Euthanasia

“They (the doctors] departed from the traditional medical ethic which maintains the value and sanctity of every individual human being… they betrayed the trust society had placed in them as a profession … it is to be assumed that initially they did not realize that the ideas of those who held political power would lead to the denial of the fundamental values on which Medicine is based. Research in Medicine as well as its practice must never be separated from eternal moral values. Doctors must be quick to point out to their fellow members of society the likely consequences of policies that degrade or deny fundamental human rights.”

[Statement of British Medical Association after the Nuremberg Trials trying Nazi war criminals, including German eugenics physicians.]

Euthanasia: Medical Murder by Dr. Peggy Norris (Population Research Institute)

A Brief Chronology

1973- Prior to 1973, euthanasia was illegal in the Netherlands. However, when a doctor convicted of killing her terminally ill mother was sentenced to a week in prison, a precedent was set, and the courts gradually chipped away at the law, allowing for more exceptions to the rule; these exceptions included that the euthanizing must be voluntary and the patient must be terminally ill.

1975- The Karen Ann Quinlan case eased the distinction between the right to choose one’s own death and the right to choose another’s death.

1984- Guidelines for euthanasia were established in the Netherlands, including discussing the situation with the patient, family, and another doctor.

1985- A court in the Netherlands decided that patients no longer had to be terminally ill to request an assisted suicide.

1985- In the case of Claire Conroy the debate moved from removing medical treatment, such as a respirator, to defining food and water as optional treatment instead of basic care.

1986- In California, Elizabeth Bouvia, an intelligent, alert woman completely dependent since birth because of Cerebral Palsy, asked for and was granted by the Court, the right to have the hospital assist her to starve to death comfortably. However, after winning in the courts, Ms. Bouvia changed her mind and decided she wanted to continue living.

1987- The New Jersey Supreme Court in the case of Nancy Ellen Jobes set aside the standard of clear and convincing evidence of the patient’s wishes, and substituted a standard of best judgment from the family. This case changed the focus from the benefit of care for Ms. Jobes to the perceived benefit of life itself as determined by others.

1988- Rhode Island was the first state to hear a food and water case in Federal Court. Marcia Gray’s case was based on the right to privacy arguments first articulated in the 1973 Roe v. Wade abortion case. This established federal precedent for ordering health care providers to actively assist in carrying out a third party’s desire to cause the death of a patient.

1989- The Missouri Supreme Court refused to allow the withdrawal of food and liquids to a severely impaired woman who was not dying.

1993- Criminal Charges were brought against Dr. Jack Kevorkian, who helped an Alzheimer’s victim commit suicide with a machine he invented. The charges were dropped because Michigan law did not specify that facilitating a suicide is criminal.

1995- By this time in the Netherlands, it was not uncommon for doctors to kill patients without their consent (active involuntary euthanasia), including babies born with birth defects. Also in 1995, the Northern Territories in Australia approved a euthanasia bill; though it became law in 1996, it was overturned the following year.

1995- The Michigan Supreme Court ruled that the wife of a severely brain-damaged man could not remove his feeding tube. The U.S. Supreme Court later rejected the wife’s appeal.

1998- The state of Oregon legalizes assisted suicide.

2001- A new (and current) law was introduced in the Netherlands with new guidelines: the patient must be informed, must consent, must consult with his or her doctor and conclude “that there is no other reasonable solution,” consult with an outside physician, the suffering must be intense with no hope of lessening, and the doctor must exercise due medical care and attention in terminating the patient’s life or assisting in his/her suicide” (Q3A). Minors aged 12-15 may request to be euthanized, but there must be parental consent; minors 16 and older do not need parental consent (Q16A).

The Netherlands Ministry of Foreign Affairs cited “loss of dignity” as a reason for allowing euthanasia (Q1B). Euthanasia is still “a criminal offence” as of 2008, but if doctors report it and satisfy “due care criteria,” then they can be exempted from criminal liability and it will not be reported to the Public Prosecution Service (Q2A). The Ministry explains that the “aim of exempting doctors from prosecution is to ensure that they no longer feel like criminals and can act openly and honestly in relation to requests for euthanasia, provided that their decision-making and medical procedures satisfy the statutory due care criteria” (Q2B).

In response to objections that doctors ought to save and not end life, the Netherlands Ministry of Foreign Affairs states that:

“A doctor’s main duty is indeed to preserve life. Euthanasia is not part of the medical duty of care. However, doctors are obliged to do everything they can to enable their patients to die with dignity. They may not administer pointless medical treatments. When all treatment options have been exhausted, the doctor is responsible for relieving suffering.” (Q14A) (from the Dutch Ministry of Foreign Affairs website)

2002- Belgium legalizes euthanasia under many of the same guidelines as the Netherlands.

2005- On March 31, 2005, Terri Schindler Schiavo, aged 41, dies of marked dehydration following more than 13 days without nutrition or hydration under the order of Circuit Court Judge George W. Greer of the Pinellas-Pasco’s Sixth Judicial Court.

2006- In Gonzales vs. Oregon, the United States Supreme Court upheld, in a vote of 6-3, an Oregon law (Death with Dignity Act) allowing patients to commit suicide with the assistance of their doctor. The court cited that the federal government could not override state law.

2008- An Italian court ruled that life support could be removed from Eluana Englaro, a young woman in Milan who has been in a coma for sixteen years.

 

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Citations

[1] Life expectancy in the United States is currently 78.24, according to the CIA:https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

According to the BBC, average lifespan around the world is around double what it was 200 years ago. http://news.bbc.co.uk/2/hi/health/1977733.stm

[2] The percentage of the population over 60 in the United States is projected to rise to 26% by 2040, from 16.3% today. Source: Brookings Institution, Center for Strategic and International Studies, Congressional Budget Office as cited by http://www.washingtonpost.com/wp-srv/business/daily/graphics/ss_020205.html

[3] Traditionally defined as an illness or condition that will cause a person’s death within a relatively short time. Some state courts are expanding the term to include a condition in which death will occur if treatment, including nutrition and hydration, is removed.

[4] http://articles.cnn.com/2010-06-14/health/kevorkian.gupta_1_kevorkian-dr-jack-euthanasia-assisted-suicide/3?_s=PM:HEALTH

[5] A condition in which the upper portions of the brain are damaged through disease or injury, but the brain stem is normal. Basic body functions such as breathing and digestion occur, and the individual has sleep-wake cycles. But these patients are not attentive, do not speak or have voluntary muscle movement.

[6] Nutrition that is provided with the help of another. This may be spoon-feeding, through a gastrotomy tube, or through a tube into the vein.

[7] A state of unconsciousness from which the patient cannot be aroused, even by powerful stimulation. This state rarely lasts for more than two to four weeks, by which time the patient dies, enters into a vegetative state, or regains some form of consciousness.