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Being Against Voluntary Euthanasia Philosophy Essay

My argument is against the use of Euthanasia. Euthanasia I think is not proper to be practiced in any form. Namely I am against Voluntary Euthanasia. But before discussing my point of view we take a look at the definition, types and history of euthanasia then we describe arguments for and against euthanasia. Then in defending my argument we also view some organizations that are against the use of euthanasia and there arguments.

Definition of Euthanasia

The origin of the word euthanasia is Greek, eu means well or good and thanatos means death. The House of Lords, Committee of medical ethics defines euthanasia as, a deliberate intervention undertaken for relieving intractable affliction with the express purpose of ending a life. [1]

The intentional killing by act or omission of a dependent human being for his or her alleged benefit is called Euthanasia.

There are indeed different types or kind of Euthanasia let us take these into consideration. [2]

Narrow and broad definition of euthanasia

To some philosophers euthanasia is defined narrowly they say intentional killing of some person is morally wrong so, the intentional killing of some one i.e., euthanasia is equivalent to killing someone, is wrong so it can not be allowed. Whereas, allowing some to die with terminal illness, to which death is imminent and is in extreme pain, is morally right.

Active and Passive Euthanasia

To some philosophers, both killing a patient and allowing him to die is morally right. These thinkers take a broad view of the term euthanasia. They term killing a patient as active euthanasia and letting die as passive euthanasia. Arguing against the views of the philosophers who take a narrow view of the term, these philosophers say that if they consider active euthanasia morally wrong then, they should as well let down the passive euthanasia.

The broad view thinkers find justification for euthanasia by saying that if letting patients die is not wrong then euthanasia is justifiable. Having a moral backing for euthanasia these thinker argue that at times both active euthanasia and passive euthanasia can be practiced. So there arises a lot of debate as to which form of euthanasia is morally justifiable or not.

Active euthanasia is by means of of fatal substances for killing; and is the most argumentative method. [3] Passive euthanasia is the discontinuing of cures, such as antibiotics, essential for the maintenance of natural life. [4]

Voluntary and Non Voluntary Euthanasia

Voluntary and non voluntary euthanasia can be differentiated. Voluntary decisions about death refer to cases in which a competent adult patient requests or gives informed consent to a particular course of medical treatment or non treatment. Voluntary decisions also include cases in which persons take their own lives either directly or by refusing treatment, and cases where patients deputize others to act in their behalf. [5]

In other words Euthanasia executed with the agreement of the patient is named voluntary euthanasia. Nevertheless, if a patient with the assistance of a doctor kills himself it is known as assisted suicide. [6]

A non voluntary decision about death refers to cases in which the decision is not made by the person who is to die. Such cases would include situations where, because of age, mental impairment, or unconsciousness, patients are not competent to give informed consent life-or-death decisions and where others make the decisions for them. But in actual practice the difference between voluntary and non voluntary decisions about death is not always clear. For example, take the case of a man who has heard his mother say that she would never want to be kept alive that way “machines and pumps and tubes.” Now that she is, in fact, being kept alive that way, and is unable to express a life-or-death decision, the man is not sure that his mother actually would choose to be allowed to die. [7]

Putting the definition of non voluntary euthanasia differently; for the sake of lucidity, euthanasia undertaken while the approval of the patient is absent then it is termed as non voluntary euthanasia, for instance, child euthanasia. [8]

“The voluntary and non voluntary distinction is relevant to both the narrow and the broad interpretation of the meaning of euthanasia. Each interpretation seemingly distinguishes four kinds of death decisions, in which the voluntary-non-voluntary distinction plays a part.

Thus the narrow interpretation recognizes cases of:

Voluntary euthanasia

Non voluntary euthanasia

Voluntary allowing to die

Non voluntary allowing to die

By this account the first two generally are considered immoral; instances of the second two may be moral under careful circumscribed conditions.

