The global controversy has centered on whether euthanasia and physician-assisted suicide (PAS) are moral actions in the medical profession. Kelly Crocker supports the legalization of euthanasia in hospitals in her paper, Why Euthanasia and Physician-Assisted Suicide are Morally Permissible. According to the author, studies have focused on Euthanasia and PAS separately over the years, preventing a discussion about the morality of the two acts. PAS refers to the administration of lethal medication doses to patients at their request, whereas Euthanasia refers to the voluntary method of administering lethal drugs to a patient (Crocker 2). The author acknowledges that countries should legalize the medical processes in order to enhance quality of life as well as respect individual rights. Thus, the key ethical principle addressed in the article is whether is a moral conduct to individually practice or nationally legalize the practices of euthanasia and PAS.
The author presents various arguments to support her position. The first argument presented is the ideology that there are already existent models that successfully practices PAS. According to Crocker, PAS has already been legalized in different states including Vermont, Montana, Oregon, and Washington (3) The laws that guide the states propose double diagnosis of the terminally ill patient by different doctors to avoid any error or misuse of the process. It is also provided that the patients must be given the lethal drug prescriptions verbally two times within the period of request. Another rule is that the physicians performing PAS must ensure that the patient is mentally competent in regards to decision making. In Oregon, the drugs request must involve two non-family member witnesses who work where the patient is treated (Crocker 4). Because of the rules and the will of the patient to take his/her life, the author proposes the need to legalize euthanasia and PAS.
The need to provide quality life has also been considered an argument to support the medical processes. Crocker defines life as the state of having hope and happiness to pursue and fulfill one’s needs (4). It involves one’s ability to control what he desires and his own body without compromising the existence of others. As such, she argues that if one loses autonomy as a result of illness or is no longer able to pursue their interesting hobbies due to disability, then there is no need for life (Crocker 4). Most patients that are no longer able to take care of themselves lose the hope of living. Amidst the fact that the aged would consider loss of autonomy a normal process, those who lose their independence due to terminal illness deserve the freedom of taking their own life. She further provides an account of the Oregon Public Health Division statistics which indicate that out of the total terminally ill patients that considered PAS, 93.5% of them gave their reason for being loss of autonomy with another 77.9% feeling they had lost dignity (Crocker 5).
Crocker also argues that every individual has the individual right to make the choice of whether or not to live. She cites John Kitzhaber, one of Oregon’s physicians, who claimed that preventing the terminally ill from ending their lives is like prolonging their deaths (Crocker 5). The author argues that every individual has the right to control his or her life by determining what happens to the body whether they want to live or die, as long as they do not harm others in the process. Due to human rights, the values of autonomy, freedom, and privacy should be protected. Therefore, Crocker advocates for the legalization of both euthanasia and PAS as they are strictly implemented on patients that make the medical choices by free will.
Utilitarian argument supports the idea that euthanasia and PAS are moral activities. Through the utilitarian lens, Crocker argues that the decision to take one own life is based on the idea that one should increasing happiness in their existence and decrease suffering (6). Utilitarianism, therefore, believe that euthanasia is morally right as it aids in the reduction of misery for various individuals including the patient, the caretakers, families, and friends of patients. Through the approach, the author advocates doe a monitored PAS system in which patients are assisted to die justly to alleviate any unnecessary suffering as well as the prolonged pain of the loved ones witnessing the patients’ suffering.
To further defend her position, Crocker proposes the consideration of the usual experiment of anima euthanasia. The author asserts that many times humans euthanatize animals including their pets with the aim of alleviating the pain and suffering they undergo (Crocker 6). Amidst the fact that humans do not explain to the animals why they are killed, the decisions are usually made based on their best interest. Crocker, therefore, asks why the same sanity used to carry out euthanasia in animals is not used to alleviate pain to humans (7). Although many people consider the comparison disanalogous, the author suggests that both animals and humans are sentient beings, and as such should have similar opportunities.
The author applies three key ethical principles to defend her position including principle of respect for autonomy, the beneficence, and principle of nonmaleficence. The principle of autonomy advocates for the obligation towards respecting an individual’s autonomy in regards to the decisions about their own life (Beauchamp 3). In the healthcare setting, the principle requires that every patient has autonomy of intentions, thoughts, and actions towards a particular healthcare procedure. Thus, the process of making choices should be free from coercion or intimidation. It is, however, important to ensure that the patient understands the benefits and risks associated with the decision, as well as the success rate (Nelson and Lindemann 34). Considering the arguments made in the article, the author applied this principle by suggesting that terminally ill patients should be given the autonomy and freedom to choose whether they want to live or consider any of the two medical procedures.
