Introduction
Many people feel that they have no control about when or how they are born, but they do have control over how they die. Individuals who have been diagnosed with diseases or chronic conditions may wish to end their lives early by suicide based on the fear of experiencing excruciating pain and misery. Suffering is a patient-defined definition that encompasses both physical and psychological distress suffered by terminally ill patients (Ay & Öz, 2019).
As a result of their pain, many people would prefer to die rather than go through a long-lasting disease and lengthy treatments (Sumachev, 2020). Euthanasia, also known as physician-assisted suicide or mercy killing, is a highly contentious legal and ethical topic. The aim of this essay is to explore the legal and ethical perspectives on euthanasia or physician-assisted suicide. The essay will also discuss the perspectives of ethical egoists and social contract ethicists and to determine if there is any professional code of ethics concerned that contradicts professional and familial responsibilities.
Legal and Ethical Benefits and Drawbacks
Euthanasia is a highly contentious issue, with several reasons both for and against it. Many people feel that they have the absolute right to end their emotional and physical misery and to choose when and how they will die, regardless of whether their choice is decent or unethical. Euthanasia is classified as voluntary, where both the practitioner and the patient wish to end the person’s health. Non-voluntary is where the patient is unable to consent, and involuntary is when a third party initiates the patient’s death without the patient’s permission (Pesut et al., 2020).
Furthermore, euthanasia is on the one hand classified as active, where killing entails administering a fatal dosage of a drug to the patient, causing them to die painfully. On the other hand, is inactive or passive killing, which entails purposefully allowing the patient to die by withholding or withdrawing the ventilator (Thiele & Dunsford, 2019). People who support euthanasia claim that it should be legalized all over the world, and everyone has the right to choose.
Therefore, it would be ethically and psychologically unethical to subject terminally sick patients to needless pain and suffering before they died naturally. Euthanasia should be a natural expansion of the patient’s rights, helping them to determine the importance of life and death by themselves (Sumachev, 2020). Maintaining life support devices against the patient’s wishes is illegal and immoral in both law and medical philosophy (Pesut et al., 2020). Many people support passive forced euthanasia for terminally ill patients who are unable to make their own decisions. Opponents may regard this as homicide when it is carried out without the patient’s consent. Relatives who prefer passive involuntary euthanasia will believe it is morally correct to make choices about terminally ill patients and let them go because they are going to die regardless.
Suicide or killing, according to the opposition, is both morally and ethically unprincipled. According to some scholars, there is a philosophical difference between deliberately ending a patient’s life and removing medication that ends a patient’s life (Wallace, 2019). Adversaries argue that deliberately killing amounts to mass murder, in which family members either manipulate the patient’s decision or deliberately killing them for personal benefits, such as money. They also assume that it is unethical for physicians to assist their patients in dying; rather, their task should be to provide the high quality of service possible, such as pain management, in order to extend the client’s life. Furthermore, some antagonists may be opposed to legalizing euthanasia based on religious grounds.
Moral Uniformity
There is a philosophical distinction between passive and active-assisted death when one explores the function of causation and the concept of allowing somebody to pass on or die and also killing. The dissimilarity concerning initiating the dying and “walking” with nature does not provide a reliable measurement for determining the problem’s tolerability. If this were not the case, multiple attempts to alleviate discomfort by symptom and pain control would be considered unethical, as would interfering with the natural phase of dying. Refusing care as a means of hastening death is argued to be unfit for civilized and human culture, resulting in undignified and immoral death. Rather, assisted dying should be requested for a much more peaceful death.
Actions of negligence include killing and allowing others to die. It is founded on the idea that one is often less liable for failing to act or omitting to respond than they are for their deeds. The major point with this issue would be whether the action is performed or not and whether the act is an omission or an intervention.
If the sufferer’s initials and the endpoint are just the same, and the medical practitioner is only an intermediary between the two states, so the omission doctrine is ambiguous. The majority of the literature has found that it is difficult to distinguish between omission and intervention (Ay & Öz, 2019). This fails to make a strong distinction regarding active and passive euthanasia. Disconnecting a feeding tube from a client, for instance, may be both a killing act and a passive act of allowing the patient to die. More research across various settings is needed to distinguish between omission and action and to support the corresponding moral consistency.
If there is an ethical discrepancy, additional factors such as the intentions of the action should be regarded. This is due to the law of double effects, which defines cases in which destructive acts or omissions are permitted to pursue the good. The following conditions must be met in order to explain these two results. The behavior must not be intrinsically unethical, and the positive influences must not be a direct product of the negative consequences.
