As a Filipino citizen, we have great trait towards family which we called “close family ties”. This means that we have strong connection and great affection on our family members whether to our parents, grandparents, siblings or any other relatives. We value our relationship with our relatives so much that we can’t go on with our live easily without them. But what if the time comes when we we’re about to decide whether to let go or not on our family member who is suffering too much because of illness?
Are we going to let go to finish his or her sufferings? Or are we going to pretend that we cannot see how much he or she is suffering just to live together with him much longer? In that case, euthanasia issue opens. Euthanasia from the Greek word “eu-” meaning well or good and “-Thanatos” meaning death. Euthanasia is a broad term for mercy killing—taking the life of a hopelessly ill or injured individual in order to end his or her suffering. Mercy killing represents a serious ethical dilemma. People do not always die well.
Some afflictions cause people to suffer through extreme physical pain in their last days, and euthanasia may seem like a compassionate way of ending this pain. Other patients may request euthanasia to avoid the weakness and loss of mental faculties that some diseases cause, and many feel these wishes should be respected. But euthanasia also seems to contradict one of the most basic principles of morality, which is that killing is wrong. Viewed from a traditional Judeo-Christian point of view, euthanasia is murder and a blatant violation of the biblical commandment “Thou shall not kill. From a secular perspective, one of the principal purposes of law is to uphold the sanctity of human life. Euthanasia is so controversial because it pits the plight of suffering, dying individuals against religious beliefs, legal tradition, and, in the case of physician-assisted death, medical ethics. This moral dilemma is not new. The term “euthanasia” is derived from ancient Greek, and means “good death. ” But while the debate over mercy killing has ancient origins, many observers believe that it is harder today to achieve a good death than ever before.
Advances in medicine have increased people’s health and life span, but they have also greatly affected the dying process. For example, in the early twentieth century the majority of Americans died at home, usually victims of pneumonia or influenza. Today most people die in the hospital, often from degenerative diseases like cancer that may cause a painful, lingering death. As a college student and as a one of the major decision makers inside the family bond, we have to be aware of this kind of approach.
Are you going to agree with legalizing euthanasia here in Philippines or are you going to fight against this? This research will help other people gain knowledge about euthanasia issue and become aware of what euthanasia is going to bring and cause to our fellowmen when be legalized. This research will explain the core of euthanasia and this can also give some of chosen Filipinos to give their sides and opinions towards the issue, must it be legalized or not to be legalized? Background of the Study: Dutch Penal Code Articles 293 and 294 make both euthanasia and assisted suicide illegal, even today.
However, as the result of various court cases, doctors who directly kill patients or help patients kill themselves will not be prosecuted as long as they follow certain guidelines. In addition to the current requirements that physicians report every euthanasia/assisted-suicide death to the local prosecutor and that the patient’s death request must be enduring (carefully considered and requested on more than one occasion), the Rotterdam court in 1981 established the following guidelines: 1. The patient must be experiencing unbearable pain. 2. The patient must be conscious. 3.
The death request must be voluntary. 4. The patient must have been given alternatives to euthanasia and time to consider these alternatives. 5. There must be no other reasonable solutions to the problem. 6. The patient’s death cannot inflict unnecessary suffering on others. 7. There must be more than one person involved in the euthanasia decision. 8. Only a doctor can euthanize a patient. 9. Great care must be taken in actually making the death decision. Since 1981, these guidelines have been interpreted by the Dutch courts and Royal Dutch Medical Association (KNMG) in ever-broadening terms.
One example is the interpretation of the “unbearable pain” requirement reflected in the Hague Court of Appeal’s 1986 decision. The court ruled that the pain guideline was not limited to physical pain, and that “psychic suffering” or “the potential disfigurement of personality” could also be grounds for euthanasia. The main argument in favor of euthanasia in Holland has always been the need for more patient autonomy — that patients have the right to make their own end-of-life decisions. Yet, over the past 20 years, Dutch euthanasia practice has ultimately given doctors, not patients, more and more power.
