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Collaborative Research Project

Collaborative Research Project: Helping People Die – Legalization of Euthanasia

Alejandra Tabares, Arjeta Balidemaj,

Bushra Chowdhury, Irin Bristy, & Vashtie Mangal

City College of New York

Purpose

Death could be perceived as a moral good if a patient does not have to spend the little time they have left suffering. Euthanasia is an important issue because it is in regards to human life. More specifically, it entails the ethically difficult question of whether or not an individual should continue to live with their condition. Before euthanasia was introduced, the belief of the role of the physician was to heal the ill, rather than seek harm. However, with the presence of modern medicine, society’s opinion towards euthanasia has shown the increase of support for this dilemma. The meaning of healing has evolved over time because of political, economic, social, religious and emotional perspectives (Doyal, 2001). While ethical issues arise from assisted suicide, the process is for the patient’s individual right. The purpose of the legalization of euthanasia is to end the suffering of a terminally ill patient.

Summary  

Euthanasia is the painless killing of a patient suffering from a terminal and painful disease. It is illegal in most countries because of the ethical conflicts that the controversial topic is associated with. Many people argue that pain experienced by terminally ill people can be controlled to tolerable levels through proper management. They claim that there is no need for physician assisted suicide. However, “tens of millions of individuals in North America do not have access to adequate pain management. Tens of millions are without healthcare coverage.” (Humber, 1994). Many people lack resources even in first world countries. Most terminally ill patients see euthanasia as their only option. Additionally, many doctors withhold adequate levels of pain killers because they are concerned that their dying patient may become addicted to the drugs. Others argue that if assisted suicide is allowed on the basis of mercy or compassion, there won’t be anything to keep doctors from actively urging, the death of anyone whose life they deem worthless or undesirable.

Jack Kevorkian also known as Dr. Death, was a former pathologist who helped more than 100 people end their lives during the 1990s. He used a method he called “terminal human experimentation.” (Charatan, 1999). He argued that convinced felons could provide a service to humanity before their execution by volunteering for painless medical experiments that would begin while they were conscious, but would end in fatality. Jack Kevorkian’s peers gave him the nickname “Dr. Death” because of his unorthodox experiments and strange proposals. (Charatan, 1999). During his career, he spent eight years in prison for second-degree murder because of the death of Thomas Youk. Dr. Kevorkian made a videotape of himself injecting Youk, a paralyzed 52 year old resident of Detroit who had amyotrophic lateral sclerosis, with lethal chemicals. The tape was broadcasted in November by the CBS News program called 60 Minutes. During his trial, Judge Jessica Cooper noted that Dr. Kevorkian had lost his medical license in Michigan eight years ago. Furthermore, he had no permission to hold the various toxic drugs he used to kill Youk. His ideology lead to an increased interest on the controversial topic of euthanasia. Ultimately, it stimulated the intervenience of multiple society groups into the private decision of suffering patients.

The American legal system endorses the principle that all persons are competent to make reasoned decisions unless demonstrated to be otherwise. The Bill of Rights were outlined to protect citizens from violations of their basic freedoms. A result of the basic foundation established by the Bill of Rights is the common-law principle of self-determination that guarantees the individual’s right to privacy and protection against the actions of others that may threaten bodily integrity. A terminally ill patient has the liberty to choose death by receiving help from their doctor. It is an absolute right possessed by an individual; the government cannot negate it.

Introduction

Euthanasia serves as a way of ending the suffering of a terminally ill patient. The process allows a way of painlessly assisting a patient in their requested death. These patients typically are suffering from an incurable and painful disease or in an irreversible coma. Euthanasia is currently only legal in Germany, the Netherlands, Switzerland and eight states in the United States of America. The reason that this seems to be very controversial is because it’s viewed a way of doctors killing their patients. Additionally, ethical and religious conflicts arise. Euthanasia is beneficial for the sole reason that there is no other cure or fixation that can help what damage has been done to the patient. In most cases, death can be the only option because they are the ones living with the pain of their condition everyday and not anyone else. The people that don’t advocate the process view it as a legal way of murder. It goes against several religions and sparks up rage in many people. However, they shouldn’t feel affected by it because the doctor isn’t making the choice to help take the patient’s life, the patient is. In fact, in a Massive Open Online Course (MOOC), people posted what their ideal way to die is, and the results were overwhelmingly in agreement with euthanasia’s standards. A MOOC is a study made available on the Internet open to anyone without charge, so the results came from a lot of different people yet there was agreement on their ideal death. A lot of the answers were along the line of dying quickly and painlessly (Sanderson 2019). Therefore, euthanasia should be legalized for those who are suffering from incurable and painful diseases or in an irreversible coma.

Policy

Patients that are limited to express their emotions due to their illness, can finally have their wishes respected in specific states. Oregon was the first state in the U.S. to legalize euthanasia under the Death With Dignity (DWD) Act which was implemented in 1997. (Hedberg, 2011). Washington became the second state to legalize euthanasia after Oregon in 2008. In 2009, the Montana Supreme Court’s ruling changed the legal status of doctor-prescribed suicide in the state. In 2013, Vermont declared that suicide with prescribed medications was a legal “medical treatment. The most recent state that enacted a bill for euthanasia is California. The California legislature passed a bill legalizing euthanasia in September 2015. The laws in place are a stepping stone to legalizing it on a national level. It has allowed other states to reconsider euthanasia.

