The struggle for death

Abstract

The rights and values pertaining to the human person occupy a very important place among the issues discussed in our times. In modern society, where even the basic values of human life are often called into question, cultural change exercises an influence upon the way we look at certain things, including suffering and death. The majority of us experience no little anxiety about the meaning of old age, suffering and death, and are concerned about the nature of the final period of our lives. This reflects not simply an apprehension of experiencing considerable suffering when dying, but also a need to retain dignity and control during our last days of life. Partially due to the interventions of modern medicine, death is nowadays increasingly preceded by an extended period of physical and mental decline as well as suffering. As medical care in recent decades has gained a dramatic new and increased capacity to cure and prolong life, the time and circumstances of people's deaths have also increasingly become a matter of choice or decision. Where once nature used to take its course, now someone must decide how long a life will be prolonged and when death will be allowed to come. Death in the seriously ill or dying can now be staved off, and this sometimes gives rise to moral problems and controversies of an ethical nature. While these revolutionary techniques often provide many great benefits to individual patients by restoring or prolonging functioning lives, they also have the power to prolong patients' lives beyond the point at which the patients desire or are thought to benefit from them. It means that it is now often possible to keep fatally ill patients alive much longer, and sometimes indefinitely, in states which few people can seriously think as being preferable to death. Some patients adjust to their impairments and burdens by finding meaning and value in new things and ways. Others however, find the decline and the suffering at the end of their lives so great so as to make them regard their life as no longer worth living. When a competent patient decides to request euthanasia, either explicitly or implicitly, s/he has decided that continued life is no longer a benefit, but now a burden. For many dying patients, maintaining their quality of life and dignity, avoiding great suffering, and ensuring that others remember them as they wish to be remembered, becomes of paramount importance and outweighs the desire to keep on living. Particularly in the often severely disabled and painful states of many critically ill or dying patients, there is no objective criterion, but only the competent patient's judgement of whether continued life is no longer a benefit. In fact there is no one, objectively correct answer for everyone as to when, if at all, one's life becomes all things considered a burden and unwanted. If self-determination is a fundamental value, then the various ideas among people regarding this subject makes it especially important that individuals control the manner, circumstances and timing of their dying and death. My objective in this essay is to provide arguments to support the practice of euthanasia. The concern will however be with voluntary euthanasia only, that is, the case in which a clearly competent patient makes a fully voluntary and persistent request for help to die. I also want to emphasise that, what I will be dealing with is the kind of active euthanasia where the motive of those who perform it is to respect the wishes of the patient and to provide the patient with a 'good death'. I will start off by giving definitions of key concepts such as euthanasia and death, demarcating the differences between active voluntary euthanasia and assisted suicide, and then proceed to outline some moral theories relevant to euthanasia, including the theories of rights, autonomy and self-determination. Later I will bring forth various arguments from different sources that are against the practice of active voluntary euthanasia and then finally shed light on the shortcomings of the criticisms of the practice and debate in favour of it by means of different arguments and theories.