The question of whether a patient should live or die is often decided exclusively by a doctor or a team of physicians. The Dutch define “euthanasia” in a very limited way: “Euthanasia is understood [as] an action which aims at taking the life of another at the latter’s expressed request. It concerns an action of which death is the purpose and the result. ” This definition applies only to voluntary euthanasia and excludes what the rest of the world refers to as non-voluntary or involuntary euthanasia, the killing of a patient without the patient’s knowledge or consent. The Dutch call this “life-terminating treatment. Some physicians use this distinction between “euthanasia” and “life-terminating treatment” to avoid having a patient’s death classified as “euthanasia,” thus freeing doctors from following the established euthanasia guidelines and reporting the death to local authorities. One such example was discussed during the December 1990 Institute for Bioethics conference in Maastricht, Holland. A physician from The Netherlands Cancer Institute told of approximately 30 cases a year where doctors ended patients’ lives after the patients intentionally had been put into a coma by means of a morphine injection.
The Cancer Institute physician then stated that these deaths were not considered “euthanasia” because they were not voluntary, and that to have discussed the plan to end these patients’ lives with the patients would have been “rude” since they all knew they had incurable conditions. Theoretical Framework: Conceptual Framework: Statement of the Problem: Significance of the Study: Life is the most precious creation in this world. No matter how advanced science has become, the beauty of nature and creation of life and cause of death remains an unfolded mystery. Life cannot be created.
Thus, it makes even taking away life punishable legally. But there are circumstances where even law is in a dilemma over the issues of life and death. And one such case is that of mercy killing or euthanasia. Mercy killing is a concept or a practice where a person who is living an abnormal life or is in a ‘vegetable state’ due to terminal illness (unable to do things which a healthy person can do due to an illness, disease or another factor), is killed legally under law. This is an extremely sensitive legal and social issue as life being extremely precious cannot be decided when to be ended.
However, the case of legalizing mercy killing can be understood by two clear perspectives i. e. for and against. Law may take steps in certain circumstances to allow euthanasia keeping in mind the ‘right to live’ which is the right of every citizen. But if due to a prolonged illness for years, a person lives in a vegetable state or in coma, and then life becomes meaningless and painful for the person. Every country is bound by laws and every citizen has to abide by the law of the land. The most popular way of governance is a democracy where a person has the right to speak, live, right to equality etc.
Right to life is where every citizen of country has the right to lead a healthy, dignified and respectful life. Thus, in such a case law can take steps to make mercy killing legal for the terminally ill and ‘brain-dead’ patients. Another aspect is performing medical experiments on such patients for benefit of medical sciences. Such a case might favor euthanasia as performing medical experiments without the consent of the patient is also unethical. Life cannot be created. So life should not be taken.
A simple stance which is clearly against mercy killing. No matter what the condition of a patient, killing of life under any circumstances is criminal and illegal by law. Thus, mercy killing can never be justified. Another aspect which goes against legalizing mercy killing is if such a law comes in place, then it would lead to an increase in criminal offences as people will use it as a loophole in overcoming the criminal laws of the country. Mercy killing or euthanasia is an ideological point which will always create a furor socially and legally.
On one hand, many NGO’s are strictly against taking the precious life of a person and on the other the relatives of person suffering call for mercy. Whatever judgment or a law a country makes, this issue will always be a legal and social dilemma. Scope and Limitation: Discussion about the assisted suicide or Euthanasia challenge ethical perspectives to explore their interpersonal values concerning the value of life, rationale of death, and the meaning of suffering, to contemplate the philosophical foundations of such action, and to examine health care responsibilities to the patients.
The over-all study includes three fundamental perspectives involved in the study specifically ethical, legal and political areas. The relationship of the three fields and euthanasia in ethical profession is the primary subject of the entire research The following are the objectives imposed into the study in to serve as the guidelines for conducting the research To be able to link the three perspectives of ethics, legal backgrounds and political stand of euthanasia To be able to identify, discuss, analyze and evaluate the issues concerning the subject of euthanasia involving the positive and negative points of the subject.
Hypothesis: Many of us will remember cases of appalling palliative care while in our house officer years. Hearing comments of families in the lead up to the Joffe Bill debate illustrates that many such bad stories are also in the public domain. As a GP, the benefits of good palliative care to my patients and their families rapidly became apparent. These good stories, however, are not media big sellers. As a result, a balanced view on end of life care is only available to a privileged few.
