Sophia Zeno Professor Winslow English 102__127 9 March 2011 Euthanasia Impacts of Law, Religion and Ethics The question of legalizing euthanasia has always been a pertinent one in current society with cancer and morbidity rates consistently rising. What is the most tolerant basis for evaluating the legality of euthanasia? In a positive aspect, it can greatly help avoid a painful or agonizing death, giving the ill patient control over their pending lives and the security of being given a choice.
However, many view it as unethical and a form of murder and suicide, doctors being the source of the assisted death. Different forms of euthanasia, such as physician assisted suicide, voluntary active, passive, and non voluntary are major factors in deciding the legality of permitting the procedure, and the various ethical views concerning the sensitive topic between the large spectrum of beliefs on the matter.
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The court systems have maintained their global stance on the illegality of euthanasia, being largely challenged by its supporters, consisting of various groups, advocating the right to die and the unconstitutionality of being denied that right. In order for one to undergo this process, some factors should be put into perspective, such as the condition and terminability of their illness, the family and patient’s realistic perspective on their current condition and life support, religion, mental health and the large judicial factor which has prohibited euthanasia on a global scale.
Physician assisted suicide (primarily active voluntary) should be approached with a more tolerant perspective when looked at from a legal perspective, giving the dying patient more choices in their situation of pending death, such as having the possibility of a painless death through a physician administered lethal drug. History and Development of Euthanasia Euthanasia stems from the Greek word “easy death,” inferring that unnecessary pain and agony may be eliminated from the inevitable dying process of terminally ill patients through this procedure.
There are various methods of euthanasia, a common one including active voluntary euthanasia. This type of assisted death is used when the patient is mentally competent with a severe sickness or physical ailment, but has lost the will to live due to their failing health and is specified as “the practice of hastening a person’s death, through such means as a lethal injection, which is carried out with the patient’s knowledge and consent” (Kitchener and Jorm 27).
Many view keeping a patient alive in this situation as prolonging their inevitable near death, and indirectly subjecting them to unnecessary and prolonged pain or discomfort. Active voluntary euthanasia is carried out by a doctor providing an injection, or providing the patient with the medical means to commit suicide. This method of euthanasia is illegal globally, and is stated by the court system to not be included under the constitutional rights in terms of due process, excluding the state of Oregon which has recently ruled it as legal under certain standards.
However, it is still performed in a sense of letting the patient die through the patient’s request, instead of maintaining the life support, which in many cases is legally accepted. However, some patients view it on an opposite spectrum. Although all suffering patients want to put an end to their prolonged pain, some feel that they would be losing their dignity in death by becoming dependent on a lethal drug to bring them to their deaths.
This is expressed through an excerpt of the court case, Cruzan v Director, Missouri Department of Health expressed by Justice Souter; “The patients here sought not only an end to pain (which they might have had, although perhaps at the price of stupor) but an end to their short remaining lives with a dignity that they believed would be denied them by powerful pain medication, as well as by their conscious-ness of dependency and helplessness as they approached death” (Minow 10). Many people expressed worry about how others will remember them in their last days.
In their dying states, they could be remembered as one who died with dignity, or as a “dependent and pathetic” person (Minow 12). Many terminally ill patients expressed that using a lethal drug as a form of passage would cause them to lose their respect and dignity through drug dependency in death. Others feel that they are losing their dignity in life by their incapacity to care for themselves. As a result, they become a burden to others, and have an inability to experience happiness and enjoyment during the end of their life in their terminally ill state.
Active voluntary euthanasia was shown to be greatly supported through a survey given to a random 2,000 registered nurses in the United States. The rules surrounding the form of euthanasia were very pertainable to many of the recorded real life cases of patients who have requested this form of assisted death. It was determined that the vast majority of nurses and physicians voted in favor of active voluntary euthanasia through a survey. The mandatory condition characteristics included, “the patient must be suffering from an illness that will result in death… here is no medical measure acceptable to the patient that can be reasonable undertaken in the hope of effecting a cure; any medical treatment reasonably available to the patient is confined to the relief of pain and/or suffering with the object of allowing the patient to die a comfortable death… the patient is not suffering from treatable clinical depression… the illness is causing the patient sever pain or suffering… the patient has been informed of alternative forms of treatment… etc” (Kitchener, Jorm 3).
