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The primary goal of any physician is to restore the health of their patients by eradicating the sickness, which makes the patient dysfunction in any way. Additionally, a physician has the responsibility of easing the pain, which is brought by the original illness or from the treatment directed towards curing the patient. Despite the advancement of pain-relieving techniques in the 21st century, there are ethical issues that arise from the practice. (1)
Pain is termed as anything that results in agony or misery. This pain might be emotional or even spiritual. However, the pain that is addressed in the medical field is the one that arises from disease, injury or illness affecting any part of the body. The issue of pain alleviation in itself gives rise to various ethical issues. Pain medication is said to have the ability to impair a patient’s cognitive function making it hard for that person to prepare for death. While the death of a person undergoing intense pain might be a big relief for the affected family, it might bring about emotional pain. (2) In most cases, a patient might demand euthanasia to lessen their pain.
This gives the family and the doctor’s leeway to administer euthanasia to the affected patient. This leads to the historical argument that voluntary euthanasia is often the beginning of a slippery slope that gives rise to unintentional euthanasia and the murder of people who are unwanted in society. This is because the pain that is present in the body might not end thus giving rise to spiritual or even emotional pain. Additionally, while the society might want to adopt euthanasia as a means of relieving pain, there are concerns that this weakens society’s respect for life and it is a sure way of admitting that some lives have less worth than others do. (3)
Traditionally, the use of non-opioid medications is encouraged to prevent minor pains. In cases where there is severe pain, the use of opioid analgesics such as morphine is recommended to suppress the pain. While some opioids like codeine do not have major side effects, others are known to impair the cognitive function of the brain. Given in large amounts, the opioids are capable of repressing the central nervous system something that might in effect lead to the loss of consciousness. According to the Catholic Church, this is an ethical issue since once a patient lapse into unconsciousness he/she is denied an opportunity to share in the suffering of Christ and this might deny them an opportunity to repent their sins. The other ethical issue that arises because of the use of strong opioids is that its ability to quicken death is in itself an act of passive euthanasia. (4)
The issue of who is to decide when the patient is unconscious has been a divisive matter. The Catholic Church has a realistic approach when it comes to the issue of pain relief. For those who are still conscious, they are allowed the freedom of choice if they will take drugs that might lead to semi-consciousness. For patients who are unable to express themselves, their family has the liberty to assume that those patients wish to take those medications. On the issue of who is responsible for determining if the patient is unconscious, it is obvious that the doctors are the ones responsible for this. (5)This can be seen in the Postma case where her family had failed to end their mothers suffering even after she showed a clear desire to have her life terminated.
Faced with this decision, the family kept on encouraging her to continue trying and to enter rehabilitation programs. When it became obvious that Mrs. Van Boven had lost all her will to live, her daughter in consultation with her husband who was both medical doctors decided to inject their mother with 200 mg of morphine. Although Mrs. Van Boven had demanded voluntary euthanasia, it only took Mr. and Mrs. Postma who were medical doctors to administer euthanasia to their mother. This case is present in many other scenarios where doctors are given the right to decide which patient deserves to receive euthanasia or not. (6)
There is an existing ethical debate surrounding mercy killing. This is often concerning the proper treatment of people approaching the final stage of life. In reality, some physicians and law practitioners argue that life has to be prolonged unless there are no other means to escape death. To others, hastening death in the name of relieving pain is a matter of morality and therefore unacceptable. Others consider using pain medication that comes with the risk of impeding respiration, which might bring an early death to be passive euthanasia. Additionally, other people believe that medicine has no intrinsic value and end up referring the decision to hasten death to the affected families or even to the courts. (7)
Despite these obvious variations, the Catholic Church has clear distinctions regarding actions, which hasten death and the intention to relieve pain even if the act would end up bringing swift death. According to Catholics, human life is a gift given to fulfill a certain mission. This means that prolonging life is not the most important thing but rather directing oneself to live a life that is well-pleasing to God. Christians are therefore called to make their lives useful and they are not at liberty to destroy their lives at will. This means that murder and suicide are contrary to God’s providence for human lives.
It, therefore, follows that if the pathology used to prolong life imposes a grave burden or is futile, then there would be no moral obligation to use it. The ethical dilemma in this situation is addressed since there is a big difference between passive or active euthanasia and using pain medication to alleviate pain as death approaches. Even in situations where medication quickens death for a dying person, this is only considered an unexpected side effect since the primary intention of the act is to alleviate pain. In euthanasia, the principal intention is to bring a quick death to alleviate pain. Even in the presence of intense pain, the decision to take another person’s life is not by God’s word. (8)
There has been a protracted legal and political debate regarding euthanasia in the United States. Throughout history, there are numerous records about patients with incurable metastatic cancer, suffering from unrelieved pain begging an end to their misery. While some doctors have taken upon themselves to end the lives of patients who are considered unable to recover from their maladies, the decision has remained open to court interpretations.
On one side, some courts have concluded that euthanasia is morally wrong and needs to be punished. This same verdict was given on the Postma case where the family doctors were found to have erred. However, the debate has evolved and many courts now seem to be on an agreement that euthanasia is justified in some conditions and circumstances. Many politicians agree that someone should be allowed to choose if they want to live or not since prolonging one’s life in the reality of death is tantamount to holding them hostage. (9)
Indeed, there is no ethical justification for euthanasia in its entirety. In human life, pursuing a desirable and worthwhile good may involve accepting some unwanted side effects. The death that results from the use of morphine should not be misconstrued to mean the same thing as advocating for euthanasia. Instead, this is considered an unforeseen side effect. This is different from directly advocating for euthanasia to shorten the period of pain. People are not at liberty to terminate their own lives and only God has the authority to do so. Today, there are medical inventions, which have considerably improved the lives of patients experiencing intense pain. This means that there is no moral justification for euthanasia and it should be discouraged. (10)
The ethical debate on euthanasia will probably go on for a long time to come. The teaching of the church concerning pain relief is crucial in modern society due to the ongoing campaign to approve euthanasia. The people clamoring for the legalization of euthanasia are only concerned with the cost aspect of prolonging. In the end, euthanasia enthusiasts betray human dignity and the links of the community. No doubt practicing euthanasia is tantamount to failing to appreciate the human person in the community. Indeed, ethical justification can only be said to have been achieved if the human dignity of the concerned party is considered and so far, this has not been achieved.
- David, Kelly, Medical Care at the End of Life: A Catholic Perspective. (Georgetown University Press, 2006) 12-25.
- Kevin, Wildes and John Harvey, Birth, Suffering, and Death: Catholic Perspectives at the Edges of Life. (Springer Science & Business, 1994). 157-169.
- Ibid 159
- Kelly, 15
- Gerald, Dworkin, The Theory and Practice of Autonomy (Cambridge University Press, 1988), 33-41.
- H. ten Have and Welie Jos. Death and Medical Power: An Ethical Analysis of Dutch Euthanasia Practice. (Open University Press, 2005) 1-26.
- Ibid, 20
- Wildes and Harvey, 162
- Kelly, 19
- Wildes and Harvey, 168
Dworkin, Gerald. The Theory and Practice of Autonomy. Cambridge University Press, 1988.
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Have, H. ten and Welie, Jos. Death and Medical Power: An Ethical Analysis of Dutch Euthanasia Practice. Open University Press, 2005.
Kelly, David. Medical Care at the End of Life: A Catholic Perspective. Georgetown University Press, 2006.
Wildes, Kevin and Harvey, John. Birth, Suffering, and Death: Catholic Perspectives at the Edges of Life. Springer Science & Business, 1994.