Sunday, January 15, 2006


The word euthanasia refers to a positive or passive act of allowing someone to die, or assisting them to death. According to the General Social Survey, young people are far more willing than the old to consider euthanasia as an acceptable act. When asked the question, “When a person has a disease that cannot be cured, do you think doctors should be allowed to end the patient's life by some painless means if the patient and his family request it?”, 71 percent of the 18-24 year olds answered “Yes” compared to only 39 percent of those in the 85 age category.
The survey also showed that men in all age groups are more willing to approve of euthanasia than women-for instance, at 18-24, 75 percent of the men approved compared to 68% of the women, and at 85 , 46 percent of the men approved compared to 36 percent of the women. In general, there has been growing acceptance of the idea that euthanasia may be appropriate, especially with reference to the idea of "death with dignity" under conditions of hopeless illness when the patient is unconscious. The practice of euthanasia, however, is still laden with difficult personal, medical, legal, and ethical problems. Oddly, these problems have been provoked in part by the outstanding progress of medical science and technology; progress that now makes it possible to support life by means of breathing, nutrition, and blood circulation apparatus, when an individual has become, or remained, brain dead for weeks or months.
By 1968 the medical capacity to take "heroic measures" to maintain life when the patient was in a coma had made the issue of euthanasia so persistent that Joseph Fletcher, writing in Ethical Issues in Medicine, defined four types of "elective death." One type, which he identified as "voluntary and indirect," depended on the individual's own instructions to discontinue extraordinary measures to support his/her life. Such instructions are often given by means of a "living will" in which individuals protect professionals and family members from prosecution by directing them to discontinue treatment when their recovery from an illness is out of the question. Over half of the states have adopted living will laws. A second form of elective death is involuntary as well as indirect, and may be chosen when a person has fallen into a permanent coma without any form of a living will. Under these circumstances relatives must direct physicians to discontinue extraordinary efforts to maintain the individual's life. It is not uncommon for the children or spouse of an older person to confront the need to decide to carry out an act of "passive" or "negative" euthanasia. Though the legal status of such decisions remains uncertain in a number of states, prosecutions for them are rare.
Two other types of elective death are highly questionable legally and even more so ethically. The first form, known as voluntary and direct, is equivalent to suicide, and applies when an individual consciously chooses to induce his or her own death. Family members and medical personnel who may be asked to assist in this process risk legal liability. The second, known as involuntary and direct, involves a positive act by someone to terminate a patient's life, as by administering a deadly drug overdose, without the patient's consent. This is considered illegal, liable to prosecution, and tantamount to murder.
People who object to the first two types of euthanasia (voluntary and indirect, and passive and negative death) make several arguments in opposition, the two principal ones being that: New medical discoveries may lead to the patient's survival with a meaningful life; and legal acceptance of the right to terminate life may lead to actions taken for the benefit of others -- notably prospective heirs-rather than the patient.
Those who argue in favor of these two forms of euthanasia point out that extraordinary efforts to support life may simply prolong death rather than support life; and, secondly, that individuals have a right to die a "good death"-- one that is peaceful, painless, and proceeds naturally without human interference. Whatever point of view one may have on the issues involved, it is likely that growing public acceptance of the first two types of euthanasia will eventually lead to effective resolution of the personal, ethical, medical, and legal questions at stake.
Russell, C. H., and Megaard, I. The General Social Survey, 1972-1976: the State of the American People. New York: Springer-Verlag, 1988.
Ward, R. The Aging Experience, 2nd ed. New York: Harper and Row, 1984.


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