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The term “right to die” refers to various issues around the death of an individual when that person could continue to live with the aid of life support, or in a diminished of enfeebled capacity. In some cases, it refers to the idea that a person with a terminal illness and in serious condition should be allowed to commit suicide before death would otherwise occur. The concept is often nicknames, normally by supporters, “dying with dignity” (wikipedia.org).
The problem in today's society from many American's, is dying has become far more complicated that it once was. Many centuries ago, most people died at home of illness that medicines couldn't cure or defeat the infections. Now that we have so much training and technology that it creates a choice of life or death. This is what raises the question among many families, the choice about human dignity and what constitutes a “good death” (euthanasia.com)
Most people die in hospitals, nursing homes and or intuitions, that staff makes a valiant effort to keep patients alive, until there is no reasonable chance of recovery. However, for many people that is what they want a no-barrier effort to fight off death as long as possible! For those who are facing terminal illness, they come to that point where the fight no longer seems worth it (Williams, 2001).
Personal control over health care is a value founded on the ideal of personal liberty and deeply rooted in our ethical and common law tradition. Yet in practice, this value is often disregarded by health care practitioners and is sometimes undercut by legislative restrictions. The difficulty is particularly severe for patients who cannot express their will at the time a health care decision is made. Perhaps the most striking cases are those of seriously ill patients who, contrary to previously articulated wishes, are subjected to technological procedures designed to prolong the interval before their death (Williams. 2001).
Right to die law and legislation has their ultimate goal the heightening of our autonomy and self-determination in matter of health care. It could enhance the individual's liberty in facing death. Limitations on the common law right of personal control over health care, choices are grounded on protection of various social interests and on protection of the patient's own life or health. Both general types of limitation on self-determination to the extent that society's choice treatment differs from the choices patients would have made. Both of these have beneficial effects to counterbalance the loss in individual autonomy (Landau, 1997).
The common law has long been a source of judicial reference in defining the concepts of constitutionally protected liberty and the implied limits on state power. In this tradition, some courts have held that the common law right of personal control over health care choices, encompassing the right to refuse treatment, is reinforced by the constitutional right of privacy. In landmark decisions of the U.S. Supreme Court, Griswold v. Connecticut, 381 U.S. 497 (1965), which has the extended the right to privacy to the right to die and remains the most compelling constitutional argument for that right under the Fourth Amendment (Irving,1988).
Most often, the idea of the right to die is related to a person's wish that caregivers allow death, for example; by not providing life support or vital medication, under certain conditions when recovery is highly unlikely or impossible. It may also refer to issues regarding physician-assisted suicide. It may be called passive euthanasia in cases where the patient is unable to make decisions about treatment. Living wills and do not resuscitate orders are legal instruments that make a patient's treatment decisions known ahead of time, allowing a patient to die based on such a decisions is not considered to be euthanasia. Usually these patients have also made explicit their wish to receive only palliative care to reduce pain and suffering.
Physician-assisted suicide refers to, a physician who provides either equipment or medication, or informs the patient of the most efficacious use of already available means, for the purpose of assisting the patient to end his or her own life. While Euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life (Ethics in Medicine, 1998). For patients whose quality of life and expected lifespan has become so limited as to make earlier death preferable to prolongation of life, the professional standard of care should be that of aggressive palliation of suffering and enhancement of opportunities for a meaningful life, not that of intentional termination of life (http://www.americangeriatrics.org). It is morally acceptable for a physician to administer a medication or forgo a treatment calculated to improve the patient's and the family's experience, knowing that this plan of care may have the unintended effect of hastening the patient's death. Good care may include the withholding or withdrawing of any medical intervention as well as the specific palliation of symptoms, even if this shortens a person's life (Williams, 2001).
Do people know the right to choose death? Euthanasia involved death that is intended to benefit the person who dies, and requires a final act by some other person such as a physician-assisted suicide or doctor. No matter the initial point that both intentionally it ends a human life (euthanasia, 2001).
