Introduction
The questions of life and death have always worried humanity since the time of its creation. Recently raised considerations concerning the rights of people to terminate their lives have provoked a debate that is marked by strong arguments on both the supporting and opposing sides. Philosophers, legislators, ethicists, healthcare workers, and theologists provide their respective reasoning either against or in favor of voluntary euthanasia. This ethical issue is of vital significance in the modern-day world that strives to fulfill human rights for quality life and well-being. Medical ethics faces an urgent need to explicitly address both sides of the debate, review the existing cases of countries and states where euthanasia is legal, and make sound decisions.
The reason why people in a healthy state of mind feel the need to end their life is that they suffer from an incurable disease that causes them unbearable pain. The desire to die painlessly is reasonable and should be tolerated. Moreover, significant psychological and ethical issues come to force when scrutinizing the pros and cons of euthanasia. In particular, terminally ill patients lose their dignity, autonomy, and the ability to enjoy life, which contradicts the depiction of quality life. Therefore, voluntary euthanasia should be legalized to enable individuals who are suffering from unbearable pain caused by lethal conditions or those experiencing existential suffering to end their lives peacefully and painlessly with autonomy and dignity. In this paper, the case of the Oregon Death with Dignity Act will be reviewed as an example of legalized assisted dying in the USA. Particular ethical considerations will be presented to support euthanasia; opposing views and their rebuttal will follow. The claims presented in the paper are based on the research of reliable sources.
Euthanasia Gives the Ability to Avoid Physical Suffering
In the Netherlands, Belgium, the states of Oregon and Washington, either physician-assisted dying or voluntary euthanasia are legally allowed. In these regions, it is practiced and publically accepted that a person in a condition of terminal illness has the right to choose death over painful life. According to Keown (2018), euthanasia derives from the Greek word with the meaning “gentle and easy death” (p. 9). Within the medical context, it is defined as a “procedure that has an effect of shortening life” of a person who is suffering from a terminal illness or a condition referred to as indignity (Keown, 2018, p. 9). The very definition allows emphasizing the supporting claim that euthanasia is ethically valid because it enables a person to avoid suffering and pain caused by their current condition.
One of the conditions under which a person might be administrated to voluntary euthanasia is the diagnosis of a terminal illness that would cause death within half a year (“Oregon Death with Dignity Act,” 2018). Since incurable diseases are associated with durable pain, a person should have a choice to avoid it. Moreover, not only people with terminal illness might be willing to end their lives voluntarily. If one experiences existential suffering and considers dying the best option, he or she should be given legal right to reason their choice and be admitted to voluntary euthanasia. For example, old people who have satisfactory health conditions might prefer voluntary euthanasia to avoid immobility and die with dignity.
Well-Being Deprivation
The voluntary ending of life should be a human right under the circumstances when one is unable to lead a good life. Indeed, apart from physical pain, terminal illness symptoms, especially in the older age, lead to difficult psychological conditions. According to the report on Oregon Death with Dignity Act (2018), the three most frequent reasons why patients chose to end their lives voluntarily included loss of autonomy, decreasing the ability to take part in activities that bring joy to life, and loss of dignity.
It is relevant to refer to Nussbaum’s characteristics of a good life, as articulated by DeHaan, Hirai, and Ryan (2016). An individual’s well-being ought to be characterized by the “ability to have bodily health, … ability for bodily integrity, including freedom of movement and freedom from fear of violence,” and “ability to use one’s senses” (DeHaan et al., 2016, p. 2038). When deprived of the freedom of movement, bodily health, or ability to use senses under the conditions of a severe illness or due to aging, a person no longer leads a good life. Therefore, it is ethically relevant to provide such a person with an opportunity of terminating his or her life.
Loss of Dignity and Autonomy
The lack of autonomy and loss of dignity as significant psychological implications connected with terminal diseases are ethically unacceptable because they obstruct well-being. As the features of quality life presented by DeHaan et al. (2016) imply, a person is expected to be treated with respect, preserve his or her dignity and autonomy to achieve well-being. If such an opportunity is lost due to an illness or very old age, it is only morally correct that patients are given the right to end their life when they deem necessary to be able to die with dignity. According to Oregon Death with Dignity Act (2018), the majority of people who are admitted to death under the Act are those aged 65 and older (79.2%) and diagnosed with cancer (62.5%) or neurological disease (14.9%) (p. 6). Such conditions are associated with significant pain and suffering that turn the life of such individuals into unbearable existence. Moreover, they lose their autonomy, are exposed to various procedures that violate their dignity as human beings.
