In addition, they may be given the opportunity to make amends, finalize their affairs, and die in the presence of family and friends. However, in order for the end of life to be considered good, it is critical for the choice to be made by the dying person, not a physician or a family member. Furthermore, death by euthanasia may provide comfort to the survivors because they are aware that the person died at their choosing and they have been given the opportunity to say goodbye and make peace with that person, resulting in a good death.
Leon R. Kass' article entitled "Why Doctors must not Kill" begins with a series of questions, including the following: "Do you want your doctor licensed to kill? Do you want your doctor deciding, on the basis of his own private views, when you still deserve to live and when you now deserve to die? Speaking generally, shall the healing profession become also the euthanizing profession?" (7). These questions are harsh to the reader because most people would disagree with them, but these issues may be the wave of the future. The potential opportunity for doctors to obtain the right to perform Euthanasia in daily medical practice will result in the destruction of the patient-doctor relationship because all semblances of trust will disappear. Imagine if a male patient enters the hospital with a serious illness that his doctor believes is terminal. Upon review of test results, three possibilities exist: a surgical option, from which the patient has a 25% survival rate for three years, a combination of chemotherapy and radiation treatments that will increase survival for nine to twelve months, or taking no action at all, which will likely result in death within six months. A doctor that possesses the right to prematurely end life may not even offer the person the first two options; rather, he may weigh the options and believe that with the surgical option, the likelihood for survival is relatively slim, the recovery time is extensive, and the quality of life would be poor. A combination of chemotherapy and radiation treatment would result in many side effects and a poor quality of life. Finally, taking no action at all will result in a shorter life span, but this would provide the patient with an opportunity to settle affairs and come to terms with the idea that the end of life is near. Another possibility is that the doctor may offer the patient all three options but convince them that the third is the only alternative that is worth the risk. If a doctor possesses the freedom to influence his patients in such a way, it is likely that many patients will choose to end life prematurely by withholding treatment. If even a remote chance exists that a patient will be able to prolong life through treatment and that the remainder of life can be lived with dignity, then that option should be the doctor's primary concern. After all, doctors are in the business of healing, not killing or allowing death without treatment.
Physicians may consider the following defense if such actions occur: "Physicians get tired of treating patients who are hard to cure, who resist their best efforts, who are on their way down - 'gorks,' 'gomers,' and 'vegetables' are only some of the less than affectionate names they receive from the house officers. Won't it be tempting to think that death is the best 'treatment' for the little old lady 'dumped' again on the emergency room by the nearby nursing home?" (8). A current change in law proposes that doctors would assist only those who request such action be taken to encourage death. However, in many of these instances, the dying person is in no emotional or psychological condition to make a rational decision. According to Kass, "Often a demand for Euthanasia is, in fact, an angry or anxious plea for help, born of fear of rejection or abandonment, or made in ignorance of available alternatives that could alleviate pain and suffering" (8). If this is indeed the case, a doctor has no right to accept such a decision because the consequences may be difficult to bear: "The physician-euthanizer is a deadly self-contradiction" (11). Legalized Euthanasia interferes with the natural progression of death, and this is generally not acceptable.
Physicians are trained to take whatever means necessary in order to heal a patient. They must commit to a code of ethics and the following underlying moral principle exists: "The physician as physician serves only the sick. He does not serve the relatives or the hospital or the national debt inflated due to Medicare costs. Thus he will never sacrifice the well-being of the sick to the convenience or pocketbook or feelings of the relatives or society. Moreover, the physician serves the sick not because they have rights or wants or claims, but because they are sick. The healer works with and for those who need to be healed, in order to help make them whole" (10).
A physician that is practicing with high moral standards is committed to healing patients and if that is impossible, his job is to make them feel as comfortable as possible while they are under his care, particularly in the final days. As a result, persons that are cared for by physicians that possess these ethical principles will be given the opportunity to die a good death, as theorized by Cassem. Supporting this theory, Kass presents the following statement towards the end of his article: "The present crisis that leads some to press for active Euthanasia is really an opportunity to learn the limits of the medicalization of life and death and to recover an appreciation of living with an against mortality. It is an opportunity for physicians to recover an understanding that there remains a residual human wholeness - however precarious - that can be cared for even in the face of incurable and terminal illness" (13). This statement supports the idea that physicians must apply their code of moral principles and perform whatever tasks are necessary to ensure that patients who are suffering from terminal illnesses are cared for and are made comfortable so that they may die with dignity and peace, surrounded by family and friends.
The final article by Charles Stein entitled "Ending a Life" is a discussion of the work of Ned Cassem, a psychiatrist and Jesuit priest who spends his days caring for terminally ill patients. He and a team of medical professionals are responsible for making interventions when patients and families disagree regarding end-of-life care: "The committee has no authority to make decisions. It can only offer recommendations. The goal of a consultation is not to find the truth or to say definitively, "This is the point at which we should stop.' The purpose is more modest: to help the people involved reach some kind of consensus. Often, just the introduction of an outside perspective can be helpful, especially to families who, without preparation, are asked to make monumental decisions" (16). As a result of his experience in these situations, Cassem states the following: "The final days of life are a time to search for meaning, and it is the job of the doctor and other caregivers to draw that meaning out....Patients should be asked about their favorite books and music, about the contributions they have made professionally and personally, about the people who have meant something to them, about the 'times they laughed so hard, milk came out of their nose' " (19). This example clearly demonstrates Cassem's theory that all efforts towards the end of life should be made for the sole purpose of gaining comfort and coming to terms with imminent death. This may be achieved through socialization, and conflict should not exist because it threatens the overall integrity of the situation. If the living take the time to say goodbye and comfort the dying person, the benefits can be supportive in coming to terms with the concept of death and the loss of that person. These actions are critical to the overall concept of a good death, and if this is realized, grief and coping will be more acceptable to the living.
In conclusion, many opposing viewpoints exist regarding the ethics and legality of Euthanasia. Many opinions are based on religious beliefs, and many religions do not accept the practice because it interferes with the natural plan of death put forth by God. However, for the dying, it is often difficult to live a quality life while enduring much pain and suffering. Therefore, out of anger, frustration, or helplessness, many individuals choose to end their lives through measures involving Euthanasia. They will seek the assistance of physicians who will either agree with the decision to withhold treatment or end life quickly and painlessly. With either measure, the choice is often made irrationally. Doctors are trained to heal, and when this is impossible as in…