Foreword:
This paper describes Euthanasia that is now taking a major place in the debates among people. Many people are in favor of this process as they think that it is employed in order to bring the suffering people to peace while many people are against this process. Most of such opponents are religious people who think that this process is against the code of ethics and religion. So, both types of arguments, that is, in favor and against, are discussed in this report. Then the ethical issues from nurses’ point of view are also discussed.
Euthanasia
Euthanasia occurs when a medical doctor provides the means for death to occur and the patient self administers it. Euthanasia currently is one of the most frequently debated issues in American society. Abundant information indicates Americans are divided on the issue. The debate puts forth such arguments as preservation of life; autonomy and the self-determination of individuals; older people using up expensive medical services; the slippery slope that Euthanasia will eventually lead to involuntary deaths; and issues of ethical and moral complicity such as proxy deaths of children. Most people agree that. euthanasia should be reserved for people who are dying from terminal illness. Proponents of euthanasia believe dying people are in intractable pain and should be allowed to end their lives and thus their pain. Opponents argue that underutilization of narcotics for pain control leaves terminally ill people in pain. It is said that dying is not painful; it is the illness that causes the pain. However, an individual does not have to have a terminal illness to have intractable pain, to which many people with conditions such as arthritis and fibromyalgia will attest. (Raphael, 2001)
Little research has been conducted on the etiology of actual cases of Euthanasia. The majority of available data is on suicide among individuals who acted alone. The clinical research, for example, has focused on predicting which people are likely to choose suicide as a means of ending their lives. Predictors of suicide include prior suicide attempt, suicide of a family member, and recent loss of a loved one, pain, and psychiatric illness. Depression is one of the most salient features of individuals who contemplate or complete suicide. It has also been found that when individuals received mental health treatment for the depression, the desire to kill them diminished. In addition, according to Leenaars, when people are experiencing personal difficulties or have lowered coping capacity, they are at risk of suicide. Having a terminal illness (often cited as a reason for Euthanasia) may precipitate depression and reduced coping capacity; however, terminally ill people are rarely suicidal. To make sound, ethical decisions, it is important for all helping professionals to be aware of the many factors involved in and treatments for depression in terminally ill individuals (Ian Dowbiggen, 2003).
Providing more and better palliative and other care will undoubtedly help quell the demand for assisted suicide. This includes measures such as increasing access to hospice care, improving physician training in the principles and clinical science of palliative care, improving hospital and nursing home capabilities in palliative care, financing for palliative care, and creating openness to discussions about the end of life between physicians and patients. These and other measures could reduce public anxiety and fear about death and the desire for physician-assisted suicide but will not eliminate all requests
Arguments Favoring the Euthanasia
Arguments supporting Euthanasia highlight the duty to relieve patient suffering or stem from a vigorous understanding of the duty to respect patient autonomy. The suffering of patients at the end of life can be great. It includes the suffering occasioned by somatic symptoms, such as pain and nausea, or psychological conditions, such as depression and anxiety. It encompasses interpersonal suffering (due to dependency on other persons or to unresolved interpersonal conflicts) or existential suffering (based on a sense of hopelessness, indignity, or the belief that one’s life has ended in a biographical sense but not yet ended biologically). In certain clinical situations, some aspects of suffering cannot be satisfactorily controlled with standard pharmacologic or surgical interventions. Many proponents of assisted suicide have argued that trust is eroded when physician-assisted suicide is not an option, or an option for discussion, in these circumstances. Physician-assisted suicide is, in this view, an act of compassion that respects patient choice and fulfills an obligation of non abandonment. (Dworkin et al 1998)
Positions in favor of legalizing physician-assisted suicide are related to the contemporary trend toward emphasizing patient autonomy in bioethics and law. It is argued that the decision to end one’s life is intensely personal and private, harms no one else, and ought not to be prohibited by the government or the medical profession. (Raphael, 2001)
Arguments against the Euthanasia
While popular arguments for physician assistance in suicide commonly refer to the need to relieve pain or suffering, these appeals have no legal standing in the act. Rather, the act is framed exclusively in terms of patients’ “control” over their lives and their “right” to end those lives in a humane and dignified way. In political campaigns, advocates for the act relied entirely on the argument that people have the right to control the manner and timing of their death. Terminally ill patients need not be in pain or suffering to exercise this right.
