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The Morality of Euthanasia

Technology has brought about drastic changes in the morality of today?s society. One organization it has greatly effected is the medical field. Few would argue with the fact that medical technology has greatly improved the quality of life. However, with doctors and other health care workers having the authority to contribute to both the patients? well-being and inevitable death, society believes there should be limits to best serve the patient?s wishes. The controversial issue that society now stands against, and questions is the practice of euthanasia. Is this ?medical advancement? ethical?

Attitudes towards death changed rapidly in the twentieth century as a result of the tremendous advances in medicine. Hiding the approaching death for as long as possible from the patient, which many think of as contemporary behavior, actually started in the second half of the nineteenth century. Doctors and families both thought it would be ?too stressful? (Knopf 5) for the patient to ?know there is no hope? (Knopf 5). The family was no longer gathered by the bedside, for fear of alarming the patient, and the priest was not summoned to perform the last rites until the patient had lost consciousness or already has died. The clergy protested, causing Vatican II to change the traditional name of ?Extreme Unction? to ?Anointing of the sick? (Knopf 5) so that the priest could come at any time during a serious illness. Families sacrificed final words of farewell with loved ones because any conversations dealing with impending death were banned.

The mid-twentieth century brought death out of the home and into the hospital, further removing the dying person from his family and spirituality. The image of the dying person became a patient in a ?sterile hospital room with tubes attached to virtually every orifice of the body? (Knopf 5). It had come under the control of the doctor who could manipulate the time and length of dying with medical technology.

The medical profession, however, saw death as a failure and doctors frequently chose to avoid dealing with a patient who would soon die. As a result, patients were, and still are, heavily medicated, permitting them to slip away, unknowingly or ?snowed out?(Williams 112), the complete opposite of the medieval period when men and women prepared themselves, made their peace, and then welcomed death. But by 1985, an estimated eighty- percent of those who died did so in a hospital or a nursing home, under the care of strangers. In addition, these strangers have been taught in their medical education that their job is to fend off death. So they perform their duties under the growing fear that if every effort is not made to postpone death they have failed and may be sued for a ?mercy killing? (Knopf 8). Today death is often correlated with seriously ill or aging patients and physicians and other health care workers all over the world are receiving training to deal with death, hospice care is taking death out of the hospital and bringing it back to the home. Even though many still want to follow the traditional way in dealing with death, family, friends and health officials should be able to handle the situation in accordance with the best interest of the terminally ill patient.

As people take death back into their own control, they demand the right to die when they feel ready. The right to die is becoming an increasingly controversial issue. As more people insist that the right to die is a personal liberty, others, with opposing views, feel strongly about preserving life at all costs and rally together to fight planned suicides, disconnecting support systems, and other efforts to end lives. Those who do not agree with their right to die, warrant those individuals and surrogates, who claim that right for mentally incompetent patients and seriously ill newborns, to exercise the procedure.

Put aside the arguments about the right to die. Shelve the ethical question about doctor assisted suicide. ?Jack Kevorkian is on the loose again? (Quill A11) explained one newspaper article. The state of Michigan has a serial killer on its hands. Or maybe, even better a mercy killer. Kevorkian or Dr. Death thinks of himself as a maverick or a martyr; even a crusader like Martin Luther King Jr. But as the count of the dead grows many feel he looks more like ?Jack the Ripper, M.D.? (Gordon 6A)

First on the list of Kevorkian?s patients back in 1990 was Janet Adkins, a woman with Alzheimer?s disease who pushed the button on the machine in his suicide mobile. He was charged with and acquitted of first-degree homicide. It was ruled that she killed herself and there was no state law against physician assisted suicide. Then last fall came Sherry Miller and Marjorie Wantz, one with multiple sclerosis, the other with chronic vaginal pain. For his involvement with these deaths, he was indicted again for murder and awaits trial. Now, there is Susan Williams, Kevorkian provided the gas canister and hands-off technical assistance to this fifty-two year old woman who was crippled by multiple sclerosis. He was present when she put the gas mask on, pulled the handle and breathed the carbon monoxide, which took her life. (Sack 24A)

Surprisingly, each of these women wanted to die. Each of them was grateful, polite, and replete with thanks to the man who provided them with the means. But that does not diminish the fact that Kevorkian has become an ?ethical outlaw, a free-lance death dealer providing paraphernalia and know-how to users? (Gordon 6A). He has no more right to wander around Michigan offering death to ill women than he has putting a loaded gun in the hands of a depressed teenager. As Susan Wolf of the Hastings Center says, ?The number one thing is that he is killing people. You have to say it how it is.? Yet others argue they will die sooner or later. Why let them die and suffer the pain, when they can feel they still have control and die with dignity.

