FREE ESSAY ON EUTHANASIA

EUTHANASIA

The Right to Choose
The main issues of euthanasia are maintaining the status of illegality, legalizing the
procedure, and regulating the procedure. The controversy of euthanasia involves moral,
ethical, and legal concerns. In this country, according to a survey reported in the
Journal of American Medical Association, nearly 63 percent of Americans favor legalizing
physician-assisted suicide, yet most state statutes criminalize it (Stark, np). People
fear that if legalized, the choice to die will eventually be taken out of their hands and
placed in the hands of people who will choose to kill select people based on their own
private criteria. Maybe this is true, but it is doubtful. The issues are more realistic
and involve our society's morals and the legal consequences of choice in dying.
Currently, the debate involving the practice of euthanasia revolves around moral and
legal issues. The moral debate involves religion and other societal beliefs. Everyone has
their own morals and values, which is their God-given, inalienable right. In America, our
society's morals are based in part on religious beliefs. Most religions, especially
Christian religions, feel that taking another's life is wrong and against God's
commandments. The Catholic church feels strongly about euthanasia and encourages both the
Catholic congregation and United States politicians to maintain the illegal status of
euthanasia.
The legal debate is a hot issue with both proponents and opponents striving to win. In
the United States, the Supreme Court decided to allow individual states to decide what to
do about physician-assisted suicide. Currently, only Oregon allows physician-assisted
suicide. Several other states are debating over the subject but without success. The main
legal argument is whether or not a citizen of the United States has the constitutional
right to choose between life and death. As it stands now, the Supreme Court ruled we do
not have the constitutional right to choose. 
One last issue is the financial effect on the person and their family. The surgeries,
life support, drugs, doctor's fees and all the other expenses of a terminally ill patient
are staggering. For one week in an intensive care unit, the cost could easily soar to
$100,000. The cost of letting a person die is close to nothing when compared to the cost
of keeping them alive.
A solution to the debate over euthanasia is highly anticipated. Maybe one day all the
issues can be resolved and the bickering over mercy-killing will end. Of course, on the
pessimistic side, the right to die debate might never be concluded. The controversy
surrounding euthanasia can only be resolved when the procedure is legalized with
mandatory, regulatory guidelines put in place to enable both physicians and individuals
to decide the best course of action for themselves without fear.
Choice in Dying reminds us that Although the concept of the right to die has interested
philosophers since the time of the Greeks, it was not until recently that the issue
became a pertinent and widespread social concern. A cancer patient named Robert Dent
wrote the following in a letter before he died of an injection that he requested
(Australian Man First in World, A5). If I were to keep a pet animal in the same condition
I am in, I would be prosecuted. If you disagree with voluntary euthanasia, then don't use
it, but don't deny me the right to use it. He requested euthanasia and received it. The
word euthanasia is a combination of the Greek prefix Eu, which means good, and thanatos,
meaning death. Webster's Dictionary defines it as the act or practice of killing
individuals that are hopelessly sick or injured for reasons of mercy. Euthanasia or mercy
killing as they more commonly call it, is a highly debated topic that has many aspects.
Financial, moral, social, and most important, legal concerns are raised whenever
euthanasia is brought up.
There were two major cases in the U.S. that pertain to mercy killing that the Supreme
court ruled on and one they refused to hear. According to Choice in Dying's Legal
Developments web page, the following three legal rulings have recently been issued. In
1996, the Ninth Circuit Court in Compassion in Dying v. Washington and the Second Circuit
Court in Quill v. Vacco, ruled that the U.S. Constitution protects the issue of
physician-assisted suicide when requested by competent, terminally ill patients. The U.S.
Supreme Court in January 1997 and June 1997 reversed these decisions based on the Due
Process Clause and the Equal Protection Clause of the Fourteenth Amendment; but, they
left it up to the states to ban or legalize physician-assisted suicide. In the third
predominant case, Lee v. Oregon (U.S. Court of Appeals, Ninth Circuit; February 1997).
