Euthanasia is the act of putting to death painlessly or allowing death, as by withholding extreme medical measures, a person or animal suffering from an incurable, often painful, disease or condition (Euthanasia, Infoplease.com). Today, medical advances have made it possible to prolong life in patients with no hope of recovery, and the term negative euthanasia has arisen to classify the practice of withholding or withdrawing extraordinary means (e.g., intravenous feeding, respirators, and artificial kidney machines) to preserve life. Positive euthanasia, on the other hand, has come to refer to actions that actively cause death such as administering a lethal drug.
Much debate has arisen in the United States among physicians, religious leaders, lawyers, and the general public over euthanasia (Euthanasia, Infoplease.com). Pro-euthanasia societies were founded in 1935 in England and 1938 in the United States. The Hemlock Society is one group that has pressed for right-to-die legislation on a national level. Positive euthanasia is for the most part illegal in the United States, but physicians may lawfully refuse to prolong life when there is extreme suffering. In the early 1990s, Dr. Jack Kevorkian gained notoriety by assisting a number of people to commit suicide and became the object of a 1992 state law forbidding such activity. Kevorkian, who had been tried and acquitted repeatedly in the assisted deaths of seriously ill people, was convicted of murder in Michigan in 1999 for an assisted suicide shown on national television. In 1997, the Supreme Court upheld state laws banning assisted suicide.
Unfortunately, in 1994, Oregon voters approved physician-assisted suicide for terminally ill patients; the law went into effect in 1997 (Euthanasia, Infoplease.com. In 2001 the Bush administration tried to undermine the law with a directive issued under the federal Controlled Substances Act, but Oregon successfully sued to prohibit the enforcement of it. In 1993, the Netherlands decriminalized, under a set of restricted conditions, voluntary positive euthanasia (essentially, physician-assisted suicide) for the terminally ill, and in 2002 the country legalized physician-assisted suicide if voluntarily requested by seriously ill patients who face ongoing suffering. In 2002, Belgium also legalized euthanasia for certain patients who have requested it.
Growing acceptance of positive euthanasia represents a disturbing trend in medical and social ethics. Those who support the practice of active euthanasia argue that:
Helping the terminally ill to bring about their own deaths, allowing them to determine the how and when, is not only humane, but also allows the person, who is simply "living to die," to maintain dignity by orchestrating their own end, thus letting them die at peace, rather than suffer to the end, perceiving themselves to be a burden and/or disgrace, to those they love." (Active Euthenasia - A Kantian Perspective)
However, this paper will present a strong case for why intentional killing of another person is wrong. It will demonstrate that a profit-driven health care system is really transferring control from patients to the medical profession to save money or possibly others that place their own interests before the best interests of the patient. Rather than pursue adequate training about how to take care of terminally ill patients, it's more cost effective to take advantage of these depressed individuals who have been made to feel that they are wasteful consumers of medical services. As usual, the majority of victims will be the financially disadvantaged and minorities. Once euthanasia becomes accepted, society is well on a slippery slope for preferring cheap lethal medications over more expensive quality health care. The only option that will prevent the victimization of the terminally ill by greedy health care institutions is to keep euthanasia illegal and to continue to fight the legality of physician-assisted suicide in Oregon.
2.0 The Case Against Euthanasia
Fortunately, the American Medical Association (AMA) has not endorsed euthanasia in recognition of the conflict of interest between a physician's responsibility to save lives and participation in euthanasia. In testimony before a congressional committee on April 29, 1996, Dr. Lonnie R. Bristow, president of the AMA, made the following statement (Kennedy, 1996):
The AMA believes that physician-assisted suicide is unethical and fundamentally inconsistent with the pledge physicians make to devote themselves to healing and to life. Laws that sanction physician-assisted suicide undermine the foundation of the patient-physician relationship that is grounded in the patient's trust that the physician is working wholeheartedly for the patient's health and welfare."
Bristow also stated that "No other country in the world, including the Netherlands, has legalized assisted suicide or euthanasia. This is one movement in which the United States should not be a 'leader.'"
The Hippocratic Oath was formulated in 400 B.C. By Hippocrates because he believed that the doctor was a powerful man who could decide on life or death (Gunning). As the patient could not know whether a white powder was meant to kill or cure him, he had to simply trust his doctor. That is why Hippocrates made doctors swear that they would never use their knowledge and experience to kill, before or after birth; not even at the patient's own request. In this humanitarian ethic, the well being of the individual is central. Today, euthanasia advocates are asking doctors and patients to accept a new utilitarian ethic where the well being of others prevails over the well being of the patient (Gunning). The doctor judges the quality and the sense of a patient's life whether he is a burden or useful to society, etc. In the past, medical ethics had been based on the notion that all men's lives had equal value. But now, utilitarianism maintains that this can no longer be maintained as over population makes it impossible to accept every quality of life. Choices would now have to be made on the basis of medical evaluation. During World War II, euthanasia was considered to be a solution for over 100,000 German patients who were killed as unwanted by doctors under Nazi Germany. Many people think that legalizing euthanasia will make them autonomous. But, in fact, it is the doctor who is made free to do as he thinks right. In the end, it is not the patient, but the doctor who decides when life should be ended.
Physicians should lavishly dispense compassion, time, and understanding; but physicians should never dispense death. Killing, even in the name of compassion and mercy, is wrong. Section 14 of the Criminal Code maintains that no person is entitled to consent to have death inflicted on him, and such consent does not affect the criminal responsibility of any person by whom death may be inflicted on the person by whom consent is given. "To create a new law that would sanction mercy killing; and grant impunity to the person(s) who takes a life, whether or not the person is competent, non-competent and/or disabled for reasons of suffering would be to cross the Rubicon and consummate a partnership with a statute that would undermine the constitutional right of all individuals to security and protection." (Eckstein, 1995).
Some argue that the euthanasia required as a last resort, when the individual can no longer manage the pain of their illness. However, pain should never justify euthanasia considering the advanced medical techniques currently available to manage pain in almost every circumstance. The real problem is that there are fundamental physician-related barriers to appropriate, humane, and compassionate care for the dying. According to research by Foley (1997), physicians are inadequately trained to assess and manage the multi-factorial symptoms commonly associated with patients' requests for physician-assisted suicide. Only five out of 126 medical schools in the United States require a separate course in the care of the dying. And, of 7048 residency programs, only twenty-six percent offer a course on the medical and legal aspects of care at the end of life as a regular part of the curriculum and fifteen percent of the programs offer not formal training in terminal care. Each resident or fellow coordinates the care of ten or fewer dying patients annually.
In a survey of fifty-five residency programs and over 1400 residents conducted by the American Board of Internal Medicine, the residents were asked to rate their perception of adequate training in care at the end of life (Foley, 1997). Seventy-two percent reported that they had received adequate training in managing pain and other symptoms. Sixty-two percent said they had received adequate training in telling patients that they are dying; thirty-eight percent in describing what the process will be like; and thirty-two percent in talking to patients who request assistance in dying or a hastened death. So, it's not surprising that terminally ill patients don't have access to the quality of care that they need to cope with their illness.
The objective should be to better educate healthcare professionals instead of promoting euthanasia.
Research Bopp and Coleson (Oregon Right to Life) shows that a major reason people seek euthanasia is because they are suffering from depressive illness or some other emotional or psychiatric problem that prevents them from making rational decisions.