Ethical Dilemma: Assisted Euthanasia
Euthanasia, a topic that has continuously had heated debate on its role in the society presents a great dilemma for both the patient, their family, and physicians. Euthanasia is simply the act of a professional nurse or doctor facilitating the death of a patient either actively or passively. Active euthanasia is a situation where a physician conducts events that lead to the patients’ death. On the contrary, passive euthanasia is the case where a doctor withdraws facilities such as medication, surgery, and life support machine that would extend a patient’s life (Wyatt, 2015). Euthanasia is categorized into three types namely, voluntary, non-voluntary, and involuntary. Voluntary euthanasia is performed when the patient consent’s to the procedure. Non-voluntary is performed on a patient who is unable to give their full consent. Finally, involuntary euthanasia is performed against a patient’s will (Sayeed, 2015). This paper will analyze the ethical dilemmas faced in assisted euthanasia.
In the interviews between Dax Cowart and Robert Burt, there are various critical issues that these two individuals discuss. Noteworthy, they discuss on the right of a patient to request for euthanasia, the patient’s understanding of the changes in quality of his/her life after treatment, and doctors’ attitudes during the treatment of critical care patients. Cowart reiterates how painful a patient feels when they request for euthanasia “When I was in the hospital there were many reasons I wanted to refuse treatment, but one was overriding-the pain. The pain was excruciating, it was far beyond that I ever knew possible…” (Burt A. R., 1998). Moreover, he also notes of the fears of the loss in quality of life after the treatment. Generally, he states that he thought he would end up selling pens and been dependent even if he recovered from his burn injuries.
In brief, Terri Schiavo was left in a vegetative state after recovering from a cardiac attack. Her change to persistent vegetative state with very little chances of success was due to lack of oxygen and blood during her cardiac arrest. In the ensuing case, Terri’s parents argued that their daughter had a chance of survival and she was tolerant to her current health status. On the contrary, Terri’s husband argued that his wife would not have liked to live in this state, as such, euthanasia was the best option. Terri’s prolonged case ended up in a federal court ruling in favor of euthanasia. Consequently, she was removed from the feeding tubes and she eventually died.
Euthanasia in itself presents a lot of dilemma to the doctor and the patient’s family. Most religious and social philosophies teach that life is sacred. In light of this, these doctrines tell their followers not to kill themselves or other people in the society. Given this social and religious background, accepting euthanasia is in a way rebelling against the social norms (Huxtable, 2010).
On the same accord, there is also a challenge in determining the capacity of the patient to determine whether euthanasia should be conducted. Evidently, most patients are usually critically ill by the time they want to undertake this procedure. Questions usually arise on whether these individuals have enough mental capacity to request for this procedure. Basically, this situation arises when the patient had not written a consent for euthanasia if his/her treatment failed to work. Even in situations where the patient appears sober, there is usually a question as to whether the requests are due to the underlying medications or the pain that the patient is facing. It is important to note that some medications may alter a person’s thinking and lead them to make irrational decisions (Sayeed, 2015).
One underlying issue that nurses and the patient’s family always have is the challenge of understanding whether the patient is properly informed on his/her underlying conditions. For example, the nurses always want to know if the patient is fully aware of the likeliness of his/her recovery after treatment and the quality of life that he/she will enjoy after the treatment. In addition to this, there is also the need to understand if the patient is fully aware of the availability of methods that may improve his/her treatment (Pappas, 2012). Effectively, this may lead to a change of heart. As noted by Dax Cowart, one overriding issue that made him want euthanasia was the lack of knowledge of the presence of other treatment options that would have eased his pain. However, the promise by his surgeon that the surgery on his hands would be done in the most painless method made him consent to this decision (Burt A. R., 1998).
Non-voluntary euthanasia, in particular, presents a challenge in determining whether this procedure is in the best interest of the patient. In this case, a patient is usually in a vegetative state and cannot speak or write. Therefore, determining if this procedure is appropriate is based on the attributable behaviors of the patient, and whether he/she is improving or not. Given the varying human behaviors, it is difficult to determine the patient’s desire just by looking at them (Webb, 2011). Similarly, relying on past patient’s character may be misleading since there is a possibility they have changed their heart. For example, in the Terri Schiavo case, Terri used to smile in the presence of her mother despite her inconsistent trend of health. In a few times, she had shown significant signs of health improvement. Consequently, it was difficult to completely state that her health was deteriorating. Given that she used to smile in the presence of her mother, it is difficult to determine if she had accepted her current state despite the change in lifestyle from her former outgoing character (Franklin Spring Media Family 2009).
To sum up, the decision to conduct euthanasia is complex and emotional for the doctor, the patient, and his/her family. Therefore, these parties must be sober enough to approach this issue with the patient’s best interest. Given that it is difficult to determine what the best interest of patients is, errors are bound to happen once in a while. Nonetheless, nurses must strive to ensure that these errors are kept at the bear minimum.
Burt A. R. (1998). Confronting death: Who chooses? Who controls? A dialogue between Dax Cowart and Robert Burt. Hastings Centre Report, 28(14), 14-24.
Franklin Spring Media Family. (2009, January 27). The Terri Schiavo Story. [YouTube]. Project: Report. Retrieved from https://www.youtube.com/watch?v=cki55BM42kw
Huxtable, R. (2010). Euthanasia: All that matters (1st Ed.). New York, NY: McGraw-Hill Education.
Pappas, D. (2012). The euthanasia/assisted-suicide debate (Historical guides to controversial issues in America). Santa Barbara, CA: Greenwood Publishers.
Sayeed, A. (2015). After all whose life is it anyway? A socio-biological sketch on euthanasia. Chandigarh, India: White Falcon Publishing Solution.
Webb, M. (2011). The good death: The new American search to reshape the end of life. New York, NY: Bantam.
Wyatt, J. (2015). Right to die? Downers Grove, IL: IVP Publishers.