Discusit The Right


Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Discusit The Right

  1. 1. %,EI?KII1J Read on ................................... The Right to Die with Dignity - Soma Saha The debate on euthanasia or mercy killing has flared up once more in the country with the death of former national chess champion, Venkatesh, 25, in Hyderabad after battling Duchenne’s muscular dystrophy, a genetic neurological disorder. He wanted his life support system turned off before his organs suffered irreparable damage. He wanted to donate his heart, kidneys and liver before it was too late. But since euthanasia or mercy killing is outlawed in India and organ donation may only take place if the donor is declared brain dead, the courts refused permission. He finally breathed his last. But he did start a larger debate on the issue of organ donation. 5 Passive Euthanasia (1975) by ome analysts argue that sympathetic cases, raises difficult University of Alabama philosophy the law must be changed ethical questions. professor James Rachels who to allow people Even history seems to be in argues that there is no moral with different medical favour of this type of death. difference between actively killing conditions to donate their Ancient Greek thinkers favoured a patient and passively allowing organs. Lawyers and others warn euthanasia, even though they the patient to die. Thus, it is less that changes to the law could be opposed suicide. An exception is cruel for physicians to use active abused as India and other South Hippocrates (460-370 BC), the procedures of mercy killing. Asian nations have a thriving ancient Greek physician, who in Depending on the method of illegal trade in organ donation. his famous oath states, “I will not ‘mercy’ killing, euthanasia can be Derived from Greek – ‘eu’ prescribe a deadly drug to please segregated into passive, and meaning ‘good’ and ‘Thanatos’ someone, nor give advice that may assisted. For doctors, the issue of meaning ‘death’ euthanasia means cause his death.” During the the right to die is most prominent ‘good death’ and everyone wants Renaissance, English humanist when a patient is terminally ill, is a good death. But the issues Thomas More (1478-1535) in intense pain and voluntarily involved in this ‘good death’ are a defended Euthanasia in his book chooses to end life to escape little too ambivalent to be Utopia (1516) saying that doctors prolonged suffering. In these cases, objectively analysed. The ethical do everything in their power to the doctor can either ignore the issue of euthanasia concerns cure ills but when a patient has a patient’s request and care can whether it is morally permissible torturous and incurable illness, the continue as usual or can withhold for a third party, such as a patient has the option to die, either life-sustaining treatment to the physician, to end the life of a through starvation or opium. In patient, and thus allow him to die terminally ill patient who is in New Atlantis (1627), British more quickly. This option is called intense pain. This controversy is philosopher Francis Bacon (1561- passive euthanasia since it brings part of a larger issue concerning 1626) writes that physicians are death through non-intervention. the right to die. These are cardinal “not only to restore health, but to The doctor can also provide the concepts in any country or society, mitigate pain; and not only when patient with the means of taking which professes to embrace such mitigation may be conducive his own life, such as a lethal dose liberalism and freedom. Staunch to recovery, but when it may serve of a drug. This practice is called defenders of personal liberty argue to make a fair and easy passage.” assisted suicide, since it is the that everybody is morally entitled One of the most cited patient, and not technically the to end his life when he deems fit. contemporary discussions on the doctor, who administers the drug. But the subject, even in the most subject of euthanasia is Active and
  2. 2. %,EI?KII1J Read on ................................... Finally, the doctor can take active The supporters of euthanasia argue that the measures to end the patient’s life, doctor-patient relationship has changed a lot over such as by directly administering a lethal dose of a drug. This the last 50 years, from ‘doctor knows best’ towards practice is called active euthanasia a more equal relationship with doctors giving since the doctor’s action is the patients the information they need in order to make direct cause of the patient’s death. their own informed decisions. But when it comes Active euthanasia is the most to an end-of-life decision-making the relationship controversial of the options and is is far from equal, patients are still disempowered. currently illegal in several countries in the world. Two additional concepts are relevant to the discussion of euthanasia. First, voluntary euthanasia refers to mercy killing that takes place with the explicit and voluntary consent of the patient, either verbally or in a written document such as a living will as was the case with Venkatesh. Second, non-voluntary euthanasia refers to the mercy killing of a patient who is unconscious, comatose, or otherwise unable to explicitly make his intentions known. In these cases it is often family members who make the request. It is however important not to confuse non-voluntary mercy killing with involuntary mercy immeasurable and a patient’s contributing to this attitude of killing. The latter would be done condition terminal, should doctors mind. against the wishes of the patient be permitted to end a life?” The supporters of euthanasia and would clearly count as “Should doctors take an active role argue that the doctor-patient murder. in hastening a patient’s death?” relationship has changed a lot over The physician treats death as an the last 50 years, from ‘doctor The dilemma of medical enemy and suffers a sense of knows best’ towards a more equal personal defeat when he fails to relationship with doctors giving professionals avert it. This ’mono-culture’ of the patients the information they need Medical advances have created mind of fighting death, coupled in order to make their own ethical dilemmas, which no with adherence to concepts of informed decisions. But when it previous generation of doctors and ethics has led to a mental and comes to an end-of-life decision- health care workers ever faced. emotional block among most making the relationship is far from New life-sustaining techniques physicians towards voluntary equal, patients are still and practices are forcing euthanasia which is irrationally disempowered. physicians to ask questions that equated with `killing’ and hence According to experts, medical never needed to be asked before. with death. Perhaps the fear of the science and technology have “When suffering is law and opportunism in society is produced an impact, which calls
