“Thou shall not kill” ~ Bible
The four words that govern modern day Australia and the medical profession. The basis of all our laws, procedures and rules the interpretation of good. However when it comes to Euthanasia, these interpretations become inconsistent and we start to ponder our stance on what is actually good and right. The following is a look at different perspectives; either for or against Euthanasia.
The ultimate free will
We, as Australians, live in a country that exercises a right to free will. Have the choice to say and do whatever we please, as long as we are not harming others. Euthanasia is a personal decision, why is there an issue if no one else is getting hurt? Euthanasia is the ultimate choice for anyone, a choice to continue their life or to end it.1,2 Autonomy is considered one of the four basic ethics by which doctors are expected to abide.3,4 Autonomy involves patient consent and self-determination of health care.1,4 Patients should have the right to choose their treatment plan and how they are treated. If this involves ending their life they should have the right to do so.
There are many aspects to patient consent, especially with Euthanasia. If Euthanasia were accepted, situations may arise that may compromise the integrity of the patient.3 This is the view point of many individuals that are against euthanasia. Many countries do counteract this with comprehensive protocols and precautions that specifically stop the abuse of the euthanasia.3 These legalities shall be discussed later in fuller detail.
Passive Euthanasia vs. Active Euthanasia
Everyone, in Australia, already has the right to decline health care. Patients are able to refuse treatment for whatever reason. Many a times this can lead to death.3 This is the definition of passive euthanasia. Is there a difference between passive and active euthanasia? In both cases, patients die but many times with passive euthanasia the underlying condition causes the death.3 This can be painful and take time.3 If we allow this passive euthanasia, what exactly is wrong with active euthanasia?
Especially with passive euthanasia, there is a lot of suffering and it takes quite a while for death to occur.3 This can cause excess suffering and take unnecessary time.3 Another one of the four principles for doctors to be ethical is beneficence, the idea of doing no harm.4 Suffering and then dying, in passive euthanasia or just progression of disease, can cause more harm than just active euthanasia.3 Patients are spared the suffering and the worsening standard of living and hence given more dignity in their death.
There is a belief in the “sanctity of life” and that all life should be preserved with directly opposes Euthanasia. All living things struggle each day to survive, it is programed in our survival mechanisms. While this may be the case, with life does come death and they both have to occur.1 Death is a naturally part of living and although sad shouldn’t be considered a bad outcome.2 Keeping this in mind, wouldn’t hurting and then dying be a worse outcome than passing away peacefully? Medication can help with pain, physical struggle, what about mental struggle? Is lying helpless in a bed all day waiting for death, really living?1 These are questions to be asked and hence for many eligible patients this may be a useful “treatment” strategy.1 Factors affecting administration of euthanasia like age or mental state shall be discussed in further detail in the coming week.
Dignity in Death
Society does rule an action that is killing another person wrong and hence euthanasia is then considered, in the words of Dr. Daniel Callahan, “consenting adult killing.”1,3 At the end of the day, we are ending life and that is why this topic is controversial. However individuals are voluntarily agreeing to the ending of their life and we are not causing harm to others. Why shouldn’t members of the community at least be given the option of a painless, peaceful passing?
With an agreement and proposed time of death, patients feel in control and can keep their dignity during death.5 The standard of living remains high and they enjoy their life without the constant waiting and unknown. In the words of Brittany Maynard, a 29 year old sufferer of terminal brain cancer who died by assisted suicide, “To have control of my own mind… to go with dignity is less terrifying. When I look at both options I have to die, I feel this is far more humane.” Euthanasia, with control, gives individuals a time to say goodbye and get their affairs in order. Individuals can then enjoy their life to full extent and experience a higher standard of living. The last days can then be remembered as joyous instead of sickening.
“We’re all stories, in the end. Just make it a good one, eh?” ~ The Doctor from Doctor Who
- Callahan D. When Self-Determination Runs Amok. The Hastings Center [Internet]. 1992 [cited 2015 Apr 1];22(2):52-55. Available from: http://philosophyfaculty.ucsd.edu/FACULTY/RARNESON/Courses/CallahanSELFDETERMINEAMOK.pdf
- BBC. Pro-euthanasia arguments [Internet ]. BBC; 2014 [cited 2015 Apr 1]. Available from: http://www.bbc.co.uk/ethics/euthanasia/infavour/infavour_1.shtml
- Ebrahimi N. The ethics of Euthanasia Australian Medical Student Journal [Internet ]. 2012;3(1):73-75. Available from: http://www.amsj.org/wp-content/uploads/files/articles/amsj_v3_i1/AMSJ_v3_i1_pp73-75.pdf
- Gillon R. Medical ethics: Four principles plus attention to scope. British Medical Journal [Internet]. 1994;309(6948). Available from: http://search.proquest.com.ezproxy.library.uwa.edu.au/docview/204000636?accountid=14681
- Bartels L., Otlowski M. A right to die? Euthanasia and the law in Australia. J Law Med [Internet ]. 2010;17(4):532-555. Available from: http://www.westlaw.com.au.ezproxy.library.uwa.edu.au/maf/wlau/app/document?&src=search&docguid=I2a88fbcdcfdc11e08eefa443f89988a0&epos=1&snippets=true&fcwh=true&startChunk=1&endChunk=1&nstid=std-anz-highlight&nsds=AUNZ_JOURNALS&isTocNav=true&tocDs=AUNZ_AU_JOURNALS_TOC&context=18&extLink=false&details=most&originates-from-link-before=false&details=most&originates-from-link-before=false