Euthanasia
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.