The debate over physician assisted death is a small, but important, part of a broader effort to give the dying better pain relief, more understanding, and more choices. Most dying patients will find dignity and adequate relief through ?comfort care? (Quill A11). This puts emphasis on human contact, relieving symptoms and enhancing a patient?s quality of life.

For the same reasons as above, the Dutch move to enact a law which makes euthanasia easier. The Dutch Parliament approved, on Tuesday, February 8; the world?s least restrictive euthanasia policy. Establishing specific rules that would allow a doctor to assist in a suicide or kill a terminally ill patient at the patient?s request. Although ending a patient?s life or helping in suicide is illegal, and would remain part of the criminal code, the new rule will protect doctors prosecution if they notify the coroner of any death they have brought on and provide a detailed account of the circumstances. Dutch courts have condoned Euthanasia and doctor-assisted suicides for more than a decade.

Prosecutions have been rare under the Dutch Parliament?s rule. Under the pre- existing law, the maximum sentence was 3 to 12 years in prison, depending on the form of death, but no doctor had ever gone to prison in such cases. Interviews with relatives, physicians, health inspectors and lawyers who had been involved in euthanasia suggest that the decision to bring on death is usually reached after long and agonizing discussions. Several doctors said they found the experience difficult and draining.

But many Dutch physicians say they believe that when death is near, suffering need not be ?prolonged unnecessarily and that people have a right to take charge and die in dignity? (Simons A9). Dignity and the freedom to choose when he would die was Jan van den Broek?s last wish. In the last minutes of his life, his wife and children sat by his bed at home, holding his hand, watching as two family doctors prepared to administer the lethal fluid.

The physical and mental aspects of suffering are always intertwined. A person with lung cancer who has witnessed fellow patients drown in their own lung secretions may be terrified about his/her future, and might seek reassurance that a physician would ease his/her death if terminal suffocation sets in. Unless doctors are allowed to consider the psychological suffering of their patients, they will be reduced to treating bodies instead of people.

Though few patients reach this desperate state, doctors need to be able to respond to their needs. Whether created through legislatures, referendums, or the courts, a public policy is needed to ensure that patients will approach the final phase of life knowing there is escape should they face their worst scenario.

Likewise, opinion polls show that a majority of Americans want to help terminally ill patients, suffering intolerably, to end their lives. Yet there is no consensus on the best way to give doctors that legal authority. Although many see the courts as a good place to start giving doctors this kind of legal authority. In a major right-to-die case, New York?s top court ruled that a Long Island man must pay a nursing home for it?s life sustaining care of his comatose wife, even though he had asked that she be allowed to die. The unanimous ruling by the Court of Appeals underscored the strictness of New York?s laws and legal precedents on the rights of patients and their relatives to terminate life. And it gave new ?impetus? (Sack 24A) to call for the Legislature to expand the rights of family members to make medical decisions for incapacitated relatives.

In conclusion, although the subject of euthanasia is a ?sticky topic? it is one that must be addressed. Should doctors and other medical workers do everything in their power to sustain life for as long as possible? Or should someone with a terminal illness be able to take control and die with self-dignity? Even though death is a topic that many have a problem talking about, once people come to terms with the fact that is inevitable, they will be able to decide in the best interest of a terminally ill person. Or the person himself/herself must come to terms with their own death before they can make a valid decision on their life.

Gordon, Ernest. A Manual of Death Education. North Carolina, The Celo Press, 1977.

Knopf, Michael. ?Death and Dying: Who Decides?? Information Plus 6 November 1994: 60-67.

Quill, Timothy E. ?The Care of Last Resort.? New York Times 23 July 1994: A11.

Sack, Kevin. ?Court Upholds Payment for Life-Sustaining Care for Women in Right to Die Dispute.? New York Times 9 February 1993: A24.

Simons, Marlise. ?Dutch Move to Enact Law Making Euthanasia Easier.? New York Times 15 October 1993: A9.

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