EUTHANASIA (Assisted suicide)
The intentional killing by act or omission of a dependent human being for his or her alleged benefit. (The key word here is “intentional”. If death is not intended, it is not an act of euthanasia).
Euthanasia is the act of deliberately ending a person’s life to relieve suffering.
For example, a doctor who gives a patient with terminal cancer an overdose of muscle relaxants to end their life would be considered to have carried out euthanasia.
Assisted suicide is the act of deliberately assisting or encouraging another person to kill themselves.
If a relative of a person with a terminal illness were to obtain powerful sedatives, knowing that the person intended to take an overdose of sedatives to kill themselves, they may be considered to be assisting suicide.
WHAT EUTHANASIA IS NOT?
There is no euthanasia unless the death is intentionally caused by what was done or not done. Thus, some medical actions that are often labeled “passive euthanasia” are no form of euthanasia, since the intention to take life is lacking. These acts include not commencing treatment that would not provide a benefit to the patient, withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted, and the giving of high doses of pain-killers that may endanger life, when they have been shown to be necessary. All those are part of good medical practice, endorsed by law, when they are properly carried out.
HISTORY OF EUTHANASIA
According to the historian N. D. A. Kemp, the origin of the contemporary debate on euthanasia started in 1870. Euthanasia is known to have been debated and practiced long before that date. Euthanasia was practiced in Ancient Greece and Rome: for example, hemlock was employed as a means of hastening death on the island of Kea, a technique also employed in Marseilles and by Socrates in Athens. Euthanasia, in the sense of the deliberate hastening of a person’s death, was supported by Socrates, Plato and Seneca the Elder in the ancient world, although Hippocrates appears to have spoken against the practice, writing “I will not prescribe a deadly drug to please someone, nor give advice that may cause his death” (noting there is some debate in the literature about whether or not this was intended to encompass euthanasia).
TYPES OF EUTHANASIA
Euthanasia can be classified in different ways, including:
• Active euthanasia – where a person deliberately intervenes to end someone’s life – for example, by injecting them with a large dose of sedatives
• Passive euthanasia – where a person causes death by withholding or withdrawing treatment that is necessary to maintain life, such as withholding antibiotics from someone with pneumonia
EUTHANASIA CAN ALSO BE CLASSIFIED AS:
• Voluntary euthanasia –
Where a person makes a conscious decision to die and asks for help to do this.
• Non-voluntary euthanasia –
Where a person is unable to give their consent (for example, because they are in a coma or are severely brain damaged) and another person takes the decision on their behalf, often because the ill person previously expressed a wish for their life to be ended in such circumstances.
• Involuntary euthanasia –
Where a person is killed against their expressed wishes.
Depending on the circumstances, voluntary and non-voluntary euthanasia could be regarded as either voluntary manslaughter (where someone kills another person, but circumstances can partly justify their actions) or murder.
INVOLUNTARY EUTHANASIA IS ALMOST ALWAYS REGARDED AS MURDER.
There are arguments used by both supporters and opponents of euthanasia and assisted suicide
LEGALITY AND ETHICS OF EUTHANASIA
Euthanasia, also known as assisted suicide, physician-assisted suicide (dying) , doctor-assisted dying (suicide) , and more loosely termed mercy killing, basically means to take a deliberate action with the express intention of ending a life to relieve intractable (persistent, unstoppable) suffering. Some interpret euthanasia as the practice of ending a life in a painless manner. Many disagree with this interpretation, because it needs to include a reference to intractable suffering.
In the majority of countries euthanasia or assisted suicide is against the law. According to the National Health Service (NHS), UK, it is illegal to help somebody kill themselves, regardless of circumstances. Assisted suicide or voluntary euthanasia carries a maximum sentence of 14 years in prison in the UK. In the USA the law varies in some states. The British House of Lords Select Committee on Medical Ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering”. In the Netherlands and Flanders, euthanasia is understood as “termination of life by a doctor at the request of a patient”
Active euthanasia is currently only legal in Belgium, Holland and Luxembourg. Under the laws in these countries, a person’s life can be deliberately ended by their doctor or other healthcare professional.
The person is usually given an overdose of muscle relaxants or sedatives. This causes a coma and then death.
HOWEVER, EUTHANASIA IS ONLY LEGAL IF THE FOLLOWING THREE CRITERIA ARE MET:
• The person has made an active and voluntary request to end their life.
• It is thought that they have sufficient mental capacity to make an informed decision regarding their care.
• It is agreed that the person is suffering unbearably and there is no prospect for an improvement in their condition.
Active euthanasia is a much more controversial subject than passive euthanasia. Individuals are torn by religious, moral, ethical and compassionate arguments surrounding the issue.
Euthanasia has been a very controversial and emotive topic for a long time.
ARGUMENTS FOR VOLUNTARY EUTHANASIA:
Choice – freedom of choice is the cornerstone of free market systems and liberal democracies. The patient should be given the option to make their own choice.
Quality of life – only the patient is really aware of what it is like to experience intractable (persistent, unstoppable) suffering; even with pain relievers. Those who have not experienced it cannot fully appreciate what effect it has on quality of life. Apart from physical pain, overcoming the emotional pain of losing independence is an additional factor that only the patient comprehends fully.
Dignity – every individual should be given the ability to die with dignity.
Witnesses – people who witness the slow death of others are especially convinced that the law should be altered so that assisted death be allowed.
Drain on resources – in virtually every country there is never enough hospital space. Channeling the resources of highly-skilled staff, equipment, hospital beds and medications towards life-saving treatments makes more sense; especially when these resources are currently spent on terminal patients with intractable suffering who wish to die.
Public opinion – in nearly all countries a significantly higher proportion of people are for euthanasia than against it. In a democracy legislation should reflect the will of the people.
Humane – it is more humane to allow a person with intractable suffering to be allowed to choose to end that suffering.
Loved ones – it helps shorten the grief and suffering of the patient’s loved ones.
We already do it – if a loved pet has intractable suffering we put it down. It is seen as an act of kindness. Why should this kindness be denied to humans?
Prolongation of dying – if the dying process is unpleasant, the patient should have the right to reduce this unpleasantness. In medicine, the prolongation of living may sometimes turn into the prolongation of dying. Put simply – why should be a patient be forced to experience a slow death?
REASONS AGAINST VOLUNTARY EUTHANASIA:
The doctor’s role – doctors and other health care professionals may have their professional roles compromised. The Hippocratic Oath, in its ancient form stated “To please no one will I prescribe a deadly drug nor give advice which may cause his death.”
Moral religious argument – several religions see euthanasia as a form of murder and morally unacceptable. At best, some see voluntary euthanasia as a form of suicide, which goes against the teachings of many religions. Euthanasia weakens society’s respect for the sanctity of life.
Competence – euthanasia is only voluntary if the patient is mentally competent – has a lucid understanding of available options and consequences. Determining or defining competence is not straightforward.
Guilt – there is a risk patients may feel they are a burden on resources and are psychologically pressured into consenting. They may feel that the burden – financially, emotionally, mentally – on their family is overwhelming. Even if the costs of treatment are provided by the state, there is a risk hospital personnel may have an economic incentive to encourage euthanasia consent.
Slippery slope – there is a risk things will start with those who are terminally ill and wish to die because of intractable suffering, and eventually begin to include other patients.
The patient might recover – the patient might recover against all odds. The diagnosis might be wrong.
Palliative care – good palliative care makes euthanasia unnecessary.
How can you regulate it?
Euthanasia cannot be properly regulated.