The U.S. District Court had held that Oregon's Death with Dignity Act (Measure 16), the
first law in the nation to legally authorize physician-assisted suicide, violated the
Equal Protection Clause because the safeguards were insufficient to protect the rights of
terminally ill patients who may seek assistance in dying. The Ninth Circuit Court of
Appeals, in a 3-0 vote, found that the plaintiffs had no legal standing to challenge
Measure 16 because they failed to show any threat of immediate harm and that their claim
rested upon a 'chain of speculative contingencies.' The Court did not decide the
constitutional merits of physician-assisted suicide. The U.S. Supreme Court refused to
hear the appeal (Choice in Dying, Legal Developments, np).
As medical technology, financial concerns, and the age of people all increase, so will
the demands for a legal decision on the euthanasia issue. Medical technology has advanced
to a point that people can now be kept alive against their will. The people who support
the right to die believe that medical technology has advanced so much that doctors can
keep a person's body alive, even if the brain is not functioning. Medical advances and
technologies have made it possible to survive pneumonia, heart attacks, and kidney
failure. New drugs and surgeries have made living longer possible. And when people are in
critical condition and about to die, artificial respirators and tube feeding will keep
the body alive, even when the person might want and need to die. Medical technology will
continue to advance and will necessitate alternatives to current medical practices and
changes to medical and societal beliefs.
Various religions and society impose their beliefs and morals on the individual causing
more confusion. In Euthanasia: The Battle for Life, Dr. Raymond Bohlin discusses what the
Bible says about life, suffering, and death. He quotes scripture that reflects the
Christian beliefs that God has created us, numbered our days, and that no one can take
another's life because it breaks God's commandment. He goes on to imply that the issue
can be resolved by praying, speaking out, and reaching out to the sick and the elderly.
Just days before he died, Chicago Cardinal Bernardin had this to say to the court,  I am
at the end of my earthly life. As one who is dying, I have especially come to appreciate
the gift of life. For the court to accept assisted suicide would send a false signal that
a less-than-perfect life is not worth living (Peres, News Section). This stance is
surprisingly different from surveys of Jewish willingness to participate in
physician-assisted suicide. With a ratio of almost 3:1, Jewish respondents would
participate in the procedure although it appears that the response is against Jewish
teaching. However, it may not be against the teachings because the prime teachings are
that each person is an individual and that 'loving kindness' should be extended to each
person (Newfield, np. The two illustrated religious thoughts reflect our society's
confusion over the issue of euthanasia. On one side are the people who want to legalize
physician-assisted suicide because they believe that it is an individual's choice to
decide to die with dignity. On the other side are the people who believe euthanasia
should remain illegal because it is wrong to kill. Both religion and society have changed
their established standards of beliefs in the past to encompass the beliefs of the
people. They can do it again.
Another cause of the euthanasia debate is the financial concerns for both the family and
society. As reported by The Villanova Center for Information Law and Policy, most people
who are against euthanasia believe it will only be a matter of time before courts will
sanction putting people to death, not because they are desperately ill and want to die,
but because they are deemed to pose an unjustifiable burden on society. P.J. King feels
that the insurance industry in the future will offer patients the option to die instead
of spending a lot of money on expensive treatments. This decision will be based on solely
on cost containment. Not only do we have the insurance industry interested in the money
saved through euthanasia, but we also have the heirs of the terminally ill who might be
interested in the money they can receive it the patient chooses to die instead of suffer.
Money and age, these are powerful change agents.
There are three primary solutions which could feasiblely be argued both for and against
by the people and politicians most interested in the euthanasia debate. To properly
evaluate the solutions, certain criteria must be chosen. Personal - Is the patient
terminal and suffering and does he choose to die? Medical - Is it ethical, accepted
practice and is the patient terminal/suffering? Religious - Is it moral and have the
individuals involved considered their actions concerning their beliefs? Legal - Is it a
crime to assist a terminally ill patient in dying?