We as GPs are able to experience this to a degree, often depending on how well resourced our local palliative care services are. Palliative care clinicians, on the other hand, live these stories with their patients on a daily basis. As doctors we have a unique insight into the dangers of legalizing euthanasia. Many of us will have been in a position where we have been directly or indirectly asked to end a patient’s life. However, once the reason behind the request has been identified and addressed, the request is usually withdrawn.
Palliative care clinicians, who meet these requests more frequently, tell me that their most common experience is the same. As GPs and palliative care clinicians we see errors in prognosis and diagnosis. We see the use of time as a therapeutic tool: patients, who once wished themselves dead, are glad to be alive. We see how tired families can become caring for a loved relative, so that death can seem like a welcome release, not so much for the patient, but for the family. Statement of the Problem: Review of Related Literature: Voluntary Euthanasia
First published Thu Apr 18, 1996; substantive revision Mon Mar 29, 2010 The entry sets out five individually necessary conditions for anyone to be a candidate for legalized voluntary euthanasia (or, in some usages, physician-assisted suicide), outlines the moral case advanced by those in favor of legalizing voluntary euthanasia, and discusses five of the more important objections made by those opposed to the legalization of voluntary euthanasia. * 1. Introduction * 2. Five Individually Necessary Conditions for Candidacy for Voluntary Euthanasia * 3.
A Moral Case for Voluntary Euthanasia * 4. Five Objections to the Moral Permissibility of Voluntary Euthanasia * Bibliography * Other Internet Resources * Related Entries When a person carries out an act of euthanasia, he brings about the death of another person because he believes the latter’s present existence is so bad that she would be better off dead, or believes that unless he intervenes and ends her life, it will become so bad that she would be better off dead. The motive of the person who commits an act of euthanasia is to benefit the one whose death is brought about. Though what was just said also holds for many instances of physician-assisted suicide, some wish to restrict the use of the latter term to forms of assistance which stop short of the physician ‘bringing about the death’ of the patient, such as those involving mechanical means that have to be activated by the patient. ) Our concern will be with voluntary euthanasia — that is, with those instances of euthanasia in which a clearly competent person makes a voluntary and enduring request to be helped to die.
There will be occasion to mention non-voluntary euthanasia — instances of euthanasia where a person is either not competent to, or unable to, express a wish about euthanasia and there is no one authorized to make a substituted judgment (in which case a proxy tries to choose as the no-longer-competent patient would have chosen had she remained competent) — in the context of considering the claim that permitting voluntary euthanasia will lead via a slippery slope to permitting non-voluntary euthanasia.
Nothing will be said here about involuntary euthanasia, where a competent person’s life is brought to an end despite an explicit expression of opposition to euthanasia, beyond saying that, no matter how honorable the perpetrator’s motive, such a death is, and ought to be, unlawful. With that brief sketch of the historical background in place, we now proceed to set out the conditions that those who have advocated making voluntary euthanasia legally permissible have wished to insist should be satisfied.
The conditions are stated with some care so as to give focus to the moral debate about legalization. Second, we shall go on to outline the positive moral case underpinning the push to make voluntary euthanasia legally permissible. Third, we shall then consider the more important of the morally grounded objections that have been advanced by those opposed to the legalization of voluntary euthanasia. Advocates of voluntary euthanasia contend that if a person . is suffering from a terminal illness; b. is unlikely to benefit from the discovery of a cure for that illness during what remains of her life expectancy; c. is, as a direct result of the illness, either suffering intolerable pain, or only has available a life that is unacceptably burdensome (because the illness has to be treated in ways that lead to her being unacceptably dependent on others or on technological means of life support); d. as an enduring, voluntary and competent wish to die (or has, prior to losing the competence to do so, expressed a wish to die in the event that conditions (a)-(c) are satisfied); and e. is unable without assistance to commit suicide, Then there should be legal and medical provision to enable her to be allowed to die or assisted to die. It should be acknowledged that these conditions are quite restrictive, indeed more restrictive than some would think appropriate. In particular, the conditions concern access to voluntary euthanasia only for those who are terminally ill.
