Sociological analysis of mercy killing
Mercy Killing is a general term used for the medical term ‘EUTHANASIA'. The term Euthanasia Comes from an ancient Greek word meaning 'a good death'. The word has come to mean the bringing about of an easy and gentle death. When euthanasia is performed following the request of the person who dies. When euthanasia is performed following the request of the person who dies, it is voluntary euthanasia. Ending the life of an able patient without their permission or against their will is involuntary euthanasia. This is murder.
Even though euthanasia is a common topic for general discussion, its real nature and significance are complex and, not surprisingly, it is therefore often misunderstood. Euthanasia is the intentional taking of the life of another person, by act or omission, for compassionate motives. It is voluntary when a person has requested it for him/herself non-voluntary when there has been no request or consent, and involuntary when it is carried out despite an expressed wish to the contrary. Assisted suicide occurs when one person supplies the means of self-killing to another, with the intention that they will be used for that purpose.
Euthanasia is a form of homicide — even if legalized, it would be legalized homicide. Intention is central to the concept. There is no euthanasia unless the death is intentionally caused by what was done or not done. Thus, some medical actions that are often labeled passive euthanasia are no form of euthanasia, since the intention to take life is lacking. These acts include not commencing treatment that would not provide a benefit to the patient, withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted, and the giving of high doses of pain-killers that may endanger life, when they have been shown to be necessary. All those are part of good medical practice, endorsed by law, when they are properly carried out.
Though it is not always easy to make the distinction between the intended consequences of an act and those that are foreseen but not intended, and some people may then think there is no distinction, it is nonetheless real, and important to make it. It provides the ethical justification for some of the necessary actions of doctors in certain complex situations near the end of life, for example, when appropriately removing medical treatment that has been shown to be useless. When continuing medical treatment would be futile, that is without any known predictable benefit, it is both legal and ethical to withhold it or remove it with the intention of ceasing the needless prolongation of inevitable dying, even though death may be foreseen as a consequence. (In passing, it can be mentioned that terminally-ill patients are rarely attached to life-support systems, such as ventilators. The issue of the removal of life-support is separate from euthanasia). It is sometimes said that intention cannot be tested, but there is a simple test to apply to clarify the matter of intent when dealing with euthanasia. Ask the question ‘What would then be done if the patient did not die?' If treatment was withdrawn and the patient didn't die, he or she would then receive all necessary care until eventual natural death. If a lethal injection didn't work, further doses would be given until the patient died. One risks death and the other seeks it. Some object to the word ‘killing' as applied to euthanasia as ‘emotive', but it is simply descriptive of what is being proposed, that is, ‘to take the life of'. Nobody becomes emotionally upset when they read that ‘Mr. So and So was killed yesterday when hit by a speeding car'. The term ‘mercy killing' is accurate and inoffensive. On the other hand, while euthanasia is technically the crime of murder, this word may be offensive because its motive is usually not malicious, but compassionate.
Thus, Euthanasia is the process of painlessly helping a terminally ill person to die. Known also as assisted suicide or mercy killing. Generally, euthanasia is performed by lethal injection, using the same drugs as those on death row are executed. Hippocrates, the father of modern medicine, stated in 400 B.C., "I will give no deadly medicine to any one if asked, nor suggest any such counsel". Today, doctors are still bound by this oath. Like abortion, the debate about assisted suicide is a heated one. Many argue that quality of life is an issue, while those on the other side believe life must be preserved at all costs. The arguments from both sides are of both moral and legal ramifications. Proponents of assisted suicide believe that state has no right to interfere with a person's right to die. Opponents voice the opposite opinion; that no one but God has the authority to determine when a person is to die. The Hemlock Society is very vocal in their belief that euthanasia should be allowed, especially if the patient has conveyed those wishes. Very few stand on the middle of the road on this issue. Most religions and medical professionals are opposed to euthanasia.
The topic was brought to the forefront of public opinion with the trial of Doctor Jack Kevorkian in the late 1990s. He was sentenced to 10-25 years in prison for the murder of Thomas Youk after giving him a lethal injection. Dr. Jack Kevorkian, nicknamed Dr. Death, is the most controversial physician in America. He is also considered by some to be one of the most important doctors of the 20th Century. To many he is seen as a hero for his work in crusading for the legalization of euthanasia, and to others he is nothing more that a common murderer. He was stripped of his medical license in 1990 after he began publicly helping terminally ill people to die. The doctor was taken to court on many occasions, but was not convicted until April 13, 1999. To date doctor Kevorkian has helped at least 130 people die. I think that even though he has broken anti-euthanasia laws many times his example should be looked upon with respect. In reality he is doing nothing more than help desperate suffering people die with dignity.
According to him “Each person in this world is worthy of respect, and the basic rights and freedoms to control his or her own destiny. If people have the right to decide how they live their lives, then they should also have the right to decide how their life is going to end.” He believed that terminally ill patients should have the right to choose euthanasia as a possible option for ending their lives. One of the main reasons that he put forward was the simple fact of pain and suffering. It is a fact that at least 5% of terminal pain can not be controlled, even with the best of medial care. There are also many other symptoms that a patient can get that are not always possible to keep under control, such as sickness and breathlessness. Another main issue is quality of life. A patient should not be forced to stay alive during their last days of weeks of their life in a way which, to them, is undignified. Keeping the person alive only causes more unneeded pain and suffering for the patient. Lastly the practice of euthanasia has been going on for quite a while, and in most cases doctors that are caught are almost never prosecuted. The problem is that in these cases doctors are assisting their patients to die behind closed doors. If euthanasia were to become legalized it would be openly discussed and most importantly regulated, so the rights of these patients can be protected.
