Example Of Moral Reasoning And Ethics Essay
Moral reasoning and ethics
The world today is focused on convenience and fast service. The communication systems have advanced significantly to send and receive messages in seconds or less. Shopping has become an indoor activity with rich rewards. Life is moving at extensive pace with little patience in the age of the internet. However, some factors haven’t changed. Discovering cures for diseases that threaten our senior citizens, namely senility or Alzheimer’s have remained a slow process. The medical community and the pharmaceutical industry still struggle to progress even at a reasonable pace. The question before us today is whether or not voluntary euthanasia should be permitted. Our present generation would have no hesitation in ceding to it; after all, these diseases take away memories, competencies and render the patient a mere pawn waiting for death.
What does the medical community feel about this subject? What does the law say? How do we implement such a practice even if it were deemed admissible? Is it morally the right thing to do? Is it ethical for the medical fraternity to cede to this practice whenever a patient feels excessive pain or is diagnosed with Alzheimer’s? This paper evaluates the various aspects of voluntary euthanasia. Subsequently, the boundary between moral absolutes and professional ethics hold the key to the answer.
Morals and Ethics in the Medical Profession
The first lesson that a doctor learns at medical school is in not harming patients. A medical practitioner has the ability and knowledge to improve the condition of patients. The practitioner always focuses on improvement and seldom gives up hope. There is no room in the medical profession for abandoning treatment, which might ease the pain to favor harming the patient and expedite death.
At the height of the second outbreak of bubonic plague (or black plague) in Europe, physicians were battling the disease in any way they could. Although, in the 1400s the political scenario might have allowed voluntary euthanasia, there was no doctor advocating it. They were all fighting desperately to keep their patients alive.
The medical fraternity has progressed significantly from avoiding transference in emotions to a compassionate community. There is always the chance of doctors yielding to pressure from their patients to end their lives. There were a few cases across the United States and the UK where the doctors were acquitted of murder for assisting patient suicides. Yet the numbers are on the rise despite bound by their sacred oath to do no harm.
What is voluntary euthanasia?
Voluntary euthanasia is the term used for patient suicide or medically assisted suicide. The practice is legal in certain parts of Europe; whereby an individual suffering pain from an incurable disease is allowed to commit suicide with the help of a physician. The practice is widely compared with Ubasuten (Feudal Japanese custom in which the elderly people sacrifice themselves or are abandoned to die of starvation) by those who oppose it. However, unlike Ubasuten, the patient requesting voluntary euthanasia should consent. The patient is also required to be of sound mind.
There are cases however where the patient is in a coma or too young to decide (an infant). In these cases their families step in to decide. Although this is equivalent to murder; since the patient might still want to live, this practice is also rampant. This practice is known as non-voluntary euthanasia (BBC, 2014).
According to Cathleen Kaveny, the term euthanasia means that one individual decides to end the life of another individual on the pretext of ending pain or suffering. In some cases, the course of action merits the morals of the individuals involved. For example, shutting down the life support for a parent who cannot be revived ends the suffering and allows family members closure (Kaveny, 1997).
There have been quite a few lawsuits across the globe where patients pleaded with the officers of the judicial system to uphold their desire. However, suicide is predominantly a crime that is punishable by law in most of those countries.
Should voluntary euthanasia be accepted?
The primary obstacle for voluntary euthanasia is the fear of misuse. There are several poisons that cannot be traced in a normal blood test conducted by hospitals or clinics. Thallium for instance can cause severe abdominal pain and yet not show in a routine medical test. If someone wanted to commit the perfect murder of a spouse or sibling, all they would have to do is use thallium and then convince the victim that voluntary euthanasia as a way out as there was no responsive treatment available.
Moreover it is a controversial topic. The intent to end human life is not for another individual to decide; especially with one who is expected to do the opposite. Doctors assisting suicide cannot be accepted into widespread practice owing to legal formalities and professional ethics of the medical profession.
What are the consequences of accepting voluntary euthanasia into hospitals?
There are several adverse consequences of making voluntary euthanasia a regular hospital practice. Medical services are increasingly costlier for the average American citizen. The acceptance of physician assisted suicide could prop the numbers significantly on both sides. Physicians may be tempted to encourage voluntary euthanasia for moving incurable patients out of their clinic roster. Citizens on the other hand might take matters into their own hands and commit suicide in staggering numbers for want of affordable quality medical services.