One solution, legalization of euthanasia, would decriminalize the procedure and allow
patients a true choice. At this time our citizens time, money, and resources are being
ill-used in law suits and criminal cases to determine the legality of physician-assisted
suicide. Barbara Dority, in The Humanist states In order to grant the wishes of dying
patients for help to end their suffering, we have to change the fact that doing so is
against the law. How can we ask doctors- -in consultation with families, clerics, and
communities- - to commit a serious crime for which they risk losing their licenses and
possibly being arrested and going to jail? The legal issues must be confronted and a
legal right to request physician aid in dying for the terminally ill secured. Justice
John Paul Stevens noted in his U.S. Supreme Court opinion that under certain
circumstances, if state bans on assisted suicide were found to 'impose an intolerable
intrusion on the patient's freedom,' they could be invalidated (Peres, News Section). 
The evaluation of legalization of euthanasia as a possible solution reflects that all
criteria are minimally met. Euthanasia is a private matter between the terminal and
suffering patient and the physician. The decision is made with physician and patient but
there are no guidelines to protect against abuse. The moral issue is private and no
longer relative because the action is not a crime; therefore, no one would be
prosecuted.
The opponents of euthanasia feel that legalization would not be supported and if passed,
there would be no guarantees of protection from abuse. Opponents of euthanasia in both
the Netherlands and the United States argue that there are insufficient control and
oversight procedures to legalize physician-assisted suicide (Stark, np). According to
Susan Okie of the Washington Post, recent surveys reflect that less than 16 percent of
the nation's physicians admit to receiving requests for euthanasia and only 4 percent
have taken action.
Outright legalization of euthanasia would be a very chaotic idea. Very few people or
physicians support this idea. Some people may be left dying slowly and painfully, while
others may receive euthanasia when they don't want it or need it. Outright legalization
provides relief to some, while creating problems for others.
Regulated legalization will provide the choice to patients and physicians along with
guidelines for implementation. Guidelines are needed to ensure the proper choice is made
based on the individual's condition and that the timing is appropriate. In the United
States, Oregon has a new law known as the Death with Dignity Act. It provides terminally
ill adults with the right to obtain a prescription from a physician for medications to
end their lives. The law has three main conditions that need to be met: two doctors
decide life expectancy is less than six months; patient must request assistance three
times, once in writing; and the physician must wait 15 days after the initial request.
Physicians who follow the guidelines cannot be prosecuted or disciplined (Health
ResponseAbility, np). In 1990, the Dutch Ministry of Justice voted to accept the royal
Dutch Medical Association guidelines which determined when euthanasia is not acceptable
and becomes a crime (Smith, p 36). Regulated euthanasia would not only give people a
dignified death, but also save families money. It costs thousands of dollars a year to
keep someone alive through medication and technology, but it only cost a few dollars to
give someone a lethal injection. The evaluation of regulated legalization as a possible
solution reflects that all criteria are fully met. Terminal and suffering patients can
make a choice that is right for themselves. The medical ethics and guidelines are
established and should be followed.The religious criterion is met because the moral issue
is private and since it is no longer illegal, no commandments are broken. Again, but much
stronger, the legal criterion is fully met as there is no prosecution unless guidelines
are not followed, which protects patients from abuse.
The opponents of legalization feel that not enough care is provided and that legalization
will cause people to be killed when they don't want to die. In his book, Keown warns
about the slippery slope of killing others than those who clearly state they want to die.
Safeguards, he claims, have proved ineffectual. Non-voluntary euthanasia is now widely
practiced and increasingly condoned. His alternative is a strong advocacy of palliative
care: a mix of proper pain management, symptom control, psychological and spiritual
support (Killing With Kindness, p 16). Palliative Care, opponents feel, should be more in
the forefront. According to Choice in Dying, more than two million people in America die
each year with 80 percent of those in care facilities. Vivienne Nathanson, head of ethics
at the BMA, says that Doctors have become more aware that palliative care is effective.
