According to the Experts

1. "By withdrawing life supports, the doctor is only respecting the patient's wishes regarding medical treatment, not intending the death of the patient. That the patient may be refusing treatment because he wants to die is irrelevant—the right itself is a safeguard to prevent doctors from abusing their power, not an acceptance that hastening death is ever appropriate." -- James D. Torr (Greenhaven Press - Opposing Viewpoints)
2. “Above all, I must not play at God”  -- Hippocratic Oath
   
3. “Persons with mental illness or Alzheimer's disease, deformed infants, and retarded or dying children would thus be denied our new humane "aid-in-dying." But not to worry. The lawyers, encouraged by the cost-containers, will sue to rectify this inequity. Why, they will argue, should the comatose or the demented be denied a right to assisted suicide just because they cannot claim it for themselves? With court-appointed proxy consenters, we will quickly erase the distinction between the right to choose one's own death and the right to request someone else's.”  -- Tamara L. Roleff (Greenhaven Press - Opposing Viewpoints)
   
4. “The common law definition of  ‘death’ was legislatively expanded to include ‘whole brain death’ (beginning with Kansas legislation in 1970)”  -- Clarke D. Forsythe (PROTECTING UNCONSCIOUS,  MEDICALLY-DEPENDENT PERSONS AFTER WENDLAND & SCHIAVO - Ebsco)
5. “Physicians have a duty to provide adequate medication to relieve pain, yet high doses of pain relievers such as morphine can be lethal. The doctrine of double effect, a respected principle of medical ethics, holds that a doctor may prescribe high doses of morphine in order to relieve pain. If the dose also results in the death of the patient (the double effect), the doctor's act is considered ethical as long as his intent was only to relieve pain. For similar reasons, intending to remove unduly burdensome treatment is acceptable even if, as a secondary effect, it ends up causing death”  -- James D. Torr (Greenhaven Press - Opposing Viewpoints)
   
6. Physicians who prescribe medication “often or in large amounts for particular patients” are at risk of being prosecuted by the Drug Enforcement Agency.  -- Jane E. Brody (Terminal Options for the Irreversibly Ill - NY Times
7.  “Patients can refuse unwanted treatment if they are mentally competent, or a health care agent can make the request for them if the patients had previously completed a living will and health care proxy” --  Jane E. Brody (Terminal Options for the Irreversibly Ill - NY Times

The Rest of the Arguments

Argument 2 - Non-voluntary Active Euthanasia 

My stance on non-voluntary active euthanasia falters every time i read more information. My final decision on the matter is the non-voluntary active euthanasia is not moral, nor should it be legal, under most circumstances.  However, I feel there are certain situations where it can be considered acceptable. In 1970, Kansas legislation began a movement which led to the creation of a common law definition of "death" that was legally extended to include "whole brain death".  I feel that in scenarios where the patient is completely and irrevocably brain dead, non-voluntary active euthanasia is moral; and based on the common law definition of death, it is also legal.  When the patient has no brain function whatsoever, any means of keeping them "alive" is hopeless.  Hospital bills will continue to increase and days will pass by without providing solace for loved ones because they will know that their family member has zero chance of recovering.  In essence, the patient is no longer anything except a shell of their former selves. There must be thorough, foolproof tests administered to all patients who are in comas in order to determine whether their brains are functioning or if they are totally "brain dead".  Again, as is the case with passive euthanasia, the presence of advance directives helps to make such situations more clear cut. 

Nonetheless, non-voluntary active euthanasia is wrong in all other cases.  Kate Adamson-Klugman is one example of why it is unacceptable.  She was left paralyzed after a double brainstem stroke.  Suffering from “locked-in syndrome”, Kate was fully awake and aware of her surroundings but was unable to make people aware of this. She was able to feel everything that happened to her and heard everyone around her as they spoke of her as unresponsive.  Her husband Steven acted as her advocate and never accepted the idea that Kate would die.  In such situations, it is completely immoral to remove the patient from feeding tubes and life support because though they are unable to say so, they may wish to accept treatment and live. Kate made a full recovery, aside from her left side being paralyzed, and she now acts as an advocate for protecting others from what almost happened to her.  Who can truly make the decision when to "pull the plug" on a patient as if they were a kitchen appliance?  Even when people are in a coma, they are living creatures that must be protected.  