  3. 3. %,EI?KII1J Read on ................................... for re-evaluation of value systems, like this: “Let’s face it, people are our being human? History has societal and medical ethics. The already doing it.” shown that when we devalue prime duty of the medical The combined effect of these human beings, we open the door professional is to relieve suffering four arguments is persuasive and to abuse. and euthanasia should be viewed many feel the need for legalised f. What effect will this have on in that context. Indeed it is the duty physician-assisted suicide is self- doctor-patient trust? People, who of the physician to treat, heal and evident. At the same time there are traditionally rely on their doctors offer an acceptable quality of life a variety of arguments against to provide guidance in their health to a patient but above all is the legalising physician- assisted care decisions may become relief from suffering by all means suicide. Here are the most widely confused, even alarmed, when one available to him. An end point is cited concerns: of the treatment options presented often reached when death via the a. Medical doctors are not is the death machine at the end of medium of voluntary euthanasia is trained psychiatrists. Many, if not the hall. the only ’good medicine’; hence most, people have wished they g. What about doctors who supporters of euthanasia feel the could die rather than face some don’t believe in killing? Will they physician cannot and should not difficult circumstance in their lives. be required by law to prescribe a deny the patient this final wish for Doctors who are given authority to treatment- death they don’t believe relief. When dealing with grant this wish may not always in? irremediable diseases, the choice of recognise that the real problem is Euthanasia around the the patient - even though it may be a treatable depression, rather than for euthanasia - has to be respected. the need to fulfil a patient’s death world The four primary arguments for wish. Holland is widely regarded as legalising physician-assisted b. How will physician-assisted one of the world’s most civilised suicide according to legal experts suicide be regulated? countries and was the first country are: c. The “Slippery Slope” to legalise active euthanasia, but a. The Mercy Argument, which Argument. A Hemlock Society* for the past decade, the states that the immense pain and spokesperson acknowledges this government has not prosecuted indignity of prolonged suffering to be the strongest argument doctors who report having assisted cannot be ignored. We are being against legalisation. In ethical their patients to commit suicide. inhuman to force people to dialogue, it is conceded that there But the International Task Force continue suffering in this way. are situations when an acceptable on Euthanasia and Assisted b. The Patient’s Right to action should not be taken because Suicide notes that in Holland about Patient it will lead to a course of Self-determination. 20 percent of the euthanised empowerment has been a trend for consequent actions that are not patients did not consent. more than twenty-five years. “It’s acceptable. Some were comatose, others my life, my pain. Why can’t I get d. The “Occasional Miracle” incompetent. A 1997 article in a the treatment I want?” Argument. Sometimes remarkable British medical journal found that c. The Economics Argument, recoveries occur. Sometimes eight percent of the infants who die which notes that the cost of diagnoses are far from the reality. in the Netherlands are killed by keeping people alive is e. Utilitarian versus sacred view their doctors. Frequently, patients exceedingly high. Who’s footing of life. This is probably a subset of are not informed of the full range the bill for the ten thousand people the Slippery Slope argument, of treatment options. There are no being sustained in a persistent focusing on the cultural shift in recorded instances of the vegetative state? Aren’t we attitude toward what it means to consultant disagreeing with the wasting precious resources when be human. The argument is, are we initial diagnosis. an already used up life is important only as long as we are In America, assisted-suicide is prolonged unnecessarily? making a contribution to society? on the same track as abortion was d. The Reality Argument runs Or is value something inherent in
  4. 4. %,EI?KII1J Read on ................................... 30 years ago. Abortion was suicide is not a crime. According legalised by one state to the Indian Penal code, which (Washington) before it went was mainly adopted from British national. Penal Code, attempted suicide was In his 1998 book, “Freedom to a crime, punishable with years of Die,” Hemlock Society founder imprisonment. With the recent Derek Humphry muses,’ “Is there medical knowledge gained by in fact a duty to die — a researchers and the opinions responsibility within the family expressed by eminent psychiatrists unit — that should remain all over the world, the judges in voluntary but expected their verdict were sympathetic to nonetheless.” Dutch Health those who attempted suicide Minister Els Borst says she isn’t saying that attempting suicide is a opposed to providing suicide pills however, believed the situation mental derangement and hence for seniors “who have had enough was unsatisfactory, and that they not to be considered as a crime. of living.” could face prosecution simply for Though attitudes of doctors (Think of the money they’ll trying to do their best for their towards voluntary euthanasia in save.) Humphrey writes, patients. India has not been analysed on a “Economic reality, therefore, is the Many doctors admitted in significant scale, extracts