Discuss and evaluate ethical dilemmas - Euthanasia

Another question faced by doctors is the long debate over abortion. The mother is the one who has the foetus and will give birth to the child, so should it be her decision, does it make it right? The unborn infant is living so abortion is murder, this is the main issue. If abortion is right what time is right, should abortion be allowed even to late-term or should abortion only be acceptable during the foetus's first few months?

Siamese twins and their separation is another dilemma, take the recent case between the parents, who wanted them to stay together, and the doctors, who wanted to separate the twins so that one would live, but one would die and the living twin would have a very uncertain future, she might live to be two or twenty. Keeping the twins together would have resulted in death for both of them but if they were separated one would always have the death of their twin on their conscience. What is right, what is wrong?

Finally we come to euthanasia, a mercy killing by means of non- treatment (passive) or deliberately attempting to end the life quickly and painlessly (active). This has been debated widely especially between pro-life groups (including the catholic church) and pro-euthanasia groups such as EXIT. Should the right to die be the responsibility of the person involved or the doctor? If the patient is in a 'persistent vegetative state' then who should decide their fate, the doctors or the family?

The legal situation of euthanasia is very cloudy throughout the world, in England legal precedents are commonplace and these precedents make the law more complicated. In the Netherlands euthanasia is illegal but tolerated by the authorities if a certain procedure is applied, prosecution if this procedure is applied is rare. The Tony Bland case was a legal precedent in England when the courts allowed for him to be euthanised after his brain shrunk through oxygen starvation during the Hillsborough disaster which left him in a 'persistent vegetative state'. This case is often used now as a basis for other parents who wish for their brain-dead child's life to be ended quickly and with dignity, but not many other cases have been accepted by the courts other than the case of Tony Bland. A new human rights act which has only recently come into force may have some affects on the legal situation.

The recent case of 'Ms H' and 'Mrs M', two patients trapped in a 'persistent vegetative state' was won by doctors who wished for the artificial feeding to be stopped. The relatives of the PVS victims were also for the mercy killing, pro-life groups are outraged by the decision and are considering taking such cases to the European court in future. The hospital trust released a statement which included the words "The Trust wishes to stress that it has at all times sought to act in the best interest of the patient". Guidelines recommend that doctors should only consider withdrawal of artificial feeding if the patient has been in a 'persistent vegetative state' for more than one year.

A case which would have been an excellent milestone did not go to court as the child in question died in his home from cerebal palsy. The parents of Thomas Creedon, who could not hear or see, claimed that their son was paralysed, had constant fits, was in constant pain and suffering by being forced to stay alive. The Times newspaper states that 'Thomas's doctors wanted to continue feeding him and were set to oppose his parents application. They disputed the Creedons belief that he was constantly in pain. Mrs Creedon had said "Thomas has a very distressing existence and I find it difficult to see how the medical profession in this particular area is prepared to perpetuate that suffering, no matter what the realistic outcome is likely to be.".'This was a case of distress for Mrs Creedon.

Euthanasia raises many questions, is a doctor a judge or is he just a doctor, is one who involves oneself in euthanising another a saint or a sinner? What constitutes unbearable pain, whose dcision is it? All of these questions and many more all constitute to the cloudy and complicated legal system. Should euthanasia be legalised, is it right.

Stephen McManus