Several foreign countries including the Netherlands and Belgium allow euthanasia to be performed on patients if certain conditions, such as chronic pain associated with an incurable illness, are met.
Objections To Mercy Killing
The arguments against Mercy killing or Euthanasia are normally classified on the basis of religious objections and other objections. In the following paragraphs, some of the objections to mercy killing have been enumerated.
Objections Based On Religion
Many of the arguments made against voluntary euthanasia come from a religious basis. There are many different religions who oppose this practice. The strongest is the Roman Catholic Church. Buddhist and Islamic faiths also oppose the euthanasia. Even though many of these religions do not support euthanasia, there are many ordinary believers and priests who do support this practice.
Three Basic Arguments
1. The Sanctity of Life.
One of the common arguments against euthanasia from a religious basis is the 'sanctity of life.' Many religions teach that life is simply a gift from God, and that only He can decide when it is to end. This means that any deliberate killing of an innocent person is wrong. So many believe that the concept of voluntary euthanasia breaks that law, even though it is one's own personal choice. This gives people the message that they do not have the right to make their own choices regarding their life.
2. Intentional Killing is Forbidden.
The argument that intentional killing is forbidden is taken from the 6th Commandment, which states 'though shalt not kill.' Churches translate this Commandment to include voluntary euthanasia as intentional killing. However, it is important to remember that this Commandment has never been absolute in its definition. Churches allow for intentional killing in wars, self defense, and in cases of capital punishment.
3. The Value of Human Suffering.
In Christianity they teach that human suffering is part of God's plan for human beings. They believe that suffering has spiritual significance, and that it leads to growth. They also think that is part of the process of redemption. So in short they reject the concept of voluntary euthanasia on the basis that the extreme suffering that a patient is enduring is all part of God's will.
1. Euthanasia would not only be for people who are "terminally ill."
There are two problems here -- the definition of "terminal" and the changes that have already taken place to extend euthanasia to those who aren't "terminally ill." There are many definitions for the word "terminal." For example, when he spoke to the National Press Club in 1992, Jack Kevorkian said that a terminal illness was "any disease that curtails life even for a day." The co-founder of the Hemlock Society often refers to "terminal old age." Some laws define "terminal" condition as one from which death will occur in a "relatively short time." Others state that "terminal" means that death is expected within six months or less. Even where a specific life expectancy (like six months) is referred to, medical experts acknowledge that it is virtually impossible to predict the life expectancy of a particular patient. Some people diagnosed as terminally ill don't die for years, if at all, from the diagnosed condition. Increasingly, however, euthanasia activists have dropped references to terminal illness, replacing them with such phrases as "hopelessly ill," "desperately ill," "incurably ill," "hopeless condition," and "meaningless life."
An article in the journal, Suicide and Life-Threatening Behavior, described assisted suicide guidelines for those with a hopeless condition. "Hopeless condition" was defined to include terminal illness, severe physical or psychological pain, physical or mental debilitation or deterioration, or a quality of life that is no longer acceptable to the individual. That means just about anybody who has a suicidal impulse .
2. Euthanasia can become a means of health care cost containment
Physician-assisted suicide, if it became widespread, could become a profit-enhancing tool for big HMOs. Drugs used in assisted suicide cost only about $40, but that it could take $40,000 to treat a patient properly so that they don't want the "choice" of assisted suicide. Perhaps one of the most important developments in recent years is the increasing emphasis placed on health care providers to contain costs. In such a climate, euthanasia certainly could become a means of cost containment.
In India, thousands of people have no medical insurance; studies have shown that the poor and minorities generally are not given access to available pain control, and managed-care facilities are offering physicians cash bonuses if they don't provide care for patients. With greater and greater emphasis being placed on managed care, many doctors are at financial risk when they provide treatment for their patients. Legalized euthanasia raises the potential for a profoundly dangerous situation in which doctors could find themselves far better off financially if a seriously ill or disabled person "chooses" to die rather than receive long-term care. Savings to the government may also become a consideration. This could take place if governments cut back on paying for treatment and care and replace them with the "treatment" of death. For example, immediately after the passage of Measure 16, Oregon's law permitting assisted suicide, Jean Thorne, the state's Medicaid Director, announced that physician-assisted suicide would be paid for as "comfort care" under the Oregon Health Plan which provides medical coverage for about 345,000 poor Oregonians. Within eighteen months of Measure 16's passage, the State of Oregon announced plans to cut back on health care coverage for poor state residents. In Canada, hospital stays are being shortened while, at the same time, funds have not been made available for home care for the sick and elderly. Registered nurses are being replaced with less expensive practical nurses. Patients are forced to endure long waits for many types of needed surgery.
3. Euthanasia will only be voluntary,
they say Emotional and psychological pressures could become overpowering for depressed or dependent people. If the choice of euthanasia is considered as good as a decision to receive care, many people will feel guilty for not choosing death. Financial considerations, added to the concern about "being a burden," could serve as powerful forces that would lead a person to "choose" euthanasia or assisted suicide.