Temptation may come when adequate care is not available. But that's exactly what doctors
and families should be demanding, not euthanasia. Once we have a perfect palliative care
system, that is the time to look at the issue (Killing With Kindness, p 16).
Regulated legalization is the best solution because the concerns of both opponents and
proponents are addressed. To reach the point of legalization, people must first be
properly educated of all the facts. The appropriate organizations should establish
implementation guidelines and set up regulatory and censorship procedures. Politicians
will need to use these guidelines to decriminalize the act of euthanasia.
Outright euthanasia is illegal. Dr. John Keown, editor of Euthanasia Examined (Cambridge
university press), who is opposed to voluntary euthanasia says: 'The fundamental basis of
the case for voluntary euthanasia is an acceptance of the notion that certain lives are
no longer worthwhile (Smith, p 36). The Christian Medical Fellowship discuss their
beliefs and further state A law enabling euthanasia will undermine individual and
corporate incentive for creative caring. A patient with a terminal illness is vulnerable
and may not be objective about their own situation. Patients who on admission to the
hospital say they want to die, usually change their mind after effective symptom relief.
Terminally ill patients also adapt to a level of disability that they would not have
previously anticipated they could live with. They come to value what little quality of
life they have left. Wesley Smith of the National Review reminds us that Outright
euthanasia remains illegal in every state. And assisted-suicide is banned, either by
statute or through court interpretation in 47 states. President Clinton has signed a law
prohibiting federal funds from being used for assisted-suicide.
The evaluation of outright euthanasia as a possible solution reflects that only some
criteria are met. There is no legal choice; therefore, the procedure is still cloaked in
secrecy and shame. Since there is no legal or ethical protection, it will still be done
but at the risk of prosecution. Theological and societal beliefs are not eroded because
euthanasia is not an openly accepted practice. And, the legal status remains the same;
there will be prosecution for physicians who aid the dying.
A better basis for public policy is to ensure that treatment is according to the
patient's wishes. In the United States, a solution has not been agreed upon. However, the
best solution will have to address not only society's concerns, but also the individual's
desires to be the best the solution. 
Legality offers opportunity for choice. Those who are pro-choice, as reported on
Villanova's internet page, believe the decision how and when to die is one of the most
intimate and personal choices a person can make in a lifetime, a choice, central to
personal dignity and autonomy. How a person dies not only determines the nature of the
final period of existence, but in many cases, the enduring memories held by those who
love him. Guidelines provide security from abuse. Not only will our terminal ill and
suffering be protected, but our depressed, disabled, and otherwise incompetent citizens
will be protected from physicians and family members who may want their loved ones' lives
ended. Maintaining the illegality of euthanasia does not solve any of the issues and
contributes to secretive and shameful procedures.
The best solution is controlled regulation and through legalization, the
decriminalization of euthanasia. The Voluntary Euthanasia Society has already established
proposals for a voluntary euthanasia law. Some requirements are: the patient must be a
mentally competent, incurably ill adult that is suffering unbearably; request must be in
writing; must seek a second medical opinion and psychiatric assessment; the final
decision must be the patient's alone; and only a doctor may perform the act (Voluntary
Euthanasia - The Basics, np). By decriminalizing the act of euthanasia, doctors no longer
need to worry about prosecution and can freely choose to help or not to help a patient
end their suffering. State laws or regulations governing physician-assisted suicide will
be necessary to protect against abuse and ensure that assisted-suicide is conducted
professionally and fairly.
The evaluation of regulated legalization as the best solution reflects that all criteria
are fully met and compared to the other possible solutions, the best choice for all
parties.
People will have a choice and there will be guidelines to help them and their physicians
decide the best course of action. Religious and social morals would be upheld because
euthanasia will be a legal but private decision. Physicians, no longer prosecuted, will
be able to assist the dying.