While that expression is not free of all ambiguity, for present purposes it can be agreed that it does not include the bringing about of the death of, say, victims of accidents who are rendered quadriplegic or victims of early Alzheimer’s Disease. Those who consider that such cases show the first condition to be too restrictive may nonetheless accept that including them would, at least for the time being, make it far harder to obtain legal protection for helping those terminally ill persons who wish to die. The fifth condition urther restricts access to voluntary euthanasia by excluding those capable of ending their own lives, and so will not only be thought unduly restrictive by those who think physician-assisted suicide a better course to follow, but will be considered morally much harder to justify by those who think health care practitioners may never justifiably kill their patients. The second condition is intended simply to reflect the fact that it is normally possible to say when someone’s health status is incurable. So-called ‘miracle’ cures may be spoken of by sensationalist journalists, but progress toward medical breakthroughs is typically painstaking.
If there are miracles wrought by God that will be quite another matter entirely, but it is at least clear that not everyone’s death is thus to be staved off. The third condition recognizes what many who oppose the legalization of voluntary euthanasia do not, namely, that it is not only release from pain that leads people to want to be helped to die. In The Netherlands, for example, it has been found to be a less significant reason for requesting assistance with dying than other forms of suffering and frustration with loss of independence.
Sufferers from some terminal conditions may have their pain relieved but have to endure side effects that for them make life unbearable. Others may not have to cope with pain but instead be incapable, as with motor neuron disease, of living without forms of life support that simultaneously rob their lives of quality. A final preliminary point is that the fourth condition requires that the choice to die not only be voluntary but that it be made in an enduring (not merely a one-off) way and be competent.
The choice is one that will require discussion and time for reflection and so should not be settled in a moment. As in other decisions affecting matters of importance, normal adults are presumed to choose voluntarily unless the presence of defeating considerations can be established. The burden of proof of establishing lack of voluntariness or lack of competence is on those who refuse to accept the person’s choice. There is no need to deny that this burden can sometimes be met (e. g. by pointing to the person’s being in a state of clinical depression).
The claim is only that the onus falls on those who assert that a normal adult’s choice is not competent. The central ethical argument for voluntary euthanasia — that respect for persons demands respect for their autonomous choices as long as those choices do not result in harm to others — is directly connected with this issue of competence (cp. Brock 1992) because autonomy presupposes competence. People have an interest in making important decisions about their lives in accordance with their own conception of how they want their lives to go.
In exercising autonomy or self-determination, people take responsibility for their lives; since dying is a part of life, choices about the manner of their dying and the timing of their death are, for many people, part of what is involved in taking responsibility for their lives. Many people are concerned about what the last phase of their lives will be like, not merely because of fears that their dying might involve them in great suffering, but also because of the desire to retain their dignity and as much control over their lives as possible during this phase.
Opponents of voluntary euthanasia have endeavored to counter this very straightforward moral case for the practice in a variety of ways (see, for example, Keown 2002 and Foley, et al. 2002). Some of the counter-arguments are concerned only with whether the moral case warrants making the practice of voluntary euthanasia legal; others are concerned with trying to undermine the moral case itself. In what follows, consideration will be given to the five most important of the counter-arguments. (For more comprehensive discussions of the ethics of medically assisted death see Keown 2002; Biggar 2004; Gorsuch 2006; and Young 2007. Objection 1 It is often said that it is not necessary nowadays for anyone to die while suffering from intolerable or overwhelming pain. We are getting better at providing effective palliative care, and hospice care is more widely available. Given these considerations, some have urged that voluntary euthanasia is unnecessary. There are several flaws in this counter-argument. First, while both good palliative care and hospice care make important contributions to the care of the dying, neither is a panacea. To get the best palliative care for an individual involves trial and error, with some consequent suffering in the process.
Far more importantly, even high quality palliative care commonly exacts a price in the form of side effects such as nausea, incontinence, loss of awareness because of semi-permanent drowsiness, and so on. A rosy picture is often painted as to how palliative care can transform the plight of the dying. Such a picture is misleading according to those who have closely observed the effect of extended courses of treatment with drugs such as morphine, a point acknowledged by many skilled palliative care specialists.
