Mental Health Ethics: Euthanasia

Author: Pedro Gondim

Euthanasia (Greek: ευθανασία - ευ "good", θανατος death"), according to the Penguin Dictionary of Psychology, is described as the “easy and painless death or the means for producing one. Advocated by many for those suffering from intractable pain that accompanies the terminal stages of many incurable diseases. A distinction worth noting (in respect to matters legal and ethical) is that drawn between passive euthanasia, when one simply ceases to supply requisite extraordinary support measures needed to keep an individual alive, and active euthanasia, when specific means are taken to terminate life.” (Page 253)

Active Euthanasia, Passive Euthanasia and Assisted Suicide

The distinction between these terms is one of the main discussion points regarding euthanasia and its legal-social effects. The so-called active euthanasia, as previously described, consists in a direct or indirect action with the purpose of ending one’s life. Such actions would include, for example, the injection of a lethal substance into the patient’s bloodstream. The passive euthanasia consists in ceasing life support supplies (or treatment), such as a respiratory tube or a specific medication.

Although this does not constitute in a direct action towards ending one’s life, it does have the same purpose and result. In legal terms, both definitions fall under the same category – and there are people who argue that passive euthanasia is a mis-term of what would be simply another active form of the event. In the other hand, assisted suicide is the term which defines the supply of means to end one’s life. It is almost the same as euthanasia; the difference is that in this case, the patient is responsible for performing the final action which results in his/her own death. This definition comprises the term physician-assisted suicide, which occurs when a doctor assists a patient, whether by giving information or access to means, to commit suicide.

This has been the center of much discussion among several societies, as it represents a paradox to common medical ethics* – and it also raises a discussion of priorities in health care.

*Most doctors are ethically obliged to the Hippocratic Oath, a document written by the famous Greek physician Hippocrates, which states that a doctor shall not provide any means to help producing death.

The ‘Slippery Slope’ Argument

A common person would probably argue that, upon request, an individual should be allowed to choose between life and death. After all, it is a matter of freedom of choice, which is one of the basic principles of a democratic society. However, both euthanasia and assisted suicide invoke a deeper concern in health specialists – a problem commonly called the slippery slope.

According to them, the legalisation of both practices would cause the society to gradually switch their views towards life and death issues involving severely ill, disabled (both mentally and physically) and other patients unable to express their will – allowing euthanasia to be such a common practice that, at some point, patients would feel pressured to end their lives in order to spare resources to maintain them alive, or end their family suffering. In an overall perspective, life would be less valued, and people would become increasingly insensitive to patients in severe conditions.

Palliative Care and the Development of Health Care

Some advocates of the previous argument also affirm that, in a certain period of time, when healthcare has become widely available and non-costly - it would be possible to legalise both euthanasia and assisted suicide. Ideally, those conditions would allow both medical staff and the public to place life care as an ultimate priority. This can be considered as utopian, however, the progressive advances in technology could play a main role in creating this environment.

Current Situation

Until this article was written (2005), only few places in the world legally allow euthanasia and assisted suicide. The only country to approve both practices is the Netherlands. Meanwhile, Switzerland and the US state of Oregon allowed assisted suicide, and in Belgium, only voluntary euthanasia (authorised by the patient) is fully legal. Other areas, including the UK, have been analysing the possibility of legalising one or both of these activities. In 1996, The Rights of the Terminally Ill Act (ROTI) was passed by the Parliament of the Northern Territory by one vote. In 1997, the Australian Parliament overturned the ROTI Bill, and voluntary euthanasia became illegal again.

The discussion around euthanasia remains a polemic and unsolved issue. Several pro-euthanasia institutions have been established throughout the world, and every year, a growing number of patients travel to Switzerland in order to peacefully end their lives. However, researched data has not concluded whether the slippery slope effect will become prominent or not – and whether other issues regarding the legalisation of euthanasia could take place.

Article Source: http://www.articlesbase.com/health-articles/mental-health-ethics-euthanasia-139798.html

About the Author:
Pedro Gondim is a writer and publisher for the Australian Institute of Professional Counsellors. The Institute is Australia's largest counsellor training provider, offering the internationally renowned Diploma of Professional Counselling. For more information, visit www.aipc.net.au/lz.

