Good Example Of Healthcare Ethics Argumentative Essay
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Euthanasia and People with Disabilities
The controversy over euthanasia and physician-assisted suicide is not new. As of 2015, euthanasia is legalized in a handful of countries around the globe. As for assisted suicide, it is legal in the US states of Montana, New Mexico, Oregon, Vermont, and Washington, as well as a few other countries worldwide (Eckholm). Euthanasia has been the subject of intense and repeated discussions, with Bills being introduced to the Congress, only to conclude that permitting the wilful destruction of a human life underlies dangers that outweigh any potential benefits from legalizing euthanasia. While the debate over euthanasia is still highly controversial, there are advocacy groups that insist it is a human right to choose the way one wants to die. To them, people do not choose when to be born, but they, at least, want the right to choose when to end their lives, especially when suffering and in pain. This paper will discuss whether euthanasia can be provided as an option for people with disabilities, how disabled people feel about it, and where society stands towards this issue.
Many people claim that euthanasia should not be an option for people with disabilities. The bottom line is though that a vast majority of this group of people lacks advance directives, and their end-of-life decisions have to be made by someone else, they should be well protected from abuse. Thus, legalizing euthanasia or physician-assisted suicide to them would involve high risks of abuse, especially in the midst of health care cuts. It is highly likely immoral individuals encourage more deaths to reduce health care costs (Emanuel & Emanuel 540); therefore, euthanasia should not be an option for people with disabilities. After all, everybody has the right to get as much assistance as possible to improve their life, not end it.
The issue of euthanasia is extremely polarizing when it comes to that particular group of people. Some people with disabilities see physician-assisted suicide or euthanasia as a means to providing choice in dying (McDougal & Gorman). Organizations and individuals sharing this view have a principle argument. They believe that some people with severe handicaps may be physically unable to end their life, thus denying them help with performing what they want (to commit suicide) is unfair to the point of discrimination (McDougal & Gorman). On the opposite side, those that insist on not legalizing euthanasia or physician-assisted euthanasia argue that people with disabilities is a vulnerable group of people that medical personnel and doctors could easily abuse.
If advocates of euthanasia and assisted suicide and those against it have something in common that is that they both focus on the patient’s quality of life, only they have opposing views about it. Supporters of legalizing euthanasia and physician-assisted suicide to people with disabilities believe that if a person does not have the desired quality of life and lives their day in pain and suffering, they should have the right to die. On the other hand, those supporting the criminalization of euthanasia and physician-assisted suicide claim that quality of life is completely subjective (McDougal & Gorman 13). They believe that physicians and those that perceive a patient’s quality of life as being low, due to his or her disability, might not take into much consideration what the patient thinks of the quality of the life he or she is living at that moment. In other words, a physician may place a higher value on their personal assessment in regards a patient with disabilities’ quality of life, over the perception the patient him/herself has.
A very interesting article published in Disability Studies Quarterly, mentions that the word euthanasia literally means a good death (Davis). This aligns with the Eugenicists perceptions that people of good health should be encouraged to reproduce, and end particular disabilities and diseases by preventing others from reproducing (Stanford Encyclopedia of Philosophy). In the United States, there are numerous programs that encourage positive eugenics, such as the Fitter Family Fairs, while promoting sterilizations of women and men that are deemed unfit to reproduce, because they were mentally insane, poor, or any other (Stanford Encyclopedia of Philosophy). This reflects how society sees people with disabilities: unworthy to live.
Today, many people tend to use euthanasia as if it means to consciously kill an individual that is, for some reason, perceived to be better off dead, such as people with incurable disabilities, as well as those with deadly illnesses (Council of Canadians with Disabilities). That group of people is at high risk of being considered not worth living. However, no one considers their point of view and how they feel about the quality of their life, as well as whether they want to end their life or not. Some are fighters, some prefer a decent death. No matter the case, no one asks them, in the majority of instances. Those supporting the right to die claim that euthanasia should be strictly regulated to prevent possible abuse of the law. The question that arises here is “Can safeguards prescribe who is eligible to legally end their life via assisted euthanasia and who is not?”. Who qualifies for euthanasia?
The problem is that there seems to be a distinction between groups of people. For example, persons with suicidal intentions are usually helped to live if they have no apparent illness or disability. On the contrary, according to the safeguards imposed, those terminally ill and with degenerative or disabling conditions qualify for the right to die (Davis). It is wrong to let the second group of people die, but it is right and ethical to allow the first group of people end their life, just because the law considers them to qualify for euthanasia? Why are those that are perceived wrong to die provided with much help to live, and not the disabled people? This country employs professionals that help people with suicidal tendencies live. Those professionals are also obliged to help individuals with disabilities live and better their lives. There are also suicide prevention techniques to prevent an individual from wanting to end their life (Davis).
