Write an essay on the moral defensibility of voluntary euthanasia for an autonomous adult.
Write an essay on the moral defensibility of voluntary euthanasia for an autonomous adult.
It goes without saying that, when the time comes, most people would hope for a peaceful death. A death free from suffering and pain, and a death that allows the individual to retain some measure of dignity. It is not unreasonable then for autonomous adults to want to exercise the same control over the circumstances of their death, as much as possible, as they do their life. After all, dying is the natural and unavoidable conclusion to life. Their hope for a peaceful and dignified death is the motivation behind those who seek out euthanasia.
The word euthanasia derives from the Greek "eu-thanatos" meaning "good death" and originally referred to intentional mercy killing (Voluntary Euthanasia Society of Victoria, 1998:6). These days, euthanasia can be defined as the inducement of a gentle, distress-free death at the request of a patient, especially in the cases where the individual in question suffers from an incurable and painful illness or disability. Voluntary Euthanasia is the administering of euthanasia to a clearly competent individual who makes an enduring request to die. Euthanasia is different from assisted suicide, where a patient voluntarily brings about his or her own death with the assistance of another person, usually a physician. In cases like this, the act is considered suicide because the patient actually causes his or her own death (Voluntary Euthanasia Society of New South Wales, 1993:4).
In cases where assisted suicide is possible, it should be attempted before voluntary euthanasia. The wishes of the patient should be more obvious in these cases, and there can be little or no confusion over the fact that the patient did want to die (Glover, 1977:184). Debate over the morality and legality of voluntary euthanasia has raged mostly in recent times, however, this essay will only be concerned with the moral defensibility of voluntary euthanasia.
There are several conditions or criteria which supporters of voluntary euthanasia believe should be satisfied by any person who wishes their life to end in this manner. The person must be suffering from a terminal illness; be unlikely to benefit from a cure for their illness in the time they have left; be suffering intolerable pain or their life be unacceptably burdensome; must have a competent and enduring wish to die; and they must be unable to commit suicide without the help of another.
These conditions are somewhat narrow, as they do not account for illnesses such as Alzheimer's Disease, or motor neurone diseases. But a broader criteria would only confuse the issue and make it more difficult to gain society's acceptance and moral support (Molloy, 1993:189).
There are many commonly heard arguments for euthanasia, of which only a few will be examined here. The most popular argument for voluntary euthanasia is choice. People like to exercise autonomy over the circumstances of their life, which includes their death. This may well involve making choices about the way in which they die, and the timing of their death (Molloy, 1993:172).
Understandably, people are also concerned with what the last stages of their life will be like. Many fear a long and drawn out period of pain and suffering before death, which is something that ...
This is a preview of the whole essay
There are many commonly heard arguments for euthanasia, of which only a few will be examined here. The most popular argument for voluntary euthanasia is choice. People like to exercise autonomy over the circumstances of their life, which includes their death. This may well involve making choices about the way in which they die, and the timing of their death (Molloy, 1993:172).
Understandably, people are also concerned with what the last stages of their life will be like. Many fear a long and drawn out period of pain and suffering before death, which is something that nobody should have to endure.
There are others who worry about retaining their dignity in the last stages of life. There have been a great number of advances in medical technology in the last century, most of which are aimed at extending life. But extending life does not mean extending quality of life. Many believe that modern medicine is more concerned with keeping an individual's biological functions operating, instead of treating patients as people (Smith, 1997:214). And many people worry about becoming a burden on family, such that their lives become no longer worth living. This is another reason why competent individuals should have the right to choose voluntary euthanasia, if they genuinely feel that their life is no longer worth living.
There are many opponents to voluntary euthanasia who believe the practice is never necessary, due to the high standards of palliative care available to those who are afflicted by a terminal disease (Molloy, 1993:189).
There are several problems with this argument. The first is that palliative care is not available to everyone with a terminal illness. In fact, only a small percentage of those with a terminal illness receive palliative care (Voluntary Euthanasia Society of New South Wales:14) and even then, it is only in the last few weeks before death. Just because palliative care is available, does not mean it is effective in every case. Pain medication administered to patients can have an array of side effects such as nausea and incontinence, and for some individuals, the pain they suffer from cannot be relieved at all. The only choice for such patients, if voluntary euthanasia is to be denied, is sedation. A comatose state can be induced, so as to prevent the individual from experiencing any pain. It goes without saying that this existence is hardly dignified. And to maintain such a state until the patient dies of natural causes, perhaps weeks or even months away, would no doubt be quite costly.
It is argued by some that if society allows voluntary euthanasia to be legally permitted, it would result in a decline in the respect we have for human life (Rachels, 1986:170). And because of this we will have set foot on a slippery slope which, eventually, will lead society to support other forms of euthanasia, such as killing those who cannot, or will not, give consent, also known as non-voluntary euthanasia (Royal Australasian College of Physicians, 1993: 26).