The prospect of discovering cures for deadly diseases such as cancer, AIDS, Alzheimer’s, etc. will drastically reduce due to acceptance of voluntary euthanasia. All the important cures in the history of humankind draw to an incurable disease. Eventually we obtained penicillin and saved the lives of thousands of American soldiers returning home from the great wars. If patients take the shorter route of physician assisted suicide, researchers will not have the necessary push to work towards a possible cure.
Cases of illegal practitioners
The case of Philip Haig Nitschke, the founder of Exit International indicates the deep emotional bond that the doctor shared with his patients; in particular, with Nigel Brayley. Nigel Brayley had killed at least three women and decided to end his life rather than face long term imprisonment. Nitschke supplied the suicide drug to Brayley and this act cost Nitschke his practitioner's license.
Jacob "Jack" Kevorkian was sentenced to a 10 to 15 year jail term in 1999 for assisting the suicide of a patient. He served 8 years of the prison term and was released in 2007 under the condition that he never encourages or propagate voluntary euthanasia.
In 1992 Dr Cox defied the law and administered a potassium chloride injection to one of his elderly patients. The patient had persisted with Dr Cox for an assisted suicide for months before the doctor relented and gave in. He was given a suspended sentence.
Tourism in a handful of nations catered to a new respite in Suicide Tourism. This term is derived from people visiting these countries to end their lives. In most countries around the world, voluntary euthanasia is criminalized. Hence, some countries that have legalized this practice have been targeted (USA, Today 2006).
Mexico, Switzerland, Belgium, Netherlands, Cambodia and the United Kingdom are popular suicide tourism countries. In particular, over 96% of all deaths were caused by doctors in 1999.
Eternal law theory or Natural law theory – against Voluntary Euthanasia
The eternal law or natural law convenes all those behavior that are deemed naturally right. There is however, a distinction between natural right and what is right by nature. There have been several interpretations for these terms. Let’s consider the most important interpretations from intellectual giants.
Plato describes the natural law conforms to the universe being orderly; with orderly interpreted as the form of good. Plato also believed that the form of good to be the cause of all things and the source of wisdom to humankind.
Aristotle called the father of natural law. He refers to it as a paradox than something in actual existence; in his treatise on the art of persuasion, which each nation set up laws for themselves apart from nature (common law). He also refers to Sophocles and Empedocles; calls the natural law as the Universal law. However, this interpretation is disputed by critics who state that Aristotle merely advocated that individuals could always look to the natural law if the law of the respective state or city was not going to support their stand.
Thomas Hobbes describes nineteen laws of the natural law in his book, the leviathan. They are,
First Law: Live in peace and try to attain peaceful co-existence even through war.
Second Law: Do not enslave others unless it threatens your own freedom.
Third Law: Honor all the agreements or contracts that were made and maintain peace.
Fourth Law: Express gratitude towards those who help you.
Fifth Law: Exhibit willingness to be accommodative and polite to maintain peace.
Sixth Law: Forgive the wrongdoings of others when they repent of it.
Seventh Law: Do not seek revenge.
Eighth Law: Refrain from hate propaganda.
Ninth Law: Practice equality.
Tenth Law: Non conformance to laws of the land that keep the peace should be adhered to without question.
Eleventh Law: Individuals appointed to the position of judging others must act impartially.
Twelfth Law: What cannot be divided should be shared equally and what can be divided should be provisioned with an equal share for all.
Thirteenth Law: The first time ownership of anything cannot be divided or shared in common. It should be determined by lottery.
Fourteenth Law: The items or property that cannot be divided or shared should belong to the first person who takes possession of it or to the one who inherits it.
Fifteenth Law: All those who intend to negotiate peace should receive a safe conduct.
Sixteenth Law: When there is a lot of disagreement, the matter should be left to the judgment of an arbitrator.
Seventeenth Law: No one can assume the role of an arbitrator if they are involved in the case.
Eighteenth Law: No one should stay on as a Judge while acting partially.
Nineteenth Law: Judges should admit testimony that is backed by evidence if one of the parties testifies. In the case of no relevant evidence to support the claim, the judge should look for other witnesses.
