Each member in society is equipped with specific roles which are tied with carrying out certain responsibilities. A teacher is in charge of educating the society’s children, preparing them to be future leaders. In the same way, medical professionals, especially nurse practitioners, are assigned roles to take care of the ill, elderly and lost, healing them physically and emotionally through medicine and counseling. During their careers, medical personnel are faced with numerous difficult decisions, ones that require moral and ethical judgment. All views and beliefs one has are greatly challenged by situations in which one cannot reference the graduate books or professors. At these times, the right answer depends on the ethical belief system of an individual and his or her clear understanding of the particular issue. Euthanasia, also known as voluntary or assisted suicide, is used for terminally ill patients to end their lives instead of undergoing painful treatments and torment of waiting for death.
The Euthanasia procedure requires a doctor and nurse’s help in administrating the proper method, which is using a lethal injection to end a patient’s life, with their complete consent. The official definition of Euthanasia is: “The act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment” (American Heritage). Even though there are split opinions in the medical and legal realms, Euthanasia is a noble practice which needs to be legalized and morally accepted by medical professionals before others can accept it. No one realizes the importance of Euthanasia for terminally ill persons more than doctors and nurses, who develop personalized relationships with patients, and who understand the pain and suffering they are going through. The pain and suffering are unnecessary and if patients require the freedom from their critical conditions, they should be encouraged and supported. This paper will explore conflicting positions on the moral responsibility of nurses and doctors to conduct Euthanasia on willing patients.
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Life, liberty and pursuit of happiness are fundamental rights given to people, which others can only take away by force, in which case it would be murder or oppression. The right to die should not be viewed any differently, especially in dire medical circumstances. When a patient willingly wants to end his or her life and suffering, no one else will be affected as much as the patient. Professional nurse practitioners know very well that not everyone can handle pain to identical levels, as each person has varying tolerance levels. This includes both physical and mental distress. Furthermore, nurses also realize that the best judge of pain tolerance is no other than the patient, who is the best moral judge to make the final decision, which needs to be respected and obeyed by doctors as they have the moral duty to keep their patients happy and comfortable. The ethical focus here is on autonomy, allowing the patient to have the final say (Beauchamp, 2009). Nurses who are active administrators of the assisted suicide process stress the moral responsibility they have for the patient which has “to do with quality of life and respect for autonomy” (Berghs, 2005).
Furthermore, terminally ill people have dim futures, which will keep dragging them into depressive and painful realms. The famous rugby player, Daniel James, permanently damaged his spine during a game, making him paralyzed. Instead of looking into his grim future, he decided to end his life and keep the great memories with him, instead of making horrid new memories of living a paralyzed life. He could not deal with the new dependency and that was his moral choice. Terminally sick patients must see themselves slowly and miserably deteriorate in health, with each organ failing, losing hair, getting physically unpleasing, and experiencing mood swings (Smart, 2008). These symptoms will ultimately affect their minds, making them delirious and unstable. In other words, the patients need Euthanasia to leave this world with dignity and high self-esteem. Refusing assisted suicide will only lead to more Sue Rodriguezs. Sue Rodriguez’s request to end her life with a doctor’s help was considered unethical and refused in court. She knew that because of Lou Gehrig’s disease, her muscles and bones would stop working and simply go to waste and that she would choke herself to death. However, she was not given that dignity she wished to die with (Docker, 2000).
Dying with dignity is essential to terminally ill patients who opt for Euthanasia. Deborah Annets states, “We get so many calls from terminally ill people saying, 'please just let me die with dignity' and we are committed to making this a reality.” Annets is the chairperson of the Voluntary Euthanasia Society, now known as Dying with Dignity, an organization that aims to carry out doctors’ moral duties towards their sick dependents. Research conducted by the group showed that more than 80% of public citizens agree with them when it comes to dignity-that it is completely a personal matter and one should have the right to receive it at one’s deathbed (Annets, 2006). In fact, polls from 1990 showed that “66% of the people polled believed that it was acceptable to end their own life when recovery was not expected” (San Filippo, 1992).
As for opponents who compare Euthanasia to suicide, they are greatly misinformed. Suicide is carried out in secret, and is a pathetic and cowardly way to face one’s problems or ask for help. When one person commits suicide, his or her family members and friends are completely devastated, often left with unanswered questions as to what went wrong. Euthanasia, on the other hand, is morally dignified and allows families to become closer towards a life’s end. There are concrete steps that nurses and doctors go through in the entire process, and the families play active roles throughout. In fact, along with bonding closer to each other, family members might even be able to dissuade the patient from carrying out the assisted suicide and spend more family time together. The important moral result is that there are no loose ends, people receive satisfying and honest reasons about a family member’s death and are able to engage in open communication before death (Humphry, 2005).
