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The different perspectives of Euthanasia

Introduction

            In his Case Conference paper, Dr. Megan Best observed that the issue of euthanasia often triggers what he considered as strong emotions. To him, eliciting such emotions is not surprising because euthanasia involves issues of life and death. He noted that for more than two millenniums, euthanasia was prohibited across the globe in the medical fraternity with very few exceptions. However, this reality has been changing over the recent years across different countries as the legislatures legalize it allowing people, especially those without hope of recovering, to make the final decisions on when they should end their lives (Best, 2010).

            While seeking to explain the meaning of euthanasia, Vaibhav Goel (2008) observed that survival is undeniably important and valuable to all people but under certain conditions life can prove to be too painful, unbearable or even impossible. When life gets there, it is possible for the victim or the immediate family to perceive life differently, sometimes terming it as abuse or a curse. Goel observed that it is at such a point in life that some patients or even the immediate family may require to obtain a “license” or a “permit” that they will issue to a medial professional allowing them to end the life of such a suffering individual. Thus, the author simply defined euthanasia as “the intentional killing by act or omission of a dependant human being for his or her alleged benefit” (Goel, 2002, p. 224).

Eliminating Euthanasia Confusion

            Immense confusion surrounds the concept of euthanasia as one of the several other end-of-life issues. Some stakeholders have argued that the concept of euthanasia is somewhat ambiguous and may trigger a number of possible meanings depending on the person looking at it. Goel (2010) therefore advised on the need to explain its meaning whenever it is being used to create a clear understanding. Somehow, euthanasia is often explained in the light of subjects like suicide. However, it is agreeable among many scholars, theorists, opinion leaders, policy makers, and medical experts among other stakeholders that suicide is a form of murder where the victim is also the perpetrator. This is different from euthanasia as it involves ending a person’s life for compassionate motives when the person is already terminally sick or when the victim’s conditions and sufferings have become unbearable. It is often defined as an easy or gentle death especially when looking at the person’s circumstances such as painful sickness or incurable condition.

            Euthanasia is not the same as physician assisted suicide (PAS) as the latter involves the doctor providing the victim with the necessary facilities or tools such as drug so that they can end their own life on their request. Unlike in the case of euthanasia, PAS involves the victim personally administering the killer drug to him/herself ending own life. Euthanasia is also different from non-voluntary termination of life, which is defined as administration of medication or use of other means especially by a medical professional to end the life of a patent especially in situations where the patient is not able to make such a request or give their own consent. Moreover, withdrawing or withholding treatment from a patient leading to their death is also different from euthanasia (Oliver, 2006).

            Sometimes the physician or other medical professional may decide to administer medication so as to control certain symptoms such as sedation or analgesia especially for an agitated or confused patient which may lead to their death. This is different from euthanasia because the intention in so doing is not to end the life of the patient only that it happens accidently (Oliver, 2006). According to Oliver, the definition of euthanasia is clear cut and must not be confused with other subjects revolving around end of life even in tabling arguments in its support of objection. The arguers must base their arguments on the definition and the issues surrounding the subject matter.

How Euthanasia is done

            Dr. Tricia Briscoe (2004) highlighted some of the most common medical methods of euthanasia as highlighted in this section. The first approach involves the use of drugs where a physician prescribes drugs with the intention of killing a patient who has already given consent for such an action. Such lethal drugs are often given in the company of anti-emetics to prevent patients from vomiting. 

            The second method involves the use of injection whereby the patient is rendered into a comatose after which a second injection is done for stopping the heart. The coma is induced through administration of barbiturates, which is followed by a muscle relaxant before the lethal killing injection. Intravenous potassium chloride is injected if death delays hastening cardiac arrest.

The third common method involves the use of gases or peaceful pills. Commonly used in this case is carbon monoxide that can also be prepared at home. Peaceful pills enable the patients to sleep quietly and eventually die while asleep without experiencing any pains or discomforts (Briscoe, 2004).

Briscoe also observed that euthanasia could be carried out through dehydration and starvation. The Right-to-die activists have advocated for the withdrawal of water and food in an endeavor to hasten the patient’s death. They use of terminal sedation makes the person sleep permanently and then foods or water are withheld thus eventually the individual dies. The terminal sedation seeks to control some common symptoms such as suffering from agonizing pain.