A Critical Assessment of Euthanasia

by Stephen Ainsah-Mensah

The question of whether, say, a man should have the right to take away his life granted pain and suffering have overcome him is a very important question today. A different way of putting this question is this: ‘Should a man have the right to take away his life if he ceases to function as a human being?’ This matter would have been laid to rest had it not been that it strikes at the heart of law, key matters of health, and morality. It is a subject that, if not properly addressed, can cause some nasty consequences to the lives of people and pose unwarranted danger to the stability of a society.

The present question bears the amazing name “euthanasia”. Those who think that a man, for instance, has the right to take away his life under the condition stated may have some important points to put forward. Yet their points, upon closer inspection, could be seen to be overtly subjective, and, hence, moot.

A man – call him John - should have the right to function properly and contribute, in whichever form, to the collective movement of life. When this primary function is taken away, it ought not bring about a burden to people close to him or to others bearing no direct relation to him. But if his awful suffering prompts others to direct much of their time into taken care of him, then the multiplying effects are huge. The patient in question suffers severely and the others in question suffer mentally and emotionally.

Consider the three children of John who are engaged in skilled jobs. Their respective companies prize them as essential toward the general success of the company. But following the terminal illness of John, they have to spend much time in looking after him. One can see that this state of affair weighs heavily on the creative capacity of John’s children. Most likely, it would sting their emotional and mental health as well as their respective financial capacities. Furthermore, if matters of health in the society are largely supported by the state, then much money has to be spent on John to help sustain his life. In fact, the moral bases of these actions are in keeping with the fundamental tenets of human rights. Should the state or John’s children do otherwise, one could reasonably argue that the bestial character had controlled the conscience, so too passion. And this would have set a dangerous precedent since the easiness of self-centered life is sometimes valued far more than a hard life full of moral, legal and logical alertness. Most likely, others would follow the morally deficient example set by John’s children or the state; and to what extent their actions could be justified would be very hard to estimate. In this light, it is, indeed, very hard to put forward a straightforward answer in favour or against euthanasia.

If one ponders over the role the helpless patient plays in euthanasia, many questions compete for selection. Is John in the right emotional and mental condition to endorse his “compassionate” killing? Are his close relations in agreement with him that he should “compassionately” die? How can one sufficiently ascertain – bitter as this may seem - that John’s close relations have not conspired to end his life in order to ease their own (individual) disproportionate stresses in looking after him? In short, who should be trusted when the matter at hand refers to ending a person’s life through another agent, whether an expert or a lame person? And even if a medical expert approves, generally, of euthanasia and the specific case of John, how could one determine the motive at stake so as to free euthanasia of any element of suspicion?

It is in confronting such questions that it becomes difficult to justify euthanasia on logical, legal and moral grounds even though some specific instances may be claimed to warrant euthanasia. For assuming the agent himself, say, John, ended his life through his own doing and not through any agent, then one may, fairly quickly, conclude that he did the right thing in order to put excruciating pain to final rest.

Careful thought casts some doubts on the personal action of John. One can, for instance, ask whether John was in the right frame of mind prior to ending his own life or whether he was emotionally stable. And to say that the condition of John is irrelevant to judge the rightness or wrongness of his action may be foolish. It amounts, by a parallel reasoning, to saying that any individual knows best what condition he or she is in and has the sole privilege in correcting that condition, either to enhance life or terminate it. But this contention goes against the fundamentals of reasoning. It is purely a personal contention and does not submit itself to an objective scrutiny in order to free it of crude biases and moral dishonor.

Since one can choose to do to one’s own life what one pleases – because of the subjective character of inward life – one could equally claim that it should not matter what kind of person wants to terminate life: a mad or sane person, a minor or an adult, an idiot or a sage, and so on. From this viewpoint, one can see that the previous contention is baseless. Abnormality of any form should not be sanctioned or unduly promoted. That is why people who lack the standard human disposition are often seen as having trodden the path of gross errors and need to be corrected by appropriate means without fail. Danger awaits the society if abnormal persons or premature persons are granted the personal right – not freedom – to take away their own lives, either by themselves or through the mediation of agents. This brings to the fore the point that the sufferer acted, not according to a clear conscience or a composed will-power, but under some kind of pressure, either by being persuaded to end his/her life or by persuading himself/herself. The sufferer, in other words, did not have all the available options at his/her disposal from which to make the ultimate rational choice about the issue of compassionate death. But suppose all the available options were at the sufferer's disposal, it still might not be morally proper to end life as an interventionist procedure was induced.

