EUTHANASIA.   Term Paper ID:25739 Click to get this paper

Essay Subject: Pros & cons, types (voluntary, active, passive, physician-assisted), legalities, ethics, role of medical personnel.... More...

10 Pages / 2250 Words 7 sources, 16 Citations, APA Format $40.00 Return to List of Papers

Paper Abstract: Pros & cons, types (voluntary, active, passive, physician-assisted), legalities, ethics, role of medical personnel. Paper Introduction: The debate regarding euthanasia, either active or passive, and the right to physician-assisted suicide has strong proponents on both sides. This paper will look at the definitions of the various practices and discuss the problems and issues arising from each side of the debate. It will also look at the two sides of the issue individually, and look at the perspective taken by those on either side. There are four ways in which the lives of the terminally ill can be brought to an end (Quill, Lo and Brock, 1997, p. 2099). The patients can voluntarily stop eating and drinking, and die from dehydration or starvation. This is considered acceptable by many, but can also lead to abuses if family members deprive those who are ill of nourishment against their will. Terminal sedation is also quite acceptable, and renders the patient unconscious and Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. Many oppose it on religious grounds, while others on moraland ethical grounds, fearing that what is clearly a merciful act for somewill lead to abuse for others. Health and Social Work, 21, pp. Opponents of euthanasia argue that whatever the status ofautonomy, it is not sufficient to override the absolute prohibition of thetaking of a life. (1997). There are four ways in which the lives of the terminally ill can bebrought to an end (Quill, Lo and Brock, 1997, p. Terminal sedation offers several advantages. (1996). Elliott, C. Self-administration does not guarantee competence or voluntariness (Quill, Lo,Brock and 1997, 21 1). Nevertheless, the method remainscontroversial. Euthanasia and assisted suicide: a familypractice perspective. British MedicalJournal, 315, pp. P. Social work and end-of-life decisions: self-determination and the common God. The physician is needed to make available to thepatient the necessary medications to end life. Physician-assisted suicide has some disadvantages. Opponents believe the socialconsequences of legalization would be profoundly negative. M. J. 2439). (1997). Terminalsedation is passive in that it is not intended to cause death directly. American Family Physician, 55, pp. 115-122.----------------------- 12 21 1). Studies in the Netherlands haveshown that active euthanasia of patients with mental handicaps is a highlyexceptional event, occurring perhaps once or twice a year. 2437-2441. British Medical Journal, 314, p. Thephysician was convicted of murder, but given only a one-week suspendedsentence. On the third factor, proponents of legalization argue there is noimportant moral distinction between active and passive euthanasia.Opponents argue that equating the two practices confuses causality withculpability: when life-support is withdrawn, the cause of death is theunderlying disease, not the actions of the physician (Gates, 1997). In the United States, a study showed that fourpercent of physicians surveyed had received a request for active euthanasiawithin the year studied, and 24 percent had responded by administering alethal injection. According to many normative ethical analyses, active measures thathasten death are unacceptable, whereas passive or indirect measures thatachieve the same ends are permitted (Quill, Lo and Brock, 1997). 14 1-14 2. van der Maas, P. Others believe that respect for autonomy demands ahigher standard than simply acceding to the subjective desire of theindividual. In about one-third of all deaths of mentally handicapped people in the Netherlands in1995, there had been a decision to withhold or withdraw life-prolongingtreatment, while in about 1 percent of cases, opioids had been given. 21 ). Voluntarycessation of eating and drinking does not challenge current laws, and so isconsidered by many to be the best alternative. Physician-assisted suicide occurs when the physician gives thepatient a lethal dose of some medication, but the patient administers ithim/herself. In terms of end-of-life decisions, Wesley believes socialworkers should advocate for public policy and practice strategies thatrespect the client's right to self-determination, and support the commongood. There is no philosopher-patient relationship to complicatematters, and they are unencumbered by the traditions that make many doctorsreluctant to perform euthanasia. References Churchill, L. Oregon is so far the only state inwhich physician-assisted suicide is legal. The Journal of the American Medical Association, 278, pp.2 99-21 4. The National Association of Social Workers Code of Ethics defines theethical responsibility of social workers as making "every effort to fostermaximum self-determination on the part of the clients" (Wesley, 1996). Although it is recognized that such apractice takes place daily in hospital and hospice settings, no one likesto admit it. The patients canvoluntarily stop eating and drinking, and die