The specific sociological problem that is the topic of this research paper is euthanasia. The purpose of this research is to identify the variables associated with euthanasia. It also discusses the variables associated with various types of euthanasia and suicide. I believe that elderly suicide is an example of active euthanasia, and therefore it is important to discuss the issue to have a better understanding of the social problem of euthanasia and suicide.
I will also discuss variables that influence whether a person supports euthanasia or not, such as religious belief, gender, age, region, educational level, and marital status that influences how a person views the issue. I will also discuss the definitions of death. I will discuss the ethical and moral aspects of the problem of euthanasia. I will try to use Emile Durkheims social integration theory to explain the causes of active euthanasia, and suicide in general.
I will also use Charles Tittles defiance category of deviance, which represents escape or withdrawal from active participation to social relationships or normative obligations to society. I want to integrate both Durkheims egoistic type of suicide, which applies to those that are inadequately integrated into society, and Tittles defiance category of deviance. I believe that both show a lack of social integration can increase the likelihood of suicide, and active euthanasia by those that lack coping skills, suffer from depression, have mental problems, and no longer value life.
The lack of attachment to society and withdrawal from active participation in social relationships or social positions, which can increase the likelihood of active euthanasia or suicide, includes the following: 1) problems with the family, such as divorce, or the lose of a loved one; 2) interpersonal problems; 3) lack of problem solving; 4) depression; 5) drug and alcohol use; 6) health problems. These problems can influence the thought processes and coping behaviors that can lead to an increased likelihood of suicidal behavior.
Euthanasia is the practice of painlessly ending the lives of people who have incurable, painful, or distressing diseases or handicaps. It may occur when incurably ill people ask their physician–or a friend or relative–to put them to death or to allow them to die. It may also occur when ill people ask others to help them commit suicide. Euthanasia is sometimes called mercy killing. Euthanasia is a very controversial issue. Some people believe patients should have an unqualified right to die. Others consider all forms of euthanasia to be murder or suicide and thus immoral.
Still others approve of some forms of euthanasia and disapprove of others. Medical ethics is the field of study concerned with moral problems created by the practice of modern medicine. Medical ethics is divided into three branches: (1) public policy medical ethics, (2) biomedical ethics, and (3) clinical ethics. Public policy medical ethics deals with issues related to the regulation of medical practice by governments and by the governing boards of such institutions as hospitals and nursing homes. For example, state and federal governments establish spending limits for public health care.
These limits raise ethical questions about the type and extent of medical services available to people who depend on public funds to pay medical bills. Other problems involving public policy include the control of medical research, the question of whether all citizens have a right to health care, and the availability of drugs for severe illnesses, such as AIDS. Biomedical ethics addresses moral questions that arise from the use of medical technology to begin or maintain a life. Many ethical questions focus on medical procedures that affect human reproduction.
These include in vitro fertilization (starting human life in a test tube), the cloning (duplication) of human embryos, and abortion. Another important issue is euthanasia, the practice of painlessly putting to death people who are hopelessly injured or terminally ill. Clinical ethics evaluates the morality of decisions about medical care made by or with patients and their families. Problems of clinical ethics include deciding whether or not to remove life-sustaining treatment, making medical decisions for a severely retarded newborn or an unconscious person, and dealing with requests for euthanasia from patients or their families.
All three branches of medical ethics relate to one another. For example, patients with AIDS are concerned with the availability of newly developed medications (public policy medical ethics), participate in arguments about whether or not physicians are obligated to treat them (biomedical ethics), and make decisions about their care and death with loved ones and physicians (clinical ethics). Euthanasia means mercy killing to some, and natural death without the aid of life extending, or death prolonging medical devices.
It means good death, based on the fact that it ends suffering when the quality of life becomes unbearable. The two main perspectives on euthanasia are those who support the sanctity of life, verses those favoring a quality of life viewpoint. The sanctity of life perspective is imbedded in the Western Judeo-Christian tradition that values life as a right given by God, and that man has no right to play God by deciding who lives and who dies. They oppose abortion, suicide, and euthanasia.
