Euthanisia

ABSTRACT

In recent years, Euthanasia has become a very heated debate. It is a Greek word that means "easy death" but the controversy surrounding it is just the opposite. Whether the issue is refusing prolonged life mechanically, assisting suicide, or active euthanasia, we eventually confront our society's fears toward death itself. Above others, our culture breeds fear and dread of aging and dying. It is not easy for most of the western world to see death as an inevitable part of life. However, the issues that surround euthanasia are not only about death, they are about ones liberty, right to privacy and control over his or her own body. So the question remains- Who has the right?

FINAL EXIT

Under current U.S. law, there are clear distinctions between the two types of euthanasia. One group of actions taken to bring about the death of a dying patient -withdrawal of life support, referred to by some as passive euthanasia- has been specifically upheld by the courts as a legal right of a patient to request and a legal act for a doctor to perform. A second group of actions taken to bring about the death of a dying patient, physician assisted death referred to by some as active euthanasia, is specifically prohibited by laws in most states banning "mercy killing" and is condemned by the American Medical Association. Although it is not a crime to be present when a person takes his or her life, it is a crime to take direct action intentionally designed to help facilitate death, no matter how justifiable and compassionate the circumstances may be. With active euthanasia, it is the doctor who administers the lethal drug dose. Since it is tantamount to homicide, the few U.S. doctors who perform it have been brought to trial but none of them have ever been convicted and imprisoned.

Modern interest in euthanasia in the United States began in 1870, when a commentator, Samuel William's, proposed to the Birmingham Speculative Club that euthanasia be permitted "in all cases of hopeless and painful illness" to bring about "a quick and painless death." The word "painless" is important: the idea of euthanasia began gaining ground in modern times not because of new technologies for agonizingly prolonging life but because of the discovery of new drugs, such as morphine and various anesthetics for the relief of pain, that could also painlessly induce death. Over the next three decades William's proposal was reprinted in popular magazines and books, discussed in the pages of prominent literary and political journals, and

debated at the meetings of American medical societies and non-medical professional associations. The debate culminated in 1906, after the Ohio legislature took up "An Act Concerning Administration of Drugs etc. to Mortally Injured and Diseased Persons", which was a bill to legalize euthanasia. After being debated for months, the Ohio legislature overwhelmingly rejected the bill, effectively ending that chapter of the euthanasia debate.

Euthanasia reemerged in the 1970's, when in 1976 California was the first state to legalize a patient's right to refuse life-prolonged treatment. The Legislature passed the Natural Death Act, which allows for living wills, an advance directive to a doctor requesting the withholding or withdrawing of life sustaining treatment. Today, all states have some form of living will legislation. In addition, the individual who wishes to have such a will, may also designate a family member or friend as a proxy to make the decisions for him or her, should he or she be unable to make the decisions himself or herself. Some states also require the individual to sign a power of attorney to do so.

In 1976, the New Jersey Supreme Court decided the parents of Karen Ann Quinlan won the right to remove her from a ventilator because she was in a persistent vegetative state. The justices unanimously ruled that this act was necessary to respect Quinlan's right to privacy. Some medical ethicists warned then that the ruling was the beginning of a trend--the slippery slope--which could lead to decisions to end a person's life being made by third parties not only on the basis of medical condition but also on such considerations as age, economic status, or even ethnicity.

In 1990, the Supreme Court case, Cruzan v. Missouri, recognized the principle that a person has a constitutionally protected right to refuse unwanted medical treatment. In 1983, Nancy Beth Cruzan lapsed into an irreversible coma from an auto accident. Before the accident, she had said several times that if she were faced with life as a "vegetable," she would not want to live. Her parents went to court in 1987 to force the hospital to remove the tube by which she was being given nutrition and water. The Missouri Supreme Court refused to allow the life support to be withdrawn, saying that there was no "clear and convincing" evidence Nancy Cruzan wanted that done. The U.S. Supreme Court agreed, but it also held that a person whose wishes were clearly known had a constitutional right to refuse life-sustaining medical treatment. After further proof and witness testimony, a probate court judge in Jasper County, Mo., ruled Dec. 14, 1990, that Cruzan's parents had the right to remove their daughter's feeding tube, which they immediately proceeded to do. Nancy Cruzan died Dec. 26, 1990.

The Cruzan decision sparked a fresh interest in living wills and in 1990 Congress passed the Patient Self-determination Act. It requires health care facilities that receive Medicare or Medicaid funds (95 percent of such centers) to inform new patients about their legal right to write a living will. Or choose a proxy to represent their wishes about medical treatment, and what kind of measures will be taken automatically for patients as institutional policy. Where state law permits, these institutions must honor living wills or the appointment of a health care proxy.

On March 6, 1996, for the first time in U.S. history, in the case Washington v. Glucksberg, the U.S. Court of Appeals for the 9th circuit in San Francisco overturned a Washington State law that made assisted suicide a felony. The

existing ban on assisted suicide was successfully challenged under the equal protection clause of the Constitution's Fourteenth Amendment. The court noted that, under present law, a dying patient on life support may legally have it removed to facilitate death while another dying patient, not on life support but suffering under equivalent circumstances