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Euthanasia (from of a Terminally Ill Person in a Painless or minimally painful way, for the purpose of limiting Suffering . Laws around the world vary greatly with regard to euthanasia and are constantly subject to change as cultural values shift and better Palliative Care or treatments become available. It is legal in some nations, while in others it may be Criminalized .


TERMINOLOGY

Euthanasia can be conducted in various ways. In order to distinguish certain methods, more specific terminology may be used when discussing euthanasia.

Euthanasia by means

Euthanasia may be conducted passively, non-aggressively, and aggressively. Passive euthanasia entails the withholding of common treatments (such as antibiotics, drugs, or surgery) or the distribution of a medication (such as morphine) to relieve Pain , knowing that it may also result in death ( Principle Of Double Effect ). Passive euthanasia is the most accepted form, and it is a common practice in most hospitals. Non-aggressive euthanasia entails the withdrawing of life support and is more controversial. Aggressive euthanasia entails the use of lethal substances or force to kill and is the most controversial means.


Euthanasia by consent

Euthanasia may be conducted with or without consent. Involuntary euthanasia is conducted against someone’s will and equates to Murder . This practice is almost always considered wrong and is rarely debated. Involuntary euthanasia can be administered when the person is incapable of making a decision and it is thus left to a proxy. One recent example of non-voluntary euthanasia is the Terri Schiavo case. This is highly controversial, especially because multiple proxies may claim the authority to decide for the patient. Voluntary euthanasia is euthanasia with the person’s direct consent, but is still controversial for reasons discussed below.


Other designations

Some important and a secondary technique call Exsanguination .


HISTORY

The term euthanasia comes from the Greek words “eu” and “thanatos” which combined means “good death”. and Epicureans , where a person no longer cared for his life.See Senicide In Antiquity

The English Common Law from the 1300’s until today also disapproved of both suicide and assisting suicide. However, in the 1500s, Thomas More , in describing a utopian community, envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of "torturing and lingering pain".See Humphry and Wickett (1986:8-10) on More, Montaigne, Donne, and Bacon.


Modern history


Since the 19th Century, euthanasia has sparked intermittent debates and activism in North America and Europe. According to medical historian Ezekiel Emanuel, it was the availability of anesthesia that ushered in the modern era of euthanasia. In 1828, the first known anti-euthanasia law in the United States was passed in the state of presentation), Euthanasia.com. ''"The earliest American statute explicitly to outlaw assisting suicide was enacted in New York in 1828, Act of Dec. 10, 1828, ch. 20, §4, 1828 N. Y. Laws 19 (codified at 2 N. Y. Rev. Stat. pt. 4, ch. 1, tit. 2, art. 1, §7, p. 661 (1829)), and many of the new States and Territories followed New York's example. Marzen 73-74."'' Retrieved June 16, 2007. After the civil war, voluntary euthanasia was promoted by advocates, including some doctors.Humphry and Wickett 1986:11-12, Emanuel 2004. Support peaked around the turn of the century in the U.S. and then grew again in the 1930’s.

Euthanasia societies were formed in England in 1935 and in the U.S.A. in 1938 to promote aggressive euthanasia. Although euthanasia legislation did not pass in the U.S. or England, in 1937, doctor-assisted euthanasia was declared legal in Switzerland as long as the person ending the life has nothing to gain. During this period, euthanasia proposals were sometimes mixed with Eugenics .''Merciful Release'' and other sources... While some proponents focused on voluntary euthanasia for the terminally ill, others expressed interest in involuntary euthanasia for certain eugenic motivations (e.g., mentally "defective"). EugenicsArchive.org During this same era, meanwhile, U.S. court trials tackled cases involving critically ill people who requested physician assistance in dying as well as “mercy killings”, such as by parents of their severely disabled children.Kamisar 1977

Prior to World War II, the Nazis carried out a controversial and now-condemned euthanasia program. In 1939, Nazis, in what was code named Action T4 , involuntarily euthanized children under three who exhibited mental retardation, physical deformity, or other debilitating problems whom they considered "life unworthy of life”. This program was later extended to include older children and adults.


