Janet Adkins Euthanasia Case Study

Janet Adkins, a fifty-four years old, who was in the early stages of Alzheimer’s besides her ability to enjoy a full schedule of activities with her husband, had reached a decision that she wanted to end her life rather than lose her cognitive capacities. Adkins communicated with Kevorkian who invented a death machine. When they met in the park, he inserted a tube in her arm and started a saline flow. This machine had a button that if Adkins were to press, the drug would inject into her body which would cause her death. And she did press it! According to Merriam-Webster dictionary, the definition of euthanasia is the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for
reasons of mercy. Euthanasia has been a major controversial subject for many years and ethicists have different opinions regarding this difficult topic. The principles of nonmelaficence obligates the medical staff to abstain from causing harm to any patient. These principles in medical field supports several moral rules, for example, do not kill, do not cause pain or suffering and do not deprive others of the goods of life. Although the medical staff in some circumstances assisted death by the patient’s request, the principles of nonmaleficence determine the acceptable decisions about treatment without causing harm to others according to many guidelines that have developed by the philosophers, religion, public policies and law.
Religion, moral philosophy, public policies and law have developed many guidelines to determine the principle of nonmaleficence and forgoing life-sustaining treatments with the difference between withholding and withdrawing treatments. Many professionals and family members prefer withholding treatments that never started rather than withdrawing treatments that already initiated. For example, in one case, an elderly patient suffered from many major health problems without any chance of recovery. This patient was unable to communicate and he was comatose. Medical team was using intravenous tube to provide nutrition and to keep him hydrated and antibiotics to fight infection. This patient had no family member as a decision maker or any wishes for life-sustaining treatment for him. Medical team decided not to resuscitate “DNR” if the patient has an arrest. In this case the physician allowed the patient to die. The distinction between withholding and withdrawing is morally dangerous. Especially, if the caregivers make their decisions about treatment without any dissuasion, the caregivers are morally culpable for any negative outcomes (B & C 161).
The rule of double effect (RDE) is another attempt to specify the principle of nonmaleficence, which called the principle or doctrine of double effect.
This rule incorporates a distinction between foreseen effects and intended effects. One example of the use of RDE, a patient has terrible pain and suffering who asks his physician to end his life. If the physician ends the patient’s life to end his pain and suffering, the physician in this case intentionally causes the patient to die and his action is morally wrong. While if the physician gives the patient a medication to relieve his pain, the patient would die from the risk of the medication. But if the physician intended to give medication to relieve the patient’s pain and suffering without intended to cause death. In this case, according to RDE the act of indirectly hastening death is not wrong. The classical formulation of RDE identify the four conditions of morally permissible action. These four conditions are; the nature of the act (the act must be good), the agent’s intention (the agent intends only the good thing not the bad thing), the distinction between means and effect (the bad thing must not be a means to the good effect) and proportionally between the good effect and the bad effect. One case, a pregnant woman has a cervical cancer and she needs a hysterectomy to save her life, but the surgery will result of the death of the fetus. In this case, according to Beauchamp and Childress, the physician will decide to
make the medical procedure to save the pregnant woman’s life with the foreseen without intended of the fetal death. The aim in this case is to save the pregnant woman’s life.
Killing and letting die is the most difficult distinctions that have been used to determine the acceptable decisions about treatment.
The killing and letting die distinction has also affected the distinctions between suicide and forgoing treatment and between homicide and natural death (B & C 174). In one case, a congenital condition that connects the trachea to the esophagus i.e. tracheoesophageal fistula that occurs in infants with Down Syndrome. The parents and the physicians decided to let the baby die not to perform the operation. In this case, the public erupted over the case and the critics charged that the parents and the physicians had killed the child by allowing him to
die. Several studies have described the experiences of the physicians for euthanasia, besides the reasons for making this decision whether it’s made by the patient, the family member or the medical team. Most of the patients who died after letting them to die (according to the patient’s decision), they concern about the loss of dignity, the activity of daily life dependence, pain and cognitive capacities like Janet Adkins’s case. These patients are ready to die and ready to say goodbye to their family and friends. Therefore, these patients see that euthanasia is the way to stop their suffering and their illness, according to Georges et al. But the conditions that are sufficient for justified physician assistance in ending life and its morally accepted include; a voluntary request by a competence patient, the ongoing relationship between the patient and the physician, mutual and informed decision making by patient and physician, a supportive yet critical and analytical environment of decision making, a patient expression of a durable preference for death and unacceptable suffering by the patient (B & C 184).