The debate
Medical science and technology have made great strides in recent years. The medical profession has
today more power over life and death than it would have chosen to have. It has the power to prolong life
where life seems to have lost its meaning and power to terminate life without suffering. There are many
points of view on euthanasia -- legal, social and compassionate.
The debate on euthanasia has again become a live issue in India as the supreme court of India recently
passed a verdict that attempted suicide is not a crime. This signifies social approval of suicide and
euthanasia which is assisted suicide.
What is euthanasia?
Euthanasia is deliberately bringing about a gentle and easy death making the last days of the patient as
comfortable as possible. This is to ensure a calm and peaceful death, within the context of relieving
incurable suffering in terminal illness or disability. Euthanasia is voluntary, when requested by the
sufferer, involuntary or compulsory if it is against the will of the patient, passive when death is hastened
by deliberate withdrawal of effective therapy or nourishment.
The dilemma
While I was working in England, I was resuscitating an elderly lady who was admitted in the hospital
emergency ward with severe demonstrable cerebral damage. My chief of surgery, an Englishman and
devout Christian, told me gently,“I don’t want to interfere with your procedures but if she were my mother I
wouldn’t do all that you are doing and would allow her to die peacefully”.
This is often our dilemma. Should one prolong the act of dying in a case of inevitable death or when a life
is effectively over? One of the achievements of modern medical technology is the use of artificial life
support systems like artificial feeding, dialysis, controlled respiration, pump circulation etc. In some cases
it can be so dehumanising, painful, hazardous or costly that other considerations outweigh the aim to
conserve life.
Euthanasists raise the question, how long should one sustain life? A patient might say,“I do not want a
vegetative existence by drips, drugs and dialysis. I want to die with dignity. I have a right to lay down my
life just as I have a right to live”.
In a well known trial, a Dr. Arthur in U. K. had prescribed an overdose of codeine to a baby with Down
syndrome with the object of hastening his death Dr. Arthur was charged with murder. Many eminent
witnesses were tried. Most of them justified the procedure. Finally the court acquitted Dr. Arthur as his
motive was compassion. There is an argument that if a foetus is found to be abnormal and severely
handicapped it should be eliminated before birth as such children are socially valueless. Do not the
physically handicapped and mentally retarded have as much right to life as others and get the needed
care?
Death and dying
The concept of death is changing in the light of new knowledge. It may be obtained by redefining life.
Descriptions of life are organised at many different levels of complexity - molecular, cellular, organ,
system, corporal, mental, spiritual etc. Human life may be described as the ability, actual or potential to
respond to others, or to be self-aware. This is based on cerebral function. Silverman and others in 1969
have established this by extensive studies and confirmed it by encephalogram findings. Once cerebral
death is confirmed, there is no chance for survival though heart and lung functions continue. So it would
be quite unnecessary to continue supportive measures after cerebral death.
The Christian concept
Almighty God has created man in his image. He is the giver and sustainer of life. He alone has the right to
withdraw life. Life is not a right but a gift of God, belonging to God and at all times in His hand. We have
no right to take away deliberately a human life, even one’s own.
Euthanasia requests may be born of depression and confusion or out or a feeling of worthlessness or due
to persuasion of interested parties with ulterior motives. Respect for the person of the patient and concern
for the family should lead us to use our resources as best as we can to promote life. The essence of our
approach to a dying patient is to give ourselves in loving care to meet his need. A patient is not merely a
biological unit but a person before God with social family connections.
Suffering
Suffering can be redemptive and purposeful. It is as much a God- sent opportunity as is health and
provides an opportunity for a creative outcome or an amendment of life.
Let me share with you the experience of two of my friends who faced the issue of caring for children with
disability. One was a hospital chaplain. When a child with disability was born to him, he asked God why
this happened to him, but he could not get an immediate answer. He loved that child but the child could
not respond to his love in the normal way. They helped the pastor to realise how God loves us inspite of
our not being responsive to His love. The other was a colleague of mine and a highly qualified
paediatrician when a child with disability was born to him and his doctor wife. They did their very best to
sustain her life. The child became critically ill immediately after birth,needing exchange blood
transfusions. Though their colleagues questioned the wisdom of taking such an extreme step for such a
child, they choose to have the exchange transfusions. The child recovered and subsequently brought a
new purpose to their life before she finally died at 4 months of age. Through this the parents realised that
God had a purpose in bringing her to their home. This experience was an act of God to make them aware
of the need of caring for many neglected children with disability in our society.So they resigned from their
clinical work and offered their lives to start a centre for children with mental handicaps and special needs.
