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                        Euthanasia Term Paper

    A considerable size of society is in favor of Euthanasia mostly because
they feel that as a democratic country, we as free individuals, have the
right to decide for ourselves  whether or not it is our right to determine
when to terminate someone's life.  The stronger and more widely held
opinion is against Euthanasia primarily because society feels that it is
god's task to determine when one of his creations time has come, and we as
human beings are in no position to behave as god and end someone's life.
When humans take it upon themselves to shorten their lives or to have
others to do it for them by withdrawing life-sustaining apparatus, they
play god.  They usurp the divine function, and interfere with the divine
plan.

    Euthanasia is the practice of painlessly putting to death persons who
have incurable , painful, or distressing diseases or handicaps.  It come
from the Greek words for 'good' and 'death', and is commonly called mercy
killing.  Voluntary euthanasia may occur when incurably ill persons ask
their physician, friend or relative , to put them to death.  The patients
or their relatives may ask a doctor to withhold treatment and let them die.
Many critics of the medical profession contend that too often doctors play
god on operating tables and in recovery rooms.  They argue that no doctor
should be allowed to decide who lives and who dies.

    The issue of euthanasia is having a tremendous impact on medicine in
the United States today.  It was only in the nineteenth century that the
word came to be used in the sense of speeding up the process of dying and
the destruction of so-called useless lives.  Today it is defined as the
deliberate ending of life of a person suffering from an incurable disease.
A distinction is made between positive, or active, and negative, or
passive, euthanasia.  Positive euthanasia is the deliberate ending of life;
an action taken to cause death in a person. Negative euthanasia is defined
as the withholding of life preserving procedures and treatments that would
prolong the life of one who is incurably and terminally ill and couldn't
survive without them.  The word euthanasia becomes a respectable part of
our vocabulary in a subtle way, via the phrase ' death with dignity'.

    Tolerance of euthanasia is not limited to our own country. A court case
in South Africa, s. v. Hatmann (1975), illustrates this quite well.  A
medical practitioner, seeing his eighty-seven year old father suffering
from terminal cancer of the prostate, injected an overdose of Morphine and
Thiopental, causing his father's death within seconds.  The court charged
the practitioner as guilty of murder because 'the law is clear that it
nonetheless constitutes the crime of murder, even if all that an accused
had done is to hasten the death of a human being who was due to die in any
event'.  In spite of this charge, the court simply imposed a nominal
sentence; that is, imprisonment until the rising of the court. (Friedman
246)

    Once any group of human beings is considered unworthy of living, what
is to stop our society from extending this cruelty to other groups?  If the
mongoloid is to be deprived of his right to life, what of the blind and
deaf? and What about of the cripple, the retarded, and the senile?

    Courts and moral philosophers alike have long accepted the proposition
that people have a right to refuse medical treatment they find painful or
difficult to bear, even if that refusal means certain death.  But an
appellate court in California has gone one controversial step further.
(Walter 176)

     It ruled that Elizabeth Bouvia, a cerebral palsy victim, had an
absolute right to refuse a life-sustaining feeding tube as part of her
privacy rights under the US and California constitutions.  This was the
nation's most sweeping decision in perhaps the most controversial realm of
the rights explosion: the right to die...

    As individuals and as a society, we have the positive obligation to
protect life.  The second precept is that we have the negative obligation
not to destroy or injure human life directly, especially the life of the
innocent and invulnerable. It has been reasoned that the protection of
innocent life- and therefore, opposition to abortion, murder, suicide, and
euthanasia- pertains to the common good of society.

