Eric Brandon Ngaba

EUTHANASIA: A QUESTION OF ETHICS AND MORALITY. Introduction: Health, friends, and family are among the core reasons why many people find life bearable. When any is removed from the equation; it becomes significantly harder for one to live. Take health for example; the world over, [who is affected] many people are admitted to hospitals suffering from a lot of pain. Illness, old age or irreparable physical injury are usually the common culprits behind such pain. In certain countries, it is within the law for such a patient to opt out of their life through an act referred to as euthanizing when they feel their quality of life has deteriorated to a point where continued existence is unbearable. When I was a teenager [transition], my grandfather received a stage IV cancer diagnosis after a routine screening picked up on a malignant growth inside his prostate. On the onset of treatment, everything seemed hopeful and he was certain he still had ample time left ahead of him. As time dragged on without any notable improvements, my grandfather grew [active] discouraged because he could feel his body falling apart. He kept his feelings hidden from us whenever we would visit. Eventually, the strain of his illness forced him into revealing how he felt to us – a mere two days before he succumbed to it. In this reveal, Grandfather went over the hospital's uncomfortable attempts at treatment, and how they made him feel undignified. He mentioned how fitting it would have been had he just died peacefully in place of the myriad of procedures the doctor's kept running on him. Thinking back, it is easy to draw parallels between his case and that of many patients already on the verge of death. This is because, although my grandfather was never euthanized, he would have benefitted from the relief it offered. Others, however, often disagree. To understand why euthanization is a controversial topic, we have to define it. Christian Nordqvist, in his article on the topic, describes [active] euthanasia as a "deliberate action taken with the intention of ending a life, in order to relieve persistent suffering." This, he adds, can further be refined to account for two factors: nature of execution, and whether or not the patient consents to be euthanized. When it comes to nature of execution, euthanasia can be active – using lethal means to kill a patient, or passive – withholding crucial medication/ unknowingly administering it in incremental doses that prove fatal to the patient. [controversy] Of the two, active euthanasia forms the controversial hotbed of the topic, and is heavily debated because it promotes the act of killing. Somerville informs [active] us that "pro-euthanasia advocates give priority to autonomy… (while) anti-euthanasia proponents to respect for life." Thesis Statement: From the foregoing [transition], it is clear that euthanasia asks us to consider how a person might feel about their current standard of living when faced with a terminal condition. With this in mind, it is my belief that euthanization is a valid resort for suffering patients because it allows for self-determination. Body: Euthanasia allows for self-determination because the pain/discomfort a person feels is entirely subjective – and not even doctors can quantify it. Intense pain accompanying physical deterioration from a terminal illness/old age is a common reason why people opt to be euthanized (Nordqvist). The word euthanasia originates[active] from Greek where its parent-name meant a good death. The Oxford definition also accommodates for suffering as an important criterion in defining euthanasia. It's easy to understand why someone would not want continued pain from an illness/old age; pain is one of the most important signals in the body – yet science has yet to come up with a way to accurately define pain in a patient (S.t. 1). Doctors usually follow [active] a patient's description of their pain. Only the patient can adequately understand just how significant their pain is; which is why euthanasia should be allowed because it will give the person a choice in whether or not to keep up with the pain. [Area of Synthesis] While transition pain might be a factor for euthanasia, Hitchcock seeks to argue that something else entirely is at play in patients feeling tired of holding on (C.C. 1). She mentions that "studies show that the desire to hasten death for those with a terminal illness comes principally from a feeling of hopelessness." (Hitchcock). According to her, a person might feel miserable and helpless because they feel abandoned by those they love or consider themselves a burden to their family because of the cost of keeping them alive. This shows that for some, pain is only a secondary reason, and in some instances, might even not be a contributing factor to a patient's choice in the matter. While physical pain and the hopelessness that Hitchcock is arguing in favor of appear to be different motivations for euthanasia; I am of the belief that the two compound each other's effect since they both describe someone who is hurting (S.t 2). A good example is when the suffering patients are also depressed, and doctors offer them relief through the use of anti-depressants along with pain relief medication – here the doctor has treated both the physical and emotional(hopelessness) pain in the patient. Hitchcock gives an example of how "the combination of morphine and midazolam is extremely powerful… Barbiturates can render one unconscious in minutes." (Hitchcock). While this is good news for those against euthanizing [active], it also [transition] attracts controversy because in some cases it can result in passive euthanasia (C.C. 2). Termed the 'Principle of double effect'; these unique instances tell us "that sometimes the doses of drugs needed to control symptoms at the end of life will secondarily lead to a hastening of death" (Hitchcock). This is proof that pain is not an easy symptom to treat, hence speaking up for euthanasia because it will allow the patient peace of mind in knowing they can find permanent relief from their pain sooner rather than later – when the very medications meant to keep pain at bay eventually end up causing their death (Con 1). It will also [transition] allow doctors to solve a patient's suffering in the most humane way possible, and prevent cases of doctors stalling treatment. Giving someone the right to control their death when in pain will prevent the frequent cases of doctors abandoning their patients to suffer without treatment in the hopes that they die or families being jailed due to taking it upon themselves to euthanize their loved ones. Medical negligence of patients in the face of dim recovery prospects is not humane and points to a need for euthanasia because it shows failure in a doctor's ability to treat certain illnesses/conditions – which the patient is then stuck suffering from without any hope of relief being offered (S.t. 3). For example, in the UK, "around 57000 patients a year are dying in NHS hospitals without being told that efforts to keep them alive have been stopped." (Donnelly) [Statistical evidence]. [Explanation of evidence:] This communicates a willingness by doctors to let go of trying to treat a patient when their recovery is not likely – something that improves the argument for euthanasia because allowing it will enable these doctors to guiltlessly offer the patient an easy way out of their suffering. When a doctor has to abandon a patient because the law does not allow them to ease their pain, the only thing we will have achieved are cases of patients spontaneously dying in hospitals against all indication that they were being treated. In response to this [transition], Somerville brings up a different opinion in this matter when she informs us that "doctors in the Netherlands and Canada are opting out (of euthanasia) because they are suffering mental trauma from providing it." (Somerville). This shows that euthanasia will not be a good thing for the countries involved in it, because the act of killing it promotes is bound to have psychological effects on the doctors carrying it out (C.C. 3). Somerville has therefore exposed a vulnerability in doctors that speaks volumes to why every human has an obligation to maintain life – the mind itself can end up broken when a person is placed in a situation where they have to take a life. How about [transition] family members who, after helping their loved ones commit assisted suicide after doctors turn them down, end up being tried and jailed for assisted suicide? Such individuals deserve to have their motivations understood – something that allowing euthanasia will help achieve (S.t. 4). Terry Pratchett's says [active] he wants to die peacefully rather than be left suffering an incurable illness, requesting for an investigation into euthanasia that will help decrease instances of people being jailed for having assisted their friend/family member who was in pain. (Pratchett). He mentions how his father repeatedly told him that death was better than being strapped to a hospital bed, and why it will be better for the families involved in helping a loved one pass along if there exists a committee that will track euthanasia cases until completion. [Counter-Argument Paragraph] As a counter to this [transition], Hitchcock argues that [pathos example] "any attempt to make death easy will inevitably expose those in the community who are vulnerable to untimely deaths, to feeling worthless and burdensome." (C.C. 4) This reiterates her earlier opinion that majority of euthanasia patients are feeling hopeless – and with some care can be influenced to regain a sense of belonging that will give them the desire to keep on living. [Refutation] In light of Pratchett's suggestion [evidence backing up rebuttal], Hitchcock's argument fails to hold up because it assumes that euthanasia will be impossible to regulate – and available for anyone who is willing to go through with it (R. 1). On the contrary, the very fact that people are suggesting methods to enforce euthanasia shows that it can theoretically be carried out without resulting in anyone dying unplanned. This will mean vetting possible candidates to decide whether or not the act will be suitable for them. One possible way [transition] of vetting will involve analyzing the patient's understanding of their personal dignity. Euthanasia fosters self-determination by allowing the suffering patient to preserve his/her sense of dignity. Dignity is an important aspect of our existence as humans. The Oxford dictionary defines it as a "state or quality of being worthy of honor or respect". As such, when a person is considering euthanasia, it is sometimes out of a desire to maintain the same level of respect others, and society at large had for them (S.t. 5). This happens because the natural progression after the onset of illness/disability can oftentimes be undignified. As an example; Tony Nicklinson was paralyzed following a stroke – he could not move or speak (Bingham.) This means that a lot of his daily routine had been affected by this disability, thus cutting him off from most