Euthanasia: Making the Decision

Active euthanasia should be permitted as a medical treatment to allow people the right to die with dignity without pain and in peace. Euthanasia, also known as assisted suicide or mercy killing, takes on many different forms. When most Americans think of euthanasia, they think of a specific form that is referred to as active euthanasia which means to actively do something that will end a patient’s life with or without that individual’s consent.

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When euthanasia is performed in an involuntary manner it is usually because the patient is comatose, unconscious, or otherwise unable to communicate whether or not they want to have their life prolonged through artificial means. In such cases, the physician makes an executive decision whether to end the patient’s life, deeming it just because that individual would experience only pain and suffering in the continuity of their state. In the United States, active euthanasia is currently banned, with the exception of the state of Oregon. Oregon’s Death with Dignity Act (DWDA), which was enacted in late 1997, allows terminally-ill adult Oregonians to obtain and use prescriptions from their physicians for self-administered, lethal doses of medications (Death With Dignity Act). It would appear to be an easy assumption that most people in the United States believe that ending the life of a human being who is alert and able to communicate is morally wrong, though most likely is suffering and experiencing a lesser quality of life because of that; for example, a patient who is suffering from a terminally ill disease like Lou Gehrig’s disease, cancer and multiple sclerosis. With a closer examination of the facts, however, might lead to an extreme change in the opinions of even the strongest supporters of anti-euthanasia. Michael Petrou’s article titled A Time to Die provides a prime example of a situation where active euthanasia was the appropriate course of action. Petrou writes about the final chapter in the life of a man named Hans Knottenbelt. Knottenbelt was an adored husband and father, living in the Netherlands, where euthanasia is legal and practiced regularly. The right to die in the Netherlands is highly regulated. Certain situations must come in to play, the patient must be experiencing unbearable pain, the patient must be conscious, the death request must be voluntary, the patient must have been given alternatives and time to consider these alternatives, there must be no other reasonable solutions to the problem, the patient’s death cannot inflict unnecessary suffering on others, there must be more than one person involved in the euthanasia decision, only a doctor can euthanize a patient and great care must be taken in actually making the death decision (Euthanasia in the Netherlands).

In the later stages of his life, he was diagnosed with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease. He and his family immediately recognized that this was a death sentence. The disease would cause the nerves which control his muscles to slowly deteriorate. They knew that, in time, he would become essentially paralyzed. He would quickly lose his ability to walk and eventually not even be able to speak or swallow. Finally, he would get to the point where he could no longer take in enough oxygen, and he would suffocate. What made this disease especially terrifying to Knottenbelt and his family, however, was the fact that the disease would not affect his mental capacity. This meant he would be completely aware of what was happening to him as he inched closer and closer to his imminent demise (Petrou 22). After suffering with the disease for some time, Knottenbelt came to the conclusion that euthanasia was the only reasonable solution for his affliction. The doctor, whose name was disclosed in the article, came to his home and provided the only means of escape from his disease. Knottenbelt lay down on his bed and received a dose of anesthetic, then a dose of a drug to stop his heart. Knottenbelt’s daughter described the peaceful passing of her beloved father as “one of the most beautiful things [she had] seen in [her] life” (qtd. in Petrou 23). Had Hans Knottenbelt been living in any of the forty-nine out of fifty American states where euthanasia is illegal, the sight of his death would have been anything but beautiful. His daughter describes what an average night was like for her father while he was suffering from Lou Gehrig’s disease: “My Dad woke up in the evenings like a scared rabbit. He was so scared. Not scared of dying, but scared of suffocation, of the way he would die” (qtd. in Petrou 22). Without the option of peacefully ending his life, Knottenbelt’s fears would have become reality. The most likely scenario would have been for him to wake up in the middle of the night and discover his airway blocked up with fluids. In a panic, he would have furiously rung the bell beside his bed to alert his family he needed help, as he did on a near nightly basis. This time his help would either arrive too late, or be unable to clear his windpipe. Knottenbelt would have died in one of the most excruciating ways imaginable. The unlucky family member who had come to his side to try to help him would be forced to watch him violently struggle for air right up until the moment of his death.

Frank Collins from Baruch College wrote an essay titled To die or not to die which gives another prime example of a case where active euthanasia should be practiced. He writes about the tragic story of a French woman by the name of Chantal Sebire. Sebire was diagnosed with Esthesioneuroblastoma, an extremely rare form of cancer of the nasal sinuses. It leaves the patient horrifically disfigured and in constant excruciating pain. Sebire’s extensive facial tumor took her sight, as well as her senses of smell and taste. Her request for legal euthanasia went all the way to the high court in Dijon, France where it was rejected. Sebire was found dead two days after the court made its ruling. She had committed suicide by overdosing on barbiturates. Sebire was a former school teacher and a mother of three. She attracted a strong outpouring of sympathy when she appeared in a French television news interview for the right to “depart peacefully”. Before-and-after pictures of the woman, her face severely deformed, have been featured in the press along with her account of frightened children who ran away at the sight of her. Sebire learnt in 2002 that she had developed an esthesioneuroblastoma, an uncommon malignant tumour in the nasal cavity, which she said had led to “atrocious” suffering (Collins). “In 2000, I lost the sense of smell and taste… and I lost my sight in October 2007,” she said in the television interview. “One would not allow an animal to go through what I have endured,” she said before urging President Nicolas Sarkozy to intervene and grant her request (The Daily Telegraph). It would seem nearly impossible to make a case for telling patients in situations such as Knottenbelt’s and Sebire’s that they do not have the option to die with dignity. The majority of American lawmakers, however, do just that. The most common, and seemingly strongest, argument used by knowledgeable detractors of euthanasia is the idea that a system of legal, active euthanasia would be impossible to properly enforce. Those who oppose the Death with Dignity Act say it is a certainty that euthanasia would be abused and there would be no way for law enforcement to ever prosecute those responsible. The best that euthanasia-supporters can offer, they argue, is a sort of honor-system (“Should Euthanasia” 26). These supporters of the ban on euthanasia seem to have overlooked the system currently in place in Oregon, which seems to provide reasonable guidelines. The state’s Death with Dignity Act lays out strict guidelines to prevent the misuse of euthanasia. The law states that, in order to participate, a patient must be: 1) 18 years of age or older, 2) a resident of Oregon, 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that will lead to death within six (6) months. It is up to the attending physician to determine whether these criteria have been met (DWDA).

According to the act, doctors may provide lethal medications only to patients who are terminally ill with less than six months to live, who receive a second medical opinion, who formally request lethal medication three times, and who do not seem to be suffering from a mental disorder (“Oregon’s” 3). While certainly not completely foolproof, this system seems to work well enough to put in place and allow patients in Hans Knottenbelt’s situation to avoid painful, traumatic deaths. Opponents of the Death With Dignity Act, such as former attorney general John Ashcroft, say the law violates the Controlled Substances Act because it allows doctors to prescribe drugs that are not for a “legitimate medical purpose” (“Death” 33). However, this argument is innately flawed since Ashcroft fails to make a case as to why the drugs Oregon doctors prescribe are not for a “legitimate medical purpose.” One has to wonder what purpose could possibly be more “legitimate” than saving a person from an agonizing death such as the one with which Hans Knottenbelt was faced. Active euthanasia should be allowed under very strict circumstances. When a person is faced with an imminent, painful demise, as Knottenbelt and Sebire were, it is the most suitable option.

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