With these mandatory guidelines being taken into severe account, 95% of the 2,000 nurses included in the study supported the legality of active voluntary euthanasia. The controversiality of this topic remains to be supported and unsupported by many with different outlooks on the life or death situation. The controversial outlook may be their own, a loved one’s, a judicial view, or from a complete outsider’s perspective. It further shows that physician assisted death is supported by many of the individuals who are administering the lethal drug, although it is continued to be prohibited by the legal system.
Active voluntary euthanasia is also rejected by members of the dying target group in the perspective of their personal wishes to die in dignity with no dependency on a lethal drug, allowing them to pass on feeling proud in dying with dignity through their natural death. Judicial systems around the world have maintained the illegality of euthanasia through frequent court cases of prosecutors attempting to legalize the controversial method of premature death. Any form of suicide continues to be frowned upon, even through the form of a physician assisted death for terminally ill patients.
The issue is viewed by the opposers in the perspective of ethics and law, maintaining that taking your own life, or the life of another is in not in accordance of the law or people’s natural rights. The issue is viewed from a different perspective of those who fight for their right to die “a good death” by euthanasia. Through this perspective, many supporters claim that their right to die is supported through the 14th amendment, and they should have the liberty without pain and dependence should never be denied them. Two 1997 Supreme Court cases challenged the constitutionality of the prohibitions against physician-assisted death.
The court cases are titled Washington v. Glucksberg and Quill v. Vacco. In the first case, Washington v. Glucksberg, Dr. Harold Glucksberg, four physicians, three terminally ill patients and a nonprofit organization providing council to terminally ill patients seeking physician assisted suicide presented this case challenging Washington state’s outlaw of physician assisted suicide. The prosecutors claimed that the ban was unconstitutional by violating the fourteenth amendment’s Due Process Clause by denying mentally healthy, terminally ill patients the right to choose life or death for themselves.
Their advocations on the demand of rights pertaining to physician assisted suicide was based on a “liberal conception of the good that values individual autonomy, abstractrationality, equality, and tolerance” (Church 234). However, the court denied the validity of Glucksberg’s claims of being denied certain rights of death under the fourteenth amendment by banning assisted suicide by stating, “assisted-suicide is not a fundamental liberty interest, it was therefore not protected under the 14th Amendment” (Meisel 157). This decision was supported by almost 700 years of previous prohibition of the practice.
The act of a medical doctor aiding one in a requested death through a lethal drug was still a crime in almost every state, further supported by the Federal Assisted Suicide Funding Restriction Act of 1997, restricting the use of any government funds to euthanasia. The Supreme court unanimously ruled against Glucksberg in his arguments for the legality of euthanasia. This practice continues to be unsupported globally through the court systems, making it legally impossible for physicians to practice the assisted suicide for terminally ill and suffering patients.
The issue has been strongly rebutted through other court hearings. Supporters of euthanasia continue to make their voices heard, and continue their active support of euthanasia in a legal aspect through very prominent court hearings. Another essential court case fighting in favor of legalizing physician assisted death includes the 1997 Vacco v. Quill case, where Quill and two terminally ill patients sued Vacco, the New York Attorney General, in claims that the ban on physician assisted suicide violates the Equal Protection Clause of the Fourteenth Amendment.
In Quill’s argument, he stated that it is unjust for the state to allow a mentally competent patient to lawfully refuse life support, but make it against the law for a mentally competent patient to obtain any form of physician assisted suicide (Church 12). The plaintiffs supported their case by introducing the state’s infringement of the Equal Protection Clause; “no state shall… deny to any person within its jurisdiction the equal protection of the laws” (The United State’s Constitution), which can be seen as an extension of “all men are created equal” and man’s natural rights.
Through this case, the plaintiffs argue in favor of their right to die as terminally ill patients with support of the fourteenth amendment and equal rights, in the contexts that all terminally ill patients should be able to either hasten death on their own free will, or personally receive of an accelerated death by a physician. However, the Supreme court remained in the opposing position toward physician assisted deaths, with the beliefs that New York’s ban on physician assisted suicide was constitutional, and the regulation of euthanasia is very much inside the boundaries of the state’s control.