There are several forms of slippery slope argument, but I will limit this argument to only two. The first is the logical version. It argues that once a practice like voluntary euthanasia is accepted, logically we will have no choice but to accept other practices such as non-voluntary euthanasia. And since non-voluntary euthanasia is clearly unacceptable, voluntary euthanasia - the first step in the process - should not be permitted (Rachels, 1986:172). But there's quite a difference between a patient suffering in agony who requests to die, and an elderly woman with Alzheimer's Disease who is in no pain, and does not make a request to die. It's a ridiculous notion to think that we will have no choice but to 'bump off' the latter individual by way of non-voluntary euthanasia just because the former has access to voluntary euthanasia.
The second form of slippery slope argument is the psychological version. This argument claims that once a practice is accepted, people will go on to accept other more serious practices. This argument is a poor one. The supposed inevitability of sliding from voluntary euthanasia to non-voluntary euthanasia is hard to see. Why should anyone who supports the autonomy of the individual and, consequently, their right to choose voluntary euthanasia, suddenly be psychologically driven to support the practice of non-voluntary euthanasia, where there is no patient autonomy being exercised? A suitable analogy can be found in the writing of Michael Tooley (1979). He uses the example of sexual activity to demonstrate the ridiculousness of the slippery slope argument. He argues that if somebody was to advocate sexual activity, and critics objected when only voluntary sexual activity was being advocated, the proposal would be extended to cover non-voluntary sexual activity, otherwise known as rape (Tooley, 1979:69). This having been said, there is no reason for accepting the slippery slope argument.
The doctrine of double effect is a religious principle that has been applied to end of life medical decisions, to justify medical intervention that relieves pain and suffering, and, consequently, hastens death (Kluge, 1981:16). It is when treatment relieves suffering but also indirectly brings about the death of a patient. For this to be permissible, four conditions must first be met: the act itself must be permitted; the bad effect must not be intended; the bad result must not be used as a means to achieving the good result; and the good accomplished in the good result must outweigh the evil of the bad result (Rachels, 1986:16). If these criteria are met, then the act is ethically and legally permissible (Ladd, 1979:180). Many consider the doctrine of double effect is relevant only where a person's death is an evil, or a harm - which can be defined as damage to a person's interests. So if a person dies from voluntary euthanasia because they requested it and considered it beneficial, then the act cannot also be considered harmful. It follows then that the doctrine of double effect is irrelevant to the moral permissibility of voluntary euthanasia.
A final objection to voluntary euthanasia is the belief by some that we never have good enough evidence to believe that the request made by a person wanting to be helped to die is a rational, enduring and voluntary one (Glover, 1977:185).
Never is too strong a word in this case. Many individuals have a lifetime to discuss and debate the issue, and come to a decision as to whether voluntary euthanasia is a path they will consider taking. Surely that is enough time for a request, if made, to be considered an enduring one. And there is also the possibility of a cooling off period. Many believe that such a period should be allowed. There are, of course, cases where aspects of a person's illness makes it difficult to assume their request to die is a rational, enduring and voluntary one. In cases like these it is possible for people to indicate their wishes in advance, before their illness results in their not having the capacity to do so. Living wills and advanced directives are the means through which this can be achieved, and should be thought of and respected as evidence of a decision that has been carefully considered (Foot, 1979:38). Some then argue that this decision to be helped to die cannot be made before a person actually suffers from the illness, because they cannot really know what it is like until they experience it for themselves. This is another poor argument. Many people, before finding themselves in the same position, can be witness to the effects of such illnesses in friends and family. And consequently, can have an understanding of what it would be like to suffer from such an illness themselves. From this they can certainly form their own opinions and exercise their autonomy accordingly.
Unfortunately for some, the last stages of life hold much suffering and pain for those afflicted by a terminal illness. Anxiety and feelings associated with becoming a burden to others, especially family, are also of great concern. Strict conditions have been laid out for those wanting access to voluntary euthanasia, and the arguments against this practice have been found lacking. If an autonomous individual feels that his or her life is no longer worth living, and, after careful consideration, a rational, enduring and voluntary request is made for assistance to die, then the rights of the patient should be respected and the request should be granted. This will allow many people affected by pain and suffering due to terminal illness, a more peaceful and dignified end to their life.
References
Foot, P. (1979). 'Euthanasia' in Ethical Issues Relating to Life and Death, edited by John Ladd. New York: Oxford University Press.
Glover, J. (1977). Causing Death and Saving Lives. London: Penguin
Kluge, E.W. (1981). The Ethics of Deliberate Death. New York: Kennikat.
Ladd, J. (1979). 'Positive and Negative Euthanasia' in Ethical Issues Relating to Life and Death, edited by John Ladd. New York: Oxford University Press.
Molloy, W. (1993). Vital Choices: Life, Death and the Health Care Crisis. Ontario: Viking.
Rachels, J. (1986). The End of Life: Euthanasia and Morality. Oxford: Oxford University Press.
Smith, W.J. (1997). Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder. USA: Random House.
Tooley, M. (1979). 'Decisions to terminate life and the concept of person' in Ethical Issues Relating to Life and Death, edited by John Ladd. New York: Oxford University Press.
Voluntary Euthanasia Society of New South Wales (1993). Voluntary Euthanasia - A Choice. Broadway, NSW: V.E.S.N.S.W.
Voluntary Euthanasia Society of Victoria (1998). Voluntary Euthanasia: The Right to Choose. Melbourne: V.E.S.V.