     Among the potential effects of a legalised practice of euthanasia are
the following:

     "Reduced pressure to improve curative or symptomatic treatment".  If
euthanasia had been legal 40 years ago, it is quite possible that there
would be no hospice movement today. The improvement in terminal care is a
direct result of attempts made to minimize suffering.  If that suffering
had been extinguished by extinguishing the patients who bore it, then we
may never have known the advances in the control of pain, nausea,
breathlessness, and other terminal symptoms that the last twenty years have
seen.  Some diseases that were terminal a few decades ago are now routinely
cured by newly developed treatments. Earlier acceptance of euthanasia might
well have undercut the urgency of the research efforts which led to the
discovery of those treatments.  If we accept euthanasia now, we may well
delay by decades the discovery of effective treatments for those diseases
that are now terminal. (Brock 76)

     "Abandonment of Hope".  Every doctor can tell stories of patients
expected to die within days who surprise everyone with their extraordinary
recoveries.  Every doctor has experienced the wonderful embarrassment of
being proven wrong in their pessimistic prognosis.  To make euthanasia a
legitimate option as soon as the prognosis is pessimistic enough is to
reduce the probability of such extraordinary recoveries from low to zero.

    "Increased fear of hospitals and doctors". Despite all the efforts of
health education, it seems there will always be a transference of the
patient's fear of illness from the illness to the doctors and hospitals who
treat it.  This fear is still very real and leads to large numbers of late
presentations of illnesses that might have been cured if only the patients
had sought help earlier.  To institutionalize euthanasia, however
carefully, would undoubtedly magnify all the latent fear of doctors and
hospitals harbored by the public.  The inevitable result would be a rise in
late presentations and, therefore, preventable deaths.

    "Difficulties of oversight and regulation". Both the Dutch and the
California proposals list sets of precautions designed to prevent abuses.
They acknowledge that such are a possibility. The history of legal
"loopholes" is not a cheering one.  Abuses might arise when the patient is
wealthy and an inheritance is at stake, when the doctor has made mistakes
in diagnosis and treatment and hopes to avoid detection, when insurance
coverage for treatment costs is about to expire, and in a host of other
circumstances. (Maguire 321)

    "Pressure on the Patient". Both sets of proposals seek to limit the
influence of the patient's family on the decision, again acknowledging the
risks posed by such influences.  Families have all kinds of subtle ways,
conscious and unconscious, of putting pressure on a patient to request
euthanasia and relive them of the financial and social burden of care.
Many patients already feel guilty for imposing burdens on those on those
who care for them, even when the families are happy to bear the burden.  To
provide an avenue for the discharge of that guilt in a request for
euthanasia is to risk putting to death a great many patients who do not
wish to die.

    "Conflict with aims of medicine". The pro-euthanasia movement
cheerfully hands the dirty work of the actual killing to the doctors who by
and large , neither seek nor welcome the responsibility.  There is little
examination of the psychological stresses imposed on those whose training
and professional outlook are geared to the saving of lives by asking them
to start taking lives on a regular basis.  Euthanasia advocates seem very
confident that doctors can be relied on to make the enormous efforts
sometimes necessary to save some lives, while at the same time assenting to
requests to take other lives.  Such confidence reflects, perhaps, a high
opinion of doctor's psychic robustness, but it is a confidence seriously
undermined by the shocking rates of depression, suicide, alcoholism, drug
addiction, and marital discord consistently recorded among this group.

    "Dangers of Societal Acceptance". It must never be forgotten that
doctors, nurses, and hospital administrators have personal lives, homes and
families, or that they are something more than just doctors, nurses, or
hospital administrators.  They are citizens and a significant part of the
society around them.  We should be very worried about what the
institutionalization of euthanasia will do to society, in general , how
will we regard murderers?  (Brody 89)

    "The Slippery Slope". How long after acceptance of voluntary euthanasia
will we hear the calls for non-voluntary euthanasia? There are thousands of
comatose or demented patients sustained by little more than good nursing
care.  They are an enormous financial and social burden.  How long will the
advocates of euthanasia be arguing that we should "assist them in dying".