Second, though the sort of care provided through hospices is to be applauded, it is care that is available to only a small proportion of the terminally ill and then usually only in the very last stages of the illness (typically a matter of a few weeks). Third, and of greatest significance, not everyone wishes to avail themselves of palliative or hospice care. For those who prefer to die on their own terms and in their own time, neither option may be attractive. For many dying patients, the major source of distress is having their autonomous wishes frustrated.
Fourth, as indicated earlier, the suffering that occasions a wish to end life is not always due to the pain occasioned by illness. For some, what is intolerable is their dependence on others or on machinery; for these patients, the availability of effective pain control will be quite irrelevant. Objection 2 A second, related objection to permitting the legalization of voluntary euthanasia argues that we can never have sufficient evidence to be justified in believing that a dying person’s request to be helped to die is competent, enduring and genuinely voluntary.
It is certainly true that a request to die may not reflect an enduring desire to die (just as some attempts to commit suicide may reflect temporary despair). That is why advocates of voluntary euthanasia have argued that normally a cooling off period should be required before euthanasia is permitted. That having been said, to claim that we can never be justified in believing someone’s request to die reflects a settled preference for death goes too far.
If someone discusses the issue with others on different occasions, or reflects on the issue over an extended period, and does not waver in her conviction, her wish to die surely must be counted as enduring. Perhaps, though, what is really at issue in this objection is whether anyone can ever form a competent, enduring and voluntary wish about being better off dead, rather than continuing to suffer from an illness, without having yet suffered the illness. If this is what underlies the objection, though, it is surely too paternalistic to be acceptable.
Why is it not possible for a person to have sufficient inductive evidence (e. g. based on the experience of the deaths of friends or family) to know her own mind and act accordingly? Objection 3 According to one interpretation of the traditional ‘doctrine of double effect’ it is permissible to act in ways which it is foreseen will have bad consequences, provided only that a. this occurs as a side effect (or, indirectly) to the achievement of the act that is directly aimed at; b. the act directly aimed at is itself morally good or, at least, morally neutral; c. he good effect is not achieved by way of the bad, that is, the bad must not be a means to the good; and d. The bad consequences must not be so serious as to outweigh the good effect. According to the doctrine of double effect, it is, for example, permissible to alleviate pain by administering drugs such as morphine, knowing that doing so will shorten life, but impermissible to give an overdose or injection with the direct intention of terminating a patient’s life (whether at her request or not). This is not the appropriate forum to give full consideration to this doctrine.
However, there is one vital criticism to be made of the doctrine concerning its relevance to the issue of voluntary euthanasia. On one plausible reading, the doctrine of double effect can be relevant only where a person’s death is an evil or, to put it another way, a harm. Sometimes the notion of ‘harm’ is understood simply as damage to a person’s interest whether consented to or not. At other times, it is understood, more strictly, as damage that has been wrongfully inflicted. (For an extended discussion of the doctrine of double effect and its bearing on the moral permissibility of voluntary euthanasia see McIntyre 2001.
Objection 4 There is a widespread belief that passive (voluntary) euthanasia, in which life-sustaining or life-prolonging measures are withdrawn or withheld, is morally acceptable because steps are simply not taken which could preserve or prolong life (and so a patient is allowed to die), whereas active (voluntary) euthanasia is not, because it requires an act of killing. The distinction, despite its widespread popularity, is very unclear. (For a fuller, and very helpful, discussion, see McMahan 2002. Whether behavior is described in terms of acts or omissions (a distinction which underpins the alleged difference between active and passive voluntary euthanasia), is generally a matter of pragmatics rather than anything of deeper importance. Consider, for instance, the practice (once common in hospitals) of deliberately proceeding slowly to a ward in response to a request to provide assistance for a patient subject to a ‘not for resuscitation’ code. Or consider ‘pulling the plug’ on an oxygen machine keeping an otherwise dying patient alive as against not replacing the tank when it runs out.