People for euthanasia say that voluntary euthanasia will not lead to involuntary euthanasia. They look at things as simply black and white. In real life there would be millions of situations each year where cases would not fall clearly into either category. Here are two:
Example 1: an elderly person in a nursing home, who can barely understand a breakfast menu, is asked to sign a form consenting to be killed. Is this voluntary or involuntary? Will they be protected by the law? How? Right now the overall prohibition on killing stands in the way. Once one signature can sign away a person's life, what can be as strong a protection as the current absolute prohibition on direct killing? Answer: nothing.
Example 2: a woman is suffering from depression and asks to be helped to commit suicide. One doctor sets up a practice to "help" such people. She and anyone who wants to die knows he will approve any such request. He does thousands a year for $200 each. How does the law protect people from him? Does it specify that a doctor can only approve 50 requests a year? 100? 150? If you don't think there are such doctors, just look at recent stories of doctors and nurses who are charged with murder for killing dozens or hundreds of patients.
Legalized euthanasia would most likely progress to the stage where people, at a certain point, would be expected to volunteer to be killed. Think about this: What if your veterinarian said that your ill dog would be better of "put out of her misery" by being "put to sleep" and you refused to consent. What would the vet and his assistants think? What would your friends think? Ten years from now, if a doctor told you your mother's "quality of life" was not worth living for and asked you, as the closest family member, to approve a "quick, painless ending of her life" and you refused how would doctors, nurses and others, conditioned to accept euthanasia as normal and right, treat you and your mother. Or, what if the approval was sought from your mother, who was depressed by her illness? Would she have the strength to refuse what everyone in the nursing home "expected" from seriously ill elderly people?
The movement from voluntary to involuntary euthanasia would be like the movement of abortion from "only for the life or health of the mother" as was proclaimed by advocates 30 years ago to today's "abortion on demand even if the baby is half born". Euthanasia people state that abortion is something people choose - it is not forced on them and that voluntary euthanasia will not be forced on them either. They are missing the main point - it is not an issue of force - it is an issue of the way laws against an action can be broadened and expanded once something is declared legal. You don't need to be against abortion to appreciate the way the laws on abortion have changed and to see how it could well happen the same way with euthanasia/assisted suicide as soon as the door is opened to make it legal.
4. Euthanasia is a rejection of the importance and value of human life.
People who support euthanasia often say that it is already considered permissible to take human life under some circumstances such as self defense - but they miss the point that when one kills for self defense they are saving innocent life - either their own or someone else's. With euthanasia no one's life is being saved - life is only taken.
History has taught us the dangers of euthanasia and that is why there are only two countries in the world today where it is legal. That is why almost all societies - even non-religious ones - for thousands of years have made euthanasia a crime. It is remarkable that euthanasia advocates today think they know better than the billions of people throughout history who have outlawed euthanasia - what makes the 50 year old euthanasia supporters in 2005 so wise that they think they can discard the accumulated wisdom of almost all societies of all time and open the door to the killing of innocent people? Have things changed? If they have, they are changes that should logically reduce the call for euthanasia - pain control medicines and procedure are far better than they have ever been any time in history.
Facts And Ethics Behind Mercy Killing
Euthanasia is defined by The American Heritage Dictionary as "the action of killing an individual for reasons considered to be merciful" (469). Here, killing is described as the physical action where one individual actively kills another. Euthanasia is tolerated in the medical field under certain circumstances when a patient is suffering profoundly and death is inevitable.
The word "euthanasia" comes from the Greek eu, "good", and thanatos, "death," literally, "good death"; however, the word "euthanasia" is much more difficult to define. Each person may define euthanasia differently. Who is to decide whether a death is good or not? Is any form of death good? All of these questions can be answered differently by each person. It is generally taken today to mean that act which a health care professional carries out to help his/her patient achieve a good death. Suicide, self-deliverance, auto-euthanasia, aid-in-dying, assisted suicide -- call it what you like -- can be justified by the average supporter of the so-called "right to die movement" for the following reasons:
The first reason is that an advanced terminal illness is causing unbearable suffering to the individual. This suffering is the most common reason to seek an early end. Second, a grave physical handicap exists that is so restricting that the individual cannot, even after due care, counseling, and re-training, tolerate such a limited existence. This handicap is a fairly rare reason for suicide; most impaired people cope remarkably well with their affliction, but there are some who would, at a certain point, rather die. We say that there is a second form of suicide; justifiable suicide, that is a rational and planned self-deliverance from a painful and hopeless disease which will shortly end in death.
The word "suicide" does not sit well in this context but we are stuck with it. Suicide is the taking of one's own life. Why does the term euthanasia even exist? Is euthanasia not suicide? A differentiation must be made between the two. Suicide is condoned by society as being unacceptable but euthanasia is viewed as moral and acceptable in most instances. The term "self-deliverance" is difficult to understand because the news media is in love with the words "doctor-assisted suicide". This is because the news media is dissecting the notion of whether or not doctors, who are supposed to preserve life, should partake in euthanasia. The media is failing to look at the actual issue of euthanasia, but instead, they are looking at the decision of whether or not doctors should assist in euthanasia. Also, we have to face the fact that the law calls all forms of self-destruction suicide. There are ethical guidelines for euthanasia. If the following guidelines are met, then euthanasia is considered acceptable.
