The Moral Argument of Requested Euthanasia

Abstract

The ongoing discussion of euthanasia has its supporters and foes. It is already somewhat legal in few places in the world, but still strictly monitored and followed where it is available. Advocates fight for the cause stating that assisted-suicide provides an peaceful end to lives hindered by old age, terminal illness, and empty meaning of life. Those against euthanasia suggest that it is unethical to assist in any type of suicide and that human life should be lived to its fullest to the point that the life naturally ends. Doctors find themselves within the debate citing their own pledge of honor as a moral guide against euthanasia while others are determined to help their patients in anyway possible. Public opinion seems to be growing in favor of euthanasia as the debate goes on. The legalization of assisted-suicide if passed must be done with the most extreme caution and meticulous detail in ensuring that the system will not be abused.

Requested Euthanasia

Death is the final stage of life where the individual completes his or her arduous and fulfilling life and moves on to the unknown afterlife. The right to choose when to end one’s own life in a reasonable manner should not be taken because the individual has full responsibility to do what they want to themselves. At a certain point in life a person may deem that he or she has lived to the fullest extent that makes the individual feel complete. Usually when this occurs, people are at an elderly age of around 85 where numerous diseases and conditions could be hindering their daily lives with the only end in sight being death.

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In particular, David Goodall experienced a similar situation towards the end of his life. A somewhat renown Australian scientist, Goodall was 104 years old suffering from deteriorated health that hindered his life to the point of stopping him from partaking in most activities such as working at the University of Melbourne where Goodall was asked to leave his position due to his frailty and to cease driving, performing in theatre, and using public transport. Losing all this left his left empty with little to do according to his daughter which stated, “His work is his hobby, as well as his passion, and without his work, I don’t think that there would be a purpose for him any more” (Joseph, Y. 2018, May 03). Due to these complications from his diminished health, he decided to go through with euthanasia. When asked if Goodall had any hesitation leading up to the procedure he sadd, “No, none whatever,” Goodall said. “I no longer want to continue life, and I’m happy to have a chance tomorrow to end it” (Joseph, Y., & Magra, I. 2018, May 10). To have this whole procedure done Goodall and his invited family members had to fly from Australia to Switzerland for the euthanasia to be legal. This is a costly price to pay especially for those who do not have an excessive amount of money to pay for travel. Due to the price, some of his grandchildren and children could not be present at the time of his dead. As an advocate for euthanasia, Goodall hoped his actions would incite changes in Australia’s laws regarding the issue. Finally after spending a final day with his present family members, he was able to die on his own terms accompanied by his final song of choice “Ode to Joy” by Beethoven.

Advocates like Goodall try to convince the public to further pursue legislation to allow for euthanasia worldwide. Euthanasia is to an extent permitted in Belgium, Canada, Colombia, Luxembourg, Netherland, and certain states in the U.S.. However, Switzerland is the only place that offers euthanasia to foreigners if the assistant is not benefitting from the person’s death. Public opinion has been slowly growing towards being in favor of allowing euthanasia according to Gallup's annual Values and Beliefs poll done during May 3rd to 7th in 2017. This poll questioned through telephone interviews done with a random sample of 1,011 adults of at least 18 and older, living in all 50 U.S. states and the District of Columbia. In general 73% of Americans support euthanasia according to Gallup, Inc. on 2017, June 12. Of churchgoers that attend church weekly 55% believe in allowing euthanasia while 87% of those who seldom attend are in favor. On a moral basis 57% of Americans say that it is morally acceptable for a doctor to assist a patient in suicide. Due to recent polls showing public opinion increasingly moving towards favoring euthanasia, legislation in the states. States such as California and Colorado along with the District of Columbia most recently voted for death in favor of dignity in death. However, states such as Nevada and Maine still complicate passing more legislation by voting down any euthanasia or assisted-suicide movement. In conclusion, Americans have steadily grown support for euthanasia with it becoming increasingly morally acceptable for doctors perform the procedure leading to a rising movement for passing legislation in the U.S..

