Act of Euthanasia and the Ethics of Egoism

Euthanasia and Ethical Egoism

Euthanasia

Euthanasia is the practice or act of terminating a person's life in order to relieve pain and suffering AVMA Panel on Euthanasia, 2001.

Euthanasia is loosely termed as mercy killing since it is a deliberate action that is intended to end life in a painless manner. Physician-assisted suicide is another terminology for euthanasia. A person's life would be terminated either by a lethal injection or by suspension of medical treatment. When a decision is made that restricts the conducting of heroic measures when a patient is in a life-threatening situation, the term euthanasia would apply. Euthanasia is illegal in many countries. The National Health Service states that regardless of the person's circumstances, it is illegal to assist the person kill themselves. In the United Kingdom, assisted suicide carries a sentence of 14 years, while in the United States, the law varies based on the state.

Euthanasia is a viable option for terminally ill patients. The patients would have to survive and suffer under life support machines if euthanasia is not prescribed. The costs associated with maintaining a person's life are high, and this would affect the family members. It is not the patient that suffers, even the family members still suffer since they have to endure seeing their loved one hooked up to countless equipment for survival. Euthanasia provides the family members with an option of saying goodbye early to their loved one and not see them suffer.

In the future, it is possible for doctors to find cures that would benefit a terminally ill patient. If the patient's life it terminated early, the family members would loose out on the medication, and the opportunity of spending more time their loved one. Legalizing euthanasia could result in immoral practices where doctors would choose to terminate a life instead of wasting time caring for the patient.

Types of euthanasia

Passive euthanasia, active euthanasia, voluntary euthanasia, non-voluntary euthanasia, and involuntary euthanasia are the different classifications of euthanasia. Passive euthanasia occurs when a person is denied the necessary treatment for maintaining their life Jecker, 1997.

There are extraordinary and ordinary means of supporting life. Ordinary means include hydration and nutrition, which are a person's basic right and should not be withheld. For passive euthanasia, life supporting medication is withdrawn. Depending on the individual case, extraordinary means of supporting life will differ. The main idea behind passive euthanasia is that the patient does not receive any medications, and there is no life supporting equipment connected to the patient. Withdrawing medication allows the patient's condition to worsen, and the patient will die eventually. There are instances when the patient cannot ingest food by himself or herself, and they rely on the life support machines for all their basic needs. In such instances, withdrawing the medical treatments will also involve removal of the machines.

Active euthanasia involves the direct or deliberate termination of a person's life. The intervening person will mostly use some lethal injections De Wachter, 1989.

Someone else or the patient conducts the life ending action. An act has to occur during active euthanasia unlike in passive euthanasia where the patient dies naturally. According to Jochemsen and Keown (1999)

voluntary euthanasia occurs when a patient makes a conscious decision that they want to die. The patient will then request for assistance to accomplish this. In this situation, the patient could have a written will in advance. The will would provide instructions directing what should happen if they are too ill. Another situation is where the patient is able to make sound decisions and requests that they be assisted to terminate their life. This would mostly occur if the patient is terminally ill and there is no possibility of recovery.

Non-voluntary euthanasia occurs when it is impossible to acquire the patient's consent. When a patient is in the ICU in a coma, or brain is severely damaged, another person would have to determine if they should stay on life support, or their life be terminated. If there is no likelihood the patient could recover from their condition and maintaining them on life support is too expensive for the family, then a non-voluntary decision to terminate their life would be sought. This is a difficult decision especially to the family members as they would have to decide on what is best for the patient. Robertson (1975)

posits involuntary euthanasia as the name suggests occurs against the patient's direct wishes. A patient would prefer that they be kept on life support, but the doctors opt to terminate their life. The decision to terminate the patient's life would be medically based in order to prevent any lawsuits from the family members. Involuntary could also mean that the patient's life was terminated without consent been sought from the next of kin or the patient.

Pros and cons of euthanasia

Patients have a choice on whether they would prefer to terminate their life or stay on life support. This choice is a fundamental right for all individuals. Only the patient really knows how they feel, and what they are experiencing. Administering pain relievers to the patient does not relieve the pain and suffering. Without euthanasia, this patient would continue to suffer, and this affects their quality of life DIEKSTRA, 1995.

The patient's loved ones are allowed to grief for a short period. Prolonging a patient's life is like prolonging the inevitable and this will increase the loved ones suffering.