Post-War history


Due to outrage over Nazi euthanasia, in the 1940s and 1950s there was very little public support for euthanasia, especially for any involuntary, eugenics-based proposals. Catholic church leaders, among others, began speaking against euthanasia as a violation of the Sanctity Of Life . (Nevertheless, owing to its Principle Of Double Effect , Catholic moral theology did leave room for shortening life with pain-killers and what would could be characterized as passive euthanasia.Papal statements 1956-1957 and Gerald Kelly) On the other hand, judges were often lenient in mercy-killing cases. Humphrey and Wickett, ch.4. See also, Kamisar and John Bodkin Adams case. During this period, prominent proponents of euthanasia included Glanville Williams (''The Sanctity of Life and the Criminal Law'') and clergyman Joseph Fletcher ("Morals and medicine"). By the 1960s, advocacy for a right-to-die approach to voluntary euthanasia increased.

A key turning point in the debate over voluntary euthanasia (and physician assisted dying), at least in the United States, was the public furor over the case of Karen Ann Quinlan . The Quinlan case paved the way for legal protection of voluntary passive euthanasia.For the U.K. see the Bland case. In 1977, California legalized living wills and other states soon followed suit.

In 1990, Dr. Jack Kevorkian , a Michigan physician, became infamous for encouraging and assisting people in committing suicide which resulted in a Michigan law against the practice in 1992. Kevorkian was tried and convicted in 1999 for a murder displayed on television. In 1990, the Supreme Court approved the use of non-aggressive euthanasia. Cruzan V. Director, Missouri Department Of Health

In 1994, Oregon voters approved doctor-assisted suicide and the Supreme Court allowed such laws in 1997. The Bush administration failed in its attempt to use drug law to stop Oregon in 2001. In 1999, non-aggressive euthanasia was permitted in Texas.

In 1993, the Netherlands decriminalized doctor-assisted suicide, and in 2002, restrictions were loosened. During that year, physician-assisted suicide was approved in Belgium. Australia's Northern Territory approved a euthanasia bill in 1995, but that was overturned by Australia’s Federal Parliament in 1997.

Most recently, amid government roadblocks and controversy, Terri Schiavo , a Floridian who was believed to have been in a vegetative state since 1990, had her feeding tube removed in 2005. Her husband had won the right to take her off life support, which he claimed she would want but was difficult to confirm as she had no living will and the rest of her family claimed otherwise.


ARGUMENTS FOR AND AGAINST VOLUNTARY EUTHANASIA

Since World War II , the debate over euthanasia in Western countries has centered on voluntary euthanasia (VE) within regulated health care systems. In some cases, judicial decisions, legislation, and regulations have made VE an explicit option for patients and their guardians.See Government Policies below for specific examples Proponents and critics of such VE policies offer the following reasons for and against official voluntary euthanasia policies:


Reasons given for voluntary euthanasia:

  • Choice: Proponents of VE emphasize that choice is a fundamental principle for liberal democracies and free market systems.

  • Quality of Life: The pain and suffering a person feels during a disease, even with pain relievers, can be incomprehensible to a person who has not gone through it. Even without considering the physical pain, it is often difficult for patients to overcome the emotional pain of losing their independence.

  • Economic costs and human resources: Today in many countries there is a shortage of hospital space. The energy of doctors and hospital beds could be used for people whose lives could be saved instead of continuing the life of those who want to die which increases the general quality of care and shortens hospital waiting lists.

  • Moral: Some people consider euthanasia to be just another choice a person makes, and for moral reasons against it to be undue influence by others.See also Utilitarianism

  • Pressure: All the arguments against voluntary euthanasia can be used by society to form a terrible and continuing psychological pressure on people to continue living for years against their better judgement. One example of this pressure is the risky and painful methods that those who genuinely wish to die would otherwise need to use, such as hanging.

  • Sociobiology : Currently many if not most euthanasia proponents and laws tend to favor the dying or very unhealthy for access to euthanasia. However some highly controversial proponents claim that access should be even more widely available. For example, from a sociobiological viewpoint, genetic relatives may seek to keep an individual alive (Kin Selection), even against the individual's will. This would be especially so for individuals who are not actually dying anyway. More liberal voluntary euthanasia policies would empower the individual to counteract any such biased interest on the part of relatives.



Reasons given against voluntary euthanasia:


  • Professional role: Critics argue that VE could unduly compromise the professional roles of health care employees, especially doctors. They point out that European physicians of previous centuries traditionally swore some variation of the .