from a main answer to the question, why private that they have given lethal sample survey of 200 doctors not now?”’ doses of drugs to patients knowing carried out by the Society for the Australia was the stage for the full well that the patient will die. Right to Die with Dignity in world’s first fully legal act of Britain’s ageing population Bombay, do offer some indications: voluntary euthanasia after the could force the question of 90% stated they had the topic Northern Territory cleared the way euthanasia and other end of life in mind and were concerned. with legislation in 1996. Bob Dent, issues into the spotlight. With 78% argued that patients a terminally-ill cancer patient, was people living longer and longer should have the right to choose in the first person to take advantage because of medical and other case of terminal illness. of the legislation. He received a advances, health experts believe 74% believed that artificial life lethal injection and died on 22 the number of people suffering supports should not be extended September of that year. The lethal from debilitating conditions such when death is imminent; but only dose was administered by a as cancer and heart disease will 65% stated that they would computer, using software grow and could affect their quality withdraw life supports. developed by Dr Philip Nitschke, of life. 41% argued that the will to live a campaigner who pushed for the Each year ‘mercy killing’ cases should be respected. 31% had legislation in the first are brought to courts around the reservations. place. However, right-to-life world but juries refuse to convict, Considerations involved ethics, campaigners have questioned the or when they do, judges only give morality, law and religion in that psychiatric condition of patients suspended sentences. Without order of importance. seeking euthanasia. legal safeguards there is little More than 70% were Although euthanasia is illegal in protection for vulnerable people. apprehensive of the abuse of the the UK, doctors are allowed to law if one was enacted to legalise Euthanasia in India administer potentially lethal doses voluntary euthanasia. They are of of painkilling drugs to relieve the opinion that the country is still The debate on Euthanasia in suffering, provided they do not not ready for legalising euthanasia India had intensified since the primarily intend to kill the patient. as it can only give rise to more Supreme Court of India in 1994 This is known as the doctrine of serious consequences like illegal passed a verdict that attempted double effect. Most doctors, trade in human organs, murders,
  5. 5. %,EI?KII1J Read on ................................... etc beyond one’s control. . Religious teachings are of moral, legal or theological In a letter Mahatma Gandhi opinion that Euthanasia requests considerations. It is an issue of himself supported euthanasia. He may come out of depression and humanism and compassion. writes. “Would I apply to human confusion or out of a feeling of Society will need to change its beings the principle (read worthlessness, or due to value systems in the context of the euthanasia) that I have enunciated persuasion of interested parties changing medical scenario, of in connection with the calf? Would with ulterior motives. Respect for socio-economic environment, of I like it to be applied in my own the patient and concern for the increasing price tag on medical case? My reply is yes. Just as a family should lead to the use of services and their cost- surgeon does not commit him as resources to promote life. If effectiveness. According to experts when he wields his knife on his monetary resources in preserving society has to leverage knowledge patient’s body for the latter’s life are huge and can’t be sustained and new technology intelligently, benefit, similarly one may find it by family and in case of the else if it adheres to dogmas and necessary under certain imperative destitute without any immediate beliefs with no relevance for this circumstances to go a step further family, the problem assumes larger age of biological revolution and and sever life from the body in the proportions. The essence of our spectacular medical expertise, the interest of the sufferer.” approach to a dying patient is to purpose is lost. give loving care to meet his need. Albert Einstein once stated that The Religious Concept A patient is not merely a biological ‘everything should be made Almost all religions prohibit unit but a person before God with simple, but not simpler’. The euthanasia. According to religious social and family connections. freedom of choice raises one issue concept, God has created man and Recently, the Vatican reaffirmed - that of the ‘reasonableness’ or is the giver and sustainer of life. He its total opposition to euthanasia, ‘unreasonableness’ of the decision alone has the right to withdraw in particular for children, following or request. Though the debate on life. Life is not a right but a gift of information that the practice could euthanasia has come far from God belonging to God and at all soon be used on minors in a where it began, it still has a long times in His hand. So we have no paediatric clinic in the city of way to go before a line can be right to take away deliberately a Groningue in the Netherlands. drawn between the right and the human life, even one’s own. In The issues of right to a dignified wrong. At the same time it is also medieval times, Christian, Jewish, death and voluntary euthanasia important in this day and age that and Muslim philosophers opposed are not the concern of the medical if we have to call ourselves a active euthanasia, although the profession alone. All sections of civilised society, we must Christian Church has always society must be vitally involved as understand the gravity and finality accepted passive euthanasia. the issues transcend philosophical, of death, respect it and civilise it, as much as we respect life. * Hemlock Society: Founded in 1980 by Derek Humphrey, the Hemlock Society is the oldest and largest right-to-die organisation in the U.S. A not-for-profit organisation Hemlock believes that people should have a choice and dignity at the end of life. They should have the option of a peaceful, gentle, certain and swift death in the company of their loved ones.