Euthanasia Debate

The intention to deliberately help someone accelerate the death of an incurable patient, even to stop his or her suffering has never been an easy task. The ethics of euthanasia is one that has been debated over since the fourth century B.C. Euthanasia is translated from Greek as "good death" or "easy death. At first, the term referred to painless and peaceful natural deaths in old age that occurred in comfortable and familiar surroundings. Today the word is currently understood as when one person ends the life of another person for the purpose of ending the killed person's pain or suffering.

The World Medical Association's Declaration on Euthanasia, adopted by the 38th World Medical Assembly, Madrid, Spain, October 1987 and reaffirmed by the 170th WMA Council Session, Divonne-Les-Bains, France, May 2005 states: Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient's own request or at the request of close relatives, is unethical. This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow its course in the terminal phase of sickness.(WMA 2017). A person who undergoes euthanasia usually has an incurable condition. But there are other instances where some people want their life to be ended. In many cases, it is carried out at the person's request but there are times when they may be too ill, and the decision is made by relatives, medics or, in some instances, the courts.

Euthanasia can be carried out either by taking actions, including giving a lethal injection or by not doing what is necessary to keep a person alive (such as failing to keep their feeding tube going). Although the very idea of euthanasia originated a long time ago, from the time of Hippocrates to the present day, traditional medical ethics includes a ban: To please no one will I prescribe a deadly drug, nor give advice which may cause his death. Euthanasia is called any action aimed at putting an end to the life of a person, in pursuit of his/her will, and an uninterested person must do this. It should be noted that The World Medical Association reaffirms its strong belief that euthanasia is in conflict with basic ethical principles of medical practice, and The World Medical Association strongly encourages all National Medical Associations and physicians to refrain from participating in euthanasia, even if national law allows it or decriminalizes it under certain conditions. Some people think the act of euthanasia is more humane in some cases. People should have the right to be able to choose to end their life if there is no other cure and chance of living rather than prolonging their lives and suffer.

Euthanasia comes in several different forms, each of which brings a different set of rights and wrongs. What's chosen depends on a variety of factors, including someone's outlook and level of consciousness. There are 3 types of euthanasia, voluntary euthanasia, non-voluntary euthanasia and Involuntary euthanasia. Voluntary euthanasia occurs at the request of the person who dies. Non-voluntary euthanasia occurs when the person is unconscious or otherwise unable (for example, a very young baby or a person of extremely low intelligence) to make a meaningful choice between living and dying, and an appropriate person takes the decision on their behalf. This includes asking for help with dying, refusing medical treatment. Asking for medical to be stopped, or life support to be switched off. Refusing to eat and simply deciding to die. Non-voluntary euthanasia also includes cases where the person is a child who is mentally and emotionally able to take the decision but is not regarded in law as old enough to take such a decision, so someone else must take it on their behalf in the eyes of the law. For example, the patient is in a coma, is senile and or has brain damage. Involuntary euthanasia occurs when the person who dies chooses life and is killed anyway. This is usually called murder, but it is possible to imagine cases where the killing would count as being for the benefit of the person who dies.

With the three types of euthanasia, there are different ways of approaching euthanasia. There's active euthanasia where a person directly and deliberately causes the patient's death. Active euthanasia is when death is brought about by an act - for example when a person is killed by being given an overdose of pain-killers. Passive euthanasia when they don't directly take the patient's life, they just allow them to die. Passive euthanasia is when death is brought about by an omission when someone lets the person die. This can be by withdrawing or withholding treatment. Withdrawing treatment, for example, switching off a machine that is keeping a person alive, so that they die of their disease. Withholding treatment is not carrying out surgery that will extend life for a short time. Finally, there is assisted suicide. This usually refers to cases where the person who is going to die needs help to kill themselves and asks for it. It may be something as simple as getting drugs for the person and putting those drugs within their reach. Assisted suicide is sometimes called physician-assisted suicide (PAS). PAS means a doctor knowingly helps someone end their life. This person is likely experiencing persistent and unending suffering. They may have also received a terminally ill diagnosis. Their doctor will determine the most effective, painless method. In many cases, doctors will provide people with a drug they can take to end their life. A lethal dose of opioids, for example, may be prescribed for this. In the end, it's up to the person to decide whether they take the drug. With euthanasia, a doctor can end the person's life by painless means. The WMA has made a statement on physician-assisted suicide, "Physician-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However, the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient." (WMA 2017).

There is a lot of discussion between the moral distinction between active and passive euthanasia. The argument is that it is acceptable to withhold treatment and allow a patient to die, but that it is never acceptable to kill a patient by a deliberate act. Traditionally, passive euthanasia is thought of as less bad than active euthanasia. But some people think active euthanasia is morally better. Medical professionals like this idea because it allows them to provide a patient with the death they want without having to deal with the difficult moral problems they would face if they deliberately killed that person but some people think this distinction is nonsense. in active euthanasia the doctor takes an action with the intention that it will cause the patient's death. In passive euthanasia the doctor lets the patient die when a doctor lets someone die, they carry out an action with the intention that it will cause the patient's death so there is no real difference between passive and active euthanasia since both have the same result.