Recognizing no logical or morally relevant distinction between euthanasia and allowing dying, the broad interpretation allows four forms of euthanasia:

Voluntary active euthanasia

2. Non voluntary active euthanasia

3. Voluntary passive euthanasia

4. Non voluntary passive euthanasia

The narrow and the broad interpretation differ sharply in their moral judgment of deliberate acts taken to end or shorten a patient’s life. The narrow interpretation terms voluntary or non voluntary euthanasia, and the broad interpretation terms voluntary or non voluntary active euthanasia. This means that the concept of euthanasia has complexities in it.” [9]

Moreover, euthanasia conducted contradictory to the will of a patient is known as involuntary. Euthanasia which is voluntary, non voluntary, and involuntary is further classifiable into passive or active types. [10]

History of Euthanasia:-

11The earliest mention of euthanasia can be seen in the writings of Hippocrates. He gives account of euthanasia in the Hippocratic Oath that was written, as early as, amid 400 and 300 BC the original Oath states, “To please no one will I prescribe a deadly drug nor give advice which may cause his death.” In unambiguous dissimilarity to the philosophy of Hippocratic Oath, Greeks and Romans generally did not consider that life needed to be conserved at any cost. They were accepting suicide in cases when no respite could be offered to the person about to die. In case of Stoics and Epicureans, they were people who no longer were concerned for the life of a sufferer.

The English Common law, from the 14th century up to the middle of twentieth century, characterized suicide as a criminal act both in England and Wales, and in case of helping other people committing suicide it remains illegal therein. However, in the 16th century, Thomas More, considered a saint Roman Catholics, envisioned and described a utopian community; a society that would assist the death of those people who do not want to live due to afflicted and prolonged pain.

Modern History of Euthanasia:-

12Since the 19th Century, euthanasia is being debated in North America and Europe. According to Ezekiel Emanuel, a medical historian, the availability of anesthesia promoted the phenomenon of euthanasia in modern times. It was in the 1828 when in U.S the first anti-euthanasia law being passed in New York. This ushered similar legislation in other States of U.S in the coming year. But voluntary euthanasia was supported by some advocates and doctors after the U.S Civil War. Support for euthanasia increased in early 20th century and in its third decade. In an article, in the Bulletin of the History of Medicine, Brown University historian Jacob M. Apple explained that extensive political debate over legislation for (PAS) physician-assisted suicide in Iowa and Ohio in the year 1906. Apple indicates social activist Anna S. Hall was the key activist for this cause. Additionally, the historian Ian Dowbiggin says that prominent personalities such as Clarence Darrow and Jack London were supports of legalizing euthanasia.

In England euthanasia society was organized in the year 1935 and in United States euthanasia society was formed in the year 1938. But euthanasia remained illegal in both these countries. In Switzerland doctor assisted euthanasia was legalized; its approval in the year 1937 and in 1947 it came into effect; if personal gain of concerned doctor does not influence the administration and execution of euthanasia. In the meantime, US courts undertook cases involving seriously ill people who requested PAS as well as “mercy Killings”; for example parents of severely disabled children requested euthanasia for their children.

After the World War II, Glanville Williams and Clergyman Joseph Fletcher are the acclaimed advocates of euthanasia. In addition, the support for euthanasia increased in the U.S by 1960’s and onwards.

In recent history of euthanasia it is important to note that voluntary euthanasia is legal in these countries: Belgium; Luxembourg; the Netherlands; Switzerland; and the U.S. states of Oregon and Washington. [13]

However, non voluntary euthanasia is illegal worldwide. Still it is legalized under certain limitations in the Netherlands through Groningen Protocol.

Eduard Verhagen created the Groningen Protocol in 2004. He is a medical director of the department of pediatrics at the University Medical Center Groningen (UMCG) in Groningen, Netherlands. Groningen Protocol contains commands with principles through which doctors can perform “active ending of life on infants” (child euthanasia) without fear of legal prosecution. [14]

15A professor of History at University of Prince Edward Island, Ian Robert Dowbiggin is opposed to legalizing PAS. He says that if PAS is legalized then it will adversely affect the society in medical, economic, and social terms. It is so because he says that the harms of euthanasia outweigh its benefits.

Ian Robert Dowbiggin further states, that the word euthanasia is of Greek origin for ‘good death’ and was first coined in early seventeenth century by the English philosopher Francis Bacon. Death is the grim equalizer. How society determines what is and is not a good death potentially affects every human being. It is the haunting question that lies at the heart of evolving history of euthanasia.

Additionally, he states that the need for euthanasia in recent times has been due to emergence of new diseases and advanced medical technology. For example, the emergence of AIDS in late twentieth century has highlighted the use of euthanasia. It is when a patient is suffering from the disease feels the sense of approaching death he has immense agony of both mind and body. In this situation he opts for the use of euthanasia.

