This was written before my grandfather passed away this past December. Euthanasia wasn't involved; but I do mention him in this piece and say that I have "three grandparents remaining" (paraphrased), so I feel compelled that I should mention this. Grandpa Irving, z"l.
Everyone has to deal with death. Whether it is their parents' deaths, their relatives, or eventually their own, we all have close encounters with what seems in our society to be the biggest "Enemy" of them all: death. Fortunately for myself and my family, we haven't had to deal with this issue too much -- three of my grandparents are still living. But just recently over this past summer, we had a near brush with death -- my paternal Grandfather went through a series of medical problems, and it was an extremely scary affair. Thankfully he is still alive, but there was a point at which we didn't think he would be able to pull out -- obviously he is a very strong person and his will to live is still there. Needless to say, we are very happy that he is still with us, but there was a point where my parents and grandmother were confronted with the possibility of signing a "DNR" form, Do Not Resuscitate. This was after my grandfather had a mild heart attack, along with an extremely high sugar reading (over 800) for his diabetes, and he was in the emergency room. It presented a unique problem: what to do? In the end they did not sign the form, and it was not necessary either, as his sugar went down to normal levels and he is now doing somewhat better. But many, many people have to deal with these issues every day -- and the question remains, not only what is the right thing to do, but do they have the right to do it?
The "right to die" is a prominent issue in today's medical world, though it has not been as politicized as abortion. The issue is whether or not people have the right to any or all types of euthanasia. Dictionary.com defines euthanasia as:
The act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment.
Euthanasia literally means "good death" in Greek. The Dictionary.com definition is fairly close to what I think euthanasia is: I would define euthanasia as the hastening of death either by: the use of lethal chemicals, carbon monoxide or other lethal materials, or the holding back of care, at the request of the patient. Essentially they have the same meaning, but a major difference is that there are many different kinds of euthanasia. Some of the differences between the different types of euthanasia are very small, and others are very large differences, mostly having to do with how the patient asks for the death. There are voluntary, involuntary, nonvoluntary, active, and passive euthanasia. They are effectively the same thing (the patient always ends up dead in the end), but they have key differences that make them important in the arguments over whether to "legalize" euthanasia. Active euthanasia is when the doctor takes an active role in the death of the patient (i.e. giving them a lethal injection or something akin to that in order to end the patient's life), and passive is simply the denial of treatment, which is actually already legalized in the form of a "Do Not Resuscitate" order. Voluntary is when the patient expressly requests, in a capable, understandable, informed and explicit form, to have either passive or active euthanasia; and involuntary is when they don't make this request in such a manner. Nonvoluntary euthanasia is when the patient doesn't have the ability to make such a request (i.e. they are incapacitated) and so someone else, usually a family member, makes the request for them. Many people who are pro-Euthanasia are only for certain types of Euthanasia and not others, which makes these distinctions important.
Many people who are anti-Euthanasia ("pro-life") are that way because they are afraid of its repercussions and its effects on society. They are afraid of the "death culture" they believe will begin to permeate society, where people look forward to their death and become obsessed with it. They look at organizations such as the Hemlock Society (an organization focused on legalizing assisted suicide and how to do it yourself), and are scared out of their wits because it goes against their values. They also believe that if we legalize involuntary, nonvoluntary, or active euthanasia (or any combination of the types), then many people will be taken advantage of by people such as HMOs who could profit by having them have assisted take place, because then they wouldn't have to pay for their care (thus saving money), or malicious doctors. They look at these people who are pushing Euthanasia, and ask: Why are these people for it? And their answer, self-interest, not in the interest of the patients. They also are afraid that many people will die before they have to, because people might believe that they have no chance of surviving a deadly disease such as cancer, and ask their doctor for euthanasia, when they really have a chance of pulling through. They are also afraid that people might be pressured into euthanasia. Physical force is unlikely, according to them, but the social, emotional and psychological pressures might be enough to push them over the edge, and that would be a bad thing because people should only die if they have to, according to the pro-lifers.
The pro-Euthanasia, or "Right-to-death" people usually come from backgrounds where a family member or friend has died a very painful death. They have seen what a painful death is, and don't want to see others go through the same process, or want to give them a way out if they want it. Many in the pro-euthanasia are a member of the Hemlock Society, a non-profit organization that was created by Derek Humphry, an ex-journalist who wrote a number of books on the issues of euthanasia and the right to die. The Hemlock Society has been trying to legalize all forms of euthanasia. Many anti-euthanasia folks think that the Hemlock Society encourages a "death culture" where people only focus on their upcoming and imminent deaths, and not on the lives they are living. The people on the pro-Euthanasia side believe that people have the right of self-determination, i.e. that people can choose for themselves when they want to die. Derek Humphrey calls the right to death the "ultimate civil liberty". In addition, people claim that euthanasia, both active and passive, happened an incredible amount in the past, undocumented -- family doctors on the frontier giving patients lethal concoctions to end their lives when they asked for it, and things like that. It's just now that things are better tracked these days, so because of that it's harder to hide those things from the authorities.
There's also the Hippocratic Oath to consider with all of this. The Hippocratic Oath is an oath all doctors take before becoming bona-fide physicians; the basic rule of it is to "do no harm." Is euthanasia "doing no harm"? The pro-euthanasia faction will say that yes, it is doing no harm, because it is actually helping the patient because they are going to die, and by executing euthanasia, they are helping them and their family get through the dieing process quickly and easily. Those on the other side of the fence, though, think that killing in any form is bad, and so euthanasia is always doing harm because someone is getting killed.
