In the last 20 years, the use of the term bioethics primarily focuses on an investigation and a study of the decision-making tendencies in medicine and science. These decisions usually affect both the health and lives of individuals, the society and the environment in which we live. On a fundamental basis, bioethics typically concerns itself on formulating moral grounds on questions that regard basic human values such as the right to health, life, and death. Moreover, bioethics further expands on the rightness or wrongness of particular progress in medicine, technology, and the responsibility of the society to accord proper health and life to its members. Therefore, on pertinent issues within the society, bioethics can influence every level of human community from the local health centers to the huge international conferences. As a branch of applied ethics, bioethics needs the expertise of various people who work in extensive disciplinary ranges such as philosophy, law, theology, medicine, life sciences and much more. In essence, while looking at bioethics, indispensable values such as human life, dignity and health care accentuate its need and virtuous practice. This paper presents a case study on a controversial contemporary bioethical question that remains unsolved to date.
The case of Miss Nancy Cruzan and her battle with the Supreme Court on the applicability of euthanasia, a bioethical controversy that accords families the right to die with dignity, was perhaps the most debated cases of all time on this pertinent bioethical question. The case of Miss Cruzan morphed into a centerpiece depicting lengthy and bitter debates concerning the right of families to remove medical treatment and nourishment resulting in the eventual death of a loved one who is seriously ill or incapacitated. In an article published in the New York Times on December 27, 1990, the case of Miss Nancy Cruzan underwent in-depth analysis resulting in shifting bioethical remarks and stands. According to a representative from the Society for the Right to Die, the Cruzan case brought about national attention on the issue of euthanasia in a way that was unprecedented (Lewin, 1990). The representative further notes that while the Cruzan’s’ has undergone intense ghastly agony, the public has been educated on the issues of euthanasia or mercy killing. Incentivisation of euthanasia has consequently led to an acquisition of the necessary motivation to obtain living wills and the comprehension of legislations that enable people to plan. However, concerning the moral value of using and encouraging euthanasia, its significance may sometimes be a peril rather than a solution. This is so since during the case, numerous protests ensued, and people made statements that were contrary to the practice of euthanasia.
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Euthanasia has seen a long journey of endless debate since the immense publication of the Cruzan case. Mixed reactions and varied opinions have encompassed its use and validity. During the Cruzan case, outspoken individuals such as a reverend denounced its applicability and consideration in any situation; categorically stating his sympathies for the hardship of looking after a helpless woman. However, Rev. Joseph Foreman further stated that no sympathy should be directed to a family that elucidates their problems through euthanasia while there were bona fide offers willing to take care of the patient (Lewin, 1990). Such a stance, which is contrary to the implementation of this controversial medical procedure, shows the complexities of this issue and the bioethical inferences involved. In essence, what Rev. Joseph Foreman was implying was that euthanasia is the taking of human life, a killing to be precise. Another reason why this controversy persists is that according to the Hippocratic Oath, a doctor’s mandate is to preserve life and not take it. Therefore, by allowing the practice of euthanasia, doctors would be going against their medical ethics, and this may bring about the emergence of rogue doctors who take life without necessary repercussions.
The Nancy Cruzan case brought about numerous discussions concerning life support from the circles of doctors to homes as families could now openly discuss this bioethical issue. Presently, public proposals on the best way to die keep on surfacing suggesting a much freer society on the question of euthanasia (Montgomery, 2015). Cruzan’s case also brought about changes in the legislation as the Supreme Court’s first ruling on the case recognized the right to die. However, the court was categorical in stating that it was the patient’s prerogative and not the family when it came to the decision to take life. This resulted in increasing interests on the changing of living wills and other directives that accorded the chance to spell out in advance, the mode of treatment and the transfer of decision-making abilities in the event of patient incapacitation. This ruling also led to the Congressional passage of the Patient Self –Determination Act that took effect in November 1991 (Lewin, 1990). Under this ruling, nursing homes and hospitals gave patients advance directive forms, which provided right-to-die options under the laws of a given state. However, the Supreme Court ruling did not set precise national guidelines, leaving the states to set their laws regarding euthanasia.