Doctors find themselves at the forefront of the euthanasia discussion. Among doctors euthanasia is a divisive issue of ethics in medical practice. One side opposes assisted-suicide because they enter the field with the intention of healing or curing people of their maladies while the other side advocates that doctors must take up the responsibility of granting the wish of euthanasia for the elderly and terminally ill. The side opposing euthanasia cites the Physician’s Pledge as why the practice of assisted-suicide should not be done by doctors. The pledge from The World Medical Association states:

AS A MEMBER OF THE MEDICAL PROFESSION:

• I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
• THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
• I WILL RESPECT the autonomy and dignity of my patient;
• I WILL MAINTAIN the utmost respect for human life;
• I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
• I WILL RESPECT the secrets that are confided in me, even after the patient has died;
• I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;
• I WILL FOSTER the honour and noble traditions of the medical profession;
• I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
• I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
• I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
• I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
• I MAKE THESE PROMISES solemnly, freely, and upon my honour.

This pledge states that the doctor will not use their medical knowledge to violate any human rights or civil liberties. This can go both ways in the doctor’s argument of euthanasia. Rejecting a patient’s request could be upholding human rights, yet supporting it can also be violating the civil liberty of the patient. However, the pledge has already been questioned and considered somewhat out of date. David Warriner, a clinical fellow at the Academy of Medical Royal Colleges, uses the oath as a moral compass saying that, “It helps you with circumstances you face where you’re not sure what to do,” (Oxtoby, K. 2016, December 14). In contrast to Warriner, Clare Gerada, a GP partner in London, argues, “We are not royalty or priests, but health professionals doing a job, regulated by law and the GMC. That should be enough” (Oxtoby, K. 2016, December 14). In total the oath may provide medical practitioners a set of moral guidelines, but it proved to be out of date due to changing attitudes from modern ideas. Even with discussions advocating for a change of attitude on assisted-suicide the World Medical Association's Declaration on euthanasia stands strong in their stance stating that 'Physicians-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically” (WMA Resolution on Euthanasia. 2002, October 06). This statement seems to give doctors on the border of assisted-suicide a direct push towards avoiding the practice or supporting it. In conclusion doctors tend to be split on the issue of euthanasia with certain ideas becoming out of date with modern idea, yet major organizations in the medical field stand cemented in their stance against assisted-suicide.

The dignity of the patient is one of the utmost concerns in the discussion over assisted-suicide. Barring a suffering patient from their choice of euthanasia could be a somewhat spit in the face to the subject. When a patient chooses euthanasia, he or she has complete control on exactly how the final moments leading up to death will happen. The ability to die on one’s own terms gives the person a sense of peace because everything is occurring the way the individual expects. A patient that is diagnosed with a terminal cancer that only gives about 6 months left to live may choose to end the gnawing suspense of the imminent death. In no way does offering the choice of euthanasia force or incline the patient to choose it, but it gives the patient the freedom that. If he or she wish for euthanasia, it will be granted. Even if euthanasia became widely legal, in the instances that it the request is still denied because doctors and hospitals are not obligated to perform the procedure: “Across California, and in the five other states where medical aid-in-dying is now allowed, access is not guaranteed, advocates say. Hospitals, health systems and individual doctors are not obligated to prescribe or dispense drugs to induce death, and many choose not to” (Aleccia, J. 2017, January 25). It may take hospitals or clinics that specialize in assisted-suicide to be founded so that patients have somewhere to go for the method. Over time, as it has been recorded by studies, the overall public opinion on euthanasia will probably grow in favor leading to eventual more widespread practices of the procedure.

