Euthanasia is a controversial subject, not only because there are many different moral dilemmas associated with it, but also in what constitutes its definition. At the extreme ends of disagreement, advocates say euthanasia, also known as physician aid in dying, is a good or merciful death. Opponents of euthanasia say it's a fancy word for murder. There are reasons that would make a person lean toward the side of euthanasia, and there are also reasons that would turn someone away from euthanasia.

The arguments against euthanasia include the church's view on the topic of suicide. The arguments in favor of euthanasia include the patients wish to have dignity. However, regardless of the patients wishes, suicide is against the law. If a person has a living will, it would allow the doctors to lawfully end any life preserving treatment. Without a living will this cannot be done. The decision to allow a patient to end his or her life is clearly not an easy one.

The courts feel that unless there is a living will to state what the patient would want to be done, the authorities must try to save the patient. The law does not require that everything must be done to keep a patient alive. Some people feel that keeping a patient alive against his or her wishes is not only cruel and inhumane, but it is also contrary to law and practice. However, for centuries now, physicians in training have been taking the "Hippocratic Oath'. This oath is taken from the Greek physician Hypocrites who lived thousands of years ago. The "Hippocratic Oath' imposes on two duties: to prolong life, and relieve suffering.

The problems come about because these two duties are often in conflict. The question most of the time is to decide when prolonging life should take precedence over relieving suffering. There is often much confusion and questions about the difference between physician aid in dying and physician assisted suicide. First I will talk about physician assisted suicide. " Physician assisted suicide is the provision by a doctor, consciously and legally, to a patient who has competently requested it, the means for that patient to end his or her own life' (McCuen 12). I also found a definition on the World Wide Web that stated, "In assisted suicide, a non-suicidal person knowingly and intentionally provides the means or acts in some way to help a suicidal person kill him or her.' I personally find the second definition a little bit easier to understand.

An example of an assisted suicide is if a doctor writes a prescription for a drug that he or she knows will kill the patient. Physician aid in dying (euthanasia) is a little different from assisted suicide. "Physician aid in dying is assisted by a qualified medical practitioner in implementing a patients considered wish to end his or her own life usually by means of lethal injection' (McCuen 13). The stronger and more widely held opinion is against Euthanasia primarily because society feels that it is God's task to determine when one of his creations time has come, and we as human beings are in no position to behave as God and end someone's life.

The church holds very strong views against euthanasia. They feel that suicide is a sin because murder is a sin. "Murder is a sin, not only because it is contrary to justice but, also because it is opposed to charity which a man should have towards himself: In this respect suicide is a sin in relation to oneself. In the relation to the community and to God, it is sinful, by reason also of its opposition to justice' (Donnelly 41). The church is trying to say that if a person decides on euthanasia it not only affects that person but it also affects the community and God as well. The church feels that God is the only one who has the right to take someone's life.

Many people believe that when humans take it upon themselves to shorten their lives or to have others to do it for them by withdrawing life-sustaining apparatus, they play God. They usurp the divine function, and interfere with the divine plan. I agree with the fact that God is the one who should take our lives, but I also have to believe that God would not want us to suffer. When people are in agonizing pain from a terminal illness they not only feel a loss of dignity; they feel a sense of comfort with the thought of ending that suffering, even if it means death.

A patient might choose euthanasia because, "he or she might choose to die nobly rather than to fall into the hands of the wicked and to suffer abuses unbecoming his / her noble birth' (Donnelly 40). This idea is trying to tell us that a person feels that they would rather die with dignity than to die suffering. I also found an example of this concept in the book Doctor Assisted Suicide and the Euthanasia Movement, Lydia had been fighting cancer on and off for Ten years. Lydia fought bravely to keep living Through various complex treatments and their Aftermath. Finally the doctors told her that there Was nothing more they could do and that she Should expect death soon. Lydia wanted to die With dignity and she saw no dignity in cornice drug Sedation.

