Euthanasia

Introduction

Euthanasia is a term used to refer to the act of terminating the life of an extremely ill patient to relieve them from the often excruciating suffering that the illness brings to them. Usually, euthanasia is conducted only on a patient with an incurable disease or terminal condition. In many countries, including the United Kingdom, and many states of the United States, it is against the law to help anyone to kill themselves. The question is whether a terminally ill patient who is in great discomfort and pain should be allowed to end their life, if that is the patient’s desire. Another question is about who holds the right to deny such a patient a less painful end to their lives. These two questions cause quite a controversy, and they have heavily been debated on. Regarding this debate, those in favor of the practice argue that the patient should be given the right to decide their fate, whereas those against it argue that the practice could be misused, especially by the doctors. The following discussion is an argument in favor of the practice of euthanasia, especially focusing on the dignity of the patient, their rights, and the need to regulate an already practiced act.

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Right of the Patient

People should have the right to choose how and when to die. Many supporters of euthanasia believe that every person has the right to control their life and body; hence, they should have the liberty to decide the manner and time they will die. The right of a terminally ill and competent person to embrace a dignified and timely death bears the sanction of history and it is implicit in ordered liberty concept. The exercise of this right to die is pivotal in bodily integrity as well as personal autonomy just like other rights touching on contraception, marriage and refusal on life-saving treatment. State’s categorical ban on controlled euthanasia substantially interferes with the interests and liberty of a terminally ill person and cannot be sustainable in the long run. The common argument that has been put forward is as follows. In cases where the patient has no dependants who might put pressure on the final decision in one way or another, the right of the patient to choose when and how to end their life should be paramount as long as the patient’s intent is clear beyond doubt and he or she is lucid (Hunnell). Therefore, there need not be any further interrogations on the desires of the patient (Hunnell). Such patients should enjoy the right not to be forced to suffer as noted by Hunnell in her article “Do no Harm?: Medical Journals Show Increasing Support for Euthanasia”. Moreover, it should be taken to be a crime to force someone with justification to continue living against their wish just as much it is a crime to take life without one’s consent (Onwuteaka-Philipsen et al.). The right to life guarantees an individual the right not to be killed if they do not want to be killed; hence, the respect and adherence to this law will guarantee that doctors among others stakeholders will not be able to misuse euthanasia. Ending the life of a patient without permission of the patient would amount to violation of their human rights. Therefore, unwarranted killings will not be carried out. Arguably, death ultimately is a private matter, and if there is no harm to anyone else apart from the person seeking it, there is no right to deny that individual their wish to die (Hunnell). In other words, if the practice upholds the interests of all the concerned parties and that there is no violation of human rights in the process of guaranteeing this wish, it becomes morally acceptable for voluntary euthanasia to be carried out.

Ethics

Ethically, if one puts aside the notion that in no way can death have in it anything positive, one can consider that in some certain circumstances, death is the better option than keeping alive someone who is in discomfort and terrible pain (Chao et al. 129). This argument holds weight because, if death were not considered as the worst outcome, most of the objections to euthanasia would no longer exist or be legitimate because the majority of the arguments against euthanasia are based on the notion that death cannot be a good outcome under any circumstances. Generally, people avoid death since they value and enjoy being alive above everything else. However, in the case of someone who is terminally ill, that person does not expect to get better at all. Secondly, in this case, the patient continues to be in great discomfort and pain and expects it to get worse rather than better; therefore, such a person is not able to enjoy or even value their life any longer. The continued deterioration of the body can cause a patient to devalue his or her life, and they may choose not to endure any longer such suffering and pain (Fraser and Walters 122). In such a case, the wish of the patient should be respected because their death could be a better option than keeping them alive. The main concept here revolves around “quality of life” and it is central to this argument. Under this concept, the religious argument that life is sacred and therefore, under all circumstance life is better than death is rejected. The ethical argument here is that life should be allowed to continue as long as the individual feels that their life is worth having. Opponents of this argument argue that palliative care is readily available and it may help relieve the pain of a terminally ill patient. However, not all the trauma associated with terminal ailments is physical by nature. Drugs alone cannot do away with the mental anguish and emotional pain of someone knowing that their state of being will only deteriorate instead of improving (Fraser and Walters 124). One can imagine a scenario whereby euthanasia is already legalized and regulated. When legalized, it is possible to expect a reduction in the availability of palliative care given that there will be options available. Euthanasia is a more cost effective method than prolonging the life of a patient who will eventually die. This scenario could significantly reduce the availability of palliative care to a patient; reduced care obviously translates to increased discomfort and pain to the patient and ultimately a reduced enjoyment and value of the life of the patient.

