Abstract
Since euthanasia is a medical practice that involves the termination of life, its legalization in various jurisdictions has triggered public policy debates. The debates revolve around the technical aspects of euthanasia such as the nature of euthanasia and safeguards to prevent abuse. Proponents of euthanasia argue that dying patients have the right to die with dignity, caregivers have a right to discontinue medical interventions due to unbearable burden, and healthcare providers have a duty to act in beneficence. On the other hand, critics contend that making euthanasia lawful would amount to inviolability of life, encourage wrongful use of mercy killing, and contravene the non-maleficence principle.
Technical Aspects
Euthanasia is a medical practice, which allows healthcare providers to terminate the life of a patient to relieve pain, alleviate suffering, and save medical resources. The nature of euthanasia varies according to the sources of the informed consent. Technically, euthanasia can be voluntary, non-voluntary, or involuntary. Voluntary euthanasia is a type of euthanasia where patients give informed consent regarding termination of their own life.
According to Math and Chaturvedi (2012), non-voluntary euthanasia happens when family members give the informed consent on behalf of a patient who has no capacity to do so. Involuntary euthanasia occurs when healthcare providers and family members consent to the euthanasia of a patient against his or her will. Therefore, the nature of informed consent technically determines legal and ethical aspects of euthanasia.
Since euthanasia is prone to abuse, health care systems in countries that have legalized euthanasia have put legal and ethical safeguards. Pereira (2011) states that for euthanasia to meet legal and ethical requirements, there must be written and voluntary informed consent, reporting of the case, performed by physicians only, and consideration of the second opinion.
The requirement of written and voluntary informed consent prevents physicians and family members from performing non-voluntary and involuntary euthanasia. Reporting is an important requirement that promotes accountability in medical practice given that there is fear of the slippery slope. The requirements of physicians to perform euthanasia and consideration of the second opinion eliminate the violation of legal and ethical stipulations, and thus, control the performance of euthanasia in health care environment.
Public Policy Debates
Supporting Arguments
The proponents of euthanasia hold that people have right to die just as they have right to life because they can make rational decisions based on availed information or experience. In this view, autonomy is an important right, which allows people to make decisions regarding their end of life care. Autonomy is a central pillar that supports euthanasia because it regards individuals as entities, which have a capacity to make moral decisions about plans for their lives. Friend (2011) argues that autonomy is not only a right of the patient, but also an obligation of healthcare providers to respect the decisions of patients and grant them their requests. Hence, patients receive dignity when healthcare providers respect their autonomy in making decisions about their end of life care.
Given that patients with terminal illnesses, which are disabling and degenerative conditions, writhe in pain and impose a huge burden on caregivers, proponents argue that it is ethical to allow them to die with dignity. Math and Chaturvedi (2012) note that when the burden of caregivers becomes unbearable in terms of finance, time, emotional feelings, social aspect, physical state, and mental condition, family members have a right to terminate the life of the patient. This argument holds that it is unethical to sustain the lives of patients using massive medical resources, yet caregivers are unable to bear the cost. Therefore, in instances where patients use expensive drugs or are sustained by life support machines, withdrawal of these interventions is justifiable.
Proponents assert that euthanasia is a moral practice that aims at promoting the interests of all parties involved. Essentially, euthanasia does not violate the rights of anyone, but it promotes the interests of the patients, healthcare providers, and relatives. According to Friend (2011), it is morally defensible for healthcare providers to permit patients, who do not have advance directives or unable to express themselves, to die in beneficence. In the interest of the society, family members, and the patient, non-voluntary euthanasia is applicable because it upholds the principle of beneficence, which is an integral pillar of medical ethics (Pereira, 2011). Therefore, euthanasia is a medical practice that balances the interests of different parties and acts in their best interest.
Opposing Arguments
Opponents of euthanasia argue that life is sacred and no one has the right or capacity to end its continuity. Since euthanasia terminates the continuity of life, it violates the sacredness of life. From a religious perspective, no one has a right to take life except God. As euthanasia gives healthcare providers the right to terminate life, they usurp the responsibility of God. According to Math and Chaturvedi (2012), if society embraces euthanasia, it will eliminate people with disabling and incurable conditions, hence, reducing the sacredness of life. Thus, the opponents of euthanasia require the society to uphold the sacredness and sanctity of life in handling dying patients.
Critics also advance the slippery slope view, which holds that euthanasia is abuse-prone and thus, its ban should remain in place. Math and Chaturvedi (2012) argue that family members and relatives are likely to misuse euthanasia so that they can inherit the property of the patient. To determine the veracity of euthanasia is very complex because it entails different conflicting interests, which may not be acting in the interest of the patient.
Gardner (2012) argues that the fear of the slippery slope is overwhelming because it hinders legalization of euthanasia in most countries. According to Benatar (2011), opponents of euthanasia perceive that legalization of euthanasia will lead to non-voluntary and involuntary euthanasia. Such a perception supposes that the society has no capacity to monitor and regulate the medical practice of euthanasia in health care systems.
Furthermore, opponents of euthanasia argue that the practice of euthanasia violates medical ethics because it enables healthcare providers to end the lives of their patients instead of preserving them. Medical ethics demand that healthcare providers should not harm their patients, but improve their quality of life. Schafer (2013) notes that the legalization of euthanasia may lead to reduced caution and increased harm of the vulnerable patients, who are suffering from debilitating illnesses. In this case, the legalization of euthanasia would increase the vulnerability of patients to harm and death.
Personal Opinion
Since everybody has right to quality life and death is a process of life, euthanasia ensures that dying patients receive quality life during their death. Denying them the right to die amounts to violation of their autonomy as rational beings, and hence, degrade their quality of life and reduce their dignity in the face of death. In this view, healthcare providers need to consider quality of life, burden of care, the decision of a patient, and interests of the parties involved before undertaking euthanasia. The opposing arguments such as the slippery slope, sacredness of life, and violation of medical ethics do not warrant illegalization of euthanasia as appropriate safeguards are in place to prevent abuse.
References
Benatar, D. (2011). A legal right to die: responding to slippery slope and abuse arguments. Current Oncology, 18(5), 206-207.
Gardner, D. (2012). Quality in life and death: Can we have the conversations? Health Policy and Politics. Nursing Economics, 30(4), 224-232.
Friend, M. (2011). Physician-assisted suicide: Death with dignity? Journal of Nursing Law, 14(3), 110-116.
Math, S., & Chaturvedi, S. (2012). Euthanasia: Right to life versus right to die. Indian Journal of Medical Research, 136(6), 899-902.
Pereira, J. (2011). Legalizing euthanasia or assisted suicide: The illusion of safeguards and controls. Current Oncology, 18(2), 38-45.
Schafer, A. (2013). Physician assisted suicide: The great Canadian euthanasia debate. International Journal of Law and Psychiatry, 36(5), 522-531.