The Living Pain
For centuries, death was measured by a physician feeling for a pulse and putting a mirror under the patient’s mouth. If there were no signs of life-no pulse, no breath, death was certified. In the last few decades, however, a physician’s duty has not been so simple. More intricate scientific tests may be called for; and the law defining the point at which life ends is not so easy to formulate.
Many steps must be taken to determine death. At the same time, many steps must occur so the person can have the right to say that they do not want to be respired.
In “passive or negative euthanasia” the person dies naturally of the disease process; in “active euthanasia” the person is killed. “Active euthanasia” is often confused with allowing the terminally ill person to die naturally of the disease. Allowing an individual to die means foregoing or stopping medical treatments intended to prolong life. For example, a terminally ill person on a respirator (breathing machine) in an intensive care ward may request that the machine be turned off and that they be allowed to die. The discontinuation of the life support technology when any realistic hope for recovery has completely vanished is a legal, ethical, and appropriate act also known as “passive euthanasia.”
Through the research of this paper, I have looked at both sides of the argument. I can say that I agree with the side of “passive euthanasia”.
One advocate of the legalization of “active or positive euthanasia” has said “that it matters very much indeed if but one person who would have decided for a quick death is forced to undergo a protracted one. It also matters, of course, if but one person who would have decided to live longer is pressured into accepting a quick death” (McKenzie 491).
For some people, any appeal to utility in considering the desirability of legalizing euthanasia will seem cruel and inappropriate.
If “passive euthanasia” becomes legally and morally accepted, it is inevitable that strong pressures will be put on many patients who “do not want to die, but who feel they should not live
on, because to do so when there looms the legal alternative of euthanasia is to do a selfish or a cowardly act” (McKenzie 479).
An important attempt to incorporate euthanasia into law took place in England in 1931. Dr. Killick Millard, health officer for the city of Leicester, gave his presidential address before the Society of Officers of Health. In a subsequent article in Fortnightly Review, he presented his specific proposals in a draft bill entitled “The Voluntary Euthanasia Legalization Bill.” It included the following provisions:
1. An application for a euthanasia permit may be filed by a dying person stating that they
have been informed by two medical practitioners that they are suffering from a fatal
and incurable disease, and that the process of death is likely to be protracted and
2. The application must be attested by a magistrate and accompanied by two medical
3. The application and certificates must be examined by the patient and relatives
interviewed by a ‘euthanasia referee.’
4. A court will then review the application, certificates, the testimony of the reefer and any
other representatives of the patient. It will then issue a permit to receive euthanasia to
the applicant and a permit to administer euthanasia to the medical practitioner (or
5. The permit would be valid for a specified period, within which the patient would
determine if and when they wished to use it. (Humphry 13)
Are these the kind of pressures we want to inflict on any person, let alone a very sick person? Are these the kind of pressures we want to impose on any family, let alone an emotionally shattered family? And if so, why not also proper considerations for the crippled, the paralyzed, the quadruple amputee, the iron-lung occupant and their families?
The withholding of grand-style heroic surgery from a ninety-nine year old hopelessly dying patient who begs to be left alone is not euthanasia even if surgery could prolong the life several more weeks. The injection of a massive dose of morphine to this same patient, producing death, would be considered euthanasia. The difference is that of an act of commission as opposed to an act of omission. Euthanasia induces death by commission. It does not allow nature to take its course. The act itself is the same cause of death.
Acts of omission do not interfere with the natural process. The withholding of treatment permits death to occur naturally. It does not induce death.
There is another difference between “passive euthanasia and “active euthanasia”. Although “active euthanasia” is based upon the right to die, it also includes the right to kill.
The right to die involves the right of the individual to self-determine – the right of that person to refuse treatment, the right of the individual to privacy. These rights are isolated to that individual. They are not associated with the placing of burdens, obligations or responsibilities on other people or on society.
Euthanasia includes the same rights of self-determination, but at the same time, demands that another member of society induce death. Does an individual have the right to impose such a burden on someone, probably the physician, to comply with the request? Does he have the right to impose on society the responsibility of devising necessary safeguards?
