Реферат: Euthanasia Essay Research Paper PhysicianAssisted Suicide is
Euthanasia Essay, Research Paper
Physician-Assisted Suicide is defined as suicide in which a physician supplies information and/or the means of committing suicide (e.g. a lethal dose of sleeping pills, or carbon monoxide gas) to a person, so that individual can easily terminate their own life (?Passive Euthanasia?). Some terminally ill patients are in unbearable pain and/or experiencing an unbearably poor quality of life (?Passive Euthanasia?). They would rather end their lives than continue until their body finally gives up. Does the state have the right to deny them their wish (?Passive Euthanasia?)? During the first year of legalized physician-assisted suicide in Oregon, the decision to request and use a prescription for lethal medication was associated with concern about loss of autonomy or control over the bodily functions, not with fear of intractable pain or concern about financial loss (?New England Journal of Medicine?). Suicide is a legal act that is theoretically available to all. But, a person who is terminally ill or who is in a hospital setting or disabled may not be able to exercise this option, either because of mental or physical limitations. In reality, they are being discriminated against because of their disability (?Passive Euthanasia?). Euthanasia, or physician-assisted suicide, should be legalized, and an open option to patients who are mentally or terminally ill. It should be the patients right and choice.
Religious opposition to medical relief of suffering is not a new topic. In 1591, Eufame Macalyane, a lady of rank, was charged with seeking aid for the relief of pain at the time of birth of her two sons and was burned alive on the Castle Hill of Edinburgh (Brazil). Using pain killers such as chloroform was considered contrary to the will of God as it avoided one part of the ?primeval curse of woman? (Brazil). The same thinking is shown in the modern-day opposition to physician-assisted suicide; with Catholics believing that end of life suffering purifies the soul and must therefore be ended (Brazil). In a personal interview with Father Edward Domin of St. Jane Frances de Chantal Church, Father Ed stated that the Church was against any type of suicide regardless of the knowledge of the action (Personal interview). ?Some opponents believe that physician aid-in-dying would undermine public trust in medicine?s dedication to preserving the life and health of patients??(Egendorf 116). Physician-assisted suicide is active voluntary euthanasia. It is active euthanasia because it concerns methods that intentionally cause the death of the patient. It is voluntary because the patients make the decision to have their lives ended (?Physician-Assisted Suicide?). When one looks at the issue in terms of these distinctions, two separate moral questions arise: Is it morally acceptable for a Christian to request assistance in indirectly causing his or her own death? Is it morally acceptable for a Christian physician to adhere to the wishes of a patient who makes such a request (?Physician-Assisted Suicide?)? What Christians say about issues of morality should be and is usually reflective of their fundamental faith convictions (?Physician-Assisted Suicide?).
?It is a pledge by medicine to find more effective ways of eliminating pain, or providing emotional support, and of assisting the sufferer to experience a ?good death? (Physician-Assisted Suicide)?.. The refusal by medical caregivers to assist in a patient?s suicide is a pledge that the caregiver will never give up on a patient and never cease active forms of care (?Physician-Assisted Suicide?). The argument here is that it is neither a part of the cure nor is it a form of care (?Physician-Assisted Suicide?). Why isn?t eliminating the suffering person an acceptable part of the cure (?Physician-Assisted Suicide?)? Proponents of physician- assisted suicide argue that people care for pets and animals who are in pain by ?putting them to sleep? therefore, shouldn?t everyone do the same for their loved ones (Physician-Assisted Suicide)? (Beliefs about suicide varied considerably in ancient Greece. The Stoics and Epicureans believed strongly in the individual?s right to choose the means and time of his death (Jamison 13). This is also supported by today?s Right to Die society of Canada: ??the right of any?individual?to choose the time, place, and means of his or her death? (?Right to Die Society?)). Aside from the fact that people and animals are treated differently in many ways, there are moral constraints and obligations arising from fundamental beliefs about responsibilities to God and each other that define acceptable care (?Physician-Assisted Suicide?). One obligation is to eliminate the suffering of others with the constraint that people cannot eliminate the suffering by eliminating the sufferer (?Physician-Assisted Suicide?).
?Too many people suffer unnecessary pain, and the medical treatment of pain is often deplorable. Medical licensing authorities are key to effect the necessary changes? (?Compassion?). An individual has a constitutional right to request the withdrawal or withholding of medical treatment, even if doing so will result in the death of the patient (?Part 2?). ??The history of the law?s treatment of assisted suicide in this country [is]? rejection of nearly all efforts to permit it. The asserted ?right? to assistance in committing suicide is not a fundamental liberty interest??? (Van Biema 30). Most Americans treasure their individuality and their freedom to decide what to believe. This after all, is the American way. It started with our founding fathers who saw the trouble European nations experienced from church interference with the state and opted for a strictly secular government in the country (Brazil). By maintaining strict neutrality toward religion, this new type of government could provide an assurance that freedom of religion would be offered to all. Americans were to be free to believe or to not believe as they saw fit (Brazil). Unfortunately, some of the current legislatures violate this principle and use their governmental powers to impose personal beliefs on others. The ?Pain Relief Promotion Act of 1999? (PRPA) is a case in point. This bill, sponsored by Senator Don Nickles and Representative Henry Hyde, both Catholics who would amend the Controlled Substances Act to make it illegal to use prescribed drugs to assist in the planned suicide of a patient (Brazil).