The beneficence principle advocates for the obligation to promote good in every action individuals take. According to the principle, involves are expected to work towards creating a common good with the aim of avoiding harm (Sveinsson 549). Every physician or doctor is expected to help patients get better rather than causing harm. The goal of healthcare is to promote patient welfare, and doctors must possess the right knowledge and skills that can help achieve this. Beneficence could also include ensuring the rights of others are protected, rescue patents from pain, and help people with disabilities (Fletcher 3). Crocker believes that it is the role of physicians to relieve patients from pain especially when they feel they no longer possess autonomy or feel as burden to the society. This assertion further applies to other stakeholders like family members and friends who must consider the need to relieve a terminally ill patient from pain. Thus, it is moral obligation of doctors and family members to permit PAS or euthanasia in case a patient feels extreme pain.
The author also utilizes the principle of nonmaleficence which prohibits individuals from harming others. The principle requires that every activity performed should either improve the wellbeing of others, and the action must have more good than harm. In the case of caring for patients, physicians may not evade the act of causing harm (Jacobs 925). This choice, however, must be bound on the moral obligation of choosing the lesser evil. For instance, although many people would opt to feel prolonged pain to undergo a surgery, but in some cases the patient may chose death in the case the prolonged living become more painful and more burden than living (Walker and Nicki 22). Euthanasia and PAS are procedures that are aimed at achieving a common good. According to Crocker, the procedures can be used to help alleviate pain from patients who may suffer in agony over a long period of time. Further, in relation to the nonmaleficence principle, the procedures may help in the utilization of resources for more significant activities (Skeff 19). For instance, the funds used for life-support care may be used to educate the remaining members of the family.
The arguments that the author presents in accordance with the three principles are very valid. Autonomy principle requires that physicians respect the right of choice and making decisions among the patients. Every patient must be let to act and think towards his/her care. The second principle, beneficence, suggests that it is important to act in a manner that improves the wellbeing of others or attain a common good. It is, therefore, the responsibility of the physicians to ensure that all healthcare stakeholders including the patients, their families, friends, and the healthcare fraternity are positively impacted by the decisions made. Nonmaleficence principle was found to encourage a common good as it prevents any harmful activities that may affect other members of the society. All the principles propose a medical action that will not only attain a common good to the patients, but also improve the status of the family members and the hospital setting. A terminally ill patient who is in agony would opt for euthanasia to end the pain. Some procedures such as Cardiopulmonary Resuscitation (CPR) for patients with intestinal carcinoma or life sustaining support (dialysis) for cardiac arrest may present a painful experience to the patients compared to life termination. Thus, the author is justified to conclude that the euthanasia and PAS are moral as long as the rights of the patient are not violated.
Beauchamp, Tom L. “Principlism in Bioethics.” Bioethical Decision Making and Argumentation. Springer International Publishing, 2016. 1-16.
Crocker, Kelly. “Why Euthanasia and Physician-Assisted Suicide are Morally Permissible.” (2013).
Fletcher, Joseph F. Morals and Medicine: the moral problems of the patient’s right to know the truth, contraception, artificial insemination, sterilization, euthanasia. Princeton University Press, 2015.
Jacobs, Michael S. “Euthanasia Considered: Professional Paternalism or Individual Freedom?.” DePaul Law Review 40.3 (2014): 925.
Nelson, Hilde Lindemann, and James Lindemann Nelson. The patient in the family: An ethics of medicine and families. Routledge, 2014.
Skeff, Kelley M. “Applying the Professional Principles of Ethics, Caring, and Teaching: Dr. Kelley M. Skeff, Georgetown University School of Medicine Commencement.” The Medical Commencement Archive 3 (2016).
Sveinsson, O. A. “Euthanasia–a moral choice?.” Laeknabladid 93.7-8 (2007): 543-551.
Walker, Brian R., and Nicki R. Colledge. Davidson’s Principles and Practice of Medicine E-Book. Elsevier Health Sciences, 2013.