BBA 2011-14

Terminal Disease - Right to Die

BY:

Ishani Patel (0220111)

SUBMITTED TO:

Dr. Kamlesh Misra

18thApril 2013

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Contents

Acknowledgement .......................................................................................................................... 2

Introduction ..................................................................................................................................... 3

The Ethics of Euthanasia ................................................................................................................ 4

Why people want Euthanasia? ........................................................................................................ 4

Forms of Euthanasia ....................................................................................................................... 5

Active Euthanasia ........................................................................................................................ 5

Passive Euthanasia ...................................................................................................................... 5

Voluntary Euthanasia .................................................................................................................. 5

Involuntary Euthanasia ............................................................................................................... 6

Indirect Euthanasia ...................................................................................................................... 6

Assisted Suicide ........................................................................................................................... 6

Euthanasia Pros and Cons ............................................................................................................... 7

Euthanasia and Technology ............................................................................................................ 8

Religion and Euthanasia .................................................................................................................. 9

Buddhism .................................................................................................................................... 9

Christian ...................................................................................................................................... 9

Hinduism ................................................................................................................................... 10

Islam .......................................................................................................................................... 11

Alternative solution to Euthanasia ............................................................................................... 12

Impact on Society .......................................................................................................................... 14

Cases on Euthanasia...................................................................................................................... 15

Conclusion ..................................................................................................................................... 17

Harvard Referencing ..................................................................................................................... 18

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Acknowledgement

The satisfaction and euphoria that accompany the successful completion of any task would be

incomplete without the mention of the people who made it possible, whose constant guidance

and encouragement crowned my efforts with success.

I would like to express a great appreciation to my Vice Chancellor and Mentor Dr. Kamlesh

Misra for his constant guidance and support. I take this opportunity to express my profound

gratitude and deep regards for the valuable and constructive suggestions during the planning and

development of this project. I would also like to express my deep gratitude for the patient

guidance, enthusiastic encouragement and useful critiques of this project. The willingness to give

his time so generously has been very much appreciated.

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Introduction

“Euthanasia” is a broad term for mercy killing—taking the life of a hopelessly ill or injured

individual in order to end his or her suffering. Mercy killing represents a serious ethical

dilemma. People do not always die well. Some afflictions cause people to suffer through extreme

physical pain in their last days, and euthanasia may seem like a compassionate way of ending

this pain. Other patients may request euthanasia to avoid the weakness and loss of mental

faculties that some diseases cause, and many feel these wishes should be respected.

But euthanasia also seems to contradict one of the most basic principles of morality, which is

that killing is wrong. Viewed from a traditional Judeo-Christian point of view, euthanasia is

murder and a blatant violation of the biblical commandment “Thou shalt not kill.” From a secular

perspective, one of the principal purposes of law is to uphold the sanctity of human life.

Euthanasia is so controversial because it pits the plight of suffering, dying individuals against

religious beliefs, legal tradition, and, in the case of physician-assisted death, medical ethics.

This moral dilemma is not new. The term “euthanasia” is derived from ancient Greek, and means

“good death.” But while the debate over mercy killing has ancient origins, many observers

believe that it is harder today to achieve a good death than ever before. Advances in medicine

have increased people’s health and life span, but they have also greatly affected the dying

process. For example, in the early twentieth century the majority of Americans died at home,

usually victims of pneumonia or influenza. Today most people die in the hospital, often from

degenerative diseases like cancer that may cause a painful, lingering death.

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The Ethics of Euthanasia

Euthanasia raises a number of agonizing moral dilemmas:

Is it ever right to end the life of a terminally ill patient who is undergoing severe pain and

suffering?

Under what circumstances can euthanasia be justifiable, if at all?

Is there a moral difference between killing someone and letting them die?

At the heart of these arguments are the different ideas that people have about the meaning and

value of human existence.

Should human beings have the right to decide on issues of life and death?

There are also a number of arguments based on practical issues.

Some people think that euthanasia shouldn't be allowed, even if it was morally right,

because it could be abused and used as a cover for murder.

Why people want Euthanasia?

Most people think unbearable pain is the main reason people seek euthanasia, but some surveys

in the USA and the Netherlands showed that less than a third of requests for euthanasia were

because of severe pain.

