Euthanasia: Death and Life-sustaining Treatment

By: William
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Bastian 1 Euthanasia, the act of relieving the prolonged pain and suffering of terminally ill patients by inducing death, has been the subject of controversy for sometime. Dying with dignity, the kind of end we hope for ourselves as well as others, has in some ways become more difficult. With the advancements in medicine having leaped forward within the last 20 years, prolonging life by means of technology has become common place in the medical community. These life-sustaining advances in treatments have brought up moral issues of whether it is the right of an individual to suppress his or her own life-sustaining treatment if they so desire. Our society has become a youth-worshipping society. It is almost as if we have taken on old-age and death as just another disease that need to be conquered. The fact is, we all die sooner or later. Death is not our enemy. It is as much a part of living as being born. Some seventy percent of the deaths that occur here in the U.S. take place in a hospital or institution, and almost three-quarters of the people who die each year are over sixty-five.(Ogg 2) This figure has not always been the case though. Before immunizations of infectious childhood diseases, death at a young age was common. In 1915 the average life expectancy was 54.5 years. Today the average is about 75 years. Most adults who died were not really old by today's standard. (Ogg 2) Death was part of living, commonly taking place at home with family and friends. Bastian 2 Today, as the figures show, death is highly institutionalized. This hiding away makes death easier for everyone to deny. The question of how to treat the dying surfaces. As one doctor stated, "there is a time to resist a disease and a time to recognize that future resistance would be inhumane, as well as futile." (Kubler-Ross 8) Traditionally, doctors had the responsibility for deciding what should or should not be done for dying patients. Now, patients, their families, and patient representatives have a say in such decisions. Other factors such as religion come into effect as well. Jewish custom sanctions and perhaps even demands the withdrawal of artificial machines to prolong life, whether implanted or not.(Kubler-Ross 42) The Catholic Church is opposed to any form of euthanasia, but at the same time, the Church has for centuries sanctioned the withholding of useless treatments in hopeless cases. (Colen 56) To understand euthanasia we must be able to differentiate between passive and active euthanasia. Passive euthanasia is seen as non-treatment of an illness, whereas the untreated disease or ailment is left alone so as to run rampid in the person and kill them. Also, withholding a respirator is also considered passive. Active is seen as intentionally performing an action such as administering a lethal dose of medication. Physicians who go about such actions usually inject a lethal dose of a drug called Curare.(Ogg 50) Bastian 3 Another form of active euthanasia would be removing a patient from a respirator with the intent that the patient will die. One such case would be that of Karen Ann Quinlan. The case of 21 year old Karen Ann Quinlan touched off a national debate about the care of the terminally ill. After Karen had been in a coma and attached to a respirator for more than six months, her parents sued for the right to have the artificial life support discontinued. The New Jersey Supreme Court authorized removal of the life support. Ironically, death never occurred. Karen miraculously continued to live, and was able to breathe without the support of the respirator.(Colen 7) Because of the irony that may occur with certain cases, such as that of Karen Ann Quinlan, questions arise as to what constitutes a person as dead. Brain death has been accepted as the medical basis for declaring a person dead. But as of now brain status does not yet specify criteria for establishing total brain death.(Colen 45) Physicians and nurses may demonstrate a sense of discomfort and sense of guilt when left to face terminally-ill patients. The concern for what happens after the plug is pulled must be taken into account. As it stands, a doctor is not held responsible for not putting a patient on a support system initially. Once the patient is on the support however, the doctor can be held liable for removing the support. Most doctors would not pull the plug for Bastian 4 support until state laws protect from charges of murder. In light of this situation, many compassionate doctors hold back initial life support in cases where patients seem unsalvageable.(Ogg 10) Because of the legal issues involved in euthanasia, many contend for a legal document called a Living Will. This document is one created by a person at any time in their healthy life. It declares the forethought wishes of that person. In circumstances of accidental or sudden illness or injury the preferred treatment would be known to the victims family and physician. The terms and conditions of the will could outline consent for withholding or withdrawing life-sustaining treatment. This in effect protects the tending physician from malpractice. Unfortunately, Living Will documents in some states have certain restrictions. For example, in the U.S., North Carolina gives the family a dominant say in whether or not treatment continues. There may be problems associated with this however. In certain instances financial burdens placed on the family may determine the decisions that are made. On the other hand, the plight of some families to gain monetarily can have a large impact on what decisions are made toward the treatment of the victim. Issues such as these make it necessary for guidelines to determine the outcome of patients. Bastian 5 In certain areas of the world euthanasia has already been adopted. The Netherland's is one such place. Here they created guidelines which necessitate the four following before any actions are taken, they are: (1) patient competence, (2) consistent-voluntary requests, (3) intolerable physical suffering w/no recovery hope, (4) and physician performed. With legal guidelines society is not left with many questions or decisions. The patient is made responsible for his own well-being. Closer to home, California has been pushed to create proposed guidelines for euthanasia. These were pushed for by an organization called "Americans Against Human Suffering", which is part of the Hemlock Society. The guidelines are identical to the Netherland's with two exceptions, these are: (1) the patient must be terminally ill and have less than 6 months to live, and (2) a person can request euthanasia seven years in advance, this is termed ‘Advance Directive'. Public opinion for euthanasia has always been mixed. But a recent poll, taken by the Gallup Organization in Canada during July 1995, reveals that people are starting to see advantages in euthanasia. The first question that was asked was: "When a person has an incurable disease that is immediately life threatening and causes that person to experience great Bastian 6 suffering, do you, or do you not think that competent doctors should be allowed by law to end the patients life through mercy killing, if the patient has made a formal request in writing?" The response was overwhelmingly pro-euthanasia. Three quarters of the people surveyed believed that the choice should be given to the patient. (Internet) Although euthanasia may seem like the right choice to a large consensus, there are still moral issues involved that keep euthanasia from being legalized. The arguments for euthanasia are based on the belief that euthanasia is a more humane route to take in cases of suffering, and also that a person should have the right to self determination. The arguments against euthanasia involve religion, and the fear that misuse may occur. By misuse, the idea is that old, poor, and powerless people would be selected more often than rich people. In either case, pro or con, it may be some time before euthanasia would be allowed in the U.S.. The world would seem a very different and cruel place to many if legalized. But from the information received from the polls, euthanasia may be only a short time away.

Word Count: 1363 Euthanasia