There have been laws legalizing euthanasia passed and/or proposed in California and Oregon. In Oregon, the Death With Dignity Act, which legalized voluntary euthanasia, was passed in 1994, but it was re-voted on in 1997. The first time it just passed, with 51% voting yes to the 49% voting no. In 1997, it passed again, with a much higher margin, of 60 % to 40% in the polls. In California, a proposal was put up to vote in 1992, but was voted down. These turns of events have boosted the causes of their respective winning sides, because it shows that there are people who will fight for their causes.
There have been a number of highly publicized cases in the past of euthanasia. A person who has become a celebrity of sorts, Jack Kevorkian, also known as "Dr. Death", is usually what people think of when they hear "assisted suicide" because he was involved in a number of these cases. Jane Adkins was his first "patient", whom he assisted in suicide in 1989. She was newly diagnosed with Alzeheimer's Disease, and she wasn't even in a position with a chronic disease, nor was there proof that she gave explicit consent and request for the operation. After the euthanasia Kevorkian was charged with murder. Charges were dropped shortly, however, because Michigan (where the case took place) didn't have any laws outlawing physician-assisted suicide.
In the book Last Rights, the author, Sue Woodman, writes of her 90-year-old British aunt, "Aunty". She had a number of problems, and was admitted to the hospital, and had an operation on her fractured leg. When it was done, she found out that she had a life-threatening condition with a blood clot in her leg denying blood to her leg and calf. She would have to get it amputated, or else she would die of gangrene within the week. She contemplated the circumstances and whether or not to get the amputation. If she didn't, it'd be euthanasia -- and if she did, then she would have to live the rest of her life without a leg. Woodman writes that "I asked (my Aunt) whether she was afraid to die. 'No, no, I'm not afraid,' she answered emphatically. 'I would love it -- just to go to sleep, to be finished...'" When given the odds of 50-50 for survival with such an operation, she took the opportunity and had the operation. The choice for her was obvious -- life was worth it. But after the operation, she was extremely depressed by the fact she had no leg. She was afraid of what was to come -- would she ever get out of the hospital, or would she have to go to an old-age home? But later, she talked about how she had made the right choice, to keep on living. The will to live in a human is incredibly strong, and the circumstances from one euthanasia (or non-euthanasia) case is extremely different from one another.
In the Journal of the American Medical Association (JAMA), an unsigned piece called It's Over, Debbie was published in 1988. Whether it actually happened is not known, but it did cause quite a stir. Basically, what happens in this disturbing story is that a tired out medical student (it's in the middle of the night) is walking around a hospital, and gets called up to check up on a patient who he has never seen before, who wasn't even on his usual duty station. When he gets to her, he looks at her, and is taken aback by what he sees -- a twenty-year-old woman named Debbie who was dieing of Ovarian Cancer, who was vomiting because of an alcohol drip, and weighed about 80 pounds. The only words she says were, "Let's get this over with." The medical student then decides to, based on those words, give her 20 mg of morphine sulfate -- more than enough to kill a person -- because he "could not give her health, but I could give her rest." It continues: "I asked the nurse to draw 20 mg of morphine sulfate into a syringe. Enough, I thought, to do the job. I took the syringe into the room and told the two women I was going to give Debbie something that would let her rest and to say good-bye." He goes on to administer the morphine, and let Debbie die. After it is all over, "The dark-haired woman (who had previously been holding Debbie's hand) stood erect and seemed relieved." (JAMA, 1988, anonymous) So, it's all over, at least for Debbie. But it wasn't all over for JAMA, because after it was published, many in the medical establishment pushed for the author of the piece. We still don't know if it really took place, or if it were a piece simply published to provoke discussion and debate. Many doctors were aghast that JAMA would publish such a story in the first place, and said that whoever was the doctor in the story was a murderer, because if anything the patient didn't give consent or even a request to be administered with the morphine -- especially an amount that would guarantee death. All she said was "Let's get this over with", which could have been referring to oral medicine or stomach suction or anything else, not euthanasia. Especially when the doctor had never seen this patient before, just glancing over her medical records as he went up to her room.
I too, am in shock every time I think about this. After reading through the arguments of both sides of the issue, everyone agreed that it was wrong for doctors to take advantage of patients for any reason. This is most definitely an example of a doctor taking advantage of a patient: the doctor's actions were taken from an assumption on a simple phrase from the patient! I think that this example can be shown that while euthanasia may be a good thing for certain people (i.e. those who are about to die a very painful death very soon, so that their going can be eased), it's also a risky thing. We could easily open this Pandora's Box and have major problems on our hands with our society. The anti-euthanasia people may say that euthanasia will cause a "death culture" to form, and one could say that we have a "life-culture" now where people are obsessed with life and afraid of death like the devil, doing anything and everything in our power to prolong our lives here even if it means we'll be living in great pain; but I think the most important issues here are the implications of any decision that we as a society make: if we do legalize this, our society will go through even more fighting as the anti-euthanasia side tries to fight euthanasia in the same way it is fighting abortion, and what about societal and doctorate pressure to go through with euthanasia? Would someone ask for euthanasia to ease the pain of death for their family? I don't know, and like with Sue Woodman's aunt, we can't know except that these issues will come up. Personally, I think that euthanasia will be legalized at some point, and that it should be legalized for the same reasons abortion should be legalized -- while I am against these two things in the most general cases, there are always cases when these things are going to have to be used, and to outlaw them entirely is a grave mistake because euthanasia can truly be a "good death" if it is done the right way, and to the right person.
Sources:
- http://www.hemlock.org/
- http://www.cbhd.org/resources/aps/wernow-dignity_02-3
- http://www.deathwithdignity.org/
- Forced Exit: The Slippery Slope from Assisted Suicide
to Legalized Murder, by Wesley J. Smith
- Bioethics & the New Medical Technology, by Margot Mable
- Arguing Euthanasia, by Jonathan D. Mereno, Ph.D.
- Last Rights, by Susan Woodward