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Sample Case Study on Euthanasia

Case Study on Euthanasia

Euthanasia, a widely disputed practice, is one that should be accepted in our society. Most people today feel afraid of death, or are they are afraid of dying? Everyone knows it will happen eventually, but as Woody Allen put it, “No one wants to be there when it happens.” The questions of how, when, where, and most importantly, for how long, find their way to the surface of our minds. Everyone wants to die painlessly, to insure a good death one must plan for it. People with an incurable illness or injury should have the right to end their life.

Webster’s dictionary definition for Euthanasia is “Act or method of causing death painlessly, so as to end suffering: advocated by some as a way to death with victims of incurable diseases.” This definition can be interpreted several different ways leaving ample room open for debate. Some believe euthanasia is assisted suicide when there is a distinct difference between the two. To distinguish the difference between euthanasia and assisted suicide one must look at the last act, which is the act without which death would not occur. Assisted suicide is taken place if the person who dies performs the last act. If the patient pushes a switch to trigger a fatal injection after a doctor has inserted an intravenous needle into the patient’s vein or if the patient swallows an overdose of drugs that were provided by a doctor for the purpose of causing death, these are examples of assisted suicide. To determine if the cause of death was considered to be euthanasia one could see if a third party performs the last act that intentionally causes a patient’s death. The third party may give the patient a lethal injection in order to end the patient’s life.

Active euthanasia is one of two forms of euthanasia. Active euthanasia is taking positive steps to end the life of the terminally ill. The second form is passive euthanasia. Passive euthanasia is when a patient is being kept alive by mechanical means. When there is no hope that the patient will ever be able to live without the assistance of a machine and when their future is sure to be burdened by further pain and coma only then are the life-support systems removed. The individual is then permitted a “natural” death.

In the United States the most common case of “passive euthanasia” is that of Karen Ann Quinlan who lapsed into a coma on April 14, 1975. A year later, after a lengthy court battle, she was finally removed from the respirator. Still living in 1981, a weak eighty-pound figure in a comatose stage curled in a fetal position and kept alive by intravenous feeding. Completely unaware of her surroundings and completely dependant upon others. She passed away in 1985 from pneumonia. Her case was heard in 1976 by a New Jersey Supreme Court. Refusal of live-saving treatment fell under the constitutional right to privacy. (Humphry, Derek pg.87)

Most minority religious groups believe “Only God gives life and only God should take it away.” (Humphry, Derek pg.87) These groups do not support the “passive euthanasia” concept. Opposed to these groups, most contemporary religions such as the Judeo-Christian groups support the concept of passive euthanasia.

Euthanasia derives from the Greek word eu-thanatos meaning “good death.” Ancient Greeks believed that suicide should be accepted, in some Grecian cities people could request government help in killing themselves.

In 330 A.D. the official religion of the Roman Empire was Christianity. Acts of suicide were called felo de se, meaning “self murder” (Gorman, Martha pg. 6). The church forbade suicide and those who committed suicide were denied a Christian burial and often their bodies were left on the side of the road impaled on a stake. Christian beliefs condemn all suicide strictly because it violates ones natural desire to live. In 562 A.D. the council of Braga in France denied all funeral rights to people who had committed suicide. Infanticide, suicide, and killing in self-defense were unacceptable throughout Western Europe.

The Roman Catholics traditionally refused funeral rights and burial in consecrated grounds to suicide victims. The victims were placed in a separate area in the cemetery, which was an unattended fenced-in area. This was done as a reminder to those belonging to the church that killing one’s self was not “God’s plan.”

During World War II Hitler’s government carried out the first euthanasia program. It was put into effect to purify the German race. This program was designed for people the Nazi’s deemed “lebensunwerten” or life unworthy of life. Between 1939 and 1941 the Nazi euthanasia program was estimated to have killed as many as one-hundred-thousand disabled people, all Aryan Germans.

Modern technology has made it possible to sustain life. Euthanasia began to appear in several newspapers and physicians were put on trial. The first of these trials was the trial of a physician from New Hampshire, Herman N. Sandor, he had been charged with first degree murder for taking the life of a female patient with incurable cancer. His trial ended in an acquittal because the jury felt there was no way to conclude beyond a reasonable doubt that the women hadn’t already died.

A living will is a legal document designed to provide families, hospitals, and physicians with an understanding or an individuals wishes for medical treatment in the event of incapacitation (Gorman, Martha pg. 16). The will must be signed while a person is mentally competent and is only used if a person cannot participate in decisions involving his or her care.

Similar to a living will is durable power of attorney which allows an individual to designate a proxy to make decisions in the event he or she cannot do so. All fifty states and the District of Columbia have statutes accepting some form of durable power of attorney.

The patient self-determination act was introduced by John Danforth, Missouri senator. This act was the first step toward clarifying the responsibilities of the physician, patient, family, and health care facilities. This bill went into affect on December 1, 1991.

The Death with Dignity Act was originally passed in 1994 through the Oregon initiative process. The law was challenged in court and was prevented from going into effect. In November 1997 Oregon voters voted to support the law by a sixty-to-forty margin. If a physician in Oregon wishes to help their patient die they may issue a prescription to their patient, but they may not in any way administer a deadly dose. The physician can be present during the death, but may not assist in the death, if they do they would be committing euthanasia. The law requires the Oregon Health division to collect information and publish an annual report of statistics about assisted suicide deaths, however there is no law or penalty for physicians who fail to report their information.

