May 302012
 

#800000;">*the following is a paper that i wrote for a class back in March, 2009 (a year and 1/2 before my diagnosis). i do not agree with everything in this paper – the assignment was given to take an opposing and even argumentative viewpoint of the assigned topic. this paper is about #003300;">involuntary #800000;">euthanasia#800000;">a family member or caregiver making the decision to end a life – not necessarily the individual’s decision.  my personal thoughts are complex when it comes to right to die topics. and it’s popping up in many areas lately. on the surface and in my gut, i believe a person should have the right to choose to die. people do it everywhere, every day, without a thought to the government and the laws. people decide they want to die and stop eating or taking their treatments/medications.  but wouldn’t it be so much more compassionate to allow a person to die in a more dignified and pain free manner? t think so…as you read this paper, keep in mind that this is a paper written with an opposing view of my own feelings. but there are statements made throughout that i do believe…. complex… tough subject….

 

In 1933, Adolf Hitler began his program of euthanasia. His goal was to sterilize and then murder people who had physical and/or mental handicaps, including infants. In 1939, Hitler decided to expand this program of euthanasia and began murdering adults with any type of handicap. In October of 1939, Hitler signed a document giving two doctors legal protection for carrying out his euthanasia program (Friedlander, 1995). This program was genocide. #800000;">*the process of “weeding out” those that are undesirable or ill, not able to contribute to the whole of the community, is beyond comprehension to me

 

Today, euthanasia is performed, many times illegally, in an effort to lessen the burden of caregivers and provide relief for suffering patients.  The caregivers and family members make the decision that it would be more humane to end the patient’s life than to allow the suffering. If this continues, it is easy to imagine that euthanasia will once again become a solution to the problem of dying and a new beginning of genocide. When the cost of long term healthcare is examined, and then compared to the average median income, it becomes painfully clear that most people do not have the means to place loved ones in a long-term healthcare facility. The alternative is that care is provided in the home. In many cases, this lifestyle creates an extreme burden on a family. Even with this realization, caregivers and family members must realize that it is morally and ethically wrong to end a life unnaturally. #800000;">*but shouldn’t it be the right of a patient to decide for themselves when they are ready to die? if this is something that has been discussed openly among family members, they will know when it’s time… and in many instances, the caregiver/family members will be the ones to assist in ending the life. this should be okay. there should be no fear of arrest, prison, damnation 

 

There are various options available to the patient and caregivers and these options do not include euthanasia. When a patient is suffering, the caregivers need to offer palliative care. Simply stated, palliative care is providing comfort and relief from pain. The most humane thing a caregiver can do is make the patient comfortable. Medicine and medical technology has advanced in such a way that this has become entirely possible. There are many types of analgesic medicines available, up to and including morphine. When these analgesics are used in combination with other forms of treatment, such as tens units, a high level of pain relief can be achieved. Some people are afraid to give too much morphine. They see the patient sleeping in a coma-like state for most of the time. What is wrong with this? If a patient is in severe pain, they should be allowed to have this sedation. Another concern of many caregivers and loved ones is addiction to the narcotic. This should not enter the decision making process. If a person is terminally ill, is having severe discomfort, addiction should not be a factor. They are terminal. They will not be living with a life-long addiction to morphine.  #800000;"> *there is no reason for pain and suffering. no reason at all. when/if i reach a point in my illness that i am in severe, chronic pain, i want every possible drug flowing through my veins. i want to sleep peacefully, even if it is the final sleep. and we cannot forget that pain is not the only source of suffering… for a person who has a low quality of life, who’s mind is fully functional – there can be shame, guilt, feelings of worthlessness… many would likely feel as if they are a burden to the caregiver… many relationships turn from lovers, couples, friends to that of caregiver/patient. tough place to be i would think…

 

People do not have a right to choose to die. This is called suicide. It is against most laws of state and country, and it is against most religious doctrines. Life should be considered a gift and a privilege. People did not choose to live; we are born without our own permission. People do have a right to a full and comfortable life. When it comes to terminal illness, people have a right to ordinary care. This means that the care received is a benefit to the patient without creating excessive burden. Extraordinary care is that which may be a benefit to the patient, but it also causes excessive burden on the patient and caregivers. This does not imply artificial or natural care. There are types of care in both categories that would be considered ordinary care.#800000;"> *this paragraph is hard for me. although i believe in my soul that all life is precious and that each of us are on a journey that we must travel, is it safe to assume that choosing to die could be part of that journey?