For eight years, Nancy Cruzan was kept alive by a feeding tube when a Jasper County judge permitted her family to remove feeding and hydration, effectively ending her life. Years after this decision, proposals that support euthanasia continue to surface and intensify. In 2015, the governor of California, Jerry Brown, signed a measure that cleared the way for the prescription of drugs that allowed terminally ill patients to end their lives. Commensurately, more than two states are eying the “death with dignity” bill, such as Kansas and Missouri. While their passage is highly unlikely, this trend raises the significant question on the ethical basis of euthanasia and its applicability in different medical situations. In an article depicting the impact of the Supreme Court decision on the Cruzan case, those who had hoped that the Supreme Court would give families the constitutional right to remove life support from a patient are disappointed as there is no known national mechanism to do so ("The Impact of Cruzan", 2017). Furthermore, the bioethical standpoint of pivotal institutions such as the American Medical Association shows that this organization supports life termination on the basis that it is the patient’s prerogative ("The Impact of Cruzan", 2017). In addition, the ethical side of the physician is also placed into consideration as they are also affected by euthanasia. Although physicians are trained to uphold the Hippocratic Oath, there are those elements who view treating terminally ill patients as an inconvenience thereby resulting in controversies concerning euthanasia and as a bioethical issue.
Ultimately, the Cruzan case paved the way for the consideration of euthanasia as a viable option in cases whereby terminally ill patients undergo suffering. While the law has not completely allowed the use of euthanasia, different versions of it have surfaced through bills accentuated by state legislations. The major bulk of resistance comes from right-wing parties and moral institutions such as churches as they view mercy killing being akin to murder in its essence. While some medical practitioners consider euthanasia as being just another medical procedure, others see it as a method that undermines their medical profession and their essential medical oath. Overall, as a bioethical issue, euthanasia will continue to be a germane issue in the society eliciting different opinions and mixed reactions.
Annotated Bibliography
Lewin, T. (1990). “Nancy Cruzan Dies, Outlived by a Debate over the Right to Die.” The New York Times, Accessed 23rd July, 2017 from http://www.nytimes.com/1990/12/27/us/nancy-cruzan-dies-outlived-by-a-debate-over-the-right-to-die.html .
The article begins by describing the state Nancy Cruzan was in and her death after her accident, which the writer termed as “vegetative.” She was in that state due the car accident that she had succumbed to a couple of years back. The article then goes on to talk and illustrate how weak and rigid she had been after the accident as it had left her completely paralyzed. This led her to being fed using a feeding pipe. Additionally, it speaks on how her family saw no need in caring for her, as she was helpless and thus moved to court looking for a ruling that will enable them to stop the feeding process. The state of Missouri, which had been paying for her hospital bill, did not agree with it and took the issue to the Supreme Court where eventually Cruzan won. A judge by the name of Teel ruled in Miss Cruzan’s favor, the feeding tube was removed, and she died a few days later.
Montgomery, R. (2015). “Nancy Cruzan’s legacy: Open talk about death with dignity,” The Kansas City Star, Accessed 23rd July, 2017 from http://www.kansascity.com/news/business/health-care/article51696025.html .
This article begins with describing the trauma that Cruzan’s niece is going through 25 years later after the death her aunt. It talks on how most of her family members died through their own wishes. It describes on how Cruzan’s death brought about an endless debate on matters of ending lives and quotes the 1990 issue of The Kansas City Star, “Discussions about life support and medical treatment moved from doctors’ circles to dinner tables.” It then goes on to talk about how Governors from other states have signed bills that gave doctors and physicians the right to prescribe or administer drugs to end the lives of patients with incurable diagnoses. It has been nicknamed “death with dignity” and states like Kansas and Missouri are weighing it. Cruzan’s niece until to date does not support doctor assisted suicide.
The Impact of Cruzan . (2017). Biotech.law.lsu.edu . Retrieved 27 July 2017, from http://biotech.law.lsu.edu/books/lbb/x346.htm
This article illuminates the disputes that came after the ruling on Cruzan’s case. People thought the right of the family to decide when to end the lives of a loved one. They did not see it right for a physician, an outsider, to be deciding that. It further goes to say that “The American Medical Association” is in favor of terminating the lives of patients in life support. In addition to all that, it speaks on the implications and financial constraints that families with loved in intensive care are faced with and that assisted suicide is the best way to go about saving these families from debt. It ends by describing how man has lost his sense of humanity as he sees intensive care as death prolonged rather than life being preserved.