There are many arguments against and for Euthanasia. For some they argue that euthanasia (1)wouldn't only be for people who are terminally ill, (2) can become a means of health care cost containment, (3) become non-voluntary, and (4) a rejection of the importance and value of human life (euthanasia.com).
Euthanasia won't just be for terminally ill patients but there are two problems with the definition in which we consider “terminal,' due to the changes that have already taken place to extend euthanasia to those who aren't terminal. The national press club in 1992, Jack Kevorkian said terminal illness was “a disease that curtails life even for a day.” But on the flip side the co founder of the Hemlock Society often refers to terminal as “terminal old age” (Hemlock Society). Even if we had a specific life expectancy like (nine months) is referred, to medical experts acknowledge that it is virtually impossible to actually predict a patients life span. Some people who are diagnosed as terminally ill don't die for years, from the diagnosed condition(s). However, euthanasia activities have dropped references to terminal illness, replacing them with such phrases as “hopelessly ill,” “desperately ill,” “incurably ill,” “hopeless condition,” and “meaningless life.”
In a journal article, from the Suicide and Life-threatening Behavior, they describe assisted suicide guidelines for those with a hopeless condition. “Hopeless condition” was referred to as including terminal illness, serve physical or psychological pain, physical or mental debilitation or deterioration, or a quality of life that is no longer acceptable to the individual. It is trying to say that just about anybody who has a suicidal impulse (Williams, 2001).
“Physician assisted suicide, if it becomes widespread, could become a profit- enhancing tool for big HMOs.” -euthanasia, 2001
Perhaps one of the most important developments in today and in most recent years in the increasing emphasis placed on health care providers to contain cost. In such a situation, euthanasia can certainly become a means of cost containment.
Today in the United States there are thousands who suffer from not having medical insurance care. The ones who suffer the most are those who are poor and minorities. Generally they are not given the opportunity or access to available pain control, and manage care facilities, that physicians are being offered cash bonus if they don't provide care for these two particular patients (poor and minorities). With the greater emphasis being put onto doctors, many are now at a financial risk when they do provide treatment for their patients. If legalized euthanasia raises a huge potential for the dangerous situations in which doctors themselves could be far better off financially if a seriously ill or disabled person “chooses” to die than rather receive long-term health care. Doctors don't want to take on this situation in which they rather have their patients do long-term care for as long as their natural bodies can handle.
“Drug used in assisted suicide cost only about $40, but that is could take $40,000 to treat a patient properly so that they don't want the “choice” of assisted suicide.”- euthanasia, 2001
Euthanasia will be involuntary in emotional and psychological pressures could become very overpowering for depressed or dependant people. If euthanasia was even considered as a choice to receive care, many people many feel guilty for not choosing the next step in life (death). “Being a Burden” along with financial considerations have or could have great concern on one individual choice making. But this could serve as a powerful force that would lead a person to choose euthanasia or assisted suicide.
Let's take for example: when I did my social devaluation paper on a dear friend in nursing home, she was no longer able to understand her daily food menus and she was asked to sign a form consenting to be killed. Now she can't read well anymore and is just asked to sign a form in which she has no idea about. She believes it to be her daily food menu she signs stating what she would like to eat of the day is this involuntary or voluntary? Will my friend who signed this form be protected by the law in anyway? But as of right now the overall prohibition of killing stands in her way. Since and once she has signed this form, her signature can sign away one's life. There is no strong protection as the current and absolute prohibition on direct killing. So therefore, there is NOTHING that anyone can do (Williams, 2001).
Legalized euthanasia would most likely progress to the stage where people, at a certain point and time, would be expected to volunteer to be killed. Take for example, that since the dog/cat recall came into effect and your dog was affected by the kidney failure, that the veterinarian doctor said “it isn't worth your dog suffering the rest of his life on medication that he should be put out of his misery,” but you refused to consent. What do you believe that your veterinarian would say? What would the others in society think? Many people today have animals instead of children and think of them as a family figure. The truth about this is, that your vets may not treat your loved animal as they had before when your animal was “healthy.” Rather this animal would be a burden to take care of since there isn't anything more they can do (euthanasia, 2001).