Theodore Roosevelt states, “Justice consists not in being neutral between right and wrong, but in finding out the right and upholding it, wherever found, against the wrong” (Lawrence). Unfortunately, the legal systems today do not always carry out justice based on morality, many times making a clear distinction between the two. There are few places, four to be exact, in the world where Euthanasia is legal: the State of Oregon, Belgium, Switzerland and the Netherlands. In fact, many countries including the United States, Hungary, and Russia punish doctors and nurses who carry out the moral obligation of helping their ill patients. An increasing number of medical professionals desire to see legal changes; according to a recent survey, more than 46% doctors are encouraging changes in the law (Humphrey, 2005).
Supporters of legalizing Euthanasia point to the principle of nonmaleficence, which states that in order for society to be considered just and fair, it must have strong moral foundations, especially in the medical field. This theory states that people, specifically doctors and nurses, have specific ethical obligations towards human beings and their main goal should be to keep the patients safe, happy and away from pain, whenever possible (Beauchamp, 2009). The principle of nonmaleficence strongly supports Euthanasia, as it is an honorable act with the sole intention of benefiting another human life. Critics will point out that one of the basic tenants of the nonmaleficence theory is that killing is prohibited; however, the principle also has a sub-component known as the double effect. This clause promotes understanding the moral good that can come out of something seemingly negative, especially if the positive result will free one from pain and torment. “Deciding what is bene%uFB01cial overall to the patient and what constitutes harm can be fraught with dif%uFB01culty, particularly with regard to end- of-life decisions such as withholding or withdrawing treatment.” Doctors who fear legal punishment, yet believe it is their moral duty to conduct Euthanasia, often cite the double effect clause to relieve the patient’s suffering and avoid court punishment. In order for this to happen, the doctors and nurses use medicine that shortens a terminally ill patient’s life, but the focus is on relieving symptoms and pain; the quickened death is a secondary result (San Filippo, 1992).
In her article, Guilty but Good: Defending Voluntary Euthanasia from a Virtue Perspective, Ann Marie Begley states, “the wrongdoer was perceived as a hero in adversity while the nurse who reported a crime was cast as villain” (Sellman, 2008). There is sarcasm in her claim as she is stating that the true heroes are the doctors and nurses who help their patients. They are the ones that should be morally applauded as opposed to receiving accusations from the patient’s family and being punished by the legal courts. Nurses and doctors are so heavily obligated by their moral duties towards a patient that despite being illegal, Euthanasia still takes place in secret. Most notably, Dr. Death or Jack Kevorkian aided hundreds of patients in ending their suffering. Humphrey applauds Dr. Kevorkian’s honorable campaign in his book, Final Exit, pointing out that the doctor fully carried out his ethical duty, despite the corrupt justice system (Humphrey, 2005).
In order to fully comprehend the ethical duty of nurses and doctors to carry out assisted suicide, it is important to know what the opposing sides are saying as well. The main argument posed is that when medical professionals engage in Euthanasia, they are depriving their patients of the complete decision making process. This means that once a person dies, he or she cannot make any more choices nor have the chance to change his or her mind; therefore, doctors and nurses should never accept the patients’ requests for ending their life. Moreover, the main reason terminally ill individuals hope for death is because they are constantly wrapped and suffocated by depression, and depression is most definitely a curable condition. According to the opponents, medical teams need to focus on relieving depression symptoms instead of jumping to Euthanasia. Medical personnel who believe Euthanasia is immoral do so because they believe that depriving patients of future choices is highly unethical and will make them regret their involvement (Hendin, 1998).
Furthermore, palliative care today is extremely successful and flexible, being able to customize to individual patient needs and requirements. Euthanasia condoners’ main goal is to keep life going for as long as possible, and the quality of life should no longer be the central concern as modern medical care relieves pain until death. Even though terminally ill patients are greeted with dark futures, Euthanasia opponents argue that the focus needs to shift from a complete alternative, which encourages running away from problems, to helping deal with that problem. From medicines to therapy, the palliative care options are unlimited and improving with each day as scientists and therapists continue to make ground-breaking discoveries. Ethically, society needs to encourage doctors to help patients via counseling and teach them to accept their fate (Docker, 2000).
