American politics is referred as a huge sub field of international
politics, since United
States is the biggest world power in the
international political arena. Therefore many scholars analyze the politics in United States .
The aim of this essay is to analyze an issue that is occupying an important
place in American politics recently, which is euthanasia.
Euthanasia is the intentional killing by act or omission of a dependent
human being for his/her alleged benefit. When killing is done by act, than it
means that the person who killed the patient has done something like giving too
much morphine. In other words, the person has done something that causes death.
However when the killing is done by omission then the person does not do such
things as artificial respiration or he switches off a machine that keeps the
patient alive. “Euthanasia can involve actively causing death (which is almost
always illegal) or assisting someone to commit suicide; some also extend it to
the practice of not interfering with suicide, such as allowing a patient to
decline vital medication or treatment” [1].
Euthanasia is
divided into two main headings. First one is active euthanasia and second one
is passive euthanasia. In the active euthanasia the person who is responsible
of the act of killing, like the physician or so, causes the death of the
patient with a direct action. Passive euthanasia on the other hand, is as
stated above killing someone via omission. The difference of these two from the
physician assisted suicide is that, in assisted suicide the physician gives
information to the patient or supplies him the means for committing a suicide.
An example for this could be writing a prescription for overdose pills. “In
euthanasia one person does something that directly kills another. In assisted
suicide, a person knowingly and intentionally provides the means or in some way
helps a suicidal person kill himself”[2].
There are three different types of
euthanasia. The first one is voluntary euthanasia, in which the patient who
would like to end his life asks for euthanasia. The patient could make this
request during his illness or when his situation is going to stay the same like
in a coma situation. Second one is called non-voluntary euthanasia and in this
situation due to the illness the patient is suffering from, the patient cannot
decide for living or ending his life. An example for this kind of euthanasia is
“turning off life-support”; in cases where physicians think that improvement is
merely possible or when there is a serious brain damage etc. Last one is
involuntary euthanasia and in this case the patient may understand the
difference between life and death, unlike the other situations. However even if
he does not accept to have euthanasia, due to his future pain because of the
illness he is suffering from, the physicians may try to oblige him to accept
euthanasia.
If we start to examine the
concept euthanasia throughout the history we can see its evolution and also the
important cases that left a great impact that carried the concept today. At the
outset, assisted suicide was something that should be punished. However it was
prohibited by the Western laws in the early times, for those who wanted to legalize
it, individual liberty was the first reason to make it something acceptable. Euthanasia,
which can also be regarded as “the practice of killing a person or animal, in a
painless or minimally painful way, for merciful reasons, usually to end suffering”[3],
has first appeared in Ancient Greece and Rome .
In certain situations killing somebody or helping them to die was something
acceptable. “In the Greek
city of Sparta
all newborns with severe birth defects were left to die”[4]. In some societies even the
voluntary euthanasia for elderly people was regarded as normal. In 400 BC,
doctors have made their Hippocratic oaths and with this oath, they have
promised not to give any harm to patients and not to suggest any counsel for
deadly medicine. Between 1300s and 1900s the English Common Law has disapproved
both suicide and assisting suicide, and regarded suicide as a crime. Meanwhile
in 1828, in America ,
American statute expressly forbid assisting suicide.
The turning point
in the issue of euthanasia was Aktion T4. This was a program of Nazi Germany,
which was aiming to kill children and adults that were born with physical
deformities or that had mental problems. The euthanasia program killed these
people with carbon monoxide gases. Later, when the public started to realize
this program not to get all the attention on them, the personnel with these gas
vans were taken to Eastern Europe, where the gassing experiments were continued
in concentration camps like Auschwitz . This
program helped the intention of creating the pure Aryan race with no flaws. The
doctors in Nazi Germany could designate who was worthy of life, and that was
indeed wrong because Aktion T4 was regarded as giving too much power to doctors
about issues like life and death.
