Research Paper: The Slippery Slope of Euthanasia and Where Medical Ethics Fit

Euthanasia is one of the topics that are extensively debated upon in the medical field due to its controversy in medical ethics as well as medical laws. The subject came to be a prominent issue in the United States in 1985 after the death of Karen Ann Quinlan whose parents requested doctors to disconnect her from her ventilator while she was in a comma. The request was not immediately honored, and it raised important questions on bioethics, moral theology, civil rights, and legal guardianship. Today, the subject has not yet received a conclusive stance, and no consensus has been universally reached regarding its legality or morality. There are entirely different viewpoints that different nations have taken on the issue and in the US, few States have legalized euthanasia. The states include Oregon, Washington, Vermont, and Montana. The states, however, legalized euthanasia after numerous failed attempts, which indicate that opinions are still varied in the whole issue. For a person to be euthanized, they have to be 18 years or older. They also have to be residents of the state. Accredited doctor who will suggest that the patient has six months or less to live must also diagnose them with a terminal disease. Additionally, for a patient to be euthanized, he or she must be free of any mental health disorder. The focus of this paper is to discuss the slippery slope of euthanasia, medical ethics, and arguments for and against euthanasia.

The Slippery Slope

The slippery slope is a phrase used with a consequentialist view. It asserts that a relatively small first step may lead to a chain of related events that culminate in a chain of significant and often adverse effects. The term slippery slope is occasionally used to refer to the unintended consequences of decision-making (Volokh, 2013).

The notion that euthanasia is a slippery slope is attributed to its critics. Critics argue that the legalization of euthanasia will lead to cases of non-voluntary and involuntary euthanasia. It is important to note that euthanasia can be classified in three ways: voluntary, involuntary, and non-voluntary euthanasia. Voluntary euthanasia is described as a process in which a physician administers a lethal drug with the consent of the patient. Involuntary euthanasia is a process where a doctor administers a lethal drug against the patient's will. Non- voluntary euthanasia is a process in which a clinician injects a lethal drug into a patient without the input of the patient (Mrayyan & Naga, 2013).

Lerner and Caplan (2015) state that the slippery slope argument in euthanasia says that if doctor-assisted suicide is allowed in the medical profession, it will lead to the occurrence of practices which are deemed unacceptable which in this case is voluntary and involuntary euthanasia. Lerner and Caplan (2015) argue that for it to be possible to prevent the occurrence of the unacceptable practices, the initial step, which constitutes legalizing doctor-assisted suicides, should be avoided.

According to Saunders (2013), the slippery slope effect can be manifested in Belgium, where euthanasia was legalized in 2002. Between the year 2003 and 2012, there was a 500% increase in deaths through euthanasia in the country. Some of the deaths were not due to the intended purpose of eliminating the suffering of a patient. For instance, Mark and Eddy Verbessem were 45-year-old identical twins who were deaf. They were euthanized after their eyesight began to fail. In another case, Nancy Verheists life was ended in front of television cameras after a series of failed sex change procedures. In another similar case, Ann G, a patient suffering from anorexia, decided to end her life after being sexually abused by her psychiatrist. At the moment, the country practices organ donation, and there are recommendations to include persons suffering from dementia and minor in the program. The country has already experienced three cases of involuntary euthanasia while some cases are thought to go unreported.

Saunders (2013) further provides an account to how the legality of assisted suicide in Switzerland has contributed to unintended consequences. When suicide supported statistic was released in the year 2009, it was revealed that there was a 700% increase in assisted suicides. It was reported that people were traveling from abroad to the country into a Dignitas facility to end their lives. Individuals who went to the facility were not considered as terminally ill. Some of the individuals who ended their lives at the facility were blind, had arthritis or diabetes. Some of the patients felt that living with their spouses was too unbearable.

Apart from the fact that allowing legislation permitted the act of euthanizing persons who were not terminally ill or incurably suffering, it also led to a situation in which cremated bodies were dumped at Lake Zurich. There were also report of body bags being found in residential lifts or suicides being carried out in car parks. It was also said that the facility made an estimate of $9,000 in profit per death.

The description of events in Belgium and Switzerland are an indication of how a step meant at predominantly assisting patients who are suffering from terminal illnesses and experiencing immense suffering is being exploited for other reasons but not the intended purpose. Passing legislation that permits euthanasia does not only lead to involuntary and non-voluntary euthanasia but also leads to suicide due to preventable and flimsy reasons.

