Final Draft
Jonathon Freeman-Anderson
English: Period 4
February 1, 1999
Euthanasia or Physician Assisted Suicide is a strongly debated subject. Euthanasia delves into moral, ethical, and personal issues, which is where most opposition comes into effect. Many of the people who oppose the right to die issue are the same people who oppose the death penalty and abortion issues. All these issues are life or death oriented. What makes the right to die issue stand out from the others is the fact that death in this instance is not being feared or run away from, but welcomed and gladly received by people with terminable or incurable diseases who are suffering everywhere. Most understandably, little measure if any has been taken to help these poor ailing people. The help has come in the form of a living will, a legal statute giving hospital patients the right to decide whether they want to be put on ventilators if certain circumstances succumb the patient. This living will sounds like a blessing, but the will in many instances is dishonored via legal matters or hospital issues. Some of these problems with the living will issue have cropped up from an ethical issue with doctors. Surprisingly though, there are doctors in the world such as Doctor Kavorkian who admit to helping terminable patients on a personal level commit suicide. These doctors have supposedly been helping patients die before living wills were even a glimmer in some apathetic politicians eye. Oddly enough, even if doctors were practicing euthanasia illegally for years, someone failed to mention the legal acts of death and permission to kill committed during war and law practice which many condole as sad, but understandable. Regardless of how the nonsense of war works, on the home front and abroad the right to die issue is reaching the world. The world is beginning to understand euthanasia through new laws in America and other countries. Whether physician assisted suicide is legalized in Australia or debated in the U.S. Supreme Court, the right to die is a very serious issue dealing with the choice of many people who are in a world of never-ending pain.
Euthanasia has been an issue on people’s minds for a long time. Wondering why should someone suffer, this question was without response for a long time. The right to die issue lasted this way until some people made headlines for helping murder their terminally ill family member. Well, from here an outcry broke out. Protest groups were organized, the issue was on the cover of Time, 60 Minutes did a piece on the issue, and a horrendous tidal wave of internet response took place all because some people finally broke down and took action. After politicians saw the response, an even greater response was taken to reinforce the already written law that euthanasia is illegal. All this activity took place in the early 90s resulting in legal action in 1992 with a law known as the living will statute. This statute gives people the choice to be on life-support if such life-threatening circumstances persist. At first glance, the law is a dream come true for those who want a choice in their existence. The idea of a simple document with one question on whether or not a heroic measure should be taken to preserve the life of a patient is great. However, the broad reference this simple question pertains to takes different approaches by doctors and hospitals around the country. Some experts believe that detailed living wills with exact instructions are a better way to protect your rights, because doctors are more likely to follow specific instructions rather than broad guidelines. Other experts believe that detailed instructions give the doctor the ability to create double-meanings for patients specifications, which the doctor is supposed to respect. Ann Fade, Director of Legal Services at Choice in Dying, a national organization that helps people plan to die according to their values and desires, says A detailed form is clever and simple. However, problematic because the people who create it do not understand the laws that govern medical practice and patients rights. The result is that people are not getting their living wills honored. Instead of using this form, Fade recommends that people consult a physician before documenting preferred treatment under various circumstances. Another law that is in confusion is the right of a proxy or agent to speak for a terminally ill patient in case the person is unable to make decisions about their medical care. Many people do not take this worthwhile right into effect because they feel if worse comes to worse a family member will speak for them. In recent history, many families have split and often gone to court over the choices of an ill family member. Many states have forbidden any related connection to the patients to be a proxy. Patients also believe that if a family member can not be a proxy, end-of-life decisions fall under the decision of a doctor. Yet many patients do not realize doctors are trained to preserve life, regardless of what kind of life that may be. Not to mention, doctors are under the gun of malpractice and, faced with a fatal decision, may be accused of neglect. Proxies and living will statutes fall under a program known as an Advance Directive, which needs to be signed, dated, and witnessed by two unrelated adults for best effectiveness. It would be best to consult a lawyer and a physician to consult to be sure to dissolve unnecessary complications. T. Patrick Hill, Education Director for Choice in Dying, says that, Unless we make our wishes known, life and death become painful and burdensome legal issues for family, friends, and doctors. Yet only 5 to 10 percent of the population has Advance Directives, which express their treatment preferences. This means more of America has little or no knowledge of Advance Directives resulting in more confusion, conflict, and ultimately pain.
