The term euthanasia is one of the most controversial terms considering ethical practices in the medical field. The term originated from the Greeks to connote a good death. Euthanasia is practiced in two main dimensions as either passive or active. In the case of active dimension, there is the employment of activities such as deliberately introducing a drug to cause death. In the passive form, the practice employs withholding or denying the patient all the necessary life-supporting equipment at the health center, for instance, those at the intensive care units. This article entails the discussion on euthanasia through comprehensive analysis so as to give a response as to whether its practice is justifiable or health decisions supersedes the ethical practices.
It should be remembered that this practice involves some level of consent from either the patients themselves or the guardians of the patients. In a situation whereby the patient gives a consent then its termed as voluntary. Nonetheless, when the consent is given by the guardian due to the patient’s inability to give consent then the process is termed as involuntary. The last case is known as the physician-assisted in which a medical expert prescribes a medication which is administered by either the guardian or the patient himself (Math & Chaturvedi, 2012).
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There have been debates concerning the act of premature ending of life in which some people argue that it is unethical as far as medical practice is concerned. The issue is holistic in its coverage as it touches in almost all aspects of life. There are legal concerns, ethical issues in the medical field, spiritual and religious conflicts, social and cultural norms and most importantly the human rights as stipulated in Article 2 of the American constitution. The issue of euthanasia is drawing a lot of support from the people who feel that a patient should not be left to undergo pain and suffering yet there is a solution such as ending life. However, for the opponents of the act, there is a need to grant the patients the deserved autonomy in which they should be given the right to life.
In their arguments, the opponents of euthanasia believe that if there is embracement of death with validity citing the medical complications as the reason for the decision, then there is a problem with people of incurable diseases. Importantly, they give an alternative to the situation whereby they settle on the palliative care. According to their arguments, palliative care is more active creative and is in a position to provide relief from the pain and even the symptoms. In addition, it is likely to give relief both to the caregiver and the patients.
According to the Indian constitution, there is a provision for the right to life as contained in Article 21. This provision is only applicable in the case of natural death. Therefore, any incident such as suicide which is considered unnatural termination of life is not applicable in this article. The duty of the state is to provide life security to the people. On the same note, the medical practitioners are given an obligation to ensure that they protect the lives of individuals medically. There are negative consequences in case there is the legalization of the euthanasia in a country. First, there is the possibility and likelihood that the state may cut funds meant for health and medical care for the people deemed incurable. Second, there will be incidences of neglect from the medical caregivers (Math & Chaturvedi, 2012). Looking at cases in the Netherlands, there is a decline in the level of medical care with the introduction of euthanasia as many patients who have been declared terminally ill receive less attention and medical services. With these incidences, it is evidently convincing to the opponents that legalization of the act will lead to a laxity in medical provision. Additionally, there is the likelihood of the state not putting to task its officials and even supporting the medical care for the patients deemed incurable.
The opponents of euthanasia are enriching their arguments giving cases of suicide in which those who have attempted suicide are seen as undergoing depression and mental challenges. In their case, there has been involvement of psychiatrist services to evaluate their situation and give the formidable solutions to their cases. Pegging the argument from this, it is important for the medical personnel to apply the psychiatrists’ services in incidences where a patient has applied for euthanasia
There are counter-arguments from those who are in support of euthanasia in which they point at the burden faced by the health providers and other caregivers. They point out that those with incurable conditions and defects should be given the right to die. The caregivers’ sufferings are inflicted in all aspects of life ranging from the financial, emotional, mental, social, mental, social and physical wellbeing. They are for the idea that the state should not claim that there is a right to life when they are not capable of financing the medical proceeds emanating from the care given to people of extreme medical conditions like severe mental illness.
Patients have the right to refuse treatment and this is well enshrined in the legal documents. This gives the chance for the application of the passive euthanasia. The same case applies to the incidents of abortion committed on a 14-week pregnancy and even other abortion cases in which an unborn child is seen to pose danger to the mother.
To summarize these arguments, it can be prudent if the state gets involved in the provision of medical care and giving the necessary support to the medical caregivers so as to ensure that there is a reduction to the burden linked to the sufferings undergone by the medical caregivers. In case this is done, there is the likelihood that the people in support of euthanasia may reconsider their stand (Math & Chaturvedi, 2012).
From these antagonistic arguments, it is appropriate to point out that the issue of euthanasia is of great concern not only to the patients and their family members but to the medical field and the state in general. Thus, when the state and the health practitioners can collaborate aptly then the incidences of euthanasia cannot be an alternative in the medical field.
As concerning the ethical observations by the doctors in the practice of euthanasia, there is a well-stated oath sworn by all health practitioners on how to deal with patients. It is stated well that the role of a physician is to protect the life of the patient at whatever cost and conditions. However, these traditional oaths have been breached by the current health practitioners. Taking, for instance, the case of abortion, there is documentation that the practice is unethical. However, many people have come to terms with the reality that the case of abortion should be a matter of privacy between the patient and the physician.
According to Gail (2013), there are many practices carried out by modern physicians which otherwise could have been unethical in ancient times. Taking, for instance, the case where the life supporting machine or other equipment is withdrawn from the patient who is seen as incurable can be seen as unethical. However, modern medical practice views this as necessary depending on the circumstances at which physicians find themselves in. As per Gail’s argument, the act of ending the life of a suffering patient is mistaken by the opponents in that the patient would otherwise request for it. The conflict is seen with the perception of the patients who believe that their dignity at the ending life is of more importance and they will request for euthanasia was they realize that their dignity is in jeopardy. The issues of spirituality and social needs pose more challenging phenomenon to the patients. Even though most of these patients have confidence that their pain will be dealt with at the end of it, they are worried about their spirituality and social life.
