The dangers of euthanasia and physician-assisted suicide

Euthanasia has had a long history. Greeks and Romans allowed the euthanizing of people under certain circumstances. Euthanasia is the practice of ending a person's life for the sole purpose of relieving the person's body from excruciating pain and suffering due to an incurable disease. The term euthanasia is often referred to as mercy killing or the 'good death' as derived from the Greeks. Euthanasia can be classified into four categories. In active euthanasia, a person's life is terminated by a doctor through a lethal dose of medication. Passive euthanasia implies non-provision of life-sustaining treatment to a patient based on logical reasoning or in other words doing nothing to save a person's life by abstaining to give life saving measures like putting a person on artificial respirator.

A simple way of distinguishing active and passive forms of euthanasia is a difference between act and omission. The other forms include voluntary euthanasia in which a person's consent is obtained for either active or passive euthanasia. Whereas non-voluntary euthanasia involves ending a person's life who is not mentally capable of making that decision (i.e. on life support and unresponsive). There are many sides to the dilemma of whether or not euthanasia should be carried out.

There is the question of morality, the question of active versus passive euthanasia and the question of when euthanasia should be put into use. The applied ethical issue of euthanasia, or mercy killing, concerns whether it is morally permissible for a third party, such as a physician, to end the life of a terminally ill patient who is in intense pain. The euthanasia controversy is part of a larger issue concerning the right to die. Voluntary euthanasia involves a request by the dying patient or that person's legal representative. Passive or negative euthanasia involves not doing something to prevent death.

In recent years, euthanasia has become an ardently disputed topic with some debate over the last few decades. Some support assisted-physician or euthanasia while others are against supporting it. People have their reasons for supporting either or, however, when people are pro-euthanasia or pro-physician-assisted suicide it brings into thought the kinds of negative consequences that often stem from supporting these actions. This essay will examine such negative consequences and bring to light the dangers of euthanasia/physician-assisted suicide.

The first negative consequence is unexpected pain/loss. Those that support euthanasia/physician-assisted suicide do so under the assumption it helps eliminate pain. However, the processes involved may end up being painful anyway, causing potential complications. The essay titled: "Vulnerable People: Practical Rejoinders to Claims in Favor of Assisted-Suicide," written by Cohn and Lynn favors against legalizing physician assisted-suicide. They explain physician-assisted suicide may be something that people fear instead of favor due to the kind of power a person has through dictating how long someone else lives.

Although the pain of someone terminally ill could be ended through euthanasia or physician-assisted suicide, the pain of a family losing a loved one is still there. Doctors instead of being seen as healers and advocates for a patient's well-being can potentially become feared and viewed as playing God. Looking at it from a sociological perspective, the authors note in addition to the fear euthanasia/physician-assisted suicide brings, there is the potential layer of 'if someone cannot afford care, they may get euthanized'. Those who are poor and cannot afford medical expenses like the middle or upper classes may not have a chance to fight for their loved ones and keep them from being euthanized. (Battin et al.) By greenlighting euthanasia or physician-assisted suicide, the possibility of many poor, sick people ending up dead due to healthcare expenses is frightening.

Families fight hard to keep their relatives safe and together and would end up bankrupting themselves to avoid such a conclusion. The "haves" or the ones able to afford ongoing treatment, will become protected from such situations, further splitting the economic classes. The ostensibly practical alternative thus develops into something coercive that the rich are immune from and the poor must endure. This has already been seen in the real world in countries that permit euthanasia. "Countries that allow euthanasia have already fallen pretty far, allowing for children and people with mental illnesses to be killed." (Fiano). With nations that are pro-euthanasia quickly expanding the killing from terminally ill elderly to several other groups of people like the mentally ill and the young and terminally ill, euthanasia has grown rapidly.

The fear is that poor people will be eradicated in great numbers because of their inability to pay for healthcare and their medical bills. People like the Lithuanian health minister Rimante Salaseviciute have made such fears a reality when she recommended those who are terminally ill should be euthanized if they cannot afford to pay their medical bills. "Euthanasia might be needed for poor people who cannot access palliative care. The minister has also raised the idea of euthanasia for children." (Cook) The AMA has in its code of ethics a section on euthanasia that questions the role of euthanasia in healthcare.

Euthanasia is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks. The involvement of physicians in euthanasia heightens the significance of its ethical prohibition. The physician who performs euthanasia assumes unique responsibility for the act of ending the patient's life. Euthanasia could also readily be extended to incompetent patients and other vulnerable populations. (AMA)

The section stating how euthanasia could quickly and easily reach helpless populations demonstrates how euthanasia alters from a feasible option to an involuntary obligation removing options from vulnerable populations and inflicting pain and suffering.

Some like the Lithuanian health minister Rimante Salaseviciute believe that the legalization of euthanasia would be a good option for those who cannot afford palliative care. Some would also say an individual's right to determine the time and manner of their death is more important than keeping a suffering person alive for the sake of preserving life. While the legalization of euthanasia will most likely lead to an excuse for many people who are not terminally to end their own lives, proponents for euthanasia and physician-assisted suicide believe that an evaluation by a mental health professional for those suspected to have clinical depression or mental incompetence can help prevent most of this.

There are many good and bad points to the legalization of euthanasia and physician-assisted suicide like any controversial issue. The main reason those for it understand it to be a good thing is because it gives someone dying a peaceful and dignified way to end their life. However, the problem and the main concern is when would that option become mandatory?