There is a movement from voluntary to involuntary euthanasia on abortion from the life and health of the mother many years ago, to today as abortion is on demand even if the baby is half born. Euthanasia people state that abortion is something people choose and there for it is not forced on them so voluntary euthanasia wouldn't be either. You don't need to be on any side of abortion because if euthanasia was declared legal it would change the law. And this lays on the same lines for euthanasia/ assisted suicide as soon as the door would open to make it legal. Euthanasia is the importance and value of human life. People who do support euthanasia say it is considered to take human life under self-defense (euthanasia.com).
History has taught us the dangers of euthanasia and that is why there are only two countries in the world today where it is legal (Oregon and the UK). This is why almost all societies, even religious ones for thousands of years have made euthanasia a crime. It is remarkable that euthanasia advocated think that they know better than the millions of other people throughout history who have outlawed euthanasia. Have things changed? If they have, they are changed do that they should logically reduce the call for euthanasia, pain control medicines and procedures are far better than they have ever been any time in history (euthanasia.com).
“Congress is putting at risk the practice of medicine, the treatment of pain and care for the terminally ill.” John A. Kitzhaber
The Rights of Terminally Ill Act authorizes an adult person to control decisions regarding administration of life-sustaining treatment by executing a declaration instructing a physician to withhold or withdraw life-sustaining treatment in the event of the person is in a terminal condition and is unable to participate in medical treatment decisions (Sloan 1988). As this act is narrow, it does not address treatment of the person who have not executed such a declaration, it doesn't cover treatment of minors and it doesn't address treatment decisions by proxy. The impact is limited to treatment that is merely life prolonging, and will soon occur, and who are unable to participate in treatment decisions. This act is not intended to affect any existing rights and responsibilities of persons to make medical treatment decisions. The act provides one way by which a terminally ill patient's desires regarding the use of life-sustaining procedures can be legally implemented (Sloan 1998).
“Physicians should not be allowed to honor the requests for physician assisted suicide and euthanasia to patients” stated by Alan Astrow (Williams, 2001). Astrow also stated “it is granting the doctors the right to kill.” This would contradict the life-serving purpose of medicine and ultimately create more difficult conflicts for the terminally ill and their loved ones. Instead of endorsing euthanasia, Astrow argues medical policymakers should see that doctors and nurses acquire better training in pain alleviation and comfort care for the dying. The arguments for physician- assisted suicide and euthanasia rest on those cases for chronically ill patients who can find comfort nowhere else but in death. There are those of some patients who are depressed and discourages by the prospect of lingering physical decline but are not yet “actively dying,” want an end to their suffering and assistance in ending their lives (Williams 2001). Therefore, should terminally ill have the right to choose the time of their death and should/shouldn't have access to assisted suicide? Suicide means that the person is in act of taking one's own life voluntarily and intentionally. Dying people want to commit suicide in order to end their own suffering or to ease the emotional and financial burdens in their loved ones. Many argue that it is ok for those who want to take their own lives into their hands because their pain isn't tolerable anymore. But there are those who are perfectly healthy who just don't want to live anymore and therefore kill themselves for no reason. There are two parts that we can argue on those who should and shouldn't have access to physician assisted suicide. Wesley Smith an attorney for International Anti-Euthanasia Task Force and argues that assisted suicide devalues the lives of the sick and dying people and undermines a physician's oath to “do no harm,” (Williams 2001). It should rather be nurtured to those who have effective pain control should be the preferred treatments for the terminally ill. Smith quotes “Legalizing assisted suicide for people who are diagnosed with a terminal illness is wrong.” If this is legalization of physician assisted suicide spreads, the nonfatally ill and the disabled will face increased pressure to end their lives in order to cut health-care cost ( Williams, 2001).
