseases as well as more effective methods to relief pain in such patients. In
situations where medicine is presently unable to treat or relief an illness, I feel that
it is an individuals autonomous right to end their life if the suffering has reached an
unbearable level. I see physician-assisted suicide as being a legitimate option if there
is no further medical assistance that can relief a person's illness. 
By no means am I discrediting medical research; however, in cases where no medical help
can be provided I feel that euthanasia should be an option upon request. An individual
should not be pressured into the procedure; however, it is a person's constitutional
right to end their terminal suffering. I believe that assisted suicide should be
available upon request by licensed practitioners regardless of an individuals social,
economic or political status. 
I feel that euthanasia should only be legalized under very specific guidelines. I agree
that there should be an established committee that analyzes the competency of the
patient's mental status, thus assuring that the patient is fully able to make such an
irreversible decision. I see Euthanasia as being a justifiable procedure provided that
the patient is not forced into doing anything that they do not desire, and that there is
an assurance that the patient will be capable to make such a decision. With the proper
safeguarding against abuse, physician-assisted suicide is a moral option to those in need
of a way out of their terminal suffering.
Bibliography
Throughout this investigative report on euthanasia, there have been 4 primary text
sources used. The first was titled Physician-Assisted Death, A Biomedical Ethics Review
1993 edited by James Humber, Robert Almeder, and Gregg Kasting. This source provided
numerous arguments both in favor and against the practice of Euthanasia. This ethics
review began with pertinent definitions of assisted suicide, the publicly acknowledged
pros and cons on the issue. The next source used is titled Medical Ethics, The Second
Edition, by Robert M. Veatch. This text provided reliable fundamental concepts and
principles relevant in modern medical ethics debates. This medical ethics book was
especially useful with the history of ethics in medicine, the normative principles and
how the concepts of ethics relate to medical issues such as euthanasia and
physician-assisted suicide. Medical Ethics thoroughly discussed the morals involved in
the physician-patient relationship and the ethics pertaining to a patient's informed
consent.
The third source used was Ethical Issues in Modern Medicine, The Second Edition, by John
Arras and Robert Hunt. This text again provided information on the publicly excepted
principles of bioethics dealing with assisted suicide. Discussions of Euthanasia and the
Care of Dying Patients dealt with the controversial beliefs on whether or not an
individual is competent enough to make a life ending decision. Finally, Saul Kassin's
text, Psychology, The Second Edition, was used for insight on the psychological relevance
of euthanasia to an individuals moral and cognitive development. This source was
particularly useful in related my controversial issue topic to the field of psychology.