Since the doctors would not help and her Husband did not actually want to be the one to kill His wife, Lydia died naturally seven days later, With no dignity (PP 151-152). Some people choose to end their suffering because they do not want to be seen in such misery. I feel that when a patient is in such a state that holds for them only pain and suffering, the families of the patients sometimes want to keep their loved one alive for purely selfish reasons. The families, perhaps without even realizing it, might want to only keep their suffering parent, grandparent, sibling, friend or other relative around just so they would not have to adjust to life without their loved one. They might not realize that the person who is suffering might not be able to stand the pain anymore. On the other hand, there might be some families who are hurting just because their loved one is suffering.

The families of the terminally ill patients might act as an influencing factor mainly because they do not want to see a person, whom they love very much, suffer. If a person is in such agonizing pain, their family wants nothing more than to stop that pain. "Years ago when physicians ran out of superficial veins into which they could insert their needles, they did cut downs, minor surgery to expose for their ministration the deep veins in their ankles and armpits.' (Peck 8) This procedure since then has become obsolete. But in this book I found an example of a mans reaction when his grandmother had this procedure done, Putting myself in the role of resident physician In charge of the case, I can only wonder, "why In Gods earth should I bother to try to stick a needle In yet another vein in this poor eighty-four-year-old Women who is apparently senile, who probably wont survive anyway, and who, if by some miracle she should survive, clearly wont be any good for anything anyway?' It seemed to me at the time of my visit that they should have pulled the plug (8). This reaction clearly illustrates the families pain in watching their loved ones suffer. They would rather end the suffering than have their loved one around for a little while longer.

There is also the cost of keeping individuals on life-support systems when there is no quality of life. Many times, the individuals are in a coma and can live a long time, being totally unaware of their surroundings. Sometimes a family spends their entire life savings keeping someone alive. This takes a mental toll also, having to decide when to visit and the feelings of guilt that more cannot be done. The Hemlock Society is an organization that was established in 1980 by Derek Humphry. They support "voluntary euthanasia for the terminally ill through assisted suicide'.

It has 47, 000 members, which include several hundred doctors. Because of Humphry's book, Final Exit, which became a #1 best seller on The New York Times list, the society has grown by approximately twenty percent. The book gives suggestions on how to end one's life. This shows that many people are taking this issue seriously enough to join an organization and to research information that they may use in the future.

People are questioning whether or not doctors will continue to act for the well being of the patient. If doctors are allowed to assist euthanasia, who is to say when they go too far? The Hippocratic Oath, which doctors' take saying that they promise to preserve life, was originally for the protection of patients. Doctors though have the power to kill as well as heal. People who are against euthanasia might also say that the complete confidence that once formed the basis of doctor-patient relationship will be severed and no one will be safe if euthanasia goes too far.

If physicians are allowed to kill their patients, where will it end? I think that when euthanasia is decided upon, the doctors are only concerned with the patient's wishes. It is sometimes forgotten that another part of the "Hippocratic Oath' deals with relieving the patient's pain. People might say that euthanasia is wrong because it gives people the authority to say when someone should die. We have forgotten how Nazi Germany began its Reign of Terror.

It began not with Hitler, but with A group of German doctors who begun practicing Euthanasia on the mentally ill and the handicapped. Hitler approved of their euthanasia program, exploiting And extending it to rid the state of other "useless eaters.' Today America is rushing blindly to embrace the Philosophy that some lives are not worth living – the Corner store of Nazi belief (McCuen 158). Although this very well might be true, now in present time I feel that if euthanasia takes place it is not meant to harm the patient, it is meant to relieve their pain. Another proponent of euthanasia is the option of Hospice Care.

