The Dilemma In Dealing Death

By , Sugar Land, TX
The eighth day has come and gone and I’ve never felt so alive. It feels like death is more than just an arm’s length away, as if I couldn’t feel its desolate chill brush against my finger tips. And yet— do I really want to leave everything I love behind? Am I really hopeless? I’m of no use anymore, am I? Let’s face it—
I have nothing left. Nothing here. Nothing there. I’ve been left here to be forgotten. What’s the point anymore? As I am, I simply exist. No purpose can be served but to burden others’ existences. And yet, I can’t help but feel this unrest within my heart. It’s almost as if I’m communicating with myself, but a different me. And then, I see it.
Memories.
Remembering my family, my friends, my life, that unrest became more than just a simple feeling, but an urge, a desire, a need to continue living. I’m recalling talks that convinced me that within my heart exists that desire, and then I realize— I don’t want to die. If this is what mercy is, then I want no part of it. I do not want to die.
Euthanasia in and of itself is considered to be dealing death to a person, normally a terminally ill patient, in order to show mercy or allow them to die with dignity. The main controversy that surrounds the topic is whether or not it should be legalized. It takes upon different labels which are also variables that may affect the stances people take in regards to accepting it. Active euthanasia and passive euthanasia are terms used to describe the physician’s role in a patient’s death. Active euthanasia, which is often confused with physician-assisted suicide (PAS), is a physician taking direct action in dealing death to a patient rather than the physician distributing lethal medicine for the patient to choose to take or not with PAS. Passive euthanasia is the opposite, where the physician is indirectly responsible for a patient’s death through abstaining from prolonging their life through medicinal or technological means. Euthanasia can also be voluntary or involuntary, which are self-explanatory; voluntary euthanasia is done with the consent of the patient while involuntary is done without it. While each type varies in context, each has its own flaws which may prove problematic if euthanasia were to be legalized.
One must first consider the reasons that patients would decide to allow themselves to be euthanized in the first place. According to a study that was conducted by Meier involving patients and the option of euthanasia, the reasons patients may consider a request for it include “discomfort, loss of dignity, fear of uncontrollable symptoms, actual pain, loss of meaning in life, being a burden, and dependency” (Alters 71). Each reason listed holds an abstract subjectivity whose magnitude of severity can be altered through appropriate communication, aside from the actual pain, of course. For example, emotional burdens can be sorted out through simply talking any personal issues out with a trained professional, such as a psychiatrist, or even with loved ones who can the patient can sympathize with.
Emotional state of being contributes to requests for euthanasia as well. In the case of voluntary euthanasia, patients give their consent to allow physicians to euthanize them. Leaving the patients to decide their fate is a troublesome matter, as depression has a tendency to find its way into the psyche of patients along with their diseases. Depression evokes feelings of hopelessness in a person’s life, which in the case of empowered patients, may influence them to provide unwarranted consent to be euthanized. In America specifically, “approximately 6 million suffer from depression and 1 million of these suffer from severe depression” (Alters 142). While 1 out of 6 is by no means a majority, a large chunk of the population faces difficulty with their emotions, possibly leading them to turn to such ends that would cost them their lives.
If, hypothetically, euthanasia were to be legalized, the physician would bear responsibility to act with appropriate judgment in deciding a patient’s fate. Despite patients being empowered to that “privilege” under the contexts of voluntary euthanasia, the physician essentially holds final say in whether to comply with the patient’s wishes under any contexts, and possibly the only say when the patient is unable to give their consent (in the case of involuntary euthanasia). This becomes problematic as the judgment relies heavily on the individual attitudes of the physician, causing the outcomes and situations to vary. The subjective approach that must be taken when making such decisions proves to be an unreliable means to come to a conclusive consensus as far as circumstances where euthanasia would be acceptable.
Empowering physicians to such an extent allows for certain abuses to become a possibility, especially when dealing with involuntary cases in which consent from the patient cannot be given. Physicians hold influence over a patient, with the capability to serve as a catalyst that sparks the patient’s interest in euthanasia by simply suggesting it. Also, the physician is capable of essentially killing the patient on his/her own accord without proper consent. While this may not stand true in every case, it is not untrue in any case.

