Euthanasia is one of the current concerns that has sparked heated debate. Euthanasia has been a topic of discussion in human rights communication because it affects the legal, moral, and ethical issues that affect health care providers and patients. Euthanasia is described as the deliberate hastening of an individual's death based on current medical conditions. Euthanasia is a contemporary contentious issue that generates numerous questions that must be addressed. Oncology nurses and physicians, for example, face ethical quandaries when caring for patients towards the end of their lives and must make a decision and choose between arduous or unacceptable alternatives (Wilson et al., 2002).
Definition of Euthanasia
The term “Euthanasia” is borrowed from Greek word meaning “good death”. Euthanasia attributes to the ending of a person’s life, to end their suffering, usually from a terminal condition or an incurable disease. There are two types of Euthanasia which have been identified which include Active and Passive Euthanasia. Active euthanasia refers to the intentional act of ending the life of a terminally ill or incurable condition of a patient, usually through the deliberate injection of lethal drugs. Passive euthanasia refers to be the deliberate withdrawal or withholding of life-prolonging medical treatment which results in the individual’s death. The practice of “passive euthanasia” unsurprisingly in Australia and most countries around the globe is not considered as euthanasia at all (Wilson et al., 2002).
According to Keown (2002), the acts of euthanasia can be further categorized as voluntary, involuntary and non-voluntary. Voluntary euthanasia refers to euthanasia which is performed at the request of a patient. Involuntary euthanasia is the term used to describe a situation where euthanasia is achieved without the patient’s consent, with the aim of relieving their suffering – which, in a sense, amounts to murder. Non-voluntary euthanasia refers to a situation where euthanasia is performed to a patient who is incapable of consenting. The term which is significant to euthanasia debate is active voluntary euthanasia, which collectively refers to the deliberate act of ending the life of a terminally ill patient, through the administration of lethal drugs at his or her request. There are many arguments which have been put forward for and against the implementation and legalizing of Euthanasia which include:
Rights-based argument
Supporters of euthanasia have argued that a patient has the moral right to make their own choices about how and when they should die, based on the principles of self-determination and autonomy. Autonomy is the concept which stipulates that a patient has the right to make decisions which relate to their life so long as it causes no harm to others. Advocates describe the notion of autonomy to the right of an individual to use their own body, and that they should have the right to make their independent decisions regarding how and when they should die. Furthermore, it has always been argued that as part of our human rights, we should create our own decisions and exercise the right to a dignified death (Emanuel, 2002).
Beneficence
The principle of beneficence states that a person should act to further the well-being and benefits of another and prevent any evil or harm to that person. The principle of non-maleficence states that a person should refrain from inflicting harm on another person. It is argued that relieving pain and suffering from a patient by performing euthanasia will do more good than harm. Supporters of euthanasia express this notion as the integral moral values of society, compassion and mercy, which stipulates that no patient should be allowed to suffer be allowed to suffer oppressively, and mercy killing should be permissible (Wilson et al. 2002).
Arguments Against Euthanasia
The sanctity of life
Pivotal to these arguments against euthanasia is the society’s outlook on the sanctity of life. The fundamental ethos is that human life must be appreciated and preserved. The Christian prospect sees life as a gift from God, who ought not to be offended by the taking of that life. Similarly, the Islamic faith insinuates that “it is the sole privilege of God to bestow life and cause death.” The withholding or withdrawal of treatment should then be allowed when it becomes critical, as this is viewed as permitting the natural course of death (Emanuel, 2002).
Euthanasia as form of murder
The community sees an action which has the sole aim of killing another person as inherently wrong, irrespective of the patient’s consent. The debate about the legalisation of active euthanasia in intentionally end the life of a terminally ill patient as a means to end the suffering remains controversial. Many people argue that euthanasia is no better than murder and its practice should be deemed illegal. Other opponents think that euthanasia should be permitted to alleviate the unnecessary suffering and pain of terminally ill persons and can have a concession to the legalisation of euthanasia (Emanuel et al. 2000).
Abuse of autonomy and efforts of human rights
While supporters use autonomy to advocate for euthanasia, it also features in the argument against euthanasia. Proponents believe that the principle of autonomy does not permit the voluntary termination of a patient’s life due to a severe medical condition. It has also been ruled out that the patients’ requests for euthanasia are autonomous, as most of the terminally ill patients may not be of sound mind. The supporters argue that the aspect of self-determination and autonomy enables every individual the right to live their own lives as envisioned by the good of the society, and therefore individuals should consider the risk of harm for the common good. In relation to human rights, some critics of euthanasia argue that the act of euthanasia contravenes the “right to life”. (Wilson, 2000).
Description of the Ethical Concern/Topic
Several arguments have been made by supporters of euthanasia claiming that active euthanasia is better off than passive euthanasia which constitutes the withholding or the withdrawal of treatments which ultimately ends the patient's life. Beyond this view, it is however argued that active euthanasia should be permitted just as passive euthanasia is acknowledged. James Rachel who is a is a well-known proponent of euthanasia advocates for this view. James states that there is no moral difference between killing and letting die, as the aim is usually similar based on the utilitarian argument. James also argues that Active euthanasia is more humane than passive euthanasia which is a quicker and painless process of administering a lethal injection to the victim whereas passive euthanasia may result in a relatively slow and painful death (Keown, 2002).
History of Euthanasia
The word euthanasia is derived from two Greek words which means “a good death”. Historically Euthanasia was practiced in Ancient Greece and Rome: Euthanasia was vehemently opposed in the Judeo-Christian tradition. America also attempted to legalize euthanasia, when Henry Hunt introduced legislation into the General Assembly of Ohio in 1906 but the Bill to legalize euthanasia was defeated in British House of Lords in 1936. Voluntary euthanasia act was later introduced in US Senate in 1937. Pauline Taylor becomes precedent of the euthanasia society of America 1n 1962 as the US Senate hold their first national hearing on euthanasia (Emanuel et al. 2000).
