Religious Studies: Ethics. Euthinasia.

Euthinasia is the inducing of a painless death, by agreement and with compassion to ease suffering.

Against Euthinasia.  For Euthinasia. 

• "I will not perscribe a deathly drug, to please someone, nor give advice that may cause his death." Hippocrates.
• Some doctors still maintain this view, arguing that killing a patient does not fit with what a doctor should do. A doctor should heal, prevent diseases and assist people in living a healthy daily life. 
• "(Physicians are) not only to restore the health, but to mitigate the pain and dolours; and not only when such mitigation may conduce to recovery, but when it may serve to make a fair and easy passage. Francisis Bacon. 'New Atlantis' 1627.
• Some doctors today feel that the need to preserve the patients quality of life extends to a duty to help that patient to end his or her life in the way that he or she see's fit. 
• It can be agreed that a peacful death is one in which pain and suffering are minimised, where the patient is never neglected and whose needs are always taken account of. 
• However in all countries, the peacful death is not thought in legal terms to include euthinasia. 

• Active/Direct Euthinasia involves a specific action (such as a lethal injection) intended to bring about death) is illegal in the UK.
• Passive Euthinasia is when patients are allowed to die by withdrawing treatment and/or nutrients and is generally thought of to be legal in the UK and is common, but there are objections on ground of religion. 
• Indirect Euthinasia which is the provision of pain relief which has the side effect of hastening death is common and generally considered legal as long as the killing was not the intention. This is not usually contriversial.

• Medical science presents us with the ability to keep some human bodies alive, almost indefinatly while at the same time it leaves us unable to prevent te suffering of many people approaching death. This is the view of R.H Crook. 
• This raises the question of if a person should be allowed to bring death on at a time of their choosing, whether it is is the right to switch off the support systems keeping a body alive, when there is no hope of recovery.
• Situation to consider: A person has lived a full and active life, but is now suffering from an incurable disease that slowly limits a persons ability to move, communicate with others and think as he or she usually did. Should they be able to take their own life while they still have some control over their own destiny. As well as this, is it right that a doctor assist them with that process. 

• Advocates of Volentary Euthinasia point out that while people remain able to kill themselves, they have a quality of life that they do not want to end their life. What they want is someone to help end their life, once their quality of life is no longer desirable and they are unable to end it alone.
• Euthinasia is a criminal offence in virtually all countries and is strongly oposed by governments and most religious organisations. 
• In Holland, about a 1,000 assisted deaths take place each year, and organisations such as the Volentary Euthinasia Society (VES) campain to have a similar practice available in the UK. 

• Involentary Euthinasia is helping a person to die when they are unable to request this for themselves. 
• If a patient cannot express their opinion because they are unconcious, typically when a person is comatose, with no likelyhood of regaining conciousness, or with such serious brain damage that counciousness could never be possible does there become a time where the ventilator should be switched off, medical treatments withdrawn, or food/water withdrawn?
• Should a person be able to write a living will so that in the event that a severe injury is endured, which takes away the capabilty of basic mental function, medical treatment is not used to prolong this state? 
• Should a person be able to sign a DNR so a person can die and not be resucitated or kept alive following a severe injury. 
• Should a doctor or person of authority be able to decide when it is right to switch off life support or withdraw artificial feeding? 

• If someone is terminally ill they may ask doctors to not interviene medically to help them, which then allows them to die sooner (this is passive volentary euthinasia). Or you may wish to do so after they have lost conciousness and basic brain functions (passive involentary euthinasia). 
• The person may ask you to give them medicines which will bring about their death (active volentary euthinasia) or you may wish to do so once they have lost conciousness and basic brain function (active involentary euthinasia).

• Should have a person have the right to choose the manor and time of their death? 
• Should a person be given assistance in that process if needed? 
• The ethical arena of volentary euthinasia is divided between those who tend to feel that it is right and merciful for us to have the freedom to decide the time and nature of our deaths, and those who claim that such autonomy would have harmful side-effects on society, or that it goes against religious beliefs. 
• Pain relief can help people who are terminally ill, there may be situations where people are in terrible pain, or have such a profound sense of indignity because of their mental deterioration that they wish while they still have the chance to express a choice, to bring about death more quickly. 

There are several arguments in favour of legal volentary euthinasia.

- Volentary euthinasia is not murder. (1)

- Volentary euthinasia maintains quality of life. (2)     - Volentary euthinasia is merciful. (3)

- Volentary euthinasia gives people autonomy. (4)     - Euthinasia goes on already.  (5)

Argument: Volentary euthanasia is NOT murder. 

• In the article (written by Gregory E. Pence) "Why physicians should aid the dying" in 1997, Pence argues that killing humans who don't want to live is not wrong. It isnt wrong to help the dying to die, because they are already actually dying.
• By helping a person who is gravley ill and wants to die, to die is being merciful and stopping them from experiencing unessacary pain.

Argument: Voluntary euthanasia is merciful. 

• Voluntary euthinasia shows mercy for those suffering from intolerable pain from an incurable disease. 
• "A torturing and lingering pain, so that there is no hope, either of recovery or ease (they may) choose rather to die, since they cannot live but in much misery" Thomas More. Utopia. 1516. 
• Voluntary euthanasia is a merciful opurtunity to end needless suffering, one in which we offer to animals and should offer to humans as well. 

Argument: Voluntary euthinasia gives people autonomy.

