Why Euthanasia should not be Legal

Introduction

Euthanasia is a controversial practice entailing the relief of physical suffering through deliberate, often medically assured, death. The term is derived from Greek, meaning 'good death' or 'well dying,' a meaning most often taken by its advocates. The WHO denotes differing forms of the practice, such as "active" or "passive." Arguments for and against the ethical and moral implications of euthanasia and its legalization include personal suffering and the wider socioeconomic burden incurred through maintenance, challenging societal notions of compassion and protection, as well as advancing autonomy and personal responsibility.

Legalization varies internationally from country to country, state to state, with marked differences between northern European nations and the United States. Notwithstanding, euthanasia is growing increasingly common on an illegal, medically assisted basis.

Until the first of November 2021, euthanasia was only legal for terminally ill persons 18 years and older with unbearable suffering whose death was clearly foreseeable. Such persons were able to undergo medical assistance in the form of life termination at the date and time of their choosing if they made a considered request to their practitioner, and all due care requirements were met. Important requirements for providing due care are: a voluntary and well-considered request of the patient; the patient is well-informed about their situation and prospects; the physician has come to the conclusion that the patient's suffering is enduring and unbearable and that there is no reasonable alternative in the patient's perspective. In the case of euthanasia, medical practice in respect of terminations of life on request has somewhat expanded to include children of 12 to 17 years. In these cases, the patient's physician now has to be consulted, and juvenile and parental consent has to be obtained. Research continues to assert a slowly rising support for euthanasia. Language note: "Euthanasia" in the Netherlands in this context refers specifically to medically acted, intentional life termination. "Mental frailty" does not refer to senility or neurodegeneration.

Ethical Considerations

From a philosophical perspective, different lines of argumentation exist which have produced long-standing debates. Utilitarians would argue that it is morally right to maximize happiness and well-being, which may justify assisted death. Conversely, deontological reasoning would dictate that certain moral obligations are upheld despite potential negative impacts. Virtue ethics emphasizes the role of the moral agent. In this case, if the agent is truly compassionate, then helping a person in their final moments may be acceptable. A number of complex and interrelated arguments exist which either argue in favor of or against euthanasia. Arguments focus on individual autonomy and the right to self-determination, as well as the moral obligation to preserve life and prevent self-harm.

Imagine a patient path of someone suffering from an incurable disease. As death approaches, several scenarios are possible. The first scenario is a patient suffering with no family or friends to support them. This patient has no legal capacity, which means they cannot give consent for euthanasia even if they wanted to. The healthcare professionals involved in the care and management of this patient would not consider euthanasia without consent, even if the patient is begging for it. To do so would open up the possibility that euthanasia could take place when the interests, desires, or needs of someone other than the patient are being served. Another scenario involves a patient at the end of life suffering greatly. The patient has expressed a clear wish to end their own life and has taken all the necessary steps to document and communicate their wish to cease living. While the situation is distressing, in this hypothetical scenario, healthcare providers could consider ending the patient’s life rather than insisting the terminal person continue to suffer. However, all of the above examples assume full and informed consent, which is philosophically challenging to prove given the context of a diagnosis of HSD. Full informed consent assumes that a person is able to determine what they desire, understand the consequences of their desires, and retain the ability to communicate and consent to the action being discussed. Healthcare professionals may prolong life even if the patient asks not to. This may happen if the healthcare professionals believe it is in the best interests of the patient. Giving powerful pain medication with the knowledge that this drug may hasten death is a practice in place today. Ethical arguments for and against the practice of 'suicide tourism' have been well described. This is relevant given that EHAD often involves patients from other jurisdictions despite having legal prohibitions on physician involvement.

Impact on Vulnerable Populations

There are a number of vulnerable groups who are mentioned as a matter of great concern in the context of these developments. This includes older people, people with chronic and life-limiting illnesses, long-term disabilities, people with acquired brain injury, stroke, and degenerative diseases. This growing number of elderly people is also of great concern, and we are all worried about the pressure placed on these elderly individuals. Whenever I meet my mother-in-law, who is 92, there is always a reference to her age, and I often think that if I were a society or a light in my own eye, I could feel great pressure. Statistics show that disabled people might be fearful of becoming or remaining disabled and considering assisted suicide or euthanasia because of this.

There is also awareness of a young woman with Friedreich's Ataxia who felt that she had to apply for euthanasia because of the context of prenatal screening and selective abortion in cases like the one she was living in; "I'm next in line," she said. These are real examples from ordinary people. This approach to life and its precious nature could make them the next person in line. We question the question, "Is it acceptable for society to say or do anything that expresses its institutional attitudes?" What does this say? In this particular case, it says that the fact is, "Your life has lost value; therefore, why should we not help you to end it?"

Alternatives to Euthanasia Legislation

There are alternatives to euthanasia. The basic concern in our culture is not so much what should be done, as that patients who are dying experience and anticipate the end of life as a painful, horrific experience that they fear. As we have seen, quality of life is of great concern to patients. Alternatives to euthanasia point toward 'care' where quality of life also links with quality of death. Treatment that is directed at relieving the patient’s suffering without directly hastening the process of dying is central to such an approach. The development of better health care policies and the reallocation of health care resources to ensure that patients receive the best achievable care is important. Many more resources should be allocated to the prevention and management of pain, particularly as this also acts as a responsible deterrent to requests for euthanasia or any other form of death according to will.

Palliative care is one manifestation of a care-not-a-cure approach, acting as an expression of the culture of life ethic. Palliative care is a total approach to care, treating the patient as a whole: physically, psychologically, emotionally, spiritually, and socially. Greater palliative care resources, new ways of providing and administering analgesia, and more research into the relief of pain must become priorities. Some patients fear a painful, distressing death, but most fear dying in the loss of dignity. The value to patients, then, of an approach such as that of palliative care is obvious, although many are unknown to a large proportion of the population. Nevertheless, terminal illness is difficult to cope with, and most patients and their families would benefit from the help of the hospice total approach ethos. Retraining doctors, clergy, and other carers in the psychosocial and spiritual care of the dying is also beneficial.

Conclusion

The matters we face when considering euthanasia legislation are as much questions about the values and ethics that define us as they are about moral or legal practice. They address the very heart of our humanity and are, as such, weighty and important. With myriad contracts and limitations, the cost of medical care for the elderly and infirm, as well as weaknesses in and clashes between health insurance plans and providers, make for startling effects. The calls for euthanasia or physician-assisted killing are gradually increasing. This potentially disastrous resolution leads to a severe conversation and understanding of the catastrophe claims.

I have argued the case for taking seriously the issue of euthanasia legislation and its full implications. Although I have attempted to highlight some of those who find solace in the rhetoric of this being merely a matter of individual choice, or others who see legislation as being merely pragmatic, I have put forth strong arguments to the contrary. Is it not clear that euthanasia legislation and practice raise grave and significant ethical, moral, and societal questions? Is it not abundantly clear that it’s often our care and compassion that are really in question? Rather than enabling yet another law that risks undermining and undervaluing vulnerable people, let’s instead put our energies into the question of identifying and providing compassionate forms of modern care, restoring respect and dignity at the arc of life. Care that assists people during fragile times, and doesn’t lead them to their death, but instead makes them as comfortable and secure as they can be until they do. There are, in this case, alternatives. Let’s make them our first priority.

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