The person must be a mature adult. This is essential. The exact age will depend on the individual but the person should not be a minor who would come under quite different laws. Secondly, the person must have clearly made a considered decision. An individual has the ability now to indicate this with a living will (which applies only to disconnection of life supports) and can also, in today's more open and tolerant society, freely discuss the option of euthanasia with health-care professionals, family, lawyers, etc. The euthanasia must not be carried out at the first knowledge of a life-threatening illness, and reasonable medical help must have been sought to cure or at least slow down the terminal disease. We may not believe in giving up life the minute a person is informed that he or she has a terminal illness. Life is precious, you only live once, and it is worth a fight. It is when the fight is clearly hopeless and the agony, physical and mental, is unbearable that a final exit is an option. The treating physician must have been informed, asked to be involved, and his or her response been taken into account. The physician's response will vary depending on the circumstances, of course, but they should advise their patients that a rational suicide is not a crime. It is best to inform the doctor and hear his or her response.For example, the patient might be mistaken. Perhaps the diagnosis has been misheard or misunderstood. Patients raising this subject were met with a discreet silence or meaningless remarks in the past but in today's more accepting climate most physicians will discuss potential end of life actions. The person must have a Will disposing of his or her worldly effects and money.
This shows evidence of a tidy mind, an orderly life, and forethought, all things which are important to an acceptance of rational suicide. The person must have made plans to die that do not involve others in criminal liability or leave them with guilty feelings. Assistance in suicide is a crime in most places, although the laws are gradually changing, and very few cases ever come before the courts. The only well-known instance of a lawsuit concerning this is the doctor-assisted suicide of Dr. Kevorkian. The person must leave a note saying exactly why he or she is taking their life. This statement in writing removes the chance of misunderstandings or blame. It also demonstrates that the departing person is taking full responsibility for the action. These are all guidelines for allowing euthanasia to take place. By this, It is meant that the doctor is involved in the patient's decision and actively performs the euthanasia. Passive euthanasia would show a lack of interest on the doctor's part. Simply allowing a patient to die does not require a doctor's presence.
Passive euthanasia should not even exist. Euthanasia is defined as "the action of killing..." James Rachels states in his "Active and Passive Euthanasia" that "The important difference between active and passive euthanasia is that in passive euthanasia, the doctor does not do anything to bring about the patient's death. The doctor does nothing and the patient dies of whatever ills already afflict him. In active euthanasia, however, the doctor does something to bring about the patient's death: he actively kills him"
Is allowing a patient to die considered to be an action? Rachels states "...the process of being allowed to die can be relatively slow and painful, whereas being given a lethal injection is relatively quick and painless" (1020). Disconnecting respiratory devices is not an acceptable method of euthanasia. It causes the patient to starve for oxygen and gasp for it, but when he/she cannot breathe, the body is starved of oxygen and suffocates. This is not merciful by any means. Rachels also states, "One reason why so many people think that there is an important moral difference between active and passive euthanasia is that they think killing someone is morally worse than letting someone die" The idea that a patient utilizes a medical device and has grown dependent on it for life is a grim one indeed; however, relieving a patient who relies on this machine for his/her life by simply cutting it off is not acceptable.
Leon Kass states in his "Why Doctor's Must Not Kill," "Ceasing medical intervention, allowing nature to take its course, differs fundamentally from mercy killing. For one thing, death does not necessarily follow the discontinuance of treatment" (1034). Euthanasia is the physical action of putting someone to a painless death who is suffering tremendously. The passive nature of allowing someone to die is not euthanasia. This is not a physical action taken by a doctor to ease a patient's suffering and agony.
The doctor should decide whether the ailment is curable and if it is not, he/she should decide whether the patient will live productively for months or even years to come. If the ailment is not immediately fatal, will it cause pain and suffering for the rest of the patient's life? How old is the patient? Will he/she live much longer anyway? All these factors should come into play when deciding whether a patient should be euthanized; however, the doctor's answers to these questions may differ from those of the patient and his/her family. It is up to the patient's doctor to decide whether the patient's ailment is indeed curable. The patient should be presented with the facts. The doctor should tell the patient exactly how it is and not project the false hope that the patient may recover. With this information, the patient can make an informed decision and feel that it is the best one.
Sidney Hook states in his "In Defense of Voluntary Euthanasia" that "Each one should be permitted to make his own choice - especially when no one else is harmed by it. The responsibility for the decision, whether deemed wise or foolish, must be with the chooser" (1028). This is evidenced quite simply by the mere fact that everyone has civil rights and liberties. No one can decide who should die and who should not. Everyone is in complete control of his/her own life and; therefore, should be free to decide.
Having considered the arguments in favor of auto-euthanasia, the person should also contemplate the arguments against it. First, should the person go into a hospice program instead and receive not only first-class pain management but comfort care and personal attention? Put simply, hospices make the best of a bad job, and they do so with great skill and love. The right-to-die movement supports their work, but not everyone wants a lingering death, not everyone wants that form of care. Today many terminally ill people take the marvelous benefits of home hospice programs and still accelerate the end when suffering becomes too much. A few hospice leaders claim that their care is so perfect that there is absolutely no need for anyone to consider euthanasia.