The main goal of Hospice Care is to alleviate the pain that a patient is feeling and to make them live well while dying. Hospice Care refuses the burdens of aggressive life sustaining treatment. "Today over seventeen hundred hospice care programs in the United States enable thousands of people to receive excellent home care during their last months' (McCuen 161). Should a patient have the right to end his or her life? "Every patient has the right to judge his suffering as unbearable and the right to ask his / her doctor for euthanasia', said Dr. Peter Admiraal at the eighth Biennial World Conference or right to die societies. "Our laws must be changed so that any patient in consultation with family, close friends and consulting doctors may voluntarily choose to terminate his / her life humanly when there is no rational expectations for anything but never ending misery' (McCuen 153).

They are trying to say that the patient him / herself should have the authority over their life to choose when to die. They feel that the courts should not have this authority. In the Supreme Court case of Nancy Cruzan, the debate was whether or not they should continue keeping her alive as a vegetable. Nancy Cruzan was in a terrible car accident, which left her in a comatose state. When her family wanted to have Nancy's feeding tubes removed, the Missouri Supreme Court would not authorize this.

Justice Rehnquist acknowledges that, A competent person has a constitutionally protected Right to refuse life saving nutrition and hydration. However, in the case of an incompetent person, it is Not unconstitutional for Missouri to insist that nutrition And hydration can be terminated only if there is "clear And convincing evidence' that termination of treatment Is what the person would have wanted (Steinbeck 7). The U. S. Supreme Court agreed, but it also held that a person whose wishes were clearly known had a constitutional right to refuse life-sustaining medical treatment. After further proof and witness testimony, a probate court judge in Jasper County, Mo.

, ruled Dec. 14, 1990, that Cruzan's parents had the right to remove their daughter's feeding tube, which they immediately proceeded to do. Nancy Cruzan died Dec. 26, 1990. The Cruzan decision sparked a fresh interest in living wills and in 1990 Congress passed the Patient Self-Determination Act. It requires health care facilities that receive Medicare or Medicaid funds (95 percent of such centers) to inform new patients about their legal right to write a living will or choose a proxy to represent their wishes about medical treatment, and what kind of measures will be taken automatically for patients as institutional policy.

Where state law permits, these institutions must honor living wills or the appointment of a health care proxy. Another case where euthanasia was involved was on March 6, 1996 where for the first time in U. S. history, in the case Washington v.

Glucksberg, the U. S. Court of Appeals for the 9 th circuit in San Francisco overturned a Washington State law that made assisted suicide a felony. The existing ban on assisted suicide was successfully challenged under the equal protection clause of the Constitution's Fourteenth Amendment. The court noted that, under present law, a dying patient on life support may legally have it removed to facilitate death while another dying patient, not on life support but suffering under equivalent circumstances and equally close to death, has no means by which to end his or her lives. The court, ruled that, bans on assisted suicide constitute a violation of the second patient's equal protection rights under the Fourteenth Amendment.

In his majority opinion, appellate Judge Stephen Reinhardt of Los Angeles wrote: "If broad general state policies can be used to deprive a terminally ill individual of the right to make that choice, it is hard to envision where the exercise of arbitrary and intrusive power by the state can be halted.' Reinhardt's analysis relies heavily on language drawn from U. S. Supreme Court abortion case, Roe v. Wade, because the issues have "compelling similarities,' he wrote. Like the decision of whether or not to have an abortion, the decision how and when to die is one of "the most intimate and personal choices a person may make in a lifetime,' a choice "central to personal dignity and autonomy.' On April 2, 1996, in the case of V acco v.

Quill, the U. S. Appeals Court for the Second Circuit in New York struck down that state's law making it illegal for doctors to help terminally ill people end their own lives. But whereas the Ninth Circuit decision was based on the Fourteenth Amendment and privacy issues, the Second Circuit ruling in April invoked an "equal protection' argument that people suffering terminal illnesses should have the same right as those, such as Quinlan, who are in a coma and have the law on their side in the decision to halt life-sustaining nourishment or treatment. "Physicians do not fulfill the role of 'killer' by prescribing drugs to hasten death,' wrote Second Circuit Judge Roger J. Miner, "any more than they do by disconnecting life-support.