Terminally ill people can have their quality of life severely damaged by physical conditions such

as incontinence, nausea and vomiting, breathlessness, paralysis and difficulty in swallowing.

Psychological factors that cause people to think of euthanasia include depression, fearing loss of

control or dignity, feeling a burden, or dislike of being dependent.

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Forms of Euthanasia

Euthanasia comes in several different forms, each of which brings a different set of rights and

wrongs.

Active Euthanasia

In active euthanasia a person directly and deliberately causes the patient's death. In passive

euthanasia they don't directly take the patient's life, they just allow them to die.

This is a morally unsatisfactory distinction, since even though a person doesn't 'actively kill' the

patient, they are aware that the result of their inaction will be the death of the patient.

Active euthanasia is when death is brought about by an act - for example when a person is killed

by being given an overdose of pain-killers.

Passive Euthanasia Passive euthanasia is when death is brought about by an omission - i.e. when someone lets the

person die. This can be by withdrawing or withholding treatment:

Withdrawing treatment: for example, switching off a machine that is keeping a person

alive, so that they die of their disease.

Withholding treatment: for example, not carrying out surgery that will extend life for a

short time.

Traditionally, passive euthanasia is thought of as less bad than active euthanasia. But some

people think active euthanasia is morally better.

Voluntary Euthanasia Voluntary euthanasia occurs at the request of the person who dies.

Non-voluntary euthanasia occurs when the person is unconscious or otherwise unable (for

example, a very young baby or a person of extremely low intelligence) to make a meaningful

choice between living and dying, and an appropriate person takes the decision on their behalf.

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Non-voluntary euthanasia also includes cases where the person is a child who is mentally and

emotionally able to take the decision, but is not regarded in law as old enough to take such a

decision, so someone else must take it on their behalf in the eyes of the law.

Involuntary Euthanasia Involuntary euthanasia occurs when the person who dies chooses life and is killed anyway. This

is usually called murder, but it is possible to imagine cases where the killing would count as

being for the benefit of the person who dies.

Indirect Euthanasia This means providing treatment (usually to reduce pain) that has the side effect of speeding the

patient's death.Since the primary intention is not to kill, this is seen by some people (but not all)

as morally acceptable.A justification along these lines is formally called the doctrine of double

effect.

Assisted Suicide This usually refers to cases where the person who is going to die needs help to kill themselves

and asks for it. It may be something as simple as getting drugs for the person and putting those

drugs within their reach.

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Euthanasia Pros and Cons

Arguments for Euthanasia:

It provides a way to relieve extreme pain

It provides a way of relief when a person's quality of life is low

Frees up medical funds to help other people

It is another case of freedom of choice.

Arguments against Euthanasia:

Euthanasia devalues human life

Euthanasia can become a means of health care cost containment

Physicians and other medical care people should not be involved in directly causing death

There is a “Slippery Slope” effect has occurred where euthanasia has been first been

legalized for only the terminally ill and later laws are changed to allow it for other people

or to be done non-voluntarily.

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Euthanasia and Technology

Euthanasia has a long history involving vehement debate (Dowbiggin, 2005). Present-day

proponents argue, typically, that people have a right to die at a time and place of their own

choosing. Instead of spending their final days in a hospital or nursing home with the prospect of

pain, breathlessness, indignity and loss of autonomy, many people prefer to die at home among

friends and family, in a dignified way under their own control at a time of their own choosing.

Proponents argue for legalization of voluntary euthanasia, with tight controls to ensure consent is

freely given and is not distorted by mental illness.

Many aspects of advanced medical intervention are widely welcomed. For example, people can

now recover from heart attacks and live many more years of productive life. However, high-

technology medicine has created a new phenomenon: the extension of life in a medical

environment, often in a hospital or nursing home under constant medical care, with reduced

consciousness and a lower quality of life. Whereas people previously would die at home as

disease progressed, now their life may be extended through medical interventions. Some, seeing

this happen to family or friends and fearing a similar outcome for themselves, see voluntary

euthanasia as an alternative, as a way to achieve death with dignity.

Anyone desperate to die has plenty of choices, such as jumping from a building, leaping in front

of a train, using a gun, or hanging. None of these methods is entirely reliable. People with

limited mobility may have difficulty leaping in front of a train or even getting out of a window.

