A Question of Euthanasia

Introduction

Humans are finite. This reality does not intimidate the mature Christian. The believer recognizes the opportunity to serve others is limited but nonetheless significant. The faithful follower seeks to live a temporary life for an eternal purpose. Even dying itself can serve this end.

If only we were all mature Christians, then the approach to life and indeed to death would not be so varied and emotive. The reality is mature Christians are in the minority and death is either wished away or in other circumstances desired and though death is inevitable, to all who have to the very minimum biological life, death can be unpredictable or predictable, quick or drawn out, peaceful and painless or painful and filled with suffering while yet to others death is a right just as the right to pursue happiness and right to life. However, to the latter, when the process of dying is accompanied by suffering and pain, then the right to life and right to pursue happiness seem to contradict.

When one is faced with these apparent contradictions, certain questions seem to dominate conversations e.g. In what circumstances is anyone justified to end their on life when in distress? Who decides when to end another's life? Can life be meaningless? Does one have a right to choose how they die? And when does the right to a dignified and humane death become more precious than the right to life?

These contradictions are heightened within the medical profession where medical personnel are faced with life and death decisions on a daily basis and petitions made by patients to care- givers to assist them escape the agony and pain that accompanies terminal illness is not uncommon. Attitudes and positions on this matter have been developed over the years and in order to have a context to the development of these attitudes, a brief history would suffice. Equally important is a description of the terms that have been adopted over the years to describe the so called help.

Classification of euthanasia.

Euthanasia.

Its described as the intentional termination of the life of an incurably ill person out of compassion for the persons suffering. It is broadly classified into two categories: passive and active.

Active euthanasia.
This occurs as a result of the administration of a pharmaceutical agent that results in the termination of life and is further classified as voluntary, involuntary and non-voluntary.

Voluntary active euthanasia.
Involves administering of a pharmaceutical agent at the patients' request resulting in death. Nonvoluntary active euthanasia.
It implies that a lethal dose of medication is given to a patient that is incompetent but who had previously expressed the will to be killed if suffering enormous pain.

Involuntary active euthanasia.
Involves cases where family, friends or physicians make the decision to end a patient's life knowing that this person would want to be killed under these circumstances.

Passive euthanasia.
This describes the death of a person who is terminally ill by forgoing potentially life prolonging measures. Along with the forgoing of the application of life prolonging technologies, is the actual administering of palliative treatment that may result in death . The physician's main intent is to control pain but the medicinal dosage may also hasten death . It is subclassified as voluntary, nonvoluntary and involuntary.

Voluntary passive euthanasia.
This describes cases in which the patient requests that certain medicinal treatment be withheld or withdrawn. It also includes incapable patients who indirectly communicate their treatment wishes with written advance directives or by previous oral testimony.

Nonvoluntary euthanasia.
This includes cases in which one does not know for sure what treatment an incompetent patient wants but there is a good reason that the person would want to die in the circumstances. Involuntary passive euthanasia.
Describes cases in which death of the patient(who is terminally ill) occurs as a direct result of withdrawal of medical technology that is life prolonging without the express will of the patient but relying on other parties to effect the withdrawal. It assumed this is the patient's best interest.

Physician assisted suicide (PAS).
This describes a situation where the choice in dying rests fully with the patient but specifically the physician supplies the lethal dose of medication to end life and the patient administers it to him or herself.

Historical perspectives of PAS.
To comprehend fully the intricacies of the current ethical debate concerning PAS and, it is important to provide a historical view of its conceptual origins. Proposals to legalize PAS for the terminally ill became a focal point of public policy debate in several countries toward the end of the last century. The place of the physician in treating the dying patient received significant attention in those early years. The physician, it was thought could slow down the unavoidable process of dying. Current technology has allowed for early diagnosis, better palliative care as well as more effective pain management making terminal illness more chronic in nature. Many patients with illnesses such as AIDS and cancer are living longer and dying more delayed deaths. Technological advances in medicine have also contributed to this prolonged dying and prior to these advances terminally ill patients died sooner and physicians had no choice but to offer comfort until death. These advances have helped create a controversy that has opened the doors for increased concern about the right-to-die. The capacity to prolong life and consequently prolong suffering was a catalyst for many of the contemporary arguments prompting legislators to introduce legislation in favor of PAS.

There has been an apparent acceleration in the legalization of PAS over the last two decades which is partly attributed to the importance culture now places on autonomy, the changing personal and cultural attitudes towards suffering, pain and death and the pursuit of happiness and a dignified death combined with new found freedom within the political system of democracy, all drive people towards seeking their inalienable rights including the right to have a dignified death.

Most significant is the advancement in healthcare even when the quality of life is low and questionable. Modern medicine seems to treat biological life as an absolute value . This prolonging of life in this state is deemed dehumanizing giving the pursuit of PAS a human face.

This accelerated efforts in legalizing PAS, has raised legal. ethical and moral questions within the medical, theological and legal fraternities and several routes to adjudicate an ethical position have been taken. In this paper, I will consider the theory of Utilitarianism and assess the pros and cons as well as the impact of applying it in regard to PAS and compare and contrast it with a Christian perspective.

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