Euthanasia and the Right to Die With Dignity

the man ... to free himself from this bitter life... or else voluntarily permit others to free him." (Moore 18). Upon describing a perfect, utopian society, Sir Thomas Moore supported the notion of letting a terminally ill patient decide how and when he should die. Moore's utopian society was supposed to consist of people whose quality of life was so wonderful. Because terminally ill patients no longer have this quality, if they prefer to die then it should be allowed and regulated. Why should these people have to accept a long, empty life extended for them by the use of medical technologies, when this would prevent them from enjoying their life. Now in the twentieth century, there are many views on assisted suicide and euthanasia. There are those who sympathize with the patients and others that believe it is a sin against god. One of the arguments that is frequently brought up against assisted suicide and euthanasia is the question of the doctors playing god when they assist in a patient's suicide. After all, isn't it for god to say when a person should live or die? Thus a doctor would be playing god's role if he were to assist his patient in dying. The argument claims that god has his reasons for causing pain, and the interference of a doctor would mean the interference in the divine law. The general response to these claims on "playing god" would then be to distinguish whether doctors weren't already playing god when they put an organ from one person's body into a different person's body. What about blood transfusions? The advances in medicinal technology have made it possible to sustain life when, a few years ago, death would have been certain. Medical technology has blurred the line between the capabilities of man and god. Thus it has posed the question, " Are you Ô playing god' when you pull the plug or put it in ?" (Neils 3). Suicide is considered by a vast majority of the population "right" when it serves human dignity, or a larger cause. In such cases, people protest injustices by taking their lives, or sacrifice themselves for the good of the many (Momeyer 20). Such cases come up many times throughout history. An example of such a death with dignity occurred during wars when young ladies, aware that soldiers would come to rape and then kill them, drank poison. Thus, they died their inevitable death painlessly, purely, and with dignity. They were able to choose to die with dignity, just as they had the right to live with dignity. So is the case for people with terminal illness. They have lived with a certain dignity. Why must they sacrifice all that in the final stages of the diseases? Especially when the drugs given to them might affect them to the point that they'd be slipping into and out of consciousness. Such a life, with tubes and various things stuck into your body, is in no way dignified. Assisted suicide would provide the patient with a chance to die, surrounded by their close friends and family . To deny the right to assisted suicide is to deny freedom. Thomas S. Szasz stated in Suicide Right or Wrong: Personal freedom is included in the fourteenth amendment of the Constitution, and the courts have recognized this right in many cases involving assisted suicides. The courts have recognized the right of autonomy, or the right to be left alone to make your own choices. In addition they recognize the constitutional right to privacy, "to be protected from unwanted evasive medical treatment." (Wanzer 52). The courts have broadened the legal concept of the right to refuse medical treatment. They have supported this right in more than eighty court decisions dealing with cases involving patients who were terminally ill. Thus, in the eyes of the protectors of the law, patients should have not only the choice of how to end their lives, but also the ability to have their decisions respected and kept private. Those who uphold justice see that denying a terminally ill patient the right to choose the way to die is a dismissal of the patient's individual feelings and rights. Furthermore, it is the forcing of public morals onto the individual. If the right to choose is denied because the public thinks it's an immoral action, the patient is forced into doing something that may be against his personal beliefs- but acceptable according to the public morals. Death is inevitable; that fact does not change. But the attitudes of the public towards a dying patient's rights, like the times, have changed. The results of a public opinion poll revealed that over half, 68%, of those responding believed that, "people dying of an incurable painful disease should be allowed to end their lives before the disease runs its course." (Wanzer 52).A remnant of the change in public opinion is the increase of sensitivity to the dying patient by health professionals. Hospitals now take into consideration patients' wishes as expressed in living wills. Physicians take the responsibility of thoroughly discussing with their patients the forms and methods of treatment available to the patient. The patient's wishes concerning his treatment are being carried out as well as they can be by physicians. However, when a patient who is terminally ill desires to terminate their life, there is a difficulty for the physician to respect this wish. Hopefully with this increased sensitivity, physicians will be granted the opportunity to help those who are terminally ill leave this world in a painless and dignified way. New laws have been passed that enable a patient, or the relatives of a patient, to refuse life support or to be taken off life support. DNR (do not