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The issue of euthanasia is tearing at the social fabric of the United States, as proponents and opponents attempt to answer a myriad of questions about an individual's right to die and society's responsibility in either permitting, assisting, or denying that act. The word "euthanasia" is of Greek origin, and literally is translated as "a good death. " According to the American Heritage Dictionary, euthanasia is "the act of killing a person for reasons of mercy" (AHD 670). But the issue is far more complex and controversial than what a simple dictionary's explanation can possibly encompass. There are profound issues surrounding the act of mercy killing that are yet to be resolved in the United States, and internationally. The only way that resolution of the issue will occur is if a measured, objective and careful scrutiny is employed of the legal and ethical issues surrounding all sides of this controversial debate Numerous questions confound the legalities of euthanasia in the United States and in other countries.
For example, how does one define what is merciful death? If legalized, how should such so-called "merciful deaths" be performed? Should active means such as lethal injections be administered at patients' request, or only more passive means allowed, such as the withholding of food and water? Should criteria be established as to what types of cases are legally sanctioned as mercy killings and what types are not? Does not allowing voluntary euthanasia violate an individual's constitutional rights? To date, US government agencies, legislators and leaders have not been able to agree on their answers to those questions.
Still, records indicate that mercy killing is not largely embraced in the US or internationally, from a legal point of view. The Netherlands is the only international region today permitting voluntary euthanasia. Suicides there have risen three percent since legalization. Not only have suicides increased, but also controversy is brewing regarding whether the mercy killings are voluntary or involuntary. Opponents in the Netherlands are launching an initiative to repeal the law, claiming one in five cases of euthanasia are occurring without explicit patient consent. A survey released in the Journal of Medical Ethics looked at Netherlands' figures for 1995 alone, and found that while there were 3, 500 authorized cases of physician-assisted suicide, there were 900 other cases in which doctors had acted without clear approval from the patient.
In a follow-up report it was revealed that in those cases, physicians did not consult patients regarding their own suicides because they believed their patients had dementia or were incompetent. The study also found that even with decriminalization of euthanasia, numerous cases are being "swept under the carpet. " The article cites the conclusions of Dr. Hen Jochensen and Dr. John Keown, the researchers who carried out the study. "The reality is that a clear majority of cases, both with and without consent, go unreported and unchecked.
Dutch claims of effective regulation ring hollow. " (Groenewoud et al 1720). In 1997, Australia repealed right to die legislation it approved in 1995, after suicide statistics grew rapidly and allegations of ineffective regulation also ran rampant over the issue (Kimsan 195). In the United States, only Oregon has legalized voluntary euthanasia. There are only two states -- North Carolina and Wyoming -- which do not legally prohibit physician-assisted suicide either through specific criminal statute or state common law. Congress has attempted unsuccessfully to stop assisted suicide nationwide by barring the use of federally controlled substances at lethal levels intended for mercy killing.
While crafted to stop the practice of assisted suicide in Oregon, critics of the proposed ban complain that since Oregon passed its measure through two voter referendums, any federal ban would go against the documented wishes of its voters (Belkin A 04). Last year, the US Supreme Court unanimously ruled that states have the right to ban assisted suicides but failed to rule on whether or not mercy killings should be allowed. Presently, enforcement of the issue is murky. The US Drug Enforcement Agency (DEA) in 1997 threatened Oregon doctors who prescribe drugs for assisted suicides with severe sanctions, including the loss of the license to prescribe drugs. Last year, US Attorney General Janet Reno overturned that position, ruling that physicians may provide lethal doses of medicine without risk of any sanction. Reno commented that such prosecutions "would be beyond the purpose" of current federal law, which provides criminal and civil penalties to doctors dispensing controlled substances.
It is Reno's decision that the congressional opponents of euthanasia are now vowing to fight (Mapes A 1). US pathologist Dr. Jack Kevorkian, who by his own admission has assisted 130 people with their own suicides, has been the target of considerable media and government attention. Kevorkian is the leading "right to die" icon in the US because of his work providing lethal medication to patients so that they may commit or orchestrate their own suicides.
But the release of a videotape by Kevorkian in January, 1999, showing the physician injecting lethal medication into a patient in Michigan has changed the nature of the controversy from the right to die to medically assisted euthanasia. Kevorkian is charged with murder and faces trial next spring. Dr. Kevorkian is the first known US physician to carry out an act of mercy killing (Bai 17). The ethical issues surrounding an individual's right to die and mercy killing are diverse and difficult.
