Several surveys indicate that roughly two thirds of the American public now support physician-assisted suicide, and more than half the doctors in the United States do too (Angell). Active voluntary and nonvoluntary euthanasia matter because they allow the patient or family to relieve them of pain and suffering, and to die with dignity and respect. In this paper I will argue that it is immoral and unethical to deny a patient the right to die and that active voluntary and nonvoluntary euthanasia should be a legal practice in the United States.
When denied the right to die one can endure a tremendous amount of physiological and emotional pain. The 1973 case of Dax Cowart is a great example of this. Dax went through fourteen months of grueling, barbaric treatments of skin debriding, tank soakings, and dressing changes. He compared the debridements to being skinned alive and the solutions poured over his skin were like having alcohol poured over raw flesh except it burns more and longer (Asher). Dax requested on several different occasions to just leave him alone and let him die but all of his physicians refused his requests and kept going with their treatment plan.
The physicians were going against the principle of non-maleficence, which states, Physicians have an obligation to do no harm to the patient (Munson, 2012, p. 892). Dax suffered through painful debridements for months without proper pain control because his physicians were too worried about him becoming addicted to the pain medications. They knew how painful these debridements were for their patient and they continued to maintain the same treatment plan with no modifications.
They deliberately violated the principle of non-maleficence. If active voluntary euthanasia were an acceptable practice in society, Dax ould have been able to refuse the treatments and die by way of infection, or a physician could have given him a lethal injection. Either of these options would have helped Dax to die keeping his wishes of dignity and respect intact. In this case, death is less harmful than the barbaric treatments that Dax had to endure for countless months. Today, many Americans are so concerned about the possibility of a lingering, high technology death that they are responsive to the idea of doctors being allowed to help them die (Angell). This is why we need to legalize active voluntary and nonvoluntary euthanasia in the United States.
In an article from The New England Journal of Medicine, Marcia Angell states, The most important ethical principle in medicine is respect for each patients autonomy, and that when this principle conflicts with others, it should almost always take precedence (Angell). To deny someone his or her autonomy is to treat that individual as something less than a person (Munson, 2012, p. 900). It is wrong to take control of someone elses life and to dictate their actions. Each person has a right to act autonomously; in doing this they must have the ability to choose among different options.
A forced option is no option at all (Munson, 2012, p. 901). Dax Cowart was denied his autonomy when the doctors would not listen to his wishes of wanting to die; instead they did what they wanted. Munson states that, Making decisions for the good of others, without consulting their wishes, deprives them of their status as autonomous agents (Munson, 2012, p. 902). Dax was not given options to choose from, nor was his voice heard at all in the process, which violated the entire principle of autonomy. It should have been his choice because it was his life.
In a completely different case, Terri Schiavo was denied her autonomy when she was kept alive on a feeding tube, when she had previously stated this was not what she wanted if it ever came down to it. With our autonomy, we should have the right to say how and when we die. It should not be based solely on societies morals, values, and beliefs. No one else should have the right to decide how one ends their life, except for that person. We value our autonomy because we are more willing to live with our own choices then to have somebody else decide for us.
Active voluntary and nonvoluntary euthanasia give patients their autonomy and right to die with dignity. Active voluntary and non-voluntary euthanasia should be an approved practice because it allows patients who are in a persistent vegetative state the chance to die with dignity, while allowing their loved ones to keep their morals and values in place. Patients that end up in such unfortunate circumstances are unable to use their autonomy and make decisions regarding their treatment and potential end of life care.
Maintaining ones autonomy is part of a dignified death. If these were approved practices, it would allow family members the chance to put an end to their loved ones suffering the way they would have wanted. It is unethical to force someone to do something against their will, as it is also immoral to make someone live if its against their wants or beliefs. On February 26, 1990, Terri Schiavo collapsed and unexpectedly went into a persistent vegetative state, where she remained for fifteen years by sustaining artificial hydration and nutrition through a feeding tube.
Terri lost all dignity and autonomy when her terminal illness came, requiring care around the clock. Michael Schiavo believed that his wife would not want to be kept alive in her condition, which ultimately lead to his decision of discontinuing her feeding tube. After a long, tortuous thirteen days, Terri starved to death. The way Terri died was very inhumane and unethical; however it is an approved practice in the United States that continues to be used even today.
If active voluntary and non-voluntary euthanasia were an acceptable practice in the United States, patients like Terri would not have to die in such a barbaric way. It is unethical to allow a patient to starve to death, as it is also unethical to deny a patient the right to die (Munson, 2012). Non-voluntary euthanasia would have allowed Terri to die pain free with her dignity and wishes in place. In Timothy Quills article, Death and Dignity, A Case of Individualized Decision Making, he talks about his patient Diane, who was diagnosed with leukemia.