While there is no wish to criticize them, they are wrong to claim perfection. Most, but not all, terminal pain can today be controlled with the sophisticated use of drugs, but the point these leaders miss is that personal quality of one's live is foremost to some people. If one's body has been so destroyed by disease that it is not worth living, that is an intensely individual decision which should not be swayed. In some cases of the final days in hospice care, when the pain is very serious, the patient is drugged into unconsciousness. If that way is acceptable to the patient, then so be it, but some people do not wish their final hours to be in that fashion. There should be no conflict between hospice and euthanasia, both are valid options in a caring society. Both are appropriate to different people with differing values.
The other consideration is related to religion: does suffering glorify a person? Is suffering, as related to Jesus Christ's suffering on the cross, a part of the preparation for meeting God? Are you merely a steward of your life, which is a gift from God, which only He may take away. If your answers to these questions are yes, then you should not be involved in any form of euthanasia. Remember that there are millions of atheists, as well as people of differing religions, and they all have rights, too. Many Christians who believe in euthanasia justify it by reasoning that the God whom they worship is loving and tolerant, and would not wish to see them in agony. They do not see their God as being so vengeful as refusing them the Kingdom of Heaven if they accelerated the end of their life to avoid prolonged, unbearable suffering.
A doctor should not be allowed to "play God" and decide who should live and who should die. In fact, even the patient should not be allowed to, but it is the patient's life and he/she has to live it. So, it is only logical to allow the patient and no one else, to decide. Another consideration must be that, by ending one's life before its natural end, is one is depriving oneself of a valuable period of good life? Is that last period of love and companionship with family and friends worth hanging on for? Even the most determined supporters of euthanasia hang on until the last minute; sometimes too long, and lose control.
They, too, gather with their families and friends to say goodbyes. There are important reunions and often farewell parties. Euthanasia supporters enjoy life and love living, and their respect for the sanctity of life is as strong as anybody's. Yet they are willing, if their dying is distressing to them, to give up a few weeks or a few days at the very end and leave under their own control. Ultimately, the decision lies with the beholder. It is the right of a person to make his/her own choice, with some limitations. It is the doctor's responsibility to provide the patient with an accurate prognosis so that the patient may make an educated decision.
If Mercy Killing Becomes Legal
Many people support the right of a terminally ill patient to die but what if the right becomes an obligation? And what of the potential for abuse by impatient heirs? Should dying patients have the right to order their doctors not to start or continue medical treatment? Should doctors be protected from prosecution if they shorten a patient's life expectancy with pain-killing drugs? Most of us would answer yes to both questions. But does this mean we need a "right to die" law? Or is there more to the issue than first meets the eye?
Public discussion of the treatment of dying patients often confuses two separate issues. First, is the right of the terminally ill person to be allowed to die without being subjected to invasive medical procedures? Second, is the question of whether a dying person should also have the right to hasten his or her own death, and require the help of doctors and nurses to do so?
It is often overlooked that patients have the common law right to refuse any medical treatment. A doctor who treats a patient against his or her express wishes can be charged with assault. It would be wise to educate people as to their right to refuse treatment. There is no need to convert this well established legal principle into legislation. Regardless of the intention of "right to die" or "aid in dying" laws, they could very easily open the door to active euthanasia.
In the present climate of opinion, it is easy to imagine a doctor giving a lethal dose of pain-killing drug and then claiming that death was the best way to eliminate physical suffering. If the doctor could also show that the patient had requested the lethal dosage, the court might well interpret the law in the doctor's favor. Many do not find the prospect of legal voluntary active euthanasia in any way alarming. But two things should give us pause.
First, as a soon-to-be-published Canadian study will show, most health care professionals who work with the dying endorse the patient's right to refuse medical treatment, but oppose legalizing active euthanasia. The professionals recognize that if pain is controlled, as it can be in virtually all cases, very few terminally ill people ask to be put to death. Second, experience in Holland tells us that voluntary Euthanasia can quickly become involuntary euthanasia.
Dutch Experience With Euthanasia
Holland is widely regarded as one of the world's most civilized countries. Active euthanasia is legal there, but for the past decade the government has not prosecuted doctors who report having assisted their patients to commit suicide.
A recent Dutch government investigation of euthanasia has come up with some disturbing findings. In 1990, 1,030 Dutch patients were killed WITHOUT THEIR CONSENT. And of 22,500 deaths due to withdrawal of life support, 63% (14,175 patients) were denied medical treatment WITHOUT THEIR CONSENT. Twelve per-cent (1,701 patients) were mentally competent but were NOT CONSULTED.
These findings were widely publicized before the November 1991 referendum in Washington State and contributed to the defeat of the proposition to legalize lethal injections and assisted suicide. The Dutch experience seems to demonstrate that the "right to die" can soon turn into an obligation. This concept is dangerous, and you could find yourself the victim if Euthanasia becomes legal in North America. We have all heard and some of us have experienced, moving stories of elderly people in great pain, unable to perform even the most basic human functions, who have asked to die, or have perhaps brought about their own deaths.
What these stories overlook is that today, in almost all cases, it is possible to kill pain without killing the patient. When someone's pain is relieved that person usually wants to go on living. We need to reflect carefully on the consequences of legalizing active euthanasia. If we enshrine the absolute right to die, will it then become illegal to intervene to obstruct would-be suicide? Will pharmacists be obligated to sell a lethal dose of hemlock to anyone who is temporarily depressed?