As time went by,
certain forms of euthanasia were accepted by some states. The first legal step
about euthanasia has come from North Australia ,
although the result was not very good. With the Rights of the Terminally Ill
Act in 1995, euthanasia was legalized. Even though Northern
Australia has been the first jurisdiction legalizing euthanasia,
in 1997 the federal Parliament of Australia overturned this law. On the other
hand Netherlands
had been the first country, which legalized active euthanasia and assisted
suicide in 2001. Although Netherlands
is known as one of the leading country in attaining social policies, in the
subject of euthanasia and assisted suicide they have some strict rules that the
physician should follow. If the patient is facing huge amount of pain, if he is
asking for euthanasia / assisted suicide voluntarily, if the physician shares
ideas about the condition of the patient with another physician and lastly if
the physician examines the condition of the patient for the last time for once
more, then the assisted suicide / euthanasia could be done within the legal
borders. If a physician following the procedures does not fulfill these
conditions step-by-step, then both euthanasia and assisted suicide will still
be regarded as crimes. Another country that legalized active euthanasia was Belgium .
Although they have passed laws that favor euthanasia in 2002, again like in Netherlands
there were some limitations. Additionally to the rules in Netherlands approval of a
government commission was needed for realizing a euthanasia case. The
complicated process of euthanasia in Belgium is regarded as “bureaucracy
of death”[5], but it is only a
precaution to prevent the numberless illegal cases of euthanasia cases.
Meanwhile in US,
the issue of euthanasia was still problematic. Although in 1970s people have
started to look at the issue with less prejudice, yet none of the states had
accepted it. With the fast growing technology, ill people started to live for
very long times, with the help of respirators and kidney machines and this
resulted in nothing but suffering of the patients and their families. After some debates, euthanasia took part in
constitution of United
States for the reason that it represents the
individual rights of people on deciding “life or death”. One of the example
cases, which had an important impact on euthanasia concept is; Karen Ann
Quinlan’s case on passive euthanasia. She could only live with being connected
to a device because she had a dreadful damage in her brain. The girl was in
coma and the medical indicators suggested that she would stay like that for the
rest of her life. Therefore her family decided and requested for euthanasia,
but the hospital refused. After a long legal war between the Quinlan family and
the courts, in 1976 Quinlan family has succeeded to get an approval and the New
Jersey Supreme Court gave the permission to Quinlans for disconnecting the
device. When the device was disconnected Karen Ann started to breath and for 9
more years she lived unconsciously. Therefore, by
1997 nearly every state has adopted the system of living wills, which indicates
wishes about death support. These wills are different from an assisted suicide
because the individual makes them, and by making them he deters the time and
manner of his death. “In particular, these directives empower and instruct
doctors to withhold life-support systems if the individuals become terminally
ill”[6].
There is only one state in US that has legalized euthanasia and that is
Oregon . In
1998 physician-assisted suicide became legal in Oregon , although there are certain limits to
that. The legalization of assisted suicide in Oregon was done through the voting of the
Death with Dignity Act. The Oregon
voters have accepted this act with 60% of votes. “The Death with Dignity Act
allows terminally ill Oregon
residents to obtain from their physicians and use prescriptions for self-administered,
lethal medications”[7]. According
to this act if a person decides to end his life by obeying the rules stated in
the act, then this would not be considered as a suicide. One important thing
about the Oregon Death with Dignity Act is that it only allows assisted suicide
and it absolutely prohibits euthanasia. Some important articles from this act
are stated below: “In order to request a prescription for lethal medications,
this act requires that a patient must be:
·
18 years old or older,
·
A resident of Oregon ,
·
Capable of make and communicate health care
decisions
·
A terminal illness that would cause the death of
the patient should be determined within 6 months.
·
After these conditions are met, patients are
eligible to request a prescription.
·
The patient must make two verbal requests to
their physician, separated by at least 15 days
·
The patient must provide a written request to
their physician.
The prescribing
physician and a consulting physician must confirm the diagnosis and prognosis.
