Today, it is fairly widely accepted that an individual has a right to dictate what is to be done with his or her remains after death. With advances in medical technology, it has become increasingly possible to transplant organs from a dead person to another individual. Many people choose to donate certain body parts to others after death. Others decide to have their bodies sent to medical schools or research institutions.
But there is less general acceptance of the idea that physicians should be allowed to do anything other than fight on for the patient`s life, no matter what the circumtances. For example, if a dying individual is suffering great pain or discomfort and, indeed, would welcome death-should physicians be permitted to speed the death in some painless and humanitarian way, such as by administering a lethal drug or terminating life-sustaining treatment? Such a killing, called euthanasia, might be merciful to the dying person but would also place a difficult burden on the family, physicians, judges, and other people who might become involved in the decision. At this time, euthanasia is illegal, but a report published in 1983 by the President`s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research said that nothing prevents a doctor from giving pain-relieving drugs is not to end the patient`s life, but to relieve unbearable pain.
A related question is : Can a patient, or a patient`s family or physician, refuse medical treatment that might reasonably be expected to save the patient`s life-without this action`s being legally considered suicide on the part of the patient or homicide on the part of the family or physician? This question became a public issue in the mid-1970s, when the Quinlan family of New Jersey agonized over whether their daughter Karen Ann should be taken off a respirator that was believed to be keeping her alive. Karen Ann Quinlan was bedridden in a deep coma; her parents petitioned the courts to have the respirator shut off, arguing that she no longer had a life worth living. The Quinlan case prompted a public debate, which is still raging, over just what right people have to decide the circumtances of their own dying days, and what rights others may have. In view of the presidential commission, mentally competent patients should be given all the necessary information and then be allowed to decide whether to halt medical treatment that keeps them alive but offers no hope of curing or improving their condition; in the case of mentally incompetent patients (such as the newborn, the retarded, or the comatose), family members should be allowed to make similiar decisions.
At the time of this writing, twelve states have “natural death” laws, allowing patients to refuse treatment in terminal illnesses; forty-two states allow patients to appoint surrogates, who can act on their behalf if they are unable to make the decision themselves. A simultaneous movement to develop “living wills” has also emerged, designed to give Americans the right to control the way they die. In a living will a person specifies that he or she does not want to be kept alive by artificial means under certain circumstances. Most often the living will is written as a legal document, witnessed by at least two people, and notarized to ensure that the person who draws it upis of sound mind. More than 750,000 people have drawn up such documents. But mos legal authorities doubt that living wills have the force of law without a law passed specifically to back them up. To date, only California has passed such a law. Living wills also leave the question of recovery up to physicians, and doctors do not always agree on a patient`s prognosis-nor are they always correct even when they do. In the case of Karen Ann Quinlan, doctors predicted that she would die shortly after the respirator was withdrawn. But she lived on for years after the courts ordered it removed.
Even beyond these questions of judgement, there are other concerns about the right-to-die laws. Many people question whether anyone can anticipate how he she will feel about dying when the actual moment approaches. Would a car-accident victim, paralyzed and unable to speak yet fully conscious, want to be taken off a respirator? What if alternative treatments arose that the person had not anticipated when he or she made the decision? Finally, many people worry that right-to-die laws could become smoke screens for inadequate care for the dying. It is difficult enough for a dying person to secure a caring and attentive environment without such laws; they might be used to justify further inattention and neglect, these people fear, as part of a person`s right to die.
References :
Harold M. Schmeck, Jr, “U.S. Panel Calls for Patients’ Right to End Life”, New York Times, March 22, 1983.
Marguerite Mancini, “Death with Dignity : Are Living Wills the Answer?” American Journal of Nursing, December, 1978.
Marvin R Levy, Mark Dignan, Janet H Shirreffs, Essentials of Life & Health, Fourth Edition, Random House, New York, 1984.
Marc Lappe, “Dying While Living”, Journal of Medical Ethics 4 (1978).
Joan Gibson et al, “Right to Die : A Medical, Moral, or Legal Decision?” Journal of Family Practice 7, No.5, 1978.
