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Euthanasia: An Understanding
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Euthanasia: An Understanding
Dharmender Kumar Nehra, Pradeep Kumar
and Sheetal Nehra
Death a friend that alone can bring the peace his treasures
cannot purchase, and remove the pain his physicians cannot
cure. —Mortimer Collin
It is universal truth that death is the only certainty in this uncertain
world. Everyone knows that death will occur eventually, whether
one likes it or not. It affects everyone, whichever social group
people belong to: whether they are young or old, poor or rich, the
pauper or the king, the ruler or the ruled, the sinner or the pious. In
addition, one has to face the death of loved ones, even before one
have to face own death and this is what makes death poignant,
impregnable and fearsome. Despite all this knowledge, it is very
difficult for most of us to think about death of oneself and that of
loved ones. Most of us feel afraid of death, as perhaps the most
basic human response to death is flight from death but some people
seem to see death as a simple solution to their complex problems.
Anthropologist Ernest Becker (1973) argued that “the idea of death,
the fear of it, haunts the human animal like nothing else; it is the
mainspring of human activity—activity designed largely to avoid the
fatality of death, to overcome it by denying in some way that it is
the final destiny for man”.
In addition everyone wants to die painlessly; but this is not the
destiny of some with an incurable illness or injury. To end their
suffering, dying patients may take their own life, in some cases
TYPES OF EUTHANASIA
There is a debate within the medical and bioethics literature
about whether or not the non-voluntary (and by extension,
involuntary) killing of patients can be regarded as euthanasia,
irrespective of intent or the patient’s circumstances. In the definitions
offered by Beauchamp & Davidson and, later, by Wreen, consent
on the part of the patient was not considered to be one of their
criteria, although it may have been required to justify euthanasia
(Wreen, 1988; Beauchamp et al., 1979), others see consent as
essential. However, Euthanasia may be classified according to whether
a person gives informed consent into three types: voluntary, non-
voluntary and involuntary (Perrett, 1996; Lafollette, 2002).
1. Voluntary euthanasia: Euthanasia conducted with the
consent of the patient is termed voluntary euthanasia. Active
voluntary euthanasia is legal in Belgium, Luxembourg and
the Netherlands. Passive voluntary euthanasia is legal
throughout the U.S. per Cruzan v. Director, Missouri
Department of Health. When the patient brings about his
or her own death with the assistance of a physician, the
term assisted suicide is often used instead. Assisted suicide
is legal in Switzerland and the U.S. states of Oregon,
Washington and Montana.
2. Non-voluntary euthanasia:-Euthanasia conducted where
the consent of the patient is unavailable is termed non-
voluntary euthanasia. Examples include child euthanasia,
which is illegal worldwide but decriminalized under certain
specific circumstances in the Netherlands under the
Groningen Protocol.
Euthanasia: An Understanding 61
terminally ill people only or even for the debilitated and mentally ill
too? Euthanasia also known as mercy killing is a way of painlessly
terminating one’s life with the “humane” motive of ending his
suffering. Euthanasia came into public eye recently during the Terri
Schiavo controversy where her husband appealed for euthanasia
while Terri’s family claimed differently. This is a classical case
shedding light on the pros and cons of mercy killing. Albania,
Belgium, Netherlands, Oregon, Switzerland and Luxembourg are
some places where euthanasia or assisted suicide has been legalized.
Let’s have a look at the arguments that will help us understand the
reasoning for/against mercy killing.
Pro-euthanasia Argument
Legalizing euthanasia would help alleviate suffering of terminally
ill patients. It would be inhuman and unfair to make them endure
the unbearable pain. In case of individuals suffering from incurable
diseases or in conditions where effective treatment wouldn’t affect
their quality of life; they should be given the liberty to choose
induced death. Also, the motive of euthanasia is to “aid-in-dying”
painlessly and thus should be considered and accepted by law.
Although killing in an attempt to defend oneself is far different from
mercy killing, law does find it worth approving. In an attempt to
provide medical and emotional care to the patient, a doctor does
and should prescribe medicines that will relieve his suffering even if
the medications cause gross side effects. This means that dealing
with agony and distress should be the priority even if it affects the
life expectancy.
Euthanasia follows the same theory of dealing with torment in
a way to help one die peacefully out of the compromising situation.