Think about the point that modern society is full of scientific-technogical facilities that have added a lot of sophistication to the movement of life. A person's life-threatening disease could be artificially controlled or manipulated by using complex machines or genetically engineered medication. Simply applying the sophistication just stated could definitively end a person’s life-threatening disease. The moral dilemma that euthanasia brings about in this sense is largely connected to the question of manipulating a condition that leads to the death of the victim. Why should not death be allowed to occur naturally, thereby concluding that what happened was a noble death, a death in dignity? It seems clear that to tamper with this arguable noble death, by artfully and artificially facilitating it, is not in keeping with the natural play of human decency. It is an endeavour that may hint at the progress and development of science and technology; but if issues about cloning are morally questionable, therefore quite a threat to the harmonization of social life, then euthanasia may be viewed in like manner in spite of the scientific-technological creativities that may be advanced in its favour.

Euthanasia may engender the proliferation of all kinds of experiments about medication and medical equipment intended to justify the most effective means of stirring up mercy killing. Such practices will not serve the general interest of the society, for the issue of fame and profit may outweigh the question of selflessness. For example, the medical expert may not engage in the straightforward job of facilitating meaningful death in accordance with the patient’s wish, by an act of endorsement, directly or indirectly. The said expert may be more interested in the undeclared motive of testing a medical theory or/and the efficacy of a new drug on the victim. Once success in this area is confirmed, he/she may then continue to nourish the ego and the intellect with more experimentation on many other victims.

The question, then, ought to, finally, be confronted: Should moral, logical and legal matters resolve the rightness or wrongness of euthanasia? Or, should medical and scientific-technological issues decide the rightness or wrongness of euthanasia? If we go by the second point, then we can argue persuasively that it has been largely responsible for the evolution of human beings into the present form. And if the question of morality, law and logic were made to decide human evolution, then we, most likely, would not have been able to reach our current station in terms of advancement. But we are dealing with crucial issues about life and death, and the question of whether euthanasia is right or wrong must, for the present, lie unresolved. Perhaps, since there is no clear-cut answer to this question, the question itself need not be topical; nor should it proliferate. Those who want to practise euthanasia may then be censured.

Article Source: http://www.articleset.com

About the Author
Mr. Stephen Ainsah-Mensah is a Canadian Educator, Race Relations Consultant, Writer, and Community Projects Coordinator. He has worked in various capacities as an instructor at the post-secondary level in Business courses and Life Skills. Currently, he is the principal of Handan-Lilac Education Group in China.
kamch22@yahoo.ca
» Read more articles by Stephen Ainsah-Mensah

Ethical and Religious Considerations in Physician Assisted Suicide

By Sam Oliver

Some terminally ill patients are in so much pain that they would rather end their life than to go on suffering and experience a poor quality of life. Because of physical and mental limitations, people in pain have a much different view on living than people with good health. This altered view makes some choose certain courses of care in a debilitating illness he or she may not even consider in a healthy state of being. Many healthcare providers claim that terminally ill people’s pain can be controlled to tolerable levels with good pain management, yet there are tens of millions of patients who do not have access to adequate pain management in the U.S. alone.

Many religious organizations believe that suffering can be used to purify us. This purification can be for the caregiver and for the patient. It is a time to learn and be aware how the body becomes more soul in the process of transformation associated with dying and death. Christians believe that life is a gift from God and God does not send us any experience we cannot handle. Islam states in the Qur’an, “Take not life which Allah made sacred otherwise than in the course of justice.” And “Since we did not create ourselves, we do not own our bodies.” Orthodox Judaism states that “This is an issue of critical constitutional and moral significance which Jewish tradition clearly speaks to. We believe that the recognition of a constitutionally recognized right to die for the terminally ill is a clear statement against the recognition and sanctity of human life….”