The right to die, particularly for someone who has a terminal illness and is suffering from intense pain is perhaps understandable from the patient's perspective. There are definitely proponents for it. The leading right-to-die organization in the US is The Hemlock Society, based in Oregon, which boasts more than 20, 000 members. The organization has been in existence for 17 years, and it is the leading organization in the US pushing for legislation to legalize the right-to-die and assisted suicide. Founder Derek Humphrey, whose own wife died of bone marrow cancer following months of painful, debilitating degeneration, claims that the issue deserves to be resolved on a personal basis. "While it is true we have no control over our births, at least we ought to have control over our deaths.
How can we claim to be free people if someone else's moral standards govern the way we die?" Humphrey demands in Final Exit (44). Humphrey notes that while modern advances in medicine in the 20 th century have enabled people to live longer, the problem of terminal pain and the ethical issue of medically extending a life absent of its quality has never been solved, whether a patient is declared terminally ill or not. He purports that perhaps that issue should not be left to the medical profession to solve. Humphrey adds that people "die differently these days. " Listing the scourge of AIDS and degenerative diseases such as Multiple Sclerosis, Parkinson's Disease, Alzheimer's and Osteoporosis, Humphrey points to statistics indicating that two out of every five Americans are likely to die of degenerative diseases that will linger an average of 10 - 15 years prior to death. Humphrey maintains that society has become more autonomous and today's legal decisions about the right to die and mercy killing are behind the times. "With the empowerment of better knowledge, we nowadays make more decisions for ourselves Gone are the days when the doctor 'played God'" (Smith 48). Some would counter that Dr.
Kevorkian, and others who might follow his lead, would be in effect, "playing God" by assisting patients to die. Kevorkian, conversely, appears to be revered by his dying patients and their families. He claims that patients are screened carefully for any signs of mental illness and adds that he turns down many more patients than he agrees to assist with death. The American Medical Association (AMA), the US Surgeon General's Office and other medical professional associations have come out in opposition to the issue. While the AMA in 1973 passed a Bill of Rights allowing patients to refuse life-sustaining medical treatment, the AMA has recently taken a firm stand against medically assisted euthanasia, in any form or fashion.
The AMA has filed an amicus brief in a 9 th Circuit Court of Appeals case regarding doctor-assisted suicide. The brief states, "There is compelling evidence of the need to ensure that all patients have access to quality palliative care, but not of any need of physician-assisted suicide" (Amicus Curiae Brief 96). The brief explains the AMA's position that doctors perform a crucial act of healing and saving life. Accepting the dual role of also taking life, the legal brief counters, undermines physicians' credibility and the sacred trust between doctor and patient. In the final analysis, it would appear there are similarities, historically between the voluntary euthanasia debate and the US controversy of legalized abortion. The issue of whether one's constitutional rights extend to the freedom of assisted suicide may then be decided on a personal basis as a constitutional privilege, with some level of government control and regulation imposed at the both the state and federal level.
It is unlikely that the controversy will end, as it has not ended yet with abortion. Deep chasms remain between pro-lifers and those who support the right to choose. One aspect clearly differentiates the two controversies, however. While remorseful patients who have undergone abortions often cross the line to pro-life support, the experience of euthanasia offers no such opportunity for regret. It is this with this onus, more so than even abortion, that society and its leaders must deliver a solution. Works Cited American Heritage Dictionary. "Euthanasia. " American Heritage Dictionary.
New York: Random House. 1997. Amicus Curiae Brief. "Washington v Glucksburg. " American Medical Association Declaration. 2 Nov. 1996 Bai, Matt. "Assisted Suicide. " Newsweek. 28 Dec. 1998, 17 - 21. Belkin, Lisa. "There's No Such Thing as Simple Suicide. " New York Times. 14 Nov. 1993. A 04. Groenewoud, Edward. "Physician Assisted Death in Psychiatric Practice in the Netherlands. " New England Journal of Medicine. 19 June 1997. 1720 - 1744.
Kimsan, Gerritt. Drug Use in Assisted Suicide and Euthanasia. New York: Pharmaceutical Products Press. 1996. Mapes, Jeff. "Suicide Law Ruling May Shake Up Fall Vote. " Oregonian. 16 June 1997.
A- 1. Smith, Wesley. Forced Exit. New York: Random House. 1997.
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Research essay sample on Physician Assisted Suicide American Heritage Dictionary