Achieving the legislation for assisted-suicide to become legal throughout the world would not be the final stage of this issue. First of all in determining if assisted-suicide should be legalized, having legislation passed against euthanasia may be found unconstitutional. In a situation from a Michigan court that created a law specifically prohibiting assisted-suicide a new issue arose. A journal from Yale about the law in question wrote that

A week later, the American Civil Liberties Union of Michigan brought a lawsuit on behalf of two cancer patients and several health care professionals who specialize in the care of the terminally ill, attacking the law’s constitutionality. The essence of the challenge is that insofar as the law prohibits a health professional, family member, or friend from assisting a competent, terminally ill person who wishes to hasten her death, the law violates the due process clauses of the state and federal constitutions and the “Right to Privacy Guarantee” of the state constitution (1993, May 01).

Ironically, laws prohibiting euthanasia can possibly be found unconstitutional while those legalizing it would not. As a civil liberty the freedom to choose assisted-suicide can fall under one of the inherited rights under the Constitution. Either way if euthanasia becomes legal and therefore normalized it may lead to a snowball effect. At first it may still seem unacceptable but with the passing of time euthanasia would become more and more practiced. Without descriptive laws detailing how a patient can apply or qualify for an assisted-suicide, the system may become abused by those who are not in need of it due to the possible lax nature that could build around it writer Ross Douthat says,“Once legalized, euthanasia would become routine. Over time doctors would become comfortable giving injections to end life and Americans would become comfortable having euthanasia as an option” (Douthat, R. 2009, September 07). Ways to combat the issue would be passing detailed legislation on the matter, however throughout history numerous loopholes have been found in countless laws passed by the U.S.. Another way to prevent the problem is to have close monitoring of any doctors that administers euthanasia on a somewhat common basis. In summary the effects of the legalization of assisted-suicide can be society becoming normalized to it, the system is abused by those who do not need it, and society’s view on doctors shifting from healing to killing.

As such in other issues, the world is transitioning away from past ideas and practices towards new modern ideals. It is important to not barr but provide all freedoms an individual may request. For those who suffer from old age effects on the body, terminal illness, or having no meaning left after a complete life euthanasia can offer a peaceful controlled method to end one’s life course. Global attitudes seem shifting towards acceptance of this freedom, yet there are still copious amounts of people that disapprove it. A general consensus on the matter seems plausible with hopefully a reasonable agreement between both sides of the euthanasia discussion.

References

1. WMA - The World Medical Association-WMA Declaration of Geneva. (2018, July 9). Retrieved from https://www.wma.net/policies-post/wma-declaration-of-geneva/
2. Joseph, Y. (2018, May 03). Why David Goodall, 104, Renowned Australian Scientist, Wants to Die. Retrieved from https://www.nytimes.com/2018/05/03/world/australia/david-goodall-right-to-die.html?action=click&module=inline&pgtype=Article
3. Joseph, Y., & Magra, I. (2018, May 10). David Goodall, 104, Scientist Who Fought to Die on His Terms, Ends His Life. Retrieved from https://www.nytimes.com/2018/05/10/world/europe/david-goodall-australia-scientist-dead.html
4. Gallup, Inc. (2017, June 12). Majority of Americans Remain Supportive of Euthanasia. Retrieved from https://news.gallup.com/poll/211928/majority-americans-remain-supportive-euthanasia.aspx
5. WMA Home Logo. (2002, October 06). Retrieved from https://web.archive.org/web/20151124001332/http://www.wma.net/en/30publications/10policies/e13b/
6. Aleccia, J. (2017, January 25). Legalizing Aid In Dying Doesn't Mean Patients Have Access To It. Retrieved from https://www.npr.org/sections/health-shots/2017/01/25/511456109/legalizing-aid-in-dying-doesnt-mean-patients-have-access-to-it
7. Douthat, R. (2009, September 07). A More Perfect Death. Retrieved from https://www.nytimes.com/2009/09/07/opinion/07douthat.html
8. Yale. (1993, May 01). Are Laws against Assisted Suicide Unconstitutional? Retrieved from https://www.questia.com/library/journal/1G1-13931599/are-laws-against-assisted-suicide-unconstitutional
9. Oxtoby, K. (2016, December 14). Is the Hippocratic oath still relevant to practising doctors today? Retrieved from https://doi.org/10.1136/bmj.i6629