    "Costs and Benefits".  Perhaps the most disturbing risk of all is posed
by the growing concern over medical costs. Euthanasia is, after all, a very
cheap service.  The cost of a dose of barbiturates and curare and the few
hours in a hospital bed that it takes them to act is minute compared to the
massive bills incurred by many patients in the last weeks and months of
their lives.  Already in Britain, There is a serious under- provision of
expensive therapies like renal dialysis and intensive care, with the result
that many otherwise preventable deaths occur.  Legalizing euthanasia would
save substantial financial resources which could be diverted to more
"useful" treatments.  These economic concerns already exert pressure to
accept euthanasia, and, if accepted, they will inevitability tend to
enlarge the category of patients for whom euthanasia is permitted...

    "Do not tolerate killing". Now is the time for the medical profession
to rally in defense of its fundamental moral principles, to repudiate any
and all acts of direct and intentional killing by physicians and their
agents.  We call on the profession and its leadership to obtain the best
advice, regarding both theory and practice, about how to defend the
profession's moral center and to resist growing pressures both from without
and from within.  We call on fellow physicians to say that we will not
deliberately kill.  We must say also to each of our fellow physicians that
we will not tolerate killing of patients and that we shall take
disciplinary action against doctors who kill. (Chapman 209)

    On the other hand some people strongly feel that euthanasia is not bad
and should not be looked down upon.

     Are there no conditions when life is meaningless and should be quietly
ended?  If a person is subject to pain that won't stop as a result of a
disease that can't be cured, must he or she suffer that pain as long as
possible when there are gentle ways of putting an end to life?  If a person
suffers from a disease that deprives him or her of all memory and makes him
or her a helpless lump of flesh that may live on for years.

       If euthanasia were legalized,it should be admitted that there might
be some abuses of virtually every social practice. There is no absolute
guarantee against that.  But we do not normally think that a social
practice should be precluded simply because it might sometimes be abused.
The crucial issue is whether the evil of the abuses would be so great as to
outweigh the benefit of the practice.  In the case of euthanasia, the
question is whether the abuses, or the consequences generally, would be so
numerous as to outweigh the advantages of legalization.  The choice is not
between a present policy that is benign and an alternative that is
potentially dangerous.  The present policy had it's evils, too.

    We spend more than a billion dollars a day for health car while our
teachers are underpaid, and our industrial plants are rusty.  This should
not continue.  There is something fundamentally unsustainable about a
society that moves its basic value-producing industries overseas yet
continues to manufacture artificial hearts at home.  We have money to give
smokers heart transplants but no money to retool out steel mills.  We train
more doctors and lawyers than we need but fewer teachers.  On any given
day, 30 to 40 percent of the hospital beds in America are empty, but our
classrooms are overcrowded and our transportation systems are
deteriorating.  We are great at treating sick people, but we are not that
great at treating a sick economy.  And we are not succeeding in
international trade.  When you really look around and try to find
industries the United States is succeeding in, you discover that they are
very few and far between.(Lamm 133)

    There is no way we are going to come to grips with this problem until
we also look at some of these areas that aren't going to go away . One of
the toughest of these is what Victor Fuchs called "flat-of-the-curve
medicine"- those medical procedures which are the highest in cost but
achieve little or no improvement in health status.  He says that they must
be reduced or eliminated.  We must demand that professional societies and
licensing authorities establish some norms and standards for diagnostic and
therapeutic practice that encompass both costs and medicine.  Wer'e going
to have to come up with some sort of concept of cost-effective medicine.

    Individuals have the right to decide about their own lives and deaths.
What more basic right is there than to decide if you're going to live?
There is none.  A person under a death sentence who's being kept alive,
through so called heroic measures certainly has a fundamental right to say,
"Enough's enough.  The treatment's worse than the disease.  Leave me alone.
Let me die!".  Ironically, those who deny the terminally ill this right do
so out of a sense of high morality.  Don't they see that, in denying the
gravely ill and suffering the right to release themselves from pain, they
commit the greatest crime?

