Essay, Research Paper: Euthanasia

Psychology

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There are numerous controversial issues that currently affect the evolving field
of psychology. Unsolved issues on human experimentation, abortion, genetic
testing, animal rights are a few examples of themes that arouse conflict and
contention. Euthanasia and Physician-Assisted suicide is yet another
controversial issue that has particular relevance to the field of psychology
because of the apparent moral and ethical dilemmas involved. Euthanasia, by
definition “a happy death,” implies an easy or painless death. The purpose
of this procedure is usually to end suffering analogous to the phrase “mercy
killing,” the practice of putting to death a persons suffering from incurable
conditions or diseases. This subject brings to discussion one of the oldest and
most controversial issues in the practice of modern medicine. On one side of the
argument, Euthanasia would appear to be contradicting the Hippocratic oath,
which proscribes inducing death, even if it is requested by the patient. On the
contrary, medicine could be referred to as the practice that not only prevents
death, but enhances the quality of life through prevention of suffering. The
issue of assisted suicide also stimulates the debate of legality versus
situation ethics. Should jurors, in physician-assisted suicide cases involving
Dr. Jack Kervorkian, vote on grounds that empathy and compassion takes
precedence over the letter of the law? Antithetically, should the juror take the
conventional or legalist perspective and enforce the law as not allowing room
for such compassion? Is it is morally permissible for individuals to end their
lives when they no longer wish to go on living or suffering? This central
question of assisted suicide directly relates to the worries of how society
would be impacted if Euthanasia were to be legalized. In addition to the
societal impact of legalizing such a procedure, does this violate the ethical
codes of the practice of medicine? These are some of the obvious and reoccurring
questions in the controversial ethics pertaining to Euthanasia. The
controversial issues of Euthanasia have direct relevance to the field of
psychology in the judgment of whether or not an individual is “competent” to
make such a determination to end their life. For an example, clinical and
counseling psychologists often are consulted by physicians regarding DNR (Do Not
Recesitate) orders to examine the psychological stability of the patient to make
a life ending decision. Additional parallels that relate psychology to
Euthanasia are an individual’s moral development and how it effects their
decision making process’ in relation to moral dilemmas in the law. Everyone is
put in situations where they are forced to form an opinion that potentially goes
against an accepted or legal policy. Psychology examines and theorizes how
people may react in such a situation as well as analyzes the varying factors
that may lead up to an individual’s decision in such a predicament. Examples
of this, relevant to Euthanasia, would be jurors sitting in on an assisted
suicide case such as those obtaining to Dr. Jack Kevorkian. In this situation,
the jurors were faced with the psychological decision to either declare that it
is wrong to assist in one’s death because it is legally prohibited. Or, on the
contrary, that the suffering and pain of a terminally ill patient was ended
allowing the patient to die in a peaceful manner; delineating that the action
should be deemed honorable due to its inherent value rather than its
consequences. There are various types of Euthanasia that must be explained
before further discussing the topic. If the act is undertaken at the explicit
request of a competent patient, it is defined as voluntary euthanasia.
Involuntary euthanasia is when this action is carried out without the explicit
request of the individual, also known as murder. Those who argue against
physician-assisted suicide primarily base their justification on the moral
probity of the medical profession. There are many worries that go along with the
legalization of euthanasia. In the Netherlands, euthanasia has already been
legalized and is being practiced. Some of the frequent concerns are the possible
pressuring of patients into consenting, especially those without health
insurance or financial support. Economic and financial hardships could
potentially play a major factor with the unjust persuasion of an individual into
such a procedure. The Netherlands, indeed, finds itself having an alarmingly
high rate of involuntary euthanasia, which is unequivocally impermissible.