Euthanasia should be a natural extension of patient’s rights allowing
him to decide the value of life and death for him. Maintaining life
support systems against the patient’s wish is considered unethical
by law as well as medical philosophy. If the patient has the right to
discontinue treatment why would he not have the right to shorten
his lifetime to escape the intolerable anguish? Isn’t the pain of
waiting for death frightening and traumatic? Family heirs who would
68 Suicide: Attitude and Prevention
misuse the euthanasia rights for wealth inheritance does not hold
true. The reason being even in the absence of legalized mercy
killing, the relatives can withdraw the life support systems that
could lead to the early death of the said individual. This can be
considered as passive involuntary euthanasia.
Here they aren’t actively causing the death, but passively waiting
for it without the patient’s consent. It can be inferred that though
euthanasia is banned worldwide, passive euthanasia has always
been out there which can also be called as passive killing and
moreover law doesn’t prohibit it. Disrespect and overuse of (passive)
euthanasia has always existed and will be practiced by surrogates
with false motives. These are the ones who don’t need a law to
decide for one’s life. Present legal restrictions leave both the incurable
patients as well as pro euthanasia activists helpless who approve
euthanasia as good will gesture for patient’s dignity. Health care
cost is and will always be a concern for the family irrespective of
euthanasia being legalized.
REFERENCES
Becker, E. (1973). The Denial of Death. New York: Free Press.
Beauchamp, T.L. & Davidson, A.I. (1979). The Definition of Euthanasia,
The Journal of Medicine and Philosophy, Vol. 4, No. 3 (September),
294-312.
Burgess, S. & Hawton, K. (1998). Suicide, euthanasia and the psychiatrist.
Philosophy, Psychiatry and Psychology; 5, 113-176.
Cherney, N.I., Coyle, N. & Foley, K.N. (1994). The treatment of suffering
when patients request elective death. Journal of Palliative Care,
10, 71-79.
Dowbiggin, I. (2003). A merciful end: the euthanasia movement in modern
America. Oxford University Press, 10–13.
Euthanasia: An Understanding 75
Ryan, C.J. (1998). Pulling up the runaway: the effect of new evidence on
euthanasia’s slippery slope. Journal of Medical Ethics, 24: 341-344.
Schoevers, R.A., Asmus, F.P. & VanTilburg, W. (1998) Physician-assisted
suicide in psychiatry: developments in the Netherlands. Psychiatric
Series, 49, 1475-1480.
Spanjer M. (1994). Mental suffering as justification for euthanasia in
Netherlands. The Lancet. 25 June.
Stolberg, M. (2007). Active Euthanasia in Pre-Modern Society, 1500–
1800: Learned Debates and Popular Practices. Social History of
Medicine, 20 (2): 206–207.
Tillyard, A.R. (2007). Ethics review: ‘Living wills’ and intensive care - an
overview of the American experience. Crit Care, 11: 219.
Van. H, & Marusic, A. (2003). Understanding the suicidal brain. British
Journal of Psychiatry; 183, 282 - 284.
Van Der Maas, P. J., Van Der Wal, G. and Haverkate I. et al. (1996).
Euthanasia, Physician-Assisted Suicide, and Other Medical Practices
Involving the End of Life in the Netherlands. 1990–1995. New
England Journal of Medicine 335: 1699–1705.
Wreen, M, (1988). The Definition of Euthanasia. Philosophy and
Phenomenological Research, 48 (4): 637–653.
Internet references:
Euthanasia - Wikipedia, the free encyclopedia en.wikipedia.org/wiki/
Euthanasia retrieved on 10.12.2012.
“Euthanasia: Widely debated, rarely approved”. Times of India. 8 March
2011. http://timesofindia.indiatimes.com/india/Euthanasia-Widely-
debated-rarely-approved/articleshow/7651439.cms. Retrieved 8
March 2011.
“India’s Supreme Court lays out euthanasia guidelines”. LA Times. 8
March 2011. http://www.latimes.com/news/nationworld/world/la-fg-
india-euthanasia-20110308,0,1497102.story. Retrieved 8 March 2011.
Pros and cons of Euthanasia www.sanjuan.edu/.../pros%20and%20cons%
20of%20euthanasia.pdf retrieved on 10.12.2012.