Euthanasia: The Good Death
"You matter because you are you.
You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live until you die."
-Dame Cicely Saunders, founder of Hospice
The history of the euthanasia debate is long and the debate continues to be hotly contested across the globe. Indeed, as far back as 400 B.C., Hippocrates, the "father of medicine" and Greek physician, set forth the foundation from which the medical community would base its practice: "I will give no deadly medicine to any one if asked, nor suggest any such counsel" ("INFORMATION for RESEARCH on EUTHANASIA, PHYSICIAN-ASSISTED SUICIDE;" "NOVA, Doctors' Diaries"). Accordingly, our modern physicians take this oath upon which they vow that they will not provide deadly medicine nor deadly counsel. As such, the very notion of actually assisting someone to die becomes contrary to the oath by which a physician takes and has a duty to uphold. This paper recognizes the seemingly apparent contradiction, but seeks to take the analysis a step further. From the perspective that euthanasia is a peaceful act of compassion, by assisting in suicide, the physician is merely a vehicle by which the patient's wishes can be respected because even in time of terminal illness, as noted by the founder of Hospice, until the end, "you matter." Inherent in mattering is respecting one's wishes; inherent in compassion is empathy. The practice of medicine should not be so rigid so as to remove the patient's voice and the physician's sense of empathy since patients already deemed terminal should not have to endure incredible pain and, moreover, since the ultimate choice of how to live and/or die should not be taken away because the rights and wishes of the terminally ill do matter.
Euthanasia has many different definitions. Typically, the definition will vary according to the political stance one takes upon the issue itself. For instance, those who do not believe that medical professionals should be able to assist a patient in killing himself or herself state the definition as "the intentional killing by act or omission of a dependent human being for his or her alleged benefit" ("INFORMATION for RESEARCH on EUTHANASIA, PHYSICIAN-ASSISTED SUICIDE). In this definition, the point is made to define the action as "killing" and the patient as a "dependent" human being thereby providing the notion that the patient is weak and the doctor is in a position of superiority. For those whom see the utility and humanity of euthanasia, it is oftentimes defined as a "broad, generic term meaning 'help with a good death'" and physician-assisted suicide, which is oftentimes referred to as euthanasia, as when a medical doctor helps a patient to die by prescribing a lethal overdose. In the latter definition, the verb "help" is used providing a more humane connotation to the definition. For the purposes of this paper, semantics shall try to be placed aside and euthanasia is defined as the action of a physician assisting in the suicide of a patient (Humphrey). Furthermore, this paper shall be limited to defining patients as those individuals whom have already been diagnosed as "terminally ill."
Background of Controversy
Euthanasia has been deemed illegal for most of our modern day history. For instance, Supreme Court Justice William Rehnquist noted in Washington v. Glucksberg (1997) that "for over 700 years, the Anglo American common law tradition has punished or otherwise disapproved of both suicide and assisting suicide" (Washington v. Glucksberg). In addition to the law frowning upon physician-assisted suicide, the medical community is likewise. Specifically, the World Medical Association which includes eighty-two nations has adopted clear resolutions stating their disdain for the practice. In these resolutions condemning physician-assisted suicide, all national medical associations have been vehemently urged to refrain from participating in physician-assisted suicide even in situations where the law of that particular county allows and/or decriminalizes such practice of medicine (World Medical Association Policy). Accordingly, it is not surprising that today physician-assisted suicide is only legal in the Netherlands, Belgium, and the state of Oregon (Mahr). While euthanasia is illegal in most parts of the globe, according to World Values Surveys (2005), the general public typically supports a patient's right to decide whether or not to end his or her life ("Physician-Assisted Suicide: Public Opinion").
Arguments in Support of Euthanasia
When one traditionally thinks of suicide, one has negative thoughts of an individual in deep despair whom may or may not be thinking clearly and whom does so on his or her own volition and does so by themselves. Typically, this person is going through a transient episode which will pass in time. However, in the case of physician-assisted suicide, the person has already been deemed terminally ill such that recovery is not going to happen; it is not a transient diagnosis or condition. Furthermore, the patient is not alone. Therefore, the suicide is not what Philosopher Immanual Kant would deem as motivated by self-love and/or be the result of a selfish decision; instead, the choice of suicide derives more from a sense of treatment or medical need because the sustainment of life would just cause additional physical and emotional suffering by the patient as well as additional grief of the patient's caregivers (Cangiolose).
Indeed, it is humane to allow an individual whom has already been given a firm diagnosis that they are terminal to make them live through the suffering associated with the dying process if there is treatment that could essentially cease the pain associated with death and dying. As eloquently noted by Faye Girsh, Ed.D., author of How Shall We Die and Senior Advisor of Exit Network, "Americans should enjoy a right guaranteed in the Declaration of Human Rights -- the right not to be forced to suffer. It should be considered as much of a crime to make someone live who with justification does not wish to continue as it is to take life without consent" ("Euthanasia - ProCon"). Merely because historically the issue has been framed as suicide, it does not mean that we cannot reform our thinking to comport with notions of humanity and respect for the dignity and wishes of the terminally ill. Perhaps, if physician-assisted suicide were called "the good death" or the "right to the good death" or "the right to not suffer," then the philosophical right of the patient to have his or her will respected would become a part of and a deciding factor in this debate.
Moreover, from a legal standpoint, the United States Supreme Court in recent years has carved out a constitutional right to privacy between a physician and a mother in the decision of the mother to continue with a pregnancy or, in other words, to have an abortion. The same legal analysis is applicable in the case of a patient's right to die. In fact, according to briefs of the Americans with Civil Liberties Union, a terminally ill person is also a person whose choices should be protected as they too have a "protected liberty interest in choosing to end intolerable suffering by bringing about his or her own death." Thus, by categorically banning or restricting a physican's ability to assist in a competent and terminally ill patient's suicide substantially interferes with a protected liberty interest as defined in Roe v. Wade and its progeny (Dixon 131; "Euthanasia - ProCon").
Arguments Against Euthanasia
Many individuals who oppose euthanasia believe that if it is legalized and/or not restricted or banned that it will lead to more people wanting to kill themselves. However, research done in areas which have allowed access to physician-assisted suicide reveals that such a contention is not supported by data. According to the October 2007 edition of the Journal of Medical Ethics, an analysis of physician assisted deaths in Oregon and the Netherlands reveals that the rates of assisted death were no higher than average in those groups whom people traditionally deem are vulnerable to being "coerced" into taking his/her life such as the impoverished, the elderly, and women. Actually, the only group who sought physician-suicide more frequently was that of white men, a group which traditionally is not thought of as being susceptible to coercion. A professor at UCLA's School of Medicine, Russel Korolbkin explains
that the people who take advantage of such laws (such as the 292 people who have done so in Oregon in the past 13 years) are well educated about their options; and, the option of physician-assisted suicide generally provides peace of mind as well as a sense of control to them in this critical and turbulent time (Mahr).
Additionally, as recently as 1997, the U.S. Supreme Court utilized historical notions of physician-assisted suicide as a crime and a moral wrong to support a modern day issue (William v. Glicksberg). If we were to fall back upon historical Arguments, then our society would still outlaw intermarriage between whites and blacks and we would still have separate public…