from dehydration orstarvation. Itwill also look at the two sides of the issue individually, and look at theperspective taken by those on either side. A recent article suggested a new alternative: philosopher- assistedsuicide. The problem with thisapproach is that, while it is entirely voluntary, and requires noparticipation by the physician, it may take weeks for death to occur, andthe patient may suffer during this time because he/she may experienceexcessive thirst and hunger (Quill, Lo, and Brock, 1997, p. With its roots in both the Hippocratic oath and the Judeo-Christianethic of the sanctity of life, Western medicine has long opposed thepractice of euthanasia (Gates, 1997, p. Palliative options oflast resort: a comparison of voluntarily stopping eating and drinking,terminal sedation, physician-assisted suicide, and voluntary activeeuthanasia. Opponents fear that legalization might distort the doctor-patientrelationship and undermine trust, as well as undermine an alreadyinadequate commitment to palliative care. Suicide attempts are notalways successful, and the patient may end up in an emergency roomreceiving unwanted life-prolonging treatment. They believe it is self-contradictory to appeal to autonomy asthe highest ethical principle in order to justify an act that abolisheslife, which is itself a necessary condition for autonomy. 21 ).Again, death may take weeks to come, and usually results from starvation ordehydration, or some other intervening complication. The question now seems to benot whether or not it is right, but whether or not it is right for someoneto assist in another's decision not to continue with life. This is considered acceptable by many, but can also lead toabuses if family members deprive those who are ill of nourishment againsttheir will. There are complex legal issues involved in life-terminatingdecisions. Activeeuthanasia is active assistance in dying, while stopping life-savingprocedures is usually seen as passive assistance in dying. Incontrast, in the general population, these figures were 2 percent and 19percent respectively. The estimated amount of time by which life had beenshortened for the mentally handicapped was, on average, lower than in end-of-life decisions in the general population, suggesting that end-of-lifedecisions in people with mental disability are made in a late stage of theterminal illness. These would have to be exercised through surrogates, bringing in anothercomplicating factor. 14 ). Becauseindividual self-determination is so highly valued in American legal andcultural tradition, those in favor of euthanasia usually begin theirargument with an appeal to the principle of autonomy. A. Quill, T. Theycite the Netherlands as an example, where as many as 4 percent ofeuthanasia cases are carried out either nonvoluntarily or involuntarily. Public opinion polls have consistently shown that a large majority ofthe American public favors legalized euthanasia. They invoke the"slippery slope" argument that once these practices are legalized, it willbe impossibly to restrict them to competent, terminally ill patients. With terminal sedation, the patient is rendered unconscious, usuallywith barbiturates or benzodiazepines (Quill, Lo and Brock, 1997, p. Social workers are uniquely positioned, she says, for advocatingrespect for the individual and also for the common good. It can be carried outin patients with severe physical limitations; the time delay between onsetand death permits reassessment by members of the family and the healthteam; physicians can ensure that the patient's decision is informed andvoluntary before beginning the procedure; and in patients who lack decision-making capacity but are seen to be suffering intolerably, the surrogate orfamily can make the decision. Legally and socially, proponents argue that as euthanasia andassisted suicide already occur, legalizing them would allow safeguards andpublic accountability which are now lacking. This goes contrary to traditional medicalprohibitions against intentionally causing death (Quill, Lo and Brock,1997, p. Academic philosophers have been prominent in expressing theirarguments for ethical and legislative changes in current euthanasiapolicies (Elliott, 1996). Such a practice goes directly against thepremise of hospice care, which holds that there is value in "sufferingthrough" the dying process, and that it should not be cut short. The Royal Dutch Medical Society subsequently proposed guidelinesfor physicianparticipation in voluntary euthanasia, and the state agreed not toprosecute if these were followed. Proponents arguethat decisions about the end of life are among the most intimate andpersonal issues that anyone has to face, and that no one can be qualifiedto make that decision other than the individual person concerned. The patient may have impaired judgement at the timeof request, or may be pressured into making it. The modern debate oneuthanasia began in 1973 in the Netherlands when a Dutch physician wastried for giving a lethal injection to her debilitated mother. End of life decisions in mentallydisabled people. While thephysician may be seen as morally responsible for the suicide, the patientactually carries it out. The generally agreed upon care for the terminally ill is palliative,but for some patients intolerable suffering still exists. Direct euthanasia generates the most heateddiscussion for those opposing it. Thepatient's mental clarity may be lost toward the end, and this may thenraise questions about whether the decision is still a voluntary one. 1 88-1 89. Terminal sedation canbe interpreted here not as the cause of death per se, but as a means tokeeping the patient comfortable while dehydration and starvation occur.The Supreme Court recently approved of this method of treatment forterminal patients, and the practice is carried on openly in many palliativecare and hospice groups with a reported frequency ranging from zero percentto 44 percent. 