This is an essay on euthanasia. I know, I know, essays are boring. But I think there are some pretty valid arguments here, so... *shrugs* The stuff here is referenced, but I didn't include any sources here. E-mail me if you want them.


The word euthanasia has its origin millennia ago in Ancient Greece, where it means literally "the good death". However, in today's society, there are deeper and more layers of meaning to euthanasia than before. There are three basic types of euthanasia: voluntary, non-voluntary and involuntary. Voluntary euthanasia concerns itself with the express wish of a mentally competent person to die through the assistance of others. Voluntary euthanasia can further be divided into two categories: passive voluntary which is the specifically requested withholding of unwanted medical treatment, and active voluntary which is the deliberate action of killing the patient at that patient's informed request. Should dying human beings be made to suffer horribly during their last days in this world before looking forward to a painful and undignified death when they wish it to be otherwise? The answer is no. As such, voluntary euthanasia should be legalized for terminally ill patients.

For many people, euthanasia is a preferable option to dependence and unbearable suffering. The results of a 1994 Morgan Poll in Australia showed that 78% of Australians agreed to voluntary euthanasia for patients with fatal diseases or were injured beyond recovery. A study was conducted on patients' assessment of states worse than death by Robert Pearlman, a physician specializing in geriatric care at the Seattle Veterans Health Center. In-depth interviews were held with 56 adults suffering from cancer, AIDS, or who had spent time in a coma from heart attacks. The results, published in the Journal of Clinical Ethics, showed that 96% felt it was worse to be kept alive under hopeless circumstances with impending death than it would be to die. 82% felt that total loss of independence would be worse than death, and 73% were so averse to a life of unremitting pain and suffering that they would rather be dead. For patients suffering from terminal illness, the pain they undergo as the disease progresses can sometimes only be relieved by rendering them unconscious. They would have to spend the last days, weeks or even months of their life heavily sedated and unaware of their surroundings. This places stress on their loved ones as well, who have to stand by and watch as their mind and body degenerate before their eyes. The measure of life lies not only in quantity but in its quality as well. The Law Reform Commission of Canada believes that considerations of quality of life are legitimate factors in decision-making and are valid criteria in justifying certain acts.

Sue Rodriguez was a 42-year-old mother who suffered from amyotrophic lateral sclerosis, otherwise known as Lou Gehrig's Disease. Soon she would lose the ability to speak, swallow, walk and move her body without assistance. As the disease progressed, she would be unable to breathe without a respirator, to eat without a gastrotomy and would eventually be confined to bed. She wished to obtain the assistance of a physician in ending her life by her own hand when she would be in a condition in which she was unable to enjoy life. In 1993, Rodriguez appealed to the Supreme Court of Canada, but was denied the right to doctor-assisted suicide. The Supreme Court found against her favor five by four, and one of the dissenting judges in the case held that "state prohibitions that would force a dreadful, painful death on a rational but incapacitated terminally ill patient is an affront to human dignity". Rodriguez died in February 1994 assisted by an anonymous doctor.

Although the case of Sue Rodriguez gained national attention in Canada, she was by no means the only terminally ill patient seeking release from the agony they are in. In Australia, artist Neil Savage and his wife who were both terminally ill decided to die together in a suicide pact rather than be institutionalized for their illnesses. The couple consumed a lethal cocktail of drugs and alcohol, resulting in the death of Fay Savage, 62, but not of her husband as the morphine caused him to vomit. Neil Savage pleaded guilty to the charge that he aided in his wife's suicide and was sentenced to 200 hours' community service by the presiding judge. They had witnessed the terrible and lingering death of their parents and they did not want to go through a similar experience themselves or put their loved ones through it. It is indeed a sad reflection on the world today that dying people have to go through exhausting legal proceedings and painful, often unsuccessful suicide attempts in order to relieve themselves of their suffering.

Secondly, the negative consequences of not legalizing euthanasia are very real and cannot be ignored. Some terminally ill patients who are denied euthanasia attempt to terminate their suffering by ending their lives themselves and have botched their suicides in the process, bringing further suffering on themselves and those around them. By denying them their right to euthanasia, the government satisfies its own moral standards but ignores the outcome of its action. Some patients cannot bear the excruciating agony that accompanies terminal illness and when they cannot obtain physician-assisted suicide, try to kill themselves even though they may not be in a condition to do so. They may also beg for the help of loved ones not trained in medicine in their suicide. As a result, the suicide may often be messy, painful and sometimes unsuccessful. It is unfair on the family and friends of the patients to have to go through such a nightmare when all they want is to free their loved ones of pain and torment.