Supposedly for years, before assisted suicide and living wills were even an option, a group of actively sympathetic doctors would prescribe and help patients on a personal level end their pain and suffering. Of course, because physician assisted suicide is illegal it would not make sense to be up front about committing the act. Now, though, with these legal ramparts against assisted suicide possibly soon toppled, doctors all over the country can come out of this silent conspiracy. The elite doctors could be as up front about their work as Dr. Jack Kevorkian, which tends to disturb most of these doctors because Kevorkian has been taken to court 36 times, yet 36 times acquitted. If this group of doctors come out of the closet, they could be faced with scrutiny from family members and lawyers. All agree, though, that if medical professionals are going to be held accountable, there must be clear guidelines of what constitutes a terminally ill patient. A good example of physician assisted suicide before its time is the tale of one Dr. Bry Benjamin, now a 71-year old New York internist, who will never forget the first time he helped a patient commit suicide more than a quarter-century ago. Terminally ill with cancer, an elderly couple in terrible agony walked into Dr. Benjamin’s office and asked for a supply of pills just in case. The law was against what the couple asked, but Dr. Benjamin’s conscience said otherwise. In the end, his conscience won out and Dr. Benjamin had to struggle with the ethical dilemma of his decision alone. An obvious personal and unlawful decision to make, Dr. Benjamin’s experience like many other doctor’s possible experiences lead to the whispered seedlings of legal physician assisted suicide from hospital halls to court rooms. Dr. Benjamin says, I get one or two requests a month for help in dying but talk most of my patients out of it. You don’t want to give pills to someone you think decided to commit suicide on Tuesday and on Wednesday would have changed his mind. Looking at physician assisted suicide from a logical stand point aside from personal, the law should have necessary restrictions to keep manic depressant and suicidal mental patients from taking advantage of such a law, if someday a law is passed. In the past 30 days there have been more legal developments in the field of physician assisted suicide than there have been in the previous 20 years, says University of Michigan law professor Yale Kamisar in April 1996. If so, it means the law is finally coming around to what some physicians have been quietly doing all along. In a 1996 survey of Oregon doctors in the New England Journal of Medicine, 60% said they should be able to help some terminal patients die, and 7% admitted to having previously done so. That’s just Oregon, the numbers may be much higher if a survey was taken across the country. Examples of previous experiences of assisted suicide by doctors have been mentioned. However, most noteworthy is that although these doctors have been in secret for so many years, they pushed the envelope to start a chain reaction allowing many other doctors to reveal their secrets of this silent euthanasia conspiracy.
While the medical field involving physician-assisted suicide is making great leaps and bounds, long, long ago another medical field far, far away with an extremely slight connection to euthanasia was formed, eugenics. Despite the similarity of having the same Greek prefix “eu,” euthanasia and eugenics are two quite contrasting topics. According to Random House Webster’s Dictionary 2nd edition, euthanasia means the painless killing of a person or animal suffering from an incurable disease. The definition of eugenics according to Webster’s Dictionary is a science concerned with improving the genetic traits of a breed or species, especially the human species. Now surely if thought about long enough, a scary realization of a great plot for a new science fiction story might be thought of. What if euthanasia became legal and some Hitler-crazed doctor decided to think he had the right to determine that his patients was “terminally” ill just to obtain his very own master race through the science of eugenics. Of course, the possible future claimed above is most unlikely, but the only clear connection between euthanasia and eugenics could be found in eugenics very own history. The notion of eugenics got its start back in 400 BC, when the Greek philosopher Plato proposed that “the best of both sexes ought to be brought together as often as possible, the worst as seldom as possible . . . if our herd is to reach the highest perfection.” However, eugenics was an idea during Plato’s time, eugenics didn’t really have a major impact until Charles Darwin wrote his infamous theories on evolution and natural selection. Darwin’s cousin, Sir Francis Galton, perverted Darwin’s words into the idea of artificial selection. Galton became obsessed with the potential of using artificial selection to create a master race. Like Plato, he proposed arranged marriages between men of distinction and women of wealth to produce a gifted race. This idea carried great favor with the European upper classes, which saw it as justification for their privileged status. Galton spread his fantastic idea without mentioning anything about the idea of killing “lesser quality” humans. By the year, 1905 Galton’s work had become widespread and many nations have jumped on the eugenics bandwagon. According to Galton, a eugenicists main goal is to cleanse the human race by sterilizing the “unfit.” In 1931, 27 states passed sterilization laws in the United States. In 1935, Norway, Sweden, Denmark, Switzerland, and Germany all passed similar laws. Germany’s extreme enforcement of the new laws changed some people’s minds on eugenics as soon as Hitler’s determination