Kantian thinking emphasizes the autonomy of human beings. He believed that given the freedom to do so, human beings can effectively apply reason to arrive at decisions. Euthanasia is highly defensible on these grounds. We, as a society, have the duty to respect that right. For the good of society, however, a distinction must be drawn. Participation of doctors and others in hastening death of another is not compatible with that persons rights. Knowingly or unknowingly, the helper is casting undue influence over the patient. Euthanasia is an intensely human issue.
As such, it generates passionate emotion and debate on both sides. The definition of euthanasia itself is not always agreed upon. Is it simply withdrawing medication? Or, is it active participation in facilitating someone’s death. As a society, we have to ask ourselves the question, “Should a person be forced to stay alive? ” Some forms of euthanasia are legal and some are not. We may think of it as an obscure topic, but as the number of people who die of chronic long-term diseases continues to rice many of us will be faced with this issue.
Despite what the current law may say, Lisa Yount (2000) points out in Physician-Assisted Suicide and Euthanasia that the practice is already going on: Even though they seldom have an explicit right to do so, survey after survey makes clear that, under certain circumstances physicians regularly if clandestinely do assist death, just as surely as the have throughout history. (4) Attitudes about euthanasia vary from place to place and from era to era. These differences have a lot to do with the fact there is not on common, worldwide definition of the term.
In general, euthanasia is classified into several different types. Knowing these types can help us draw a line as to what is ethical, moral and protective of individual rights. Types of Euthanasia Passive euthanasia refers to removal of some form of life support. It may be to not perform CPR when a person goes in to cardiac arrest, or it may involve a patient removing themselves from life-extending medication. In some cases, a patient is given high doses of pain medication. This relieves pain, but it also may suppress breathing and hasten death. This is considered ethical behavior by most medical associations.
Active euthanasia takes place when a physician or another caregiver takes direct action to cause the death of someone who is terminally ill. The patient may be overdosed on sleeping pills, for example. In physician-assisted suicide, the doctor provides the patient with the means of committing suicide. The patient then starts the process that will lead to death. Involuntary euthanasia refers to the killing of a patient who is in a vegetative state or who is unable to make his wishes known. Involuntary euthanasia has also been performed on people who were aware and objecting to the process.
The eugenics program in Nazi Germany is a notorious example. In this context, euthanasia is murder. In favor of Euthanasia Humanist beliefs dictate that the right of self-determination gives us the authority to pursue what we think is in our best interest, as long as we don’t impinge on someone else’s rights. Michael Manning emphasizes this point in Euthanasia and Physician Assisted Suicide (1998): The patient who either consents to being killed or asks assistance In committing suicide presumably harms no other person. From this erspective, laws restricting assisted suicide or euthanasia seem paternalistic, unjustified and arbitrary. (26) No one can really know what it is like to go through unbearable, unending pain unless they experience in for themselves. We are endowed with the rights of life, liberty and the pursuit of happiness. For some, the pursuit of happiness may mean permanent removal from the pain of terminal illness. There are certain tools that can assure that the patient’s rights are protected. Living wills and advance directives protect both the patient and the doctor carrying out his or her wishes.
These documents stem from the Kantian viewpoint that nobody should make decisions for the patient but the patient himself. For good reason, there are legal limits to these documents. They allow the physician to withdraw care, but not to perform active euthanasia upon a patient who is unable to make his wishes known. Against Euthanasia For many, opinions about euthanasia are based on deeply held beliefs. Christian beliefs dictate that life can only be given or taken by God. Suicide violates the natural god-given drive to live, and it harms others in untold ways.
Arguments against Euthanasia may be based on religious grounds, but there are daunting ethical factors to consider as well. In his book Euthanasia and Physician-Assisted Suicide (1998), Michael Manning cites the belief of some ethicists that any artificial distinction between allowing to die and killing is meaningless: But (Dan) Brock makes the case that physicians already kill, because he sees no moral distinction between allowing to die and killing outright. Attempting to maintain a distinction between killing and allowing to die is moral legerdemain, in his view. (45)
Euthanasia is a decision a person cannot change later. Even the life of the terminally ill has value. We should be working to help them find that value instead of encouraging them to die. Manning (1998) summarizes the position of some euthanasia opponents. Opponents of euthanasia claim that our compassion for the pain and suffering of the dying should cause us to redouble our efforts to improve the quality and distribution of health care for the terminally ill. (44) In an era of corporation managed heath care, some critics fear that euthanasia will become a means of cost management.
The majority of heath care expenses come in the last years of life. In this context, it is possible that a large heath corporation will be too quick to give up on a patient, tacitly encouraging doctors to promote assisted suicide. Physicians operate under the ethic “do no harm”. Some have construed this to include facilitating the end of life if it is in the patient’s best interest. This is an illogical position. Everyone has the “right to die”. Participation of the physician in the process, however, casts undue influence on the decision-maker.
We do not have the right to a painless death any more than we have the right to a painless life. Making death easier can only encourage it. Life is precious and valuable, no matter how painful, and it is the job of physicians to protect that life. Participating in assisted death may send the doctor down a slippery ethical slope he can never reclimb. Conclusion Should people be forced to stay alive? No, they should not. If a person chooses, in sound mind, to remove themselves from medical care, that is well within their right. Assisting in someone’s premature death is another matter, however. Physicians are charged to save lives.
Having them involved in hastening death creates a slippery ethical slope that may end up costing lives unnecessarily. Asking for assisted suicide is often a cry for help in much the same way as typical suicide attempts. A very small percentage of people who attempt suicide unsuccessfully actually go on to take their lives later. This suggests that suicidal thoughts are transient in nature. Consequently, people seeking assisted suicide could possibly be treated in other ways, such as more effective pain management or involving the patient in activities that will take his or her mind away from the pain as much as possible.
Chronic pain may not be the true reason someone requests suicide. A person who is terminally ill may no longer feel valuable. There are plenty of ways to make a person feel worthwhile again. Assisted suicide means giving up. The patient gives up and the physician gives up. In certain instances, it is perfectly understandable for the patient to give up. It is not the role, however, of the physician to give up on life. Suicide will never be completely non-existent. People should have the right to refuse medication and treatment as long as they are in the right mind to do so.
Life cannot be forced on anyone, but it should be encouraged. People do have the right to a natural death. Physicians should never be in the business of hastening death, however. Kant is right that a patient should have autonomy to make decisions on their own behalf. It is also a basic element of nature that the human mind changes. Many people who are suicidal change their minds. Therefore, if a person is suicidal, it is the doctor’s duty to try to help in a way that preserves life. Providing a means to an easy death is the same thing as promoting it. That is a violation of the Hippocratic Oath.