There are arguments both, for and against euthanasia.

Arguments for euthanasia

It offers a method to do away with extreme pain

It provides a control of relief, when an individual’s value of life is low

It enables to supply medical funds for other people

It is a case of freedom of choice

Arguments against euthanasia

It is a rejection of the importance and value of human life

It is a slippery sloop. Euthanasia would not only be for people who are terminally ill, it could extend its scope to that is not terminally ill.

It can become a means of health care cost containment

It will become non-voluntary

Organizations against euthanasia:-

16Euthanasia prevention coalition is a Canadian Based organization. It says, “The Euthanasia Prevention Coalition exists to build a well-informed broadly-based network of groups and individuals to create an effective social barrier to euthanasia and assisted suicide. Our goal is to help build a stronger unified coalition of those who oppose euthanasia and assisted suicide.”

The organization beliefs includes, amongst others, of which two are stated here. It terms euthanasia as killing of individual; be it active, passive, voluntary non voluntary on the compassionate grounds. On still another account of its belief it states the Canadian present law which states, [17] “The present law in Canada does not distinguish between euthanasia, assisted suicide and other forms of murder. The key consideration is the intention to cause death. Consent or motive- even one of compassions- does not change the reality of killing a human being.”

Moreover, the concerns of the organization against euthanasia include amongst others.

Mercy killing there is growing tendency as a panacea for pain, suffering, aging, increased health care costs and its containment.

As the case of Netherlands is concerned the legalizing of voluntary euthanasia has made way for the practicing of non voluntary euthanasia cases and abuse of law in this regard and of the vulnerable patients.

When assisted suicide is legalized it leads to a compromise in health care institutions services i.e. hospitals hospice, palliative care and its pain management services.

In this first, another organization against euthanasia, [18] International Symposium on Euthanasia and Assisted Suicide held in Toronto, in which more than 300 people attended this debut session against euthanasia numerous informative speakers spoke on the subject, and some people shared there personal experience which were very weighty and moving thoughts on the subject.

I would like to mention the sayings of one such speaker Alison Davis, she was from UK. She explained that she once, was supportive of euthanasia. She was at pains with the how horrible vulnerable people are treated in there society. They are being treated prejudicially. Consequently, such vulnerable people being in pain or suffering or illness, are killed. In her own words, “I have experienced all the symptoms which they claim are symptoms for euthanasia, if my country had had laws allowing euthanasia and assisted suicide when I was at my lowest point, I would be dead”. She remarked her attempts of suicide which had been nullified by those around her. She affirms that any one in agony needs love and caring, not being put to death. In such a situation she remarks, “Love becomes a kind of medicine.”

19WAY has about 15,000 members individually covering Africa (Nairobi), Asia-Pacific (Manila), Europe (Brussels), Latin America (Mexico), North America (New York). This organization supports decision of, December 2, 2008, Grand Duke Henri of Luxembourg, who threatened to veto the proposed legislation that would legalize euthanasia in Luxembourg. The Alliance supports, the Grand Duke of Luxembourg by saying, “Dignity, or intrinsic worth, is inherent in human beings and euthanasia is a violation of that dignity.”

20World Federation of Doctors who Respect Human life is an organization which aims at the following:

To uphold the Hippocratic Tradition or Oath.

To support health personal and doctors who are discriminated on the basis for support of this Oath.

To call for legal defense of humanity, from conception/fertilization till there death, according to

(a). the U.N Declaration of Human Rights, 1948,

(b). the declaration of the Rights of Child, 1959

(c). The Declaration of Helsinki, 1975, where it states: “In research on man, the interest of science and society should never take precedence over considerations related to the well-being of the subject.”

vi. To promote Doctor, in any part of the world, that supports this association.

Turning our attention from the organizations against euthanasia to arguments against its use we proceed further.

