• Ethics Discussion V1 -
    2 replies, posted
Brought about by a discussion with Zonesylvania and I on Steam. This thread pertains to the discussion of ethical dilemmas, outlined, but not constrained to topics such as: - Pro-Life and Pro-Choice (abortions and family planning) - Pro and Anti Vaccinations - Anti and Pro Euthanasia - ...and more (all we could think of) Considering the ethics of both sides that take stake. Rules (subject to change): - Remain civil during discussions/debate. - Keep your posts on point - Any evidence provided must be pertinent to the topic at hand and not digressive. - You can play devils advocate without stating as such, but you must provide authentic and convincing support for your argument. - Always quote the person(s) to which your post is addressed. - You cannot overly politicize your position, but you can provide political sources to your argument if it's relevant. - If you cite an authority, please provide a source (scientific articles, newspapers, books, etc), if you cannot, then it's fair to be assumed as anecdotal. - Anecdotes may be used, but cannot be treated as conclusive, absolute, or authoritative. - If you wish to change the topic, make sure that it is known, and place your primary argument in that post (provided the topic doesn't depend on the title). I am considering making the title topical so as to progress the discussion. [B]**This OP is a work in progress.[/B]
Let me kickstart this thread with an argument about euthanasia. Euthanasia is defined as the practice of intentional ending of a life to minimize pain and suffering. There are a number of accepted legal and medical definitions country-wise, for instance, the House of Lords Select Committee in Britain defines it as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering." Euthanasia itself may be defined under several categories; voluntary (done with the consent of the patient, which itself has active and passive subcategories), non-voluntary (done when the patient cannot provide consent, in the event of brain death or a persistent vegetative state, also including child euthanasia, which is illegal universally except in certain instances in the Netherlands falling strictly under the Groningen protocols), and involuntary euthanasia (where an individual is euthanized despite being able to provide informed consent, either because they do not wish to die, or were not asked.) Historically, euthanasia has been practiced in different forms by many cultures worldwide. Hippocrates was said to have mentioned, in his famous Hippocratic Oath, that "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death", but it is hotly debated whether it was meant to include euthanasia or not. The Geneva Declaration also says "I shall maintain the utmost respect for human life." It is my personal belief, that a patient suffering from terminal illness, who has no hope for recovery, who is aware of his options, and whose requests for euthanasia persist over a period of time, should be allowed to die with dignity. I do not believe in the perpetuation of needless suffering of an individual if that is all that's left to them, and find it contradictory to the physician's calling to aid the suffering. Despite this however, there must be oversight - at least one or two independent doctors must confirm the conditions required for a patient to be voluntarily euthanized, after a full individual consultation. Children should have parental consent for their euthanasia until they reach the age of their majority as legally defined by their country of origin. However, this subject being what it is, it remains hotly debated among my peers in the medical field and experts in the field of bioethics. In general, most doctors choose to interpret the Geneva Declaration or Hippocratic Oath in such a way that euthanasia should not be considered a fit or acceptable action by a medical professional, who must treat all life with the sanctity it deserves. Many pharmacists, anaesthetists, and those in the paramedical fields lean more towards the side of pro-euthanasia, as viewed by many polls. Individuals have the right to self-determination, and have the right to choose their own fate, there is a clear distinction between active and passive euthanasia, the former being unsubstantive, the latter being often permitted. It is my belief that each type of euthanasia is a distinct entity of its own, and you can support certain kinds and disavow others through a choice of principles without being inconsistent, as there is a clear distinction between the three accepted classifications. Here is a personal incident from my career; [quote=Zonesylvania]One instance of this that's gnawed at me for the last two years was a little old man who was admitted for medical management in our hospital one afternoon. He was partially paralyzed on one side from an old stroke, diabetic, hypertensive, suffering from severe diabetic retinopathy, liver failure, renal compromise, asthma, thrombosis of most of the veins in both legs, all on top of which was the cancer of the stomach which had spread to his liver, lungs, several of his bones, and most recently his brain. The terrifying part was this poor man was still extremely lucid and aware of all the pain and suffering he was going through. When I spoke to him during my initial assessment, after I had finished asking my questions, he grasped my hand, and he requested me in a broken voice that he just wanted to die, and damn any treatment or further care, and begged me to find a way to make it possible. I couldn't say one word, but just released myself and walked out of his room after offering an apology. Euthanasia is pretty much illegal in India besides assisting death at a terminal stage, after obtaining a Do Not Resuscitate order, and only in the event of unsurvivable systemic collapse and/or brain death. Every day I met him on my rounds, he kept begging me he wanted to die. Do you know what that kind of situation does to people? I consider myself to be a very strong willed individual, but I ended up with disturbing nightmares and poor sleep for an entire week while the patient was still with us. He was later discharged at request and taken to a hospice at the behest of the man's relatives, but I'll never forget that man's face, nor will I ever forget his suffering.[/quote] To sum up, while it could be argued that while somebody who wishes to die could be making a selfish decision so as to not prolong their own suffering, but if his family and friends want him to stay alive to fulfill their own emotional needs, they are not respecting the patients' own wishes, and are being equally selfish. Every individual has the right to determine their own fate. Many difficulties surrounding end of life protocols could be alleviated if informed discussions take place between the doctors and their patients, with regards to their chances, the treatment available, and its outcomes. The relatives must also be well-informed about the patient's situation and how long they have to live, especially if decisions to stop life support or treatment are to be made. It is my belief that honoring a patient's request for a dignified death and saving them needless suffering is an honorable ideal, as long as the appropriate safeguards are put in place, to prevent abuse of the system. Further Reading and Sources: [url]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733179/[/url] - A two decade long study on euthanasia and the slippery slope in the Netherlands published by Judith A. C. Rietjens et al. [url]http://www.nejm.org/doi/full/10.1056/NEJMp058026#t=article[/url] - an NEJM publication of the Groningen protocols by their creator, Dr. Eduard Verhagen [url]http://www.uvm.edu/~lkaelber/children/Kaelber-4.2c1.pdf[/url] - an analysis of the involuntary euthanasia of children in Germany during WWII [url]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800142/[/url] - a paper detailing the murder of schizophrenic patients by a Nazi during WWII published by E. Fuller Torey et al. [url]http://www.gallup.com/poll/171704/seven-americans-back-euthanasia.aspx[/url] - 2014 Gallup Poll on Euthanasia
I took a class called Death and Dying and euthanasia in cases of terminal illness/comatose patients was a huge issue. There is a pressure for doctors to do everything they can to keep a patient alive and the assumption is that if a patient dies, it means they have failed at their job. I think it is understandable that the loved ones of someone who is terminally ill or comatose may have difficulty accepting the inevitability of the situation. The concern I have with euthanasia is the potential for it to be abused as an option. We watched a documentary in my class in which a man received a letter from his insurance company saying that they would not fund his continued cancer treatment, but would fully fund doctor-assisted suicide for him. Aside from that, if a terminally ill patient wanted to continue treatment and live as long as possible, if their doctor disagreed with them, they might not treat their patient as well. If a patient wanted to discontinue treatment for a terminal illness, assuming they still are somewhat functional (not comatose, able to leave the hospital), they would be completely able to "opt out" and simply stop seeing their doctor, but having a doctor potentially withhold treatment options is a matter out of the patient's control. Nurses already have been shown to treat terminally ill patients worse and neglect their needs more because of not wanting to emotionally deal with that situation. It's hard to talk about the issue of the legality of euthanasia without considering the impact it would have on the behavior of doctors and insurance companies toward their patients.
Sorry, you need to Log In to post a reply to this thread.