Euthanasia is also seen as being a serious distraction to physicians and others
in the medical field because of the potential luring of doctors away from the
improvement of pain control, suffering and terminal care. In addition to this,
frequent practice of euthanasia could very well negatively affect the trust
entailed in the patient-physician relationship with doctors who are known to
actively practice assisted suicide. All practitioners in the medical field take
the Hippocratic oath stating the following, “…I will follow that system of
regimen which, according to my ability and judgment, I consider for the benefit
of my patients, and abstain from whatever is deleterious and mischievous. I will
give no deadly medicine to any one if asked, nor suggest any such counsel…”
The Hippocratic oath strongly implicates that participating or approving of
physician-assisted suicide could very well destroy the legitimacy of the medical
practice, with direct regard to the value and sacredness of life. Additional
views against such procedures claim that most pain and suffering in terminal
illnesses are controllable using current medical technology, thus suggesting the
nonnecessity of Euthanasia. There are many dangers that can be presented by the
misuse of assisted suicide. Without proper guidelines and precautions
established, euthanasia could easily become a dangerous hazard. A
misunderstanding could easily transpire in regards to what level of pain the
patient should be in for assisted suicide to be offered. Moreover, guidelines
must be set as to determine whether or not the patient is psychologically
competent to make the decision to end their life. I feel that there is a crucial
difference in the manner that Euthanasia should be permitted. I feel that a
physician should not convince an individual the worthiness of life; however, I
feel that euthanasia should be allowed because of its reverence for a person’s
judgement on his or her own quality of life provided that all other medical
options have been considered. One of the greatest dangers is to ignore or deny
lessons learned from world history. Nazi Germany actively had programs to
eliminate the weak and vulnerable, moreover in this movement euthanasia was
frequently meditated. Hitler focused on this topic and legalized the assisted
suicide for all those who were mentally retarded as well as anyone who was
“incurably sick by medical examination.” By1941 in Nazi Germany had
euthanized 70,000 patients in mental institutions. For Hitler, this act was
merely an advancing step towards a better social hygiene. The power of the state
rather than the empowerment of the individual with respect to euthanasia
displayed the danger of such practice. What the Nazi’s did was purely murder
for the good of the state; however, the possibility for legalized euthanasia to
once again become such a hazard must be recognized. There are five commonly
excepted ethical reasons for those against physician assisted suicide. The first
is that the American Medical Association has ruled out any “mercy killing,
which is defined as “ the intentional termination of the life of one human
being by another.” They argue that a physician’s duty is to prevent medical
suffering in the first place as laid out in the Hippocratic Oath, an oath that
all physicians take upon completion of medical school. “Western medicine has
regarded the killing on patients, even on request, as a profound violation of
the deepest meaning of the medical vocation…Neither legal tolerance nor the
best bedside manner can ever make medical killing medically ethical.” The next
argument recognizes the slippery slope that could easily develop as did with
Hitler in Nazi Germany upon the legalization of assisted suicide. The opposition
also fears that more and more physician’s will become insistent in their roles
with assisted suicide, and begin to offer and urge it on patients who have
become not only depressed about their circumstances, but also a burden to
themselves and to others, even an economic burden. They also feel that the
doctor-patient relationship depends solely on trust, and if the public begins to
mistrust the profession of medicine, because its unhealthy participation in
death-dealing, then the profession of medicine itself will suffer irreversible
losses. They also see the potential for physician’s having the ultimate power
of life and death in their hands as being an instigator to infringement and
control over an individual’s life. Lastly, the opposition feels that more
often than not, euthanasia would be offered before all moral, political and
social ramifications have been considered. On the contrary, there are many that
argue in favor of euthanasia and assisted suicide. In fact, euthanasia is
commonly practiced legally throughout the Netherlands. Euthanasia can easily
seen as a method allowing an individual to die peacefully and painlessly if they
are suffering from an incurable sickness. In 1991 an estimated 516,170 Americans
died from cancer. If 5% of these people died suffering with severe pain, this
surmounts to 25,809 people dying a painful death that could have been eased with
assisted suicide. This statistic clearly proves that there are a considerable
number of people that are suffering painful deaths in areas that the medical
field has been able to remedy. If a patient is physically and emotionally
competent and able to coherently understand their dainty condition, the option
of euthanasia and a peaceful death should rightfully be presented. For patients
that are suffering from terminal cancer and other incurable sicknesses, pain is
by no means the only cause of their suffering. Other common symptoms of
terminally ill patients are weakness, pain, anorexia, dyspnea, nausea/vomiting,
confusion, pressure sores, fecal incontinence, as well as offensive odors. Dr.