An apparent traumatic experience became the rallying point for a new mission and for compassion.
Our guiding principle
Ever since the time of Hippocrates in the fifth century BC, the medical profession has been guided by the
concept of the worth of each individual human life. This was recently reaffirmed by the Geneva code in
1948, which states,“I will show the utmost respect for human life from the time of conception.”
Hitler had a utilitarian philosophy of life. He preserved any person who had utilitarian value. The others he
eliminated. We respect the unique value of human life. Life should be cherished, supported and cared.
Some practical steps
1.Doctors should serve and care for their patients in love.
2.Deliberate attempt to end or shorten life, whether by omission or commission, is wrong and should not
be done.
3.Our society should proclaim the way of righteousness and truth and provide compassionate care. It
must take a stand against taking innocent lives.
4.Medical personnel and the people at large must be educated in moral and spiritual values. These
should lead to sound legislation.
5.Bring in the principle of love as the mainspring.
Conclusion
Views, ideas, even concepts of ethics are fast changing in the context or the progress of science and
technology. The traditional institutions in our society, which protect human life and spiritual values, are
gradually being pushed aside or getting eliminated. Love is the foundation of ethics. Loving our God with
all our heart, soul and mind and loving our neighbour as ourselves, are the two foundations for our ethical
practice. Only a code of ethics based on sound principles can lead our society to lasting
happiness,harmony and peace.
They lie to you about birth and death. Modern medical fashions soothe the unsuspecting into believing the
good birth and the good death are simply a matter of getting the right currently modish care - "natural"
entry into the world, eased "naturally" out of it at the end with the right palliation. But these comforting
myths are misleading and sometimes pernicious.
In the beginning the all-powerful natural childbirth lobby deludes first-time mothers into believing drug-free
birth is a painless joy, as misdescribed in natural childbirth classes. The cult of the natural deliberately
frightens women away from the drugs and modern medical techniques that can make birth safely pain-
free.
Now I discover that they lie to you about death, too. The modern myth is that these days generous and
carefully calibrated doses of morphine administered by the best palliative care teams will make final
departure a gentle slipping away in pain-free dignity. But it is often not so - and people should know it.
My mother died three weeks ago, less than a year after a diagnosis of terminal cancer. From the start she
faced its inexorable course with rational calm, unafraid of dying but determined to avoid lingering beyond
what she thought bearable. She went to her solicitor and signed a living will. But all the same, linger she
did, many weeks beyond what she found either dignified or bearable: it was no way to end a good life.
The NHS couldn't have given her better or kinder care. District nurses came twice a day to check the
pump that was pouring morphine into her bloodstream. Carers were on offer, with every kind of
equipment delivered. An excellent palliative care team was on call 24 hours a day, with her own
designated nurse, sensitive and thoughtful, who visited regularly. She had long home visits from the
hospital's palliative care consultant. All of them did all they could to keep her comfortable, pain-free,
undepressed. But it was not enough. She wanted the one thing they could not and would not give her,
however often she asked them - an easy death.
Palliative care as a specialism has transformed the treatment of terminal patients, dedicated as it is to
pain relief. Before doctors, interested only in cure and success, often ignored the pain of terminal cases
past help. But because palliative care can now be so good, the myth has grown up that death is
vanquished: just take the well-prescribed morphine and you can drift away on cloud nine to a contented
oblivion. The truth about dying has been sanitised by comforting notions that no one now need exit life
through the torture chamber. But for many patients that just is not so, however good their treatment.
Yet the medical profession keeps pumping out the myth that it can guarantee a good death. They were at
it again yesterday, the mighty heads of the British Medical Association and the Royal College of Nursing
in their letter to the Guardian. They were opposing the assisted dying for the terminally ill bill proposed by
human rights lawyer Lord Joffe, now being debated in a Lords committee.