According to these arguments, it is obvious that there is an existence of ethical conflicts between the traditional health practices and the current or rather modern health practices. As seen it was unethical for the physicians to initiate any activity which would facilitate or result in the death of patients. However, with the modern practice this is seen as part of the choice of relieving the pain of the patient. As a matter of analysis, it is inappropriate for the physicians to initiate the death of their patients even at the request of the patient. This argument is informed by the fact that the health practitioners may exploit the loopholes to start performing euthanasia even to the patients who do not need it like in the case of Netherlands where half of the population euthanized did not consent for the same (Gail, 2013).
From the ethicists point of view, there is no problem in patients recommending euthanasia which results into dignity upon the death of the patient. It is argued that there is no difference in killing and allowing the patient to die. According to the modern perspective of ethics and the physicians at large, there is a principle of balancing whether the happiness resulting from the procedure will outdo the unhappiness of the current situation of the patient. With this it is clear that the decision for euthanasia is brought about by the contention between happiness and unhappiness. With the analysis of the aspect of happiness, merciful killing becomes one of the options. Thus, merciful killing of the patient in an incurable condition remains to be a moral act (Nunes & Rego, 2016).
In many parts of southern European countries, it is illegal to take the life of a person whatever the circumstances dictating otherwise. However, there are evolutions which have taken place in these countries which may create a softer landing for the practice of euthanasia. The reduction in the influence of Catholicism in the better part of European countries, the increase in the number of people preferring small families and the incidences of long life expectancy has changed society’s view. Many people especially the elderly are contemplating euthanasia as they have no people to take care of them at the old age. Regarding the ethics in this argument, most of the patients who are terminally ill feel that there should be the inclusion of euthanasia in the medical practice as it is in line with the elements of self-determination. According to these patients, the physicians should put it as part of the profession. What makes the patients to consider euthanasia is the fact that they do not have people to take care of them and contemplating self-care becomes stressful to them (Nunes & Rego, 2016).
The most important aspect of the decision on euthanasia is whether it is voluntary or involuntary from the perspective of the patient. In this case the consideration is given to the people who are vulnerable to decision making about their lives. It is essential to note that the physicians are also protected through the world ethical standards in which they are given right to self-conscience. With this, the physician has a right to object to euthanasia if it will infringe his conscientious standing. Through this discussion, it is significant to assert that the decision of the patient is paramount and it is what should determine whether there should be euthanasia or not. Second the conscience of the physician must be evaluated by the physician himself so as not to bring the challenges of thoughts. Lastly, as a point of analysis it is logical to dig deeper and detail out the moral and mental standing of both the volunteer patients and those who have not volunteered. In all these it is important that those patients who have not accepted the act should not even be convinced to contemplate it. In addition, the other alternatives should be exploited.
There is complexity in the argument of the euthanasia both within the legal and ethical contexts in that there is seen shape contradictions. Looking at it in the ethical perspective, it is ethically unacceptable for a health provider to facilitate the death of his patients at whatever conditions they may find themselves in. Again it is an issue of ethics for the patients to be given the autonomy and self-determination by the health provider. This leaves the doctors in a point of dilemma on what ethical mandate stands most. In the argument, when the state or any other outside source intervene through the legal framework on the personal issue such as pain and suffering then moral applications become inevitable (Harriss, 2005).
There are instances where there are conflicting interests between the dying patients and those close to them in regard to property and responsibility. In such cases the autonomy of the patients is disregarded with the state intervention. However, there is need for the application of the law to offer protection for both parties. In application of the law, there is a need for the consideration of morality. According to Harris (2005), there is bias in the natural law in that it is pegged on one angle thought which is dictated by a given supreme law and being such as God’s commands thus do not accommodate logical reasoning. However, the decision of a dying individual is based on his perception on the future, the present or the past and how that relates to his condition.
The argument, in this case, becomes complicated as there is contention between the set-out rules and the logical reasoning. The natural law dictates what individuals are expected to do at whatever condition. For instance, people are not allowed to kill. On the same note the logical reasoning may require that there is mutual understanding between the dying person and the physicians regarding euthanasia which will require no application of the natural law between the two. But as the author puts it, there is the need for the implementation of both the law and morality in going about these issues.
Human beings have the right to live, and this principle should form the utmost consideration by any health official dealing with a patient in his dying moments. Since modern societies are contemplating legalizing euthanasia, they should be guided by the respect for the right to life of an individual. Again, in whatever way people may view the issue of euthanasia the fact remains that it is unethical and should not be considered (Keown, 2018).
Conclusion
In summary, the life of an individual is essential not only to oneself or society, but to the conscience of all individuals. Any legal, ethical or professional argument geared towards ending an individual’s life should be disregarded at whatever cost. It should be known that nobody including the victim of the dying patient has the right to take life. Death is like birth where people cannot choose to be born but find themselves on earth. Provided there are laws protecting people’s lives they should be considered as the only abiding norms which should be followed. It is prudent that the rules of the right to life should override the self-determination and autonomy of the patients.
References
Gail Van Norman, M. D. The Ethics of Ending Life: Euthanasia and Assisted Suicide, Part. CSA Bulletin , 66.
Harriss, I. (2005, September). Ethics and euthanasia: natural law philosophy and latent utilitarianism. In 12th Annual Conference of the Australian Association for Professional and Applied Ethics, Adelaide (pp. 28-30).
Keown, J. (2018). Euthanasia, ethics and public policy: an argument against legalisation . Cambridge University Press.
Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: right to life vs right to die. The Indian journal of medical research , 136 (6), 899.
Nunes, R., & Rego, G. (2016). Clinical Research & Bioethics. Routledge.