Ezekiel J Emanuel MD PhD, saying that [21] “It seems clear that the arguments for and against euthanasia have changed neither in form nor substance in almost 120 years. They predate by many decades those arguments made in Nazi Germany, and they appeal to various philosophical traditions. This history suggests that factors other than technology play a critical role in making people receptive to euthanasia. In trying to identify general patterns that might explain public interest in euthanasia in the United States and Britain, the resurgence of individualistic conservatism, characteristic of both the Gilded Age and the Reagan-Thatcher years, is striking, as is the waning of interest in euthanasia in the early 20th century when this individualistic public philosophy was repudiated by Progressivism. It is also striking that British and U.S. interest in euthanasia flourished at the two times in the last century when the struggle over physician authority was most pronounced. Such connections raise important questions about what forces are driving our current interest in euthanasia and whether there are alternative ways to achieve a compassionate and painless death.”

22It is stated that in a study conducted in UK on terminally ill patients that, both malignant and non-malignant, weather to legalizing euthanasia or not. Most of the respondents replied in affirmatively. Few of the patients rejected its legislation, claiming the bad consequences of involuntary euthanasia and religious obligation. [23] The Thames ide doctor, Kailash Chand argued for legislation to allow assisted death demanded by patients who are terminally ill and for patients who do no have mental capability. Later Doctors of BMA thereafter a debate on assisted suicide; maintained their opposition against legalization of euthanasia.

Doctor Brain keighley, Deputy Chairman of the BMA in Scotland, said: [24] “It is clear that doctors do not wish to play a role in assisting a patient’s death. Assisting patients to die prematurely is not part of the moral ethos or the primary goal of medicine. If the legislation were to be changed, it would have serious negative consequences on the relationship between doctors and their patients. It remains vital access to the best quality palliative care is available in order to ensure that terminal suffering is properly managed”. Thus BMA maintains its opposition to changes in principles of this suggested legislation.

Indeed if the legislation takes place for the voluntary euthanasia then it might lead all kinds of exploitation of the patients. Furthermore, the advance medicine is capable to decrease and reduce any pain or agony unto the patient who is in pain.

I am concerned to the voluntary euthanasia of terminally ill patients, be it active or passive of which I disapprove. As is mentioned in all the preceding debate about the unacceptability of euthanasia we move on to further argue against it.

My first argument against is that the euthanasia should not be practiced because sanctity of human life is a very higher value to be destroyed by euthanasia. In this regard I would say that human individual welfare is the zenith of all the human endeavors. Lets look at all the advancement in science and technology and all the social sciences that their ultimate motive is human welfare. Still on a micro level if a child is taken to school on his first day it is parents decisions for the good of the child in future life that he would prosper and live a happy life. So human well being is end of these worldly activities. All the good things are for the humans.

Now if we specify this, in our case, to a terminally ill patient we agree that this human being is in need of help. All the resources that are available ought to be for his welfare because his being proceeds in value terms than any other thing. In this case if that individual is euthanatized than it would mean that the costs or scarce medical technology available, for his life sustaining, have over valued his life. Whereas it should have been other wise; human life as shown takes a much higher status hierarchically at top of all other worldly considerations. Here I would like to add is that if such an individual is in a state of brain death and is irreversible then or in extreme pain even if so all the available means be utilized to ensured that in the former scenario he reaches his natural death and in the latter only relieve his pain, through the enhanced modern medicine, and not kill them.

My second argument against euthanasia is that it should be discouraged because in some cases there is not a clear demarcation between active and passive euthanasia. Because regarding the distinction between active and passive there is little evidence to differentiate between these two. Firstly, in case when a patient is terminally ill there might be conditions in which the active euthanasia is more preferable to passive. As shown earlier in the discussion of broad and narrow out looking of euthanasia, exemplarily a patient in terminal illness is in extreme pain and he has consented for his death, the doctors if allow passive euthanasia my increase his pain because by letting him die would mean more time for his death consequently more pain. Active euthanasia, whereas, like giving him a dose of lethal injection might decrease his pain by killing both in terms of quick relief from pain and easy death so active euthanasia if allowed will be morally on better terms than passive.

Again if the same patient is left for passive euthanasia prolonging his period of dying would mean that his family would have to bear much more financial costs whereas a lethal injection would be far cheaper than the costs due to his medical care again the active euthanasia is more feasible than passive. It is but a simple example to let the difference of active and passive euthanasia null and void. Morally and financially speaking then there seems blur diction between killing a letting die. This also weakens the argument of moral consent for euthanasia which we discuss soon.