The second negative consequence of euthanasia/physician-assisted suicide is regulation, or lack thereof. Euthanasia and physician-assisted suicide are legal in certain parts of the world with physician-assisted suicide legal in five states: Oregon, Montana (somewhat), Washington, California, and Vermont. That means terminally-ill patients of sound mind and body can get a prescription from a doctor of a fatal dose of medication, killing them. This seems harmless because the patient is the one making the choice and committing the act. However, things can quickly escalate to where healthy individuals can ask to end their lives and murderers/rapists can be given a choice to end theirs simply because their lives feel unbearable in prison. "In September 2014, a convicted murderer and rapist who argued he was living a life of unbearable psychological suffering in prison was granted the right to die under Belgium's liberal euthanasia laws, paving the way for at least 15 similar requests from other inmates." (McDonald-Gibson)

By Belgium opening up the right for people living in the country to ask doctors to terminate their lives under extreme emotional or physical duress, anyone can qualify to have their life taken even if that person is not terminally ill. Living in prison for three decades, he was evaluated by the board of doctors and allowed to die under his terms. The rapist and murderer, Frank Van Den Bleeken was allowed to die because his life in prison was too painful for him to bear. Although he was not euthanized due to pleas by his victim's families, this is just one of several cases of individuals not deserving euthanasia, almost getting it because of less stringent euthanasia/physician-assisted suicide regulations.

This leads back to the fear of euthanasia becoming something that is forced on people rather than presented as an option. If regulation of euthanasia can almost include the killing of a fairy healthy man simply because he wanted to, what if laws change and policy includes euthanasia for patients that are non-responsive? Comatose patients are often left on life support for weeks, months, even years. What if euthanasia starts to include these kinds of patients? Then it becomes a lack of choice and more of an applied standard.

A third negative consequence is the way doctors feel about taking a life. Doctors are trained to save lives, to prevent illness and death, to treat and help the sick. When doctors are asked to kill, this goes against everything they believe in. (Jeffrey) The role of the physician wears away and is substituted by the part of God or reaper. By granting the power of deciding if someone lives or dies physicians then change their aims from healing to instead seeking to euthanize those deemed cannot be saved or do not have the funds for treatment.

Hospitals and clinics throughout the United States and slowly throughout the world, have looked towards adoption of a business model, in order to increase their profits and reduce needless expenses. If physicians are given the responsibility of assisting people in dying or euthanizing them, this could mean they will have to make these decisions based on expenses along with terminal illness. The problem with euthanasia and physician-assisted suicide is that in theory they have several beneficial and practical applications. Conversely, in practice euthanasia takes on a much more ominous tone.

In a 1992 article, Brock's response to euthanasia leading to people not trusting or respecting physicians as healers when it comes to active voluntary euthanasia, patients would not fear being killed by a physician because it is a choice for the patient and not the physician to make. "If active euthanasia is restricted to cases in which it is truly voluntary, then no patient should fear getting it unless he or she has voluntarily requested it (Brock 16). That is not to say Brock is for euthanasia, adding that active voluntary euthanasia could turn into a negative situation when considering the amount of trust a patient has with his or her physician. That trust can easily be broken as seen in the case of Dr. Jack Kevorkian.

Dr. Jack Kevorkian, a 71-year-old retired pathologist, is known to many as the patriarch of assisted suicide. He is currently serving a sentence of 10-25 in a Michigan correctional facility for his involvement in helping at least 130 people die from euthanasia. He was charged for several murders in both 1991 and 1992 when patients of his used a suicide machine he developed, and his medical license was revoked. Both charges were later dropped though when state judges pointed out that there were no laws against assisted suicide in the state of Michigan.

It wasn't until 1993 when assisted suicide laws took effect, and Kevorkian, who had killed several more patients by this time, was charged again for murder. He served some jail time when he refused to pay the bail after the judge raised it. (Ekland-Olson and Aseltine) He was released from jail though later that year when supporters posted the bail. Some called Dr. Kevorkian a saint, making books about him, even a movie called You Don't Know Jack. But were his killings something to admire or something more sinister?

Between 1994 and 1996, Kevorkian killed some thirty more patients, and was charged for murder three more times. In 1998, Kevorkian videotaped the injection death of Thomas Youk which aired two months later on "60 Minutes." (Russell-Brown and Davis 188) He was again charged for murder, and in 1999 was convicted for second-degree murder and delivery of a controlled substance. Dr. Kevorkian remains one of the most controversial physicians in America today and has changed the image of a doctor from that who heals into what some say is a serial killer.

Physician-assisted suicide was a Dr. Kevorkian specialty. His suicide machine made famous this kind of 'mercy killing'. What his machine did was inject a lethal dosage into the patient's blood stream, killing them painlessly within ten minutes. Active voluntary euthanasia and part of physician-assisted suicide is when a conscious, mentally competent person, usually with a severe physical ailment, loses the will to live. They may ask that life support equipment be disconnected so that they can die quickly, painlessly, and with dignity or as in the case of Dr. Kevorkian, ask that the physician interfere via prescriptions or acts like lethal injection. Most doctors are trained to try their best to defeat death, or at least try to delay it as long as possible. But if the patient is hopelessly ill, and would prefer to die, the doctor may consult the hospital ethics committee, and perform what the patient requested.