Those supporting a quality of life perespective believe that when life no longer has a quality or meaning due to a terminal illness, or for some a disease like Downs Syndrome see death as preferable to life (Leming, &Dickenson, p. 212-214). Active and passive euthanasia are the two main types of euthanasia that have been debated for decades around the world. Many people oppose active euthanasia, such as the injection of a lethal drug, because it requires one person to deliberately kill another person.
Fewer people oppose passive euthanasia– the withdrawal of life-sustaining medical treatment– for patients who request it. Passive euthanasia involves a situation where a physician goes by a protocol that no action or medical intervention to allow a natural death to be hastened. This type can involve a physician to not use (CPR) cardiopulmonary resuscitation that was introduced in 1960 and is used to save many lives every year. CPR is used routinely by doctors in hospitals without considering the patients chances for survival, or without considering the quality of life the person may live, such as having brain damage.
Those favoring the quality of life perspective oppose any medical devices being used to bring a person back from the edge of death. They think that those who do not want to live if they suffer life threatening injuries, are terminally ill, or in need of life sustaining devices, such as the respirator, should have a right to have their death wish accepted. If the person is unconscious and want to die, they must have a living will that expresses their wish that no extraordinary means by way of life extending medical devices will be used to prolong their suffering.
But what if the persons family is opposed to the patients living will, to the patients death wish, then what should the doctor do. It is clearly left to the discretion of the doctor whether to accept a living will, or a death wish by a patient. All doctors are expected to use ordinary means to preserve the life of a patient by all medicines, treatments, and operations that offer a reasonable hope of benefit for the patient and that can be used without excessive expense, pain, and other inconveniences.
Extraordinary means to preserve life basically means that any treatment, medicines, and operations that cannot be done without excessive expense, pain, or other inconvenience, or that would not offer a reasonable hope of benefit (Leming, & Dickenson. p. 216-7). But the problem with this is that what is extraordinary measures in the past may be ordinary now due the ever changing and advancing technology of the medical profession.
Who decides what the definitions mean, such as reasonable hope, or excessive pain, because persons can disagree on their meaning, with some seeing CPR as an ordinary, cheap, and very effective way to save lives, while others may view it as an excessive, painful, life prolonging technique that is not needed if the quality of the persons life would be unbearable. One problem is that of cultural lag, which results in static definitions of biological life and death being applied to new medical technological advances that change require new definitions to define when a person dies, such as the issue of brain death.
The definition of death will determine if a person is pronounced dead before death has actually occurred. Doctor Paul A. Bryne says that no one should be pronounced dead unless and until there is destruction of at least the major vital systems of the body, i. e. the circulatory and respiratory systems, and the entire brain. He says that that the Uniform Determination of Death Act calls for irreversible cessation of all functions of the entire brain, including the brain stem, but that this is not what is occurring in practice.
He says that the Annals of the New York Academy of Science (ANYAS 9, 313, pg. 65, 1978) found that only 4 percent of the patients in a Collaborative Study would have met the criteria of a dying brain stem, which means that 96% of the patients did not and do not have a dying brain stem. This means that 96% of so-called brain dead patients still have a functioning brain, and this leads to the removal of life support (i. e. passive euthanasia) such as removal of a respirator that causes the heart to stop beating, which leads the patient to become dead.
But once again who defines quality of life, and who does it apply to. Does it only apply to rational adults that consent to euthanasia due to pain and suffering and not due to personal considerations like being a financial burden, depression, or loneliness. Or does it apply to anyone those in power say is unfit to live, such as the mentally ill, the disabled, or children with diseases. The most common method of mercy killing today is withholding food and fluids to those that are usually in a coma or persistent vegetative state, who usually need assistance in feeding.