resuscitate) is a policy that was at first controversial. Opponents thought that this would be like "playing god." Sound familiar? But this method has given those who prefer to die rather than live on life support an opportunity to refuse the aid of the machine in hydration and nutrition. These patients believe that there is no point to a life in a continuous vegetative state or coma. This practice is now common place in hospitals, and ethicists agree that it is ethical to remove hydration and nutrition from, "certain dying, hopelessly ill, or permanently unconscious patients" (Wanzer 52). Some critics argue that DNR is one of the worst forms of dying. Dr. Jack Kevorkian, M.D. has gained international media attention within the past several years for his work in assisting terminally ill patients to end their lives. Dr. Kevorkian began a petition drive to legalize assisted suicide in Michigan. He has assisted in the suicide of 20 people. In an interview Dr. Kevorkian, stated that: Euthanasia means good death. Passive euthanasia is a brutal death. Allowing someone to starve to death and die of thirst, the way we do now is barbaric. Our Supreme court has validated barbarism. So, not leaving the respirator on, pulling the plug - that Ôs not a good death? Gasping for air? Starving and thirsting to death? Like Nancy Cuzan: it took her a week to die. Try it! You think that just because you're in a coma you don't suffer?(Kurtz 29-31) Many people would prefer the benefits of a lethal dosage to the torment of being taken off life support. The fear is that they may not die for a period of time after they are taken off life support. If the courts find it morally right to starve a patient, then painlessly helping them to die would seem a valid choice, too, and much more compassionate. The opponents of assisted suicide bring forth the "slippery slope" argument. This argument can be understood in the following words of Dr. Neils: Life itself is precariously poised on a Ôslippery slope'. We cannot avoid life's slippery slopes.... So we must provide laws as guidelines and safeguards to draw lines and to anchor us. Hikers and climbers sometimes cross steep icy and snowy, slippery slopes. They rope together and draw a line of travel along the best and but least risky route. They set anchors into the snow and ice to insure safety. When aid-in-death is legalized, lines will be drawn between individual rights and public laws will set legal anchors to ensure against slides down the slippery slope. Once the choice of doctor assisted suicide is recognized, opponents say, the recognition will brush away all the restrictions that were placed on it. Opponents say that it will only be a matter of time before courts sanction the death of people. According to them, the pressure to commit suicide will be increased since people will fear that they are a burden to society and, thus, would commit suicide. This is the same type of argument that can be brought up against any constitutionally protected right or interest. Recognition of any right creates the possibility of abuse. For example, this argument was brought up against abortion. Critics said that it would be used as a method of birth control, but that didn't deter the Supreme Court from recognizing it as a right. The legalization of abortion has not undermined our commitment to life, nor did it lead to widespread infanticide. On the same note, there is no reason to believe that legalizing assisted suicide will lead to the horrific consequences its opponents suggest. An argument in favor of legalizing assisted suicide is that it is already happening, but it is happening in secret and it is unregulated. Surveys of doctors and nurses found that it isn't uncommon at all for the professionals to fulfill some of the death requests they receive. Figure one shows the results of a survey conducted by Anthony L. Back of physicians in Washington State. The purpose of the survey was to determine the number of requests for death and fulfillment of these requests. Of the 156 requests for assisted suicide, doctors provided a prescription in twenty four percent of the cases, while the same proportion provided euthanasia. Patients and doctors alike would clearly feel safer if such actions were regulated. The survey also asked the physicians' about their perceptions of their patients' concerns. The results of this question are shown in Figure 2. Perhaps not so unsurprisingly the patients' primary concerns were not of their physical state, pain and suffering; rather they were more likely to be focused on loss of control, being dependent or a burden to people, and loss of dignity. These results show that the main concern for most patients is the loss of control over their body and situation. If Dr. assisted suicide were permitted, then these patients would gain a sense of control over their condition. Doctors could explain to the patients how to administer certain drugs that would cause death. Thus, the patient would feel that they could stop the whole indignity of an empty life at their own discretion.That so many patients were concerned about the non medical aspects of their illness shows that medical care isn't addressing the need for care that centers around the emotional, rather than physical, aspects of dignity and suffering. A survey conducted by David Asch on nurses revealed similar results. A group of 129 nurses (sixteen percent) reported that they had participated in assisted suicide or euthanasia at least once in their careers. Five percent even reported doing so more than twenty times. One of the nurses in the study said about the positions of nurses, It's