The United States Declaration of Independence states that citizens should assume laws of nature and laws of nature’s God. Clearly, the laws of the United States are grounded on common laws that ultimately rest on natural law. Moreover, United Kingdom also formulated their laws and constitution based on the natural law and not natural right.
The natural law decrees that suicide of any form is divergent to its morals. The natural passing of life is accepted while the unnatural death caused by self or others is outlawed. That is the reason we have laws against manslaughter and murder. Moreover, the very intent to do harm has been outlawed by the laws written down by our founding fathers.
We cannot argue that our founding fathers or the earliest law enforcers did not suffer pain. In fact much of the pain killer drugs and life saving medicines including penicillin were discovered long after the laws were written. The natural law does not justify voluntary euthanasia as a means to end life for the sake of pain, disability or depression (Hobbes, 1651).
Distributive justice theory – against Voluntary Euthanasia
The distributive justice theory relates to the wealth sharing and payment of labor within a select group of people. It binds society equally responsible for each other’s welfare. It professes that the richer section of society is responsible to look to the needs of the poor and weaker section of society. It advocates equality among all humans and it binds all of society to the law of the land.
According to Forsyth in Group Dynamics, there are five norms. They are,
Equity: This norm addresses the share of those who invest their extensive quantities of money, effort or time. According to this norm, the payout for the investors should be higher than that of others.
Equality: All members of the team should receive an equal portion of the profit as a share regardless of their contribution.
Power: Group members who hold positions of power should be paid more than lower level positions.
Need: Group members, whose needs are far greater than that of others should receive a larger portion of the profits to meet those needs. This payout should not be based on their input.
Responsibility: Group members with abundant resources should help out those members who have limited resources.
This theory also advocates human rights through its norms. It propagates the message of people of any society to be sensitive to those in need and assisting them effectively. Several governments around the world use the norms of distributive justice to work out racial and ethnic issues. A good example would be South Africa; they have implemented distributive justice in the revamp of land and livestock allocation.
There is no room for assisting suicide or voluntary euthanasia under the tenets of this theory either. There might be misinterpretations of the norm of need; under which the people in dire need should have their requirements met by those who are able. This doesn’t promote any ground for voluntary euthanasia since the norm specifies that the needs should be met. It promotes that the medical community provide it’s best possible treatment to the patient in suffering or perhaps research a new drug/procedure (Konow, 2003). This norm does not support physician assisted suicide.
Furthermore, suicide represents a divide in terms of parting with the society that holding on to only an individual’s intention to end existence. It is divergent of the idea of a binding society.
Personal liberty theory – against Voluntary Euthanasia
The personal liberty is probably the most misrepresented ethics theory of all time. According to this theory, humans should analyze their choices based on the moral rights and wrongs according to society. This choice, although made by the individual would be influenced by the limitations bestowed by societal laws. Hence, this theory is more inclined towards negative liberty.
Unfortunately, humans today interpret this theory as per their instinct than by rationalization. Instinct by itself does not examine consequence; more like how a tiger hunts in the wild. The animal is focused on the game and does not calculate the risks involved in the actual hunting process.
Furthermore, in the case of voluntary euthanasia, the patient responds like the tiger; the instinct says, “Let’s get it over with”. The patient acts immediately and contacts the physician. There is no thought given to the consequences. The doctor could lose everything including the license to practice medicine or worse; face the law for manslaughter or murder in the second degree.
This theory is often quoted out of context in the Courts of Law during vain attempts of procuring a favorable ruling in voluntary euthanasia. The common interpretation of this theory is “do as you please”; hence, its representation in court.
However, personal liberty is defined as “Doing as one pleases while conforming to the law and the moral codes of the society to which one belongs”. This is also the reason why so many lawsuits filed by patients are thrown out. The constitutional right of a citizen holds valid only as long as that individual conforms to the laws of the land.
The law of the land has outlawed suicide and has gone a step further to punish those who abet suicide. How can the courts of law ignore this aspect of the constitution and only focus on what the citizen is entitled to? Personal liberty does not offer a license to either kill someone or to commit the act by self (Locke, 1689). There is a lot of compassion towards patients who suffer daily without the hope of an actual cure; cancer, Alzheimer’s, blood disorders, heart problems, etc. The doctors who work with them know the extent of the pain that they endure; they are perhaps the only ones who will ever know that. Although there might be a genuine desire to end the pain and suffering for the patient, doctors cannot indulge in voluntary euthanasia.
