The Right to Die

Over the years the right to die has remained a controversy and there is an ongoing debate as no conclusive decisions have been made in many countries on whether it should be adopted or not. The controversy is enrooted on dynamic and complex aspects, which include religion, legal, social, cultural, ethical, human rights, economic and spiritual aspects (Nelson, 2015). According to Johnson (2016) the controversy is attributed to the assumptions concerning the moral implication of consciousness and the life value of the patients that are in the vegetative state and a decision on whether to help them die needs to be done. Math and Chaturvedi (2012) carry out a research with the intent of determining the thin line that lies between the right to life versus the right to die and conclude that unless there is an understanding on the aspects the create the controversy, then the issue of right to die will remain an ongoing debate. In this regard, this paper seeks to carry out an examination of the topic of right to die by presenting arguments from supporters and opponents of the topic and explaining the significance of the topic in the world.

Arguments for the Right to Die

In their research, Math and Chaturvedi (2012) established that the supporters of the right to die argued that for persons that were suffering from degenerative, incurable and debilitating condition should be offered an opportunity to die with dignity and this includes severe mental illness. The notion was that the burden of caring for these individuals was growing huge and was cutting across varying domains; that is financial, mental, social, emotional, time and physical. As such, it was common for the family members and caregivers to file cases for the termination of the life of the patient, because continued care was a mockery to the right to life. The other argument that supporters of the right to die raised was that at some point the patient already gave in to the idea of death and thereby refused to proceed with the medication (Nelson, 2015). This was a common scenario in the case of patients suffering from chronic and terminal illnesses such as cancer and had tried all types of treatment available. As such, these individuals were no longer willing to take in the pain and thus, they opted to terminate the treatment process and even urged the caregivers to help them die. On the same note Johnson (2016, p. 186) argues, “the humanity of vegetative patients has been challenged on the grounds that they permanently lack the most essential feature of the human being, which is its undisputed capacity for living the life of a person, or rational self-consciousness.” The perception is that patients in a vegetative state are worse than death and thus, there is no option other than terminating their lives. This assertion was demonstrated through a case concerning the right to die, which was presented by parents of an ill daughter; Quinlan who sought to withdraw life support. As such, the New Jersey Supreme Court held that there was no significant interest in compelling the patient to endure what was unendurable as she was already in a moribund and debilitated state, meaning that it gave the guarantee for the parents to withdraw the life support (Johnson, 2011).

 In a study, Steck et al. (2014) established that in Switzerland there was a high affinity of individuals suffering from terminal illness and who were well educated and financially stable to request for help to die, after it became clear to them that the treatment process was no longer effective and the patients no longer wanted to be a burden to their families. Per se, the requests for help to die made by these patients were made easier by the fact that assisted suicide is legal in Switzerland. Supporters of the right to die also argue that it encourages organ donation, especially when the patient is terminally ill and there are other patients that have likelihood to survive after organ transplantation. In this case, there is a tie between the right to die and the right to life, because whereas the terminally ill patient opts for assisted suicide, the organ needy patient benefits from the organ that is donated from the other patient (Math & Chaturvedi, 2012).  

Arguments against the Right to Die

Johnson (2016) holds that in the age of hopefulness the idea of right to die is gaining a new perspective, because of the advancements that have been made in neuroscientific landscape and in medicine. Previously, ethical questions were raised in relation to saving the lives of the patients that demonstrated a sense of hope even though they were in a state of persistent vegetative state (PVS). The problem with these kind of patients was that it was difficult to predict the outcomes of their treatment process. Math and Chaturvedi (2012) argue that the need to proceed with care even when patients are terminally ill and in a vegetative state is advocated by the palliative care, which holds that regardless of the state of the patient there is need to show compassion and creative care. Palliative care seeks to offer the best care possible to the dying with the intent of helping them die with dignity and at their right time. The other argument against the right to die is that in most cases, patient suffering from symptoms of mental disorders such as substance users, schizophrenia and depression attempt to seek assistive suicide, because they are suicidal themselves. The notion is that there are guidelines that demonstrate ways through which suicidal patients can be assisted through psychiatry therapy (Math and Chaturvedi, 2012).

Another argument against the right to die relates with the declining justice and morality there are high chances of people misusing euthanasia, especially malicious family members who might have hidden agendas against the patient mostly because of the property that he or she holds. As such, investigation should be carried out especially the health care practitioners in situations where those requesting for mercy killing of a patient are family members. The idea being that physicians should be convinced that there are no malafide intention on the part of the family members and ensure that morality and justice are enhanced throughout the treatment process of the patient until a conclusive decision is reached. The other argument against the right to die aligns with the increased commercialization of health care, which has resulted in the passive mercy killing of many patients especially those with low economic status whose family members have refused to withdraw the treatment process. Math and Chaturvedi (2012) cites India as a good example where passive euthanasia has been widely utilized to get rid of poor patients, which implies that in a situation where the right to die is legalized, commercial health care facilities would serve as the givers of death sentence to patients that are not economically positioned to pay their medical bills. Emphasis on care is the other argument that opponents of the right to die advocate for, asserting that previously, the large population of patients that died comprised of those that had not arrived at the health care facility; unfortunately, the current state is the reverse whereby a large population of patients dying comprise of those in hospitals. However, with improved care, the number of patients dying in hospitals will decline as well as those that seek mercy killing.

From the ongoing discussion, it is clear that the right to die will remain a controversial issue for a while, because supporters and opponents have not yet established a level platform on which they can lie their arguments. In a study by Hendry, Pasterfield and Lewis (2012) it was established that only four countries in Europe and three states in the United States of America advocate have legalized assisted suicide, because most countries across the globe continue to be faced with the challenges posited by the controversy. Inherently, the fact that many countries are reluctant to endorse the right to die aligns with the arguments presented by Johnson (2012) that patients regardless of their condition should be allowed to die at the right time. The argument being that immature death through mercy killing are not justified and enhance immorality as many people especially those that are malicious, mostly family members end up misusing it for their own personal gains.

References

Hendry, M., Pasterfield, D., Lewis, R., Carter, B., Hodgson, D., & Wilkinson, C. (2013). Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying. Palliative Medicine, 27(1), 13-26.

Johnson, L. S. M. (2011). The right to die in the minimally conscious state. Journal of medical ethics, 37(3), 175-178.

Johnson, L. S. M. (2016). Moving Beyond End of Life: The Ethics of Disorders of Consciousness in an Age of Discovery and Uncertainty. In Brain Function and Responsiveness in Disorders of Consciousness (pp. 185-194). Springer International Publishing.

Math, S. B., & Chaturvedi, S. K. (2012). Euthanasia: Right to life vs right to die. The Indian journal of medical research, 136(6), 899-902.

Nelson, B. (2015). In right‐to‐die debate, a new focus on practicality: As laws legalizing physician‐assisted suicide gain ground, physicians consider conscientious objection, training, oversight, and access to end‐of‐life care. Cancer cytopathology, 123(7), 385-386.

Steck, N., Junker, C., Maessen, M., Reisch, T., Zwahlen, M., Egger, M., & Swiss National Cohort. (2014). Suicide assisted by right-to-die associations: a population based cohort study. International journal of epidemiology, 43(2), 614-622.