Regardless of disability or illness status, choosing to die or live is a personal psychological decision. However, when other people have a saying in such a decision-making process, the decisions become social, legal, and political decisions, rather than medical decisions (Sobsey & Wolbring). The involvement of health care professionals in decisions that related to a person’s decision to end their life does not constitute a right and reasonable process to protect people’s lives. If euthanasia or physician-assisted suicide is made legal for a selected group of people, it should be legalized for all citizens (Sobsey & Wolbring). The focus of the safeguards and the proceedings should be to inform fully with disabilities of their condition and options. To do so, only competent professionals should be involved, and by competent, we mean people that are neither forced nor otherwise influenced to proceed with terminating a patient’s life (Sobsey & Wolbring). Since such safeguards have not yet been formed, physician-assisted suicide or euthanasia should be criminalized for all US citizens, included those with disabilities
Speaking of autonomy, the case of British Diane Pretty, in 2001-2002, is indicative. Pretty was a woman suffering motor neurone disease that wanted her husband to be the one legally responsible for helping her end her life, because she did not wish to die of suffocation, due to her terminal illness. She wanted to die with dignity, when she would choose to end her life. However, her assumption that she would die by suffocation did not have a realistic medical basis. Her case was based on the right to autonomy. However, she chose to destroy her autonomy by attempting to exercise autonomy (Davis). According to Mrs. Pretty, the UK Human Rights Act of 1998 protected people’s lives and that everybody’s right to life was guaranteed (Davis). She focused though on the part of the Act that says that everyone has the “right to die with dignity” (High Court of Justice), hence no one has the right to take away one’s right to end their life intentionally. However, Lord Justice Tuckley clarified that according to Article Three of the Human Rights, one’s right to human dignity is not related to the right to die with dignity, rather than “live with as much dignity as can possibly be afforded until that life reaches its natural end” (Parliament UK).
When people with disabilities are experiencing emotional difficulties or clinical depression, they should be provided with appropriate treatment, just like any other individual undergoing the same condition. In other words, when people with disabilities exhibit suicidal behavior or have suicidal thoughts, they should have access to the same prevention programs as everybody else in the country. Providing people with suicidal intentions with all the help to allow them live, while counselling people with disability and/or illness to commit suicide is unethical and comprises a violation of the full participation in community life principle (Sobsey & Wolbring). Criminalizing counselling a person to end their life or to help in the suicide or a person without disability, while legalizing to counsel a person with disabilities to end their life or assist in the suicide is not only a violation of human rights, but also deprives the people with disability of their right to equal protection.
The right to life cannot be taken away or deprived, which means that no one, not even people themselves have the right to end their life. Mrs. Pretty lost her case and died in peace, without ever facing any issues related to suffocation, as she assumed (Davis). People with disabilities should get assistance towards their right to live rather than dying. The right to die with dignity, as discussed before, could be better interpreted as a “duty to die” (Davis), considering the fact that communities do not provide sufficient help and support to those in need of living with dignity, and chooses for killing, which is a more cost-effective option (Davis).
A society that legalizes “the killing of sick people, if it is supposed to be limited to those who actively request it, sends a dangerous message to its members: the lives of those who are sick, in pain, limited in their ability to operate in a self-sufficient manner, are worthless” (Rayner, as cited in Davis). As for incompetent patients, such as those newly diagnosed with Alzheimer’s disease, they may have sufficient advance notice to prepare a living will, before being unable to make decisions for themselves (McDougal & Gorman). For many incompetent patients, this is not an option though. Being unable to speak for themselves, decision-making for their life is done by other people, such as guardians and doctors. But, who can decide that another person’s death is the best option? What are the criteria that justify the decision to end the life of an incompetent person? If one thing is for sure is that the debate over euthanasia and physician-assisted suicide to people with disabilities is far from over.
Council of Canadians with Disabilities. “Legalizing Physician-Assisted Death: Can Safeguards Protect the Interests of Vulnerable Persons?” 2003. Web. Feb. 24, 2015 <http://www.ccdonline.ca/en/humanrights/endoflife/euthanasia/lpad>
Davis, Alison. “Commentary: A Disabled Person's Perspective on Euthanasia”. Disability Studies Quarterly, 2004, Volume 24, No. 3. Web. Feb. 2, 2015 < http://dsq-sds.org/article/view/512/689>
Eckholm, Eric. “Aid in Dying’ Movement Takes Hold in Some States”. The New York Times. 2014. Web. Feb.2, 2015 < http://www.nytimes.com/2014/02/08/us/easing-terminal-patients-path-to-death-legally.html?_r=0>
Emanuel, E . J., & Emanuel, L. L. “The economics of dying: The illusion of cost savings at the end of life”. New England Journal of Medicine, 1994, 330(8), 540-544.
McDougal, Jennifer, Gorman, Martha. “Euthanasia: A Reference Handbook”. ABC-CLIO, 2008. ISBN 1598841211.
Parliament UK. “Memorandum by Alison Davis, National Co-ordinator, No Less Human (a Group within SPUC)”. 2004. Web. Feb. 2, 2015 <http://www.publications.parliament.uk/pa/ld200405/ldselect/ldasdy/86/86we08.htm>
Sobsey, Dick, Wolbring, Gregor. “A Background Paper Prepared for The Premier's Council on The Status of Persons with Disabilities (Alberta)”. 1995. Web. Feb. 2, 2015 <http://www.bioethicsanddisability.org/eut_def.html>
Stanford Encyclopedia of Philosophy. “Eugenics”. n.d. Web. Feb. 2, 2015 <http://plato.stanford.edu/entries/eugenics/>
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