“It is sometimes permissible for us to intend death in order to stop pain.” Frances M. Kam
In our society, adults generally make health care choices for minors regardless of the young person's age. They are legally responsible for their well-bring, parents are expected to act wisely in situations where teenagers are not considered mature enough to actively participate (Landau,1997). The Dilemma which reflects concerns many areas of our society. It is hard for us to actually pinpoint the adolescent that should assume adult responsibilities. The age at which younger adults can be legally marry or independently receive health care shows similar examples of variations. The gap between law and reality has grown wider as adolescents increasingly participate in activities. The numbers now have a huge significant change with teenagers living on their own, holding jobs, bearing children, having sex, and becoming involved with alcohol and drugs. While many of these changes have occurred over the year's nevertheless health care raises important questions about adolescents care. As great question that arises is that “should older teens who largely taken control of his/ her life be treated like a child when a serious medical threat comes? This is what happened to a seventeen year old name Juan.
The seventeen year old Juan begged his mother and the doctor to forgo the surgery that was needed. He knew that meant that if he didn't have the surgery he might die, but he was willing to accept that consequence. Juan felt that at least the time he has left would be bearable. Although they were moved by his ambition to do the surgery and by his plea to be left alone, the young man's mother, along with the medical staff, felt that they knew what was going to be best for Juan. Later, that same day Juan was dragged into surgery literally kicking and screaming. As for putting the child through such a surgery there was no happy ending outcome. Juan ended up dying four agonizing month later (Landau, 1997). For this surgery only made Juan life unbearable to live, but if they would have listened to his request, he could have had a better death.
From this outcome of Juan's surgery it raises many questions in were the physicians who were involved wrong to ignore his plea of not having the surgery? With Juan knowing his body and having the operation before he knew what the outcome would most likely feel like. With this in the case should his thoughts, feelings and preference have been disregarded simply because he was still a minor! If Juan would have been eighteen, he probably would and could have enjoyed and spent the last months of his life however he wished (Landau, 1997).
In our society, children have frequently been treated by pediatricians. While pediatricians are especially trained to care for young people, their loyalty and allegiance rest with the parents. No matter what the youth's age or maturity, the parent is kept fully appraised of the situation and decides on the treatment options (Landau, 1997). However; recently things have began to change somewhat. Adolescent medicine, a new medical subspecialty, has emerged and gained recognition. Many of the practitioners of adolescent's medicine were formerly pediatricians or family practice doctors who acquired advanced and great training in treating teenagers. Most adolescent specialties approach their patients different than those of minors are usually dealt with. The doctors of these patients inform them from the start that what occurs between the teenager and themselves (doctors) will remain and stay confidential.
But, for many of these adolescents, they are continuing to be treated by doctors with no expertise in adolescent medicine. While many physician training programs are beginning to appreciate and focus on the unique medical, social and ethical concerns inherent in treating teens, adolescent medicine still remains a relatively new specialty (landau, 1997).
There are so many difficulties, that most teenagers go through with the legal roadblocks in medical care. The state law is considerable when a person can secure his/her own health care and have the last word in any life or death situation (Elaine Landau, 1997). These laws can be some what bent depending on the type of situation or circumstance.
There is not a more serious issue then death. When a person dies it may seem black and white in many cases. Besides the obvious complexities of why a loved one has left your life, there are also circumstances involving death that are equally complex and challenging. These situations can be identified as a person's right to die and the death making process. The process of death making is done by an individual when they are in a situation where they are aware that they will not survive. A person who is terminally ill has a few possible solutions and methods to choose from in order to help end their own life. An individual's right to die is commonly seen when a person is permanently incapacitated or is declared to be in a permanent vegetative state. Usually this incapacitated person's family members decide that their loved one has the right to die instead of remaining in this “lifeless” state. To some, these decisions are a right to all people but to many they are very controversial.