They wrote: "We know that some of the most distressing situations arise from individuals' anxiety about
maintaining their dignity at the end of life, combined with concern about the availability of effective
palliative care. The RCN and the BMA believe that with proper pain control, good communication and
psychological support, far fewer people would consider asking for clinical help to die." They seem to
suggest that good management can produce the good death: alas, even the best care can't promise that.
The truth is that old-fashioned morphine in its various forms is not a good drug, but that's all there is. It
more or less conquers severe pain at very high doses, but not all the time. Forget dreamy psychedelia - it
fogs the mind in unpleasant ways sometimes with unsettling hallucinations and, the doctors admitted,
contrary to myth, it is a depressant. My mother did not want to live through her last weeks, despite
plentiful visitors and a large family close at hand. Long, sleepless, painful nights seemed to her
interminable, and dependency for all personal care insufferable.
'If I was a cat, you'd take me to the vet and put me down," she would say. Or: "Where's Harold Shipman
when you want him?" Once she lost her independence, she never wavered in her wish to be gone. She
had always said firmly that it should never happen to her - and she looked balefully at us for allowing it.
Doctors and nurses were sympathetic but after Shipman the rules have tightened considerably: many,
whose GPs used to grant requests for a kindly injection to help see them off quietly, are now kept alive
unwillingly.
My mother had enough morphine pills in the house to kill her. But by then she had trouble swallowing the
few she needed for pain control, let alone the 50 it might have taken. She said she wanted that instant
annihilation that anaesthetists give before an operation: the injection that knocks you out before you can
count to five. But no doctor could. The law denies the dying that escape.
She asked us to put her on a stretcher and take her to the Netherlands or Switzerland. But we blenched
at the idea of a terrible journey of death. She begged for enough pills, but I found I couldn't contemplate
grinding up scores of them and helping her force them down. It is one thing to support her wish but quite
another to live with the memory of killing your own mother. I was cowardly; she was disappointed in me.
It doesn't altogether surprise me that a Home Office study found that 30% of mercy killers end up killing
themselves in later life, haunted by it. It is more than families should be expected to do - though an NOP
poll found 47% said they would help a relative in terminal pain to die. (I wonder if they really would, when
it came to it.) The same poll showed 80% in favour of allowing people to choose assisted dying by a
doctor: that is an overwhelming vote for the right to escape insupportable terminal pain and loss of dignity.
The medical profession is deeply divided on this, and the BMA conference only narrowly voted against
changing its stance. The Royal College of Physicians has dropped its opposition, in favour of "studied
neutrality". The Lords committee is this week in Oregon, studying its "death with dignity" laws, and next
week it will be taking evidence from a host of organisations, with the Voluntary Euthanasia Society
mounting a vigorous campaign.
On the other side, the Daily Mail is fighting furiously against, with the Archbishop of Canterbury and the
Roman Catholic cardinal together claiming "the respect for human life in all its stages is the foundation of
a civilised society". That is a religious view humans must endure, whatever their creator ordains. But 80%
of the population don't think the dying should suffer beyond what they can bear. The government? The
betting is that they'll go with the Christians and the Daily Mail, not with the great majority.
The definition of Euthanasia as given by the Oxford English Dictionary is: "the painless killing of a patient
suffering from an incurable disease or in an irreversible coma". It comes from the Greek, literally
translating as "a good death".
Euthanasia is a controversial matter, becoming a bigger issue with high profile cases like Diane Pretty's, a
woman suffering from Motor Neurone Syndrome who lost her battle to have euthanasia legalized and
died of natural causes in 2002.
Euthanasia is legal in the Netherlands and in the state of Oregon in the U.S.A. Recently, the government
on the Isle of Man has made a much debated decision to legalize euthanasia. There is a lot of pressure
mounting on other governments to follow suit, with more terminally ill patients expressing the wish to end
their lives legally. The primary reason, they say, is so that they can die with dignity.
I am going to discuss this topic and strive to give the arguments of both sides. I will then come to a
conclusion based on what I have learnt.
People who are against euthanasia are called "Pro-life"; this is also the view of Christians who regard
euthanasia as a sin. There are other non-Christian reasons: one of the strongest arguments against
euthanasia is the question of who can decide how advanced a terminal illness is in order for euthanasia to
be acceptable.
