Thursday, March 5, 2009

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

Tuesday, March 3, 2009

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.