Pros and Cons of Euthanasia

Definition arguments           

In his arguments on the subject of euthanasia, Dr. Best (2010) posited that the problems surrounding euthanasia debates emanates right from the very definition of the concept. He posited that euthanasia advocates tend to bracket the subject under other acceptable end-of-life practices in the hope to increase the support of the public and lawmakers. However, he argued that the definition must be kept clear so that the proponents and opponents will argue based on the platform of facts. Best noted that although the term is derived from the Greek word “eu thanos” which is directly translated to mean a “good death”, it does not offer much assistance in seeking to determine whether it should be supported or not. This is because the matter of good death is not usually at the heart of the debate. It is not arguable whether family, friends, and other members of the community would want to see their people dying with dignity and without pain. The issue that triggers the debate revolves around how people should go about the issue of achieving the good death.

            Best (2010) further argued that the terms active euthanasia, passive euthanasia, voluntary or involuntary euthanasia must be avoided while tabling arguments for the subject because they tend to trigger more confusion by making the term more ambiguous. For example, one cannot posit of existence of a practice such as involuntary euthanasia—as long as somebody’s life is taken without their consent is simply murder and not a form of euthanasia. He perceived such as a contradictory term.

Palliative care perspective

             In their argument against euthanasia, Have and Janssens (2001) observed that the proponents of euthanasia tend to present untrue information the subject. They often seem to indicate that at the end of life, a patient is faced only by two pain and suffering on one hand and euthanasia on the other hand. However, this is not always the case. There is a third option that they termed as palliative care, which is a form of specialized care for dying persons. The aim of palliative care is usually to maximize the quality of life and provide the necessary assistance to cares and families during as well as after the death of the patient. This form of care is geared towards liberating patients from different kinds of discomforts caused by the symptoms of their sickness without hastening or deferring the patient’s death. The slogan that guides this form of care is helping the patient live until they die (Have & Janssens, 2001).

            Supporting the concept of palliative care, Best (2010) observed that the WHO has developed a “pain relief ladder which enables up to 90% patients to be pain-free using a basic approach which all doctors can learn” (p. 6). He noted that some special centers are able to achieve higher success rates. Those who cannot afford hospice services can still benefit from some form of palliative care and live to their last day without hastening death. He cited the case of Australia where the debate for euthanasia became less prominent when the government started pouring more money into palliative care. Most people had been arguing based on pains, sufferings and discomfort caused by the terminal ailments but upon realizing palliative addressed the issues, they no longer found a good justification for their support of euthanasia.

Protection of life perspective          

            One commonly ignored perspective in the euthanasia debate revolves around the issue of the duty of the state and medical practitioners as well as medicine to protect human life. Performing euthanasia can simply be perceived as healthcare practitioners neglecting their responsibility of protecting the life of the patient. Supporting doctor’s role in taking away life destroys the doctor-patient relationship whereby the patient is assured that the doctor would do everything humanly and medically possible to save the life of their patient and to restore their health. Euthanasia acceptance amounts to violation of code of medical ethnics that have been in existence since antiquity. During graduation, health care practitioners take the Hippocratic Oath that prohibits them from helping patients die and this has been the custom since 5th Century BC. Both palliative and medical care associations across the globe have upheld this tradition and have been opposed to euthanasia all along, although health conditions, sufferings, and pains used as its justification have been there all along (Jewell, 2005).

            However, the proponents of euthanasia arguing that as much as health practitioners have a duty to protect human life, the holders of the life or the patients also have their rights that must not be taken away from them have opposed this argument. Math and Chaturvedi (2012) posited that as much a doctor may be willing to take care of a patient until the final day, it is not the doctor who experiences the sufferings and the pains but rather the patient. Moreover, the patient is the decision maker in regard to whether they should continue living and not the physician. The two authors did not support the doctor taking the action on behalf of the patient as they considered such an action as murder but argued that as long as the patient who is the victim of the pains and the suffering makes the decision, the blame must not be directed to the physician. Euthanasia in this case should be considered as one of the ways for individuals to uphold “Right to life” through honoring their “Right to die”.