Furthurmore, through the entirety of the Vacco v. Quill case, it was established by the Supreme court that there was no constitutional rights regarding physician assisted suicide, as it is viewed as murder by law, regardless to whom the “poison” is being given as a means of assisted and accelerated death, and for it to remain unlawful for any competent patient to obtain physician assisted suicide. Ethics of law enforced through the court systems world wide have been in continual opposition in the legalization of euthanasia, consistently regarding the source of death as murder.
The millions who are in favor and advocation for physician assisted death in most cases are disregarded, the law always overriding the people’s majority in their advocacy for the choices and rights of dying, terminally ill people. Although physician assisted suicide had been established as globally illegal, Oregon’s Death With Dignity act established a more lenient basis for euthanasia, making it the one of the first states in the world to legalize physician assisted death within the boundaries of certain restrictions and regulations.
Through the legality of active voluntary euthanasia in this state, the matter of life, and the death process was put in the hands of the terminally ill patient. In accordance with the Death With Dignity act, dying patients were given the liberty to end their own life in attempts to avoid the burdens of pain and discomfort, as well as the dependence of life support of machines, family and friends. Under the law, it has become possible for an Oregon citizen of 18 years of age or older to request a lethal prescription of medication through his physician in writing, with the prospect of giving the patient a means to end his life.
However, it is required that the requesting patient be diagnosed by a physician with a terminal disease that will have fatal effects within six months, the patient must initiate the request, and must be mentally competent in their application. The final decision in supplying the lethal drug is ultimately up to the physician, who may refuse to provide such drugs under their own personal and moral obligations or standards (Harvard Law Review 5).
Further mandatory details include that the request must be confirmed by two eye witnesses, one with no relation or affiliation with the terminally ill patient. After authorization, the patient is obligated to make a second request for the prescription, giving them the option to withdrawal their request at any time (Urofsky 321). This Death With Dignity act protects doctors from the liability of their supply of lethal prescription to the terminally ill patient, while in compliance with the given restrictions.
This law altercation allows terminally ill patients to have a choice in their inevitable end, as well as giving them some comfort during their illness in knowing that they are provided with the option to end their own lives, without dying in discomfort or pain. Mental competency has always been among the important deciding factors of a patient’s eligibility for physician assisted suicide. In the few states where certain forms of physician assisted suicide are legal, the patient equesting an assisted death must be in a healthy state of mind, and not depressed. However, in Oregon, that standard may be lacking. In a study conducted by Portland Veterans Affairs Medical Center and the Oregon Health and Science University, it was suggested that some clinically depressed patients have requested and received lethal prescriptions from their physician. ‘Out of 58 adults who had requested a lethal dose of medicine, eight of them were depressed and thirteen were determined to suffer from anxiety.
Many believe that depression is not a factor in many patients requests for assisted suicide, however it was established during the study that “none of those who died of lethal ingestion in Oregon in 2007 were evaluated by a psychiatrist or psychologist…. health care professionals frequently miss the signs of depression” (Harris 1). Mental competency is and should be one of the primary aspects of a patients admittance for physician assisted suicide, and when this very important facet of the situation is overlooked, their death does not follow the legalized guidelines of the assisted death.
When the possibility of taking ones life comes into play through the method of this legalized euthanasia, every attribute of the guidelines must be followed closely and correctly. Active voluntary euthanasia must not be used as a means of suicide due to depression, which can be treated through recommended forms counseling that can direct the patient to a more realistic logical path, when the assisted suicide is not appropriate in their requests of ending their life through a lethal drug provided by their physician.
Unethical deaths such as these experienced by the clinically depressed is one of the reasons behind the court system’s strong stance against euthanasia, in efforts to prevent the method in being used in inappropriate situations when other methods such as psychological help would better serve as a much better alternative. The issue of ethics has always been a prominent factor behind the controversy of euthanasia. The voices of organized religious groups are among the loudest in both favor and opposition of this issue, taking a stance in the wide spectrum of views on the topic.