In 1972 The American hospital association adopted patients’ bill of rights in 1973, and the society for the right to die was founded and became the first US hospice center opened in 1974. In 1984, the American medical association backed the withdrawal or withholding of life-prolonging treatment in certain circumstances. In 1999, the US supreme court rules there is no right to die as the supreme court upholds Oregon death with dignity act in Gonzales v Oregon case of 2006. The death with dignity act is passed November 2008 in Washington DC, as the state of Montana legalizes Physician Assisted Suicide in December 2008 (Emanuel, 2002).
Discuss how this topic affects health care.
The decision towards whether physician-assisted suicide or euthanasia is voluntary or forced by others is hard to be determined as there is no way one can be sure. Even physicians and medical personnel cannot predict firmly the time of death and whether there is the likelihood or possibility of full recovery with the advancement of clinical medicine and treatment of a particular disease. Therefore, implementing euthanasia, fosters the increase unlawful deaths which could have well been treated and diagnosed much later. The legalisation and the implementation of euthanasia will seem to empower law abusers and increase distrust among patients towards their doctors. The view of mercy killing will cause a significant decline in the provision of medical care and can result in the ultimate victimization of the most vulnerable population in the society. With the advancement in medical technology the quality of life and human lifespan can be enhanced (Wilson et al., 2002).
What are the current trends/norms related to the topic?
In 2002, Euthanasia was legalized in Belgium, several surveys have been conducted to monitor the evolution of the medical end of life practices since 1998. As illustrated by the findings the rate of Euthanasia significantly rose from 1.9 % to 4.6% deaths between 2007-2013. This was as a result of the increase in both the number of requests for Euthanasia and the frequency of the claims granted. There has been an increasing demand for PSA and Euthanasia between 2007-2013 as well as the growing demand among healthcare professionals and physicians to meet and execute those requests, mostly after numerous interventions and provision of palliative care services. Euthanasia is increasingly being considered as a valid option at the end of life in Belgium (Deliens & Van der Wal, 2003).
How are health care professionals/institutions affected by this topic?
Physician-assisted suicide and active voluntary euthanasia undermine the relationship between patients and their healthcare providers, destroying the confidence and the trust which was established in such a relationship. The role of a doctor or a physician is helping prolong lives, not ending them. Assigning physicians, the task of administering euthanasia to patients will ultimately compromise and undermine the goals and objectives of the medical profession. Many terminally ill patients seek the aid of a trained physician in dying. This is in contradiction of the physician tradition, norms, culture, and values of being devoted to the task of prolonging life. More so, physicians view their profession as being committed to alleviating pain and suffering of their patients (Emanuel et al. 2000).
How are specific populations (i.e. illiterate, minority, disadvantaged, etc.) affected in relation to this topic?
Euthanasia has become a very controversial subject as it influences the legal, social political and ethical values of a nation. Implementing and legalizing euthanasia may give rise to situations which would compromise the rights and the privileges of the most vulnerable populations in the society. These actions may include the deliberate effort of coercing sick patients who may be receiving costly treatments and medications to accept physically assisted suicide or euthanasia as they may view themselves as baggage to their relatives and families. Palliative care and rehabilitation centers should be established because they present better alternatives which if properly managed and implemented would assist the minority, the disadvantaged, and the minority populations to receive better and improved quality of care (Quill, 2008).
Conclusion
Euthanasia has been a hotly contested and controversial topic of debate for a while now. Euthanasia is defined as the conscious speeding up of the death of an individual based on the prevailing medical conditions. There are two identified types of euthanasia which include passive and active euthanasia. The acts of euthanasia can be further divided into voluntary, involuntary and non-voluntary. The debate about euthanasia has remained a widely contested topic as many people have advocated for and against the practice. As every group or individual has a differing opinion regarding euthanasia, it is considered as an ethical, legal, political, and a religious debate to this date.
References
Deliens, L., & Van der Wal, G. (2003). The euthanasia law in Belgium and the Netherlands. The Lancet, 362(9391), 1239-1240.
Emanuel, E. J., Fairclough, D. L., & Emanuel, L. L. (2000). Attitudes and desires related to euthanasia and physician-assisted suicide among terminally ill patients and their caregivers. Jama, 284(19), 2460-2468.
Emanuel, E. J., Fairclough, D., Clarridge, B. C., Blum, D., Bruera, E., Penley, W. C., ... & Mayer, R. J. (2000). Attitudes and practices of US oncologists regarding euthanasia and physician-assisted suicide. Annals of Internal Medicine, 133(7), 527-532.
Keown, J. (2002). Euthanasia, ethics and public policy: an argument against legalisation. Cambridge University Press.
Quill, T. E., Lo, B., & Brock, D. W. (2008). Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. In Giving death a helping hand (pp. 49-64). Springer Netherlands.
Van der Heide, A., Onwuteaka-Philipsen, B. D., Rurup, M. L., Buiting, H. M., van Delden, J. J., Hanssen-de Wolf, J. E., ... & Deerenberg, I. M. (2007). End-of-life practices in the Netherlands under the Euthanasia Act. New England Journal of Medicine, 356(19), 1957-1965.
Wilson, K. G., Scott, J. F., Graham, I. D., Kozak, J. F., Chater, S., Viola, R. A., ... & Curran, D. (2000). Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide. Archives of Internal Medicine, 160(16), 2454-2460.