Morally speaking it is not acceptable to terminate a person's life no matter the condition. Some people would then consider euthanasia immoral. Patients might prefer euthanasia because of guilt. A patient who feels they are a burden to their loved ones may opt for euthanasia. This would be an involuntary decision as they are making it under duress. It is likely that a patient could recover from their terminal condition if given a fighting chance.

The ethical dilemma of euthanasia

There are people who would prefer to determine what happens when they are terminally ill and unlikely to recover. The decision to terminate their life is a right for an individual in order to alleviate pain and suffering. Only the patient will experience immense pain and emotional suffering when they have a terminal condition. If there is no hope that the patient could recover from their condition, is there a need to keep them on life support and prolong their pain and suffering? This question raises more question than answers. This also brings some ethical dilemmas since no person is allowed to kill another person. A person who terminates their life intentionally is said to have committed suicide. Suicide is an act of intentionally terminating ones life. This is not equivalent to euthanasia, but the outcome is the same. In some countries, assisted suicide is illegal, but attempted suicide is not. This variation in law creates more ambiguity.

The decision a person will take to terminate their life will have a lasting effect on their loved ones especially if they were not involved when the decision was made. The loved ones will see the act as selfish and only beneficial to the patient. While a patient has the right to decide on what should happen to them, doctors also have a right to preserve a life. Allowing patients to predetermine their outcomes denies doctors their moral obligation of saving a life. This brings an ethical dilemma to the doctor, as he/she has to go against their ethical obligation and assist a patient in terminating their life. The patient also has their own rights, and in obeying those rights a doctor might compromise on their ethical obligation as a doctor.

Analyzing the past events in the world, it is clear that if euthanasia was legalized worldwide there is a possibility of it been abused. It is easy for doctors to slip into some immoral behaviors. The doctors would be reluctant to assist patients they deem as terminally ill. With euthanasia been legal, the doctors would terminate the patient's life without trying any treatment. Another ethical dilemma that presents itself is how doctors would determine a patient's wishes. A report by the Dutch Government established that one in three euthanasia deaths occurred without the patient's knowledge. This is surprising especially considering that euthanasia is legalized in Holland. If the same were replicated across the world, the number of deaths would be enormous. Doctors performing euthanasia without patient consent is unethical even if the practice is legal. The patient still has a right to decide if they prefer to terminate their life. Eliminating this option makes doctors the supreme beings that decide when a person should die.

There are two moral theories that apply to euthanasia namely egoism and utilitarianism. Egoism theory states that a moral person should do that which is in self-interest. Utilitarianism theory deals with a course of action that maximizes happiness and reduces suffering. The focus of this paper is on ethical egoism and its impact on euthanasia.

Ethical egoism

In ethical egoism, a person will act in a way that benefits their well-being Regis Jr., 1980.

They will not consider others in their actions. The person believes that by promoting their own good they are in accordance with morality. They will believe that for as long as they are doing what they see is best for them, then what they decide to do is morally right Annas, 2008.

Having such a belief would deny a person the opportunity to think what others are feeling. The person is only interested in avoiding pain as much as possible. An egoist believes that it is best if they die instead of suffering for long periods. The effect of euthanasia on an egoist would satisfy their own interests, but this would have a devastating effect on the loved ones. Considering their own interests, the egoist will not consider the effect that euthanasia would have on their loved ones. For as long as they feel that no harm is been done on them, they will feel that their decision is morally right. A person has a right on their privacy, and many egoists interpret this to mean they have a right of deciding when they can die.

Ethical egoism is a dilemma as people have different views and desires. The family members might want the loved one to stay with them and try to fight the illness. The egoist on the other hand, might desire to terminate their life without consideration of their loved ones. The ethical dilemma arises, as both parties are not willing to compromise on their decision. An egoist might be against euthanasia. The egoist will feel they are not in control of their well-being and would not allow another person to have control over their life. This would mean that the loved ones and doctors would not terminate the person's life if they are terminally ill. The person would remain on life support machines until they die naturally. The ethical dilemma here is that the loved ones cannot opt to terminate the patient's life, and they will have to bear the medical expenses. This is still an egoist thing since the person does not consider others. An individual facing a lot of pain, loss of bodily functions, and having to spend the rest of their life in bed would prefer to terminate their life. This would be morally right for them since they are using the egoism theory. Another egoist might prefer to receive all the medical technology available to ensure that his or her life is preserved. In the latter case if the person's condition is beyond recovery, when would the doctors or loved ones opt for terminating the life. This is where the moral problem arises. The patient has opted to have their life preserved using all the medical technology available, but the doctors know with certainty that the patient will not recover. Will the doctors then opt for involuntary euthanasia?