It is clearly evident that religious influence upon PAS deems such an act as going against one’s Creator, and as such, the need to pray and discern the direction of one’s life and dying should be in the consultation of clerical status of one’s own faith. To override such influence would take an autonomous individual whose beliefs have taken him or her from what can be known religiously to what can be known through them by the same force that gave them life. It is here that terminal patients choose a course of action from the core on one’s being transcending his or her belief in their creator (religiously) leading to an active participation of one’s assessed values (personal transformations) that includes their religious influence, but it is not limited to it as well.

About the author
Samuel Oliver, author of, "What the Dying Teach Us: Lessons on Living"
For more information on this author; http://www.soulandspirit.org

Article Source: http://EzineArticles.com/?expert=Sam_Oliver

Physician Assisted Suicide And The Art of Care

By Sam Oliver

In an age of managed care, rationing of care, and technological care, there is The Art of Care. We live in a society that has been given various choices to “self-determine” one’s destiny in dying as one has been able to “self-determine” one’s destiny in life itself. We have medicines and technological capabilities, and areas of the country allowing us to hasten or postpone one’s dying. The purpose of this position paper is to outline the legal, ethical, religious, and philosophical ramifications involved in Physician Assisted Suicide (PAS) and how affects of such decisions effect those connected to this issue.

The pros for PAS are:

· People should have the right to die with dignity

· People should have the right to die with their senses intact

· People should have the right to die free of pain

· People should have the right to take charge of futile care

The cons for PAS are:

· Slippery-slope effect, or acceptable and unacceptable euthanasia

· No policy is able to effectively govern the scope of the right to die

· True wishes are hard to discern due to communication challenges

· Playing God

I am simply giving an overview, and not, a detailed analysis on this issue. My intent is to surface the issues in PAS and move toward a philosophy of care that can minimize people’s fear of death by the utilization of a type of care = The Art of Care. The Art of Care will help people gain inner strength that can enable him or her to cope with the external losses happening to their body. At the end of this paper, I hope to outline practical ways people can help terminal patients cope with a dying body from a place inside them that remains steadfast – their soul.

It was Karl Barth who said that “it is for God and God alone to make an end to human life” and that God gives life to us “as an inalienable loan.” It is my belief that we are given meaning and hope in all life situations. This instinct to survive and find value in all of our existence leads me to trust that there is much to learn in all phases of our life. Our ability to trust our Creator’s divine guidance and plan to make us more soul than body at the end of life is just as important as other aspects of living as well. We may do well to trust more and control less. It appears that maturity teaches us all to let go and follow a path inside us that does not always make sense to us externally. As we do, we begin to follow insight. To see from within what cannot be seen from without is our soul’s longing to be known and to surface in our lives.

In On Liberty, John Stuart Mill cautions, “A person should be free to do as he likes in his own concerns, but ought NOT to be free to do as he likes in acting for another, under the pretext that the affairs of the other are his own affairs. Autonomy is so important to us that science, as well as religious communities strive to honor and respect it. For within autonomy is the ability for one to discern for him or herself one’s needs, values, and destiny. This is a movement into the art of care (science and religion) can work together in forging a healing response on the level of soul when physical cure is no longer possible.

On the other side of this issue, it is evident that the Oregon’s Death with Dignity Act has had its impact on America. Some people want this service available even if it is not chosen by a great number of people. The Oregon ’s Death with Dignity Act has been used very sparingly and a slippery slope does not appear to be in the present forefront. “In 2001, twenty-one Oregonians chose to end their lives by ingesting a lethal dose of medication prescribed by a physician, accounting for 0.33% of the 6,365 Oregon deaths from similar diseases. The number of Oregonians opting for physician-assisted suicide has remained fairly stable, ranging from sixteen in both 1998, the first year the law was in effect, to twenty-seven in both 1999 and 2000. Clearly, there is no landslide in the making.”

It seems then, that people still want to have some sort of control in their dying and autonomy remains prevalent throughout the issue with PAS. This strong need to determine one’s path in the face of suffering offers us hope, faith, and love in a sense of the self not easily defined without losing the grandeur of a trust within oneself to be led by the same power that brought our lives into being. It is here that we turn to the art of care to help us when curative care no longer has any answers. Here, we begin where we end, in that we trust in the very wisdom that has created us.

