Submitted to Jonathan Holmer, in partial fulfillment of
RC400G Death and Dying
Protecting patient autonomy and empowering patients to make informed health care decisions have become the cornerstones of many new health care reform initiatives. In every aspect of health care today, clinicians are taught that patients have the right to be involved in every health care decision. This is further demonstrated through the gaining momentum of legal documents such as advanced directives and living wills. These documents allow patients to exercise their right to make health care decisions at the point where they are no longer capable of making such decisions.
In our society today, the protection of autonomy and empowerment to make informed health care decisions slips in priority when a request is made for physician assistance with death. Physician assisted death is also referred to as euthanasia. Historical actions, such as genocide, have tainted the meaning of the term euthanasia but the original intent of the term was to describe a peaceful passing or “dying without pain and suffering” (Kastenbaum, 2011, p. 270). Few would argue that individuals have the right to a peaceful and happy death.
Those who oppose voluntary euthanasia often use a slippery slope type argument based on concerns that such acts might contribute to widespread abuse in other instances. The argument is based in the notion that any legal or judicial actions that promote physician assisted death or euthanasia would eventually open the door for more radical and unacceptable practices such as non-voluntary euthanasia. So the argument proposes that in order to prevent historical events from repeating, society should not take the first step toward allowing physicians to assist patients in their death.
The main element missing from this argument is the third cornerstone of health care, informed consent. Those who perform acts of non-voluntary euthanasia often do so despite laws or ethical standards. They act based upon belief systems or radial ideations that they are in a proper authority or position to make such decisions for another individual. Therefore, when making the argument against voluntary euthanasia, the argument should be focused on situations where informed consent is being given by a competent individual who desires to maintain autonomy and the ability to make personal, informed health care decisions regarding death.
Most people in western society are comfortable with patients choosing those situations in which measures should be used to save a life or extend a life. In a sense, providing informed consent through the use of advance directives and living wills. However, the boundary lines around choosing to end a life, even with informed consent, are not clearly drawn. Studies show that reactions to the idea are mixed but there does appear to be some recognition that assistance with a peaceful death may be warranted when reviewing a standard living will which states: “I do, however, ask that medication be mercifully administered to me to alleviate suffering even though this may shorten my remaining life” (Kastenbaum, 2011, p. 275). Society is not intolerant of any form of euthanasia, “the legal system and society in general have been more tolerant of the “letting go” approach (Kastenbaum, 2011, p.271).
Acts of euthanasia can be active or passive in nature but the end result is the same. Passive euthanasia is the act of withdrawing life support or withholding lifesaving treatments. Active euthanasia then is taking direct action to end a life such as delivering a lethal medication. The end result of either passive or active euthanasia is death so it appears hypocritical to believe one method is ok but the other method is not. Why is it deemed acceptable to withhold lifesaving treatments from a patient in the emergency because