Medical Ethics

Ethical Behavior

It is impossible to discuss physician-assisted suicides without involving ethics. Physicians are always required to conduct themselves ethically, which requires using moral and value-based principles to determine whether something is good or bad. In medicine, ethical decision-making must balance one's right to make the decision for his or herself, the views of the community and the desires and wishes of the family. The presence of different interested parties in such a scenario necessitates that the decision maker is fair in balancing the satisfaction of all interests so that every stakeholder is treated fairly (Steinbock, London, & Arras, 2013).

In theory, medical ethics is easy to state, however, in some circumstances it becomes difficult to implement practically. For instance, when a patient is experiencing terminal excruciating pain and suffering, the main question that the patients family usually ask is what can be done. Physicians respond by stating that they will do all that is possible to make the suffering go away. It, however, becomes extremely difficult for both patient, families, and physicians when they realize that no intervention will work on the patient and the only alternative is euthanasia.

Bioethics

The difficult and complex circumstances are what bioethicist experience. A bioethicist is a trained hospital employee who is conversant with religion, law, psychology, philosophy, humanities and social sciences. Veatch (2016), states that the role of a bioethicist is to help families and other medical practitioners make difficult medical decisions such as euthanasia through the collection of facts, medical views, and family opinion to arrive at the most appropriate solution. Essentially, a bioethicist is required to represent the interests of the patient above all others (Veatch, 2016).

Hippocratic Oath

According to Williams (2012), the requirement that a medical practitioner should represent the interests of the patient is entrenched in the doctor oath of practice. The oaths are however solely in favor of the will to preserve a patient's life and not to end it. The oath requires doctors to apply all measures required for the benefit of the sick. The oath also requires doctors to tread carefully in life and death scenarios. The requirement that a physician should tread carefully in life and death situation implies that the practitioner should do everything possible to avoid medical errors that may result in endangering the life of the patient. Besides, the requirement that doctors should apply all measures required for the benefit of the sick emphasizes the role of a doctor in ensuring the well-being of a patient which can be equated to the preservation of life. It is thus important to note that the Hippocratic Oath which all doctors are required to adhere to does not in any way condone euthanasia.

The Doctrine of Double Effect

One of the considerations in medical ethics concerning euthanasia is the Doctrine of Double Effect. According to Cushman (2016), the doctrine asserts that it is morally acceptable to cause harm as a side effect when it is anticipated that the overall effect would be good. The use of the principle is common in a military setting where it is permitted to have civilian casualties if a mission is successful and the intended good is arrived upon. In a health care setting, the use of the doctrine of double effect can be divided into two categories. The first category is that when a medical practitioner does an action that with the intent of causing a patients death, it will be different from when another practitioner does something while knowing that death would be a potential side effect. The second category states that the first stated case is morally unacceptable while the second is morally permissible.

The American Medical Association endorses the assertion that the doctrine of double effect is permissible in a healthcare setting. It has also been included in Supreme Court landmark decisions (Cushman, 2016). One of the reasons as to why the doctrine has over time gained widespread acceptance is because it explains a medical practitioners institutions in certain difficult circumstances.

Morality

The debate on euthanasia is largely due to moral reasons. One of the most asked questions is whether it is okay to commit suicide. Subsequently, one may ask it is okay for one to offer help to someone who wants to commit suicide. The questions are important in helping define culture, society, and ethics. There exist several reasons as to why the issue has been debated upon for many years. One of the reason is that each culture has had their ways of dealing with death. The distinct ways that of dealing with death comprises of mechanisms that have rituals that provide solace to the bereaved and a sense of continuity.

Medical technology has brought changes to the way the western culture views death. Most of the ailments that were known to kill patients are not treatable and are considered less risky for medical technology has provided cures. The occurrence has led to the increase of life expectancy in the country. In addition, the quality of life has increased fundamentally in comparison to previous years. Advancement in medical technology creates the notion that euthanasia is not an option since there exists a multitude of ways to treat conditions and reduce suffering. Had it been in ancient times when there were no available forms of cure, euthanasia would have been excused. However, contemporary times deny the procedure the ability to be widely accepted.

Argument for Euthanasia

Rights Based Argument

According to Vaughn (2015), persons who advocate for euthanasia argue that a patient has the right to make the decision about how and when they will die based on the principles of autonomy and self-determination. The principle of self-government and self-determination states that a patient has the right to make a decision about the course his or her life will take without harming others. A patient has rights over his or her own body and should have the right to determine how and when they will die. They also have the right to a dignified death.

Beneficence

Vaughn (2015) further states Proponent...