Tuesday, December 27, 2005

Euthanasia and Physician Assisted Suicide

Euthanasia comes from the Greek words, eu means "good" and thanatos means "death". In essence a definition of it would read as the painless and intentional termination of the life of another person at his/her request. The legalization of this process in certain parts of the world and the usage of it by physicians has created significant amounts of controversy and debate.
In essence when looking at the theoretical aspect I see two forces at play – on one hand is the ability for a person to not undergo massive amounts of pain which often result from various diseases and ailments, specially the ones which are going to result in a fatality; on the other hand is the ability of people to find a proverbial “easier” way out of a situation without trying harder to hang on to life. These situations can be better explained. The first one refers to a situation where the patient is diagnosed with a fatal disease and is in its final throes and is undergoing massive amounts of emotional as well as physical pain. The stress and the emotional hardship that a family watching a person waste away in a rather painful and discomfort filled manner, is rather substantial as well. Added to this is the finality that death is inevitable. These three factors together put the patient in a situation where the choice of life by itself is a battle that can have no ends other than death, however the period before death is the one of most horrible emotional and physical agony. In such a situation when death is certain, but pain can be controlled , if a person could chose to not go through this pain , Euthanasia or PAS are the only routes available.
On the flipside is a comparable viewpoint equally compelling – the whole essence of life has to be born from the desire to hold on. Life is sacred and a gift which no matter what should be respected and worked to prolong. Therefore in situations where pain could seem to be a rather unbearable proponent, the presence of an alternative might discourage the very desire of a person to fight on. As any good physician knows healing is mentally propagated, the body follows the brain – If in a situation a person starts to give up , using the presence of PAS then the body deteriorates since the desire to live is gone. I am not suggesting that, just a mental desire could save a person afflicted with a fatal disease, but a lot of times it does prolong and create a “cause” for the person to live on. Therefore in situations like that Euthanasia can prove to be rather debilitating.
Morally there seems to be a rather ambiguous area that this topic delves into. Free will which is the quintessential human trait allows us the right to choose. However due to our lack of better knowledge, often times these choices aren’t the best ones that we can make. Therefore , in this situation it is very important for the person to understand what the choices available are. The decision that will arise from these choices I believe is something that should be respected. It can be argued though that, even when all the choices are given to a person and they have been analyzed, the decision coming out might not be the most favorable one. This is a situation which abounds in the world, a creation of a “subjective” morality. People define right and wrong differently. Thus in the case of someone who wants to end his/her life - given the other vectors which should include them being in a situation where life will not be possible for too long due to the affect of the disease, they are in an incredible amount of physical and mental pain and there is no chance of a cure being found for the disease that they are afflicted with, within the time period they have available to live - they should be assisted in any and everyway possible to do so.
Looking at the practical aspect of PAS and Euthanasia certain facts are very important – Over 99.9% of all people dying in Oregon do so without physician assistance ,84% of people accessing PAS in Oregon cite fear of loss of autonomy as the number one cause , there have been a significant number of people specially in the Netherlands and Belgium who have “illegally” tried to get PAS, there are more than fifty recorded instances of PAS gone wrong and the lethal drug not working the way it should , due to the current moral and legal restrictions not a lot of research is being done on better ways to “euthanize” people which leaves physicians that do administer it with very few options, there has been no significant improvement in the department of pain relief in Oregon after the legalization of PAS – these are just a fragment out of the Pandora’s box of legal, clinical, moral and social issues that this topic raises. Trying to get a feel of what is the right thing to do is something that essentially changes from situation to situation.
Is euthanasia and PAS a moral way to administer healthcare – yes , can there be situations where people use it immorally to achieve ends that have no justification for their use – yes , should this option be available to people – yes, does research need to be done to better the techniques – yes , is euthanasia and PAS an answer to the state of a patient – yes and no , it just depends on the situation, and finally is there one fundamental idea of a pure and sacred death and how we reach it – No.

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