For all the states where euthanasia is legal, the patient needs to accomplish certain tasks and requirements before being assisted by the law. Not every patient is eligible for physician assisted suicide.

ELIGIBILITY FOR EUTHANASIA
Patient must be at least 18 years of age
A resident of a state where it’s legal
Suffering from a terminal illness
With a life expectancy of six months or less
The patient must make two oral requests for assistance in dying
The patient must make one written request for assistance
Two physicians must be convinced that the patient is sincere, not acting on a whim and that the decision is voluntary
The patient must not be influenced by depression
The patient must be informed of “feasible alternatives” such as hospice care and pain control
The patient must wait 15 days between the verbal requests

Limitations such as the above make euthanasia a reasonable option for terminally ill patients. These criterias take medical conditions, written and oral confirmation, and an age requirement into account. Therefore, euthanasia should be legalized as long as these guidelines are regulated. Euthanasia can properly be carried out as long as a patient passes all of the terms.

Proposal

Euthanasia should be legalized. Regulations make euthanasia a fair and valid option In the past, various physicians have granted requests for euthanasia to patients suffering from psychiatric disease or dementia. But, recently this criteria has been questioned many times and also been asked to return to a more strict interpretation of the criteria. The political and social state of a region also plays a role in this controversial topic. For example, in 2001, the Dutch parliament voted to make the Netherlands the first nation in the world to legalize euthanasia.  However, as the Dutch government legalized euthanasia, new groups of patients demanded an even more liberal interpretation of the same law. After every verdict that broadened the criteria for euthanasia, another group of citizens campaigned for even more progressive legislation. With every new demand, the debate would fire up once again. Central to the argument in favor of the new law was the right to self-determination. “My death is my own,” as the Dutch say. Today, nine out of ten Dutch citizens support the euthanasia law that went into effect in April 2002. This law allows physicians to honor requests to assist a patient who wants to end their life if there is “unbearable and hopeless suffering” with no hope of improvement. For instance, physicians would be granted the ability to prevent someone with lung cancer from dying by choking on their own blood. The solution that makes euthanasia a justifiable option is to set limitations that make it voluntary, require written consent, require mandatory reporting and allow only physicians the authority to administer the drug.

The request for euthanasia has to be voluntary, well-considered, informed, and persistent. Legal requirement of explicit written consent is important to avoid abuse. Examples of misuse in medical research is the absence of explicit informed consent (Math, 2012). A consultation request by a second physician is also important to ensure that all criteria have been met before proceeding with euthanasia. The consultant must be independent (not connected with the care of the patient or with the care provider) and must provide an objective assessment. A patient be referred to a psychiatrist or psychologist for treatment if the prescribing or consulting physician is concerned that the patient’s judgment is impaired by a mental disorder such as depression.

Conclusion

Euthanasia is a controversial topic and thus inspires intense debates and there are several reasons as to why it should be legalized. It is already legal in a few countries and a few U.S. states. Apart from no pain, euthanasia allows people to die quickly and with dignity. Euthanasia respects the patient’s autonomy since the patients’ bodies are their own. Patients should be allowed to do what they want with their own body. Therefore, it’s wrong and unethical to make anyone live longer than they want to because it violates their personal freedom and human rights. It’s immoral to force people to continue living in pain. Opponents of euthanasia fear that if euthanasia was made legal, the laws regulating it would be abused. Non-supporters believe people who didn’t really want to die would be killed as a result. Thus, the solution is a series of rules (presented in the table above) that a patient must meet to ensure that the practice won’t be abused and misused. Regulations like having several psychiatric tests to determine a patient’s mental state to verify that the patient really wants to die and is in the right mind to do so. Ultimately, euthanasia should be legalized in the United States. It should be regulated and administered by the guidelines composed in the policy.

Sources

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Bloodworth, M., Bloodworth, N., & Ely, E. W. (2015). A template for non-religious-based discussions against euthanasia. The Linacre quarterly, 82(1), 49–54. doi:10.1179/2050854914Y.0000000036

Charatan F. (1999). Dr Kevorkian found guilty of second degree murder. BMJ : British

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Doyal, L., & Doyal, L. (2001). Why active euthanasia and physician assisted suicide should be legalised. BMJ (Clinical research ed.), 323(7321), 1079–1080.

Hedberg, K. (2011). Oregon’s Death With Dignity Act: 20 Years of Experience to Inform the Debate. The Journal of Clinical Ethics

Humber, J. M., Almeder, R. F., & Kasting, G. A. (1994). Physician-assisted death.

Komesaroff, P. A., & Charles, S. (2015, May 18). A minimalist legislative solution to the problem of euthanasia. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.5694/m

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Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: right to life vs right to die. The Indian journal of medical research, 136(6), 899–902. (n.d.). Retrieved from

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Sanderson, C. (2019). “I want to die in my sleep”-how people think about death, choice, and control: Findings from a Massive Open Online Course. Retrieved from http://apm.amegroups.com/ article/vie w/24828/2330