More importantly, a dignified life deserves a dignified death. As the report on Oregon Death with Dignity Act (2018) shows, the vast majority of people in Oregon who choose voluntary euthanasia are well-educated individuals who have at least a degree of Bachelor. This fact implies that the decisions made by these patients are well-reasoned, soundly articulated, and validated by their ethical perceptions of the quality of life. Similarly, a person in a sound mind who lives a long life and anticipates long-term aging while being deprived of simple joys in life should also be given the right to end life at a reasonable time. When life becomes a burden to a person, it is only ethical to allow him or her to relieve their painful existence. Therefore, their choice to die in a manner they consider appropriate under the circumstances recognized favorable by the law must be respected as any other free choice a person makes in life.
Objections against Euthanasia
The debate around euthanasia includes the objections to the views supporting this procedure. One such claim is related to the position of the Catholic Church on God’s plans for each life under which no human being is allowed to control the time of his or her death (Pence, 2017). Also, the philosophical ideas concerning the change of attitudes toward quality of life measurements appeal to unreasonable decisions to choose one’s death. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) brings these assumptions to the discussion of euthanasia. SUPPORT claims that people’s attitudes toward what is right and what is wrong, as well as their validation of the specific features that make life quality acceptable changes over time (Pence, 2017). Therefore, although a patient chooses to die now because he or she thinks that the illness will obstruct his or her well-being, this opinion might change, and a patient might make a different decision. That is why, in the opinion of opponents of euthanasia, it is ethically and philosophically irrelevant to advocate voluntary dying.
Voluntary Euthanasia as a Reasoned Choice to Die with Dignity
To respond to the objections, it is important to refer to counter facts. Firstly, when addressing the religious point of view, the choice of religious affiliation and the issues related to faith are subject to each individual. Therefore, it is ethically unjust to apply Catholic reasoning to such a broad topic as euthanasia. Each patient is free to act according to his or her personal religious beliefs. Secondly, as the current Oregon legislation states, the procedure involves a physician’s prescription of a lethal dose of medications to a patient whose condition suffices the qualifications as per the Act.
These qualifications, among others, include capability “of making and communicating health care decisions to health care practitioners and diagnoses of terminal illnesses that would lead to death within six months (“Oregon Death with Dignity Act,” 2018). Moreover, the procedure entails a physician’s prescription of the medication that will lead to death. A patient is free to take it at any time he or she wishes. Under such circumstances, one is able to withhold from voluntary euthanasia if he or she changes the decision. Indeed, in 2018, 254 patients were prescribed lethal medications; 158 of them ingested the medication; 48 patients decided not to follow the prescription (“Oregon Death with Dignity Act,” 2018, p. 5). Thus, the physician-assisted dying procedure suffices the moral rights of choice and voluntary decision-making. In addition, unlike physician-assisted suicide, voluntary euthanasia is not limited to people with severe terminal diseases but to other groups of a population whose life might be considered as one deprived of autonomy, dignity, or well-being.
Conclusion
In summation, the broad and complex ethical dilemma behind voluntary euthanasia retrieves an array of opinions, supporting claims, and objections. From an ethical point of view, illness-related physical pain causes suffering and makes life deprived of well-being. Moreover, people with terminal diseases, as well as the elderly, face unavoidable death and are continuously exposed to psychological suffering. The conditions brought by lethal conditions lead to the lack of autonomy and dignity, the qualities that make life enjoyable. Since people diagnosed with terminal diseases cannot enjoy life as per their individual standards and have a wish to die with dignity, they must be given such a right. Forcing people to live in pain, without autonomy, with a lack of dignity, and under psychological suffering by legally restraining their choice to die is morally wrong.
References
DeHaan, C. R., Hirai, T., & Ryan, R. M. (2016). Nussbaum’s capabilities and self-determination theory’s basic psychological needs: Relating some fundamentals of human wellness. Journal of Happiness Studies, 17, 2037-2049.
Keown, J. (2018). Euthanasia, ethics and public policy: An argument against legalization (2nd ed.). Cambridge, United Kingdom: Cambridge University Press.
Oregon Death with Dignity Act. (2018). Web.
Pence, G. (2017). Medical ethics: Accounts of ground-breaking cases (8th ed.). New York, NY: McGraw-Hill Education.