Introduction
The practice of mercy killing or euthanasia is dated from ancient Greece. However, its spread was attributed to the advancement of medicine, which facilitated the creation of ether and morphine, which made medicalized suicide a possibility. These developments made medical practitioners start advocating for analgesics to relieve the pain of death. In the 1870s, Samuel Williams defined euthanasia and proposed using anesthetics, such as morphine, to intentionally terminate a patient’s life (Kumar et al., 2021). Since then, the debate about the ethics of physician-assisted suicide (PAS) has raged in the United States and other countries, culminating in 1906-1907 in an Ohio bill that proposed the legalization of PAS in the region but was ultimately defeated (Marine, 2018). Nevertheless, the campaigns to authorize euthanasia have legalized the practice in various states, such as Oregon, Washington, New Mexico, and California. The disputations propounded for and against PAS in the 19th century are the same as contemporary arguments. Euthanasia elicits ethical, medical, religious, and legal contention, making it a controversial topic relevant to the care of patients.
Argument for Euthanasia
Euthanasia shows regard for patient autonomy which is a critical medical ethic. The principle of autonomy allows patients to control their treatment process. If patients request PAS, the physicians can only expound on the risks associated with the practice but cannot object to the patient’s wishes. Additionally, in most cases, patients who opt for euthanasia are critically ill, most of whom are aged and want to die with dignity. Allowing euthanasia gives patients who are already facing death the power to decide the end of their lives (Dugdale et al., 2019). Since most of their conditions are incurable, such patients no longer have control of their lives; hence it is only right to allow them to choose how they want to die. It is unethical to keep patients alive if it is against their will. The proponents of euthanasia argue that if individuals have the right to live, they should have a right to die as well (Jakhar et al., 2021). Therefore, terminally ill patients are entitled to decide whether or not they want to be euthanized.
PAS relieves the pain and suffering of patients and their families. The core principle of medicine is to alleviate patients’ pain caused by various ailments. Nevertheless, patients suffering from life-threatening and incurable maladies are often in immense pain that cannot be relieved despite the available treatment methods (Jakhar et al., 2021). When healing is not feasible and suffering becomes unbearable, euthanasia can be used as a last resort. Euthanizing patients experiencing chronic pain is better than objecting only for the patients to attempt suicide in a bid to end their suffering (Dugdale et al., 2019). The patients’ agony is worsened by the awareness of the emotional and financial burden that their prolonged stay in hospital or palliative care has on their family members. In such cases, the patients have a right to terminate their lives. Similarly, euthanasia lessens the agony and burden of the family members. Terminal diseases affect not only the patients but their relatives and friends, who have to witness the suffering of a loved one too. Therefore, freeing critically ill patients from pain should be considered humane and an act of compassion.
Euthanasia avails medical resources to other patients who are in dire need. Due to the advancement of technology in the healthcare sector, a patient’s life may be prolonged, even in hopeless situations. For example, a patient may remain in a vegetative state for over a decade on the life support machine and eventually die. Therefore, in cases where the healthcare environments have scarce resources, terminally ill patients who voluntarily opt for euthanasia should be supported. This is because it frees critical resources to other patients who have a chance of survival (Buchbinder, 2018). It is crucial to understand that terminally ill patients will die at some point because their ailments are incurable. Thus it may be prudent to allow PAS if the patients willingly request it because it provides an opportunity to save the lives of other people who have a high chance of survival. Furthermore, it saves the patient’s family members time and resources because it alleviates the financial burden and time spent to and from the hospital. Thus, euthanasia frees up vital healthcare resources, which are critical in saving more lives.
