Passive euthanasia allows another person to die by not taking any action to stop death or prolong life. An example of this type may include withholding some type of treatment that would prevent death (Butts & Rich 2005 235). Passive euthanasia is generally accepted pursuant to legislative acts and judicial decisions (Pozgar, 2007 370). The important difference between active and passive euthanasia is that, in passive euthanasia, the doctor does not do anything to bring about the patient’s death.
The health care provider does nothing, while the patient dies of whatever ills already afflicting (Singer and Kuhse 2005 291). These decisions, however, generally are based on the facts of a particular case. Regardless of the definitional differences, though, in both active and passive euthanasia, the end outcome is still similar (Pozgar, 2007 370). Such action is still illegal on illegal perspective due to the fact that the action of doing nothing has implicated death. The health care provider may not be liable to the case of direct murder, but doing nothing, with the concept of human morality and legalities (e.
g. good Samaritan act), is the evident violation (Singer and Kuhse 2005 291; Scimenti 2005 131). A controversial debate continues in the United States about whether or not there is a real moral difference between active euthanasia, such as the intentional taking of someone’s life, and passive euthanasia, such as withholding and withdrawing life-sustaining treatments. The action versus omission distinction has caused nurses and physicians to mull over the burdening question (Butts & Rich 2005 235).
Another category of euthanasia is the voluntary and involuntary. Voluntary euthanasia occurs when the suffering incurable patient makes the decision to die. To be considered voluntary, the request or the consent must be made by a legally competent adult and be based on material information concerning the possible ramifications and alternatives available (Singer 2003 295). Voluntary euthanasia is sometimes called assisted suicide, which, at some areas, is considered as an easy means of death for a patient that is extremely suffering (Jenkins 2002 26).
Euthanasia is non-voluntary when the person whose life is ended cannot choose between life and death for herself – one example, because she is a hopelessly ill or handicapped newborn infant, or because illness or accident have rendered a formerly competent person permanently incompetent, without that person having previously indicated whether she would or would not like euthanasia under certain circumstances (Singer 2003 295; Singer and Kuhse 2005 291).
Euthanasia is involuntary when it is performed on a person who would have been able to give or withhold consent to his or her own death, but has not given consent- either because the person was not asked, or because she was asked but withheld consent, wanting to go on living (Singer 2003 295). The public and health care personnel have differing opinions regarding assisted suicide. Some loon on it as a violation of the ethical principles on which the practice of health care is based: autonomy, nonmalifecence, beneficence, justice, veracity, and fidelity.
Regardless of ethical perspective, euthanasia is still illegal in most of the countries (Singer and Kuhse 2005 291). The euthanasia issue is bringing up many associated issues around life and death, around the sacredness of life, around the quality of life, around the issues of unnecessary suffering, freedom of choice and the right to ownership and self-determination of one’s life (Lass 2002 257). The principles of mercy killing or euthanasia are based on two obligations: the duty not to cause further pain and suffering, and the duty to act to end existing pain or suffering.
The principle of autonomy is based on the thought that health professionals ought to respect the person’s right to decide and choose the appropriate and most preferred course of treatment. The principle of justice is based on the moral justification in providers performing euthanasia on patients that they regard as unsalvageable. Based on this principle, a health care provider could testify performing euthanasia on still competent but dying patient if they are regarded as unsalvageable. It is knowing where to draw the line with the principle of ethics governing the concept of euthanasia (Butts & Rich 2005 235).
However, the ethical cover up is not agreeable at almost all sects wherein, in fact, the conceptual framework of the act itself is murder whether direct (involuntary euthanasia) or indirect (voluntary, active and passive) means of euthanasia (Singer and Kuhse 2005 291; Lass 2002 257). It is that voluntary euthanasia must increase personal autonomy, in that it gives people some control over when their lives end. Moreover, if active voluntary euthanasia were allowed, this would give people some control over how their lives end. Concern for people’s autonomy obviously counts only in favor of voluntary euthanasia (LaFollette 2002 6).
Nevertheless, with the purpose of medical team as the prime life extensors and the ethical and moral value of life, the act itself becomes futile (Jenkins 2002 26). In terms of legal bodies, the concept of involuntary euthanasia is greatly criticized by rule-utilitarians for other reasons as well. One such reason is that many people would be scared away from hospital if they thought that they might be killed against their will (Scimenti 2005 131). These points of insecurity add up to a very persuasive rule-utilitarian argument against permitting active involuntary euthanasia.
In some case of passive euthanasia, there is greater risk that people will stay away from doctors and hospitals for fear of being made worse off that they are already (Jenkins 2002 26; Scimenti 2005 131). In fact, passive euthanasia is practiced in the hospital setting especially for palliative and hospice care. Such principle of euthanasia governs the concept of placebo provision, which is a “dummy” medication believed by the patient to alleviate feelings; however, these drugs do not possess any curing effects (LaFollette 2002 6).
Euthanasia is deemed beyond prolonging of life, which is in fact viewed by Catholicism as direct and intentional killing. Its legislation would place a most dangerous and immoral power in the hands of human beings. If we accept euthanasia, it only connotes that the doctor is provided with the license to kill. The dignity and care of the medical and nursing professions must not be undermined by lessening of respect of life (Scimenti 2005 131). Discussion and Summary The concept of euthanasia is elaborated in three varying perspectives in consideration to the field of health care practice.
The ethical concerns of this controversial issue play an important role in viewing the angles afflicted by such procedure, particularly the respect of life, value of patient’s decision and essence of health care practice. The legal body, on the other hand, depicts the application of such procedure in the health care as a form of legal violation or crime. Lastly, the political accompanied by the social perspective wherein the possible impact of the public’s view over the health care providers if such issue is allowed.
In providing care to the terminally ill, health practitioners incorporate fundamental ethical principles. The dilemma for ethics begins with the principle of sanctity of life, which identifies that life is sacred and should be preserved. Another key concept for health care practice is the principle of autonomy, which indicates that the patient has the right to make their own choice in terms of their own health care including those that affect their everyday activities.
Health care practitioners must also consider the principles of beneficence and nonmalifecence that state that care should be provided in the patient’s best advantage. These universal principles establish a basis for the dilemmas health care face in providing optimum care for dying patient. The universal principles involved in the implementation of care to the dying patient should always be the fundamental consideration in every action made. However, conflict arises in the argument of continuing life in terms of the advantage-disadvantage reasoning.
Even if the life of an individual is already unproductive and proves to be inefficient, granted that the former status of quality of life is impossible to restore, still, euthanasia should never be allowed. Prolonging the life of an individual who is suffering from an irreversible condition with no hope of restoration falls not as a reason for euthanasia, but falls as a valid rationale for medical practitioners to try their very best to provide the best treatment there is.
The quality of life or the hope of having such status in life is the primary goal of living; hence, even if an individual is already deprived of such cause, legalities and social considerations should not permit the implementation of the said procedure.
References Battin, M, and G A. Lipman. Drug Use in Assisted Suicide and Euthanasia. Haworth Press, 2006. Butts, J B. , and K Rich. Nursing Ethics: Across The Curriculum And Into Practice. Jones and Bartlett Publisher, 2005.