  • Moral: Some people consider euthanasia of some or all types to be morally unacceptable.http://plato.stanford.edu/entries/euthanasia-voluntary/ An overview of voluntary euthanasia This view usually treats euthanasia to be a type of Murder and voluntary euthanasia as a type of Suicide , the morality of which is the subject of active debate.

  • Theological: Voluntary euthanasia often has been rejected as a violation of the sanctity of human life. Specifically, some Christians argue that human life ultimately belongs to God, so that humans ought not make the choice to end life. Orthodox Judaism takes basically the same approach, however, it is more open minded, and does, given certain circumstances, allow for euthanasia to be exercised under passive or non-aggressive means. Accordingly, some theologians and other religious thinkers consider VE (and Suicide generally) as sinful acts, i.e. unjustified killings.See Religious Views Of Suicide

  • Feasibility of implementation: Euthanasia can only be considered "voluntary" if a patient is mentally competent to make the decision, i.e., has a rational understanding of options and consequences. Competence can be difficult to determine or even define.

  • Necessity: If there is some reason to believe the cause of a patient's illness or suffering is or will soon be curable, the correct action is sometimes considered to be attempting to bring about a cure or engage in palliative care.

  • Wishes of Family: Family members often desire to spend as much time with their loved ones as possible before they die. Therefore, the wishes of the family may outweigh the patient's right to control his own life.

  • Consent under pressure: Given the economic grounds for voluntary euthanasia (VE), critics of VE are concerned that patients may experience psychological pressure to consent to voluntary euthanasia rather than be a financial burden on their families. "Terminally ill patients often fear being a burden to others and may feel they ought to request euthanasia to relieve their relatives from distress." letter to the editor of the ''Financial Times'' by Dr David Jeffrey, published 11 Jan 2003. Even where health costs are mostly covered by public monies, as in various European counties, VE critics are concerned that hospital personnel would have an economic incentive to advise or pressure people toward euthanasia consent. "If euthanasia became socially acceptable, the sick would no longer be able to trust either doctors or their relatives: many of those earnestly counselling a painless, 'dignified' death would be doing so mainly on financial grounds. Euthanasia would become a euphemism for assisted murder." ''FT WEEKEND - THE FRONT LINE: Don't take liberties with the right to die'' by Michael Prowse, Financial Times, 4th Jan 2003 While VE proponents concede that personal and even socialized economic costs may add to the motivations for consent, they point out that health systems offer sufficient exceptions so as to relieve the pressure on hospital personnel.



GOVERNMENTAL, RELIGIOUS, AND OTHER NON-GOVERNMENTAL POLICYMAKING


During the 20th Century, efforts to change government policies on euthanasia have met limited success in Western countries. Country policies are described below in alphabetical order, followed by the exceptional case of The Netherlands. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organizations.


Albania

Euthanasia was legalized in Albania in 1999, it was stated that any form of voluntary euthanasia was legal under the rights of the terminally ill act of 1995. Passive euthanasia is considered legal should three or more family members consent to the decision. Albania's euthanasia policy has been controversial among life groups and the Catholic Church, but due to other more prominent countries also legalizing forms of euthanasia, it has meant a more relaxed world attitude to the matter.


Australia

Euthanasia was legalised in . The first person was a taxi driver, Bob Dent , who died on 22 September , 1996 .

Although it is a crime in most Australian states to assist in euthanasia, prosecutions have been rare. In 2002, relatives and friends who provided moral support to an elderly woman who committed suicide were extensively investigated by police, but no charges were laid. The Commonwealth government subsequently tried to hinder euthanasia with the passage of the Criminal Code Amendment (Suicide Related Materials Offences) Bill 2004. In Tasmania in 2005 a nurse was convicted of assisting in the death of her elderly mother and father who were both suffering from illnesses. She was sentenced to two and a half years in jail but the judge later suspended the conviction because he believed the community did not want the woman put behind bars. This sparked debate about decriminalizing euthanasia.


Belgium

The Belgian parliament legalized euthanasia in late September 2002. Proponents of euthanasia state that prior to the law, several thousand illegal acts of euthanasia were carried out in Belgium each year. According to proponents, the legislation incorporated a complicated process, which has been criticized as an attempt to establish a "bureaucracy of death".


Japan