The prescribing physician and a consulting physician must determine whether the
patient is capable. If either physician believes the patient’s judgment is
impaired by a psychiatric or psychological disorder, such as depression, the
patient must be referred for counseling
·
The prescribing physician must inform the
patient of feasible alternatives to assisted suicide including comfort care,
hospice care, and pain control
·
The prescribing physician must request, but may
not require, the patient to notify their next-of-kin of the prescription
request”[8].
One other important case of euthanasia in American politics is Jack
Kevorkian’s trial. While Oregon had been open
to accept assisted suicide, another state, Michigan , was fighting against it severely.
Kevorkian is an American physician, who was famous for helping terminally ill
people to end their lives. He had been interested with the issue of death very
much, and even before starting the act of assisted suicide, he was writing
articles about euthanasia and physician assisted suicide. “In 1986 Kevorkian
learned that some doctors in the Netherlands were helping patients
who were terminally ill or experiencing unbearable suffering to die. This news
caused his longtime interest in dying patients to evolve into a campaign to
legitimize physician-assisted suicide”[9]. In
1989 he had created a device that he named as Thanatron, Greek for ‘death
machine’, which he planned to use for patients, who were asking assistance to
die. With the help of this device, he started to become famous and in 1990 with
this machine a 54-year-old woman died because of her request, since she was suffering
from Alzheimer disease. Until 1999, Kevorkian has gone to series of trials,
which were always resulting to his favor. Nevertheless he was still assisting
many ill people to commit suicides. However in 1999, he was found guilty of
second-degree murder, because of having injected “a lethal dose of medication”[10]
to a terminally ill patient of his. Because of this act, he was sentenced to 10
to 25 years of prison.
Although Kevorkian is known as the doctor of death for many people,
with his insist on this issue he managed to pull the attention of people to
this issue. “The American Medical Association has condemned his actions as
violating the physician’s primary commitment to healing. However, others note
that he has brought much-needed attention to the moral and legal issues
surrounding assisted suicide”[11]. In
United States ,
people are ending their lives with a very common method, which is “withholding
of tube-feeding”[12]. This
is a very common way and actually sometimes the family should be careful and
try to avoid this or it is possible that this could occur. As stated above, Oregon is the only state
in US that favors assisted suicide. These laws in Oregon have been the target point of many
organizations and by politicians, who give support to these organizations.
The issue of euthanasia is a complicated subject in the American
politics. Since there are people from both sides; supporting and rejecting. If
we would analyze the ideas of the supporters first, their main argument is the
protection of civil rights and liberties. They suggest that choice of dying or
living should be in the hands of the individual, and state should not intervene
to this liberty by imposing some laws or acts. This groups also claims that an
ill person should have the chance of ending his life in tranquility, instead of
suffering great pains only to live a little bit more. “Supporters of euthanasia
state that people should be allowed to decide that they do not want to live any
more, and that terminally ill patients are respected more by having their
suffering end than by being kept alive against their will”[13].
Another point that the supporters of euthanasia argue is that when a
patient is in a condition like coma and when there is a small amount of
possibility that he could survive then euthanasia could be asked by his
relatives suggesting that it costs a lot of money. As a result of the
developing technology people can live longer and even when they are paralyzed
or are in coma they could still survive for along period. The supporters of
euthanasia suggest that this is good, however these treatments can cost a lot
of money and this could give damages to the finances of a family. Contrary to the ideas of this
group the people who are against euthanasia suggest that with the developing technology
people can still recover or not their pain can be treated. The issue of
euthanasia could be regarded as a freedom of civil liberties, however, by
implementing prohibitions on euthanasia and assisted suicide, the states try to
protect their citizens from “unscrupulous doctors”. They argue that finances
of a family should never determine the life choices of a human being, since
life is something more precious. They claim that euthanasia and especially
assisted suicide make doctor killers and therefore it clashes with a regional
perspective. Most efficient point that the contrary group supports is the fact
that there is no need for a person to ask for euthanasia when he has the chance
of committing a suicide. “People do have the power to commit suicide. Suicide
and attempted suicide are not criminalized. Each and every year, and the United States
alone, there are more suicides than homicides”[14]. The most logical issue
that they are putting forward is the fact that in a come situation the patient
is generally not in a state to decide and therefore his life is in the hands of
other people. “If euthanasia were to be allowed, it is feared by some,
doctors might press people into euthanasia to reduce medical costs, or because
their family wants them to die”[15].