• "The only part of the conduct of any one, for which (a citizen) is amenable to society, is that which concerns others. In the part which merely concerns himself, his independance is, of right, absoloute. Over himself, over his body and mind, the induvidual is sovereign." John Stuart Mill. 'On Liberty' 1859. We expect to have control over our bodies in matters of life, and it should be the same in matters of death. 
• The VES (www.dignityindying.org.uk) argues that every human being deserves respect and has the right to choose their own destiny, including how they live or die. 
• Constriversial American doctor Jack Kevorkian said "In my view the highest principle in medical ethics- in any ethics- is personal autonomy, self determination. What counts is what the patient wants and judges to be a benifit, or a value in his or her own life. That's primary." Book: Gula. 1988.
• Advocates of voluntary euthinasia argues that it should be an option for a competent adult, who is able and willing to make such a decision. They argue it should be on offer as one option among many, along with the kind of palietive care offered by hopitals and hospices. 

Argument: Euthinasia goes on already. 

• In 1994 the British Medical Journal published a survey which showed that some doctors already help patients to die. 
• Doctors can legally give pain-relieving treatment in doses that will bring about people's death more quickly, and in certain circumstance, such as in the case of the brain dead, or comatose, they may also withdraw or withhold treatment even though a person will die if they do so. 
• They cannot directly help someone to die at the persons request. 
• The VES holds that it would be more honest and much safer if voluntary euthnasia was legal and regulated. 
• They argue that there is no ethical difference between withdrawing treatment  and delivering a lethal injection.

Argument: Voluntary euthinasia maintains quality of life. 

• Human beings should be able to maintain their dignity up until the ends of their life. This is not simply a matter of pain, but of self-respect. 
• If someone's standard of living is such that they no longer want to live, then they should be able to end their life, and, if necassary, be assisted in doing so. 
• The quality of life worth living is one that only they can define. 
• Having control over their life is a way of enhancing their human dignity. 

Arguments AGAINST voluntary euthanasia.

Motives. (1)    

Mistakes. (2)

Abuse of the system. (3) 

Impacts on the community. (4)

Motives. 

• How can we be sure that a person isnt crying out for help rather than making a definitive decision? In desperate moments, someone may feel that they want their life to end- that the pain is too great and life is too agonising.  But perhaps those moments will pass and they will be pleased nobody acted on their please. 
• Can doctors be sure they know and understand all the facts? Is it possible they may fear a future which will not be realised. Any euthanasia process would have to be able to establish, beyond any doubt, the true intentions of the patient who is requesting euthanasia and that the patient is fully aware of the situation. 
• The risk of misinformation or failure to comprehend the situation leaves the patient vunerable to a decision that he or she might not truley want to make.

• The principle of withdrawing treatment that has no futher benifit, or simply extends a painful deterioration is relativley uncontraversial. However the question of withdrawing food and water is contraversial.
• Tony Bland was a victim of the 1989 Hillsborough disaster in which many football fans were crushed to death. He survived but was left in a coma from which doctors believed that he would never recover- a permentant vegitive state. In this state the body can breathe and main organs function properly. In Blands case he could open his eyes but did not respond to anything around him. He could not feed or digest food properly and needed a feeding tube to get nutrition. There was no cure for his condition but he was not dying. The question, which eventually went to court, was whether or not to it was right to remove artificial feeding, leading to the death of him. The court allowed to die through starvation and dehydration, which seems a cruel way to die if he could sence the pain (which was told it was not). 
• Under the Mental Capacity Act of 2005, explains the law that assisted feeding and hydration is a medical treatment which can be withdrawn. The ethical problem is when doctors are wrong in a prognosis. 
• This also means that in the case of disabled babies it could diminish the value of a disabled persons life. However, it may lessen the burdern of families caring for the sickiest of children.

• Roger Crook captures the Christian perspective on euthanasia by posing the question in terms of how we care for the dying. "What do we do for the person who is comatose with no hope of recovery? How do we care for the terminally ill person whose remaining days are increasingly agonisingly painful."
• The human being is not simply a biological entity but a person, in the image of God and Christ. Death marks the end of personhood in this life. 
• Biblical teachings prohibit killing; the Sixth commandment states that "you shall not kill" both in terms of murder and involentary manslaughter. Life should not be violated. 
• There is also a powerful message of the importance and role of healing Jesus's ministry to the sick and providing an emphasis on caring for the sick, not to mention his concern for the weakest in society. 
• While the prohibition of of killing seems to be a moral absoloute of Christianity there are exceptions for warfare and self-defence. 
• There are also examples in the Bible where the sacrifice of life is concidered virtuous: "Greater love has no man than this: That a man lying down his life for his friends" John 15:13. 
• The Bible does not prohibit all taking of life in all circumstances, although Christians have always traditionally considered wrong. 

• At the Second Vatican Ecumenical Council, the Roman Catholic Church condems crimes against life "such as any type of murder, genocide, abortion, euthanasia or willful suicide". 
• Life is sacred and a gift from God "which they are called upon to preserve and make fruitful" Declaration on euthanasia 1980.
• To take a life oposes God's love for that person, and rejects the duty of a person to live life according to God's plan. In the same decleration, the Roman Catholic Church made it clear it was wrong to ask someone for an assisted death, and that an induvidual cannot consent to such a death "For it is a question of the violation of the divine law, an offence against the dignity of the human person, a crime against life, and an attack on humanity".
• The kind of autonomy that Mill argues is rejected by the Roman Catholic Church. We simply do not have that freedom, because we are made by God for the purpous of loving God. God has created us for a purpouse, and it is our duty to live and pursue that purpose.