Their personal liberties do not allow such indulgences since doctors are also subject to the law. They are morally responsible to improve the quality of life for terminally ill patients. This does not include killing them.
Pros and cons of voluntary euthanasia
The following are the pros of voluntary euthanasia.
The right to end suffering and enormous quantities of medication.
Allowing patients suffering from Alzheimer’s type diseases to die with dignity.
Reduction on healthcare spending.
Reduction in healthcare budgets especially in research and development.
The following are the cons of voluntary euthanasia.
Increased suicide rates among the economically backward part of society.
Misuse of practice to commit murder.
Tendency not to attempt treatment although there might be a slim chance of recovery.
Creating false morals of killing senior citizens with deadly ailments.
Crawford W. Long, Maurice Hilleman, Frederick Banting, Alexander Fleming, Edward Jenner, Dr. Joseph Murray are the legends of medicine. Yet it was compassion and the desire to help their patients/suffering patients that led these men to compile the most important discoveries in the field of medicine. They chose to preserve life by coming up with new procedures to help those in pain.
The professional ethics of doctors have to align with their reason for enrolling in medical school. However, there are situations that defy normal circumstances. The side effects to certain drugs can cause anarchy within the body.
The practice should be the absolute last resort and not the speed of the internet age coming to effect. Human life can never be revived once put down. The power to take a life should never rest in the hands of an individual.
BBC Staff (2014). Ethics Guide. Retrieved from: http://www.bbc.co.uk/ethics/guide/.
Cathleen Kaveny (1997). Assisted Suicide, Euthanasia, and the Law. Theological Studies.
Calla Wahlquist (2014). Dr Philip Nitschke suspended from practice over allegations he helped Perth man Nigel Brayley commit suicide. Retrieved from: http://www.perthnow.com.au/news/western-australia/dr-philip-nitschke-suspended-from-practice-over-allegations-he-helped-perth-man-nigel-brayley-commit-suicide/story-fnhocxo3-1227000004448?nk=5637ef80855eb87b678b6ea3f959ebdfKevorkian, Jack (1960). Medical Research and the Death Penalty: A Dialogue. Vantage Books.
USA Today Staff (2006). Suicide Tourism Sites Website shutdown. Retrieved from: http://usatoday30.usatoday.com/travel/news/2005-11-04-suicide-tourism_x.htm
Cassam, Quassim (2015). When should voluntary euthanasia not be an option? Retrieved from: http://www.theguardian.com/commentisfree/2015/jan/06/voluntary-euthanasia-not-option-frank-van-den-bleeken
ProCon Staff (2010). Should euthanasia or physician-assisted suicide be legal? Retrieved from: http://euthanasia.procon.org/view.resource.php?resourceID=000126
Schiavo, Terri. (2012). Facts About Euthanasia. Retrieved from: http://www.terrisfight.org/facts-about-euthanasia/
Miller, Daniel (2012). My life is miserable, demeaning and undignified says locked-in syndrome sufferer as he asks High Court judges to give him the right to die. Retrieved from: http://www.dailymail.co.uk/news/article-2161494/Tony-Nicklinson-euthanasia-My-life-miserable-undignified-says-locked-syndrome-sufferer.html
Peake, Jacqui (2013). Husband avoids jail in voluntary euthanasia case. Retrieved from: http://www.abc.net.au/news/2013-02-26/husband-avoids-jail-in-voluntary-euthanasia-case/4540870
Hobbes, Thomas. (1651). Leviathan, or the Matter, Forme, & Power of a Common-Wealth Ecclesiasticall and Civill. Mineola, N.Y. 2006. P 70-72.
Konow, James (2003): "Which is the fairest one of all: A positive analysis of justice theories", Journal of Economic Literature, vol. 41, no. 4, pp. 1188–1239.
Locke, John (1689). Two Treatises of Government: In the Former, the False Principles, and Foundation of Sir Robert Filmer, and His Followers, Are Detected and Overthrown. London: Awnsham Churchill.
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