Are these acts or omissions; are these cases of passive euthanasia or active euthanasia? Further, the distinction between killing and letting die is unclear. Consider the case of a patient suffering from motor neuron disease that is completely respirator dependent, finds her condition intolerable, and competently and persistently requests to be removed from the respirator so that she may die. Even the Catholic Church in recent times has been prepared to agree that it is permissible, in cases like this, to turn off the respirator.
But it seems odd to think that a case like this is best described as one in which the patient is allowed to die. This it is a problem only if killing, in medical contexts, is always morally unjustified — a premise that underwrites much of the debate surrounding this fourth objection. But this underlying assumption is open to challenge (and has been challenged in e. g. Rachel’s 1986, chs. 7, 8; Kuhse 1987). For one thing, there may well be cases in which killing, where requested, is morally better than allowing a death — namely, where the latter would serve only to prolong the person’s suffering.
Further, despite the longstanding legal doctrine that no one can justifiably consent to be killed (on which more later), it surely is relevant to the justification of an act of killing that the person killed has autonomously decided that he would be better off dead. Objection 5 It is often said that if society allows voluntary euthanasia to be legally permitted, then we will have set foot on a slippery slope that will lead us to support other forms of euthanasia, including non-voluntary euthanasia.
Whereas it was once the common refrain that that was precisely what happened in Hitler’s Germany, in recent decades the tendency has been to claim that experience in The Netherlands has confirmed the reality of the slippery slope. Slippery slope arguments come in various versions. One (but not the only) way of classifying them has been to refer to logical, psychological and arbitrary line versions. The common feature of the different forms is the contention that once the first step is taken on a slippery slope the subsequent steps follow inexorably, whether for logical reasons, sychological reasons, or to avoid arbitrariness in ‘drawing a line’ between a person’s actions. It is also difficult to see the alleged psychological inevitability of moving from voluntary to non-voluntary euthanasia. Why should it be supposed that those who value the autonomy of the individual and so support provision for voluntary euthanasia will, as a result, find it psychologically easier to kill patients who are not able competently to request assistance with dying? What reason is there to believe that they will, as a result of their support for voluntary euthanasia, be psychologically driven to practice non-voluntary euthanasia?
Finally, since there is nothing arbitrary about distinguishing voluntary euthanasia from non-voluntary euthanasia (because the line between them is based on clear principles), there can be no substance to the charge that only by arbitrarily drawing a line between them could non-voluntary euthanasia be avoided once voluntary euthanasia was legalized. That there have only been a handful of prosecutions of Dutch doctors for failing to follow agreed procedures (Griffiths, et al. 998), that none of the doctors prosecuted has had a significant penalty imposed, and that the Dutch public have regularly reaffirmed their support for those agreed procedures suggests that, contrary to the claims of some critics, the legalization of voluntary euthanasia has not increased the incidence of non-voluntary euthanasia. Indeed, such studies as have been published about what happens in other countries, like Australia (see Kuhse, et al. 1997), where no legal protection is in place, suggest that the pattern in The Netherlands and elsewhere is quite similar.
Some have argued, further, that there may be more danger of the line between voluntary and non-voluntary euthanasia being blurred if euthanasia is practiced in the absence of legal recognition, since there will be no transparency or monitoring. Moreover, it is plausible to think that the fundamental basis of the right to decide about life-sustaining treatment — respects for a person’s autonomy — has direct relevance to voluntary euthanasia as well. Extending the right of self-determination to cover cases of voluntary euthanasia would not, therefore, amount to a dramatic shift in legal policy.
No novel legal values or principles need to be invoked. Indeed, the fact that suicide and attempted suicide are no longer criminal offences in many jurisdictions indicates that the central importance of individual self-determination in a closely analogous setting has been accepted. The fact that assisted suicide and voluntary euthanasia have not yet been widely decriminalized is perhaps best explained along the lines that have frequently been offered for excluding consent of the victim as a justification for an act of killing, namely the difficulties thought to exist in establishing the genuineness of the consent.
But, the establishment of suitable procedures for giving consent to assisted suicide and voluntary euthanasia would seem to be no harder than establishing procedures for competently refusing burdensome or otherwise unwanted medical treatment. The latter has already been accomplished in many jurisdictions, so the former should be achievable as well.