The moral and legal implications of non-voluntary active euthanasia are the hardest of all other forms to nail down.  Therefore, non-voluntary active euthanasia must be governed by strict laws that have specific restrictions and regulations.  These laws must protect people who cannot speak for themselves but who are still alive.  If there is any shadow of a doubt regarding a person's brain function, non-voluntary active euthanasia is not right. Only in scenarios where there is absolutely no brain function and no chance of "life" can non-voluntary active euthanasia be legal or considered moral. 

Argument 3 - Voluntary Active Euthanasia 

Voluntary active euthanasia is not moral and should not be legal.  This form of euthanasia is when the patient requests help to die and the physician administers the lethal drug with the intent to kill. According to the doctrine of double effect, a doctor can prescribe high doses of medicine with the sole intent to relieve pain. If the medication results in death, the doctor remains blame-free because his actions were to treat the pain only.  This is the double effect. Active euthanasia does not fall under this doctrine because the main intent is to cause death, not to relieve pain. Therefore, it is not considered morally acceptable nor is it deemed acceptable medical treatment.  Furthermore, if a patient truly wants a way out, they can do it naturally and by themselves, without lethal doses of medication from physicians who would be denying their duty as care-givers.  The organization Compassion and Choices proposes to ill patients that seek their advice the idea to stop eating and drinking.  This way is completely legal and in no way jeopardizes the morality of others.  It is a slow, peaceful process and it allows the patient to say goodbye to family members or change their mind should they decide they want to live.  It also leaves a doctor free of blame because they are not administering harmful doses of drugs. Physicians who prescribe medication “often or in large amounts for particular patients” are at risk of being prosecuted by the Drug Enforcement Agency. 

Some would argue that a patient has a "right to die" and they should be able to request death.  However, doctors have rights that must be protected as well.  Most physicians would not feel comfortable killing their patients, even when asked to do so, because it goes against their morals.  Even if a doctor agrees with the patient who wishes to die, it is very likely that they would be punished for their involvement.  The actual administration of lethal doses of medication with the purpose to kill is murder - there is no getting around that fact. 

Argument 4 - Physician-assisted Suicide

Physician-assisted suicide is very similar to active euthanasia.  It is immoral, and should not be made legal.  As of now, it is only legal by law in two of the fifty U.S. states, and declared legal by a court order in Montana.  This is considered one of the most humane forms of euthanasia and proponents of it don't see it as a medical abomination because the patient administers the drug on their own.  However, the fact that the means for suicide are provided by the physician make this form of euthanasia immoral and illegal.  It jeopardizes the professional and moral standing of the physician involved and puts them at risk of being prosecuted. Like active euthanasia, it is wrong in the sense that the intent of the medication is to kill, not to treat pain.  Jack Kevorkian, the physician often referred to as Dr. Death, was convicted in one of 130 second-degree murders for assisted suicide and imprisoned for eight years. He injected a lethal does of medication in a 52 year old patient suffering from Lou Gehrig’s Disease and televised the death. If one person is arrested for physician-assisted suicide, all doctors should be. 

Argument 1 - Passive Euthanasia

Passive euthanasia is morally acceptable and should be made legal. This form of euthanasia is when life support, such as feeding tubes and respirators, are withdrawn or omitted. The patient is fully competent and aware of these actions and chooses to be taken off of artificial means of survival. This method is moral in the sense that it doesn’t involve killing, it is merely “letting die”. While this might sound unacceptable, all it is doing is allowing the terminal illness or disease to take its natural course. The Vatican claims that “disproportionate” means should not be taken to keep a body living, but they insist that feeding tubes and the like are “proportionate” and therefore must be used. However, when a patient is totally dependent upon respirators and artificial nourishment, this places a heavy mental, physical, and financial burden on them and their family members. If the means of survival are essentially the only things keeping them alive when they’ve lost control of body functions and other physical capabilities, when they’ve suffered immense pain and succumbed to incurable disease, the life support is futile. It may keep their body alive, but their spirit, will, and reason to live have all diminished. The Vatican should re-evaluate what they consider to be the “heavy burdens” that distinguish between proportionate and disproportionate methods of survival. For these reasons, passive euthanasia is morally acceptable.

