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With the emergence of new legal and ethical frameworks, euthanasia and physician-assisted suicide have become a topic of hot public debates. The core question the developed society is trying to answer is whether euthanasia and physician-assisted suicide should be legalized. At present, only four American states treat euthanasia as legal, while others outlaw physician-assisted suicide as second-degree murder. The basic argument in favor of euthanasia is that a competent patient has the right to avoid unbearable pain and make an autonomous decision to refuse from life because of terminal illness. At the same time, physicians' roles are claimed to be absolutely incompatible with the fundamental idea behind euthanasia. My belief is that euthanasia is both moral and ethical, and it should also be made legal, for the individuals who are no longer capable of living in suffering due to terminal illness.
According to Johnstone (2011), the term 'euthanasia' originates from Greek and Latin and literally means 'easy and happy death'. However, at the times of Ancient Rome and Greece, the word 'euthanasia' was not used to signify the act of hastening someone's death. Rather, it symbolized one's state of approaching death and described the spiritual being of the person, who was dying (Johnstone, 2011). Moreover, medical professionals at that time were not allowed to engage in euthanasia in its present-day sense (Johnstone, 2011). Today, there is no single definition of euthanasia. While the Oxford English Dictionary defines euthanasia as an act of causing an easy and quiet death, Webster's dictionary describes it as a process, by which individuals who suffer from incurable diseases or conditions are painlessly put to death (Johnstone, 2011). None of the existing definitions reflects the meaning and complexity of euthanasia in its entirety, but it is clear that, to be regarded as euthanasia, death must meet a number of essential criteria. These include: intentionality of death, evidence of unbearable suffering, painless means of death, and adequate reasons for it (Johnstone, 2011). The term 'euthanasia' is used synonymously with 'active euthanasia', when the physician provides and administers the lethal drug. By contrast, passive euthanasia (or physician-assisted suicide) is when the physician simply supplies the person with the means to end his/her life, and it is the terminally ill person who makes the last move.
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ProCon (2009) stipulates the most common arguments in favor and against euthanasia, one of them being the right of the individual to make autonomous decisions and refuse treatment. Those, who do not support euthanasia, are convinced that it contradicts to the core philosophy and intent of the entire medical science, and physicians should do everything possible to satisfy the end-of-life decisions of terminally ill patients, instead of killing them (ProCon, 2009). At a deeper level, euthanasia is claimed to alter the principles on which the democratic society rests, simply because it provides little motivation for physicians to improve the quality of care and reduce the burden of terminal illness. However, my belief is that euthanasia is justifiable in cases, when unbearable suffering does not let the terminally ill patient use the opportunities of life for his/her benefit. We make a huge mistake, when we speak about euthanasia from the perspective of laws, individual rights, society, and the future of medicine. At the core of this debate is a living person, whose sufferings are so unbearable that he/she no longer wants to live. According to Dees, Vernooij-Dassen, Dekkers, Vissers and Weel (2011), unbearable suffering is not limited to physical pain but also includes negative feelings, fatigue and loss of autonomy, pointlessness and helplessness, as the terminally ill person turns into a huge family and society's burden. I do not think that euthanasia is incompatible with the goal of medicine. The goal of medicine is to alleviate human suffering (Dees et al., 2011). Therefore, euthanasia is just one of the many ways to reduce the scope of physical and moral pain, while giving terminally ill patients the right to decide whether or not they want to live.
In the context of euthanasia, special populations deserve particular attention. These include people with disabilities, ethnic minorities, women, the poor, and the elderly. One of the basic fears is that more people with disabilities will be killed through euthanasia, simply because they cannot express their will (ProCon, 2009). Another fear is that "infirm, elderly persons will come under undue pressure to end their lives from callous, financially burdened, or self-interested relatives, or others who have influence over them" (ProCon, 2009). The negative implications of euthanasia for the poor and ethnic minorities come from the fact that they have lower rates of service utilization, mostly for financial reasons (Evans et al., 2011). Such services are often inaccessible for the poor and are culturally inappropriate for ethnic minorities (Evans et al., 2011). Therefore, vulnerable populations have fewer chances to use the euthanasia option for their benefit, and they have fewer chances to avoid discrimination, manipulation, and rights violations when they seek voluntary death.
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I truly believe that vulnerable populations are under a serious threat and, without appropriate legal frameworks, euthanasia can make these population groups even more vulnerable to abuse and discrimination. At the same time, by placing a ban on euthanasia for the most vulnerable groups, the society will greatly contribute to the social and health inequities that currently exist in the U.S. The problem is that physician-assisted suicide should become a measure of last resort, a decision that is made when all possible treatment options have been exhausted. To make it happen, the American society will also have to provide its vulnerable groups with equal access to such treatment, so that the use of euthanasia is accessible and justified. I believe that euthanasia should be legalized, but I also believe that vulnerable groups will need additional protection of the state to make euthanasia legal and moral.
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As of today, only four American states have legalized euthanasia. Others either have no laws regulating euthanasia or openly outlaw it. In New Jersey, euthanasia is equaled to the act of crime. Anyone, who is known to have purposely aided another person to commit suicide, is held guilty for the second degree murder (ProCon, 2009). In case the person's conduct has led to suicide, it is categorized as a crime of the fourth degree (ProCon, 2009). Certainly, the legal climate in New Jersey is totally different from that in Oregon, where the Oregon Death with Dignity Act was passed to allow terminally ill individuals obtain physicians' assistance in dying. Ganzini, Goy and Dobscha (2009) write that Oregonians are primarily concerned about the loss of autonomy and function as a result of terminal illness, which is why they have been so supportive of the Act. Apparently, the Act should become a model of legislative protection provided by the state to everyone, who is terminally ill and can no longer tolerate the physical and emotional sufferings brought by the disease.
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In most American states, euthanasia is illegal. However, the biggest mistake made by euthanasia opponents is that they fail to consider patients' perspective. A terminally ill person who faces unbearable sufferings should have a legal right to hasten his/her death. Additional legal safeguards have to be provided to protect vulnerable populations from the risks posed by euthanasia. The laws of Oregon can become a good example of effective legislation that enables terminally ill persons make autonomous decisions and put an end to their physical and emotional sufferings due to illness.
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