The understanding of death through religion is vital, as well as preparing for various types of afterlife. The matter of death is a substantial factor in the beliefs systems of almost every faith, which greatly contributes to religious organizations being among one of the largest contributors of opinion to the controversy of physician assisted suicide. The majority of religions are opposed to euthanasia, and with hold the belief that a natural death is the only moral way to conclude one’s life, viewing any form of suicide as a sin, and express that the sanctity of life must be upheld.
A poll was presented to those of Evangelical belief, asking them weather they would submit themselves to death through euthanasia if suffering from pain and discomfort through terminal illness. Ninety four percent expressed that they would not give consent or request in the termination of their lives, firm in their belief to “let God be God” (Moulton, Benjamin, Burdette 1) when it comes to the natural life cycle.
Some believe that the government should have no say in the matter of life or death, and the deciding factor should be based on nothing more than religion and ethics, supported through the statement that “denying that opportunity to terminally-ill patients who are in agonizing pain or otherwise doomed to an existence they regard as intolerable could only be justified on the basis of a religious or ethical conviction about the value or meaning of life itself. Our Constitution forbids government to impose such convictions on its citizens” (241 Church).
This spectrum of the argument involves the constitution as a support for euthanasia, a common trend used in the controversy’s supportive arguments. In opposition to the previous claim, some have been found to believe that euthanasia should not be determined under the question of ethics, but should be supported solely upon the basis of liberty in one’s rights to be able to determine their fate, through the claim “… assisted suicide is not a substantive moral or ethical position, but is merely the embodiment of neutral rights of autonomy for individuals… Church 141). ” This excerpt supports patient’s choices through the focus of natural rights that should be permittable to all, giving them access to the rights that they were born with, the right to die. However, the court systems continue to dominate the legality of euthanasia, triumphing over the many who believe the method would be a beneficial means of giving a dying person a painless and peaceful option of passing. Ethics contributes greatly to the complicity of the euthanasia controversy, due to the many clashing perspectives in this aspect of the issue.
Euthanasia remains to be a hot topic through society and the legal system, the belief of society’s majority that the right to a “good death” is a basic human freedom, and others to be an unethical source of suicide and murder. The court systems continue to have the primary authority over physician’s ability to administer a means of death to their suffering patients, however through persistent arguments of opposers of the matter, very few exceptions have been made in terms of the legality of euthanasia.
The opposing forces will never reach a consensus, however physician assisted death (primarily active voluntary) should be approached more tolerantly by the court system while evaluating the legality of euthanasia. , giving the dying patient more choices in their situation of pending death, such as having the possibility of a painless death through a physician administered lethal drug. Works Cited Minow, Martha. “Which Questions? Which Lie? Reflections on the Physician-Assisted Suicide Cases. ” Chicago Journals (1997): 1-30. Web.
Harris, Jason. “Death with Dignity Act: Screening for Mental Disorders May Be Lacking. ” HemOnc Today 25 Nov. 2008: 53. Print Urofsky, Melvin. Lethal Judgements: Assisted Suicide and American Law. Lawrence: University of Kansas, 2000. Print. Harvard Law Review Association, comp. “Oregon v. Ashcroft, 368 F. 3d 1118 (9th Cir. 2004). ” Harvard Law Review 118. 4 (2005): 1371-378. Print. Church, Richard. “The Rhetoric of Neutrality and the Philosophers’ Brief: A Critique of the “Amicus” Brief of Six Moral Philosophers in Washington v.
Glucksberg and Vacco v. Quill. ” Law and Contemporary Problems 61. 4 (1998): 233-47. Print. Kitchener, Betty, and Anthony F. Jorm. “Conditions Required for a Law on Active Voluntary Euthanasia: a Survey of Nurses’ Opinions in the Australian Capital Territory. ” Journal of Medical Ethics 25. 1 (1999): 25-30. Print. Moulton, Benjamin E. , Terrence D. Hill, and Amy Burdette. “Religion and Trends in Euthanasia Attitudes among U. S. Adults. ” Sociological Forum 21. 2 (2006): 249-272. Print.