Anyone Intentionally dispersing, distributing, or administering a controlled substance for the purpose of causing death or assisting another person in causing death would be subject to federal persecution and a prison sentence term from 20 years to life in prison (Brazil).
The bill is a direct response to the Death with Dignity Act first passed in Oregon in 1994, that allowed doctors and physicians, after suitable safeguards, to aid a patient in achieving a painless death (Brazil). When that failed, they succeeded in bringing it up for a second vote (Brazil). ?The doctor referred to in the article refuted the statistics printed, but the issue was still presented to the people for another vote? (Brazil). This occurred on November 4, 1997, when the people of Oregon overwhelmingly expressed their support for physician-assisted suicide in a resounding 60-40 victory (Brazil).
Pass of this legislation would affect even those who do not wish for the option of physician-assisted suicide, or even those in states with no such law, as it would have a chilling effect on physicians? willingness to prescribe adequate medication for end of life care, meaning intensified agony for thousands of dying patients (Brazil). What doctor wouldn?t hesitate before prescribing full pain relief, knowing that under this bill, any police officer at the local or federal level could question his intentions and define his actions as a crime (Brazil)? The fear of investigation, even under the current regulations has led to the well documented ?under treatment? of pain, according to the CEO of the Oregon Hospice Association (Brazil). Furthermore, experience in Oregon shows that the very knowledge that relief is available is needed to provide comfort and makes pain more bearable (Brazil).
Under the Oregon Death with Dignity Act, Section 2.01 Who may Initiate a Written Request for Medication, a patient may request assistance if that individual is: An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner in accordance with this Act (?Section 2?). The patient gets the physician to confirm the disease by following The Death with Dignity Act Section 3.02 Consulting a Physician, ?Before a patient is qualified under this Act, a consulting physician shall examine the patient and his or her relevant medical records and confirm in writing, the attending physician?s diagnosis that the patient is suffering from a terminal disease, and verify that the patient is capable, is acting voluntarily and has made an informed decision? (?Section 3?). Not every patient who had applied under the Death with Dignity Act followed through, and those who did were able to have friends present with them at the end (Brazil).
An individual has a right to request the withdrawal or withholding of medical treatment, even if doing so will result in the person?s death. Honoring a person?s right to refuse medical treatment, especially at the end of life, is the most widely practiced and widely accepted right to die policy in our society. Most medical, legal, and ethical authorities agree that no ethical decision exists between an individual?s request to have life-sustaining treatment removed and a request to withhold this treatment (?Part 2?).
Proponents of the right to die have focused mainly on establishing and clarifying patients? legal rights to make decisions about their own medical care at the end of their lives. ?It was assumed that most health care providers, assured that the law permits them to do so, would respect the decisions of their patient, or of their patient?s appointed decision-maker? (?Part 3?). ?As a result, most advance directive laws impose no adverse consequences on providers who refuse to follow the instructions of an advance directive, and may foster the belief among some that noncompliance is legally acceptable? (?Part 3?). ?In recent years, however, it has become apparent that a health care provider who imposes medical treatment contrary to the instructions left in advance directive may be guilty of medical battery? (?Part 3?). Every year 2 million people die in America alone. 80 percent die in hospitals, hospices or nursing homes. Chronic diseases, such as heart disease or cancer, account for two out of every three deaths. It is estimated that approximately 70 percent of these people die after the decision to forgo life-sustaining treatment (?Part 4?).
?Deciding what is right is especially difficult when the permissibility of deliberately ending a human life is involved?(Cauthen). In these extreme situations, the rules of morality are stretched to the breaking point. Nearly everyone would agree that in some cases it would be socially acceptable to end a life deliberately, such as: self-defense, capital punishment, or intentional suicide by a spy to prevent interrogation tortures (Cauthen). This fact tells us that killing a person is not always and necessarily looked down upon and regarded as a wrong, and that it all depends on the circumstances at hand (Cauthen):
In some situations the choice of the patient takes priority over the other considerations: Consider a person with an incurable disease, illness, or a severe disability such that life has become so unbearable and racked with pain or so burdensome that desirable, meaningful, purposeful existence has ceased. Suppose that person says, My life is no longer worth living; I can not stand it any longer; I want to end it now to avoid further pain, indignity, torment, and despair, in the end after all alternatives have been thoroughly considered, the person should have the right to make a choice to die and that choice should be honored and followed through with. The role of the physician is to do what is best for the patient, and in some extreme situations this may include hastening death upon a voluntary request of the dying (Cauthen).
