Ethics of Euthanasia, Research Paper Example

INTRODUCTION

Being a morale person is to be guided by a sense of personal ethical standards and to live within the confines of the law and your religion.  This means respecting the rights of others and being equitable in your affairs with people.  Success often is born from opposite morale values like bending the legal framework to your own advantage (manipulative) and disregarding the rights or concerns of others putting your own self-interests first.  Obtaining personal ethics is really to define who you are as a person i.e. one of substance and integrity or self-centered and manipulative.  Establishing your ethical framework may be obtained at an early age by becoming involved with social clubs, communities, sporting events etc.  It is good to be competitive provided you retain a sense of personal balance and you do not become obsessive about it. Life offers many other facets that are equally rewarding, nurses being an example of people who find a great deal of satisfaction by helping others whilst retaining a healthy ambition to succeed at their job. (Leone, D. 1999)

The concept of intervention from an ethical stand-point is really based upon the premise of someone doing harm to another.  Personal intervention is based upon an assessment where someone needs help and you can make a difference without incurring personal injury or making the current situation complex or worse.  Where a criminal activity is taking place or a breach of the law then it is a Citizens duty to inform the police for legal intervention.   This introduces the complex subject of Euthanasia and assisted suicide for terminally ill patients.  Is it ethically right to assist someone in taking their life, no matter how dire the circumstances?  Christianity is an example of a religion that forbids the taking of your own life or that of another and it considered a sin and morally reprehensible to carry out such an act.

This paper explores the ethical considerations and the problems in participating in such an act from both a legal perspective, personal moral perspective and how this relates to ethical theories like Kantian ethics and utilitarianism.

HISTORICAL PERSPECTIVE

The question of ending one’s life by suicide or assisted suicide would have been unthinkable some 200 years ago.  Individuals who attempted this were often brought before the courts and handed out stiff punishments including being sent to work camps. It was considered a religious taboo and unthinkable that any medical professional should assist in such an act.  Times have since changed and it is now considered morally defensible in certain quarters that people suffering from terminal illnesses should be given the right to die.  This may be examined from a number of different ethical standpoints.

PERSONAL AND PROFESSIONAL ETHICS

In general terms the concept of ethics relates to how we conduct ourselves from a moralistic, obligatory and virtuous standpoint.   Whereas personal ethics are more in keeping with our personal values and commitments to others, professional ethics tends to be more holistic by nature and relates to those standards we uphold in our professional lives.  In certain professions these can be very serious and have life threatening consequences i.e. Doctors, Lawyers, Bankers, etc.

| Personal ethics – the right of choice?

It is fair to say that everybody, leastwise in Western democracies, has both freedom of expression and the right of choice.  As such this can be morally bad or good.  In theory we are all bound by the law of the land and as such our interpretation and application of these laws will vary according to our own moral standards.  If you are an educated person with a relatively affluent upbringing you are more likely to respect and uphold the law. In this case the laws seem much more pertinent to your position and role in life.  If you are a poor person with no education and forced to survive in the streets of a City, then your ethics are much likely to be tuned more towards survivalist as opposed to upholding the common law.

Perhaps the nicest summary of personal ethics was provided by the Dalai Llama relative to Buddhism and his Tibetan monks.  Human qualities as morality, compassion, decency, wisdom and so forth have been the foundations of all civilizations.  These qualities must be cultivated and sustained through systematic moral education in a conducive social environment, so that a more human world may emerge. The qualities required to create such a world must be inculcated right from the beginning, from childhood.  We cannot wait for the next generation.  (Lama, 2012). This is a particularly good verse because it sets out the principles of personal ethics as the foundation for all civilizations.  It describes our humanity towards one another and the importance of educating Children the meaning of right and wrong from an early age.  Never has this been so important as today.  A world approaching global catastrophes, a world of religious and racial intolerances and a world of rising tensions and conflicts.

| Professional Ethics

These are normally provided by professions and govern the code of conduct that members of the profession are expected to uphold.  It covers such items as standard of practice, continuing professional development and maintenance of currency of research in their profession, provision of due diligence and care to customers or clients,  maintaining a practice standard applicable to a body of knowledge of the profession, restraining from any fraudulent or negligent acts, behaving in a professional and responsible manner to fellow members of the profession.  Those in breach of professional ethics may be reported to a governing body and may be summoned to a hearing. If proven to be a serious breach they may be fined and in the most extreme cases struck off the professional register and have their practicing certificates revoked.  This is particularly applicable to Doctors, Dentists, Accountants, Lawyers, Bankers, Nurses, Teachers etc.

This is particularly applicable to the Medical profession of Doctors and Nurses who are ethically responsible to save lives and not terminate them.  This creates a terrible contradiction where there are terminally ill patients that are suffering before death.

