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This topic, the right to die, has stirred a huge debate in the past years with both the pro-groups and cons-groups tabling strong arguments to support their case.
Physicians find themselves at the center of this debate with many finding themselves in a dilemma. While in training they look the Hypocritical oath to sustain life. But they now wonder if they are also responsible for terminating it upon being requested by a patient.
There is also the principle of self-determination whereby a person had the right to choose the course of his life. A patient has the right to choose whether or not he wants to endure the mental and physical suffering that comes with terminal illnesses.
Euthanasia, merciful killing, physician-assisted suicide and right to die with dignity are all expressions denoting a topic that is becoming increasingly dear to scholars, health care providers and their patients. The moral dilemma surrounding the subject of right to die have stirred a heated debates nationwide and also in other parts of the world over the years. It has been argued that it is more humane to let someone choose their own way out rather than leave them to their fate, which normally is a lonely and excruciatingly painful death. However, this leads to the age-old question, who has the right to define who is fit to live or die?
The Roman Catholic Church has always been against the termination of life whether in abortion or in suicide. In his article, Richard L. Warsnop says the Roman Catholic Church restated its opposition to euthanasia in a papal encyclical letter on human life issues. In the letter, “Evangelium Vitae” (Gospel of life), pope John Paul II said that forgoing ‘extraordinary or disproportionate” measures to keep a terminally ill person alive is “not the equivalent of suicide or euthanasia”. It expresses acceptance of the human condition in the face of death.” He further said that merciful killing is false mercy as true mercy would lead one to want to share the pain and not terminate a life because he is unable to share in the pain (Worsnop R, 1995).
The Jewish law forbids euthanasia and regards it as murder. It is against the shortening of a life whether or not it will end very soon. However it allows a doctor to remove anything preventing a dying soul from departing. Rabbi Moshe Feinstein and Rabbi Shlomo Zalman Averbach say that a patient should not be kept alive by artificial use such as the use of a life support machine or ventilator where the treatment does not cure the illness but just prolongs the patient’s life temporarily.
Kenneth Jost says in his article that the right-to-life groups are unhappy with the government willing acceptance to back physician –assisted suicides based on a diminished quality of life as in the case of physical and mental disabilities. They also argue that a physician can choose to end life after deciding that the life of the patient is of diminished quality and therefore it does not deserve to be prolonged (Jost K, 2005).
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However, Charles Baron, who serves on the board of the right-to-die group Death with Dignity, is of the opinion that their movement is for the idea that people ‘should be free to get out’ and that they should be able to choose the medical care they want and don’t want.
In Richard’s article he recalls that the Stoics of ancient Rome believed that a person has the moral right to take his or her own life if he does not wish to live. Judeo–Christian tradition on the other hand holds that a person has no right to terminate his life. Human life does not belong to the one bearing it but rather it is an inherited gift.
Eugene Anne Gifford, editor of the UCLA law review wrote that the whole debate about dying with dignity has to do with people wanting to control their death the same way they control their lives.
Oregon is one of the few states that have passed a Death with Dignity Law. Other countries include Netherlands and the North Territory of Australia. In Oregon the law went to effect in November 1997. The law allows terminally ill patients who have made at least two verbal requests and one written request to at least two physicians to be assisted in suicide.
Researchers at the Oregon Health and Science University conducted a study of the levels of pain in patients who died in nursing homes and assisted living centers. They studied pain levels in patients who died before and after the passing of the law. Their findings were that 48% of the patients who died after the passing of the law were judged to be in moderate or severe pain in the last week of life compared to 31% of the pre – 1997 patients. The researchers and the secular media interpreted the results to mean that levels of pain increased in post – 1997 patients because expectations in pain control had been raised by the debate, high cost of medical care and due to addictiveness of some prescription pain relieving drugs with physicians also refusing to give a strong enough dose that could turn lethal.
The religion media on the other hand interpreted the results to mean that the increase was due to deteriorating cure as a result of there being the option of physician assisted suicide and the diminishing quality of palliative care is diminished.
However the research results could be termed as inaccurate because the research was conducted based on the evacuation of the perception of the family members on the level of pain being experienced by a dying patient and not on the actual pain being experienced by the terminally ill person.
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As an intern I was assigned to look after James Jenkins an elderly man of 79 years. James was in stage 3 Alzheimer’s disease. He had come for a routine checkup and was accompanied by his four year-old grandson. They were playing together when James glanced at his watch and suddenly turned ghostly pale before retreating to a corner. He would not speak until a colleague finally managed to persuade him to. He told us that when he glanced at his watch he had noticed it had stopped working and had decided to reset it. He however couldn’t remember how to reset the watch he had worn since his teenage years. He confided in us that the Alzheimer’s was really scaring him and that he didn’t want to wait up to the final stage (stage 7d) of the disease so that he could finally die. He said that at his age he was already a heavy burden on his children as age was already catching up with him.