In regards to family members supporting a person’s choice for assisted suicide, doctors act insensitively and unethically when they drag an entire household into watching a patient die and asking them to bid farewell with smiling faces. These families are heavily burdened emotionally, affecting their futures forever. In contrast to what the supporters of assisted suicide believe, not all patients are close to their families; in fact, there are many cases in which the patient has been pressured to ask for Euthanasia because the family and support system was not available. An ethical and moral doctor would never allow a patient to die simply because he or she wanted to escape having to deal with their terminal sickness alone. Patients who are blessed with families must not be allowed to drag them into the painful and immoral process of killing them (Berghs, 2005).
Those who commit suicide and those who ask for Euthanasia are not very different from each other. In fact, Euthanasia is nothing more than a systematic suicide designed to let someone take their life painlessly and without guilt. Just as those who commit suicide are blamed for being cowards, terminally ill patients who opt for assisted suicide are no different as they have given up the will to live and carry out their last moments bravely. As for the doctors and all members of society, it is their moral duty to stop anyone who is planning to commit suicide, whether through medicated injections or by violent means such as wrist cutting or hanging. The example most opponents of Euthanasia provide is that of a man who is ready to jump off a cliff. Those standing close to him would most likely persuade him to change his mind, and those who stand by watching are guilty bystanders (Sellman, 2008).
Finally, doctors and nurses are not supposed to play God and confuse their legal, medical and most importantly ethical obligations and roles. Every medical professional is guided with the golden rule of not hurting anyone and taking all possible measures for preserving human life. When doctors or nurses start helping patients die, they are not only breaking their professional codes, but they are greatly confusing their obligations and losing trust from society. The current legal rulings on Euthanasia are wise and should not be changed. If Euthanasia is to be legalized, doctors and nurses would face the greatest troubles.
While it is true that major ethical principles can be identified in the way nurses form their arguments, they are not always used in the same way—that is, to mean the same thing. The principle of respect for autonomy—for example, was described as: the right of the patient to decide; the patient’s own request; patient autonomy,and self-determination (Berghs, 2005).
As stated above, each nurse (as with every human being) has his or her personal views on what is moral and immoral. The line between deciding which patients truly desire escape from suffering and those who are undergoing depressive episodes becomes heavily blurred, making it impossible to make the correct choice. “Nurses claimed not to know how abstract principles could be of help in clinical practice. Some explained that attitudes toward euthanasia involved “shades of grey” (Berghs, 2005). Moreover, killing a patient simply does not go along with a doctor’s purpose in life.
If legalized, the Euthanasia medication will be greatly abused over time as are all other drugs, since it will be widely available. It is already abused by doctors as it is simply an injection. What is more, a wider audience will ask for the service as opposed to only terminally ill individuals. There is no doubt that soon voluntary assisted suicide will turn into indirect involuntary practices. For example, different nurses and doctors will have varying requests for their services to end lives and not all of these requests will be from terminally ill people. Moreover, there will be nurses who might make exceptions, as their judgment will be affected through wide use of the injection. People will start to justify their actions and play favorites by helping anyone they believe deserves to escape any kind of pain. Before long, the elderly, depressed people and suicidal teens will opt for Euthanasia instead of counseling and care, and the doctors will benefit economically by charging fees (Hendin, 1998).
All in all, the ethical responsibility of the professional nurse and doctor in regards to the Euthanasia debate is clear: these professionals not only have a duty to fulfill their patients’ wishes, but they are morally responsible for carrying them out. Terminally ill patients are entitled to dying with utmost dignity and should not have to suffer painful experiences both on physical and mental levels. There are two key reasons why health care professionals must encourage morally and lawfully legalization of Euthanasia. Firstly, patients deserve the right to choose between a miserable and dignified death. Annets states, “Patients often ask whether they will have dignity in dying because they are frightened, feel abandoned, are worried they might be left incontinent, confused or in another state that will undermine their personal dignity” (2006). Secondly, according to the nonmaleficence theory, doctors and nurses have the duty to choose the best possible care for any human being, even if it means that their benefit lies in death. There will always be obstacles in doing great and noble actions; the same is true with assisted suicide. There is great work to be done at the legal level for authorizing Euthanasia, and the only way to reach reform is for nurses and doctors to fully understand and accept their ethical responsibilities. Once the basic bioethical foundation is understood and practiced, medical practitioners may move on to comfortably and clearly seeing the boundary lines between not just this issue, but all moral dilemmas (Beauchamp, 2009).