Potential For Abuse:
We need to think of the potential for abuse if mercy killing becomes legal. What if someone stands to inherit one million dollars when Aunt Gladys dies? Might the heir not find it tempting to nudge her in the direction of accepting a lethal injection? Or, if she didn't get the hint, to make her miserable enough to want it? If voluntary euthanasia is made legal for "persons of sound mind" there will inevitably be tremendous pressure to provide it for those who "would request it if they were able to" - the mentally ill or handicapped, the senile, etc.
Finally, despite genuine compassion for the suffering of dying people, does there not also lurk in many hearts a less admirable motive? Few people are so tasteless as to link euthanasia and health care costs in the same breath, but there is a widespread few that medical care for the elderly costs more than we can afford. These financial pressures will multiply in the coming years as our population ages.Many elderly people are already responding to this not-so-subtle message by declaring their willingness to die when their lives are no longer productive. Their reluctance to be a financial burden on the young is admirable, but the long term consequences could be brutal.
What will happen to the trust that people still feel toward their doctors if our country follows Holland? What emotion will elderly or seriously ill patients feel when the nurse approaches them with a full syringe? How soundly will they sleep in the hospital?
The Alternative To Euthanasia:
The alternative to legalized euthanasia is not extraordinary, futile treatment to hopelessly dying patients. The alternatives are appropriate medical care - including
1. The withdrawal of treatment upon patient request, or if the treatment serves no therapeutic purpose; and
Dispensing drugs as necessary to control pain. No doctors, laws, or organizations oppose ceasing care when the time to die has arrived.
What Is Wrong With Making Mercy Killing Legal?
Many argue that a decision to kill oneself is a private choice about which society has no right to be concerned. This position assumes that suicide results from competent people making autonomous, rational decisions to die, and then claims that society has no business "interfering" with a freely chosen life or death decision that harms no one other than the suicidal individual. But according to experts who have studied suicide, the basic assumption is wrong.
A careful 1974 British study, which involved extensive interviews and examination of medical records, found that 93 percent of those studied who committed suicide were mentally ill at the time. A similar St. Louis study, published in 1984, found a mental disorder in 94 percent of those who committed suicide. There is a great body of psychological evidence that those who attempt suicide are normally ambivalent, that they usually attempt suicide for reasons other than a settled desire to die, and that they are predominantly the victims of mental disorder.
Still, Shouldn't It Be The Person's Own Choice?
Almost all of those who attempt suicide do so as a subconscious cry for help, not after a carefully calculated judgment that death would be better than life. A suicide attempt powerfully calls attention to one's plight. The humane response is to mobilize psychiatric and social service resources to address the problems that led the would-be suicide to such an extremity. Typically, this counseling and assistance is successful. One study of 886 people who were rescued from attempted suicides found that five years later only 3.84 percent had gone on to kill themselves. A Swedish study with a 36-year follow-up found only 10.9 percent later killed themselves. Paradoxically, the prospects for a happy life are often greater for those who attempt suicide, but are stopped and helped, than for those with similar problems who never attempt suicide. In the words of academic psychiatrist Dr. Erwin Stengel, "The suicidal attempt is a highly effective though hazardous way of influencing others and its effects are as a rule ... lasting."
In short, suicidal people should be helped with their problems, not helped to die.
But Shouldn't We Distinguish Between Those Who Are Emotionally Unbalanced And Those Who Are Making A Rational, Competent Decision?
Psychologist Joseph Richman, writing in the Journal of Suicide and Life-Threatening Behauior, notes, “As a clinical suicidologist, and therapist who has interviewed or treated over 800 suicidal persons and their families, I have been impressed that those who are suicidal are more like each other than different, including those who choose "rational suicide". All suicides, including the "rational," can be an avoidance of or substitute for dealing with basic life-and-death issues. The suicidal person and significant others usually do not know the reasons for the decision to commit suicide, but they give themselves reasons. That is why rational suicide is more often rationalized, based upon reasons that are unknown, unconscious, and a part of social and family system dynamics. The proponents of rational suicide are often guilty of tunnel vision, defined as the absence of perceived alternatives to suicides.”
What About Those Who Are Terminally Ill?
Contrary to the assumptions of many in the public, a scientific study of people with terminal illness published in the American Journal of Psychiatry found that fewer than one in four expressed a wish to die, and all of those who did had clinically diagnosable depression. As Richman points out, "Effective psychotherapeutic treatment is possible with the terminally ill, and only irrational prejudices prevent the greater resort to such measures.'' And suicidologist Dr. David C. Clark observes that depressive episodes in the seriously ill "are not less responsive to medication" than depression in others. Indeed, the suicide rate in persons with terminal illness is only between 2 percent and 4 percent. Compassionate counseling and assistance, such as that provided in many hospices, together with medical and psychological care, provide a positive alternative to euthanasia among those who have terminal illness.
What About Those In Uncontrollable Pain?
They are not getting adequate medical care and should be provided up-to-date means of pain control, not killed. Even Dr. Pieter Admiraal, a leader of the successful movement to legalize direct killing in the Netherlands, has publicly observed that pain is never an adequate justification for euthanasia in light of current medical techniques that can manage pain in virtually all circumstances.