Euthanasia has been accused as being the way out for those who cannot afford the high cost of medical care. Some argue that there is no point in postponing death by using expensive drugs that will only dig a huge hole in the family’s savings when death is inevitable. They would rather die sooner than later and save their family the financial constraint that comes with terminal illnesses (Beauchamp T, Childress J, 1994).
Since the Death with Dignity law as passed on Oregon the quality of end-of-life care has greatly improved. Barbara Coombs Lee president compassion and choices said: palliative cure has been the main beneficiary of the Oregon Death and Dignity Act so far. Since its passage, we have seen a great resurgence of interest in the medial community in palliative care. Hospice referrals have increased by 20% and now Oregon leads the nation in prescription of morphine. This has a salutary effect on end of life care.
All individuals have a right not to suffer. Suffering is inevitable during the final stages of a terminal illness. It reaches a point where the patient’s life can only be made comfortable through the administration of strong pain relieving drugs. At this time life is no longer a gift to be cherished but it becomes a heavy burden not only to a patient but also to a patient’s family. Life is no longer seen as a benefit to the patient. Therefore when a patient in his right mind decides to do without further life sustaining treatment, then he/she decides that no further life at all is better than the suffering.
Many also argue that merciful killing is an act of saving the terminally ill person the incapacitating and excruciating pain that comes with the illness. Most people would rather die a swift death by means of a lethal injection rather than endure unmanageable pain for a very long period before they eventually succumb to death. This is a case of the end justifying the means (Glover J,).
However if merciful killing was allowed, this would put the poor people, the elderly and those without access to good medical care at risk. The elderly are a quite susceptible group as they have no fixed income hence cannot seek proper health care. This group is also afflicted by most of the terminal illnesses. If merciful killing were allowed then this first generation would most certainly die out leading to a generation gap (Rachels J, 1986).
Physicians would also readily aid in the suicide of the poor since their situation would not allow them to pay for longer term are. A physician could choose to end a life after coming to a conclusion that the patient’s life doesn’t deserve sustaining since it is of low quality. It would be like they are doing poor people a favor in terminating their lives (Dawnie R, and Calman K, 1994).
Suppose a patient is admitted to an ill-equipped hospital and the staff do all they can to sustain his life. Soon they realize there isn’t much they can do. However, a few miles away there is a better-equipped hospital that is capable of catering for the patient in a better way and even helping him recover. But the patient is poor and cannot afford this other hospital. Is it justified to aid in the suicide of this patient? (British Medical Association, 1993).
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Merciful killing can also be interpreted as a rejection of the importance and value of human life. The individual wanting to die often see no value whatsoever in the life he is currently leading and therefore chooses to end it just because he has the choice of doing it. This can also be interpreted as rebellion in that someone would not want to be at the mercy of death. They wouldn’t want to sit and wait till it eventually comes – as a destiny planned it. They want to have the final word and die at the time they choose to and they also get the liberty of deciding the means by which they die – a lethal dose of drugs.
After some time, voluntary euthanasia could end up becoming involuntary euthanasia. Try to picture a situation whereby a man in a poor state of mind is given a form to sign consenting to be killed. In his disorganized way of thinking, he signs without reading the form. Isn’t this involuntary euthanasia? Terminal illnesses are often accompanies by emotional and psychological pressures. This can cause someone to think rashly and opt for the easy way out.
Euthanasia could lead patients to believe that it is their duty to die once they have been struck by an incapacitating illness. The patient would feel like a burden to their family because of their dependence on them for both physical and emotional support. Thus the right to die would be misconstrued to mean a duty to die (Brazier M, and Harris J, 1995).
This subject has its pros and cons. One of the pros being that no one should be subjected to having to ensure physical and mental anguish in a case where death is inevitable and it will eventually happen. The cons, however, could be that physicians could misuse the authority bestowed to them and make decisions on behalf of the patient without him/her being in favor of this decision. Therefore, serious consideration ought to be put in place before any policy is made regarding this matter,
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Brazier M, and Harris J. (1995). Ethics, Law & Nursing. Manchester University Press.
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Fletcher N, Holt J, (1993). Medical Ethics Today. British Medical Association. BMJ.
Glover, J. Causing Death and Saving Lives. Penguin.
Jost, K. (2005). Right to Die. Is it too easy to remove life support? CQ Researcher. Volume 15, Issue 18.
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