Medical Advances and the Ethical Considerations of Euthanasia

Medical advances over the past hundred years have extended life expectancy astronomically, transforming once-deadly diseases into manageable conditions and offering hope for a healthier, longer life. Medicine provides reassurance that in the event of an accident or illness, healthcare professionals will exhaust all possibilities and resources to preserve life. Moreover, healthcare systems offer palliative care to ensure that the remaining time on Earth is as painless as possible, providing comfort to patients and their families. However, there are moments when medicine cannot achieve its goals, and patients face unrelenting pain and suffering despite the best efforts of their caregivers.

During these times, individuals should have the autonomy to decide if they wish to continue enduring their circumstances. Physician-assisted suicide, when implemented with strict safeguards and as a last resort after palliative care options have been explored, gives patients an important additional option in their end-of-life care. Ethical Frameworks and Euthanasia

Euthanasia, as defined by Webster's, is "the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reasons of mercy." This definition sets the stage for the ethical debate surrounding euthanasia, which can be examined through the lens of principalism. Principalism is an ethical theory that employs key principles such as beneficence (do good), nonmaleficence (do no harm), autonomy (respect for the person's ability to act in their own best interests), and justice to resolve ethical conflicts or dilemmas. Fidelity (faithfulness) and veracity (truth-telling) are also crucial ethical principles in managing such dilemmas (Chitty & Black, 2011).

Applying principalism to the discussion of euthanasia, the principle of beneficence supports the physician's role in alleviating a patient's unrelenting pain through euthanasia, provided it aligns with the patient's wishes. Simultaneously, the principle of autonomy underscores the patient's right to make decisions about their health and end-of-life care. Patients trust that physicians have their best interests at heart and possess the knowledge to guide them through their medical journey, including difficult end-of-life decisions.

Physicians must also adhere to the ethical responsibilities of fidelity and veracity, ensuring they are truthful and faithful to their patients' wishes. This involves informing patients about all available options, including the possibility of euthanasia, to end their pain and suffering if desired. While the medical field strives to cure diseases and preserve quality of life, it should also offer patients the option to end their anguish when these goals are unattainable.

Pros and Cons of Legalizing Euthanasia

The decision to legalize euthanasia is fraught with complexity, often described as a slippery slope. On one hand, there are compelling arguments for legalization, such as respecting a patient's right to die. The right of a competent, terminally ill person to avoid excruciating pain and embrace a dignified death is seen as an extension of personal liberty. Courts have recognized mentally competent individuals' rights to make decisions regarding marriage, contraception, medical treatment, and abortion. This respect for autonomy aligns with the principalism theory, emphasizing the patient's ability to act in their best interests.

Another argument in favor of euthanasia is the ability to end patient suffering at the end of life. It is argued that forcing someone to live in unbearable conditions against their will is as much a crime as taking life without consent. Living wills are commonly used to articulate end-of-life wishes, providing clear evidence of a person's desires regarding medical treatment, including euthanasia.

However, there are significant concerns against euthanasia. Some view it as legalized murder, questioning whether it is ethical to terminate life, even with consent. Dr. Edmund D. Pellegrino raises concerns about extending euthanasia beyond consenting individuals, questioning the implications for incompetent patients or the elderly who may be unable to make decisions with sound mind. Moreover, end-of-life care can be financially burdensome, and there is fear that cost considerations could lead to unjustified euthanasia. Assisted suicide drugs are far less expensive than prolonged medical care, raising concerns about potential abuse. Social inequalities and prejudices in healthcare delivery further exacerbate fears that certain groups may be disproportionately affected by euthanasia practices. Conclusion

The debate over euthanasia, often referred to as physician-assisted suicide, presents valid arguments on both sides. Advocates emphasize the patient's right to die, the alleviation of suffering, and adherence to living wills. Opponents raise concerns about the potential for abuse, ethical implications of consent, and the impact of social disparities. Legalizing euthanasia requires careful consideration of these complex issues.

Ultimately, patients should have the right to decide their medical treatment, including euthanasia, following a thorough evaluation by a psychiatrist. Physician-assisted suicide should not be viewed solely in a negative light; for many, it represents a means of regaining control over the final aspect of their life—dying with dignity. A study conducted in Oregon revealed that family members of those who chose physician-assisted suicide described their loved ones as individuals who valued independence and control and sought to avoid the negative aspects of dying. For these patients, euthanasia provided a sense of agency and dignity in their final moments. In conclusion, the ethical considerations surrounding euthanasia demand thoughtful dialogue and careful policy development to ensure that the rights and well-being of patients are upheld while safeguarding against potential abuses. Only through such balanced deliberation can society navigate the complexities of end-of-life care and respect individual autonomy.

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