With legalization, greedy actions by family members and the insurance industry will be
paramount. Though it appears that legalization with regulation is the best solution, the
effort to maintain the regulatory aspects will be difficult. There will be misuse of the
guidelines. The health insurance industry will lobby and try to infringe their revenue
generating beliefs into the process. And last, but not least of all, greedy family
members hungry for their inheritance will try to coerce the dying and suffering into
choosing euthanasia. We cannot regulate society's or an individual's values and morals.
But by offering a legal alternative that provides for death with dignity, we are showing
our faith in people to do the right thing for themselves and their family members.
The benefits of regulated legalization are numerous and apply not only to the physician
and the terminally ill patient, but also to society. Decriminalization and establishment
of guidelines will mean that society no longer will have to foot the bill for
prosecutions and can feel safer that there are no more Dr. Death's lurking in the
background. The individual will no longer fear having to ask for the procedures and they
can trust their physicians to utilize established guidelines. Physicians will no longer
be prosecuted but will have a choice to participate with established guidelines to lead
them.
To have a choice in death will mean that society can be educated and grow with the needs
of its people as it has always been forced to do. The individual can understand the
guidelines before utilizing them in their own private choice. Choice will also mean that
physicians can choose to assist or not assist, as their own beliefs allow.
With medical technology advancing, along with an aging population, it is important that
the controversy over euthanasia is resolved legally and morally or we may find ourselves
at the mercy of opinionated people who will decide who dies and when they die. We cannot
regulate values and morals for individuals and society. We can offer a legal remedy to a
problem that continues to exist in hotel rooms and in the back of vans. We have all heard
of people who suffer with a terminal illness or even commit suicide. This is not the best
way to for a patient's life to end. The agony of suffering is extremely demoralizing to
the patient and to the family. 
A better way to ease the misery and the suffering is to respect the individual's right to
choose the best course of action for their life and their death. Those who are
pro-choice, as reported on Villanova's internet page, believe the decision how and when
to die is one of the most intimate and personal choices a person can make in a lifetime,
a choice central to personal dignity and autonomy. How a person dies not only determines
the nature of the final period of existence, but in many cases, the enduring memories
held by those who love him. If nothing is done about the euthanasia issue, our society
will continue to turn a blind eye to the issue and people will continue to seek
alternatives behind closed doors. Society must become educated on the issue of euthanasia
and lobby the politicians for effective and realistic changes to the law so that they can
protect physicians from prosecution and individuals will finally have the right to choose
death instead of misery. 
Bibliography
Works Cited
Australian Man First in World To Die With Legal Euthanasia. The New
York Times Sept 26 1996: A5. Proquest Direct.
Bohlin, Raymond. Probe Ministries. Euthanasia: The Battle for Life. www.probe.org.
Choice in Dying. Legal Developments. 1998. Web@ choices.org.
Choice in Dying. Issues: Background on the right to die. 1998. Web@choices.org.
Daniel, Caroline. Killing With Kindness. New Statesman. Aug. 15 1997: v126 n4347 p16.
Dority, Barbara. The Ultimate Civil Liberty. The Humanist. Jul-Aug. 1997: v57 n4 p16. 
King, P.J. Ohio Right to Life. Forced Euthanasia?. April 1996. www.ohiolife.org.
Newfield, Philippa. The Institute for Jewish Medical Ethics of the Hebrew Academy of San
Francisco. Euthanasia, Physician Assisted Suicide and the Dying Patient: Medical Status.
Webmaster.
Okie, Susan. Country's Doctors Remain Divided Over Physician-Assisted Suicide. Washington
Post, January 8, 1997. Sec A15
Peres, Judy. Assisted-Suicide Bans Upheld. Chicago Tribune. June 27, 1997. Section News.
Smith, Wesley J. Death Wars: As Euthanasia advocates press their case, the moral
health of the country is at stake. National Review. Jul 14, 1997: v49 n13 p36.
Stark, Albert. Building a National Consensus on Assisted Suicide. The Trenton Times.
March 31, 1996. America Online.
The Villanova Center for Information Law and Policy, 96 C.D.O.S. 1507. US 9
Compassion in Dying vs. State of Washington. America Online. 
