Determining what the definition of what “dead” really means is hard even as medical advances are made, it still causes confusion between doctors on when you announce someone as “dead”. Doctors and medical ethic counsels to this day argue what “brain dead” really means. In the medical law books, right now in order to be “dead” your entire brain including brain stem must be dead and permanently non functional (Callahan, 109-111). The uniform Determination of Death Act, proposed in 1981 gave legal expression to a concept that has been developing over the last 25 years. There was a consensus that the traditional heart-lung standard for determining death was no longer adequate because circulation and respiration could be maintained by mechanical ventilators and other medical inventions despite a loss of all brain functions (Orlowski, 18). It is now recognized and accepted that an individual is considered dead when the loss of brain function is complete and irreversible. The UDDA states “An individual who has sustained either 1.) Irreversible cessation of circulatory and respiratory functions, or 2.) Irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.” (Orlowski, 19). In some cases only the upper portion of the brain has failed enabling bodily functions to continue but leaving the person unconscious. This condition has been labeled as Permanent Vegetative State. (Shapiro, 30) There are thousands of PVS patients in Canada who remain unconscious and are kept alive by artificial feeding. Only very rare cases come out of unconsciousness leaving a person years at a time in a hospital bed only kept alive by artificial means of life support (Wilson, 103,107). When total brain death occurs, there is cessation not only of consciousness, awareness, and control of important voluntary and involuntary actions but also of all brain stem functions. People who are in a Permanent Vegetative State are not totally brain dead because their brain stems are relatively intact (Jenish, 41). “PVS patients demonstrate a total loss of cerebral cortical functioning, they are permanently and irreversibly void of any awareness, thought or feelings” {Evers, 25). PVS patient’s personality, memory, purposive action, social interaction, joy, satisfaction and pleasure are {forever gone} (Shapiro, 31). A physician skilled in Neurology usually can make a diagnosis of the permanent vegetative state with a reasonable high degree of reliability within weeks or months after the original injury (Shapiro, 34-35). The cost of maintaining patients in a permanent vegetative state varies by state, province, and type of institution. For example, in Minnesota, yearly costs are 18,000 to 25,000 dollars, In Massachusetts, costs are approximately 120,000 dollars per year (Brower, 76-78). One neurologist estimated that with costs from a monthly low of 2,000 to a high of 10,000 dollars, and assuming there are 5,000 to 10,000 permanent vegetative state patients in the United States, the annual national health bill for these patients ranges from 120 million dollars to 1.2. Billion dollars (Brower, 78). Is this a good idea for our economy when PVS patients are kept for 10-25 years? Is this healthy for families to suffer with a prolonged loss, and pay thousands of dollars to keep their loved one on artificial life support with little chance of coming out? Brain Death has to be properly defined before you can legalize Euthanasia, for there are to many broad and troubling concerns to be considered with medical ethics. For society to make Euthanasia legal, many things need to be defined, it is not a simple yes or no answer solved by enactment of one new law.
The question of when should an individual consider Euthanasia as an option, is not something a single written law can handle. One law can not cover every single case of human suffering. If you were to Legalize Euthanasia as a whole where would you draw the line on the amount of human suffering needed to assist death. One law can not accurately determine a euthanasia decision. A person is depressed; do they have the right use a Euthanasia law? Different circumstances call for different options and choices even if you feel bad for a person suffering does that mean their life is worthless? That they should give up hope? Depressed patients can receive therapy and medicine to help with their problems. A lot of depression cases can be solved and there is a high rate of recovery (Peck, 43). When doctors told Sue Rodriguez she was dying of Lou Gehrig’s disease, she turned her despair into determination and used her last months to fight for the right to die her way. Where Dennis Kaye chose a different path, he spent his last dying minutes with family members, his state of mind was that, if he’s going to die, he wants to die happy and in the company of his loved ones (Chatelaine, 28). There are far too many therapeutic resources in the medical field to list a complete summary of the drugs and techniques applicable to the different contingencies of critical injury and illness (Peck, 109). Although they can be divided into categories according to purpose for which they are used. The first category is Preventive therapy, which tackles illness and injury by attacking their causes and by building and supplementing natural resistance. Examples of this would be vitamins, immunizations, and antibiotics (Wilson, 100). The second Category is called Emergency therapy; this includes immediate procedures to take place, such as first aid, artificial respiration, blood transfusions, heart massage, and stimulants. They are meant to restore or replace vital functions in order to “buy” time until more adequate treatment is available or until the doctor can determine the exact nature of the problem (Wilson, 100-101). Remedial therapy is applied after diagnosis and is focused toward the sources of difficulty (Dudley, 199). The use of antibiotics, chemotherapy, radiation, and a broad range of surgical procedures that are prescribed and performed for the purpose of correcting any abnormality, healing injury, and curing disease (Wilson, 101). Ameliorative therapy is not directed towards cure, but is supportive and often treats the symptoms rather than the sources of the disorder. Hormones, protein supplements, electrolytes, radiation, respirators and pacemakers are used in order to improve the functions of the body (Wilson, 101-102). The last category of therapy is Palliative, which is also directed toward the relief of symptoms, which uses anesthetics and neurosurgery and psychotherapeutic treatments (Wilson, 103). All of these forms of treatment help to show how some injuries and illness can be cured or controlled thanks to medical advances. Therefore you cannot justify allowing Euthanasia to be legalized to end everyone’s idea of suffering. Before society can handle Euthanasia’s argument, it must first consider every aspect of when it would ever be appropriate. If legalized, it must be very specific as to what circumstances would need to be present to allow the various types to be applied or never applied. This leads to the definitions of what Euthanasia really is.