There are still some moral and physiological questions to be looked at when analyzing the case of Euthanasia.
“Most patients who ask for death reject it when faced with it. We may not understand an individual’s hidden qualms that may be strong enough to stop the act if he has to perform
it himself ” (Heifetz 99).
“If we actually inject a death-dealing drug into this patient, we remove the possibility of
that qualm, of any hesitancy to be excised. We do not give that person every possible
last moment to change their mind” (Heifetz 107).
If we legalized euthanasia, society would be placed in a dangerous relative value position that could be used by bigots, selfish survivors, as well as religious and political opportunists.
I, therefore, see only one way out of this dilemma. We must pass laws that grant the courts the right to consider and honor motivation and intent in cases of euthanasia and the right to declare no penalty.
It is inevitable that people will die. “Death is life’s certainty, weather it comes sooner or later, slowly or in the wink of an eye. It is a situation that faces us all and makes us one with all mankind in our mortality”(Barnard 83).
The concept of “death with dignity” (Goodman 1) has become an increasing focus debate, not the least because of medical progress that has brought about demographic changes in population and a major increase in the number of retired and aged persons. The issue has generated a wealth of legislation, much of which confuses rather than clarifies a silent question in euthanasia: who will pull the plug?
One of the major areas of confusion surrounding this very sensitive issue is that it is seldom the qualified person who pronounces judgement or purports to speak with authority on the problem.
Those who can claim that one can always alleviate the suffering of the dying has either not had enough exposure to the problems or is lacking in a simple quality – compassion.
Somewhere along the way the right-to-die movement went from asking about stopping treatment to asking for a doctor’s help in dying.
In Holland, euthanasia, defined as the termination of life by a doctor at the expressed will of a patient, remains technically illegal. But it is permitted under state guidelines in cases of “unbearable suffering”(Humphry 56).
The technology which would enable individuals to make decisions about the value of their own lives is monopolized by the medical profession. The drugs which would kill quickly and painlessly are not available to private individuals, forcing them to resort to highly unpleasant alternatives. In certain extreme circumstances, some doctors are apparently prepared to make the relevant drug available to individual patients. However, the context of such cases makes it clear that it is very much the doctor, rather than the patient, who controls the technology and on whose ultimate approval its application depends. In any case, this practice of “voluntary euthanasia” is currently illegal, even if this aspect of the law is not one which is very rigorously enforced.
The reluctance of medical practitioners to provide individuals with the means to their own death is often speciously justified by reference to the sanctity with which doctors are expected to regard all human life. The Hippocratic Oath is sometimes invoked: “I will give no deadly medicine to anyone if asked…”; or the Declaration of Geneva: “I will maintain the utmost respect for human life.” More pragmatically, it may be argued that doctors must work by a single, overriding principle – to improve health and prolong life – and that it would place them in difficult positions if they had to compromise this aim. This deference rings somewhat hollow, however, in the face of what actually happens in practice. For we find that doctors do make “termination” decisions as a matter of choice, and without the concent of their victims. I am not speaking here only of the killing of foetuses. Doctors apply non-voluntary euthanasia to the elderly, to comatose patients and to handicapped babies, among others. What sort of profession is it which refuses to do what its clients want, and kills them without their concent?
Now many of the people who advocate this form of euthanasia are apparently agreed that the concent of the patient is crucial, and that “involuntary” euthanasia is ruled right out of the court. Yet consider the proposed development in the light of the current situation. On the one hand, assisted suicide, where a person such as your relative helps you to die, is currently illegal, and there is no suggestion that it be made otherwise. On the other hand, “doctors” killing certain categories of patients without their concent, such as the senile or the comatose, by withholding
treatment, is a regular occurrence. Is the legalization of euthanasia more likely to be a development out of the former or the latter of these two policies?
In conclusion, I believe that euthanasia should be legal if a person is on life support and will be for the rest of their life, and also if they are suffering. I do not believe that euthanasia should be used as a means of assisted suicide, also known as “active” euthanasia.