It should also be legal because it is not injecting or prescribing lethal doses of medication to cause death. It does not put doctors at risk with the Drug Enforcement Association for providing lethal medication nor does it incriminate them for “murdering” a patient. They are just listening to the consent of the patient. In the absence of advance directives, which are documents or health care proxies that inform the doctor what the patient wants in terms of treatment and survival means, many claim that the doctor should keep the patient “alive” at all costs. If the patient has a living will that calls for no artificial means of survival, it is not considered wrong when they are taken off of life support and left to handle whatever natural direction the disease takes. But if the patient is without a living will, this same request to be taken off of artificial means of life is viewed as suicide and is therefore deemed unacceptable. In reality, the living will is no different from a competent patient’s request, and therefore passive euthanasia should be legal.

Pros and Cons

Pro: Proponents of euthanasia believe that it is acceptable because it helps people die a dignified death. They think that when death is in sight and damage to health is irrevocable, euthanasia is a way to ease suffering and end the pain. Additionally, they feel that being able to die before the illness takes over body and mind helps to keep a patient’s quality of life from deteriorating. Financially, many argue that once a person has shown no signs of life, for example when they’ve been unconscious or in a coma for a long period of time, it is more sensible to remove the expensive forms of life care that are keeping the brain-dead person alive. That way, the family will not be plagued by expensive health bills resulting from futile efforts to nourish a person who shows no sign of recovering. Furthermore, with advance directives like living wills and health care proxies, it is legal that treatment can be withheld and proponents of euthanasia argue that if that is legal, other forms of euthanasia should be as well. They feel that a doctor is not going against his job if he can “let die” rather than kill the patient.

Con: People who oppose euthanasia are very passionate about their arguments. Many feel that it is God’s decision that mandates who should be taken and when they should be taken from the earth. They feel that it is not a doctor’s right to make the decision about whether a person should live or die. Furthermore, the church condemns euthanasia and considers it to be murder. Other groups are focused more on the legal aspect of euthanasia rather than the religious. They claim it goes against the Hippocratic Oath of a doctor and places them in the position of being sued or arrested. Additionally, they worry about the individuals who are in a coma or otherwise unable to voice their opinions and who don’t have advance directives. They believe that if someone cannot express what they wish to happen to them, it is not the doctor’s right to decide whether or not they will survive.

Me: I believe that there are certain forms of acceptable euthanasia and other types that are immoral. I sympathize with people who claim that the quality of life is greatly diminished once someone succumbs to a disease and they cannot ever recover. I also believe that it is a patient’s individual right to decide if they want to withhold treatment or not. I don’t, however, believe a doctor should administer a drug for the purpose of killing someone nor do I feel they should prescribe medicine for a person to take with the intention of killing themselves. I think if a person really wants to die, it is not the doctor’s job to make that happen.

Entry 1 - Introduction

The issue I’m going to research is Euthanasia.  The topic has been the focus of debate in the medical field for several decades.  It has grown more controversial in recent years due to the tragic case of Terri Schiavo and the arrest of Jack Kevorkian, the doctor commonly referred to as Dr. Death.  There are several types of euthanasia: voluntary active euthanasia, passive euthanasia, non-voluntary euthanasia, and physician-assisted suicide.  Some people view these practices as moral because they allow the patient to “die with dignity” rather than suffer a prolonged death. Others believe any form of euthanasia is unethical and immoral because they feel it goes against a doctor’s profession and interferes with God’s will.  Still others find certain forms to be acceptable while deeming others objectionable. So far, the amount of research I’ve done, the information I’ve collected, and my own personal experiences have led me to sympathize most with this last group. Currently, my great aunt is very ill and her poor health has prompted family discussions about living wills, health care proxies, and the quality of life.  My research paper is going to focus on the different forms of euthanasia as well as the legal and moral implications that accompany each.  What role does religion play? What role does the state play? What other factors decide whether each form is an act of compassion or murder?