My third argument against euthanasia follows from the second argument. Proceeding so at times there seem no distinction between active and passive euthanasia, rather active euthanasia is preferred over passive can consequently pave the way for non voluntary cases of euthanasia also, in which the consent of death of patient is missing.

My fourth argument is that concerning the issue of consent. We examine it in two ways. First we see that the patient has given consent of death in case of terminal stages. Second we see that the case where the consent is missing. Now in the first case, a terminally ill patient has a very complex state of life; to have a minute picture of it we probe the human nature. Generally speaking human nature is very much influenced by its external environment. I will act differently in different situations in life. For example if I am in pain I would only be concerned about my health not wealth, education etc. Moreover my social and emotional thoughts and actions would be different in each state. All this suggests that human behavior is liable to change. Thus my judgment is influenced.

Now taking the case of a patient who is terminally ill can we say that there judgment is wholly rational or sound. It is not so. Because this very consent for death is against human nature, since fear of death which is universal in essence is a defense mechanism. This proves that there consent is not reasonable or sound. This left the argument of choosing life or death for a patient is weakened because these individual are in no better position to choose for them death. Thus because a patient has given consent of death does not provide a sound basis for euthanasia.

Now we turn to the second case where the patient consent is missing. Here we have to put a situation where the consent be taken from the patient’s their loved ones and doctors’ professional guidance. Again this consent if given can be biased against such factors; such as a helpless condition of the patient. Moreover for the purpose of cost containment especially in the capitalistic countries where like America health services are very costly. In addition, if there is dilemma in case, for example, of middle aged women in a hopeless situation has husband and her parents. Now let the husband decide his wife’s life be taken but the love of her mother and father does not wills so then it is husband whose decision might be final. In such a situation we can doubt the moral judgment of the decision. Nevertheless, the parents in such situation would be left in a hopeless situation of pain. In this case also defense for euthanasia seems weakened, at least.

My fifth argument is, if euthanasia is let to be practice; it ultimately leads to or would lead to a slippery slope, slowly and gradually. Euthanasia would lead from voluntary passive to voluntary active. This would make way for non voluntary and finally involuntary euthanasia. All this can be considered evil for a society.

In Societal Risks and Slippery Slopes: [25] “These factors take on still greater significance in the eyes of opponents holding view B; [26] Holders of the view B see “helping” others to die as differing fundamentally from helping them, say, to build a house or to learn an instrument. For them the question of whether killing another is helpful or harmful cannot be decided merely on grounds that the victim asked for the help. However in the light of what they see as the most serious risks from the acceptance of voluntary euthanasia: societal risks, to growing numbers of persons who have not requested euthanasia, of abuses and errors from a relaxation in the present strong prohibitions against killing. Practices may be extended to groups of patients beyond the original few who fit the strict requirements; and distinctions may be blurred, so that patients may come to die without having requested euthanasia, perhaps quite against their wishes. The fears of such risks are supported by a concern for the defenselessness on the part of groups such as the newborn and the senile, and by a lack of confidence in the social resistance to harming people.

My sixth argument in societal terms is that such legislation for voluntary euthanasia is filled with many evil results. Firstly, it is so because of the slippery slope nature of voluntary euthanasia. Secondly, in the case of developed countries, for example U.S where insurance policy health system is operative, most of the middle income and low income patient would be more vulnerable to it, because of cost constraints and containment policy of the health system. All this would mean exploitation of the helpless patient. Thirdly, the legislation for euthanasia is liable to abused. Fourthly, in case of developing countries where already there is higher population growth, rampant poverty, higher unemployment and inflation rates, euthanasia can be an easy way to decrease the increasing population, whereas in case of developed countries, euthanasia pave the way for doing away with unproductive labor. Finally, euthanasia would engender already depressed patients, who supposedly are a cause of pain and hopelessness to their loved ones, prematurely take the course of euthanasia; which is already legalized.

All this shows the wrong side of voluntary euthanasia. Now the question points to what should be the alternative course taken with this serious problem. Euthanasia should at all costs be avoided, because as stated in one of the aims of organization working against the use of euthanasia, that human life should be sustained right from fertilization till death. Additionally all the resources at disposal, including modern medical technology, be utilized in helping the patients to lessen their pain without causing death. In this regard, it might be helpful to put more financial, capital, and research resources to help people in terminal stages of life.

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