Why, then, are there so many personal stories of people in hospitals and nursing homes having to cope with unbearable pain? Tragically, pain control techniques that have been perfected at the frontiers of medicine have not become universally known at the clinical level. What we need is better training in those techniques for health care personnel -- not the legalization of physician-aided death.
What About Those With Severe Disabilities?
What would it say about our attitude as a society were we to tell those who have neither terminal illness nor a disability, "You say you want to be killed, but what you really need is counseling and assistance," but, at the same time, we were to tell those with disabilities, "We understand why you want to be killed, and we'll let a doctor kill you"? It would certainly not mean that we were respecting the "choice" of the person with the disability. Instead, we would be discriminatorily denying suicide counseling on the basis of disability. We'd be saying to the nondisabled person, "We care too much about you to let you throw your life away," but to the person with the disability, "We agree that life with a disability is not worth living." True respect for the rights of people with disabilities would dictate action to remove those obstacles -- not "help" in committing suicide.
Most people with disabilities will tell you that it is not so much their physical or mental impairment itself that makes their lives difficult as it is the conduct of the nondisabled majority toward them. Denial of access, discrimination in employment, and an attitude of aversion or pity instead of respect are what make life intolerable. True respect for the rights of people with disabilities would dictate action to remove those obstacles -- not "help" in committing suicide.
Opponents Of Legalizing Assisting Suicide Say It Will Lead To Non Voluntary Euthanasia.
Absolutely not. As attorney Walter Weber has written in the Journal of Suicide and Life Threatening Behavior, Under the equal-protection clause of the Fourteenth Amendment to the U.S Constitution, legislative classifications that restrict constitutional rights are subject to strict scrutiny and will be struck down unless narrowly tailored to further a compelling governmental interest. A right to choose death for oneself would also probably extend to incompetent individuals. A number of lower courts have held that an incompetent patient does not lose his or her right to consent to termination of life-supporting care by virtue of his or her incompetency. The "substituted judgment" doctrine authorizes indeed, requires a substitute decision maker, whether the court or a designated third party, to decide what the incompetent person would choose, if that person were competent. Therefore infants, those with mental illness, retarded people, confused or senile elderly individuals, and other incompetent people would be entitled to have someone else enforce their right to die.
Thus, if direct killing is legalized on request of a competent person, under court precedents that have already been set, someone who is not competent could be killed at the direction of that person's guardian even though the incompetent patient had never expressed a desire to be killed.
Mercy Killing In Indian Social Context
Having touched upon the controversial aspects of Mercy Killing, let us now move forward to Indian social context of Mercy Killing.The degenerative muscular dystrophy patient K Venkatesh, who had sought mercy killing, passed away in Hyderabad on December 17, 2004. This is the most highlighted case of mercy killing in India. The 25-year-old was on life support system in Global Hospital. His eyes were donated after his death but no other organ could be transplanted as the former chess player had been on a ventilator for a long period. His mother and sister were by his side when the end came. His mother had appealed to the Andhra Pradesh high court seeking euthanasia to allow her son to donate his organs. The court had earlier rejected her appeal but on Thursday ordered setting up of a committee to reconsider the matter.
A Communist Party of India Member of Parliament, S Sudhakar made a strong case for legalizing mercy killings. Referring to 25-year old former chess champion, K Venkatesh, who suffered from muscular dystrophy, S Sudhakar Reddy said the government must come forward with a comprehensive Euthanasia Act. Euthanasia is the act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition. Venkatesh and his mother K Sujatha's plea that the former's organs be allowed to be harvested had been rejected by the Andhra Pradesh high court. The court ruled that the Transplantation of Human Organs Act, 1995, has no provision to allow individuals to donate organs before they are brain-dead.
This issue made the debate of allowability or otherwise of mercy killing in India, a controversial issue. I have carried out certain telephonic interviews of randomly selected citizens of India from 20 major cities of India asking their views about acceptability or otherwise of mercy killing. This is the major source of review in my study paper and in the following paragraphs; I have elucidated the various views received from citizens of cities of India.
Reviews Of Indian General Public
As said earlier, the reviews of Indian General Public has been collected from major cities of India via telephonic interview conducted where they were asked only their view regarding acceptability or otherwise of Mercy Killing in Indian social context and were assured that their identity will not be disclosed in the study paper except that only the first name and their city will be mentioned in the paper. Following is the list of reviews and responses sought from citizens of Cities of India as Nikunj Dholakia from Mumbai said “I totally support euthanasia. Sometimes illness is more terrible than the death itself. In such circumstances the patient should have the right to allow itself to be killed. Bone cancer is one such eg. in which patient had to undergo terrible pain.” secondly “Theoretically Mercy killing is a good step because it relieves both sufferer and the family of seemingly endless pain. The only hitch could be it can get misused with dangerous implications.” Said Amit Sen from Kolkata. Thirdly “India should look out for a pragmatic solution to this issue; approaches adopted by countries like the Netherlands can form a good starting point. The idea should not be pushed under the carpet without a good debate on its pros and cons taking the Indian society and systems into context.” Responded Miss Vamsi from Kanpur but “It will be disastrous; people will be murdered in the name of euthanasia.” Was the response of Mr. Saurabh from Ahmadabad and Mr. N. S. Anand from Chandigrah has to say, “Euthanasia must never be legalized because there is a danger associated with it. There could be several people who might commit murder and make it appear like mercy killing. Hence legalizing this will provide an escape route for murderers.” next Mr. Haresh Oza, a social thinker from Jamnagar, Gujarat very seriously put forward his response as he said, “I feel it is very painful to see your loved ones suffer and just drains the family caring for the person emotionally. I think in India keeping in mind that some people may use it to get rid of people it has to be brought in under very strict laws but i think it should be allowed for the following reasons:
Alleviate the suffering of the loved ones concerned.