The contemporary debate in which the United States is currently focused on is the medical- bio ethical concerns. Medical-bio ethical concerns are the quality of life, how decisions at the end of life are made and the physicians changing role in end of life actions. The loss of such functions as the ability to eat, social interaction and pain are the most common reasons people ask to die. Several studies show that doctors often assume patients over exaggerate pain and they prescribe inadequate pain relief. Some have been lead to believe that legalizing voluntary euthanasia will mean legalizing non-voluntary euthanasia.

The first attempt at legalizing voluntary euthanasia in the United States was a bill introduced into the Ohio legislature in 1906. This bill was called the euthanasia act. During 1996 two legal decisions advanced the practice of physician assisted suicide. The first decision was made in Washington State by the ninth Circuit Court. The decision gave people the right to request physician assisted suicide in obtaining a lethal dose of medicine. The second decision was made in New York by the second Circuit Court, it ruled that equal protection under the constitution entitles patients to physician assisted suicide through prescription medications (Gorman, Martha pg. 21).

Most African cultures accept death very readily. In traditional African communities the terminally ill are cared for by the community and family. These people are responsible for all decisions concerning death if the dying person is unable to make the decision.

Euthanasia is legal in all Australian states except the Northern Territory where on July 1, 1996 a bill was passed to allow only physician assisted suicide. This legislation is called the Rights of the Terminally Ill Act.

Euthanasia is illegal in Canada. The Canadian House of Commons is considering allowing physicians to assist in suicide. Canadians don’t pay out of pocket for medical expenses. Health care is paid for through federal and provincial taxation.

The Netherlands was the first country to legalize euthanasia. It also has the most liberal euthanasia death policies in the world. In order to be eligible for euthanasia in the Netherlands a patient must have a terminal illness. In the Netherlands euthanasia is defined as “the intentional termination of life by another at the explicit request of the person who dies” (Netherlands State Commission on Euthanasia). The first official government study of euthanasia in the Netherlands is known as the Remmelink Report, it was based on the outcome of 405 physicians. In 1990 it was stated that 2,300 people died as the result of physicians killing them on request. The Netherlands Voluntary Euthanasia Society is now debating whether or not elderly people should be prescribed a suicide pill so they can end their lives when they need or wish to.

The Oregon law defines the word terminal as a condition which will “within reasonable medical judgment, produce death within six months.” A doctor must give his written approval after spending time with the patient. In Germany killing on request is illegal but assisting in suicide is not illegal, for instance the German Society for Humane Dying provides people with information on how to end their lives.

Jack Kevorkian was born on May 28th 1928 in Pontiac Michigan. He graduated from the University of Michigan in 1952. In 1956 Kevorkian visited the Ohio State penitentiary to interview two death row inmates about having medical experiments performed on them, all though they agreed the courts wouldn’t allow him to proceed.

He lost his job at Michigan Medical Center shortly after. In 1958 he presented to the American Association for the Advancement of Science, a paper which described his plan for “terminal human experimentation” (abortionfacts.com, 1998). He developed a device he called the “hanatron” and later he renamed it “mercitron.” It begins with an IV line, which injects a saline solution into the patient. The patient then presses a switch that begins a flow of thiopental, which is sleep inducing, then potassium chloride, which stops the heart. Kevorkian’s first victim to use the suicide machine was Janet Adkins, she was executed in his 1968 Volkswagon van. A year before Kevorkian had been diagnosed with Alzheimer’s he openly admitted to assisting in the deaths of more than thirty-eight people. On April 13th 1999 Jack was sentenced to two terms of imprisonment for helping a man suffering from ALS to die. For second degree murder of Thomas Youlk which was aired on Sixty Minutes he received ten to twenty five years, for using a controlled substance. He was given from three to seven years and the sentences were to run concurrently.

Efren Saldivar is a former respiratory therapist who worked at Glendale Adventist medical center, and was charged with killing six elderly patients by giving them lethal injections between December 1996 and August 1997. Saldivar told the police that he killed more than fifty patients. He admitted to giving his patients Pauvolon, a drug which causes people to stop breathing.

Compassion in Dying was formed in 1933 at the peak of the Aids epidemic, a small group of individuals wanted to make a difference. The organization challenged the law prohibiting assisted dying in two states, Washington and New York. The Hemlock Society is a nonprofit membership association and was founded in 1980 by Derek Humphry. Today there are more than 30,000 members in about seventy chapters and community groups around the country.

In the process of writing this paper I found myself changing my beliefs about death. For as long as I can remember I have always feared death. However through the process of researching this topic I have discovered I am no longer afraid. I have learned there are other alternatives to suffering, unfortunately those alternatives are in very limited locations, which is why euthanasia and physician assisted suicide should be legalized worldwide. I know that before I die I would want a chance to say goodbye to all those I care about. Euthanasia gives people that opportunity. No one wants to die painfully. When ones life becomes too painful to go on living they should have the choice of whether they live or not. Living in a vegetative-state, being fed through a tube, hooked up to machines, depending on assistance from others constantly isn’t the life I, nor anyone I know for that matter, would want to live.

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