    The period of suffering can be shortened.  If you have ever been in a
terminal cancer ward,  It's grim but enlightening. Anyone who's been there
can know how much people can suffer before they die.  And not just
physically.  The emotional, even spiritual, agony is often worse.  Today
our medical hardware is so sophisticated that the period of suffering can
be extended beyond the limit of human endurance.  What's the point of
allowing someone a few more months or days or hours of so-called life when
death is inevitable?  There's no point.  In fact, it's downright inhumane.
When someone under such conditions asks to be allowed to die, it's far more
humane to honor that request than to deny it.(Barry 405)

    People have a right to die with dignity.  Nobody wants to end up
plugged into machines and wired to tubes.    Who wants to spend their last
days lying in a hospital bed wasting away to something that's hardly
recognizable as a human being, let alone his or her former self?  Nobody.
The very thought insults the whole concept of what it means to be human.
People are entitled to dignity, in life and in death.  Just as we respect
people's right to live with dignity, so we must respect their right to die
with dignity.  In the case of the terminally ill, that means people have
the right to refuse life-sustaining treatment when it's apparent to them
that all the treatment is doing is destroying their dignity, and reducing
them to some subhuman level of humanity.

    The reasons just stated in favor of euthanasia are often over looked
due to the following arguments that are against euthanasia.

     The way you talk you'd think people have absolute right over their
bodies and lives. But that is obviously just not true. No individual has
absolute freedom.  Even the patient's Bill of Rights, which was drawn up by
the American Hospital Association, recognizes this.  Although it
acknowledges that patients have the right to refuse treatment, the document
also realizes that they have this right and freedom only to the extent
permitted by law. Maybe people should be allowed to die if they want to.But
if so, it's not because they have an absolute  right to dispose of
themselves if they want to.(Brock 73)

    Only a fool would minimize the agony that many terminally ill patient
endure.  And there's no question that by letting them die on request we
shorten the period of suffering.  But we also shorten their lives.  Can you
seriously argue that the saving of pain is greater good than the saving of
life?  Or that presence of pain is worse than the loss of life? Of course,
nobody likes to see a creature suffer, especially when the creature has
requested a halt to the suffering.  But we have to keep our priorities
straight.

    Pro euthanasianists make it sound as though the superhuman efforts made
to keep people alive are not worthy of human beings. What could be more
respectful of human life, than to maintain life against all odds, and
against all hope?   All of life is a struggle and a gamble.  At the gaming
table of life, nobody ever knows what the outcome will be. " Indeed, humans
are noblest when they persist in the face of the inevitable.  Look at our
literature.  Reflect on our heroes.  They are not those who have
capitulated but those who have endured.  No, there's nothing undignified
against being hollowed out by a catastrophic disease, about writhing in
pain, about wishing it would end.  The indignity lies in
capitulation".(Buchanan 208)
                                                                  

                        BIBLIOGRAPHY
    Friedman,Emily. Ethics Issues For Health Care Professionals.
     Baskerville: American Hospital Publishing, 1986.

    Maguire,Daniel. Death By Choice. Garden City: Doubleday &
    Company,1984.

    Reich,Warren. Quality Of Life. New York: Paulist Press, 1990.

    Brody,Baruch. Life And Death Decision Making. New York:
    Oxford University Press,1988.

    Chapman,Carleton. Physicians,Law,& Ethics. New York: New
    York University Press,1984.

    Maestri,William. Choose Life And Not Death. New York:
    Library Of Congress,1986.

    Low,Charlotte. Euthanasia - Opposing Viewpoints. San Diego:
    Greenhaven Press,1989.

    Brock,Dan. Deciding For Others. Cambridge: Cambridge
    University Press,1989.

    Barry,Vincent. Moral Aspects Of Health Care. Belmont:
    Wadsworth Publishing Company,1982.

    Current,Richard."Death".The World Book Encyclopedia,1986 ed.

    Gibbs,Nancy. "Dr. Death Strikes Again" TIME, 54 (November 4,1991),
































 


  