All these methods can go wrong and lead to serious injuries, exacerbating the agony from which

death is the desired release. Most importantly, these methods are distressing to others, including

family, friends and train drivers. They do not fulfill basic criteria for a peaceful death.

Death with dignity thus seems to be becoming less common for two convergent reasons: rapidly

developing technology to extend life, but under the control of the medical system, and removal

of easy, peaceful ways to end one's life.

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Religion and Euthanasia

Death is one of the most important things that religions deal with.

All faiths offer meaning and explanations for death and dying; all faiths try to find a place for

death and dying within human experience. For those left behind when someone dies religions

provide rituals to mark death, and ceremonies to remember those who have died. Religions

provide understanding and comfort for those who are facing death.

Religions regard understanding death and dying as vital to finding meaning in human life. Dying

is often seen as an occasion for getting powerful spiritual insights as well as for preparing for

whatever afterlife may be to come.

Buddhism

Buddhists are not unanimous in their view of euthanasia, and the teachings of the Buddha don't

explicitly deal with it.Most Buddhists (like almost everyone else) are against involuntary

euthanasia. Their position on voluntary euthanasia is less clear.

Buddhism places great stress on non-harm, and on avoiding the ending of life. The reference is to

life - any life - so the intentional ending of life seems against Buddhist teaching and voluntary

euthanasia should be forbidden. Certain codes of Buddhist monastic law explicitly forbid it.

Buddhists regard death as a transition. The deceased person will be reborn to a new life, whose

quality will be the result of their karma.

Christian

Christians are mostly against euthanasia. The arguments are usually based on the beliefs that life

is given by God, and that human beings are made in God's image. Some churches also emphasize

the importance of not interfering with the natural process of death.

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They believe that:

all life is God-given

birth and death are part of the life processes which God has created, so we should respect

them

therefore no human being has the authority to take the life of any innocent person, even if

that person wants to die

to propose euthanasia for an individual is to judge that the current life of that individual is

not worthwhile

such a Judgement is incompatible with recognizing the worth and dignity of the person to

be killed

therefore arguments based on the quality of life are completely irrelevant

nor should anyone ask for euthanasia for themselves because no-one has the right to

value anyone, even themselves, as worthless

Hinduism

There are two Hindu views on euthanasia:

By helping to end a painful life a person is performing a good deed and so fulfilling their

moral obligations

By helping to end a life, even one filled with suffering, a person is disturbing the timing

of the cycle of death and rebirth. This is a bad thing to do, and those involved in the

euthanasia will take on the remaining karma of the patient.

The same argument suggests that keeping a person artificially alive on a life-

support machine would also be a bad thing to do

However, the use of a life-support machine as part of a temporary attempt at

healing would not be a bad thing

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Hinduism is less interested than western philosophers in abstract ideas of right or wrong. Rather

it focuses on the consequences of our actions.

For Hindus, culture and faith are inextricable. So although many moral decisions taken by

Hindus seem more influenced by their particular culture than by the ideas of their faith, this

distinction may not be as clear as it seems.

Islam

Muslims are against euthanasia. They believe that all human life is sacred because it is given by

Allah, and that Allah chooses how long each person will live. Human beings should not interfere

in this.

Euthanasia and suicide are not included among the reasons allowed for killing in Islam.

a. Do not take life, which Allah made sacred, other than in the course of justice.--Qur'an

17:33

b. The Prophet said: "Amongst the nations before you there was a man who got a wound,

and growing impatient (with its pain), he took a knife and cut his hand with it and the

blood did not stop till he died. Allah said, 'My Slave hurried to bring death upon himself

so I have forbidden him (to enter) Paradise.' " --Sahih Bukhari 4.56.669

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Alternative solution to Euthanasia

Euthanasia is increasingly being touted as a beguilingly simple solution to the tragedy of a badly

managed terminal illness. However, critical examination reveals that, far from being any kind of

worthwhile solution, euthanasia turns out to be a Pandora’s Box of woes far worse than those

which now confront us.

