An Analysis of Arguments for and Against Euthanasia and Assisted Suicide: Part One

Abstract

In advanced technological societies there is growing concern about the prospect of protracted deaths marked by incapacitation, intolerable pain and indignity, and invasion by machines and tubing. Life prolongation for critically ill cancer patients in the United States, for example, literally costs a fortune for very little benefit, typically from $82,845 to $189,339 for an additional year of life. Those who return home after major interventions live on average only 3 more months; the others live out their days in a hospital intensive care unit.

What should we tell medical students and residents about euthanasia and assisted suicide?

“…Respect for a patient’s autonomy is considered an essential bioethical principle (Ersek, 2004; Thomasma, 1996). An autonomous decision is a decision that is made freely and in full knowledge and understanding of the information necessary to make such a decision.…”

Caring for Dying Patients Who Have Air Hunger

“…Although some philosophers debate the distinctions between palliating and killing, or the principle of double effect (Cavanaugh, 1998;Thomasma, 1996Thomasma, , 1998, dialog with these nurses showed that they viewed killing as wrong or "evil." April thought her Roman Catholic roots had influenced her aversion to any action that might prematurely end life ("life at any cost").…”

Euthanasia and Assisted Suicide

“…the urgency of considering issues for patients who increasingly fear that their final wishes will not be honored and thus be forced to suffer unnecessarily (Capron, 1996;Thomasma, 1996).…”

“…Some of the strongest opposition of physician-assisted suicide center around the Hippocratic oath of physicians to ''do no harm,'' which prohibits the prescription of lethal doses of medications to patients. The relief of pain, most often seen as a primary reason for requesting euthanasia or assisted suicide, should be administered through standard medical care, with the recognition that increased education regarding pain management and hospice care among physicians may be needed (Brody, 1992;Capron, 1996;Quill, Cassel, & Meier, 1992;Thomasma, 1996).…”

“…In the Netherlands, where euthanasia is permitted, an assumption exists that euthanasia can be controlled or monitored. Guidelines to protect physicians from prosecution are in place which include that: euthanasia must be explicitly and repeatedly requested by the patient (no doubt that the patient wants to die); the mental and physical suffering is severe with no prospect for relief; the patient's decision is informed, free, and enduring; all other options for care have been utilized or refused by the patients; and that two physicians must be in agreement (Thomasma, 1996). The Remmelik Commission study found that in more than 40 percent of euthanasia cases, the criteria was not adhered to; with physicians administering lethal drug overdoses to patients who were not fully competent to request euthanasia ( Van der Maas et al, 1991).…”