The person may be on a feeding tube, that when removed will lead to death. It can take several days for a person to die after the removal of fluids. The person suffers cramps, vomiting, emotional disorders, depression and confusion if not in a coma, or if not brain dead. This method is very painful and it should not be called a mercy killing, when the person suffers such great pain to their bodily organs that eventually lead to their death (ORL-Withholding Food and Fluid FAQ).
Active euthanasia requires the direct action of a person, such as a doctor, family member or any person to bring about the death of another person. The two kinds of active euthanasia are suicide, which I discuss later in this article, and mercy killing. The supporters of active euthanasia favor the term self-deliverance when a life of a terminally ill patient is terminated, but can include the mercy killing of a fetus that is know n to have a genetic disease.
They do not favor suicide for those that are clinically depressed or that suffer from psychological pain, and not physical pain. As I will show in this article the research literature shows that most who commit suicide are acting irrational based on psychological problems and an inability to cope with negative stimuli in the persons present environment. Self deliverance is justified as an act of a rational person that seeks a solution to the long term pain and suffering for the individual and their loved ones suffering from a terminal illness.
Self deliverance is said to be a voluntary act by a patient, while mercy killing involves the attitudes and behavior of others and may not be supported by the patient. Derek Humphrys book FINAL EXIT , and the Hemlock society, which is a United states based organization that assist terminally ill persons in the act of self-deliverance favors the rights of individuals to active, rational, and voluntary euthanasia when the dying process offers nothing but pain and a life devoid of dignity or meaning.
They support Oregons Death with Dignity Act that allows lets a terminally ill person that consents to euthanasia to have their wishes carried out by a doctor. The words used in the euthanasia debate, such as extraordinary, hopelessly ill, futile and virtually futile treatment are not legal terms, and are vague, meaningless, and thus dangerous terms that can be used to commit euthanasia against anyone that is ill, or has an accident, or a disease that is viewed negatively by society.
For example some favor prenatal euthanasia, due to the fact that some parents and doctors believe that recognized disabilities of the fetus based on genetic tests is a justifiable reason to commit euthanasia or abortion to end suffering. But a Down syndrome child can still find a loving home and can still live a productive life, even if some may view it negatively based on prejudices against those with disabilities and the view that their lifes must be nothing but suffering and pain. But in reality many diseases can be treated, and many with disabilities can live productive lifes that have meaning and value.
I will discuss the research literature on euthanasia and suicide to look at the various factors that increase the chances of suicide, such as family history, depression, lack of problem solving ability, drug and alcohol use, interpersonal problems, loss of a loved one, and the role of the media. Nicholas Dixon (1998) article says that those who support physician assisted suicide often seek to distinguish it from active euthanasia, but that the two face similar objections. Nicholas says that both do the following: 1) can lead to abuse; 2) implicate the physician in the death of a patient; 3) violate whatever objection there are to killing.
Nicholas says that the case for legalizing active euthanasia is morally indistinguishable from the case for legalizing physician-assisted suicide(p. 25). Active euthanasia is technically illegal throughout the world, except in Australia\’s Northern Territory and in Oregon, USA. In practice, however, it is also permitted in the Netherlands under certain conditions. In the United States, the Supreme Court ruled in 1990 that patients who have clearly made their wishes known have a right to passive euthanasia. People can express their wishes in documents called living wills and by granting durable powers of attorney.
In living wills, people state what kind of care they would prefer if, due to injury or disease, they could not express their wishes. In the granting of durable powers of attorney, people name one or more persons whom they wish to make decisions about their medical care if they should ever lose the ability to communicate such decisions themselves. Mercy killing is performed by doctors in the Netherlands, but doctors are expected to follow strict guidelines established by the Dutch medical profession and sanctioned by the courts.