Diane denied all treatments and eventually agreed upon home hospice care. It was extremely important to Diane to maintain control of herself and her dignity during the time remaining to her. She wanted to remain an autonomous person, and when this was no longer possible, she clearly wanted to die. She asked Dr. Quill for sleeping pills, which he wrote a prescription for knowing she had trouble sleeping, but also knowing it could be a means to an end when the time came for Diane. Diane was able to make an informed decision to take her own life and to die with dignity and her wishes respected in the end.
Dr. Quill states, I know we have measures to help control pain and lessen suffering, to think that people do not suffer in the process of dying is an illusion (Quill 2). This is why people in our society should be more open-minded to active voluntary and non-voluntary euthanasia. These two concepts can allow our terminally ill, suffering, loved ones to die with the dignity and respect they deserve, like Diane was able to do. Patients who are diagnosed with a terminal illness such as cancer or progressive neurological disorders eventually become weak and debilitated.
These patients end up relying on family, friends, and healthcare workers to help them do their activities of daily living such as batheing and eating. Many of these terminally ill patients lay in bed suffering, with zero quality of life, just waiting to die. These patients have lost their will to live and find no joy or simple pleasures left in life because their pain has become too unbearable. These patients suffer on a daily basis, while family and friends watch, helplessly; as their loved ones decline day by day.
It is unethical for society to expect these patients to go on with the quality of life they are maintaining. Terminally ill patients should be allowed to control their demise and end their suffering at their own disposal. Therefore, active voluntary and non-voluntary euthanasia should be a socially acceptable and approved legal practice in the United States. One could oppose the original argument saying that active voluntary and nonvoluntary euthanasia should remain illegal in the United States because it is inhumane and barbaric.
Patients do have other options such as hospice programs and pain control. These provide alternative options that can be ethically and morally acceptable in our society. There are a number of options to treat chronic pain such as narcotics. There are an enormous variety of narcotics on the market, all of which can be tried until a specific one is found to be to right for that patient. Palliative care and hospice programs are gaining more attention for the end of life care they provide for terminally ill patients.
The goals of these programs are based on comfort care, dignity and respect to the terminally ill patient. These programs allow patients to die with their dignity, respect, morals, and values all in place. Due to the fact that there are other options available for terminally ill patients, other than death, active voluntary and non-voluntary euthanasia should remain an illegal practice in the United States. Another powerful argument made by Marcia Angell is that people do not need assistance to commit suicide, with enough determination they can do it themselves (Angell).
People who are too debilitated for physical means can simply just stop eating and drinking and ultimately starve to death, while others given a terminal diagnosis, that have physical means, can end their lives by pills or a gun. This is another reason why active voluntary and non-voluntary euthanasia should remain an illegal practice in the United States. In response to this objection, a rule utilitarian could argue that, the taking of a human life is permissible when suffering is intense and the condition of the person permits no legitimate hope (Munson, 2012, p. 84). Pain cannot always be controlled by narcotics and pain-alleviating techniques, there will always be a small percentage of patients whose suffering simply cannot be adequately controlled. Palliative care and hospice programs are a great idea but are not available to everyone because not everyone has insurance and the means to afford them. They can be very pricy and space is very limited, even with insurance and affordability in place.
Allowing active voluntary and nonvoluntary euthanasia would give patients more ethical options for death, rather then having to commit the ultimate sin of suicide by starvation or the use of a gun. It is unethical to make a person feel that starvation or the use a gun are their only options. Having the options that active voluntary and nonvoluntary euthanasia can give, would enable a patient to many more ethical options for death, which would ultimately, relieve family members from having to deal with the emotional pain and suffering of finding their loved ones mutilated body after a self inflicted suicide by use of a gun.
Based on the ethical dilemma at hand, my three points have proven that active voluntary and non-voluntary euthanasia should be a legal practice in the United States. One could object this, but I have proven my argument by the physiological and emotional pain one can endure when denied the right to die, by maintaining patients autonomy and dignity throughout the process, and by focusing on the quality of life for patients diagnosed with terminal illnesses.
The long-standing ethical debate of euthanasia is decades old and will never have a perfect resolution, but one must take into account all sides of each argument to make an informed decision for their self. It is crucial that society remain open-minded regarding this issue. It is unethical to deny a person the right to die. Therefore, active voluntary and non-voluntary euthanasia should be made an approved and acceptable end of life medical practice in the United States.