Euthanasia: Harmful or Helpful

When Mary was 28 years old she was diagnosed with Glioblastoma, one of the most aggressive forms of brain cancer. Her doctor quoted her time to less than a month. However, if she chose to endure chemotherapy, she could have more time with her family. Mary decided she did not want to be in pain during her last days and that she wanted to use the physician-assisted suicide that was available in Oregon. Would Mary live her life to the fullest knowing she was in control of her future? Would she regret her choice when there is a possibility that the doctors were wrong? While the proponents argue that euthanasia and physician-assisted suicide should be a human right, opponents dispute that it will violate the Hippocratic oath and create distrust in doctors.

Euthanasia and physician-assisted suicide has become increasingly popular and more often spoken upon within the United States around 1828. During this time, a lawyer in Albany, New York, David Dudley Field, led a New York committee which composed criminal code that banned ‘aiding’ a suicide. This is categorized specifically as equipping another individual with a deadly weapon or lethal medication with having the knowledge that the individual is suicidal (ProCon.org).

Then 87 years later, Dr. Harry J. Haiselden, who was the chief of staff at a German-American hospital in Chicago, sparked rumors of physician-assisted suicide again. In the middle of the night, the parents of a severely deformed baby boy, often known as Baby Bollinger, contacted the chief of staff to save his life. He concluded that with no operation the boy would pass soon. Within five days of refusing to operate he died, which caused more Americans to talk about euthanasia than ever before.

Public opinion polls soon revealed that after Haiselden’s medical case, many Americans believed that Haiselden’s unwillingness to save those who would be deformed or a burden is the right course action. As of 1937, 45% of Americans believed in mercy killing of deformed, or mentally handicapped infants (ProCon.org). Just one year later, Reverend Charles Francis Potter established the Euthanasia Society of America which defended the legalization of voluntary euthanasia for fatally ailing patients as a charitable and Christian act (“Euthanasia”). Assisted death was slowly gaining popularity during this time, however, a downfall would soon come.

Just as euthanasia was starting to gain popularity, word of Adolf Hilter’s ‘Aktion T4’ spread in the United States in the late 1940s. ‘Aktion T4’ was a Nazi involuntary euthanasia project to depose of lives they established unworthy of living, including mental patients and handicapped children. The rise of the Nazi euthanasia project made Americans turn away from euthanasia.

The opinion polls in 1950 showed a 9% decrease in those who agreed with it (ProCon.org). Seventeen years later, Luis Kutner, an Indiana attorney, drafted the first living will. A mere year later, a Harvard committee defined a new criterion for death, an irreversible coma. It was stated it would be a burden to revive patients that are irreversible due to the pain it would inflict on the family (ProCon.org). After new criteria for death, in 1969, the Hastings Center was founded which primarily focused on death, genetics, and biology. Four years later, the American Hospital Association acknowledged the patient’s right to withdraw from, or withhold regimen, thus creating the “Patients Bill of Rights” and acknowledging the right to refuse treatment (ProCon.org).

Creating a legal landmark case, 21-year-old Karen Ann Quinlan fell into an irreversible coma in 1974 at a party. Her guardians went to court to have her respirator removed, and on March 31st, 1976 the New Jersey Supreme Court ruled she could be removed from her ventilator. Seemingly related to the landmark case, a mere seven months later, the California Natural Death Act was signed into order by California Governor Edmund G. Brown Jr. This made California the first state to allow a fatally diseased citizen to withdrawal from life-saving medical treatment when death is near (ProCon.org). California was relatively progressive in the eyes of the proponents and tended to take initiative.

California tended to be among the first in many different areas with assisted death and leading to legalization. In 1987 the California State Bar Conference passed Resolution #3-4-87 to take initiative in becoming the first public body to favor physician aid in dying (ProCon.org). Ten years later on October 27th, Oregon signed the death with dignity act. They conducted rules and safety guidelines for the state and medical professionals. You have to be 18 years or older, a resident of Oregon, capable of making healthcare decisions independently, and diagnosed with a terminal illness that would result in death in up to six months (ProCon.org). As of the current day, there are as many as ten jurisdictions that have legalized physician-assisted suicide: California, Colorado, District of Columbia, Hawaii, Montana, Manie, New Jersey, Oregon, Vermont, and Washington (ProCon.org). Physician-assisted suicide has been a topic of conversation for many years, and both sides of the argument should be genuinely analyzed and considered.

Supporters of euthanasia tend to claim that doctors are following the Hippocratic oath, using physician-assisted suicide. Some doctors have their own interpretation of the Hippocratic oath: To do what is desirable for the patient (Strauss). It is argued that if the patient is terminally ill and in pain, that the desirable thing to do would help them slip away peacefully. Physician-assisted suicide would do just that. Some medical professionals contradict that more harm is caused when life is lengthened.

