Ethical Debate on Euthanasia
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le coma. Whereas the demand rates for euthanasia are increasing rapidly, many states are yet to legalize the issue fully. The few that have permitted assisted suicide include the Netherlands, Switzerland, Canada, and Columbia, including some U.S. countries such as Oregon, Vermont, and Washington DC (Davis, 2019). Legislation has not prevented people from practicing suicide tourism, whereby patients from restricted regions travel to request euthanasia in legalized states. Consequently, one needs to understand the reasons for and against the practice alongside the matter’s ethical positions. The distinct positions of ethical egoists and social contract ethicists on euthanasia sheds light on why or why not to perform the medical practice. Reasons for Euthanasia A robust proposition for euthanasia commences by disqualifying possible alternatives such as the effectiveness of palliative care. There is little guarantee that a patient’s suffering will effectively be relieved through palliative care, especially if they are in the latter stages of an incurable illness (Vocht, 2015). The patient may be experiencing excruciating symptoms, including respiratory difficulties, muscle pain, and nausea that continually diminishes their quality of life. Palliation and hospice care are mostly used in countries where euthanasia is illegal as patients spend their last days in medical professionals’ care. Such alternatives make patients feel like a burden to family and caregivers, which limits their effectiveness. The costs related to ETHICAL DEBATE ON EUTHANASIA 3 in-house palliation and hospice care are also quite expensive, and some patients may not afford that topped up by the medical expenses and hospital check-ups (Vocht, 2015). Arguably, euthanasia is a more dignified end to palliation or hospice care because it eradicates a patient’s greatest fear which is losing their autonomy. Overall, there is little significance of palliation is the patient is suffering unbearable pain. Given the rapidly increasing healthcare costs, euthanasia presents a suitable solution for many patients suffering from terminal illnesses. The treatment costs for terminally ill patients are generally unaffordable for diagnosed patients and getting sufficient insurance covers may prove challenging (Vocht, 2015). For instance, cancer patients have to receive chemotherapy or radiation and continually visit the hospital, which is hardly covered by in or out-patient insurance policies. Such patients are placed in intensive care in critical stages, with most of them unresponsive, using up available hospital beds and resources. It may take several months before they die, during which medical bills rise dramatically and fall weightily on family members. Moreover, patients in developing regions have little access to advanced medical technologies and hospitals are mostly fully occupied, leaving little resources to alleviate their pain (Vocht, 2015). As a result, they get sent home with pain-relieving medicine and are left to die at home given that alternatives such as palliation are also unavailable or unaffordable. Ethical Debate on Euthanasia
Therefore, legalizing euthanasia will free up hospital resources and present a voluntary alternative to patients suffering from the latter stages of terminal illnesses. Reasons against Euthanasia Religious and cultural beliefs are the most used perspectives to oppose euthanasia. Patients and family members who decide on the subject based on their religion view life as a higher power gift. For instance, Christians uphold that God is the giver of life and only He ETHICAL DEBATE ON EUTHANASIA 4 should take it or decide when one dies (Vocht, 2015). Therefore, performing euthanasia is disrespectful to life’s sanctity, and experiencing suffering is part of the God-given life. Medical specialists are in most situations expected to respect the patient’s decision despite their religious stand. Consequently, health professionals also sub-consciously rely on their religious beliefs to advise for or against the practice. Patients, families, and medical specialists are often influenced by their religious beliefs, limiting them from accepting or practicing euthanasia. Arguably, euthanasia’s fear of causing a “slippery slope” is the most significant reason euthanasia opponents present. Many believe that legalizing the practice may open doors for the satisfaction of selfish desires such as involuntary euthanasia (Vocht, 2015). At times, a patient’s family may insist that their dying one be euthanized without effectively consulting the patient. This may be for selfish reasons such as the desire to inherit one’s property or relieve themselves of the care costs or burden. Consequently, patients may hurriedly opt for euthanasia to eradicate the piling medical costs before all available medical options have been tried.
Therefore, the risk of euthanasia attracting other “unwanted” consequences significantly supports the practice’s opposition. Ethical Egoist Stand From an ethical egoism perspective, whether one should adopt euthanasia depends purely on that person’s wish. The theory states, “each person ought to pursue his or her own self-interest exclusively (Rachels, 2019).” Therefore, euthanasia is right if it fulfills and maximizes a patient’s self-interest. This theory has three primary stances; individual as described above, personal ethical egoism that states, “only I should act in my self-interest,” without somewhat involving others. The last is universal ethical egoism that directs everyone to do what is best for them regardless of other people’s positions. Individual egoism supports euthanasia if the patient is ETHICAL DEBATE ON EUTHANASIA 5 willing to discontinue treatment at a time where their quality of life is significantly low. They inform their family and caregivers of their wish to terminate life if the pain becomes unbearable and they cannot speak for themselves. Universal egoism suggests that euthanasia should be performed regardless of other people’s wishes, such as the desire from the family to keep the patient alive. Ethical Debate on Euthanasia
Moreover, physicians subscribing to egoism may support practicing euthanasia based on their self-interest, given that such a practice would secure vital organs useful in saving other lives. Family members may also wish to stop ongoing treatment of their loved ones if they find the experience traumatizing and financially draining. Social Contract Ethicist’s Stand From a social contract theorist perspective, practicing euthanasia depends on the laws in place within specific regions of jurisdictions. Arguing from Hobbes’ social contract approach, the existence of laws and moral regulations prevents people from acting in their self-interests, integrating them into a well-organized community (Rachels, 2019). Therefore, a social contract ethicist would only support euthanasia if it aligns or is allowed by the patient’s state or jurisdiction. Moreover, the patient cannot perform or request another state’s practice because they are not part of that society and will have disobeyed their individual laws. Arguably, this theory prevents the occurrence of suicide tourism and limits the global legalization of euthanasia. The ANA Code The American Nurses Association (ANA) upholds that nurses should not perform or participate in active euthanasia. Active euthanasia entails somebody other than the patient ending the patient’s life, such as when nurses directly use lethal doses or injections.
By performing active euthanasia, nurses violate the Code for Nurses with Interpretive Statements and its ethical ETHICAL DEBATE ON EUTHANASIA 6 provisions (ANA, n.d.). Therefore, nurses are obligated to follow the code and provide alternative compassionate end-of-life care. ETHICAL DEBATE ON EUTHANASIA 7 References Abohaimed, S., Matar, B., & Shah, N. (2019, June 28). Attitudes of Physicians towards Different Types of Euthanasia in Kuwait. Retrieved March 30, 2020, from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598031/ ANA. (n.d.). Retired Position Statement: Active Euthanasia. Retrieved from ANA: http://ojin.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/EthicsPosition-Statements/prteteuth14450.html Davis, N. (2019, July 15). Euthanasia and assisted dying rates are soaring. But where are they legal? Retrieved March 30, 2020, from The Guardian: https://www.theguardian.com/news/2019/jul/15/euthanasia-and-assisted-dying-rates-aresoaring-but-where-are-they-legal Rachels, J. (2019). The Elements of Moral Philosophy . Vocht, H. d. (2015). Health professionals’ opposition to euthanasia and assisted suicide. International Journal of Palliative Nursing, 5-10. ETHICAL DEBATE ON EUTHANASIA 8 … Ethical Debate on Euthanasia