Another argument
followed by people against euthanasia is the religious views. Although religion
does not occupy the biggest space as a counter argument, it still is effective.
Plenty of the religious groups within Christianity, Islam and Judaism are
against euthanasia, since they suggest that God is the creator of everything
and therefore it is only in the hands of God to decide for when and how the
life of a human being could be taken away. Therefore these groups refer to
issues like euthanasia and assisted suicide as rejecting the love and
sovereignty of God. When we look
from the perspective of ethics, euthanasia raises some ethical questions.
Ethical discussions on euthanasia are over both on active and passive
euthanasia. For the reason that, ethical issues depend on the Hippocratic oath
of physicians in United
States that is “First, do no harm…”,
doing active or passive euthanasia became the target of the discussions. The
beginning of 1970s was the period that there had been debates over passive
euthanasia while active euthanasia became the target of religious groups and
some members of medical groups. Being voluntary or non-voluntary is also an
aspect in which the discussion on euthanasia lies, since in one of them the
choice is patient’s; however in the other doctor or family members should
decide on behalf of the patient.
There are two sides, which are for and against
active euthanasia. The side, which is against voluntary active euthanasia,
believes that it is not a person’s right to kill another person. As a side
effect of this situation the role of nurses, as the assistants of doctors,
creates a huge confusion, since their job is to take care of the patient. On
the other hand people who support active euthanasia believe that in some situations
it is more humanitarian to end a patient’s life rather than forcing him
continue his life by suffering, therefore doing what will be the less painful
for the patient should be the main aim of the physicians / doctors. Another
idea that supporters of active euthanasia points out is that, there should be a
respect for the decisions of the patients. If they choose to end their life it
is their decision between the life with suffering and death with tranquility.
From another point of view, a person may economically be powerless to maintain
medical treatment and therefore survive.
To sum up we would not be wrong
to suggest that euthanasia is right at the moment one of the most important
public policy issues on the agenda. It has a very critical point; since the
decisions made on euthanasia and assisted suicide can affect family relations,
and the interactions between doctors and patients. It is a human being’s right
to die with honor. However euthanasia should not be taken as a private act. In
other words euthanasia should be regarded also as the changes in law and
policies to liberate a doctor or a family member to bring an end to a person’
life. Therefore it also has a point of view in which the right to euthanasia is
given to the relatives of the patient or to the physician, but not to the
patient. Therefore, in our opinion euthanasia brings the question of how
respectable we are to life in our minds.
BIBLIOGRAPHY
· www.ebc-india.com/lawyer/articles/592.htm
· www.ohd.hr.state.or.us/chs/pas/year1/ar-intro.cfm
· www.suite101.com/article.cfm/death_and_dying/55337
· www.thedoctorwillseeyounow.com/
articles/senior_living/peg_14/
[1] en.wikipedia.org/wiki/Euthanasia.
[2] www.freeessays.cc/db/20/egn33.shtml.
[3] en.wikipedia.org/wiki/Euthanasia.
[4] www.freeessays.cc/db/20/egn33.shtml.
[5] www.wordiq.com/definition/Euthanasia.
[6] www.ebc-india.com/lawyer/articles/592.htm.
[7] www.ohd.hr.state.or.us/chs/pas/pas.cfm.
[8] www.ohd.hr.state.or.us/chs/pas/year1/ar-intro.cfm
[9] www.killer-essays.com/Social_Issues/sxg301.shtml
[10] www.suite101.com/article.cfm/death_and_dying/55337
[11] www.collegeresearch.us/show_essay/38631.html
[12] www.thedoctorwillseeyounow.com/
articles/senior_living/peg_14/
[13] en.wikipedia.org/wiki/Euthanasia
[14] www.freeessays.cc/db/20/egn33.shtml
[15] en.wikipedia.org/wiki/Euthanasia
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