Let the person go away in dignity and without suffering a lot
Vacates desperately needed medical resources for other cases
Would help with cases like organ donation
I think the government should study how it is implemented in places like Netherlands and see how it can be better modified to fit our situations. Maybe a combined team of family, doctors, medical court and an N.G.O could together grant the right to do so in each case to avoid any foul play. Also the person's own wish to do so should be available on paper signed just like a will.”
In Medical professional area there are also few person came in light who also given argument in the favor of this, so we should do that what the public want and what is needed in the jurisprudence savigny also said that should be law what is the opinion if the spirit of the people with the welfare of the society.
Analysis Of Responses
Out of the general public responses, it is revealed that general public of India at large wants to accept Mercy Killing after witnessing the case of Late. Venkatesh. It is so because there were only 3 persons opposing out of every 10 persons. That brings a ratio of acceptability to 7:3 among general public.
Out of the Medical Professionals' responses, it is apparent that Doctors' Lobby is still not taking India to be capable of accepting Mercy Killing. Though they did not oppose Mercy Killing, they in majority opined that India is still not in a position to accept or legalize Mercy Killing. The acceptability ratio in this case came to be 4:6 among Medical Practitioners.
So, it can be said that though the general public is ready at large to accept Mercy Killing, taking the view of the Doctors' lobby, it may still not be viable in Indian Context to accept and Legalize Mercy Killing.
Thus, the Hypothesis “Mercy Killing is, at large, favored by society as a whole as well as by the lobby of medical practitioners” that was suggested in the Proposal holds true to the extent that Indian Society at large is ready to accept the Mercy Killing but the assumption that the Medical Practitioners also welcome Mercy Killing, has to be reassessed as the survey reveals the opposite position.
Conclusion And Openion
The unusual request of a terminally ill person for permission to donate his organs has triggered an entirely new debate and taken the issue of human organ transplant into an un-chartered territory. It has raised the demand for extending organ donation beyond brain deaths to non-heart beat deaths. The case of K Venkatesh, suffering from Duchene's Muscular Dystrophy, is unique in two ways. Initially, he and his mother wanted him to be removed from the ventilator on which he has been surviving for more than a fortnight. It was nothing but a request for Euthanasia or mercy killing. The alibi they took was that it will enable him to donate his organs - heart, kidneys and liver - without the organs getting infected due to his peculiar illness.
However, when it was made clear to them by the doctors and lawyers that Euthanasia was not legally or medically allowed in India, they knocked on the Andhra Pradesh High Court's door with an appeal to allow even non-brain death cases to donate their organs. What they had requested to the court was inclusion of non-heart beat deaths in the Human Organ Transplant Act.The 1995 Act allows harvesting of human organs only when the donor is brain dead but his heart and other organs are still functional and his family voluntarily agrees to donate the organs. Counsel Rajender Prasad made this point before the High Court Bench pointing out that Acts were updated in many other fields including information and communication technology to meet the new situations and problems But, according to me, any such change in the Organ Transplant Act in the present social milieu will open the doors for exploitation of the poor by the rich. The rich people in search of organs will bribe the poor in to an early death, even when there is a possibility of the poor surviving.But the politicians and the policy makers will have to pay their attention to the issue of non heart beat donations, as it has already been allowed in some developed countries.The question is why non-heart beat deaths cannot be brought into the purview of the Act when it can benefit a large number of patients who want to donate their organs to other needy persons. There are 162 registered patients waiting for kidney transplant in five corporate hospitals in Hyderabad alone. If any such permission has to be given, the law should be changed. Even a court cannot do that. It has to be done by the Assembly or ParliamentBut it is not just the question of law. I would here point out even bigger and more complex social aspects of the problem. Perhaps we do not have the infrastructure to transplant the organs of every body. For example, if any poor person is dying, a rich person can approach him, saying, 'Please donate your organs to me, I will pay you.' As long as there are vulnerable poor people, such laws will only increase exploitation.Unless we end this disparity in our system, bringing such a law can be dangerous.
However, I agree that there has to be serious debate in the medical fraternity and among the legislators and policy makers on the issue on inclusion of non-heart beat cases in to the Human Organ Transplant Act. May be no such case had come to the legislature's or Parliament's note. Now there can be representation to the legislators by the people or the Medical Council of India to consider this.Organ transplant is a relatively new thing for India. If we have to compromise with it, we will have to meet the changes and challenges.Such a thing is viable only in highly civilized and developed societies. Given the vast difference between the rich and the poor in our country, if we bring such a thing today, any rich will buy the poor.With this end note, I would conclude by saying that though Indian general public is ready to accept Mercy Killing, keeping in view the opinion of the doctors' lobby, and some discussions offered by myself as above, India is still not in apposition to accept Mercy Killing as Legalized medical tool.