Mentally competent and terminally ill individuals possess their right on whether or not they prefer to have the medical treatment in consideration to their personal right to life free from suffering (voluntary euthanasia). However, incompetent and terminally ill individuals are deprived by their incompetence from deciding whether or not to alleviate oneself from extreme suffering (involuntary euthanasia).
The emphasis of the study questions the morality and ethics of laying down life and death decisions for an individual who is in terminal sickness and mentally incompetent. Involuntary euthanasia among mentally incapacitated and terminally sick patients is now becoming a controversy implicating an argument between choice to life and imposition of death. According to Johnson (1999), voluntary euthanasia (passive or active) is being respected by the western tradition as part of an individual’s fundamental right to life free from pain and suffering (91).
Considering the incapacity of these terminal patients to decide on their own, Western Guardianship Board is now suggesting involuntary euthanasia for incompetent and terminally ill patients based on the fundamental principle, “best interest”, which implies that caretakers can decide on behalf of their patient based on their observed judgment (Weeramantry, et al. 276). Discussion Right to Life of the Mentally Incompetent and Terminally Ill Right to life is the fundamental principle that exists as an intrinsic right or entitlement.
In this condition, every person possesses their individual right on whether or not they want to continue to live. In meta-ethical perspective, right to life frees anyone from the liabilities of life-associated decision toward one’s self since it is the person’s choice, which is entitled to one’s self by principle and fundamental right (Weeramantry, Angie and Sturgess 276). However, with regards to life and death situations associated to one’s decision over the individual’s life, there is a thin line separating the concept of suicide or self-murder from dignified death (Johnson 91).
In creating decisions and utilizing one’s right to life, the law considers (1) the individual’s sound judgment (e. g. mentally capacitated, coherent, etc. ), (2) current condition (e. g. terminally ill, progressive condition, etc. ) and (3) the possible resolutions available and acceptable to the person. If these three components are justified through appropriate and well sound-decision making, terminally-ill condition and palliative/hospice care provision as last option available, then the law and ethical bodies consider the appropriateness of one’s right to life and dignified death accompanied by acknowledged consent (Hester 215-216).
However, the entire picture becomes different for a terminally ill individual who cannot decide on his/her own due to mental incapacity. The following controversies arise, specifically (1) the placement of the patient’s right to life (i. e. caregiver, medical practitioners or still the patient despite of incapacity), and (2) the moral and ethical appropriateness of deciding on the life of a terminally ill and incapacitated individual.
Deciding the continuity of life for mentally incompetent individuals who are in terminal sickness is the main controversy. By principle of right to life, no single person is liable to the decision of one’s self over his or her own life; however, if one is incompetent and an involuntary euthanasia has been directed by the immediate caregiver (e. g. parents, related guardian, court-appointed representative, etc. ) based on sound judgment (e. g. seeing intense pain on the patient that is beyond palliative care capacity, etc.
), the liability is being passed to the substitute decision maker (Pozgar and Santucci 256). According to Weeramantry, Angie and Sturgess (2003), it does not matter that death is brought about on different grounds for the two categories, by choice for the competent and by substituted judgment based on the best interests of the incompetent as deemed by a court, a Guardianship Board, a legal representative or any agent normally empowered to act on behalf of a legally incompetent person (276).
Under these arguments, involuntary euthanasia directed to a mentally incapacitated and terminally ill patient is under the principle of best interest for the patient. In this argument, involuntary euthanasia is ethical and morally acceptable if one cannot decide on his/her own self due to mental incapacity or brain damage. However, according to the study of Cohen-Almagor (2002), majority of the respondents (n=18 out of 28 leading authorities) disapprove the use of involuntary euthanasia for incompetent and terminally patient.
According to the response of these authorities, allowing involuntary euthanasia, aside from the ethical complexity it can cause on other euthanasia-associated controversies (e. g. involuntary euthanasia based on medical practitioner’s judgment, etc. ), deprives the innate rights of the individual as no individual possess any ethical and moral rights to decide on the person’s behalf. According to Bryant (2003), the judgment over the life of a mentally and terminally ill patient cannot be solely based on one’s observation of pain, personal thoughts of suffering and personal intuitions (412).
As supported by Keown (2002), substituted decision is already a part of the United State medical directives for incompetent patient who are under unbearable pain and/or suffering conditions; however, he argues that there are no standardized way to measure or accurately determine the pain or suffering being experienced by the incompetent patient (78). Involuntary euthanasia has been branded as an indirect breaching of the incompetent’s right to life and to continue living.
Aside from the personal bypass directed by involuntary euthanasia, another concern is the negation of rights of autonomy and personal consent. Rights of autonomy emphasizes the person’s right to choose irregardless of whatever condition since this is part of the person’s innate liability to oneself (Amarasekara and Bagaric 2004). In essence, liability done to one’s body is a personal responsibility and not anyone possesses the right to substitute unless acknowledged by the individual’s consent. From the religious perspectives of Christianity, “…Love your neighbor as yourself.
There is no commandment greater than these” (Mark 12:30-31), and Judaism, “they do not close the eyes of a corpse on the Sabbath, nor an ordinary day at the moment the soul goes forth. And he who closes the ayes of the corpse at the moment the soul goes forth, lo, this one sheds blood” (Shabbat 23:5). These passages also negate the substitution of decision for any individual regardless of any conditions (mentally incompetent, terminally ill, etc. ). Thus, as for the second argument, incapacitated and terminally patients should die naturally regardless of pain or suffering.