A second common misconception about euthanasia is to think that there is no difference between giving a person a large dose of a painkiller to ease the person’s suffering or giving the person a lethal dose of any kind of medication for the purpose of causing the person’s death. These two acts are significantly different based on the intentions which motivate them. In the first act, the intention to ease the person’s pain by providing sufficient medication to accomplish this purpose is a good one so the action is reasonable even
if, as an unintended side effect, the person’s respiration is suppressed and she dies. On the other hand, to administer a fatal dose of medication to a person for the purpose of ending that person’s life constitutes killing the person, albeit mercifully and by request, and killing a person by administering medicine in order to cause death is very different from providing pain medication that might result in suppression of respiration and, indirectly, death.
Effect on Healthcare System During the past generation euthanasia has become a major issue in health care ethics. It was always a peripheral issue with limited appeal to a minority of the U. S. populace, but in recent years euthanasia has become a major subject for debate which, predictably, triggers heated controversy. Why is this the case? Actually, this is a complex matter with several related components.
Among these components perhaps the most significant are changing conceptions about what constitutes the role of health care professionals, as well as the way we understand rights to which competent adults are entitled. In the classical tradition of Western medicine which dates from Hippocrates, the physician’s responsibility has consistently been to do whatever is possible to bring about cures for sick people or to tend to the care and comfort of people whose illness puts them beyond cure.
The role of nurses has been understood in terms of patient education, assistance, care, and supervision. Part of the movement toward euthanasia asks us to expand our concepts of the roles of physicians and nurses to include allowing them to use their expertise to assist terminally ill people in ending their lives. This thinking holds that no one is better able to calculate the proper amount of medication needed to bring death than is a health care practitioner whose learning and experience uniquely qualify her for such tasks.
To redesign our concepts of the proper responsibilities of physicians and nurses so as to include participation in euthanasia would constitute more than an incidental revision; it would, instead, constitute a radical change in the nature of the practices of both medicine and nursing. This is one reason why resolution of the debate over euthanasia will entail a thorough reexamination of the nature of the mission of the health care professions. Contemporary attitudes regarding patient autonomy also affect the debate about euthanasia.
When the physician-patient relationship was characterized by physician benevolence toward the patient in a system in which the physician was in a position of superiority in regard to the patient, the issues of patient preference and patient right to self-determination were not accorded much interest. But the practice and culture of medicine have changed so that patients are now accustomed to deciding what kind of care they want and do not want. Within this climate, it is understandable that some people consider themselves entitled to request that they be assisted in bringing death about when life becomes too burdensome.