Jack Kevorkian, a publicly well-known advocate and practitioner of assisted
suicide argues that in the current state of law and medicine, individuals with
degenerative diseases must decide either to take their own life during the stage
of their impairment when they are still capable, or suffer the grim realities of
a lingering decline. Individuals deserve the right to have control over their
lives and to the autonomy they are entitled to. Those in favor of euthanasia
agree that it is an individual’s constitutional right to be offered a painless
cure to their suffering. The principle of respect for autonomy tells us to allow
rational individuals to live their lives according to their own autonomous
decisions without any interference. If rational individuals independently chose
to die, then proper respect for autonomy will allow physicians to assist them in
doing so. The goal of medicine is to address the suffering of patients. As the
suffering increases intractable to relief, if requested by the patient, the
medical field should offer euthanizing relief if no other options are available.
This by no means delineates that a person should be forced into assisted suicide
regardless of their social, political or economic stature. Assisted suicide
should merely be an option mentioned to the patient, moreover would be
permissible to execute upon a patients request. Supporters also argue that the
responsibility for technology should exist for these individuals as well.
Medical technology has made efforts to gain terminally ill patients some
additional time; likewise, medicine must recognize when they are unable to
further help such patients. Scientific research for cures in these areas should
continue; however, in the mean time technological methods to relieve the pain
for those via lethal injection should be offered. Furthermore, when science is
able to find a cure, there will be no need for the assisted suicide. Euthanasia
is not trying to replace scientific research, but it offers a relief to the
incurable pain and suffering that research has not yet corrected. Addition
concern should be devoted to the individual’s autonomy. The personal decision
to end ones life whether it is because of terminal pain or merely faced with old
age, suicide should be honored. However, a firm criteria for this must be
established to prevent abuse. The following are some of the few guidelines The
patient must fully understand their current medical condition and must be
mentally aware that assisted suicide is an irreversible action; moreover, the
patient must request assisted suicide on their own will. The patients suffering
must also be validated by a physician as not being caused from inapt care. A
second, non-affiliated physician should make consultation, thus ensuring that
the patient’s judgement is not distorted. The rise of “patient’s rights”
in current medical ethics debates will undoubtedly bring euthanasia closer to
being legalized in the United States. Those who support autonomy in biomedical
ethics have been promoting the right for patients to ask for assistance in
death. The supporters of assisted suicide have established numerous reasons as
to why euthanasia is a morally and legally legitimate practice. These supporters
have also instituted particular safeguarding procedures preventing against
abuse. Specific committee review boards have been devised to examine the
patient’s competence, the voluntariness of the request, and the terminal
condition in which the patients suffers from. The euthanasia committees would
consist of interdisciplinary panels of clinicians, ethicists, lawyers, as well
as laypersons. With a diversified professional panel, the committee will
effectively be able to analyze the patient’s competency levels as well as the
severity of the individual’s suffering. Corresponding interviews will be
conducted assuring the patient’s genuine desire to carry out the procedure,
and that he or she is not suffering from a mental or psychological impairment.
The committee’s purpose is not to agree or disagree with the patient’s
decision in whether or not to proceed with assisted suicide; rather it
determines the patient’s psychological ability to make such a decision. This
does not impose euthanasia, but it morally and legally sanctions the procedure
because it is of the individuals own will. Now that both sides to the Euthanasia
controversy have been described. I feel that I am prepared to present my
perspective on the issue. As an undergraduate student studying to go into the
medical field. I am an avid supporter of medical research to find cures for
terminal diseases as well as more effective methods to relief pain in such
patients. In situations where medicine is presently unable to treat or relief an
illness, I feel that it is an individuals autonomous right to end their life if
the suffering has reached an unbearable level. I see physician–assisted
suicide as being a legitimate option if there is no further medical assistance
that can relief a person’s illness. By no means am I discrediting medical
research; however, in cases where no medical help can be provided I feel that
euthanasia should be an option upon request. An individual should not be
pressured into the procedure; however, it is a person’s constitutional right
to end their terminal suffering. I believe that assisted suicide should be
available upon request by licensed practitioners regardless of an individuals
social, economic or political status. I feel that euthanasia should only be
legalized under very specific guidelines. I agree that there should be an
established committee that analyzes the competency of the patient’s mental
status, thus assuring that the patient is fully able to make such an
irreversible decision. I see Euthanasia as being a justifiable procedure
provided that the patient is not forced into doing anything that they do not
desire, and that there is an assurance that the patient will be capable to make
such a decision. With the proper safeguarding against abuse, physician-assisted
suicide is a moral option to those in need of a way out of their terminal
suffering.
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