For more than 2,500 years, doctors have taken the Hippocratic oath. The oath encourages doctors to care for and never harm those under their care. " I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it nor will I suggest to this effect." (Greek Medicine 2012). The Hippocratic oath explicitly prohibited doctors from giving their patients poisons to end life. It's said that by the very nature of their job position, any physician has an obligation to sustain life. So, they must not be allowed to take life. Despite how bleak a patient's future prognosis might look at any given moment. Desperately ill people have made last-minute recoveries and gone on to live long lives in good health thereafter. In addition, a physician may fail to make the correct diagnosis or misjudge severity of a patient's true condition. Many argue that the Hippocratic oath supports PAS since it ends suffering and brings no more harm. If we allow our patients that are terminally ill to suffer unnecessarily, then we are doing them harm. If we are drawing out medical treatment and placing a higher financial burden on their family when the result is, they're going to lose their loved one either way, then we're hurting their family. Yes, there are medications to relieve pain, but many times those medications, for some reason or another, don't take away all the pain. Not to mention, all of the horrible things they have to go through in treatment can strip a person of their dignity. It's the doctors objective to help a patient and if that patient has determined there is no longer a way for them to live and they have gone through counselling and other means but they have been through too much with their terminal illness and if their doctor has concluded they are in their right mind to choose to end their life on their own terms.

People have debated over the ethics and legality of euthanasia and PAS for centuries. Laws today about euthanasia and PAS are different across states and countries. In the United States, PAS is legal in Washington, Oregon, California, Colorado, Montana, Vermont, Washington, D.C., Hawaii (beginning in 2019). Each of these states and Washington, D.C. have different legal requirements. Not every case of PAS is legal. In addition, many states currently have PAS measures on legislative ballots, so this list may grow. Outside the United States, PAS is legal in Switzerland, Germany, Japan. Euthanasia, including PAS, is legal in several countries, including the Netherlands, Belgium, Luxembourg, Colombia, Canada (Holland 2005). There are two systems of legalized euthanasia. The Oregon approach and the Dutch approach. The US state of Oregon legalized physician-assisted suicide in 1998. During the first three years, only around 2 people a month used this to end their lives. This was partly because of the severe conditions that had to be satisfied before a request for euthanasia could be granted. Patients must be resident in Oregon and must be aged over 18. Patients must make two oral and one written request for euthanasia and there must be at least 15 days between the first and the last request. Patient must be terminally ill with a life expectancy of fewer than 6 months; this prognosis must be confirmed by a second consultant physician. Both doctors must confirm that the patient is capable of making this decision. Both doctors must confirm that the patient does not have a medical condition that impairs their judgement. Patient must self-administer the lethal medication (Ethics BBC2014).

In the Netherlands, voluntary euthanasia and assisted suicide are still criminal offences, but doctors are exempt from criminal liability in certain circumstances. The Netherlands Criminal Code Article 293, paragraph two, stipulates that the doctor must be convinced that the patient has made a voluntary and well-considered request to die and must be convinced that the patient is facing interminable and unendurable suffering. The doctor has informed the patient about his situation and his prospects and together with the patient, must be convinced that there is no other reasonable solution. The doctor must consult at least one other independent doctor who has seen the patient and given his written assessment of the due care requirements as referred to in the points above. (Ethics BBC2014). The Dutch law also permits euthanasia for non-adults. Children of 16 and 17 can make their own decision, but their parents must be involved in the decision-making process regarding the ending of their life. For children aged 12 to 16, the approval of parents or guardian is required. If a patient can no longer express their wishes but made a written statement containing a request for termination of life before they became incompetent, a doctor is allowed to carry out their request providing the other conditions are met.

Euthanasia is a topic of ongoing debate. There's been a good amount of research done about people's opinions about it and how frequently it's actually used. A 2013 poll in the New England Journal of Medicine found that 65 percent of people in 74 countries were against PAS. In the United States, 67 percent of people were against it. However, a majority in 11 of the 74 countries voted in favor of PAS. Plus, a majority of voters in 18 U.S. states expressed support for PAS. Washington and Oregon, which had legalized PAS at the time of the poll, weren't among those 18 states. This suggests that opinions about euthanasia and PAS are rapidly changing. By 2017, a Gallup poll found a large shift in attitudes in the United States. Almost three-quarters of people surveyed supported euthanasia. Another 67 percent said doctors should be allowed to assist patients with suicide. (Holland 2005). Interestingly, a study in the United Kingdom found that most doctors weren't in favor of voluntary euthanasia and PAS. Their main objection was based on religious issues.

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