DEALING WITH ETHICAL CONFLICTS

Without a doubt there are times where personal and professional ethics can collide.  A good illustration might be in the medical profession where a Doctor and Nurse are looking after a terminally ill patient.  Should the patient be allowed to suffer or should the patient be allowed to pass peacefully away.  The professional ethic is  all about saving life whilst the personal ethic may be more humanitarian and preventing suffering. To make matters worse it has legal connotations and the Doctor may face legal consequences if he breaches his medical ethics of doing all to save lives.  A similar problem may face the litigation lawyer defending a client who ultimately they may believe to be guilty.  The Accountant who allows a fraud to be perpetrated on behalf of his client or acts improperly when filing tax returns.   (Noonan, J.T. 1975)

The Nursing profession is particularly vulnerable as the ethical responsibilities are different from the Doctors and this can create ethical dilemmas.  Although the Doctors, strictly speaking are in charge, the brunt of recovery firmly resides with the Nurses. Hence Doctors and Nurses may have different ethical values that are not necessarily consistent with one another.  ” The contrast between the perceived weakness of the female gender and the strength of the nursing profession as a whole (e.g., the largest single sector of the health care industry), and  the inconsistency between the goals of the physician and institutional sectors of the health care industry with goals of the nursing profession.”  (Jardin,K. 2012)

” A code of ethics cannot resolve all ethical issues or disputes or capture the richness and complexity involved in striving to make responsible choices within a moral community. Rather, a code of ethics sets forth values, ethical principles, and ethical standards to which professionals aspire and by which their actions can be judged.”  (Killingbeck, P. 2012)

Ethics needs to be flexible because it is a personal journey. Being a morale person is to be guided by a sense of personal ethical standards and to live within the confines of the law and your religion.  This means respecting the rights of others and being equitable in your affairs with people.

 

UTILITARIANISM ARGUMENT

The concept of John Stuart Mills ‘Utilitarianism’ relates to the principal surrounding utility. This relates to where an action is right if it produces much more of an increase in happiness of all affected by it than an alternative action. The concept is based upon that of happiness and pleasure being of intrinsic value and that the opposite i.e. pain and suffering is intrinsically indivisible. As such a person is defined as being Utilitarian when then accept the principles of Utility. Hence utility may be regarded as consequentialist or goal based; as opposed to one concerned with theory of ethics which is deontological or rule based theory.  Bentham described Utilitarianism as that of the greatest happiness or greatest felicity principle’. It is the satisfaction of preferences by a life stance with happiness and pleasure being of the most paramount importance. It is therefore both characterised by a quantitative and reductionist approach to ethics. In terms of a philosophy the principle is very broad and encapsulates all aspects of a person life. As such it is holistic by nature. (LaFollette, H. 2002)

Developing the utilitarianism argument in context to that of Euthenasia then such people that advocate this philosophy believe that the misery and pain of suffering justifies the concept of taking your life and as such this is morally correct.  Each individual has sovereignty over their body and entitled to make decisions without recourse to any other authority. Hence if one prefers to die rather than to endure a prolonged period of suffering, then the government does not have a right to interfere. Utility may be regarded as consequentialist or goal based; as opposed to one concerned with theory of ethics which is deontological or rule based theory.  Utilitarianism has strengths in relationship to that of ethics, for example:  it puts forward a method for determination of a correct course of action and it upholds equality, and it accords without intuition that ethics is primarily about making the world better.

Mills idea of high and low pleasures – the concept also holds out that we should be working towards whatever maximises the concept of utility, this is somewhat impractical considering the fact that those of us who aren’t facing great hardship should always be trying to help others. The practice is also inequitable in terms of distributive justice. It seeks to bring as much happiness into the world as possible but has no regard for who gets it. As  utilitarianism focuses exclusively on the consequences of actions, it entails that no act is intrinsically good or bad; according to utilitarianism, acts are good only insofar as the increase utility and decrease pain, and bad only insofar as they do the opposite.