When the term terminally ill is said many people imagine an individual that is in the middle or end years of their life. It is easy to forget that terminally ill people come in any age, weather or not they have had a chance to experience a full life or not. For individuals that are terminally ill who are under the age of eighteen, their parents have the right to allow them to end their life. This option is seldom explored since these individuals have not had a long life and usually want to experience all the possibilities they can before their time is up. Once an individual that is terminally ill turns eighteen they have the option to explore their death making process. An exception to this is when a person who is terminally ill is over the age of eighteen and still resides with their parents. By living under their “roof”, the individual forfeits the option of making their death.
Terminally ill patients of such diseases as cancer will begin to prefer death instead of a pain filled life. When these patients go through chemotherapy and radiation treatment they can experience pains and discomfort that can afflict them constantly. The goal in many people's lives is to attain a high quality of life and maintain it for as long as possible. When a person is in continuous pain and such former pleasures such as sleeping and eating become daily challenges, their quality of life can become incredibly low. When an individual is living at a low quality of life, their life seems expendable. This feeling of expendability leads many to seek options to end their lives on their own terms. One method that has grown in popularity over the past few decades can be explored through the Hemlock society as well as a coordinating program called Compassion and Choices. The Hemlock society provides information via mail concerning how to commit suicide and Compassion and Choices trains volunteers to personally assist suicide (International task force, 2005). The method of suicide in which these programs utilize is asphyxiation. This process includes the individual placing a plastic bag over their head and then filling the bag with helium gas (International task force, 2005). The hemlock society describes the helium as providing a “gentle, quick and certain death” (International task force, 2005). This method is performed in the individual's home and is no way affiliated with the individual's medical service provider.
Another option that many terminally ill patients inadvertently discover and utilize as a means to end their life is overdosing on morphine. Many terminally ill patients are provided morphine to alleviate the physical pain. This drug can be extremely helpful for these patients in order to get through their day and complete tasks in their lives that they would not be able accomplish without it. This drug can be lethal when it is not regulated and overused. Some terminally ill patients will choice to overdose on their supply of morphine.
The right to die is a right that family members or loving friends exercise over a permanently incapacitated individual who is close to them. They feel that this individual has the right to die instead of remaining in their incapacitated state. The question that arises in this situation is what is a worthy quality of life? Is it simply breathing and having a heart beat? Or is it interacting with others, having life experiences and making memories? Those who feel that a worthy life simply involves breathing and surviving believe that no one has the right to end your life, especially when you are unable to be involved in that decision. Proponents of this perspective feel that life is worth everything regardless of the activities you are able to engage in.
The opposition to this stance feels that life is only worthy and viable when the individual can interact with the people in their surroundings. When an individual is in a permanent vegetative state they are put on life support. This support may sometimes involve the use of a ventilator to breathe and always involves a feeding tube for artificial nourishment and hydration the individual. If the feeding tube is removed, “death normally occurs within three to fourteen days” (Williams, 2001). The removal of a patients feeding tube will essentially starve them and kill them through dehydration. The removal of a patient's feeding tube has become the most used and widely accepted solution for a person in a permanently vegetative states right to die to be fulfilled. Thos who believe this method is acceptable back their decision by stating that “no evidence exists that they are aware of the process” and that “those who are near death are seldom hungry” (Williams, 2001). Although these arguments are commonly made and accepted. No one can truly tell what kind of life that incapacitated person is living and there is also no truthful opinion that will speak for that incapacitated persons beliefs concerning the continuance of their life. These reasons are widely expressed by those who are against the premature ending on a life whether or not that life is filled with interaction or simply involves surviving.
The true question that arises from this discussion is whether or not a life should be ended prematurely before the natural failure of one's bodily systems. If you believe that it is acceptable to end a person's life because they do not feel that the current quality of their life is high enough, then there are solutions and methods that will act as a means to that person's end. These methods and solutions can be performed voluntarily by the individual as well as with assistance from others (Hemlock technique, morphine overdose). This end can also be perceived as that person's right to die, which would be performed by an able assistor (the removal of artificial nourishment and hydration). These current trends are being utilized by many and challenged by popular opinion. We must decide how define what a meaningful life is before we can decide on an appropriate way to end it.