Humanist, former physician, and founder of “Exit International” Philip Nitschke explains, “Does not doing harm mean that we should prolong a life that the patient sees as a painful burden? Surely, the ‘harm’ in this instance is done when we prolong the life, and ‘doing no harm’ means that we should help the patient die.” Doctors who experience assisted death first hand argue that they are helping, like Doctor Robert Olvera who watched first hand his daughter, Emily, die after a 17-year battle with leukemia. She was blind, confined to a bed, and struggling to breathe. Olvera watched as cancer destroyed his daughter’s brain and as she became a shell of who she once was, and claims “‘Give me some pills so I can go to sleep, Daddy,” Emily Rose said in a barely audible voice. “I don’t want to be ‘chemo sick’ anymore. No one should have to live like this.’”(Olvera). This suffering is why doctors have created a modern interpretation of the Hippocratic oath and make doctors feel comfortable following the procedures of assisted death.

Doctors also feel more comfortable following the procedures of assisted death and helping citizens in the fashion of giving them life-ending medication because some say physician-assisted suicide would not be established without proper regulation and control mechanisms in place. With rules and regulations, it is believed that physician-assisted suicide will be kept under control by physicians and those who want the best for patients. ER Rich, who works at the Lienhard School of Nursing, is known for wanting a three-step practice: The first step is being that the subject has an outlook of six months or less to live.

The patient must request physician-assisted suicide on three occasions with the last one in writing witnessed by two individuals, one individual would have no interest in the patient’s death. The last rule being that the fatal drug may not be prescribed for at least 15 days after the first request and two days after the final request (Rich). While rules and regulations are vital, it is also important to look at the states that have passed these laws and if they have fallen down the slippery slope so many opponents fear. Nancy W. Dickey, an American physician, states “Neither Oregon nor the Netherlands appear to have started down a slippery slope. … Also, physicians have become better equipped to offer a wide variety of palliative care, leading them to become more effective at it and very rarely having to resort to assisted death…” (Dickey).

Not only has assisted death better-equipped physicians, but it is also making them more effective with patients. Denise-Marie Ordway, who is the managing editor of Journalist’s Resource at the Harvard Kennedy School, has done extensive research on the euthanasia or physician-assisted suicide process and claims that there are euthanasia review committees. Euthanasia review committees consist of multiple doctors within them, usually deferring the judgments of those actually performing the procedure (Ordway).

Even though there are already safeguards in place, the legalization can also be compared to other historical events. During the trials of Compassion in Dying v. Washington, where the court concluded that it was wrongful to prevent mentally sane, terminally ill, adults from seeking physician-aided suicide while allowing the terminally ill on life support to withdraw from treatment, it was said, “The legalization of abortion has not undermined our commitment to life generally; nor, as some predicted, has it led to widespread infanticide. Similarly, there is no reason to believe that legalizing assisted suicide will lead to the horrific consequences its opponents suggest” (Compassion in Dying v. Washington). Assisted death would be carefully monitored, with strict rules and regulations in place, it would be there to ease those and provide an alternative option.

Along with having the option, most of the groups who consider physician-assisted suicide and euthanasia are financially better off. According to the Death with Dignity National Center, education typically responds with income, so it can be assumed that most physician-assisted suicides occur with those who are moderately well off. The majority of those availing themselves of medical aid in dying, are typically white and usually have at least a high school diploma and some college education (Death with Dignity National Center).

Having a higher income appears to be one of the factors in deciding on physician-assisted suicide, but the patients knowing they have another option there seems to be the focus of most. Arthur L. Caplan, the Professor of Bioethics at New York University Langone Medical Center and the founding director of the Division of Medical Ethics, “In fact, of the people who make the request—and relatively few do in Oregon and Washington where it’s been policy for many years—many of them don’t take the pills. They like knowing that the pills are there, but they don’t take them” (Caplan). Lindy Willmott, a professor at the Queensland University of Technology, claims physician-assisted suicide would make citizens pay more attention to those who need protection to make sure rules are set in stone. She states, “Paying attention to the interests of the elderly and disabled people actually ensures we use appropriate eligibility criteria in the legislation. And that those criteria are supported by robust procedural safeguards as well as effective and independent oversight mechanisms” (Willmott). The groups that choose physician-assisted suicide tend to enjoy the option of it being there, and stereotypically are financially better off.

Although there are benefits of euthanasia and physician-assisted suicide, nonetheless there are those who are in opposition to euthanasia and physician-assisted suicide. One of the concerns is that euthanasia and physician-assisted suicide will go against the Hippocratic oath and give doctors too much power. This could create a strain on the patient’s relationship with the physician. Physician-assisted suicide and euthanasia create a dilemma within the complexity of the patient-physician relationship, which alters the role of the medical profession within humanity and affects expectations in the relationship and in the profession (ProCon.org).