2437). A 1996 survey of critical care nurses found that some had given drugsto hasten a patient's death, but the questionnaire used unclearterminology, as it implied that increasing the dose o morphine to a patientcould be considered euthanasia when it was only meant to relieve pain(Scanlon, 1996, p. In the case of voluntary active euthanasia, the doctor actuallyadministered the lethal dose. This case of discrimination has been argued in front of theSupreme Court, and its decision has left this inequity still standing byconfirming the constitutionality of laws that prohibit physician-assistedsuicide in New York and Washington. 137-139. Existing laws allow terminally ill people to request removal oflife sustaining medical interventions and to receive palliative drugs thatmay hasten death, which means that they are treated differently than thosewho wish to end there lives but need assistance to do so (Churchill andKing, 1997). Many physicians are stilltroubled with the idea that the only way to deal with suffering is to endthe life of the sufferer. Physician-assisted suicide has probably received the most exposurebecause of the very public actions of Dr Jack Kevorkian. Beneficence involves the physician's duty to relieve suffering, withproponents arguing that death from euthanasia is sometimes necessary toprevent unbearable pain (Gates, 1997, p. (1997). (1997). W. 2 99). Since time began,suicide has occurred for just such reasons. The Netherlands is the only country to date wherevoluntary active euthanasia and physician-assisted suicide are openlypracticed, regulated, and studied, although the practice remainstechnically illegal. The guidelines specify that the requestmust be voluntary, the patient must be experiencing suffering that cannotbe relieved by any means other than death, and a consulting physician mustagree that euthanasia is warranted. (1996). (1996). E., Lo, B., & Brock, D. Somedoctors believe that withdrawing of life-support is simply recognizing thelimits of modern medicine, while administering a lethal injection is goinga step too far. Terminal sedation is also quite acceptable, and renders thepatient unconscious and thus also susceptible to death by dehydration orstarvation. In Physician-assisted suicide, the physician actively provides the means, but is passivein the final act, which is carried out by the patient alone. Euthanasia occurs when the physician carries out the finalact. Scanlon, C. Others believe that social andeconomic pressures may transform the "right to die" into the "duty to die,"especially for elderly, poor, and uninsured persons. Familymembers, nurses and doctors may find this situation repugnant. Critical care units are characterized by the useof life-preserving treatments and nurses in these situations may be caughtbetween following a doctor's orders and relieving a patient's suffering.To ease this situation, the American Nurses Association and the AmericanAssociation of Critical Care Nurses have published position statementsrecommending that nurses not participate in euthanasia or assisted suicide. Whether it be physician-assisted suicide, direct euthanasia, terminalsedation or voluntary withdrawal from food and liquids, there are people oneither side of the issue. Theissue of self-determination is central to the debate regarding end-of-lifedecisions. Philosopher assisted suicide and euthanasia.British Medical Journal, 313, pp. This presents an interesting counter argument to thosewho believe in the inevitability of the "slippery slope" scenario. While physician-assistedsuicide is illegal in most states, there has yet been no successfulprosecution for such an act. Philosophershave no professional oaths or codes they would be violating in performingsuch a service. Physician assistedsuicide, euthanasia, or withdrawal of treatment: distinguishing betweenthem clarifies moral, legal, and practical positions. Wesley, C. The debate regarding euthanasia, either active or passive, and theright to physician-assisted suicide has strong proponents on both sides.This paper will look at the definitions of the various practices anddiscuss the problems and issues arising from each side of the debate. The New England Journal of Medicine, 334, pp. In this scenario,the physician usually prescribes a large dose of barbiturates with which apatient can end his or her life (Quill, Lo, Brock, 1997). R., & King, N. And who is to say that suffering, other than extreme physicalpain, is a less worthy reason to want to end one's life? The fearhere is that if relief