For example: the case of American Sidney Cohen, who was diagnosed with cancer and given three
months to live. He asked for euthanasia to be administered. He was suffering agonizing pain and was
bed-ridden, but was refused euthanasia because it was illegal. Eight months later, he was still living, and
said, "I now know that death is inevitable and since coming under hospice home care I now enjoy a full
life." His fears of an agonizing death had been allayed and he was now staunchly opposed to euthanasia.
The point here is that once fears are laid to rest and pain relieved, many people change their wish to have
euthanasia administered. Also, it shows that doctors are not always correct in their diagnoses. Another
point that the "Pro-life" lobby try to get across is that they believe no one dies painfully now, because of
hospices and modern drugs, so euthanasia is not needed.
Other arguments include the fact that many patients feel they are a great burden on their relatives and are
causing them much pain. For these reasons, they might ask for euthanasia to be administered, when they
may not want to die -- they just do not want to cause their family any more suffering.
Also, someone could pressure a terminally ill person for their own personal or financial gain. For example,
an elderly relative could be manipulated by someone who stood to inherit their estate. Unscrupulous
doctors may want to remove elderly patients from their lists if they require a lot of care for little financial
return. And so on.
On the other side of this argument are those campaigning for a change in the law which would legalize
euthanasia, including The Voluntary Euthanasia Society.
One of their most publicized arguments, which was used extensively by Diane Pretty's lawyers, is that if a
person was more physically able and did not need third party assistance to administer euthanasia, they
could commit suicide, which is not necessary illegal on its own. Therefore it is argued that this is
discrimination against people with physically deteriorating illnesses. That, they say, is in direct violation of
the Human Rights Act, Article 14 which outlaws discrimination.
They feel that the fact that euthanasia is not administered to people suffering agonizing pain if they wish it
is another violation of the Human Rights Act. Article 3 clearly states that it is everyone;s absolute right not
to be subjected to inhuman or degrading treatment. By not allowing people the choice end their life, the
law condemns them to prolonged suffering and increasing loss of dignity.
One argument of the "Pro-Life" camp is that we might see mass deaths if euthanasia became lawful. But
those who are campaigning to legalize euthanasia say that figures such as those from Oregon show the
opposite. In Oregon, only 0.1 percent of deaths in the last five years have been as a result of euthanasia.
The "pro-life" argument regarding improvement in pain control through drugs, hospices etc. only covers
those dying in pain. It does not apply to those suffering debilitating illnesses and physical collapse of their
body -- for example, those suffering from Motor Neurone Syndrome. In these circumstances, the loss of
independence and the breakdown of all bodily functions ensures a slow, undignified death,
understandably some of these patients would welcome euthanasia.
Before I began writing up this discussion, I would have said that I felt that euthanasia was a viable option
for those with terminal illnesses, but now I accept, not the moral and Christian views which say
euthanasia is a sin, but views of people such as Sidney Cohen. He understood that he was going to die,
was relieved of pain, and began to live a full life for the short while he had left. He was thankful
euthanasia was not an option when he requested it. On the other hand, he was still in physical control of
most of his body, unlike cases such as Diane Pretty's. She could never live a full life again after her
debilitating illness set in on her. She was totally dependent on others. For this reason I have come to the
conclusion that I would like to see euthanasia legalized. If it was legalized, then I would strongly
recommend that hefty safeguards be put in place, in order to protect the vulnerable.
I think euthanasia should always be the last option, and all medical means should be exhausted to try to
give the patient different options.
Whatever way you look at it, euthanasia is a subject which cannot be ignored. There definitely needs to
be a national -- if not international -- debate on the subject, maybe even a referendum (where everyone
votes on just one issue).
It is apparent that euthanasia should be permitted everywhere for
the following reasons: individual liberty; one’s undesired pain,
suffering, and misery; and the individual’s frustration from having a
valueless life. First of all, one should be able to understand the term
euthanasia. “In ancient Greece, eu thanatos meant ‘easy death.’