to create a “master race” came into focus of the world’s leaders. At first, Hitler practiced positive eugenics; a program designed to increase the population of persons who were regarded as racially pure “Aryans.” Ironically, the United States Birth Control Review “praised the effectiveness of the Germans” in one of their news articles. Then they tried to help Hitler, but when Hitler started his killing rampage they quickly withdrew their help and placed several retractions to their articles. The killing rampage was known as negative eugenics, a program designed first to halt the procreation of persons or categories of persons who did not meet the standards of racial purity through sterilization. Then eventually to kill them and to kill those who were regarded as the racial enemy, the Jews and the gypsies. The history of eugenics is obviously horribly. Nevertheless, what connection does it have to euthanasia? In a secret order issued in September 1939, Adolf Hitler initiated a euthanasia program; accounting for the deaths of perhaps as many as 80,000 people, mostly institutionalized mental patients. The order was simple, direct, and almost sounded humane even for Hitler: Reicheleiter Bouhler and Dr. Brandt, MD, are herewith given full responsibility to enlarge the powers of certain specified doctors so that they can grant those who are by all human standards incurably ill a merciful death, after the most critical assessment possible of their medical condition. As sugarcoated as the order sounded, giving the disabled some civil rights, honestly though Hitler had other intentions in mind. About a quarter of a million hospital bed were needed for Germany’s mental institutions designated for Germany’s seven or eight hundred thousand clinically insane people, about 10% were permanently institutionalized. They occupied bed space and the attention of skilled medical personnel, which Hitler now urgently needed for the treatment of the casualties of his war campaigns. Hitler instructed a Dr. Conti that in view of the war, a program for the painless killing of the incurably insane should be initiated. This would release badly needed hospital beds and nursing facilities for patients with a greater national priority (Irving). From a eugenic standpoint, some believe that those of whom this secret order was directed made up a large portion of those deemed unfit. In cases of genetic defect, mental or physical, the eugenic goals are that they not reproduce, which could have been achieved fully by sterilization or segregation. What eugenic purpose could possibly have been accomplished by putting to death institutionalized patients who had no chance of breeding whatsoever? Therefore, in this essence, the motive behind Hitler’s euthanasia was practical, not eugenic. Hitler’s dreadful acts of eugenics based off Darwin’s theories of natural selection are regarded as containing full and unbridled prejudice for Hitler’s motives. In many forms of human eugenic studies, the perfection of the human race is the goal, but in the process whether color, religion, disabled, or just that their may be some “unfit” qualities in a person, discrimination in one form or another always results. If a person is felt to be dissatisfactory and unnecessarily different by society, the person should be put to death. A good example is found in the Holy Bible, Luke 23,
“We found this fellow perverting the nation, and forbidding to pay taxes to Caesar, saying that he himself is Christ, a King.’ So Pontius Pilate said to the chief priests and the crowd, ‘I find no fault in this Man.’ But they were more fierce, saying, ‘He stirs up the people, teaching throughout all Judea, beginning from Galilee to this place.’ Pilate, when he had called together the chief priests, the rulers, and the people said, ‘You have brought this Man to me, as one who misleads the people. And indeed, having examined Him in your presence, I have found no fault in this Man concerning those things of which you accuse Him; I will therefore chastise Him and release Him’they all cried out at once, ‘Away with this manCrucify Him, crucify Him!’ Pilate responded, ‘Why, what evil has He done? I have found no reason for death n Him. I will therefore chastise Him and let Him go.’ But they were insistent, demanding with loud voices that he be crucified. And the voices of these men and of the chief priests prevailed. So Pilate gave sentence that it should be as they requested and he delivered Jesus to their will.”
However, one may interpret the Bible is their choice. Clearly though, eugenics is the weakening of one power for the advance of another. Darwin’s theory of natural selection coined the phrase “survival of the fittest,” referring to the natural evolution of nature. Hitler defined eugenics by the destruction of one race for the advancement of a “master race.” Although after Jesus Christ’s death, Christianity prevailed, his death was based off the same prejudice behind Hitler’s mass genocide of races. As previously explained, the comparison between euthanasia and eugenics is so far-fetched in probability, except in Hitler’s case, that it is like comparing euthanasia to war. Death is the outcome of both, but people choose to go to war even with the knowledge of possible death. The possibility of a eugenic-crazed doctor with euthanasia as an excuse scares most pro-euthanasia doctors if euthanasia were to be legalized. That is why almost all pro-euthanasia organizations, doctors, and followers agree that restrictions to prevent eugenics from becoming a legal euthanasia side-effect should be written into any law related to physician-assisted suicide. There are still eugenics organizations around today, but today’s eugenics goals are for a superior agriculture, the containment of STD’s, and prevention of teen pregnancy.
