Euthanasia
In this assignment the author is going to investigate Voluntary Euthanasia. www.Dictionary.co.uk defines Euthanasia as "the act of killing someone who is very ill or very old so that they do not suffer any more".
The author has decided to investigate euthanasia because it's a topic which the author wants to learn more about and also because not too long ago it was in the media quite a lot. It caught author's attention during high profile case of Diane Pretty, which increased author's interest in the topic. Diane Pretty was a 43 years old woman who was suffering from Motor neurone disease which destroyed her muscles, leaving her paralysed and consequently left her in a wheelchair and fed through a tube. She had every possible medical treatment that was available to her. But her condition worsened with time. Because she was paralysed she couldn't' help her self dying (commit suicide), she needed assistance from her husband but because of the English law she wasn't allowed to do this. If her husband assisted her to die, he would have been breaking the law and could have been charged for murdering her. Diane Pretty fought against this law in several different courts including European court but failed.
Euthanasia can be defined as helping someone to die who is enduring extreme suffering, for example from an incurable disease. Euthanasia can also be defined in several other ways;
* Euthanasia: the intentional killing by act or omission of a dependent human being for his or her alleged benefit.
* Voluntary euthanasia: When the person who is killed gives consent to be killed.
* Involuntary euthanasia: When the person who is killed is incapable of giving consent or does not give consent.
* Assisted suicide: Someone provides an individual with the information, guidance, and means to take his or her own life. When a doctor helps another person to kill themselves it is called "physician assisted suicide."
Active and Passive euthanasia: through this distinction, people some time convey the notion that active euthanasia (inducing a cause of death) is morally wrong, but passive euthanasia (withholding care with the intention of letting a person die) is morally acceptable. The intention of killing a person either by inducing the cause of death or by being passive and allowing death to occur is ethically unacceptable, however withholding or removing life support from a person is ethically acceptable only if life support will not benefit the patient and the intention of the care giver is to do something morally good. Passive euthanasia, allowing someone to die when nothing more can be done to give extra length or quality appears more ethically acceptable than actively killing some one.
O'Rourke, K. 2000 A Primer For Health Care Ethics 2nd Edition Georgetown University Press Washington D, C.
Although assisted dying is illegal in the UK according to a report on BBC website http://news.bbc.co.uk/hi/english/static/in_depth/health/2001/euthanasia/default.stm by Dr Moor D, doctors regularly help people to die. In a 1998 survey of UK doctors published in The Times newspaper, 15% admitted to helping a patient to die at their own request.
Care workers are faced with ethical dilemmas in many areas of everyday and specialist professional practice. We use ethical rules and principles every day in decision-making. Some ...
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O'Rourke, K. 2000 A Primer For Health Care Ethics 2nd Edition Georgetown University Press Washington D, C.
Although assisted dying is illegal in the UK according to a report on BBC website http://news.bbc.co.uk/hi/english/static/in_depth/health/2001/euthanasia/default.stm by Dr Moor D, doctors regularly help people to die. In a 1998 survey of UK doctors published in The Times newspaper, 15% admitted to helping a patient to die at their own request.
Care workers are faced with ethical dilemmas in many areas of everyday and specialist professional practice. We use ethical rules and principles every day in decision-making. Some of these decisions we make are moral absolute, which means we make the decision without thinking of the possible result of the decision.
Euthanasia illustrates a potential ethical conflict between the sanctity of life and other ethical principles such as freedom of choice (right to die) etc. Many doctors are put into a moral dilemma by receiving requests for voluntary euthanasia. This could be even though it is unlawful to help someone die the doctor may not hold the same view, so the doctor won't know what to do. The doctor may feel guilty for not helping to cure someone's disease even though that's what doctors are suppose to do. However, if the doctor does help the patient to die the doctor could almost certainly lose his or her job for helping someone to die. Because the doctor is breaking the law and is also against the doctors code of ethics.
Ethical principles to considered;
Autonomy - autonomy is all about an individual's ability to think, decide and to act independently. Respecting a client's autonomy is often the key goal of ethical practice.
Paternalism - is the "doctors know best" approach.
The principle of paternalism is much more authoritarian. It holds that decisions are frequently taken on behalf of others by those who have the best interest of those others at heart and who are in full possession of all the facts.
Autonomy - is all about individual's ability to think decide and act independently. Even though respecting a client's autonomy is often the key goal of ethical practice. But if autonomy is respected too much then this allows clients to decide for themselves when to end their lives. Requests sometimes come from people who are incurably ill and who are in pain or have other chronic symptoms, or who are mentally distressed. Sometimes the demand comes from depressed people or people who are mentally disturbed (for example, with schizophrenia) but who do not have a physical terminal illness. Someone who becomes severely disabled by an accident in the midst of healthy life or by the frailty of old age, may feel themselves to be a burden on carers, relatives and society and may demand the right to die. This is one of the reasons why the author thinks care workers shouldn't respect Autonomy because the clients assume that they are burden to the carers and are not certain about this. Supporters of euthanasia include consequentialists, approach according to consquentialists the rightness and wrongness of action depends eventually on the effects, which that action has i.e. it, consequences. The reason consequentalists supports euthanasia is because the consequence of the action is a positive one because it relieves the pain of individual, which the individual is suffering. According to the view of consequentialists, they feel that actively taking a life of someone who is in pain is more humane and moral than letting someone die slowly. The author believes Autonomy is important, but should have its limits.