About the author
Samuel Oliver, author of, "What the Dying Teach Us: Lessons on Living
For more information; http://www.soulandspirit.org

Article Source: http://EzineArticles.com/?expert=Sam_Oliver

Approaches to Care in Physician Assisted Suicide

By Sam Oliver

There is a growing interest in suicide. When people start looking for more information about suicide, you'll be in a position to meet their needs. This article is a brief description of much information on this subject. Let's start with 3 levels to discern in the act of euthanasia.

There are three levels to discern in the act of euthanasia:

1. One is a patient who is comatose or brain dead. In these cases the doctor is asked to “pull the plug,” or remove the patient from mechanical life support. These cases are generally not challenged by the general public. It is an act of withdrawing or withholding necessary mechanisms used to sustain a life that cannot sustain itself. It is here that the recognition of one’s personality is gone and the shell of a body is all that remains.

2. Another act of euthanasia involves the use of morphine to hospitalized patients in the painful final stages of her or his life with diseases such as cancer and AIDS.

3. The last category of euthanasia is patients in relatively good health and at the beginning of a terminal illness wishing to end their lives. Such cases as Alzheimer’s and Cancer preclude patients to want information on PAS. This is the most controversial of the three issues involved in euthanasia.

Euthanasia originated from the Greek language meaning “good death.” It is the intentional termination of a life by another person capable of doing so by the request of the person wanting to die. Here are a few terms that one needs to know in PAS that define actions taking place.

Passive Euthanasia is the hastening of a death by means of altering some form of support and letting nature take its course. This can include; removing life support equipment, stopping medical treatment or procedures, stopping food and water consumption which leads to dehydration or starving to death, and withholding CPR (Cardio-Pulmonary Resuscitation). The most common use of PAS is to give patients large doses of morphine to control pain. It is most likely that the pain relief will suppress respiration and cause death earlier than it would have otherwise happened. This is also done on patients who are in a persistive vegetative state or patients not able to regain consciousness due to brain damage.

Active Euthanasia is the use of intentional means to cause the death of a person through a direct action. Dr. Jack Kevorkian, a Michigan physician made this well known in 1998 with a patient who had ALS (Lou Gehrig’s Disease). His patient was afraid of the long suffering involved in ALS and wanted to die a quick and painless death. Dr. Kevorkian injected controlled substances into this patient and caused death. Kevorkian was charged with 1st degree murder, but the jury found him guilty of 2nd degree murder in March of 1999.

Physician Assisted Suicide is the provision of information or means to a dying patient with the intent to commit suicide.

Involuntary Euthanasia is the ending of a life without a patient clearly requesting it.

“There are many reasons why patients want to utilize PAS. Some are simply clinically depressed, of which, one’s illness has brought on or one’s emotional and mental processing of their illness has led to suffering in ways beyond the body. Others live in chronic pain-due to lack of healthcare coverage or means to obtain medication. This later group would rather die early and not incur medical expenses on those they leave behind. A serious disorder or disease such as: ASL, Huntington’s Disease, Multiple Sclerosis, AIDS, Alzheimer’s, etc. are just some of the illnesses people would rather avoid losing their independence and finances over. In some ways, this gives people a feeling of control over the process of their lives.”

About the author
Sam Oliver, author of, "Integrating the Feminine Spirit: Returning to the Womb of Creation"
For more information on this author; http://www.soulandspirit.org

Article Source: http://EzineArticles.com/?expert=Sam_Oliver

Euthanasia - An Emotional Passing

By Thomas Phelps

The Greek root of the word euthanasia is "good death". Some view the prospect of euthanasia as assisting in a merciful passing while others view the action as murder. By definition euthanasia is an intentional act that either promotes death or omits care. Both actions result in the death of the individual under the supervision of a physician.

As of early 2008 there were only two countries that allowed euthanasia. Those countries were Belgium and the Netherlands. In the United States, Oregon was the first to consider and pass into law a bill dealing with physician-assisted euthanasia. In the Netherlands it is estimated that roughly 2,000 individuals are euthanized each year, but there is also an indication that there are many instances that are not reported.