The Economic perspective

            Most proponents of euthanasia tend to evade the issue of cost when it comes to discussing the subject of life-or-death. However, it must be acknowledged that there is no way of going around the subject of the expenses involved in sustaining the life of a terminally ill patient. As much as one may argue that there is no amount of money that can be compared to the life of a human being, it must be acknowledged that the discussion does not revolve around whether the life is worth the money being spend. Majorly, people arrive at the decision of opting for euthanasia upon realizing that no matter how much resources they spend, the person in question has no chances of survival. Euthanasia is not a decision that one arrives at without putting numerous issues into perspective. It is extremely expensive to sustain a person in a life supporting machine or on certain pain-reliever medications only for the patient to die after spending all the family’s and huge state resources. According to some recent studies in the U.S. caring for one patient at their end of life stage can cost approximately $39,000 (Morris, 2013). Morris argued that it would be worth it if the person would eventually recover but it is wastage of resources if such a person spends so much cash only to die in the end.

Slippery Slope to Murder Perspective

            Some legal and medical professionals arguing against euthanasia have posited that the society is so obsessed with the issue of health cost for taking care of patients in their end of life stage and other principles of utility that they are willing to legalize even irrational and immoral laws. The opponents thus see permitting of euthanasia as a disadvantage in that it will act as a slippery slope to allowing various other social vices such as murder. Some arguers against it based on the slippery slope discussion perceives it as a half-way house whose destination is permitting other forms of killings such as suicide for elderly persons and involuntary euthanasia. The argument that they present in opposition is if terminating a human life can be perceived as a benefit, then why must such benefits be limited to the kind of euthanasia why the patient gives consent? Another argument that may arise is why there is need to seek consent? If wrongly approached, patients will be murdered by physicians because their consent may eventually be unnecessary (Lewis, 2007).

            Those in the camp of the proponent of euthanasia have argued against this perspective posting that such an important decision cannot be based on probability or something that has not happened. In his works, Devettere (20097) noted that the opponents base their perception of slippery slope on speculations as opposed to present reality. He therefore posited that there is need for evidence supporting the allegations of possible occurrences of murder incidences instead of basing the arguments on speculations. The proponents further noted that in countries where euthanasia has been legalized for a number of years, there is no evidence showing that the countries have moved towards that direction.

Conclusion

            The subject of euthanasia is one of the most common within the medical fraternity, especially in countries where it is yet to be legalized. Patients with terminal ailments and those undergoing unbearable pain seek the assistance of healthcare professionals in taking their lives. This subjected has been widely debated by those who support the practice versus who oppose it. The pros presented by the supporters are used on justifying the course while the opponents present numerous disadvantages that they use in opposing any attempts to engage in the practice.

This paper sought to highlight the various perspectives that served as pros and cons to euthanasia. Among the highlighted perspectives, include the use of definitions in justifying or opposing euthanasia, the palliative care perspective whereby unbearable pain concern is addressed, and the protection of life perspective where issues of medicine and doctor-patient relationship come into play. Some other common perspectives include the economic perspective that involves calculating the cost of caring for a patient at their end-of-life stage and the slippery road perspective that points at potential dangers of legalizing euthanasia.

References

Best, M. (2010). The Ethical Dilemmas of Euthanasia. CASE Conference in March 2010. Retrieved from: http://www.case.edu.au/images/uploads/Best_article__2_.pdf

Briscoe, T. (2004). Methods of Euthanasia. A New Zealand Resource of Life related issues. Retrieved from http://www.life.org.nz/euthanasia/abouteuthanasia/methods-of-euthanasia/

Devettere, R. (2009). Practical Decision Making in Health Care Ethics: Cases and Concepts. Washington DC: Georgetown University Press.

Goel, V. (2002). Euthanasia – A dignified end of life! International NGO Journal, 3(12), pp. 224-231.

Have, T., & Janssens, R. (2001). Palliative Care in Europe: Concepts and Policies. New York, NY: IOS Press.

Jewell, P. (2005). Rationality, euthanasia, and the sanctity of life. Australian Association for Professional and Applied Ethics 12th Annual Conference 28–30 September 2005, Adelaide. Retrieved from http://www.unisa.edu.au/Documents/EASS/HRI/GIG/jewell.pdf

Lewis, P. (2007). The Empirical Slippery Slope from Voluntary to Non-Voluntary Euthanasia. Journal of law, medicine & ethics, pp. 197-210.

Math, B., & Chaturvedi, S. (2012). Euthenasia: right to life vs. right to die. Indian Journal of medical research, 136(6), pp. 899–902.

Morris, M. (2010). 10 Arguments for Legalizing Euthanasia. Retrieved from http://listverse.com/2013/09/12/10-arguments-for-legalising-euthanasia/

Oliver, D. (2006). A perspective on euthanasia. British Journal of Cancer, 95, 953–954.