Today’s euthanasia generally refers to mercy killing, the voluntary
ending of the life of someone who is terminally or hopelessly ill”
(Euthanasia 1). Knowing that, it is seemingly appropriate to say
that one has the right to die an easy death if, and only if, he is
terminally ill. Otherwise, different situations should not play any
part in this issue. To understand more about the pro-euthanasia
side of this issue, it is best conceived through the viewpoints,
strong beliefs, and perspectives of proponents of euthanasia. An
individual has liberty, which includes the right of owning his life. He
is the possessor of his life. Just as he can do whatever he wishes
with his possessions, such as selling his new house, he can also
wish to discontinue his life if the reasons were rational. In a typical
situation, a person has some terrible, deadly disease. He is trapped
in a hospital bed, with all sorts of medical equipment connected to
him, unable to move or do much of anything except exist. He is in
terrible pain; he begs to have these machines disconnected so he
can go home and live out whatever life he has left and die in peace.
He does not want to endure the pain, but instead, to assuage it.
However, the doctors refuse because to turn off the machines
would surely result in his death, and they have a presumed bias
against doing this. If a person decides that he wants to die, and
someone does not think that this is a good decision, what right
does the opposing person have to tell him that he cannot do this?
“It is clear that a patient’s decision to ask for a cessation in
treatment, reflecting his own preference for death rather than for a
continuation of discomfort or suffering, must be respected, barring
exceptional circumstances” (Behnke 17). Therefore, that
individual’s decision should be carried out because he has that right
to his own personal decision, which is only one of many reasons
why euthanasia should be legalized. In addition, one should have
the right to end his life by euthanasia because of the unsolicited
pain, suffering, and misery he feels due to the disease he has or the
condition he is in. People in this position would most likely want to
alleviate their pain, suffering, and depression—just to name a few—
partially because of the inconveniences, emotional and physical
burdens, and drawbacks imposed on family members, relatives,
and friends. Furthermore, family members “may be sensitive to the
costs accumulating during terminal care” (Hagen 91).
Consequently, patients may feel guilty in this entire ordeal. Even
more, people who, maybe because of a serious illness, are
extremely depressed partly because they want to live their lives to
the fullest by perhaps participating in energetic and active events
but know that that is not possible now that they are severely ill and
sick. Since they recognize that enjoying life in those ways is no
longer possible, they may want an easy way out—euthanasia.
Others simply do not want to sustain suffering. Everybody has
different amounts of pain and suffering that he/she can tolerate
(Behnke 17). In considering suffering of terminal patients, one
cannot exclude from thought the grief due to distress, fear, and
agony. Nor must anyone underestimate the bearable level of pain in
the periods between doses of medication or simply from being
turned over in bed. There is still too little known about what is
actually experienced by patients as they approach death so it is
evident that the individual, and only the individual, has the right to
choose when he wants to die. These factors, along with unwanted
suffering, pain, and misery are only some of the components
considered in allowing the act of euthanasia. The final element
worthy of discussion in legalizing euthanasia is an individual’s
frustration in living, in his opinion, a valueless life after becoming
critically ill. People who suffer from illnesses that make them unable
to communicate do not want to live any longer. This includes people
who are in a coma, are paralyzed, or simply so sick and weak that
they cannot make meaningful sounds or other communication. If
the person is no longer able to relate in any way to his relatives and
friends, he might not want to live a day further (Bender 28). In
addition to that, some people believe that their “quality of life” is so
low that they would rather die. If this is the case, then what
position do others have to go against this? No one other than the
patient has any right to deny the patient his way of dying.
Therefore, euthanasia should and must be a legal choice. Like any
other issue, there are opposing viewpoints regarding the
legalization of euthanasia. Pro-lifers, people who are against
euthanasia, place the emphasis on killing. They believe that “we are
merely stewards of our lives; it is for God to decide when our lives
are to end. Further, suffering, is an inevitable part of life; our task
is to understand and grow from suffering, not evade it” (Mabie 65).
