Key Issues - Euthanasia

Alternatives to Euthanasia and Assisted Suicide

The World Health Organisation has recommended that there should be concentrated efforts to implement programmes of palliative care, rather than governments yielding to pressure for legal euthanasia. Hospice care, physicians and medical students better trained in pain management and palliative care, and treatment for patients suffering psychological distress, provide the best alternatives to euthanasia.


Coercion

Those opposed to the legalisation of euthanasia and assisted suicide warn that safeguards will not work. Disability groups and others fear that they will be coerced to accept euthanasia against their wishes. Studies in the Netherlands show that the subject of euthanasia is frequently initiated by the doctor, compromising the voluntariness of the patient.


Death Tourism

The practice of travelling to Switzerland where people can receive assistance in dying has received criticism from both those who oppose euthanasia and those groups who advocate it. Swiss authorities are considering passing emergency legislation to prevent foreigners arriving one day and dying the next by requiring a 6 months residency.


Elder Abuse

Financial and psychological abuse are the main types of abuse experienced by the elderly. Both in domestic homes and in hospitals and nursing homes, this abuse, when carried to the extreme, becomes non-voluntary euthanasia or murder. Elderly, non-terminally ill people are being systematically overdosed and dehydrated to death by those whose job it is to care for them.


Population control

Euthanasia was used by the Nazis to weed out, at first,the mentally and physically disabled among the population. This was later used to rid German society of dissidents and those they considered to be 'human weeds'. In many countries more people are dying each year than are being born. European populations are beginning to die off and their governments are suddenly encountering a host of new social problems, such as an levels of the elderly and labour shortages. There are concerns that the elderly and disabled will be coerced into euthanasia, in large numbers, for economic reasons.


Safeguards

While advocates of euthanassia and assisted suicide say safeguards will prevent abuses of proposed legislation, opponents point out where guidelines have been ignored in the Netherlands and Oregon and how the safeguards in their legislation has failed. In the Netherlands, due to the strict definition, there are thousands of euthanasia deaths each year that are not counted as euthanasia, while in Oregon officials have conceded "there's no way to know if additional deaths went unreported" because Oregon DHS "has no regulatory authority or resources to ensure compliance with the law."


Suicide Link

Assisted suicide advocates have borrowed a phrase from their predecessors in the abortion movement, claiming that legalisation will prevent "back-street suicides." Opponents say legalisation will send a negative message to vulnerable people who are depressed or mentally ill, and could lead to higher suicide statistics.


Brain Death

Although 'brain death' is now accepted as legal death, there is still controversy among bioethicists and medical professionals as to both the ethics and the criteria used. Saying that while 'brain dead' patients may be dying, they are not dead, critics cite the many cases where people who have been declared 'brain dead' or in an irreversible coma have woken, sometimes years later, and recovered to a large degree.


Complications with assisted suicide

Dr. Pieter Admiraal, who has practiced euthanasia in the Netherlands for years, has warned that assisted suicide can go wrong and physicians need be prepared to administer a lethal injection. Complications can include difficulty in taking the drugs, failure of the drugs to induce unconsciousness, waking from a coma and a number of days elapsing before death occurs.


Do Not Resuscitate Orders

In New Zealand standard practice is to always resuscitate patients to restore pulse and breathing unless there is a specific order for this not to happen. In some circumstances the decision on whether or not to issue a DNR order has been made in the past simply because of the age, or disability, of some patients being admitted to hospital. Some disabled people have reported instances in which hospitals have pressurised patients into signing a DNR order.


Impact on families

The effect euthanasia and assisted suicide may have on remaining family members has not been much considered. Where a family member or friend has been involved in a 'mercy killing' there can be complicated grieving. Divisions have occurred where there is bitter conflict over the decision and there is concern that that grieving and/or depressed family members may kill themselves at a later date.


Impact on society

No person makes the decision to end his or her life in isolation. There are others who are affected: friends and relatives left behind, and the healthcare staff involved in the decision-making process. A palliative care expert in the Netherlands has attributed Dutch deficiencies in palliative care to the easier alternative of euthanasia. Opponents point to the Nazi euthanasia programme and say that legalising euthanasia has the power to brutalise society.


Quality of Life

Disability rights action groups warn that while society is being sold a message that it would be better to be dead than disabled, millions of people with disabilities and those who are aging are fighting to stay alive and in their homes and communities. They are alarmed that the medical profession have deemed themselves 'the experts' in deciding what is an acceptable or unacceptable quality of life.


Value of Life

Many philosophers and bioethicists believe that the greatest happiness of the greatest number, should be the sole end of public action and policy. The belief that life is only of value if it is of some use would lead to the conclusion that some lives are not worthy of living.