The author believes a person should not be allowed to decide when they want to end their life this is also the view of people who believe in sanctity of life. According to sanctity of life point of view life is sacred and should be ended in natural way and no one should end it regardless of how much pain individual is suffering. According to sanctity of life argument poor existence is better than none. Most people whom believe or agree with this think its wrong to kill. This is reflected in laws all over the world where killing is prohibited. However others believe that life is only sacred where a person has a desire to live or have a certain quality of life. However this raises ethical issues such as is it right to end someone's life because we don't believe the life they are living lacks quality, how can we judge what a quality of life is. Quality of life definitions differ between each individuals, what one may see as quality the other person may not see it as quality. For example one person may see quality of as having lots of money and no friends or settled family and others may just see it as quality as long they are free from any illnesses regardless of how much money they have.
The author believes the paternalism view is the one, which should be respected more than the autonomy view. paternalism is the "doctors know best" approach. This is often conflict with the autonomy view. The principle of paternalism is much more authoritarian. It holds that decisions are frequently taken on behalf of others by those who have the best interest of those others at heart and who are in full possession of all the facts. This principle denies autonomy of the client and the right to play full part in decisions making about their treatment will be justified by the belief that the doctor is well-informed person and the patient can make no useful contribution to any decision-making. This is the reason, why the author believes it should be doctors who decide when a person is suited and meets the criteria to end their life. This is because doctors have greater knowledge than the patients. The criteria could be things like there's no chance of decrease in pain a person is suffering. The author supports this view because, the author believes doctors have more experience and have greater knowledge than patients to make the more adequate decision. The author also believes because of doctor's experience they would be calmer, in making right decision and not a harsh one which the clients are more likely to make. But one thing that goes against doctors making decision is that they can't judge how much pain individual is suffering.
However people who agree with autonomy would argue that, the client should make a decision independently, it is appropriate to the patient's condition and, perhaps, wishes; that it feels right to the relatives; that it is economically sensible; and that it is medically comforting.
It is what the patient wants. These are unhappy people, people who are suffering, people who request it (euthanasia). Calls for voluntary euthanasia have been encouraged either by the failure of doctors to provide adequate symptom control, or by their insistence on providing inappropriate and meddlesome interventions which neither lengthen life nor improve its quality.
Consequentalists will also support the view of the author and paternalism view because the decision, which will be made by a doctor, will usually have a positive outcome.
The author also believes the paternalism view is better than autonomy view because doctors have bodies such as BMA which monitor their practices which means they are more likely to make decision which is a professional decision and which also benefits the individual concerned, their family and society as a whole. According to the autonomy view individuals should make their own decision on Euthanasia the author believes this is wrong because they (client) could be just making that decision to benefit their family rather than benefit themselves. They could see themselves as a burden to their family and decide to end their life. The author believes this is wrong, another point, which the author believes, that is against autonomy is that if a doctor didn't follow a code of conduct properly and death was the result of it. It would therefore be easy for them to say that it was the choice of the client to die and not them doing their job improperly. Where as if the doctor is left to decide it is the doctor who will have to answer in case some thing goes wrong.
Public opinion
Progress in hygiene and medical techniques over the last 100 years has brought about a remarkable extension of life. At the same time such advances have often led to a drawing out of the dying process. The public response to this has been to question their lack of control over the end of their lives. Individuals who have been able to live where they want to live, work where they wish to work do not think that they should be denied choice and dignity once they become terminally ill.
www.ves.org.uk/DpFS_PubOp.html
The 1996 13th British Medical Social Attitudes Report reported that 82% of the British population said that an individual should have the right to ask a doctor to end their life if they are suffering from an incurable and painful disease.
since 1996 when Diane Pretty's case highlighted the euthanasia in Britain the public support has risen in favour of euthanasia, it is not seen as unethical. Series of media polls have supported euthanasia,
> The Times newspaper asked, "Should euthanasia be legal in Britain?" 80% responded that it should be.
> Teletext reported 90% support for voluntary euthanasia.
www.echr.coe.int/english/jan/prettyepress.htm
Conclusion
Suffering in all its forms is an evil, and therefore every reasonable effort should be made to relieve it when it cannot be alleviated entirely the author believes in this situation voluntary euthanasia can be justified. The reason the author thinks that voluntary euthanasia has become more ethically accepted is the fact that it has been highlighted in the mass media as way of relieving pain. The author believes the reason that voluntary euthanasia is being ethically accepted is the fact people believe its right for someone to die peacefully than dying slowly in pain. However, the author has also come across views which see voluntary euthanasia as unethical. Leon Kass stated, "We cannot serve the patients good by deliberately eliminating the patient." P.217 O'Rourke, K. 2000 A Primer For Health Care Ethics 2nd Edition Georgetown University Press Washington D, C.
Refrences
O'Rourke, K. 2000 A Primer For Health Care Ethics 2nd Edition Georgetown University Press Washington D, C.
Humphry, D and Wickett, A. 1986 The Right To Die understanding Euthanasia Harper and Row inc. London
Strauss, OS. 1978 Euthanasia Oxford university Press Cape Town.
http://news.bbc.co.uk/hi/english/static/in_depth/health/2001/euthanasia/default.stm by Dr Moor D,
www.ves.org.uk/DpFS_PubOp.html
Shahid Akbar
Eileen