Organized opponents of the act essentially conceded the moral ground to those who advocated autonomy. That concession left the moral argument to those who opposed it on medical or religious grounds–groups vulnerable to the charge of being morally authoritarian. The medical argument–that in individual instances of assisted suicide things could go very badly for the patient–was not persuasive.
Arguments offered from religious perspectives or by particular religious communities were interpreted within the context of the culture wars. State legislators who considered proposing revisions to the act were warned against “imposing religious beliefs on citizens.” Proponents also argued that those opposing the act were “held hostage” by the “raw political power” of religious institutions. A vocal political action committee was named, “Don’t Let Them Shove Their Religion Down Your Throats Committee.” It vigorously warned the public about the prospect of unleashing moral tyranny through the “imposition” of religious positions. (Kathleen 2002)
The culture wars card was played and, in some circles, warmly received, in part because Oregon’s citizens are among the least religiously affiliated of any in the U.S. The argument particularly resonated with voters because it reminded them of recent attempts by an alliance of fundamentalist Christians (the Oregon Citizens Alliance) to make biblical appeals the explicit basis of public policy on such issues as abortion, public education and gay rights. Though those efforts were all defeated, some by quite substantial margins, they made people suspicious of arguments based on religious perspectives.
Ethical Issues from Nurses Point Of View
The historic role of nurses brings their image to us as someone promoting, preserving and protecting the life. The code of nurses say that do no harm but the participation of nurses in the process of assisted suicide has ruined the ethical traditions and goals of professions.
Even though medical doctors provide the means of death, nurses could become involved as they assist patients with end-of-life decisions. Involvement with Euthanasia presents an ethical dilemma, which in this article refers to a situation in which nurses think they have no definitive guidelines for professional behavior, when values governing professional behavior conflict, or when practice guidelines have not evolved to match technology. Nurses have long been involved in ethical conflicts. Even though disagreements are voiced within the professional body, individual nurses tend to avoid issues that might create conflict. Avoidance of controversy may be one of the reasons that nursing researchers have conducted scant research on nurses’ views of Euthanasia. Several safeguards have been implemented in the nursing profession to guide nurses in making ethical decisions regarding intervention with clients. In ethical practice, adhere to federal and state legislation and their professional code of ethics. The Code of nurses defines the values and principles of the profession. The nurses’ population in Oregon is decreasing with the popularity of the Euthanasia because they are afraid of any disciplinary action that could take place against them if they will be caught in getting involved in the activities related to the euthanasia. (Raphael, 2001)
Conclusion
Citizen must begin by discussing what they hold in common rather than what is divisive. The debate over physician-assisted suicide presumes a shared commitment to improving care for the terminally ill. This is the core ethical and professional issue that has been obfuscated by the political campaign and sanitized by the reporting process. Second, proponents and opponents both affirm the importance of patient control over dying. This emphasis is already embedded in Oregon’s current policy. We need to permit the dying even greater say about where they will die, in whose presence, and with what levels of care provided.
References
Raphael Cohen-Almagor. (2001). The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law. Piscataway, NJ: Rutgers University Press.
Ian Dowbiggen. (2003). A Merciful End: The Euthanasia Movement in Modern America. New York: Oxford University Press.
Gerald Dworkin, Sissela Bok, and R.G. Frey. (1998). Euthanasia and Physician-Assisted Suicide: For and Against. New York: Cambridge University Press.
Kathleen M. Foley. (2002). The Case Against Assisted Suicide: For the Right to End-of- Life Care. Baltimore: Johns Hopkins University Press.