Doctors that are involved in euthanasia take risks. They risk their licenses being taken away, they risk being sent to jail and they also have the risk of their reputations being altered. Regardless of these risks some doctors still get involved. Dr.

Kevorkian was charged for murder so many times yet he still went back to helping all those people end their suffering. However, in the Netherlands although euthanasia is illegal it is very hard to prosecute a doctor for assisting. Because very strict sets of requirements are followed the chances of prosecution are very slim. It is said that terminal illness accompanied by pain is often what makes people want to decide on euthanasia. When death is inevitable and the pain is not tolerable, patients might request euthanasia.

"The presumption that patients who are in agonizing pain ask for euthanasia as a last resort is correct, but the reverse assumption that with proper pain treatment a patient never will ask for euthanasia is incorrect', stated Dr. Peter Admiraal, an anesthesiologist who was the first physician in the Netherlands to speak openly about euthanasia. He also stated that "the main reasons patients request euthanasia are the loss of dignity that may accompany the final stages of terminal illness and the acceptance that death cannot be avoided.' Dr. Admiraal says pain is rarely a reason for euthanasia. In his hospital when a person decides on euthanasia, they try to do things in hope that euthanasia may be avoided. Some of the things that are done is they make the patient feel more comfortable then a "team of people talk to the patient.' In the end though, the decision is totally up to the patient.

In the book Killing and Letting Die I read about a situation where a person would rather die then live in unbearable pain that was totally consuming him. The situation is, A patient who is dying of incurable cancer of the Throat is in terrible pain, which can no longer be Satisfactorily alleviated. He is certain to die within A few days, even if present treatment is continued, But he does not want to go on living for those days Since the pain is unbearable. So he aks the doctor For an end to it (PP 113).

It also states in this book that there can be two types of effects to this case. "If one simply withholds treatment, it may take the patient longer to die, and so he may suffer more than he would if a more direct action were taken and a lethal injection given (pp 113). This shows that the effects of patient's decision might be less tortuous if active euthanasia were chosen instead of passive euthanasia. In a web site that I found on the public opinions on euthanasia it states that, "some people say that the law should allow adults to receive medical help to an immediate peaceful death if they suffer from an incurable physical illness that is tolerable to them, provided they have previously requested such help in writing'. I also found in another web site the Medical opinion on the subject of euthanasia. The opinion states that, ' A doctor, acting in good conscience, is ethically justified in assisting death if the need to relieve intense and unceasing pain or distress caused by incurable illness greatly outweighs the benefit to the patient of further prolonging life'.

Of course these two opinions are not the opinions of everyone but I personally feel that these opinions make a very good point. Euthanasia (in some cases) serves the interests of everyone concerned: it is mercy to the patient, relieves emotional strain on family and friends and conserves finances and medical resources. If doctors are forbidden from providing a painless death to their terminally ill patients who request it, this is an unjust restriction on the patient's personal freedom. These ideas are hard to accept, but deserve consideration. The idea of deliberately killing someone goes against the very core of our morality. I am not suggesting that the value of life be taken lightly, nonetheless, I believe in the most tragic cases euthanasia should be permissible.

If I were in a situation where pain greeted me twenty four hours a day, and I knew my illness was incurable, I would probably want to put an end to that suffering. I would not want my family and loved ones around see me suffer. Also, I would want to die with as much dignity as possible. But then again, I am not in that situation, so I am not positive that is what I would want to do, you just have to be in the situation to make the best possible decision. Bibliography 1.

Friedman, Emily. Ethics Issues For Health Care Professionals. Baskerville: American Hospital Publishing, 1986. 2.

Maguire, Daniel. Death By Choice. Garden City: Doubleday & Company, 1984. 3.

Reich, Warren. Quality Of Life. New York: Paulist Press, 1990. 4.

Brody, Baruch. Life And Death Decision Making. New York: Oxford University Press, 1988. 5. Chapman, Carleton.

Physicians, Law, & Ethics. New York: New York University Press, 1984.