Leigh's Final Paper

Carla Jackson, age 88, has had a hard last couple of years. She has been sick with breast cancer and is just tired of fighting the battle, and she feels as though she will never get better. Carla is becoming more depressed and feeling like a burden to her family and friends. She is also feeling a disconnect from her family and just wishes that she could have a quiet and peaceful death, before her life gets even more painful and harder to live, but what Carla doesn’t realize is that her life might get better and she might survive her cancer battle. If Carla would choose to go through with the euthanasia, she is just giving up on life and not thinking positive that it can get better. If Carla had better end of life care while fighting breast cancer, she might find it easier to battle the cancer, because she feels the connection to loved ones and she does not feel like a burden. If families like Carla Jackson’s, provided their loved ones with better end-of-life care they would in turn reduce the demand for euthanasia.
Euthanasia is defined as “the administration of a lethal agent by another person to a patient for the purpose of relieving the patient’s intolerable and incurable suffering “(Decisions Near the End of Life 1992). Euthanasia has to be administered by a doctor, and can be done in a matter of a short amount of time.
Oregon, the Netherlands and Belgium are the only places where laws specifically permit euthanasia (Marker, Hamlon).
When patients ask for their life to be ended, they are usually tired of living their life. The people do not think they will get better, but in many cases patients will want to die one week, but then they are happy that they are still alive the next week. The patients will be very grateful for not going through with the euthanasia. “Patients, who once wished themselves dead, are glad to be alive” (Knight 2006).
In a study done to look at the attitudes and desires related to euthanasia in November 2000, of 988 terminally ill patients, 60.2% supported euthanasia in a hypothetical situation, but 10.6% reported seriously considering euthanasia for themselves. Half of the terminally ill patients who had considered euthanasia for themselves had changed their minds when interviewed at a later time (Emanuel, E. Fairclough, D. Emanuel, L. 2000). Another study found that in many cases euthanasia was done on an individual who might have only lived a couple more weeks if euthanasia was not performed on them.
Euthanasia can also have an effect on the doctors who perform euthanasia. It may not seem to be a hard job, but they are literally ending a person’s life by their own actions. Some doctors will just think of it as helping an individual out, by putting that person in a better place and ending suffering. But, “while the majority of physicians seem comforted by their actions, some experience adverse consequences from having performed euthanasia.” (Emanuel, E. et. al. 1998) A study done in the Netherlands found that 75% of 405 doctors studied said they felt discomfort following euthanasia. It was also found that 24% of doctors in the United States surveyed regretted performing euthanasia (Stevens)
Many individuals just happen to get so overwhelmed with their illness for a small amount of time, that they feel as though they want to die. This causes some individuals to start to think about euthanasia and how quickly they could end their life without pain. Many of the symptoms that these individuals deal with while living with their illness are temporary. A study in the Netherlands found that there are about 5,000 euthanasia requests per year for Euthanasia (Marquet et. al. 2003).
Individuals with cancer, neurological disease, and acquired immunodeficiency syndrome (AIDS) are more likely to request euthanasia. Patients were concerned about their loss of control, being a burden to their family, being dependent on others for personal care, and the loss of dignity (Back et. al. 1996).
People want euthanasia, because they feel as though they have lost their dignity. This means that people feel as though their life does not have as much value as it used to and that they personally don’t feel like they are at the same standing or rank as they used to be.
People also feel as though they are a burden to their families who have other things to worry about and they feel like they have lost that special connection with their loved ones. The patients’ family has to deal with things such as the “choice of place of care at the end of life, advance directives, and acceptance of treatment” (McPherson, Wilson, Murray 2007).
These individuals also feel like they have lost control of their own lives. They are too wrapped up in their illness that they feel as though they have become disconnected from whom they used to be. People may be very tired and worn out with having to deal with the pain and symptoms of their illness.
“Many patients in hospitals are just tired to being sick. In a landmark decision the Dutch Supreme Court ruled that doctors may not perform euthanasia unless the request comes from a patient suffering from a medically classifiable physical or psychiatric sickness or disorder. Simply being “tired of life” is no basis for doctors to act. “(Sheldon (B) 2003)
The reason patients desire euthanasia is not just because of the effects of their disease, but more to their whole life experiences. “Good end of life care can influence patients’ perception of hope and personal worth.” (Mak, Elwyn, Finlay. 2003) People who are in pain, have depressive symptoms and substantial care giving needs were more likely to consider euthanasia (Emanuel, E. Fairclough, Emanuel, L. 2000).
Heleen Dupuis of the Department of Metamedica at Leiden University Medical School did research in the Netherlands in 1995 and “discovered that of 135,000 deaths, euthanasia accounted for 2.4% of them. The report also stated that the estimated loss of life from euthanasia was low, only one to two weeks longer of a life if euthanasia was not done” (Dobson 2003).
In Washington State in 1996, a study was conducted on patient requests and physician responses to euthanasia and “the results stated that 4% of responding physicians received one or more explicit requests for euthanasia.” Patients requesting euthanasia from their doctors are not rare.
If patients received better end of life care, they would be less likely to consider euthanasia. End of life care can be improved by patients receiving “adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones” (Singer, P., Martin, D., Kelner, M. 1999). Having better end of life care will mean that fewer individuals will want to shorten their own life with euthanasia (Sheldon (A) 2003). “Good end of life care can influence patients’ perception of hope and personal worth.” (Mak, Elwyn, Finlay. 2003)
End of life care consists of keeping the person company, and as a caregiver, being able to listen to the individuals fears and concerns about dying. Also, ask if there is anything that can be done to help the person, but at the same time, still remember to give the individual his or her own space. The family of the individual should not withhold any difficult information, for they need to know what is going on and be able to be in on the discussions about things that concern them. The person might also want to know that his or her advance directives such as living wills will be honored (National Cancer Institute 2002).
Information provided by the National Cancer Institute stated that families need to provide better end of life care to help the individual feel more comfortable with him/herself, so they will in turn not think about wanting to die as much or at all. If the patient is receiving pain and symptom management, also a sense of control and a better relationship with loved ones, they will be less likely to think about euthanasia, because they will be happy that their life for the most part is going pretty well for their circumstance (National Cancer Institute 2002).
“Proponents argue, from the principles of compassion and self determination, that mentally competent patients with an incurable illness and intolerable suffering should be able to choose the manner and timing of their death. Doctors should strive to relieve suffering, not to end the life of the sufferer; the authority to terminate life would undermine their trustworthiness. Some opponents fear patients might feel obliged to request euthanasia to avoid being a burden, particularly as acts to end life already occur without the patients’ explicit requests. Some of society views euthanasia as a cheaper and preferable option to providing care, while others believe that excellent palliative care obviates the need for euthanasia.” (Mak, Elwyn, Finlay. 2003)
Carla Jackson dies naturally surrounded by family and friends when it’s “her time”, but not before. Carla’s family provided her with better end of life care, which helped Carla to feel better about herself and not wanting to go through with euthanasia. So when families help to reduce the feeling of being a burden to others, reduce pain and improve dignity of the patient, then they will be less likely to think about euthanasia.

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