In addition, doctors are afraid to openly discuss end-of-life decisions with patients due to illegalities. This prevents an open and honest relationship between doctor and patient in which the doctor can discover the patient's wishes regarding his/her own life and death. According to Associate Professor Helga Kuhse, director of Monash University's Centre for Human Bioethics, "Doctors are reticent with the patients because once you raise the issue... it looks as a case of the intentional termination of life". Often, doctors are left to make their own decisions which concern the survival of the patients. It is ironic that while euthanasia is deemed illegal, there are many cases of doctors who do not obtain patient consent when they withdraw or withhold treatment, or administer potentially life-shortening palliative care. It is much better to have the decision of voluntary euthanasia made after open discussion with some sort of "institutional safeguards" than leaving it to the judgment and conscience of individual doctors. Medical practitioners need to know where they stand on this issue, instead of making decisions themselves while being in fear of being prosecuted or torn between socially accepted norms and compassion.

Currently there are cases of misuse of euthanasia, for example in cases where the patient is pressured by family members to give consent to the ending of their lives. The legalization of voluntary euthanasia provides an opportunity for safeguards against just such a situation, and other instances of coercion and fraud. The legalizing of voluntary euthanasia would provide a set of guidelines and regulations for the parties involved to follow, such as psychological counseling and psychiatric evaluation (which will ensure that the patient's choice is one given freely without coercion), signed legal agreements and a cooling-off period, as outlined in the Rights of the Terminally Ill Act of Australia's Northern Territory, and the regulation that only doctors can perform euthanasia. An example of misuse of euthanasia is the case of Dr Jack Kevorkian, who has caused fear and repugnance by his unethical methods of offering euthanasia to all and sundry who request it. Some of his patients are not terminally ill and could have committed suicide without assistance if they wanted to, as in the case of Marjorie Wantz and Sherry Miller. Dr Kevorkian has also offered his patient's organs for transplant without following proper medical regulations and procedures, thus inciting further widespread fear of euthanasia.

Thirdly, every terminally ill patient has the basic fundamental right to voluntary euthanasia. The law must recognize the principle of personal autonomy and self-determination which is the right of every human being to make decisions regarding his own body and have these decisions respected. Patients suffering from a fatal disease who wish to end their life but are incapable of doing so themselves have the right to a physician-assisted suicide. However, doctors are in no way obligated to perform euthanasia if they do not want to. No medical staff who is opposed to euthanasia shall be required to administer it. Thus, legalizing euthanasia not only ensures that the right of the patient is respected, but the right of the physician as well. It has been found in a survey by the University of New South Wales that a majority of doctors (59% out of 2000) agreed with the principle of euthanasia but they fail to implement it because they fear the legal consequences. For those who oppose euthanasia for religious or personal reasons, euthanasia is not forced upon them and likewise, they should not impose their own moral standards on those who agree to euthanasia. Those who object to euthanasia on moral grounds can face death in accordance with their personal beliefs and will still have this freedom when voluntary euthanasia is decriminalized. Nobody forces them to change their moral outlook and they should not expect everyone else to live according to their own set of tenets.

Furthermore, in a society where people are letting technology take over their lives and allowing other parties to make decisions for them, they need to know that they at least have some manner of control over their own dying. Even if most people do not want euthanasia, it reassures them that they would have the freedom to make their own choice if and when such a situation arises. The existence of a public policy gives them peace of mind and assures them that they live in a society that is not only free and democratic, but also compassionate, in which personal autonomy is respected. As the disease progresses in terminally ill patients and they slowly lose their freedom of movement and hold over their own bodily functions, they need to know that they still have control over their life. If even that is taken away from them, then they are subjected to an undignified and bitter death. Just as everyone has the right to live with dignity, they also have the right to die with dignity.

A terminally ill man, Bob Dent, 66, became the first person to commit suicide under new voluntary euthanasia legislation in Australia's Northern Territory in 1996 before it was overturned a year later. Diagnosed with prostate cancer in 1991, Dent obtained the three signatures required from his own doctor, a cancer specialist and a psychiatrist, observed the nine-day cooling off period, and was then free to choose the time and place of his own dying. He committed suicide with help from his doctor by intravenous feeding of drugs into his cancer-ridden body. He was asleep within a few seconds, and a few minutes later he was dead. His doctor, Peter Nitschke, said that Dent saw his death as an end to suffering. Dent's case is an example of personal autonomy being respected by law and of a dying man who made a voluntary and informed decision to end his own existence. He was lucid and in full control of his faculties and his own life when he died. Despite strong public support for voluntary euthanasia (70% of Australians were in favor according to a Morgan Poll) the law was overturned by the Federal Parliament in 1997. By its action, the government did not seem to take into account its citizens' rights and wishes, and instead impose its own moral code upon them, expecting the people to follow its definition of right and wrong and what is "good" for them.

Everyone may be searching for a "good death", but terminally ill patients merely wish to have a painless, merciful death at the time of their own choosing. Surely that is not asking much. It is easy for society, the government, and people to deny them this one act of mercy by spouting "moral", "ethical" and religious tenets by the dozen. They have not traveled in their shoes, and they do not know what dying is. In the end, all that these patients want is to die, peacefully, with dignity, and no pain.


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Copyright 1999 Amis Lee