Euthanasia: pros and cons

Educational program. Euthanasia

Anna Kirikova, MednovostiThe phenomenon

The meaning of the word "euthanasia" has changed a lot over time.

And now few people understand what it really is. In ancient Greece, euthanasia was a "dignified end to life", a "good death" (on the battlefield or surrounded by close relatives). Then they began to call it "easy death", that is, death without suffering, and then "the necessary cessation of life in order to avoid pain and torment." Now "euthanasia" is a rather narrow term describing a specific medical procedure. Namely, the active murder of a terminally ill person, executed at his request by administering medications by a doctor. If the drugs provided by the doctor are administered by the person who wants to die, this is not euthanasia. According to modern ideas, such an action should be called "assisted suicide". Killing a patient by a doctor will not be euthanasia either, if the patient does not have a desire to die. It's just murder. Refusal of additional treatment for a deliberately dying patient is also not euthanasia.

Jack Kevorkian has been helping seriously ill people commit suicide in Michigan (USA) for a long time.
When the next patient was too weak to commit suicide,
Dr. Death resorted to euthanasia, as a result of which he ended up in prison.

What is the dispute aboutMost of all, politicians, religious figures, representatives of public organizations and ordinary people are concerned about whether one person has the right to take another's life.

This breaks global attitudes, including the taboo on murder and the prevailing value of any life.

In addition, it is not completely clear whether a person can make decisions about his own death. To recognize the right to die when it pleases, means, in fact, to justify suicide, a phenomenon that has been condemned for centuries.

Human rights activists see another problem in euthanasia – the possibility of abuse. For example, direct or indirect pressure on a seriously ill person, as well as various falsifications.

These are extremely difficult issues, and today euthanasia is allowed only in a very small number of countries: in the Netherlands, Belgium and Luxembourg. Assisted suicide is legal in Switzerland, Germany, Albania, Colombia and several US states (Oregon, Washington, Vermont). A number of other countries, including Canada, are actively discussing the possibility of legalizing euthanasia.

ProAmong the arguments "for" supporters of the legalization of euthanasia most often cite "autonomy".

Autonomy is understood as the patient's right to make decisions about his life independently and to be responsible for it to the end.

The need to recognize such a right is supported by another argument – the responsibility of doctors. With the development of science and technology, human life has become much longer, people encounter diseases that they simply did not live to see before, serious patients who would have died at the first opportunity a hundred years ago are being nursed and supported for years. And not always artificially maintained life is good: sometimes the patient cannot even take food on his own. Therefore, some supporters of euthanasia say, if a person has the right and opportunity to live as long as possible, there should also be the right to stop existing as long as possible, since in some cases it only causes suffering.

This, by the way, fits into another argument "for" – mercy. The purpose of euthanasia is not to end a person's life, but to stop the torment, pain and suffering. However, this argument is periodically challenged in scientific articles.

There is another opinion: it is better to allow and carefully control than to keep under a ban what is happening anyway. It is not uncommon for doctors to arbitrarily kill an unviable patient, wanting to relieve him of suffering (whether by the will of the patient or not, it is usually impossible to establish).

In addition, since the discussion about euthanasia has become so active, it means that there is a certain demand of society. A study of the opinions of seriously ill people conducted in 1996-1997 (before euthanasia became legal in the Netherlands) showed that 60 percent of patients at the terminal stage of the disease and people caring for them would like to legalize assisted suicide or euthanasia. But apparently, as a fallback option: much fewer people wanted to resort to such an opportunity. The situation has not changed since then. Moreover, people have become much more tolerant of such a phenomenon. For example, according to Gallup, 7 out of 10 Americans are in favor of legalizing euthanasia. Even in Russia, a fairly conservative country, a third of the population considers the legalization of euthanasia permissible.

ContraThe main argument against legalizing euthanasia is the value of human life.

The fate of a person should be decided by God, religious people believe. Secular ethics looks at the problem a little differently: no one should kill anyone, murder is the highest evil.

Another rather weighty argument against it is that if a doctor kills his patient, he violates the "Do no harm" rule. The doctor should treat the patient for the disease, and not be his executioner. This point of view is shared by many doctors. Only one in three British doctors is in favor of legalizing euthanasia. However, it is worth noting that doctors in countries where euthanasia is legalized, in general, more positively assess the phenomenon. So, according to the survey, American doctors are less loyal to him than Dutch ones.

Opponents of euthanasia also say that the legalization of such termination of life is a "slippery slope" or "slippery slope", that is, values will gradually shift. "First we allow to kill the terminally ill, then just the sick, and then we allow to kill the healthy." It is still difficult to say how justified the fears of such a development of events are – not much time has passed since the legalization of euthanasia. At the same time, some conclusions can already be drawn. And these conclusions are very contradictory. On the one hand, the number of people who want to resort to euthanasia after legalization has not increased. On the other hand, the euthanasia of children was legalized in Belgium (the event caused a lot of protests, since children cannot be considered capable, can not express their death wish in a balanced, conscious way and are easily pressured), and a person sentenced to life imprisonment obtained permission for euthanasia.

In addition to quite philosophical arguments, there are two practical arguments against. These are the insufficiency of the legal framework, the presence of corruption and the absence of civil society in most countries (in order to legalize murder, justice must work very clearly, and people must be aware of all responsibility), as well as the availability of alternatives (for example, in the form of palliative care – careful care for hopeless patients and reducing their suffering by administering drugs).

FinallyIf we legalize euthanasia, then taking into account the experience of countries already using it.

For example, in the Netherlands, euthanasia in relation to a patient is allowed only if all the steps necessary for the procedure have been completed: the voluntary nature and awareness of the patient's request has been proven; it has been determined that the patient's suffering is unbearable and no improvement in the situation is predicted; the patient is fully informed about his condition, treatment options and prognosis of the disease; it is known that there are no adequate alternatives to stop suffering there is; an independent conclusion of the second (unknown to the patient) doctor was obtained; a thorough examination of how euthanasia will be carried out (the doses of drugs and their effect are known).

But at the moment it is still very early to talk about legalizing euthanasia in most countries of the world. Where there is no universal high-quality palliative care, everything possible has not been done for a sick person. And to declare in this case that euthanasia is the only way out is wrong. With a poor legislative framework and contradictory laws, it is also impossible to legalize it. For example, in Russia, a patient has the right to refuse medical care, but a doctor is obliged to provide assistance if something threatens the patient's life. In other words, it is both possible and impossible for us to disconnect a person from a ventilator. With the legalization of euthanasia, the case can become even more complicated.

We thank Anna Sonkina, a pediatrician and palliative care specialist, for her assistance in preparing the material.

Portal "Eternal youth" http://vechnayamolodost.ru08.10.2014