Similarly, the valuable effects must be the direct intentions, while the bad effects must be the indirect intentions, and the good outcome should be greater or corresponding to the bad result. An excellent illustration of this is the clinician who prescribed excess opioids dosages in order to relieve discomfort; nonetheless, in doing so, they unintentionally expedite the death of the patient. Other publications have been using the multiple effects principle to suggest that the desire to kill by euthanasia is not what distinguishes it from the acts in the multiple effect hypothesis.
Nevertheless, if both actions result in death, the moral significance distinction between the indirect and direct actions cannot be readily established. This double effect enables health professionals to undergo moral scrutiny while still resolving the legal issue by claiming that they did not intend to cause death, which promotes hypocrisy. Nonetheless, the dispute that there is no difference between expected and unintended consequences is a condemnation of the double standards as one of the basic values is a rejection of the validity of the ethical principle.
Ethical Egoist and Social Contract Ethicist
Every person has the right to make their own decisions, whether they are decent or deprived, as long as they favor themselves. This point will be supported by an ethical egoist. According to Ethical Egoism, an individual ought to do whatever is certainly in their own best interests in after all. It encourages selfishness rather than folly (Schiller et al., 2019). Based on this argument, philosophical egoists would argue that it is moral for critically ailing patients to request mercy killing in order to relieve pain. Furthermore, ethical egoism asserts that individuals look out after themselves, and no one should be blamed for contributing to their own fundamental needs (Schiller et al., 2019). Ethical egoism gives people the freedom to do what is morally right and useful to them.
However, ethical egoism does not hold that one’s actions can only favor them; they can also benefit others. In terms of assisted suicide, people with incurable illnesses who request doctors’ assistance in dying may relieve their suffering, but it may also benefit their family members in terms of power and wealth. In this situation, it is difficult to believe there is a tension between loyalty to self and to society because it is simply a moral ethical decision for a terminally sick person to end their intolerable misery.
According to a social contract ethicist, moral values must be comprehended as a sensible approach to a feasible problem that arises for self-interested individuals. Humans require a peaceful, cooperative social order in order to thrive (Thiele & Dunsford, 2019). As humans it is impossible to have one until the rules have established. Morality is the collection of beliefs that all should adhere to in order to reap the rewards of social living (Thiele & Dunsford, 2019). Under this situation, social contract ethicists would argue that terminally ill patients should be provided with the best pain management treatment possible to alleviate their discomfort. Thus, it is the doctor’s responsibility to serve the public, but they cannot administer drugs or aid in suicide because that would be illegal. However, it might be agreeable to the fact that society should legalize euthanasia because it will enable doctors to offer the high-quality treatment that their patients demand.
Ethical Principles and Concepts
The essence of the clinician’s therapeutic relationship is special, making it extremely difficult for some nursing staff to support euthanasia. Caregivers maintain an ongoing, interactive relationship with their patients. The association encompasses caring, compassion, founded on understanding and respect, and involves the family as a core element. The bond causes the nurses to see the sick as people because of their necessity to create meaning to both the patients’ lives and those of their families (Wallace, 2019).
According to some posts, nurses are the ones that remain with the dying patient. They are the primary observers, and they value the circumstance in which the patients must make moral decisions (Schiller et al., 2019). As a result, nurses become advocates for other healthcare workers as well as the sick. However, in the context of euthanasia, this nurse-patient relationship was thought to be questionable.
Clinicians serve as intermediaries in the sense that they have the duty to care for their clients but lack the power to influence care decisions. A nurse might be the key witness of anguish lacking the means to diminish the suffering (Wallace, 2019). Participating in euthanasia can have an effect on the nurses’ personhood and feelings. Nurses’ honesty is critical throughout their careers; thus, they should carefully consider the conflicting demands and make a judgment that is consistent with professional standards and religious beliefs. Professional veracity must support the patient’s determination and, therefore, euthanasia demands.
According to Schiller et al. (2019), ethical competence entails more than just adopting state-enacted healthcare legislation. Nursing is a societal structure whose authority is determined by practice codes and the decisions of patients. Following the patient’s death, euthanasia will intensify feelings of failure or loss. It is believed that the clinicians’ beliefs or challenges are overlooked, which is impacting the patient-nurse relationship.
Professional Code of Ethics
Euthanasia includes medical personnel who will have knowledge that will assist their patients in making life-or-death decisions. The American Medical Association’s code of ethics asserts that medical experts are obligated to follow the ethical standards in regards to their practice, including loyalty to patients and reverence for patient self-determination (Ay & Öz, 2019). Regardless of their ethnic, social, or personal views, medical practitioners are forced to behave beyond the limits for the sake of their patients and community. Since euthanasia is unlawful, physicians should give the best treatment that their patients want, but they must not assist their patients in ending their lives or provide any details that could affect their decision.
