Euthanasia is an Individual Decision
According to the American Heritage Dictionary, euthanasia is defined as "the act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment." Not everyone agrees with this definition. I have always believed that euthanasia was the human choice or nonchoice of ending another person's life because of the excruciating pain they are suffering due to an incurable disease. Some disciplines think that euthanasia should never be an option no matter what the situation. While other disciplines question the validity of the actions of the person helping with the actual euthanasia. Still others support euthanasia in all forms as long as it is performed for the sake of the sufferer.
There are three types of euthanasia; voluntary active euthanasia, passive euthanasia and physician assisted suicide. In all cases where euthanasia is used the patient must be suffering from an incurable, fatal disease. Voluntary active euthanasia is a "deliberate intervention" by an individual other than the patient, with the pure intention of termination that patient's life. (Gula, 501) Passive euthanasia takes place when the attending physician decides to discontinue therapy or treatment that would help to keep the patient alive, basically letting the patient die without the benefit of medicine or medical procedures. Finally, physician assisted suicide, or PAS, is where a physician "helps to bring on the patient's death by providing the means to do it or by giving the necessary information on how to do it, but the patient performs the lethal act" (Gula, 501-502). Each of these methods is a form of euthanasia or mercy killing but each is different in the amount of involvement by the physician. This paper will explore views from various disciplines about all three types of euthanasia.
According to the Catholic religion, euthanasia, as well as abortion and contraception, are sins against God and the Church. Pope John Paul Ii wrote and encyclical letter that was issued at the Vatican in March 1995. Pope John Paul II shared his views on the topics of euthanasia, contraception and abortion in this very opinionated statement. The Catholic Church feels that it is wrong for people to believe that they can control the beginning and end of their lives. According to the Church , "the temptation becomes all the greater to resolve the problem of suffering by eliminating it at the root, by hastening death so that it occurs at the moment considered most suitable. (Population and Development Review, 691). The Church also holds the belief that there is value to suffering and we, as human beings, should realize that suffering is a very important part of our religious life. Also, we, as Christians, should remember that beyond this life there remains the triumph of heaven. But these dogmas do not take away the pain and suffering related to a fatal illness nor do they make the pain any less real or manageable.
On the medical front, there is always the question of ethics and morals for the physicians involved in euthanasia. Is it ethical to take a person's life even if they have repeatedly asked you to do so? A doctor has taken the Hippocratic Oath and has sworn to work to his best ability for the good of the patient. The question is, is the good of the fatally ill patient a release from the suffering or the continued attempt to help that individual during their time on earth? In his article "A problem for the idea of voluntary euthanasia", Neil Campbell explores the question of voluntary and involuntary euthanasia as well as the ethical and moral constraints of assisted suicide. Campbell believes that voluntary euthanasia may not really exist. "When a person asks to die under such conditions there is good reason to think that the decision to die is compelled by the pain and hence not freely chosen" (Campbell, 242). Is that request what the patient really wants or do they simply want an end to the pain, not necessarily their lives? Another condition to examinee is the quality of the person's life. Has their quality of life disintegrated so much so that they feel there is no other hope? In that case, the physician has to examine whether the person is clinically depressed and therefore not of sound mind for such a request. Campbell compares the suffering patient's request to die to that of torturing a prisoner to find out information. The tortured prisoner will eventually go against his own beliefs and tell his captors what they wish to know. Normally, this would not occur but because the pain and suffering are so great, the prisoner will do anything to make the pain stop. Campbell feels that, in a sense, a dying patient asking for death is similar to a prisoner in that they are asking for death when, under different circumstances, they would not really wish to die. One must also consider the fact that, unlike the prisoner, the pain will not cease for the patient simply because they ask to die, it will stop if they die.
If physicians have ethical problems with PAS, Is it a religious issue or does it go back to the doctor's desire to help people? One wonders if it is not a combination of both issues for the physician. Also, if euthanasia becomes legal, will it cause physicians to discontinue their goal of trying to cure and treat fatally ill patients? Would the legalization also lead doctors to believe that they could stop treatment at anytime because they feel that there is nothing left for them to do, even if there avenues they have not explore? I would hope that would not be the case. I believe that euthanasia should only be used where there is absolutely no other way to help the patient. In a study in Professional Psychology in 1999, 625 psychologists were surveyed about being called upon to assess a terminally ill patient's state of mind. One third of the psychologists said that this type of counseling was outside of their area of practice. Sixty percent of the remaining 275 respondents said that they would do a competency test if they were requested to do so by a physician, 7 % said that they would not do an evaluation and 33% would refer the physician to another psychologist. The researchers found that many of the psychologists would not wish to be involved in a life or death situation such as this due to moral and ethical situations. Dr. Faye Girsh, a psychologist for the Hemlock Society (a right to die organization) feels that physicians need to decide which side of the debate over euthanasia that they are on because of the rising public demand for the right to control the end of one's life. (Larkin, Vol.353). As you can see, the ethical and moral issues exist for psychologists and physicians alike. However, is it really up to them to put their morals and beliefs on to suffering patients? It seems that if a person chooses to die because there is no other option, they should be able to find some form of help to allow them to do so. That is where the legal aspect comes into play.
In 1994, Oregon passed its Death with Dignity Act, becoming the first state in the country to legalize euthanasia. In June 1997, the Supreme Court ruled that physician assisted suicide is not a constitutional right but made each state free to determine its own euthanasia laws within its boundaries. The legal issue is a very sensitive topic. Many anti-euthanasia supporters feel that if euthanasia is made legal in each state, the value of human life will disintegrate. The feel that society will call for the mercy killing of those considered to be a burden on the human race such as those with mental retardation or incurable diseases, as well as those who are dying or are unable able to pay for medical care. Pro- euthanasia supporters disagree. They feel that by making euthanasia legal, people would be more in charge of the end of their lives, the quality of their lives as well as their dignity.
The Philosophical viewpoint is much different than the other disciplines that we have explored. According to Phillipa Foot in her article Euthanasia, "an act of euthanasia...(is)...when someone is deliberately allowed to die, for his own good."(87)
This article brings into question the quality of one's life versus the quality of one's death. It would actually increase the quality of one's life by allowing for a dignified death rather than a prolonged humiliating wait for the peace that death would bring a fatally ill person. Foot also examines the question of voluntary versus involuntary euthanasia. There is no concrete way to determine whether a person is making a rational desiccation at the time of their suffering because no one can provide the ideal circumstances. The main concern here is that we as a society will not abuse euthanasia as a way to rid the world of undesirables.
Basically, how one feels about the euthanasia issue is largely based on with what discipline one views the issue. From the psychological viewpoint, one must look at the mental states involved, not only the suffering individual but also that person's family. The mental state of the individual suffering is important in that we need to know that they are making as sound and rational request as they are able to. Also, the family of the ill person has suffered through an emotional roller coaster as they helplessly watch a loved one suffer. From the religious discipline, euthanasia is wrong. Death and life are not in our control and therefore it is in God's hands to decide when our time on earth has ended. Legally, each state has the right to decide if euthanasia is legal in its boundaries. If a state passes a law legalizing mercy killings, there is no question from the legal standpoint of right or wrong. Philosophically speaking, euthanasia is intended to be used for good and never evil. All of these disciplines examine the difference between voluntary and involuntary euthanasia and it seems that they agree that there is really no such thing as voluntary euthanasia.
Personally, I believe that euthanasia should be based on an individual decision. Not everyone feels that it is the best possible solution but I believe that if you are suffering from a fatal incurable disease, there is no reason why euthanasia is wrong.
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