Voluntary Euthanasia Society. Voluntary Euthanasia - The Basics. America Online.
1994 Health ResponseAbility Systems. America Online.
1997 Christian Medical Fellowship. 12 reasons why voluntary euthanasia should not be
legalized. Webmaster@Cmf.org.uk.
Annotated Bibliography
Australian Man First in World To Die With Legal Euthanasia. The New
York Times Sept 26 1996: A5. Proquest Direct. This article describes the actual
procedure used when Australia's new law was first used to aid the dying.
Bohlin, Raymond. Probe Ministries. Euthanasia: The Battle for Life. www.probe.org. This
online article, written from the viewpoint of a Christian organization talks about what
the Bible says in relationship to living and dying. It also points out the supposed
fallacy
of the laws in Holland
Choice in Dying. Legal Developments. 1998. Web@ choices.org. This is a very good
eight page online article about the legal battles currently being fought in different
states.
Choice in Dying. Issues: Background on the right to die. 1998. Web@choices.org. This
six page online article from a major organization involved in the euthanasia issue
provides background on the right to die. It discusses the different types of euthanasia,
the medical futility, and the facts about end-of-life care.
Daniel, Caroline. Killing With Kindness. New Statesman. Aug. 15 1997: v126 n4347
p16. This cover story shows that people's sentiments are changing in the United
Kingdom about euthanasia. Many organizations are requesting the government to
legalize the procedure.
Dority, Barbara. The Ultimate Civil Liberty. The Humanist. Jul-Aug. 1997: v57 n4 p16. 
Ms. Dority, active in the right-to-die movement discusses the moral issues involved
with physician-assisted suicide. She knows there will be many complications with
legalization.
King, P.J. Ohio Right to Life. Forced Euthanasia?. April 1996. www.ohiolife.org. This
is a good three page online article about the insurance insurance industry's impact on
euthanasia.
Newfield, Philippa. The Institute for Jewish Medical Ethics of the Hebrew Academy of San
Francisco. Euthanasia, Physician Assisted Suicide and the Dying Patient: Medical Status.
Webmaster. This eight page article provides an overview of euthanasia and discusses the
religious, medical, and legal aspects of legalization.
Okie, Susan. Country's Doctors Remain Divided Over Physician-Assisted Suicide. Washington
Post, January 8, 1997. Sec A15. Ms. Okie discusses the Supreme Court
rulings and the effects as seen primarily from the opponents to euthanasia viewpoint.
Peres, Judy. Assisted-Suicide Bans Upheld. Chicago Tribune. June 27, 1997. Section News.
Ms. Peres provides comments on the Supreme Court rulings with discussion based on each of
the justices opinions.
Smith, Wesley J. Death Wars: As Euthanasia advocates press their case, the moral
health of the country is at stake. National Review. Jul 14, 1997: v49 n13 p36. The
prominent nature of the debate is due to court cases. Public opinion favors
legalization.
Stark, Albert. Building a National Consensus on Assisted Suicide. The Trenton Times.
March 31, 1996. America Online. This Special to The Times article provides
background on the euthanasia legal issues in the past and the current legal status.
The Villanova Center for Information Law and Policy, 96 C.D.O.S. 1507. US 9
Compassion in Dying vs. State of Washington. America Online. This 84 page online
article fully discusses the Supreme Court case, the background, the plaintiffs'
viewpoints, and the opinions of each of the justices. This was very interesting reading.
Voluntary Euthanasia Society. Voluntary Euthanasia - The Basics. America Online. This
two page online article from a major international organization involved in the right to
die issues provides information on the organization and it's plans to change the United
Kingdom's suicide laws.
1994 Health ResponseAbility Systems. America Online. This two page online article
discusses Oregon's new law also known as the Death With Dignity Act.
1997 Christian Medical Fellowship. 12 reasons why voluntary euthanasia should not be
legalized. Webmaster@Cmf.org.uk. This religious organization believes that legalization
should be avoided because the risk to society and patient autonomy is too great.