Debate Paper
Katherine Lund
XBCOM275
October 13, 2013
Tynia Landry

Debate Paper
Imagine being terminally ill and in an insufferable amount of pain; would you prefer to suffer or permanently relieve the pain? Until 1999, a man by the name of Jacob “Jack” Kevorkian offered assistance to people who wished to end their own life with a physician assisted suicide also known as Euthanasia. The term Euthanasia was first used in the 17th century as a medical term to describe an easy, painless, and happy death. There are two types of Euthanasia, passive and active. Passive euthanasia is when a patient refuses their medical treatment which may hasten their passing; this is also considered legal euthanasia. Active euthanasia is the acceleration of death by the use of drugs and it can be either physician assisted or done by the patient themselves and is also considered illegal euthanasia. While active euthanasia is illegal in most of the United States as well as the world, there is controversy that it should be the terminally ill patient’s choice as to whether or not they live in pain or suffer. How can helping someone relieve pain and suffering be illegal?
The ethics of euthanasia have been a debate since the 1800’s, with debates peaking every couple of decades. Many of the debates against euthanasia fall back to the ethics and how euthanasia can be used as a solution to lower medical costs, a failure to provide care for people with disabilities, or even that the doctor themselves would be going against the very Hippocratic Oath they are sworn to. First and foremost euthanasia was first used to relieve terminally ill patients from pain and suffering only if that patient was able to provide consent to the physician for an assisted death. Dr. Kevorkian performed his first physician assisted death in 1990 on a 54 year old woman who suffered from Alzheimer’s disease which resulted in Dr. Kevorkian being charged with murder. Charges were dropped in December of 1990 because Michigan, at that time, had no laws prohibiting assisted suicide and his medical license revoked. Even though the intent was and is good there is always the potential for abuse. The laws against euthanasia or physician assisted death (PAD) are in place to help protect patients from the possibility of unethical doctors or others. For instance, a terminally ill patient does not want to end their life via euthanasia or physician assistance however the family feels they cannot cover medical costs and feels that euthanasia would be cheaper than the medical expenses to keep the patient alive. The drugs used to perform euthanasia or PAD usually cost in the range of $50.00 to $75.00 which would definitely be cheaper than the medical care and treatment to keep the terminally ill patient alive and comfortable; this would be the perfect scenario for an unethical doctor or even family member to either coerce the patient into agreeing or deciding themselves that euthanasia or PAD would be the best choice. The intent of the laws was not to keep terminally ill patients in pain or to drag out the suffering but to keep people honest and ethical. Another scenario that has occurred back in the 1980’s resulted in the Baby Doe Legislation. In 1982, a baby with Down syndrome whose parent’s decided to decline the medical treatment needed to save his life not because the treatment had any risks but because the child was disabled intellectually. After an increase in infant deaths that had disabilities the government then enacted the Baby Doe Legislation which would withhold federal funds to hospitals that did not perform lifesaving treatment or procedures on newborns that were expected or showed signs of having a disability. This is just another way to keep hospitals, physicians, family members honest and ethical. Finally, the Hippocratic Oath is an oath that is taken by medical professionals where they swear to practice medicine honestly. If the physician was to help a patient perform his or her own suicide it would go against one of the lines in the oath, “I will give no deadly medicine to any one if asked, nor suggest any such counsel”. By a physician giving or providing the drugs needed to help the patient commit suicide they are violating the very oath they took when they began practicing medicine. How can a physician break an oath they were sworn to uphold??
It is easy for a physician to break an oath that they were sworn to uphold, people that are pro euthanasia find this especially true if that oath has been modified many times to fit with the changing times. Several institutions acknowledge the change of the oath so that it could be modernized and very few still use the original Hippocratic Oath while there are several different variations that are used worldwide. “Over time the Hippocratic Oath has been modified on a number of occasions as some of its tenants became less and less acceptable. References to women not studying medicine and doctors not breaking the skin have been deleted. The much-quoted reference ‘do no harm’ is also in need of explanation. Does not doing harm mean that we should prolong a life that the patient sees as a painful burden?” (Nitschke, 5/18). If prolonging the life of a terminally ill patient result in more pain for the patient then the physician is ultimately doing harm to that patient. It is definitely a perspective on the term ‘do no harm’; also if the family and medical staff are prolonging life that has no quality and is painful they are denying the patient the right to die. The right to die is essentially the “right of a competent, terminally ill person to avoid excruciating pain and embrace a timely and dignified death… The exercise of this right is as central to personal autonomy and bodily integrity as rights safeguarded by This Court’s decision” (Nitschke, 5/18). Basically a person’s right to die is the wish that their caregiver stop treatment and allow death if their recovery is highly unlikely, also known as passive euthanasia. Between the years of 1990 and 1998 Dr. Kevorkian admitted to assisting in 130 suicides where the patient was the one that took the final action that took their life. The patient was competent enough to take the final step that would result in their death. Even though all of these PAD’s were voluntary, Dr. Kevorkian was convicted of second degree murder as he was practicing without a medical license. Which brings into question living wills or even a do not resuscitate (DNR) order. If you have a competent patient who is able to make sound decisions prior to becoming terminally ill, is ethics really an issue? Living wills are usually made prior to a patient coming to realize they have a life altering illness, this means that the person decided early in life that they did not want to be put on any life support machines to prolong agony or suffering. “A recent Pennsylvania case shows the power a living will can have. In that case, a Bucks County man was not given a feeding tube, even though his wife requested he receive one, because his living will, executed seven years prior, clearly stated that he did ‘not want tube feeding or any other artificial invasive form of nutrition” (Nitschke, 5/18). This example shows that passive euthanasia is legal if there is proof that the patient was completely competent when making the decision.
Based on the arguments presented I would have to say the argument against euthanasia is more persuasive. If there is proof that a terminally ill patient is of sound mind when deciding to receive a physician assisted suicide then I do not see any reason for the decision to be questioned however, how do you know if the patient is of sound mind? An instance of sound mind is the man from Pennsylvania who made the decision seven years before he fell ill in a living will that can be changed at any time. Being from so early on goes to show he was obviously of sound mind but he was also telling the physician not to perform any treatment which is passive euthanasia not instructing the physician to administer drugs to make his death quicker. Ethics was also a big persuasion for me, there are so many possibilities that people would either coerce a sick person or make the decision for the sick person to have euthanasia performed if it were legal and it was going to benefit the person making the decision. Another thing that could potentially become an ethics issue is that medical costs can be very high for terminally ill patients that need around the clock care; the family could decide that the medical expenses would be too great and choose to have euthanasia performed for under $100 versus thousands of dollars of medical bills. These examples show the potential for abuse by the family members and physicians. The laws in place that make physician assisted death illegal are there to make sure these scenarios do not come into play not necessarily to keep the patient in pain. Also, disabilities aren’t necessarily life threatening or painful the patient may have a shorter life span but it does not constitute denying the patient treatment. However, euthanasia can also benefit the terminally ill patient by relieving their pain and it does not necessarily have to be active euthanasia. For instance, the patient can simply decide they no longer want a feeding tube or ventilator, which would result in no food, difficulty breathing, and ultimately death. But this argument only justifies using passive euthanasia and does not provide a good argument of physician assisted death.

References
Nitschke, P. (5/18/2012). ProCon.org. Retrieved from http://euthanasia.procon.org rsrevision.com. (2011). Euthanasia - Arguments FOR Euthanasia. Retrieved from http://www.rsrevision.com