There are various circumstances in which Euthanasia can play very different roll in a person’s death. There is Active Euthanasia, which means an individual chooses to have another end his or her life by means of lethal injection, etc., to bring about their death (Emanuel, 75). Where as Passive Euthanasia is someone simply refusing to intervene in order to prevent someone’s death (Russell, 20). There is Voluntary, which means the individual chooses and Non Voluntary, where a person is unable to make a choice (Humber, 57). The last type is Involuntary Euthanasia, when the individual chooses not to be put to death but their choice is ignored by others (Russell, 22). All of these types carry their own different problems and circumstances, which makes it difficult and unclear to justify the various reasons why Euthanasia should be legalized. Starting with Passive Euthanasia, someone refusing to intervene to prevent someone’s death happens commonly at hospitals (Russell, 20). An example would be an older dying patient who is going to die soon if life-support wasn’t provided. A doctor might see this person suffering a great deal and the patient’s family chooses not to intervene. They chose to withhold the treatment that could be prescribed to them, such as resuscitation. Passive Euthanasia is an act of omission, permitting natural death to occur (Jenish, 17). It has also been described as “Desisting from or discontinuing useless prolongation.” (Russell, 23). Voluntary Euthanasia the choice of a person to die is increasing in medical interest and support in the United Kingdom for legalizing this form of euthanasia. In 1990, a working party from the Institute of Medical Ethics said: "A doctor, acting in good conscience, is ethically justified in assisting death if the need to relieve intense and unceasing pain or distress caused by incurable illness greatly outweighs the benefit to the patient of further prolonging life." (Voluntary Euthanasia Society of U..K. Web site) Non Voluntary Euthanasia, a person is incapable of making there wishes known, such as those in an irreversible coma (Wilson, 56). For these individuals, euthanasia is at the request of the next of kin or legal guardian who has the responsibility of making decisions on the patient’s behalf (Wilson 56-59). It is done without the patient’s permission but not necessarily contrary to their wishes. With Involuntary Euthanasia, the patient asks not to be put to death and their request is ignored. For example, If the person asks not to be put to death if they become critically ill and asks to have all measures of life support come into effect. The doctor or family members over rule the patient’s decision. This may occur because of the seriousness of the situation and or the cost of life support for a prolonged period with no chance of recovery. Some people see Involuntary Euthanasia as murder because the patient specifically asked not to be taken off life support without extreme efforts to save their life, but the doctor or family ignored their decision (Lindsay, 77). Finally, there is Active Euthanasia when death is induced either by direct action to terminate life or by indirect action such as giving drugs in amounts that would clearly hasten death (Peck, 18). Some would limit the use of the term to direct and intentional action to end a life, however under our present laws is considered murder (Russell, 19). Even giving drugs to relieve pain that may hasten death is also a criminal act. Though proof of such intent might be very difficult to prove, even if a physician merely provides the means for a patient to end their own life. This act is illegal in most states and countries because the physician is aiding a person to commit suicide (Kjellstrand, 118). All of these types of Euthanasia can carry their own specific circumstances and different problems making it very difficult to simplify Euthanasia under one label and justify its legalization.
In conclusion, Legalizing Euthanasia as a whole is not the best decision for our country, however in certain well-defined situations it can be justifiable and legalized. Once we determine what is brain death. And where does society draw the line on what makes a person eligible to consider Euthanasia. Finally, that euthanasia is not considered one encompassing act but properly recognized in it’s many categories that suit different situations and has different meanings.