 

If the patient is not able to make their own decisions, it becomes the responsibility of the caregivers to give consent or to discontinue treatment. When the responsible caregiver is faced with making decisions of life and death consequence, many emotions get in the way. It may be hard to think about not doing everything possible to prolong a loved one’s life. So a rapid decision is made to start life support. As time goes by, it then becomes a burden and expense to maintain this care. Eventually, most caregivers reach a decision to end the care. This is very difficult to do in many cases, especially if there is more than one person involved in the decision. Should the parties involved have different opinions, it may come to a legal decision made by a court. This would create even more burden and expense on the family. #800000;">*the only time i believe it’s okay for a caregiver or family member to make this decision is if there has been prior conversation… a DNR is one step in this direction…. a living will is another. my family all know what my wishes are, and i know their’s. it’s in writing so that there can be no doubt about when it’s okay to take my life. i realize that things happen in life that prevent a person from having this conversation. those of us who are chronically or terminally ill make these choices in advance… but what of those involved in a sudden accident or acute medical problem (aneurysm, etc.) it’s important to make your wishes known when you are healthy and able to put everything in place.

 

If everyone one of us would take the time to write a living will, the decision would be removed from the caregivers. Their guilt would be lessened; there would be no concern for what others may think of them for their decisions. Choosing palliative, ordinary, or extraordinary care is a very personal decision. However, if no arrangements are made prior to the critical moment, then the assumption is made that the person would want everything to be done in order to prolong life.

 

When thinking of euthanasia, one cannot reasonably include palliative, ordinary, or even extraordinary care in comparison. The act of euthanasia is simply ending the life. It does not allow for the patient to receive any other types of care. The decision is made to speed up the dying process, not allowing the patient or loved ones the benefit of the dying process. If dying is a part of life, then it is something that must be faced and dealt with. Killing is not part of life.

 

There are many countries, and even states within the United States that allow euthanasia. The circumstances may vary by jurisdiction, but the ending of life is the same. When looking at the various laws regarding euthanasia, it is plain to see that this is a growing problem.

 

It is acceptable to practice euthanasia on disabled newborns in the Netherlands. It has been reported that as many as 8% of all infant deaths in the Netherlands are the result of euthanasia (Schadenberg, 2002). These are infants that would have lived but the parents did not want them to live. These are infants that were born with a disability or handicap. The thought is that death is preferable to living with a disability. These were not terminally ill children. #800000;">*this paragraph disturbs me. really disturbs me on many levels.

 

Oregon law allows people to receive a prescription for death if they are within six months of dying (Schadenberg, 2002). Physicians write a prescription for a terminally ill patient that allows the patient to end their own life when they choose. This practice is viewed as a right to die choice. It is allowing people to choose how and when they will die.  However, a person does not know when they have reached the prescribed time marker. No one can predict when death will come. Once the prescription has been filled, a caregiver or family member will have access to the medication and will have the ability to give the medication at any time. This is different than a patient willingly taking the prescribed medication. There is a distinct possibility that the caregiver will make the decision to end the life without the patient’s knowledge or consent. This law is the beginning of the end for society as we know it.

 

Euthanasia is illegal in most of the United States. Patients retain the right to refuse medical treatment and to accept pain management care. Even though these decisions may hasten a patient’s death, they are not considered active euthanasia. In special circumstances, the removal of life support, such as ventilators and supplemental feedings, is considered. These treatments are methods that provide some comfort and palliative care during the dying process. The refusal of treatment needs to be at the patient’s request only. A caregiver or family member should not have the right to refuse treatment. In situations such as traumatic accidents, when death is imminent, a family member should be able to refuse treatment. This should only occur when the patient is near death and there is no treatment available to prolong life. If the patient is alert and awake, this becomes the patient’s decision.

 

A study was done by the Journal of the American Medical Association in November of 2000. According to this study, only one in ten terminally ill patients had considered euthanasia. (The Commonwealth Fund, 2000). This study also showed the instability of the decisions made. During follow up interviews many patients had changed their minds about physician assisted suicide (PAS). The most relevant factor in the patient’s decision to request PAS was not pain, but shortness of breath. These patients also tended to show signs of depression and feelings of worthlessness. (The Commonwealth Fund, 2000.)

 

In 1996, hospitals in Houston, Texas enacted a policy of involuntary euthanasia. What this meant was that if a patient was terminal and there was nothing more that could be done medically, the hospitals and physicians could refuse treatment of any kind. This includes palliative care and pain management. Patients and their caregivers could request a meeting of the ethics committee and plead for life. This is one of the most inhumane policies of current times. Then, a few years later, Governor George Bush signed a piece of legislation stating that every patient deserves medical care, no matter what their terminal status was. This allows patients with terminal illnesses to receive palliative care and life support if they request it.

 

The Hippocratic Oath is required of all physicians. This oath says that physicians must do everything they can to preserve life. Euthanasia or mercy killing is in direct conflict with this oath. A patient may find it hard to trust diagnoses, treatment plans, and recommendations if it is acceptable for a physician to violate this oath.