Pro-euthanasia people, who place the emphasis on mercy, argue
that “stewardship has not prevented the religious from exercising
control in other areas of their lives—for example, in using
analgesics for surgery and childbirth. If it is for God to decide when
life will end, if suffering is ennobling, then the very practice of
medicine is and always has been wrong. Further, they hold that
theological arguments against euthanasia pertain only to the
religious; the constitutional separation of church and state requires
that opposition to euthanasia on theological grounds alone not be
codified in law” Mabie 66). Therefore, the counter-argument against
euthanasia was objectionable and absurd. “In our increasingly
secular society, many believe that humans are sovereigns, not
stewards, of their own lives. For them, it follows that respect for
autonomy should mean respect for a person’s decision to end his or
her life. How can we demand that someone endure unbearable pain
just so that we can be morally comfortable” (Mabie 67)? Other
arguments facing this issue focus on medical grounds. Critics say
that “diagnosis can be wrong. Furthermore, a cure for what is today
incurable might be found tomorrow. And what of informed consent?
Can a patient struggling with pain and the enormity of death make
a truly rational decision to end his or her life” (Mabie 65)? Pro-
euthanasia people debate that “diagnoses can be wrong, but for the
most part they are very accurate, especially when disease is so far
advanced that euthanasia is discussed. At that stage death will not
be held off even if a miracle cure is found. Proponents of legalizing
euthanasia respect the trust that springs from the physician-patient
relationship. But they feel sure that that essential trust can be
protected by establishing tight procedures to ensure that
euthanasia is not abused” (Mabie 67). Just as before, the pro-lifers
are proven wrong. Individual liberty, undesired misery, pain, and
suffering, and one’s frustration in having a worthless life all serve
as critical circumstances to be considered thoroughly in legalizing
the act of euthanasia everywhere. Euthanasia is a death option that
should not raise controversy if performed solely in the appropriate
predicaments mentioned earlier. Knowing this, shouldn’t euthanasia
be legalized? The solution to that question would have to be yes.
Coming to an end, the crux of this matter is summarized in one
simple sentence: The emphasis of euthanasia should be placed on
the purpose of the act, not the nature of the act (Bender 50).
Bibliography Behnke, John A., Sissela Bok. The Dilemmas of
Euthanasia. Garden City: Anchor Press/ Doubleday,1973. Bender,
David L. Problems of Death. St. Paul: Greenhaven, 1981.
“Euthanasia.” Compton’s Interactive Encyclopedia. Softkey
Multimedia Inc., 1996. Hagen, Richard C. Death and Dying. St.
Paul: Greenhaven, 1980. Mabie, Margot C.J. Bioethics and the New
Medical Technology. New York: Atheneum, 1992. Word Count: 1312
Should a patient who has lost all powers of reasoning and
who lives like a vegetable, totally hopeless and helpless,
a terminal case who only wants to die, be forced to live?
The number of people who are asking this question increases
each day. Although the official position of the medical
profession is to maintain life indefinitetely, regardless
of the condition of the patient, but with certain cases,
euthanasia should be administered.
We are living in an age of medical miracles. Medicine, has
made so much dramatic progress, that lifesaving techniques
were thought to be impossible, a generation age. Ill
patients throughtout the world are kept alive by the use of
defribbrilators, respirators, pacemakers and other similar
equipment. A study was done by the American Encephalograhic
Soceity has concluded that when an EEG reading is what is
known as "flat line" the person, is officially dead. What
this actually means is that although there may not be any
brain activity, other vital organs can work by means of
certain equipment. Now heart- lung machines can augment the
duration of life.
Well some say that life is precious, HOW IS LIFE PRECIOUS,
WHEN IT CAN NOT BE LIVED TO THE FULLEST ?.
I believe that Euthanasia should be legalized because of
that option of dying. People say that their should be a
option to live, but I think that there should also be a
option to die. Many also think that they should stay alive
because they don't want death for their own reason. Why not
put them out of there misery, if the pain that one goes
through is excruciating why not let them die.
Many states have laws that state, that explain the
condition of when a person is deceased. States believe that
they should authorize the death of a individual when it is
not really there's to make. I believe that there should be
a choice of death or life. I am not saying who should make
the decision, but all I am saying is that Euthanasia should
be legalized. Think of it this way, if someone dear to you
had died, you would instinctively think that the person
should live. Well, how do you think that the person that is
dear to you feels?. Maybe he is in pain? Although the
organs may work, what is the difference between death and a
vegetable when the vegetable just has his vital organs
working, and both the decesed and the vegetable have no use
of the brain.
