Euthanasia can be defined as the intentional killing by act or omission of a dependent human being for his or her alleged benefit. Usually it can be categorized into forms – voluntary, non-voluntary and involuntary. Voluntary euthanasia requires the patient’s consent and is legalized in Belgium, Luxembourg, the Netherlands, Switzerland and the U.S. states of Oregon and Washington. Non-voluntary euthanasia which is illegal in all countries is when the patient’s consent is not given. Euthanasia conducted on a person who is able to provide informed consent but does not because they do not choose to die or because they were not asked is involuntary euthanasia. Euthanasia can be supported because of rights and also argued against because of the difficulty to assess suffering.
Euthanasia gives the opportunity to exercise certain rights in terms of the patient having the right to die with dignity, the family’s right to proper closure and the medical personnel’s right to give their patient the best option. According to the Remmelink Commission’s Report (1991), 56 percent of the patients who requested euthanasia did so because of a feeling of “loss of dignity”. This dignity is often linked to the lack of autonomy the patient suffers. He or she would have experienced a certain degree of autonomy before their health deteriorated. To lose that independence triggers a sense of helplessness and a blow to their dignity in regards to how they lived their life before. Not able to function normally on a daily basis and to be in constant care of others seems to be worse option than death and thus, patients would rather end their lives on their own terms with dignity. And they have a right to that death just as they had a right to live their life whatever way they wanted. Bioethicist H.T. Engelhardt’s question (2000) “If rationality, freedom, dignity and self-determination distinguish the good life, should they not characterize the good death?” proves this point.
Euthanasia does not only affect the patient but everyone who is involved in their dying process. In light with the patient’s right to die with dignity, their family would also want their loved one to retain their dignity. They would also get a better closure knowing that the patient got what he wanted regardless of whether that is in line with their own opinion. They deserve to exercise that right since they are the ones that have most probably watched their love one suffer for a long time. In addition, research done by Swarte, van der Lee, van der Bom, van der Bout and Heintz in 2003 shows that “The bereaved family and friends of cancer patients who dead by euthanasia coped better with respect to grief symptoms and post-traumatic stress than the bereaved of comparable cancer patients who dies a natural death”. This could be because they were more mentally prepared and had the chance to express their last goodbyes. Moreover, medical personnel who handled the patient’s case should have the right to give him the best option. If they already know that no treatment would have any positive effect anymore and the patient has given consent, euthanasia then becomes that best option.
Euthanasia gives rise to the question of how to assess the suffering of the patient properly with regards to the patient’s individualistic perception of pain and the contradiction of medical personnel’s opinions. In research done by Dees, Vernooij-Dassen, Dekkers and van Weel in 2010, it was found out that “There is no generally accepted definition of ‘unbearable suffering’ in the context of a request for Euthanasia and Assisted Suicide. On the basis of the articles reviewed, we propose the following conceptual definition: ‘Unbearable suffering in the context of a request for EAS is a profoundly personal experience of an actual or perceived impending threat to the integrity or life of the person, which has a significant duration and a central place in the person's mind.” From this we can see that there is no proper, solid guideline to assess the suffering of the patient and the situation can only rely on the patient’s judgment of their pain. However, pain tolerance changes with age, gender, experience and other factors. For example, generally speaking, a sixteen-year-old would be able to tolerate the pain that a six-year-old would not be able to. So when a patient claims that they are in pain so much so that they would rather choose death over it, we do not know if really their limit of pain. Moreover, in some cases, there are conflicting opinions of the medical personnel handling the case of the patient who has requested euthanasia because of unbearable pain. For example, the medical doctor might be agreeable with the patient but the attached psychiatrist might claim that the patient does not have the mental capability to take such a decision. In this way, it gets more complex and difficult to assess the suffering of the patient and decide whether it is right to carry out euthanasia or not.
In conclusion, proponents of euthanasia mention the rights of the people involved and opponents argue about the difficulty to assess the suffering of the patient. While it is illegal in almost all countries in the world and thus, does not receive as much global attention, it will definitely become a hot issue in the near future with all the advancement in medical technology taking place. We must then prepare to take a stand with a clear conscience. After all, this is truly, a life and death matter.
Reference List
Cica, Natasha. (1996). Euthanasia - the Australian Law in an International Context. Parliament of Australia. Retrieved from http://www.aph.gov.au/library/pubs/rp/1996-97/97rp4.htm#magic_tag_18
Dees, M., Vernooij-Dassen, M., Dekkers, W. and van Weel, C. (2010), Unbearable suffering of patients with a request for euthanasia or physician-assisted suicide: an integrative review. Psycho-Oncology, 19: 339–352. doi: 10.1002/pon.1612
Swarte, N.B., Van der Lee, M.L., Van der Bom, J.G., Van der Bout, J., Heintz, P.M. (2003, 24 July). Effects of euthanasia on the bereaved family and friends: a cross sectional study. British Medical Journal. doi: 10.1136/bmj.327.7408.189
Taboada, P. Human Dignity and the Ethics and Aesthetics of Pain and Suffering. International Association for Hospice and Palliative Care. Retrieved from http://www.hospicecare.com/Ethics/monthlypiece/eithics2003/pom_feb03.htm
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