Euthanasia, often called ‘mercy killing’, is the act of putting to death someone suffering from a painful and prolonged illness or injury. It means that someone other than the patient commits an action with the intent to end the patient’s life, for example injecting a patient with a lethal dose of medication. In euthanasia someone not only makes the means of death available, but serves as the direct agent of death. The issue of assisted suicide is one of the most divisive topics on a personal, ethical, moral, and political level. In an increasingly patient centered health service individuals are demanding to make independent judgments about their own fate.
As a reflection of the general trend the topic of euthanasia has received increasing attention in recent years and has been the focus of much debate. Although euthanasia may be one of the so called medical decisions surrounding the end of life, it is still an issue that greatly affects nurses. This paper attempts to explore the complex ethical, legal, moral, and religious issues surrounding euthanasia. Does an individual who has no hope of recovery have the right to decide how and when to end their life? Those in favor of euthanasia argue that a civilized society should allow people to die in dignity and without pain, and should allow others to help them do so if they cannot manage it on their own.
As of March 2018, active human euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, and Canada (Wikipedia). Assisted suicide and the right to die has sparked political and emotional discourse in this country for over a century. In 1906, the first euthanasia bill was drafted in Ohio (Hanley, 2016). Although unsuccessful, this bill marks the inception of a debate that has raged on. Doctors are allowed to prescribe lethal doses of medicine to terminally ill patients in five US states. Euthanasia, however, is illegal. In recent years, the ‘aid in dying’ movement has made incremental gains, but the issue remains controversial. Oregon was the first US state to legalize assisted suicide.
Opponents of euthanasia say that it enhances the power and control of doctors, not patients. Advocates see euthanasia as a means to give patients dignity and compassion by offering a quick death. It has even been argued that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, child rearing and the refusal or termination of life-saving medical treatment. Nurses have a unique and important role in the euthanasia process in countries where it is legalized (Terkamo-Moisio, Kvist, Kangasniemi, 2016). Compared to physicians, nurses are considered to be more involved with the end-of-life care of patients, due to their greater bedside attendance and frequent confrontation of patients’ suffering. Despite the significant role of nurses and the need for information about their viewpoints in this matter, the ongoing debate is still very much focused on the perspectives of the physicians and general public.
Ethical aspects of nurses’ attitudes towards euthanasia
A review of the literature of nurses’ attitudes toward euthanasia in 2017 found that nurses felt conflicting emotions over euthanasia deaths and compassion for the patient, but also guilt, anger, fear, and involvement in an “unnatural event” (Hosie, 2017). They felt that they were vulnerable and their opinions were overlooked. The professional ethics of nurses are based on moral values, which also guide their arguments for or against euthanasia (Terkamo-Moisio, Kvist, & Kangasniemi, 2016). These ethics are documented in the international and national guidelines. These guidelines emphasize the respect for autonomy.
In addition, they highlight the fact that the nurse does not have to agree with an individual’s choices, but must simply respect each patient as a person. Autonomy or self determination is usually expressed as the right of competent adults to make informed decisions about their own medical care. It is probably the single most talked-about principle or concept in medical ethics. A respect for competent decisions by adult patients is also a cornerstone of medical law. Legislative changes are resulting in assisted death as an option for people at the end of life.
Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option (Elmore, Wright, Paradis, 2016). The moral experience of the nurse is defined by a profound sense of responsibility and is sustained by intra-team moral and emotional support.
Christian and secular perspectives
Regardless of your personal views on euthanasia, whether it is passive or active, the one thing that most religions have in common is the view that your life is not really yours; it belongs to “God.” It is not yours to live as you choose and it is not yours to take, regardless of how much pain and suffering you may be experiencing as you approach inevitable death. Christians are mostly against euthanasia. The arguments are usually based on the beliefs that life is given by God, and that human beings are made in God’s image. Some churches also emphasize the importance of not interfering with the natural process of death.
Many churches believe that the period just before death is a profoundly spiritual time. They think it is wrong to interfere with the process of dying, as this would interrupt the process of the spirit moving towards God. In our secular society, euthanasia must be a personal decision between the terminally ill and their families, without idle threats of supernatural damnation (Katie, 2012). It is ethically criminal to toss guilt and shame into a tragic situation. One of the strongest secular arguments for euthanasia is the right each person has to control his or her own body, including when and how to die.
Proponents of this argument believe that no person or government agency has the right to keep people from making decisions that affect only themselves. There are many disparate spiritual, philosophical and scientific secular beliefs concerning death. This argument, however, still poses the question how can someone have the right to deny another person death when that person’s beliefs and views on life and death may be completely different from their own.
Euthanasia comes in several different forms, each of which brings a different set of rights and wrongs. This debate cuts across complex and dynamic aspects such as, legal, ethical, human rights, health, religious, economic, spiritual, social and cultural aspects of the civilized society. Here we argue this complex issue from both the supporters and opponents’ perspectives, and also attempts to present the plight of the sufferers and their caregivers. Various faiths may believe euthanasia is “immoral” and equate it to murder, but I believe it to be immoral to let human beings suffer in agony when they’re begging to be put to rest, telling them that the choice is not theirs to make.
Because we can determine the course of our lives by our own will, I believe we have the right to live our lives and determine our own course. I think that people who have an incurable, degenerative, disabling or debilitating condition should be allowed to die with integrity. I wouldn’t want to be unnecessarily kept alive against my own will. To prolong a death in some cases is not helpful, I feel that it can also be counter productive. Life is precious, but when the time comes, we should have the choice to die with dignity because, after all, it’s our life.