Death with dignity: ethical perspectives and policy considerations

Death With Dignity: A Right or Not?

The issue of "euthanasia" is a matter of great controversy today. It is often difficult to judge who the "right" to die under the influence of euthanasia without the "power of attorney" should be afforded. Religiously, one cannot predict the "miracle" of God in daily life. For a patient to live through feeding-tube for the rest of his/her life in the hospital or nursing home does not show any dignity to our beloved ones. This paper will examine the issue of death and dignity from the perspective that all patients deserve to die with dignity, but face many obstacles in doing so.

One of the more frequent arguments against voluntary active euthanasia in the media and in literature is that "the push for a legalized right to die with medical assistance is a radical movement" carrying with it "alarming implications" for society (Ballis & Magnusson, 1999:312). Many feel that allowing one to voluntarily end life would perhaps result in a devaluing of life and the potential for abuse of vulnerable or ill patients (Ballis & Magnusson, 1999). However this argument is largely unfounded and based on fears and irrational misgivings about death rather than fact. There are many circumstances within the United States where patients have actively requested assistance to die in situation where they face debilitating illnesses. In this case there is no devalue of human life, but rather value in respecting a patient's last wishes.

Proponents of euthanasia claim that every person should be afforded the opportunity to 'die with dignity.' Perhaps the most well document and discussed discourse on dying with dignity emerged as a result of the actions of a Michigan physician, Jack Kevorkian, who in 1990 used what he referred to as a 'suicide machine' to enable a fifty-four-year-old woman suffering from Alzheimer's to end her life (Zucker, 1999:235). Kevorkian ended up assisting 130 voluntary suicides by March of 1999. Michigan state had issued an injunction against use of Dr. Kevorkian's machine, and he was even charged with first degree murder, however these charges were unsuccessful and dismissed when a tape was produced showing that the individual he helped requested his assistance.

At the time there was no state statue that prohibited assisted suicide. Michigan legislature subsequently banned assisted suicide in February of 1993, however the act was later repealed (Zucker, 1999). Juries acquitted Kevorkian of three more trials through 1996. In 1998 however Kevorkian was charged and convicted of second degree murder, when he produced a videotape injecting a paralyzed man Thomas Youk with a lethal solution due to Lou Gehrig's disease (Zucker, 1999). The court would not permit family testimony thus the jury convicted him.

Kevorkian has been described as both 'sinister' and a life saver depending on who you talk to. His actions certainly bring to light the question of death with dignity (Bachman et. al, 1996). Kevorkian is one example of many physicians that support a patient's right to choose to participate in physician-assisted suicide. Such allowances could be administered with regulation to ensure that patients are not abused and that the patient's wishes are carried out.

There is a large body of research that has been conducted suggesting that most people are in fact in favor of allowing individuals to 'die with dignity'. It is the government that stands in the way. More than 35% of physicians have admitted that they would participate in voluntary euthanasia practices if afforded the opportunity if patients requested it (Bachman, 1996). In another study conducted by Lee (1996) more than 46% of physicians admitted they might be willing to assist a suicide if it were legal to do so. In yet another study of pharmacists 34.3% of pharmacists admitted they would dispense prescription drugs willingly for physicians assisted suicides (Rupp & Isenhower, 1994).

In a Gallup poll conducted in 1996 more than 75% of respondents indicated that doctors should be allowed by law to end a patient's life by painless means if a patient or family member had requested in the case where a patient has a disease that can't be cured (Palmer, 2000:89).

Given the large body of evidence that exists showing support for death with dignity, one might assume that the government would support a move to allow physician-assisted suicide. Yet this is not the case, with the exception of Oregon, and there is no indication that the federal government plans on changing its viewpoint in the near future.

More than eighteen to thirty percent of physicians in practice report that they receive requests regularly from patients that are seeking help in dying (Datlof, 1999). Oregon is the only state that has allowed a physician to openly help end of life decisions, via the passing of the "Death With Dignity Act" passed in 1994 and re-approved in 1997 (Datlof, 1999). The act allows a physician to aid a terminally ill and competent patient. The same act was defeated in Michigan by voters as recently as 1999 (Datlof, 1999).

Despite seeming desire among the public to allow people to choose to die with dignity, the U.S. Supreme court in the case Washington v. Glucksberg (1997) considered it "a constitutional challenge to a Washington statue that criminalized acts of deliberate assistance of another committing suicide" and ruled that an asserted right to physician-assisted suicide "was not a fundamental liberty interest protected by the fourteenth amendment" (King, 2000:271).