Of course we want our loved ones to be a part of our lives as long as possible and thanks to modern medical technology, the average human life span is about seventy-eight years. Yet, some of us get sick, diseased or injured in an accident and become comatose. When the medical condition of a person is deemed progressive, terminal and there is no hope of recovery, that person should be able to exercise the option of ending their life. Particularly, when that individual feels he or she cannot stand the suffering in the last stages of their disease. Moreover, if a person has sustained an injury where their brain is not functional or damaged beyond basic functions, euthanasia is an option to lengthy life-sustaining treatment methods that may be futile. However, euthanasia has been a debated topic since the Greek-written Hippocratic Oath. This Oath is one of the first statements of moral conduct where doctors and health care professionals profess to do no harm by practicing medicine ethically. There are many opinions that in certain special populations, such as minorities and the disabled, euthanasia and assisted suicide give ways to possible abuse of the health care system. The three states that that now allow assisted suicide are Washington (2008), Montana (2008), and Oregon (1994), euthanasia is still illegal in the United States.
The difference between euthanasia and assisted suicide is the administration of the lethal drugs to the patient. If the physician or another person directly administers lethal medications to patient, the action is called euthanasia. Euthanasia is acknowledged in two ways: active or passive. Active euthanasia involves the use of a lethal drug to directly end the life of a patient. Passive euthanasia is the removal of life-supporting systems such as respirators, hydration and feeding tubes and the patient is allowed to die naturally. There are also three sub-categories to passive and active euthanasia: voluntary, involuntary, and non-voluntary creating six types of euthanasia for legal distinction. Voluntary is a term used when the patient gives permission verbally or written in a directive. Involuntary euthanasia is the person's has the ability give to consent and does not, even though the situation is futile and the decision is made by another person to terminate. Non-involuntary euthanasia is deemed mercy killing by many, and is where the individual is incompetent or cannot give permission. Non-voluntary active euthanasia is illegal world-wide, only practiced in the Netherlands in an agreement with the Dutch National Association of Pediatricians for mercifully ending the lives of newborn infants with terminal defects with consent of parents and doctors (procon.org, 2008).
Voluntary-active euthanasia is the description of a medical professional directly ending the life of a patient, as requested in a previously written directive by the patient. However, euthanasia and assisted suicide are not interchangeable terms. Rita Marker reports, that euthanasia is “knowingly and directly acting to cause the death of another person. Assisted suicide is intentionally knowingly and directly providing the means of death to another person so that the person can use that means to commit suicide” (Marker, 2011).
Nevertheless, the debate in the US is about the possibility of legalizing euthanasia or assisted suicide. Do terminally ill persons the right to end their life before suffering the indignity and agony in deterioration of their bodies before finally meeting death? I approve of someone wanting to end their life before the suffering gets too intense, as in the case of amyotrophic lateral sclerosis (ALS) otherwise known as Lou Gehrig’s disease, where the muscles in the body atrophy when the motor neurons shrink and disappear and finally the person becomes increasingly paralyzed. Consequently, in the end, they are smothered to death, as they are not able to breathe, with their mind intact. There are many cases like this one, where individuals are suffering a degenerative disease and want to end their lives before the bitter end. They should be able to have a physician assist them in suicide, only if they mentally competent and request the service. When physicians swear to uphold the Hippocratic Oath, they avow to do no harm and practice with moral and ethical methods, respecting the law and recognizing the “requirements that are contrary to the best interests of the patient” (Pozar, 2010). Hence, if physicians want to keep with the principle of beneficence and respect a patient’s personal autonomy, they would support a patient’s decision on refusing life-saving treatments. In addition, they will be protecting the liberty of a terminally ill person who is mentally competent to end their suffering by assisting them in bringing about their death. I would rather use the physician-assisted death than palliative care rendered by a hospice agency during the final weeks of my life because all the slow and painful experiences would have already taken place.
One argument of legalizing euthanasia or assisted suicide is that many religious people, especially the Christian faith believe that only God has the right to take a life and only He decides when it is that person’s time to go. These persons are concerned with medical personnel and healthcare ethics committees making decisions that are in the hands of their Deity, even when individuals take their own life (Procon.org).