 

To end another person’s life is murder. There is no other way to view this point. The law in most states specifically says that it is illegal to kill another human being. #800000;">*but to end my own life should not be considered murder or suicide… even if someone has to assist me in completing the act. if it is my will, my decision, then anyone who helps me should not be held accountable. another important reason to make the decisions in advance and have it all in writing… protect those who may assist you

 

According to the 1980 declaration from the Vatican, Jura et Bona, “euthanasia”, or “mercy killing” is defined as “an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.” (Pavone, 1995)

 

Most religious law tells us the same thing: it is against God’s law to take another life. For example, many Christians believe that there is meaning to suffering. Christ suffered for all of us and this certainly is not considered meaningless. Suffering provides an opportunity for personal growth and the chance to learn compassion. All human beings deserve the right to life. It does not depend on health or sickness, stability or injury. No other human being has the right to take another life away. In fact, people who are injured, ill, or weakened are more deserving of our care.

 

It has become important that all people examine their ideals, morals, and values. These things have changed so rapidly over the recent years. The world is moving at a very fast pace, and new technologies, inventions, therefore ideals have changed. This generation has a very different set of morals and values than previous generations.

 

The most accepted definition of morality is doing what is right or what is wrong. It is the action a person decides to take which makes them a moral person, or an immoral person. It has been proven that it is wrong to kill another person. There are laws forbidding murder. Therefore, it must be morally wrong to euthanize a person. When morality is applied to values, it becomes even clearer. Values are rules or a system of beliefs that a person lives by. These values help make the decision about what is right or wrong. The value system of the United States, dating back to the Constitution, is that all people are equal and have a right to life. When taken in context, it is easy to see that it is morally wrong to kill someone. 

 

Ethics are a personal way of behaving, or guiding one’s own actions. Ethical behavior is a direct reflection of a person’s morals and values. Morals and values are an internal reflection of that person, while ethics are external and can be judged by others. So, if it is morally wrong to kill a person, then it becomes ethically unacceptable to do so.  

 

We convict and condemn murderers, rapists, robbers, and drug dealers. The reason for this is that their behavior was morally wrong. Euthanasia falls into the category of murder. Ending someone’s life involuntarily is murder. Each and every human being has a basic right to life and the care needed to make that life comfortable. Society cannot decide that this person should not receive care but this one can. If euthanasia becomes legal in all states, who will be the first to be euthanized? Consider the elderly in the community who are living in nursing homes or with family members. The emotional and financial cost of caring for these people is very high. It is not unreasonable to believe that the family who wants to move or go on an extended holiday will have to find something to do with the elderly family member. Euthanasia will be considered. Now consider the disabled and indigent population. They are needy and useless members of the community. This is the viewpoint of many people. They require a high level of care, they receive government benefits, food stamps, free medical care, and the list goes on. There are those in the community who think it would be much more beneficial to euthanize them. This brings us back full circle to the problem of Hitler. This is much the same thing that he was doing with his great euthanasia plan.

 

Euthanasia, if legalized, could easily become a new form of genocide in the present day. With the rising cost of long-term health care, the emotional cost of watching a loved one suffer, and the desire to be free of caring for a terminally ill patient, it is reasonable to believe that some people will consider euthanizing family members to be rid of the burdens.  We, as human beings, must find a way to end this idea of euthanasia and learn to cope with the life journey as a whole, which includes death. #800000;">*this line of thinking scares me… when i consider the health care reforms currently on the table, the death councils, the government deciding who is worthy of medical care and who is not… the idea that the government can decide if someone is a burden to the system so refuse treatment and let them die…. makes me sick… it is a PERSONAL choice that should not be left to the government, outside agency, caregiver, family member, etc.

 

References

Bommel, H.v. (1992). Dying for care: Hospice care or euthanasia, August 1995. Retrieved

     March 19, 2009 from Dying for care:

     www.carelibrary.com/care_library/dying_for_care_intro.html

Friedlander, H. (1995). The origins of Nazi genocide: From euthanasia to the final solution.

     (p. 67). Chapel Hill, North Carolina: University of North Carolina

Pavone, F.F. (1995). Euthanasia – a Catholic view. Retrieved March 20, 2009 from Priests

     For Life: www.priestsforlife.org/euthanasia/euthrefl.html

Schadenberg, A. (2002). Euthanasia and assisted suicide. Retrieved April 3, 2009 from CHN

    International: www.chninternational.com/euthanasia_and_assisted_suicide_a_s.html

 

#800000;">*so controversy… i thought about not posting this..but i think that there are many aspects of INVOLUNTARY euthanasia, assisted suicide, and the right to die choices that each of us needs to consider. tough topic, tough choices, and something that most people do not want to think about – their death.#800000;"> there is so much more i want to say and think about this topic but it’s so heavy that i just can’t process it all…. i’m sure that through conversation more of it will come to light….

 

Being an adult is like looking both ways before you cross the street and then getting hit by an airplane.

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