The Euthanasia Bill has indeed stirred up a hornet’s nest concerning a number of emotional, legal and religious issues in the country today. Hamlet would most probably have said: “To kill or not to kill… that is the question. ” Or one could rephrase the title of a James Bond movie as “Live or Let Die! ” Webster’s dictionary defines euthanasia as “an easy and painless death” or “an act or practice of causing death particularly so as to end suffering advocated by some as a way to deal with persons dying of incurable, painful diseases (Baird, 2001).
Well it most certainly sounds simple enough but it is actually easier said than done. There are so many varying aspects and viewpoints about euthanasia. Let us then take as an example a cancer patient who is in the terminal stage of the disease. The aim of the physician here is to help the patient continue having a good quality of life until he dies. This is undertaken against the background of the patient’s illness, his symptoms, his fears, his frustrations, his family, his friends, his cultural background, his beliefs and his ability or inability to accept what is happening.
In managing terminal illness, the primary aim of the physician is no loner mainly to preserve life but to make the patient’s remaining life as comfortable and as meaningful as possible. It should be taken into consideration that what ever may be the appropriate treatment for an acutely ill patient may be definitely inappropriate for the dying (Keown, 2002). Artificial respiration, cardiac resuscitation, intravenous infusion, nasogastric tubes, and antibiotics are all primary supportive measures utilized in acute illnesses to assist a patient through the initial period towards recovery of health.
However, the to use such measures in a patient who is very clearly close to death and has no expectancy to return to health is generally inappropriate and is often condemned as bad medical care. The author believes that no one has the right or duty, legal or ethical, to prescribe or promote a lingering death. On the other hand, does anyone including the physician have the right to kill or hasten the death of a dying patient? Many years ago, it was always assumed that the physicians directed all the patient care and made unquestionable decisions about treatment and it was the patient’s duty to comply blindly.
Today however, based on legal and moral thinking, patients and immediate relatives have the right to choose acceptance or refusal of treatment (Otlowski, 2001). In other words, the physician should offer what he believes will be the benefit to the patient and in turn, the patient is also free to accept or refuse the offer. In the USA, mentally competent patients is serious state of health, after being given full information of their condition, are allowed to accept or refuse treatment. This is based on an incorrect premise because there are now very many modern modalities of pain management without using lethal poisons.
There is therefore no moral requirement for the doctor to abide by the patient’s wish for lethal poisons. Neither should the physician be convinced or coerced by the patient’s relatives because of the financial and emotional burden on them brought about by extending the life of the patient. Physicians who show their willingness to actually kill patients will most certainly cause a dramatic unfavorable impact on society’s view of the medical profession. For further clarification, let us now take a closer look at the intended and unintended consequences of medications.
Let us use as an example the administration of medication to a terminally ill patient suffering from excruciating pain. This leads us to distinguishing between intended and unintended consequences as expressed in the Roman Catholic Doctrine of Double Effect (Neuhaus, 2007). When a terminally ill patient is in extreme unbearable pain, the attending physician may consider increasing the amount of morphine to effectively control the pain. The physician however is also concerned that this high dose of medication may cause depression of the patient’s respiration to the point of hastening his death.
If the patient or responsible relatives have given consent after being appraised of the medication’s benefits and potential risks, it is morally appropriate to administer the medication because the intention is to relieve the patient’s needless suffering from pain. However, if it is the intention to kill the patient, this is morally unjustifiable and ethical. A physician should not try to gain pain relief for a patient through an act intended to kill. In addition, we should not confuse euthanasia with the justifiable decision of refusing to start or continue a treatment that is morally extraordinary, i.
e. , the risks or burdens of the treatment are disproportionate to its expected benefits. As the same afore-mentioned pamphlet explains: “In considering the concept of ‘burden,’ the individual should take into account the treatment’s type, complexities, cost, possibilities of use, and the pain or discomfort it imposes. The comparison of these factors with the expected benefit should also take into account the totality of the sick person’s circumstances including his or her physical and moral resources (Young, 2007).