Legalizing Euthanasia

Contention One: Euthanasia Without Patient"s Permission Is Unethical Euthanasia can only be applied if it meets one of two conditions: the patient has "an incurable and painful disease" or the patient is "in an irreversible coma." It is impossible to obtain the patient"s permission in the latter scenario since the patient is fully unconscious. Therefore, killing the patient in the latter scenario is unethical because every person is entitled to whether or not they wish to die by unnatural causes (euthanasia being the unnatural cause). A doctor has no right to kill a patient without their direct consent, and if the patient is in a coma, that consent is impossible to obtain; therefore, proceeding with euthanasia is unacceptable. Since killing a patient who is an irreversible coma is half the definition of euthanasia, many people"s dignity will be lost as a result. According to the Remmelink Report, commissioned by the Dutch Ministry of Justice, there were over 3,000 deaths from euthanasia in the Netherlands in 1990. More than 1,000 of these people were in a coma. Thus, it can be easily be said that some of those 1,000 people did not want to die of an unnatural cause, but they had no say in their fate, since euthanasia was applied nevertheless. Contention Two: Euthanasia Gives Too Much Power To Doctors Subpoint A: The Power May Be Overwhelming Patients generally decide to proceed with euthanasia on the basis of information given to them by doctors: information about their diagnosis, prognosis, treatments available and anticipated degree of future suffering. If a doctor confidently suggests a certain course of action it can be very difficult for a patient to resist. However it can be very difficult to be certain in these areas. Diagnoses may be mistaken. Prognoses may be wildly misjudged. New treatments which the doctor is unaware of may have recently been developed or about to be developed. The doctor may not be up-to-date in symptom control. Thus, the patient"s decision to proceed with euthanasia may be distorted since the power given to individual doctors can easily be overwhelming; thus, patients inadvertently may not receive the entire picture. Subpoint B: The Power Can Be Abused Against The Patient"s Dignity Doctors are human and are therefore subject to temptation. Sometimes, their own decision-making may be affected, consciously or unconsciously, by their degree of tiredness, the way they feel about the patient, or even the hospital"s financial status. All of these causes can cause a patient to proceed with euthanasia when alternatives are available; patients may not get the full picture from their naturally-biased physicians. Furthermore, from history we can see that legislative euthanasia aggravates these problems. Leo Alexander, a psychiatrist who worked with the Office of the Chief of Counsel for War Crimes at Nuremberg, described the process in the New England Medical Journal in July 1949: "The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the attitude, basic in the euthanasia movement that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non- Germans." This societal attitude can lead to the deaths of many against their dignity in its purest form. Contention Three: Euthanasia Undermines Medical Research Medical Research is all about finding treatments and cures for people diagnosed with "incurable and painful diseases." This procedure allows Medicine to develop as a whole. When the focus changes from curing the condition to killing the individual with the condition, this whole process is threatened. If euthanasia is legalized, we can expect advances in ktenology (the science of killing) at the expense of treatment and symptom control. Now, I"m not saying that advances in medical research will completely stop; however, they certainly will face obstructions if euthanasia is legalized. Sources: Van der Maas PJ et al (1991) Euthanasia and other medical decisions concerning the end of life. Lancet 338:669- 74 Dutch doctors pushed on to 'slippery slope' over euthanasia. The Independent Wednesday 17 February 1993 p8.