KANTIAN ETHICS ARGUMENT

Kant would argue that the concept of killing an innocent person should never be permitted as the maxim of such an action cannot be accepted as a universal law.  This differentiates between that of providing medication to reduce pain than providing a lethal dose e.g. morphine designed to terminate or end a patient’s life.  Kant’s argument is best examined from a simple case study of Agnes and Bill (Bulcock, J.A. 2006)

| Agnes and Bill – The Situation

Agnes is married to Bill.  Agnes has been told by her Doctor that she has motor neurone disease and that this cannot be cured and will degenerate over time leaving her with no real quality of life.  Agnes wishes to end her life and has asked husband Bill (willing partner) to help her do this.  This would be an illegal act and Bill acting as an accomplice could be charged with assisted suicide and go to jail.  Both Agnes and Bill want to prevent such an action being brought against Bill. The question is therefore is it deemed appropriate to assist people with suicide in similar circumstances to Agnes?

|  Kant’s Categorical Imperative theory

Considering Kant’s theory the question would be – What if everyone elected to commit suicide ?  This in turn could make the human race extinct; hence despite Kant’s morality theory we simply could not comply.  Under that line of reasoning the conclusion is that it is morally wrong to commit suicide; but this definitely is not the case.  In the example above we are looking at someone with a degenerative terminal illness. Equally, you may have a situation where somebody is living but suffers terrible pain on a daily basis; would this person not have an equal claim to suicide.  So in which case how would you interpret such a moral law and who is the final arbiter of the decision ? Therefore looking at Kant’s theory  who can say whether the act of suicide should be ruled out in its’ entirety. (Brody, B.A. 1989)

The Kant argument is based upon the premise that human life should only be treated as an end in itself.  By applying suicide to this equation means that you are ending the suffering that the person is enduring. As such this is interventionist and cannot be morally justified.

Kant builds his arguments on the basis of logical deduction and therefore it may be criticised in terms of the foundations upon which it is built.  The problem with this is that disparities may surface between the cracks of reasoning and logic.  This is the concept of our feelings and emotions.  Bill may wish to assist his wife’s suicide in order to end her suffering but another argument may be ‘ where there is life there is hope!’ and there might at a future time be a technological breakthrough that could cure or improve his wife’s situation.  Where would that leave Bill then if he had assisted in his wife’s death and suddenly there was a means of improving and prolonging the life of Agnes.  It becomes an ethical dilemma of huge proportions.

The example of Agnes and Bill demonstrates  two things, firstly, once involvement in the situation takes place on a personal level then human emotion  is a factor that cannot be ignored.  This is  not taken into account by Kant’s Categorical Imperative. It equally does not consider conflicting maxims and that is a serious flaw!  There are many situations where there will be conflicting maxims in the decision making process.

CONCLUSIONS

Your ethical style is influenced by your professional responsibility with a strong sense of service, commitment to duty and sense of loyalty. Your style is one of personal self-development and advocating policies for equal respect of others. This respects the freedom of choice of other individuals and this being in accordance with established belief precedents of right and wrong.

You face a certain degree of frustration with some ethical dilemmas.  Often a conflict between personal choice and the duty of organizational instruction. This means weighing the balance of ethical considerations but maintaining the moral and ethical duty in order to achieve the right thing.  This leaves little room for compromise in decision making.  The law is not always black and white and determining the shades of grey often poses ethical challenges. Educational training in my job function demands a high sense of moral duty and following a chain of command in decision making.  Ethics means finding your own moral compass but remaining focused on team objectives.

It is an extremely difficult and complex subject in making a judgement as to whether the ethical considerations are in favour or against the concept of voluntary euthanasia.  Certain religions like that of Christianity will view this as a sin and a profanity against God who has given you life. In this context this is not your decision to terminate your own life.  Other medical practitioners will find it difficult to deal with terminally ill patients, particularly those that enter a vegetative state and have no future prospect of any quality of life.  This argument has been extended to cover so called “brain dead” patients in a state of coma.  It is very difficult to make unambiguous moral judgements.

 

 

References

Brody, B. A. (1989). Suicide and euthanasia: historical and contemporary themes. Amsterdam: Springer.

Jardin, K. (2012, 2 6). Political involvement in nursing – politics, ethics and strategic action. Retrieved from Findarticles.com : http://findarticles.com/p/articles/mi_m0FSL/is_5_74/ai_81161374

Jennifer A. Bulcock. (2006). How Kant would choose to die: A Kantian defense of euthanasia. New Hampshire: University of New Hampshire.

Killingbeck, P. (2012, 2 8). Professional code of ethics. Retrieved from Paulsjusticepage.com: http://www.paulsjusticepage.com/cjethics/ethics_appendix.htm

LaFollette, H. (2002). Ethics in Practice : an anthology. Oxford, UK: Blackwell.

Lama, D. (2012, 2 8). Solving Human Problems Through Transforming Human Attitudes. Retrieved from A Human Approach to World Peace: http://www.fpmt.org/teachers/hhdl/teachings/122-teachings/hhdl/715-a-human-approach-to-world-peace.html?showall=1&limitstart=

Leone, D. A. (1999). The ethics of euthanasia. New York : Greenhaven Press.

Noonan, J. (1975). Professional Ethics or Personal Responsibility. New York: Monroe.