of the adoration/respect he had prior to the accident. Tony was made unable to independently decide how his days progress – and relied on help from his family members to perform even the most basic of tasks – communicating with his sympathizers. Another example is David Goodall, who fell down in his apartment and no one attended to him for two whole days. (Yonette) This is such a worrisome incident because it shows just how severe disability can be. Imagine lying down for two days without the capability to help yourself up, would you still retain a sense of dignity? Probably not, because dignity is often a measure of normalcy – we tend to feel most dignified when our existence is similar in value/quality to those of others. For Goodall, while the rest went about walking just out of sight, he was stuck with being an immobile mess on the floor – and no doubt felt really humiliated by the incident. As a result [transition], desperation for the pain/humiliation to end can cause a patient to attempt to kill themselves: Tony Nicklinson started starving himself and refusing medication after being denied permission to undergo euthanization. (Bingham.) (S.t 6) This shows that Tony was indeed serious about his willingness to die, and saddened because he was being required to keep up his existence despite his personal conviction that it was impacting his dignity. On the contrary, Hitchcock rallies [active] against deterioration in dignity as a reason for euthanasia by introducing the idea that, "the human animal has an extraordinary capacity to find meaning in and even enjoy a life marked by limited function and debility." (C.C 5) In her opinion, killing such a person does away with any chances of their coming to a realization that their life is still worth living because they will have ceased to exist. This is especially so when the pain could have been manageable and actually holds up under scrutiny because of how subjective dignity is (Con 2). In the end, every person deserves to lead a dignified life that they enjoy – marked by the ability to do the things they love. Keeping a person alive when they feel such continued existence brings them no joy whatsoever will only worsen their emotional suffering. A better alternative would be to grant the patient a period between decision and execution so that they have decent room to backtrack on their decision. In conclusion [transition], Euthanasia is a question of whether we value an individual's life above their demand for self-autonomy. My grandfather is an example of this. We, his family members, routinely encouraged [active] him to live on despite his illness because nothing would have made us happier than seeing him make a full recovery. Enter his shoes, and things get a bit different. He was a man in pain, who couldn't bring himself to voice his discomfort with his continued existence – pitting his self-autonomy against our expectations resulted in him subduing the latter. When he revealed to us how he felt, we were all shocked because none of us could have guessed any of it simply looking at him. It hadn't occurred to us that internally, he felt he had lived out the meaningful and dignified period of his life and was now satisfied and ready to let go. Mentioning self-determination as an important reason why euthanasia should be allowed is meant to draw attention to the manner in which the euthanasia controversy is currently being handled. For example, opponents frequently mention the probability that vulnerable members of society will be more exposed to the procedure, thus bringing up doubts in the government's ability to control its use. This frame of view assumes involuntary euthanasia is the topic being discussed, which is not true because self-determination would enforce the principles of voluntary euthanasia – chief among which is being of sound mind and not under any duress. My grandfather was of a sound mind, and given a chance would have opted to have his suffering cut short earlier on – soon as he received the grim diagnosis that treatment would only be able to prolong his life a few weeks at the most, during which time he'd alternate between painless drug-induced stupors and nerve-wracking pain once they wore off. In the off-chance that he wasn't really ready to die, a simple psychiatric evaluation should have been able to spot the contradictions in his motivation and thus identify the other reasons at play. Countries, where active euthanasia is already being practiced, are a good example of this because they don't just concede the act to anyone who comes asking. Such countries have in place rigorous measures to ensure no one is sent to the gallows for an ill-fitting reason. Works cited: Hitchcock, Karen. "The right to die or the right to kill: the argument against euthanasia." The Monthly. December 2015 – January 2016 issue. Somerville, Margaret. "The Importance of Stories in the Euthanasia Debate." ABC Religion & Ethics. 28 Feb. 2017. Web. 23 October 2018. Nordqvist Christian. "What are euthanasia and assisted suicide?" Medical News Today. MediLexicon, Intl., 12 Dec. 2017. Web. 22 Oct. 2018. Yonette, Joseph. "Why David Goodall, 104, Renowned Australian Scientist, Wants to Die." The New York Times. 3 May 2018. Web. 23 Oct. 2018. Bingham, John. "Tony Nicklinson dies saying: 'Goodbye world, the time has come. I had some fun'". The Telegraph, 22nd August 2012. Donnelly, Laura. "Half of those on Liverpool Care Pathway never told". The Telegraph. 1st December 2012. Terry Pratchett. "My Case for a Euthanasia Tribunal". The Guardian. 2nd February 2010.