Anyone who has ever dealt with end of life issues for a loved one understands that it can be a very difficult time emotionally. It is hard to see your loved one suffer and it can become easy to have an altered view on the issue of mercy killing.

For some the issue centers on determining boundaries. What criteria are in place to help doctors determine if a patient is a suitable candidate for euthanasia? The belief seems to be that the issue can often be subject to abuse.

The debate originally centered on the aged and infirmed, but has expanded to include infants who may be mentally challenged or who suffer from extensive medical issues following birth. In the minds of some this issue is an extension of the arguments against abortion.

Some struggle with the idea of heroic measures often used by hospitals to forestall death in patients. There is a belief that these measures are taking the opportunity to die with dignity away from the patient. However, there are many cases that indicate these heroic measures have allowed many to continue to pursue life and enjoy family and friends for an extended period of time.

Life advocates indicate pain management has successfully allowed many patients to live in a way that allows more time with loved ones. Euthanasia proponents argue that the use of pain medications can leave patients confused and may bring on a form of dementia. They argue that this provides no additional quality of life to the patient.

Each argument seeks to demonstrate kindness to the individual life under consideration. Both attempt to project an image that demonstrates the strongest regard for the individual.

This scenario may have never been more pronounced that in the Terri Schiavo case. Terri collapsed in 1990 in cardiac arrest. The lack of oxygen resulted in significant brain damage. Terry was revived, but in a near comatose state. By 1998 her husband Michael asked that her feeding tube be removed. Terri's parents objected to this and a court battle ensued. By 2005 Michael's petition was granted and the feeding tube was removed. Without food and liquid Terri soon passed away.

Two divergent opinions about the care of an individual with long-term medical complications were expressed in the Schiavo case. Each point of view garnered supporting advocates. Each perspective appeared to have the best interest of the individual in mind.

Is euthanasia a matter of easing someone's long-term pain in the midst of his or her death? Or is euthanasia nothing more than the murder of someone who may not be able to speak for themselves?

This is one controversial issue that is often driven by multiple emotional factors.

Discuss the Euthanasia Debate at ControversialForums. Discuss all of life's most Controversial Issues at ControversialForums. Discuss any Hot Topic in our Debate Forums.

Article Source: http://EzineArticles.com/?expert=Thomas_Phelps

Euthanasia - Is It Right To Aid People's Deaths?

By Victor Lensora

Should euthanasia be legal or not? There are many different views on this topic. The answer is- there is no correct answer, and there are so many different situations and individuals involved that it hard to paint the issue with one big brush!

Arguing against euthanasia, you could say that rather than killing people, increased amounts of money and focus should be concentrated on providing palliative care; this in theory should render euthanasia unnecessary. They argue that life is valuable and some people would “kill” to have that extra year that the person would have survived had they not committed themselves to death. They argue that by legalising euthanasia, society is accepting that it is okay to kill people, and it becomes a socially acceptable thing to happen and devalues human life, furthermore, they fear that it may lead to involuntary euthanasia being introduced in the near future. God fearing people also argue that it is against the will of god, that god should choose when somebody comes into the world and should also be when somebody should die.

The euthanasia enthusiasts argue that people should respect the person in question and therefore if they would like to be assisted in suicide because they cannot do it themselves, then people should respect their views and therefore assist in their death! Should people not have the choice of what to do with their lives, they have the choice of how they live their life, surely they should have a choice on how to end it. Often it appears to be the merciful thing to do, rather than making somebody suffer over a prolonged period of time until the end!

This will always be a deeply controversial topic and be fiercely debated between the religious zealots and the anti-euthanasia campaigners against the euthanasia enthusiasts. I believe that euthanasia should be legalised as long as it is strictly regulated. I believe that it is unnecessary to make people suffer until the end; we should respect their choices and aid them, when they can’t do it themselves! What our governments decide, we shall not know. Let’s only hope they make the correct decision whichever that may be!

About the author
Victor Lensora - Owner of the New, Controversial Blog that has been causing a stir with its unusual and often controversial takes on life. It’s a must to read: http://controversial-times.blogspot.com/

Article Source: http://EzineArticles.com/?expert=Victor_Lensora