Scarce Medical Resources

There is the issue of medical resources and health care spending. Euthanasia may be necessary in regards to the fair distribution of medical resources. There is the universal economic law that resources are limited while people’s wants are unlimited (Hermsen and ten Have). Although this argument may not be publicly acknowledged by health authorities and governments, in every country, there is a shortage of medical resources. This is not an embarrassment to any country or it is not intended to downplay the progress in the field of healthcare. However, it is an acknowledgement of a law of economics and a law of nature to some extent. Consequently, some citizens who are ill and who suffer from curable ailments do not get adequate and speedy access to health facilities that they require for treatment. Moreover, at the same moment, medical resources are tied up because they are utilized by individuals who cannot be cured. This is made worse by the fact that the resources are tied up on persons who for one reason or another would prefer not to continue living (Fraser and Walters 121). As a result, allowing that category of people the right to euthanasia would not only grant them their wish and right, it would free up valuable health care resources to be available to people who can be cured and who want to live. The end-of-life care is very expensive in America. According to Hermsen and ten Have, one in every four dollars set aside for Medicare goes to 5% of beneficiaries in their last one year of their lives. The families of the terminally ill patients are often left in debt after the death of the patient. On average, the cost of care for a single individual at palliative care costs about 39,000 dollars, and the upset of this is that for a 40% of households, this amount exceeds their financial assets (Hermsen and ten Have).

The Issue of Vulnerable Groups

One area of concern has been the argument that disadvantaged groups in the community may be disproportionately represented in the number of people who have chosen euthanasia. Statistics and experience in Oregon suggest that this has not been the case. In the USA, socially disadvantaged groups include the elderly, the poor, and ethnic minorities. Compared to deaths of all other Oregon citizens who have died of other causes, the ones who died out of euthanasia were significantly very low and they did not consist of these minorities (Battin et al. 593). For example, those who died of physician-assisted suicide were more likely to be Asian, college graduates and generally younger people. Moreover, even though African Americans compose of 2.6% of Oregonians, no African American patients have so far chosen to end their lives through euthanasia (Battin et al.). Since Oregon has legalized euthanasia with effect from 1998, the number of euthanasia related deaths represents only 0.2% of all patient related deaths. In 2007, the Journal of Medical Ethics reported that the vulnerable were no more likely to receive euthanasia than anyone else (Battin et al. 596). From the above statistics, one can assume that euthanasia will not be used to the detriment of minority and disadvantaged groups in society.

It Happens Anyway

It is better to legalize euthanasia so that it can be regulated because happens anyway, albeit in different forms. Many end-of-life practices are essentially forms of euthanasia under different names. For example, there is the practice that patients can requests not to receive medical treatment if they stop breathing or their heart stops beating. In itself, this is just a type of euthanasia, although passive in nature since a patient is does not get the medical treatment that potentially could have saved their life. Still, there is the practice of palliative sedation whereby a patient who severely suffers from a condition for which no known treatment is sedated to sleep by the use of sedatives. Sedation is commonly used to manage pain in victims of massive burns who the doctors do not expect to survive (Onwuteaka-Philipsen et al. 909). While it may not be carried out with the sole purpose of terminating life, many of these sedatives are risky and they may quicken death. Consequently, there comes the pragmatic argument that if society allows for these forms of euthanasia anyway, society may as well come up with regulations to ensure the safe and controlled practice of euthanasia. Therefore, particularly in regards to passive euthanasia, this is a widely accepted practice that stakeholders in the field are not currently willing to admit. Hence, it is wise to better regulate the practice properly rather than bury our heads in the sand and pretend that euthanasia is not happening under whatever form and shape. For example, in a 2005 research carried out in Netherlands by New England Journal of Medicine, only 0.4% of all euthanasia cases were done on patients without their explicit permission (Onwuteaka-Philipsen et al.). In a similar report on the same country prior to legalization of the procedure in 1991, a report put that figure at 0.8% (Chao et al. 132). That is to show that legalizing and streamlining the procedure has actually halved the total number of unwanted deaths among patients.

Conclusion

The above discussion has put forward sound arguments why society should embrace euthanasia and legalize it based on several important tenets. For example, the discussion has highlighted three major points to consider for the legalization of euthanasia. These points include the right to chose when to have a dignified end of life, medical resources are scarce and the few available could be preserved for the curable ailments in society, and death in itself may be a better option. The discussion has also provided sound arguments to counter the arguments against legalized euthanasia. In particular, the argument against legalizing euthanasia on the basis that this would act as a slippery slope for unauthorized killings without the explicit permission of the patients, especially among minority groups is very powerful. The discussion has offered various reports from publications and journals pointing out to the contrary that in fact, deaths among patients go down when the practice is regulated in societies practicing regulated euthanasia. In fact, majority groups such as white young male prefer euthanasia. It is on the basis of the arguments outlined and analyzed in depth above that this discussion urges that time has come for society to legalize euthanasia and streamline the practice to realize the benefits of the procedure and rid it of the vices that accompany it if left unregulated.

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