In order for euthanasia to occur, the following criteria must be met: 1) the choice to die must be a free will decision of the individual and not made under pressure by others; 2) the wish to die can be an enduring one; 3) the person is experiencing unbearable physical and / or emotional pain, and the chance for improvement is not reasonably expected; 4) the individual is not mentally disturbed at the time of the decision to commit suicide; 5) it is carried out in a way that does not cause harm to others; 6) the person assisting in the suicide is a qualified health professional, and only medical doctors can administer the lethal drug; 7) the assisted suicide must be fully documented, and the documents should be made available to the appropriate authorities (Leming & Dickenson, p. 221-2)
This procedure is not technically legal, but the courts in the Netherlands have enacted legal precedents that have made physician assisted suicide some what common since 1972. It is estimated that over 6000 people in Holland commit suicide with medical assistance from doctors. The majority of Hollands AIDS patients end their lives by assisted suicide.
Mercy killing has clearly become socially sanctioned in modern industrial societies. The living will is a document that states the kind of medical care an individual would prefer if, due to injury or disease, the person could not communicate his or her wishes. It also may name treatments the person would not want. Such treatments include restarting the heart, and feeding- -by artificial means– patients who can no longer eat normally. Living wills may come into force when patients are near death or in a coma from which they can never recover. Living wills are useful because, unless told otherwise, many physicians assume their patients want to be kept alive as long as possible.
To be legally valid in the United States, a living will must be written, signed, and witnessed in a manner determined by state law. The document is called a living will because, unlike a regular will, it becomes effective while the person is still alive. Self-induced euthanasia occurs when people end their own lives painlessly. In some cases, physicians provide lethal drugs that their patients then take to kill themselves. This type of euthanasia is called physician-assisted suicide. Only Australia\’s Northern Territory and Oregon in the United States have a law that clearly allows physician-assisted suicide, though the practice is also permitted in the Netherlands. The Netherlands law sanctions euthanasia, but it has been openly practiced since 1991.
In Oregon, USA, physician assisted suicide was first enacted on December 8, 1994, but was deferred through appeals, until it was confirmed by a second referendum on November 22, 1997. On May 25, 1995, the Northern Territory Parliament in Australia passed the Rights of the Terminally Ill Act. It became law on July 1, 1996, making it the first place on the planet to have legalized euthanasia. It was appealed to the Supreme Court in Australia, and was ruled valid, but on September 9, 1996 the Commonwealth Parliament of Australia the Euthanasia Laws Bill 1996, designed to repeal the assisted suicide laws of the regional territories of Australia. The bill passed and took effect on March 25, 1997 giving the Federal Parliament the power to over rule the laws of its Territories, although it cannot over rule state laws.
In the United States in the 1990\’s, Jack Kevorkian, a Michigan doctor, focused national attention on physician-assisted suicide by helping gravely ill people kill themselves. The state or Oregon permits physician assisted suicide. But Kevorkian himself violated the bounds of law when he committed active euthanasia on national television. He was found guilty of second degree murder in March of 1999. However, the issues he raised will continue to be debated for years to come. As of July 1998, assisted suicide is only legal under Oregon states statute. It is criminalized under state common law in Alabama, Idaho, Maryland, Massachusetts, Michigan, Nevada, Ohio, South Carolina, Vermont, and West Virginia.
It is criminalized under state statute in Alaska, Arizona, Arkansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Virginia, Washington, Wisconsin, and the district of Columbia (7. 6. 98, USA Today).. Many people support the concept of physician-assisted suicide. Many of those who oppose the practice argue that doctors should not help people kill themselves, because their job is to preserve life. The US Supreme Court in June of 1997 rejected the right to assisted suicide. They said that their is no protection for euthanasia under the due process clause of the Constitution.
In the decision the court upheld laws in Washington and New York that makes it a crime for doctors to give life ending drugs to mentally competent but terminally ill patients who no longer want to live. The Federal Government opposes funding assisted suicide, as can be seen by the fact that Congress passed and President Clinton signed into law on April 30, 1997 the Assisted Suicide Funding Restriction Act of 1997, that bans the use of Federal funds to pay for assisted suicide, euthanasia, or mercy killing, which would end it as a threat to those on Medicare. This means that Oregon state must pay for any assisted suicide and that Medicare will not cover it.