Ethical Issues Involved in Counseling a Patient Considering Euthanasia Term Paper

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Against Euthanasia

Death has always been shrouded in mystery, the constant litanies of myth, science, curiosity, magic, fear, and of course, religion. Just as myths have always wound down to the pragmatic, the real, and core accurate factual reporting - summarily losing the romantic, whimsical, and magical elements - so has the inevitability of human death.

Death is the central theme to life, vitality, order of society, and even powers - through the use of fossil fuels - our industry! When one, therefore, examines death objectively, he or she finds that death is a catalytic contract propelling the core beliefs and motivations of a group of people.

This evaluation seeks to isolate one aspect of death - euthanasia and a person's right to choose the time, place, and circumstance of their death without interference from legal, moral, religious, family, or other groups of social or punitive nature - and defend the sanctity of life in all circumstances.

The New Civil War

The right to die - with all its legal, moral, value-based, human-dignity, religious, and personal freedom issues attached - is rapidly becoming the new, internalized civil war for the entire human race. As proponents and opponents of euthanasia polarize their positions more and more definitively, the morality of the situation rises to the top of the list of 'reasonings'.

While some groups would structure suicide of terminally ill and abortion into this stew pot of emotional reactions, this paper will deal solely with the emergent nature, unethical nature, and negative social impact of euthanasia.

The word euthanasia originates from the Greek, "eu" = goodly or well, and "thanatos" = death - a good death. Until the late 19th century, the application of the word and attendant function was simply that - one who experienced a painless, quiet, and "good death."

It is important to make a clear distinction at this point; suicide - irrational, with defined planning and 'rationality', or the forced taking of another life, for any cause, is not euthanasia.

Thesis Statement

It is illegal, immoral, and unethical to take a human life, regardless the condition in which the patient finds himself or herself. With today's palliative measures, pain management technology, and medical intervention, the pain receptors in patient brains can be silenced without death.

All life is valuable; dying is a process of learning for the patient and their support system while edifying those remaining behind. To shorten that process is not for man to decide - the resulting act of euthanasia is murder, not self-defense.

Literature Supporting Thesis

It has been said that most people in North America die what may be classified a bad death, i.e., in pain, their desires concerning treatment go unheard and unaddressed, often after spending an average of 10 days or more in an intensive care unit. Following is a breakdown of reasoning for the partial legitimacy to this statement and proposed corrections to the problem, always maintaining that suicide - assisted or otherwise - is wrong.

Pain and the Medical Profession

Pain is a physical response to stimulus recorded in the brain. Numerous chemical and medical palliative treatments are available to curtail or even eliminate the receptors in the brain, which register pain. So, why do terminally ill patients suffer from any pain whatsoever?

Legal ramifications to triplicate prescription writing and the use of Schedule I and II drugs are severe and may cause excessive scrutiny by the DEA and other federal and local agencies.

Citizens, chemical use and abuse by physicians, and a growing -seemingly unending - war against such use inundate the American legal system with high rates of drug abuse and misuse. The black and white perceptions of this "war on drugs" in America today stem from this abuse and hold a hard line on misusing chemicals for recreational use. This author has no argument with this position, however the gray areas become problematic. For the terminally ill patient, there is no such issue as drug abuse. Addiction is a non-issue for these people, but the legal ramifications have never been clearly identified.

Physicians have personal abhorrence - based on personal ethics, beliefs, and medical school training - to contributing to drug dependency in their patients and often work within this set of personal guidelines. The terminally ill patient, therefore, suffers being under medicated as a result.

Medical schools spend a great deal of time and effort to teach future physicians that drugs, while a very necessary function of American medical care, are potentially dangerous to their careers and personal well-being. Addiction theory and prevention medicine is not studied nearly as intently as how to protect his or her practice from being sued, the doctor being implicated in criminal and civil lawsuits, and medical malpractice's increasing costs. As a result, the ramifications for the physician are such that the fear of overmedicating the patient, being sued by family members, and the criminal and legal issues create 'dead space' for the patient.

Some patients and their physicians are concerned about the possible side effects of pain medication, including addiction. Patients and physicians are acutely aware of the extremely addictive properties of drugs such as morphine and heroin. But what is less known is that these drugs' addictive properties are primarily seen among healthy people who are not in pain. They become addicted when they use these drugs illegally for the feeling of euphoria that they generate. If a person who is in severe pain properly uses these narcotics for the relief of pain, they do not feel euphoria; they do not become addicted; they simply have relief from intense pain.

Wide ranges of people are in need of such medication; including individuals who are suffering from advanced cancer, untreatable back pain, and limb amputations. Unfortunately, most physicians are not trained in the use of opioid therapy for the relief of intense chronic pain.

Even worse, the members of some state medical boards are also unaware of the need for this use of narcotics. When they review physicians in their jurisdiction who specialize in the relief of pain, all they see is "over subscription" of controlled substances. There is intense pressure placed on physicians to prescribe lower quantities of these narcotics, thus causing their patients to live in continuous pain.

Some boards have revoked the medical licenses of physicians specializing in this field. Each time this happens, the pain management of dozens of patients is terminated. Without narcotics, the desire for euthanasia, suicide, and other end-of-life decision-making is brought to the forefront of the patient's thinking; with narcotics, they can lead productive lives relatively free of pain.

The money trail is a factor in whom and how much care is provided. While America's free enterprise system necessitates the funding to develop new and emergent drugs and medical therapies yet the cost can be prohibitive for those needing them most.

In 1994, David E. Joranson, of the Pain Research Group, at the University of Wisconsin Medical School wrote: "Access to professional services, prescription drugs, and medical equipment is critical to obtaining effective pain management and to restoring quality of life. The U.S. is one of the few countries in the world where access to these products and services is based on the ability of a person to pay for them, either through personal resources or third-party private or government health insurance."

It is currently estimated that approximately 41 million Americans have no health insurance. By 2005, this number is expected to grow to over 44 million and historically seems to continue to increase at about 1 million a year. Additionally, there are the uncounted millions of people who have limited insurance and cannot afford to pay the extra costs associated with their illness.

According to the industry-respected Kaiser Survey of Family Health Experiences, in those who are uninsured with unmet needs (i.e., delaying or going without care or medication needed for management of the medical problem) 27% report problems at job or school, 30% report that their health has worsened, and 77% report they were sick longer or were forced to tolerate unnecessary pain.

Many people over the age of 65 have less ability to pay for prescription drugs because they are on fixed and low incomes. Yet these are the individuals who are most likely to need pain medication due to age-related degenerative diseases like arthritis and terminal illnesses like cancer.

Some pharmaceutical manufacturers have limited programs to make their medication available to indigent patients, but the costs for pain medication is increasingly prohibitive to the large group of people who need it and pharmaceutical companies do not implement country-wide programs or announcements of 'gifting' their products to those who cannot afford them.

In October, 1999 the federal Pain Relief Promotion Act (PRPA) was passed by the House of Representatives by a vote of 271 to 156.

If the bill had passed the Senate and been signed into law by the President, it would have:

prevented the use of federally regulated drugs in cases of physician-assisted suicides, prohibited…[continue]

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