For the most part, too many “ifs” exist to rely on euthanasia as an acceptable option— as it stands. However, certain situations may prove its usefulness if handled in an appropriate manner.
Fig. 1. A chart which shows the percentage of people in support for euthanasia and doctor-assisted suicide from 1947-2005.
As indicated by Figure 1, there has been a general upward trend regarding the number of requests for euthanasia over the years. This is most likely due in part to the increase in population and thus an increase in the number of patients that contract terminal illnesses. With the number of terminal illnesses increasing, the requests for euthanasia grow in number in proportion to the number of patients. The rise in demand for euthanasia calls for stricter regulation if euthanasia were to become an option to meet that demand.
Today marks the tenth day of my stay here. The stench of antiseptic seeps into my senses, the odor so strong that my eyes have steadily become flooded. The IV has a certain familiarity to it, almost as though it has become an extension of myself. It isn’t just the comfort of the needle thrust in my veins that I have grown accustomed to, but also the cold chills of emptiness that blanket my body, the unnerving silence which echoes through my mind, the relief of darkness cradling my head. Even the doctors and nurses feel like family to me, a family that I wish I never had. The third time I have been here this year is the third time too many quite frankly, and yet— I feel like this may be my very last.
Beep. Beep. Beep.
...Is that my heart? Or maybe he’s knocking already. I’ve never been too fond of visitors-- especially not him.
Death.
I’ve never felt this fear before. The fear of living, waiting, dying. I just want him to come already. This fear…
This constant fear of impending death haunts terminally ill patients, burdened with the ignorance of exactly when their time will come and regretful of the knowledge that nothing can be done to prevent the inevitable. With all options exhausted, the only thing left for them to do is to die. Euthanasia has the capability to allow cases such as these a means of escape, however, only when absolutely necessary.
A new problem arises with this however; as previously mentioned, there is no objective means to specify when exactly a case would present itself in which euthanasia would be useful; when absolutely necessary is. There is, however, a means of setting more defined guidelines in order to reach that consensus.
First of all, certain circumstances must be factored in when determining whether a patient is eligible to request euthanasia: mental stability and substantial knowledge in order to give informed consent.
Much like depression, mental incompetence may skew a patient’s judgment, which prevents patients who suffer from that to be included from being able to request euthanasia. Certain diseases such as autism or dementia bring about mental instabilities. In order to determine the extent of a mental illness, or if a mental illness is present at all, diagnostic tests should be run and psychiatrists should spend time determining whether the patient is stable enough to make an informed decision.
The next point of emphasis is the patient giving informed consent. Not only must the patient have the capability to process necessary information, but he/she must have a thorough understanding of his/her disease, the treatments, and any alternative measures to take before any considerations of euthanasia. This is done to prevent any hasty decisions made before all other options are exhausted. Only after attempting any other options prior to that may considerations be made.
Secondly, the actual physician must be properly trained in order to responsibly carry out the task and must maintain a certain level of trust not only with the specific patient he/she handles at the time, but his/her other patients as well.
Physicians must undergo training to be able to discern certain symptoms of terminal illnesses that may prove fatal such as shortness of breath, pain, depression, et cetera. They must also be able to convey the necessary information to the patient in order for understanding to be shared amongst them. The physician must also understand that euthanasia itself should not be a primary option and must extensively attempt to handle the patient by any other means before accepting the patient’s request.
Finally, with regard to creating a working system, the use of advanced directives and surrogates would be beneficial in regulating how a patient is to be handled in the case of their own inability to do so themselves. Advanced directives are known as a “living will” which is “drawn up by a competent individual” and “provides a legally recognized means for the expression of personal end-of-life wishes” (Larue). A surrogate is a person who acts as a substitute for the patient in deciding his/her end-of-life wishes. By taking advantage of these the patient can effectively define the method of action that the physicians will take, allowing the process to occur with less hiccups and promote a cleaner outcome.

Euthanasia, as it stands, is illegal. While it should NOT be the first option terminally ill patients should take, it definitely proves as a useful final option when following strict guidelines in order to regulate its usage.
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Works Cited
Alters, Sandra. Death and Dying. Wylie: Information Plus, 2005. Print.
Larue, Gerald A. "Worldwide Approval for Assisted Suicide Is Increasing." Current
Controversies: Assisted Suicide. Ed. Karen F. Balkin. San Diego: Greenhaven Press, 2005. Opposing Viewpoints Resource Center. Gale. AUSTIN HIGH SCHOOL- Sugarland FBISD. 25 Feb. 2011 <http://find.galegroup.com/ovrc/infomark.do?&contentSet=GSRC&type=retrieve&tabID=T010&prodId=OVRC&docId=EJ3010035262&source=gale&srcprod=OVRC&userGroupName=tlc049072572&version=1.0>.

Moore, David W. "Percent Support for Euthanasia and Doctor-Assisted Suicide," in "Three in
Four Americans Support Euthanasia: Significantly Less Support for Doctor-Assisted Suicide," The Gallup Poll, May 17, 2005. Copyright © 2005 by The Gallup Organization. Reproduced by permission of The Gallup Organization. ).Opposing Viewpoints Resource Center. Gale. AUSTIN HIGH SCHOOL- Sugarland FBISD. 25 Feb. 2011 <http://find.galegroup.com/ovrc/infomark.do?&contentSet=GSRC&type=retrieve&tabID=T007&prodId=OVRC&docId=EJ2210067720&source=gale&srcprod=OVRC&userGroupName=tlc049072572&version=1.0>.





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