It should be emphasized that opposition to euthanasia does not mean that one is committed to

maintaining existence to the last possible gasp, nor that one is obligated to apply every available

form of life support to those who are clearly dying. Providing therapy aimed at alleviation rather

than cure while a disease runs its inevitable course is not the same as willfully ending a life. The

intention of such palliative care is not to bring about the death of the patient. Consequently, to

call such treatment “passive euthanasia” is to brandish an oxymoron of the most unhelpful kind.

Considering first our duty to persons who are terminally ill, it is of supreme irony that while

terminal care has always been a major concern of physicians through the centuries, the explosive

triumph of medical knowledge in this generation has served to focus attention in directions that

have largely excluded the dying.

Such care as is offered means, in the popular mind, a hospice in the form of a gloomy building

hidden behind high walls where hushed attendants wait, impotent and silent, until death releases

their charges from further pain and suffering.

A wide range of pain relieving drugs is available. It is appropriate to begin with well-known mild

analgesics such as aspirin or acetaminophen. There are an ever increasing number of other drugs

which act in the same way as aspirin. These include indomethacin, ibuprofen, naproxen, and

sulindac. They differ in duration of action and side effects, but basically all can provide effective

relief of mild-to-moderate pain and are especially effective in providing relief of pain arising

from bone and joint.

A more potent analgesic is represented by codeine, an opiate derivative. People often

unnecessarily fear codeine because of its minimal ability to cause addiction. Its main problem,

like all opiates, is that it may cause constipation. Often combined with acetaminophen it is an

effective analgesic of moderate strength

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The fear of drug addiction in terminally ill patients would be laughable if it had not caused so

many patients to endure needless pain. It is well documented that if morphine is taken for the

relief of pain, habituation does not occur. Unless the disease advances, dosage requirements

usually remain remarkably stable for many months, and if some other pain relieving procedure is

initiated, such as a nerve block, morphine can be quite rapidly withdrawn without provoking the

type of severe withdrawal seen in a true addict.

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Impact on Society

• All types of euthanasia have an effect on society as well as society has an effect on

euthanasia.

• Should people be given assistance in killing themselves, or should they be forced to

suffer the pain and indignity caused by terminal illness.

• Some members of society feel that by not giving disabled people the ability to end their

lives is discrimination.

• Society may fear that allowing certain individuals help in ending their lives other groups

of more vulnerable people will become at risk of feeling pressured into taking that option

themselves.

• Euthanasia could be elected for wrong reason: people see themselves as a burden to

society

• “A positive choice has to be made by society in favor of protecting the interests of it’s

vulnerable members even if this means limiting the freedom of others to determine their

end”

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Cases on Euthanasia

In March 1993 Anthony Bland had lain in persistent vegetative state for three years before a

Court Order allowed his degradation and indignity to come to a merciful close. The judges said

that if he had made a living will expressing his future wishes he could have been allowed to die

in peace earlier. Exit is at the forefront of living will research in the UK. Your subscription will

help to make a peaceful death through a living will a reality for anyone who desires it

Sue Rodriguez, a mother in her early thirties, died slowly of Lou Gehrig's disease. She lived for

several years with the knowledge that her muscles would, one by one, waste away until the day

came when, fully conscious, she would choke to death. She begged the Courts to reassure her

that a doctor would be allowed to assist her in choosing the moment of death. They refused. She

lived on in terror, helped eventually by a doctor who, in February 1994, covertly broke the law to

help her die in peace. A law on assisted suicide with rigorous safeguards could have saved her

the nightmare during those months before her death, given her the confidence to carry on - with

the reassurance that when it got too bad she could rely on a compassionate doctor to follow her

wishes at the end. Exit is pledged to support research for drafting the most thorough, yet feasible,

assisted suicide Bill yet presented to Parliament. Your support will make it happen.

57 year old Georgette Malette, in the early afternoon of June 30th, 1979, was rushed,

unconscious, by ambulance, to hospital. The car in which she was a passenger, driven by her

husband, had collided with a truck. Her husband had been killed; she had suffered serious

injuries. She was a Jehovah's Witness and carried a card stating her firm conviction that no blood

or blood products should be administered to her under any circumstances. The doctor treating her

ignored the card and gave her a blood transfusion which he decided was medically indicated. In

June 1980 MrsMalette brought charges against Dr Shulman. The judge found that MrsMalette

had suffered emotionally and mentally and ordered substantial costs to be paid. It made no

difference that the medical team didn't agree with her beliefs. Her advance refusal of treatment

was unambiguous. Unfortunately, living wills tend to be far less clear cut, dealing with a wide

range of circumstances in which interpretation is sometimes necessary. Exit is at the forefront of

research into living wills and other ways of having your wishes respected at the end of life.