Argument Against Euthanasia
Non-religious arguments against PAS suggest that pain can be alleviated due to the latest advancement in healthcare practices. The introduction of modern therapeutics and palliative care has considerably helped patients diagnosed with incurable illnesses. A study shows that most cancer patients report a concern about intolerable physical discomfort and fear of being abandoned (Dugdale et al., 2019). Similarly, opponents of PAS are concerned that in Oregon, over 70% of cancer patients who request to be euthanized have emotional distress, but less than five percent are referred to a psychiatrist to rule out clinical depression (Dugdale et al., 2019). This might partly explain why the majority feel pressure to request PAS because of not wanting to burden others. However, modern medicine can help manage physical distress and psychological and spiritual stressors associated with illnesses. The team approach to palliative care can improve the patient’s quality of life and extend support to family caregivers who may benefit from referral to individual or family counseling and provide growth opportunities. Therefore, since physical distress can be reduced and the burden of caregiving made more bearable, there is no basis for euthanasia.
The promotion of life and health is a fundamental goal and principle for the ethical standards of physicians. The profession may be described as one of compassionate service for people who are sick, alienated, wounded, alone, vulnerable, and afraid. Therefore, PAS damages terminally ill patients’ trust in health practitioners to heal. From this perspective, euthanasia violates fundamental values, especially the Hippocratic Oath that dictates medics pledge not to harm (Marine, 2018). Authorizing providers to participate in PAS undermines the commitment of doctors and nurses to save lives and become official dispensers of death rather than the art of healing. This practice may discourage research for new treatments and cures for different ailments. In addition, the legalization of euthanasia is the first step on a slippery slope that may contribute to involuntary killing, where individuals perceived to be a problem or undesirable could be murdered (Dugdale et al., 2019). In this case, giving physicians the authority to decide who lives and who dies can lead to possible abuse. Thus, patients may start to fear for their lives when hospitalized.
The opposition to practicing euthanasia is based on prevailing traditional religious views. For example, in Catholicism, human life is sacred and needs to be respected. In this context, life does not belong to individuals but is a gift from God. Thus, the sanctity of life must be respected and protected from the time of conception until natural death. Christians condemn euthanasia because they believe that only God has the ultimate power over human life. When patients nearing the end of life express fears of losing control or being deprived of their dignity, they should be shown affection and provided with needed emotional support. This may make them more contented and allow nature to take its course rather than assisting them in committing suicide. The compassion accorded to patients by family members and practitioners may help them accept death as a natural process and not be hastened or delayed. Therefore, all people should be valued regardless of age, religion, race, or gender because the Bible command, “Thou shalt not kill” (Kumar et al., 2021). However, euthanasia creates loopholes for exploitation that violates the sanctity of life.
Conclusion
PAS remains a controversial topic relevant in the world today. The acceptance of euthanasia in some states has been influenced by the respect for patient rights that gives them the power to decide to die and relieve them from the pain of incurable diseases. Nevertheless, there is an ethical difficulty in interpreting the concept of a patient’s autonomy versus the professional responsibilities of physicians. PAS violates fundamental values, especially the Hippocratic Oath that dictates practitioners pledge not to harm. For this reason, non-religious proponents against euthanasia have argued that medical advances and palliative care have made it possible for patients to have the best quality of life until the very last moment. This view is supported by Christianity beliefs in the sanctity of life. In this context, people should accept death as a natural process and should not be hastened or delayed.
References
Buchbinder, M. (2018). Access to aid-in-dying in the United States: Shifting the debate from rights to justice. American Journal of Public Health, 108(6), 754-759.
Dugdale, L. S., Lerner, B. H., & Callahan, D. (2019). Pros and cons of physician aid in dying. The Yale Journal of Biology and Medicine, 92(4), 747–750. Web.
Jakhar, J., Ambreen, S., & Prasad, S. (2021). Right to life or right to die in advanced dementia: Physician-assisted dying. Frontiers in Psychiatry, 11.
Kumar, A., Avasthi, A., & Mehra, A. (2021). Euthanasia: A Debate—For and against. Journal of Postgraduate Medicine, Education and Research, 55(2), 91-96. Web.
Marine, J.E. (2018). Physician-assisted suicide: Why physicians should oppose it [PowerPoint slides]. Web.