Euthanasia in Relation to Practice of Nursing
Legalizing assisted suicide in some countries has presented nurses with several moral and ethical confusions as they try to figure out what part they should play in the situation. The caregivers sometimes seek to be discharged from the service at one stage in order to maintain professional integrity, as nursing requires disease prevention, rehabilitation, and health promotion. Full involvement in end-of-life treatment is on the other side of the spectrum (Thiele & Dunsford, 2019).
Confirmation from clinicians’ involvements in most nations apart from Canada proposes that euthanasia could become a worthwhile, multilayered, and emotionally exhausting experience (Sumachev, 2020). In view of the issue’s morality, complexities, and uncertainty, the scholars have urged nurses to speak up and debate euthanasia (Pesut et al., 2020). To do so, clinicians must be aware of the problems they would address, focus on the subject, and reach conclusions using the existing body of literature. The paper investigates philosophical perspectives on euthanasia and how they apply to the nursing profession.
Several studies have presented principles and theories supporting and those against the ethical implications of assisted death in professional nursing settings (Thiele & Dunsford, 2019). Maleficence, beneficence, liberty, and legitimacy are four biomedical values that are important in the moral concerns regarding euthanasia. The philosophies are malleable, and there is a conflict between them. According to Pesut et al. (2020), there is a contrast between honoring the patient’s independent right to request euthanasia and the ethical duty to avoid harm.
Other moral topics involved comprise both quality and sanity of life, slippery slope, and pain management. The utilization of biomedical ethics to promote euthanasia by clinicians is founded on linguistic truths, such as the privilege to pass on with self-respect and the right to self-decision. Maintaining a person’s right to die encourages human wellbeing as well as autonomous and honorable death (Thiele & Dunsford, 2019). Respect for people implies consideration for an individual’s independent choices, and it is founded on the assertion that people possess their death, just as they own their lives. Requests for assisted suicide are not a reflection of the healthcare team’s incompetence but rather about the ailing individual’s willingness to make autonomous choices.
Conclusion
Euthanasia and its approval in various countries have sparked ethical, theoretical, and social debates about its effect on nursing practice. Works of literature support the opposition, while others are undecided on the subject. This paper offers a variety of insights for caregivers to consider as they focus on their roles in voluntary euthanasia and end-of-life treatment. Although not dismissing biomedical ethics, this encourages nurses to think beyond bioethics and acknowledge other considerations relevant to the field of nursing.
The concerns of moral consistency and nurse-patient interactions should be taken into account because they can provide moral and analytical intelligence in the discussion about the nurse’s position in euthanasia. When physicians consider other topics, such as the essence of their careers and all the morality and ethics issues concerning euthanasia, they will be able to engage in the procedure in a relaxed manner regulated by morals and ethics in states where it is legal.
The subject of euthanasia is large, and raising questions like the ones outlined in this essay would add valuable intellectual significance to nursing’s ongoing conversation about its involvement with assisted deaths. As the advancement of assisted dying continues to evolve in the global setting, the publications identified in this analysis have presented a number of claims from various viewpoints for nurses to reflect. This paper also informs all healthcare providers of the conditions surrounding the practice of assisted dying.
References
Ay, M. A., & Öz, F. (2019). Nurses attitudes towards death, dying patients and euthanasia: A descriptive study. Nursing Ethics, 26(5), 1442–1457. Web.
Pesut, B., Greig, M., Thorne, S., Storch, J., Burgess, M., Tishelman, C., Chambaere, K., & Janke, R. (2020a). Nursing and euthanasia: A narrative review of the nursing ethics literature. Nursing Ethics, 27(1), 152–167. Web.
Schiller, C. J., Pesut, B., Roussel, J., & Greig, M. (2019). But it’s legal. Law and ethics in nursing practice related to medical assistance in dying. Nursing Philosophy: An International Journal for Healthcare Professionals, 20(4), e12277.
Sumachev, A. (2020). Euthanasia: Moral and legal aspects. Annals of Bioethics & Clinical Applications, 4(1). Web.
Thiele, T., & Dunsford, J. (2019). Nurse leaders’ role in medical assistance in dying: A relational ethics approach. Nursing Ethics, 26(4), 993-999. Web.
Wallace, R. (2019). ‘Dying for assistance’ – Euthanasia according to Mill. The Student Journal of Professional Practice and Academic Research, 1(1), 18-27. Web.