Medical ethics has been a field and area of interest subject to varying views, ideas and opinions from leading experts over its course of evolution. Ranging from arguing correct legislation of medical procedures that are deemed controversial such as abortion, “mercy killing” –euthanasia- and other such activities in relation to the overall aim of the profession – saving lives while improving quality healthcare delivery, there have been several well-meaning and equally convincing arguments running back and forth between key players; the ailing patient, his relatives and loved ones, the healthcare giver and the government debating the ripple effects of such procedures on the sanctity and sacredness of the human life. How shocked would you be, as a medical doctor in the nearest future, if and when asked to perform a life-taking procedure on a patient? Perhaps, requested for by the patient himself! Your first reaction, probably, would be “Hell no! I was trained to save lives and not take such” and you would declare yourself bound to the oath of your profession – the Hippocrates’ Oath, which you’ve sworn NEVER to take any life. However, is “mercy killing” – euthanasia same as “murder” – killing another human? Is euthanasia a “right” – morally and ethically correct procedure? Why euthanasia in the first instance – does it not underline the failure of the medical profession? This article aims to provide a review – not in any way a representation or definitive judgment, on the act and procedure of “mercy killing” – medically referred to as euthanasia.
What is Euthanasia?
Euthanasia, known to many in different appellatives such as “mercy killing”, “physician-assisted suicide”, “legalized murder”, is a medical procedure that gives “right” to sick or dying patients and/or their medical proxy – a person responsible to authorize any medical procedure to be carried out on a patient who is unable to do the same due to either his mental or physical state such as a person in a coma or a child, to demand the deliberate cessation or stoppage of medical assistance or aid to the sick person resulting in eventual death. Oftentimes, this “right” is evoked by terminally ill patients whose condition is already determined – death, so as to mitigate excessive pain or financial resources spent in keeping such patient alive and breathing. In a bid to avoid the “abuse” of the procedure such as in terminating sick patients with a fighting chance of life, there are strict laws guiding the practice of the procedure in countries where they have been legalized such as the established confirmation of the eventual end of such patients by at least two or three qualified and unrelated medical personnel thus establishing a distinction between deliberate murder of a patient with a slim chance of survival and the mercy killing of one without a glimmer of hope.
Is Euthanasia then morally and ethically correct?
There have been several arguments going back and forth on the moral correctness and ethical legality of euthanasia. The Terri Schiavo case in the United States was one of the legal battles on the legality of euthanasia that brought the procedure once more to the table for discussion and galvanized public opinion in the early 21st century (Caplan, 2015). Terri Schiavo, the said victim in the case, suffered a cardiac arrest in 1990 and spent 15 years in a “vegetative” state as medical science proved unable to restore her to normality. Over the years, her husband – her medical proxy, requested that she be allowed to pass away despite showing vital signs of life but was repeatedly declined as there was no law granting such permission. The case attracted media publicity and public opinion swayed heavily back and forth, involving even the meeting of then-President Bush with the family before the decision was made to disconnect Schiavo’s life support in 2005 after several appeals, motions, petitions and court hearings (Caplan, 2015). What exactly delayed the eventual decision on Terri Schiavo seeing the eventual end remained death?
Proponents in favour of legalizing the procedure have argued on the freedom of choice presented to an ailing individual. Why should anyone be denied the freedom of determining how and when to die seeing that there is absolutely no chance of his survival or leading a fairly normal and independent life? Why should be he be subject to debilitating pain and emotionally wrecking agony if there is no chance of ever surviving such pain? It has been argued that everyone should have a right to choose or decide the quality of life – one that is devoid of pain or suffering, he would live and that a person should be empowered to face his death with dignity and pride. There is no gain in eventually dying as a vegetable when he could have died wholly and proudly! It has also been argued that the procedure itself is humane in nature – in that, it saves man from the unbearable and excruciating pain that may prove otherwise in affecting his cognitive or mental capabilities which is, most certainly, an objective of the medical profession. Declining and scarcely available medical resources which may otherwise be highly expensive to procure and maintain – thus depleting the financial and economic powers of the victim’s loved ones, have been argued to be more available to victims with a greater chance of survival rather than being hoarded by victims with zero chance thus costing more lives. If these resources, tools and time are being devoted to the still surviving patients, proponents have argued, more lives would be saved and resources judiciously used if euthanasia is legalized and made compulsory in extreme cases. This also would save their loved ones the horror of watching the patient waiting for death while losing financial resources daily, and help them deal quickly with the loss and move on with their individual lives.
However, opponents of the legalization have argued on the basis of the Hippocratic Oath – on maintaining the sanctity and sacredness of human life. The original oath, though has been modified over the years, include the following words which underline the physician’s regard for the sacredness of life:
“I will neither give a deadly drug to anyone who asked for it, nor will I make a suggestion to such effect”
Relative to the days of Hippocrates when civilization was at its very cradle, some feel that the oath is outdated and irrelevant as the availability of more treatments procedures, the advancement and recent medical breakthrough and the possibility of extending life whatever its quality becomes an increasingly complex issue. Therefore, there has been an infusion of the moral angle to the narrative – legalizing euthanasia will weaken society’s respect for the sanctity and sacredness of life. Also ascertaining the mental competence of the patient or his proxy in taking such a grave decision have been argued. The patient – may be forced by the severity of the “temporal” pain to terminate his own life, or the proxy – by the horror of watching the patient “suffer” so much, that euthanasia is required. If the pain is then mitigated to the barest minimum made possible by recent scientific advancements, such a patient or his proxy would without hesitation or doubt opt for prolonged sustenance in hope of a miracle survival. Thus in countries where euthanasia is practised, there is a process of ascertaining that the patient is mentally competent with a lucid understanding of available options, consequences, and the ability to express in clear terms the understanding of their wish to terminate their own lives before authorization of such request. Some medical practitioners also expressed their unwillingness to carry out the procedure due to its repercussive effect of guilt on their mental wellbeing. Some doctors tend to view themselves as a murderer for ending the life of a terminally ill patient due to the thought of a probable but unlikely survival. Religious sentiments have also featured on the opposing side against the legalization of euthanasia as religious faith preaches possible and miracle recoveries against all scientific facts. In 2013, researchers published findings of a survey in which they asked people from 74 countries their opinions on euthanasia; 65% of the respondents voted against the legalization of such a “horrendous” procedure while in 11 of the 74 countries, the vote was mostly for. In the US where 1712 respondents represented 49 states, 67% voted against while in 18 states, the majority were for – this did not include Washington or Oregon (Colbert, Schulte & Adler, 2013).
As of March 2021 according to Wikipedia, active human euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, Western Australia, Canada, and Spain.
CAPLAN A., 2015. Ten years after Terry Schiavo, death debate still us. BioethicistNBC News. https://www.nbcnews.com/health/health-news-bioethicist-tk-n333536 (Accessed last: May, 17, 2021)
COLBERT J. A., SCHULTE J., & ADLER J. N. 2013. Physician assisted suicide – Polling results. New England Journal of Medicine, 369, e15. https://www.nejm.org/doi/full/10.1056/NEJMclde1310667
YVETTE B. 2018. What are euthanasia and assisted suicide? https://www.medicalnewstoday.com/article/182951 (PUT HASH)some-statistics.