of suffering becomes a reason to legitimizeeuthanasia, eventually some will argue that handicapped, demented, andmentally retarded patients deserve the same "rights" as the terminally ill. Following thisreasoning, they say that there is no logical reason for confining thesepractices to the terminally ill, and that it should apply to those who arechronically but not terminally ill, and those whose sufferings arepsychological rather than physical. Gates, T. 73. Theybelieve, therefore, that each individual ought to have the right to decidewhen the burden of furthering suffering outweighs the benefits of continuedlife. On the question of professional integrity and euthanasia, doctorsoften prescribe medications for patients which are not necessarily in theirbest interest - diet pills for the overweight, anabolic steroids forathletes - or perform unnecessary surgery (particularly plastic surgery),and even participate in capital punishment by lethal injection. Euthanasia and nursing practice - rightquestion, wrong answer. She believes theyshould foster a socially just public policy that promotes quality of lifefor all periods of the life cycle so that "death with dignity" can flownaturally from a life with dignity. Although assisted suicide andeuthanasia remain technically illegal in the Netherlands, an estimated3,6 cases occurred in 1995, representing approximately three percent ofall deaths. Since lethal injection is a relatively simpleprocedure, it is suggested that allowing philosophers to perform it wouldlay to rest a doctor's qualms about contravening professional oaths andethics. The debate on euthanasiacan be seen, then, as symptomatic of both the medical profession's failureto seriously address the issue of the public's concern as to what modernmedicine has in store for them, and society's failure to face the realityof human mortality and the ultimate impossibility of "controlling" death. Elliott believes this may be away toavoid the dreaded "slippery slope" leading to morally objectionable formsof euthanasia which so many fear. Proponents and opponents of the debate for and against euthanasiadisagree on four controversial issues: the nature of autonomy, the role ofbeneficence, the distinction between active and passive euthanasia, and thepublic and social implications of legalization (Gates, 1997). J. Some physicians are morecomfortable with this procedure, because while they supply the means, it isthe patient who has to make the final decision as to whether or not to takethe medication and when to do so. Indeed, in some states' jurisdictions, lethal injection withoutthe aid of a doctor is used in cases of capital punishment. They also fear thatin today's world of managed care organizations, assisted suicide may beseen as an unparalleled opportunity to cut costs while maintaining "qualitycare." van der Mass (1997) declares that the "acid test for any society thatclaims to be civilized is whether it really protects the life and promotesthe wellbeing of its most vulnerable citizens, including the very young,the very old, the chronically ill, and certainly the mentally impaired."But protecting vulnerable life does not mean prolonging it regardless ofthe amount of suffering this would entail. In light of some recent cases, it would seem that this decision isalready being made by such people, if critics Dr Jack Kevorkian arecorrect. If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.

Many of our Papers can be Downloaded From This Site!

PLEASE READ THIS, IT IS IMPORTANT!

Office hours are Monday through Friday, from 9 am to 5 pm (PST). You may place orders for custom research over the phone during office hours. E-mail requests can be made to our graduate and undergraduate department any time, and will be reviewed during office hours. You may also contact customer service any time through e-mail, and we will review your message during business hours. A great many papers can be downloaded right from this site, but not all of them. If you would like to know if a particular paper is downloadable, just look in the description for: "Available for Internet Download: Y" or "Available for Internet Download: N" If you wish to purchase a paper which is NOT available for immediate download, you will need to make other shipping arrangements. Also, please be aware that these orders are processed Monday through Friday from 9 am to 5 pm (PST). If you place your order after 4:45pm on Friday, it will not be processed until the following Monday morning. We charge $8 per page for all of our pre-written reports, plus shipping (and tax for California residents). However, the highest cost of any ONE report is $136, or 17 pages. Please, take a moment. Make sure you have chosen the report you want or need BEFORE you complete your order. If you are not sure, allow us to help you. We do not offer refunds or exchanges, so it is important for you to let us answer your questions during office hours. Reports which are e-mailed or downloaded are in Microsoft Word format. We are making more reports available for e-mail delivery faster than we can update our listings. Please call to check on the status of particular reports. There are many other shipping options which are listed on the Checkout page.