like we never planned it, but, having developed a relationship with the patient, we both knew that it was time. In some instances, the patient was unconscious, on an opiate drip, which I increased or failed to decrease when vital signs dropped .... it's mostly unspoken (Asch 70). Nurses reported that they were willing to risk breaking the law because of concerns over "the overuse of life-sustaining technology, a profound sense of responsibility for the patient's welfare, a desire to relieve suffering, and a desire to overcome the perceived unresponsiveness of the physicians toward that suffering"(Asch 71). The nurses were frustrated with physicians who would give a good prognosis, offer false hope, and then leave the patient and family to be dealt with by the nurse. Another nurse explained, "I've often felt that the sign over a critical care unit should read:Ô Within Are Often Examples of Man's Inhumanity to His Fellow Man'"(Asch 71). The humane side of doctors and nurses, their sensitivity and compassion for the patient, causes them to yield to the wishes of dying patients. Although, at this point in time, they must do this with the underlying fear that they are committing an unlawful act. They do it in secret, confiding in no one for fear that they would tell. In view of this, the public will actually be safer, not less safe,when physician assisted suicide becomes legal and regulated. To truly understand the need for assisted suicide we should explore the experiences of real people whose death was dignified thanks to assisted suicide. When Dr. Timothy Quill's patient Diane was diagnosed with leukemia, she was devastated. All she wanted was to go home and be with her family. She had no questions about treatment because she decided she wanted none. One of the most important things for Diane was to maintain control over herself and her own dignity during the time remaining to her. When this control was no longer possible, she wished to take her life in the least painful way possible. Her doctor, knowing of her desire for independence her and decision to stay in control, feared the effects of a violent death on her family, the consequences of an ineffective suicide that would leave her lingering in precisely the state she wanted to avoid, and the possibility that a family member would be forced to assist her. She discussed the decision with her family, and they respected her choice. Her doctor directed her to a source of information. When a week later she requested certain drugs, her doctor wanted to know how she would use the drugs. He was worried that she might in mental condition, such as depression, that would cloud her judgment.From their conversation, it was apparent to the doctor that she needed the security of knowing she had enough drugs to use when the time came, in order to live her life at the present to the fullest. It was also apparent that nothing was clouding her judgment. They discussed how the drugs could be used for suicide and agreed to regular meetings, including one just before she used the drugs. The doctor wrote the prescription, feeling that he was giving her a chance to enjoy the rest of her life, and helping her to maintain control and dignity on her own terms until death. Diane spent her time with her close friends and family until the future held the inevitable - increasing discomfort, pain, and dependence. She called upon her close friends, family, and doctor to say goodbye. Upon meeting with her doctor, it was evident that she knew what she was doing she was sad and frightened to be leaving, but even more terrified of staying and suffering. She died two days later, after parting with her husband and son. She was wrapped in her favorite shawl on her couch with a peaceful expression on her face. Diane's family and friends can always treasure the time in those few months they spent with her. Because of the control she felt that she had, Diane was able to live out her last months doing enjoying the company of family and friends. Loose ends were tied, promises and apologies were made, and goodbyes were said (Quill 110-114). I think that the philosophy of the Hemlock society, a well known organization advocating assisted suicide and euthanasia, expresses the many reasons patients should have the choice of how to end their lives, and the means to do it. As an American, you have the right to live wherever you want, to worship any way you wish, and to determine your own destiny. These rights are at the core of your personal liberty, they give you freedom of choice. They give you control over your life. But not over your death. Right now in America people dying from terminal illness are denied the fundamental right to choose a peaceful, dignified way to end their lives. Right now in America, the law says terminally ill people can choose a lingering death by refusing to eat. Or by refusing treatment that keeps them barely alive. Or by by refusing to be hooked to a respirator that keeps them from suffocating. But the law does not allow terminally ill patients to choose a peaceful, painless death that their doctors could easily provide. Right now in America, we've got to change the law (Landers 70). In terms of the human aspect, we should respect the decisions of patients like Diane, who wish to stay in control of their life and die in the manner they view as dignified. It is situations such as Diane's that must be considered, and that caused one doctor to say, " I intend to vote for 119[a law that would legalize assisted suicide, not because I am a doctor but because I'm a human being and I want to know that option exists for me." (Goodman 153).