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Public support will help us to help make dying more dignified for all those who want to retain

some control and self-respect in their dying phase.

When her case came to trial, Claire Conroy was unable to move from a semi-fetal position. She

was severely demented, had heart disease, hypertension and diabetes and her left leg was

gangrenous to the knee; she had sores, couldn't speak, had only a limited ability to swallow, and

had eye problems; she had a urinary catheter in place and was unable to control her bowels. She

was able to moan and scratch, and occasionally smile when someone combed her hair. Claire

Conroy eventually died before the courts were able to decide what to do. She was not a candidate

for voluntary euthanasia. She had not made a living will. But her case posed very worrying

dilemmas about end of life decisions. Pushing difficult deaths to one side will not make them go

away or make them any easier. Exit encourages open discussion of the problems increasingly

facing us in society. We care, and we listen with an open mind. We ask you to work with us so

that every person can die with dignity in the way that he or she would choose.

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Conclusion

In conclusion, there are still heavy discussions revolving around the topic of euthanasia. Both pro

and anti-euthanasia have strong points supporting for and against euthanasia. New Zealand and

Netherlands are perfect examples for those points, the two countries are exact opposites in their

stand regarding euthanasia and both countries have their own reason.

The issue on euthanasia has been debated for years where some countries have legalize it now

but other countries are still against the idea of it. Therefore, in my opinion, I believe that

euthanasia should be legalized to a certain extent throughout the world to avoid any living being

to die from pain and suffering.

Technology has played an ever-increasing role in the euthanasia issue. Advances in medical

technology have made it more likely that the final stages of life will be both extended and

dependent on medical intervention in ways that are, for some, filled with physical and mental

suffering. Parallel advances in palliative care have reduced the level of suffering for many,

including by slow euthanasia under the supervision of medical professionals. At the same time,

technological options for a peaceful death under one's own control are available but restricted by

governments opposed to euthanasia.

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Harvard Referencing

Dowbiggin, I. (2005). A concise history of euthanasia: Life, death, God, and medicine.Lanham,

MD: Rowman& Littlefield.

McInerney, F. (2000)."Requested death": A new social movement. Social Science & Medicine,

50, 137-154.

Ogden, R. D. (2001). Non-physician assisted suicide: The technological imperative of the

deathing counterculture. Death Studies, 25, 387-401.

Syme, R. (2008). A good death: an argument for voluntary euthanasia. Melbourne: Melbourne

University Press.

Yount, L. (2007). Right to die and euthanasia, 2d ed. New York: Facts on File.

Bbc.co.uk (2010) BBC - Ethics: Euthanasia and physician assisted suicide. [online] Available at:

http://www.bbc.co.uk/ethics/euthanasia/ [Accessed: 17 Apr 2013].

Bbc.co.uk (2010) BBC - Ethics - Euthanasia: Religion and euthanasia. [online] Available at:

http://www.bbc.co.uk/ethics/euthanasia/religion/religion.shtml [Accessed: 17 Apr 2013].

Bbc.co.uk (2010) BBC - Ethics - Euthanasia: Forms of euthanasia. [online] Available at:

http://www.bbc.co.uk/ethics/euthanasia/overview/forms.shtml [Accessed: 17 Apr 2013].

Bmartin.cc (2010) Techniques to pass on: technology and euthanasia. [online] Available at:

http://www.bmartin.cc/pubs/10bsts.html [Accessed: 17 Apr 2013].

Euthanasia.cc (1996) Euthanasia, right to die: Cases. [online] Available at:

http://www.euthanasia.cc/cases.html [Accessed: 17 Apr 2013].

Euthanasia.com (n.d.) Euthanasia Pros and Cons. [online] Available at:

http://www.euthanasia.com/proscons.html [Accessed: 17 Apr 2013].