Although eugenics is on the backburner of many pro-euthanasia politicians minds, there are still many neighboring countries, states, and courthouses writing laws striving desperately to legalize the right to die. The people writing these laws are on a quest to ease many people’s suffering. A 1994 Oregon law allows doctors to help terminally ill patients commit suicide by drug overdose. Oregon set a precedent in America as being the first state to legalize assisted suicide. The new law takes a great stride towards possibly legalizing assisted suicide across the country. The Oregon law though still has strict standards that limit the true effect of the law; one of those requiring Oregon citizenship to be eligible for treatment. Understandably and unfortunately, with such a sensitive issue as assisted suicide this type of restriction is necessary so that Oregon does not become a safe haven for the ill around the country. Standards such as being an Oregon citizen may convince other states that a euthanasia law could be controlled without a swarm of complications attached to the law. Not to mention, considering the Oregon law was passed by the signing of an initiative, right to die activists in other states may follow the same trend. Oregon passed the assisted suicide bill with 20,000 more than the needed signatures and over a million dollars in donations toward the campaign of the bill. Oregon physicians have not expressed their feeling about this new power, or how many might be willing to use it. However, a survey of Oregons neighboring state of Washington’s doctors in the New England Journal of Medicine in July 1994, found that 53 % of Washington doctors believed assisted suicide should be legal under certain circumstances. Forty percent said they would be willing to help a patient end his life. Oregon has given a prototype example for other states to follow in the right to die issue and hopefully Oregons small step of bettering human rights will lead to America making one giant leap for all of mankind’s unnecessary suffering. Oregon is not the only state listening to its ill. New Yorks Second Circuit Court of Appeals struck down a state law that prohibited doctors from helping their patients die. This law allows doctors, if they decide to do so, prescribe a lethal dose of medicine to a mentally competent patient in the final stages of a terminal disease. The fact states are just beginning to hear the agony of the sick and ill seems odd, but at least they are finally opening their eyes to something that has been going on since mans beginning, needless torment. In all of the cases judges make the final ruling of the law and Senior Judge Joseph Davis ruling is no different. On February 1, 1997, the Judge declared that Dr. Cecil McIver could administer a lethal dose of drugs to AIDS patient, Charles Hall, without prosecution. Of course, the decision was appealed, but if an appeal were approved, Charles Hall would have hopefully already been laid to rest. Many people supported Judge Daviss decision throughout Florida, so hopefully from the Judges decision, the Sunshine State will be the next to pass a law legalizing Physician Assisted Suicide. The fear of death is a motive for much opposition to these laws in America. Many Americans have a need to understand death and, curiously, these same Americans would like to know they have the freedom to choose death if certain physical conditions incapacitate them. America is not the only country making news in the right to die issue. The legislature of Australias Northern Territory became the first in the world to pass a voluntary euthanasia law in 1996. Terminally ill Australian citizen Bob Dent was the first person to kill himself legally under the world’s only voluntary euthanasia law. In an open letter written before Dent died, he said If you disagree with voluntary euthanasia, don’t use it, but please don’t deny me the right to use it if I want to. Mr. Dent shares the feelings of spouses, children, parents, brothers, sisters, and family members around the world that wish to stop their loved one’s distress. The laws written by the people of Oregon, New York, Australia, and Florida are good guidelines to use if the rest of the world someday intends to follow in example. The laws written wouldn’t eventually lead to murder if the murderer has accurate reasoning or the laws wont try to harass terminal patients by choking the life out of them slowly with too many restrictions. Instead, moderation between the two extremes to let patients go as peacefully and as dignified as possible is how the sympathetic wrote the laws.
People die unnecessarily every day and many never get to say goodbye or have a choice to die. The right to die, if legal, would make at least one of those people die with dignity, respect, and in peace. Dying in the presence of loved ones and having said goodbye, that one person has a choice to die using that choice without remorse.
Bibliography
1. Spencer, Geoff; “First Assisted Suicide Re-ignites Australia’s Euthanasia Debate,” Wichita Eagle, Sept. 29, 1996
2. Henry III, William A.; “do-it-yourself Death Lessons,” Time, Aug. 19, 1991
3. Stith-Coleman, Irene; “The Right to Die: Medical and Ethical Aspects,” CRS Review, Sept./Oct. 1990
4. McIntyre, Russell C.; Comment: Perspective on Medical ethics;” Infotrends: Medicine, Law, & Ethics, Spring 1989
5. Brown, David; “Medical Community Still Divided on Oregon’s Assisted Suicide Law,” Washington Post Nov. 13, 1994; p.A20
6. Lemonick, Michael D.; “Defining the Right to Die,” Time April 15, 1996, p:82
7. Taxel, Laura; “Defending Your Right to Die” Natural Health May/June 1994, Pg. 50+
8. Podolsky, Doug; “A Right-to-Die Reminder,” U.S. News & World Report Dec. 2, 1991, p.74
9. Hiaasen, Scott; “AIDS Patient Has Right to Die with Doctor’s Help, Judge Rules,” Palm Beach Post Feb. 1, 1997, pg. 1A+
10. Rosellini, Lynn; “The Final Struggle of Jamie Butcher,” U.S. News & World Report Nov. 7, 1994, pg. 67+
11. Jenish, D’Arcy; “Live and Let Die,” Maclean’s (Toronto Canada), Feb. 28. 1994 pg. 26-27