Many opponents believe that citizens would no longer trust their physicians because they would have an unreasonable amount of power. According to an article from BBC News, “Since doctors give patients the information on which they will base their decisions about euthanasia, any legalization of euthanasia, no matter how strictly regulated, puts doctors in an unacceptable position of power” (“Ethics – Euthanasia).

Doctors provide their patients with all of the information needed, patients would not know if the doctors were lying because they do not have the same information at hand and doctors hold a status of great credibility. Many opponents argue that they are to rejuvenate the sick, not ruin the patient or the time that they have left. According to Stefan Bernard Baumrin, a former professor of Philosophy at the University of New York, “The physician’s job is to heal the sick, to stave off death, and to say as best as he or she can what the future will be like for each particular patient” (Bernard Baumrin). Patients would not know if their doctor wished to heal them or execute them if physician-assisted suicide were legal (ProCon.org). If physician-assisted suicide were legal, a concern is that it would create too much power for the physicians, and create a sense of distrust within the physician-patient relationship.

With the creation of distrust and giving the physicians too much power, opponents fear this would create a slippery slope for involuntary-euthanasia to become practiced, and bring a threat to vulnerable groups. Nonvoluntary euthanasia is often defined as when people are not able to make the decision to end their life themselves, therefore it is nonvoluntary or involuntary to die. It is important to look at places where physician-assisted suicide has been practiced for years. In this example, Belgium legalized voluntary euthanasia and physician-assisted suicide in 2002, and 12 years later removed the age limit making it possible for children to have access to physician-assisted suicide (“Assisted Dying in Other Countries”).

Belgium is not the only place that has had made euthanasia available to children. In a ProCon article, it was found that “…Researchers have found cases of non-voluntary euthanasia in the form of the termination of lives of disabled infants in the Netherlands” (ProCon.org). While in the United States it is unheard of to find involuntary euthanasia cases without reprimand courses taken, some fear if the end of life options continuously become more popular involuntary euthanasia will be normalized. There are other cases in the countries surrounding that have extended their limits on physician-assisted suicide, “So-called ‘physician-assisted dying’—even for people with nonterminal illnesses, like major depression—is now accepted practice in parts of Europe” (ProCon.org). This may not be the case everywhere, but it concerns many that it has spread so quickly around parts of Europe.

When countries with certain regulations were looked at by the Bioethics Observatory, they found, “However — and we believe this is important — the percentage of involuntary euthanasia in patients who were 80-years-old or over rose to 52.7%, while in those with diseases other than cancer, this figure reached 67.5%. The decision was not discussed with the patient in 77.9% of cases (J Med Ethics 41; 625-629, 2015)” (“Review of Countries Where Euthanasia”). Assisted death is dangerous to vulnerable groups and may make them feel less valuable, and can often lead to involuntary euthanasia whether intentional or not.

Life can be devalued with assisted death and euthanasia. Sometimes in these cases, the sick can feel like a burden and in need of too much attention. According to an article from BBC News, those who are sick or disabled are at-risk due to assisted death downgrading their status as human beings and making it seem as if their lives are not worth living (“Ethics – Euthanasia: Anti-Euthanasia Arguments”). The patient may feel like a burden and even though they want to continue living they choose euthanasia for their families, and to ease their pain. A BBC News article says, “The last few months of a patient’s life are often the most expensive in terms of medical and other care. Shortening this period through euthanasia could be seen as a way of relieving pressure on scarce medical resources, or family finances” (“Ethics – Euthanasia: Anti-Euthanasia Arguments”). Being sick, in the hospital, or just medication in general can be very expensive, this is s why physician-assisted suicide puts the lives of everyone in danger especially the underprivileged, elderly, mentally ill, incapacitated, and terminally ill (ProCon.org). It is also feared that protection from the sick would be taken by insurance companies away to save money.

Peter Kavanagh, who is a scholar and a writer, explains, “It would diminish the protection offered to the lives of all. It would allow the killing of people who do not genuinely volunteer to be killed, and any safeguards, although initially observed, would inevitably weaken over time” (Kavanagh). Doctors would have to cut costs for their jobs, and insurance agents would need to save the company money, as stated previously, end of life care tends to be the most expensive. Physician-assisted suicide devalues lives and life situations can make it so patients are forced into choosing it.

Physician-assisted suicide and euthanasia have been pondered and intensely inspected for decades, and continues to be today. Euthanasia has helped certain doctors redefine their caretaking ability by creating a modern interpretation of the Hippocratic oath and has expanded human rights; but on the other hand, it has created distrust among the medical field making other physicians feel as if physician-assisted suicide were in violation of the Hippocratic oath. As euthanasia and physician-assisted suicide becomes increasingly popular around the globe it still leaves one question remaining a mystery: Do the government and physicians have the right to control when a person dies?