?I suggest that the question should be put this way: What is the best thing I could do to help my patients in whatever circumstances arising given my special knowledge and skills? In nearly every case the answer would be to heal, to prolong life, to reduce suffering, to restore health and physical well being, i.e. to preserve and enhance life. But in some extremes, hopeless circumstances, the best service a physician can render may be to help a person hasten death in order to relieve intolerable, unnecessary suffering that makes life unbearable as judged by the patient. This would be enlargement of the physician?s role, not a contradiction of it? (Cauthen).
Sometimes ending suffering takes priority over extending life. When death becomes preferable to life, everyone would benefit if it were legal to show mercy (?Euthanasia?).
One of the greatest assistants to the euthanasia movement was Dr. Jack Kevorkian. Dr. Kevorkian assisted over 100 people and even made a machine to do so. In 1986, Dr. Kevorkian discovered that some doctors in the Netherlands were helping their patients who were terminally ill, or who were suffering unbearable amounts of pain and suffering to die. This news caused him to take an interest in dying patients and to get him involved in a campaign to legitimize physician assisted suicide. In 1989, Dr. Kevorkian learned about a man with quadriplegia, paralysis of the arms and legs, who had made a public announcement for help to end his life (?Kevorkian? 2). Dr. Kevorkian then attempted to invent a device that people who were too incapacitated to end their own lives by other means could by simply pushing a button. He eventually made a device he called the Thanatron, Greek for ?Death Machine,? which administered an anesthetic and then a lethal injection of potassium chloride through an intravenous line. Potassium chloride causes the heart to stop beating and is the substance used in executions by lethal injection. Dr. Kevorkian gained publicity through media coverage of his device.
In 1989, Janet Adkins, a 54-year-old woman with Alzheimer?s disease, contacted Dr, Kevorkian and requested assistance (?Kevorkian? 2). In 1990, Adkins became the first person to die using the Thanatron in Kevorkian?s presence. Dr. Kevorkian asked his own patients to donate their vital organs or undergo a critical medical experiment to benefit science, medicine, society, and the lives of others (?Dr. J. Kevorkian?).
Perhaps the most common form of passive euthanasia is to give a patient a large dose of morphine to control pain, in spite of the likelihood of the painkiller suppressing the heart and respiration, causing death earlier than it would otherwise occur. ?These procedures are performed on terminally ill, suffering people so that natural death would occur sooner.? It is also done on people in a persistent vegetative-state, or individuals with massive brain damage who are in a coma from which they cannot possibly regain their consciousness (?Passive Euthanasia?). Compassion and benevolence demand that we legalize assisted death for the sake of the ill and those who love them (Cauthen).
Other methods of relieving the suffering of terminally ill patients are: giving medicine to relieve intolerable suffering despite the fact that it hastens death, providing continuous anesthetic, high levels of medicine to induce terminal sedation, giving medicine to relieve pain and hasten death, and administering a lethal injection that causes death quickly in order to relieve suffering (Cauthen). Some people argue that patients would be frightened that their physicians might kill them without their permission, but this is not a valid concern, because the patient would first have to request assistance in dying. If that individual didn?t ask for suicide assistance, their physician would continue to preserve and extend their patient?s life (?Passive Euthanasia?).
?With the further graying of our country?s population, no doubt, the discussion will intrude into more and more corners of our lives? (?Legality?). Euthanasia is a practice that should be opened to all who want it. It is a practice that should be legalized to benefit the terminally and mentally ill and the physically and mentally disabled people who are in intolerable pain and suffering from tremendous self- pity.
Brazil, Janet. ?Enduring the End of Life.?
(April 17, 2000).
Cauthen, Kenneth. ?Physician-Assisted Suicide and Euthanasia.?
(April 16, 2000).
?Compassion in Dying.? (April 16, 2000).
Domin, Father Edward. Personal interview. April 21, 2000.
?Dr. Jack Kevorkian and Practices:?
(April 16, 2000).
Egendorf, Laura K. Assisted Suicide Current Controversies. San Diego: Greenhaven
Press, Inc., 1998: 116.
?Euthanasia Research and Guidance Organization.?
(April 16, 2000).
Jamison, Kay Redfield. Night Falls Fast: Understanding Suicide. New York: Alfred A.
Knopf, 1999: 13.
?Kevorkian, Jack.? Microsoft Encarta Encyclopedia 99. CD-ROM. Microsoft Corp.,
?Legality.? (April 16, 2000).
?New England Journal of Medicine, The.?
(April 16, 2000).
?Part 2.? (April 16, 2000).
?Part 3.? (April 16, 2000).
?Part 4.? (April 16, 2000).
(April 16, 2000).
?Physician-Assisted Suicide.? (April 16, 2000).
?Right to Die Society of Canada, The.?
(April 16, 2000).
?Section 2.? (April 16, 2000).
?Section 3.? (April 16, 2000).
Van Biema, David. ?Death?s Door Left Ajar.? Time July 7, 1997: 30