Another argument against assisted suicide is that it can be overused to endanger people within “special populations” like the disabled, minorities, elderly, women or the poor. I do believe that some of the particular populations are susceptible to some coercion. The disabled, elderly and poor are the people who are the most vulnerable to exploitation by the fact that they do not have enough resources to adequately maintain their healthcare needs, even with Medicare and Medicaid. Especially with the threat of the government cut backs in Medicare/Medicaid coverage and community services. These populations may feel physician-assisted suicide might be a way out of adding more hardship on family members who are already impoverished (Procon.org).
Assisted suicide from a political perspective shows healthcare costs can be reduced and possibly lower costs to where people who are elderly or disabled can live their days out. According to the Balanced Politics website, “it is not unheard of for medical costs to equal $50,000 – 100,000 to keep some patients alive. We have to ask ourselves is this the best way to spend our money when the patient himself would like to die? Wouldn’t the money be better spent on the patients that can be saved?” (Messerli, J., 2007). There is no doubt that I am pro- choice when it comes to euthanasia and assisted suicide.
In the state of Texas, where I reside, the Texas Penal Code § 22.08 states, “that a person commits an offense if, with intent to promote or assist the commission of suicide by another, he aids or attempts to aid the other to commit or attempt to commit suicide. An offense under this section is a Class C misdemeanor unless the actor’s conduct causes suicide or attempted suicide that results in serious bodily injury, in which event the offense is a state jail felony” (Findlaw.com).
However, in 1999, the state of Texas passed the Texas Advance Directive Act, also stated as the Texas Futile Care Law, which is now a part of the Texas Health and Safety Code in Chapter 166. There is much controversy over a provision (Sect. 166.046), where a health care facility is allowed to discontinue life-supporting treatment ten days after giving notice if the continuation of that treatment is considered futile and medically inappropriate by the attending medical team. In 2003, the Director of the office of Clinical Ethics at the Baylor Health System and a member of the Texas Advance Directive Task Force (TADA) in Dallas, Texas added some clarifying amendments to the Advance Directive Act where the DNR directive can be honored by Emergency Medical Services Personnel and the Physician’s DNR can be honored by healthcare personnel. Also, the law requires that the ethics committee reviews the decision and gives the family 10 days notice to find another facility or provider to take in the patient before they enact the futile care law and withdraw life support (Ackerman, Todd, 2006).
Advocates debate that euthanasia/assisted suicide should be allowed to alleviate the last months of unbearable suffering for terminally-ill patients and their families. They argue for the patient’s autonomy and a physician’s beneficence in the patient’s final request for a merciful death. Presently, three states have acknowledged and practiced legalized physician-assisted suicide for several years: Montana, Oregon Death with Dignity Act and Washington Death with Dignity Act and real-time assessments can be made through actual accounts and circumstances for the arguments about legalizing just one form of euthanasia, physician-assisted suicide.
References
Ackerman, Todd (2006). “Texas’ patient care law at hub of Houston dispute,”
Houston Chronicle, July 8, 2006. Retrieved from Houston Chronicle. http://www.chron.com/news/houston-texas/article/Texas-law-at-hub-of-life-support-issue-1887343.php American Geriatrics Society (2007). American Geriatrics Society Position Statement: Physician-Assisted Suicide and Voluntary Active Euthanasia. Retrieved from www.americangeriatrics.org/
Marker, Rita L. (2011). Euthanasia, Assisted Suicide & Health Care Decisions: Protecting Yourself & Your Family. Retrieved from Patients Rights Council. http://www.patientsrightscouncil.org/site/euthanasia-assisted-suicide-health-care-decisions/ Messerli, Joe (2007). Should an incurable-ill patient be able to commit physician-assisted suicide? Retrieved from Balanced Politics. www.balancedpolitics.org/assisted_suicide.htm
Pozgar, G. D., & Santucci, N. (2010). Legal and Ethical Issues for Health Professionals
(2nd Edition). Sudbury, Maine : Jones and Bartlett Publishers.
http://www.tapm.org/news-archive_2003-6.htm
