Euthanasia article

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A Plea for Beneficent Euthanasia

(This statement first appeared in The Humanist of July/August 1974.)

We, the undersigned, declare our support on ethical grounds for

beneficent euthanasia. We believe that reflective ethical

consciousness has developed to a point that makes it possible for

societies to work out a humane policy toward death and dying. We

deplore moral insensitivity and legal restrictions that impede and

oppose consideration of the ethical case for euthanasia. We appeal to

an enlightened public opinion to transcend traditional taboos and to

move in the direction of a compassionate view toward needless

suffering in dying.

We reject theories that imply that human suffering is inevitable or

that little can be done to improve the human condition. We hold that

the tolerance, acceptance, or enforcement of the unnecessary

suffering of others is immoral.

We believe in the value and dignity of the individual person. This

requires respectful treatment, which entails the right to reasonable

self-determination. No rational morality can categorically forbid the

termination of life if it has been blighted by some horrible malady

for which all known remedial measures are unavailing.

Definition

Euthanasia, which literally means " good death, " may be defined as " a

mode or act of inducing or permitting death painlessly as a relief

from suffering. " It is an effort to make possible a " gentle and easy

death " for those afflicted with an incurable disease or injury in its

terminal stages. It is beneficent euthanasia if, and only if, it

results in a painless and quick death, and if the act as a whole is

beneficial to the recipient.

Dying with Dignity

To require that a person be kept alive against his will and to deny

his pleas for merciful release after the dignity, beauty, promise,

and meaning of life have vanished, when he can only linger on in

stages of agony or decay, is cruel and barbarous. The imposition of

unnecessary suffering is an evil that should be avoided by civilized

society.

We believe that our first commitment as human beings is to preserve,

fulfill, and enhance life for ourselves and our fellow human beings.

However, under certain conditions, a meaningful or significant life

may no longer be possible. It is natural for human beings to hope

that when that time comes they will be able to die peacefully and

with dignity. When there is great distress and the end is inevitable,

we advocate a humane effort to ease the suffering of ourselves and

others, without moral or legal recriminations.

From an ethical viewpoint, death should be seen as part of a life-

continuum. Since every individual has the right to live with dignity—

however often this right may in fact be violated—every individual has

the right to die with dignity.

Euthanasia presents an ethical problem for patients who know that

their condition is incurable or irremediable and their suffering

unendurable only if their theology or philosophy has persuaded them

that no human involvement in the termination of life is morally

permissible. For ethical humanists, euthanasia should be no problem.

Pain or suffering is to be endured with as much dignity as patients

can summon, as long as there is present a possibility of relief or

cure. It is not to be endured when it is completely pointless, as is

the case in the final stages of incurable disease.

Voluntary Euthanasia

We recommend that those individuals who believe as we do sign

a " living will, " preferably when they are in good health, stating

unequivocally the expectation that the right to die with dignity will

be respected. The individual's regular physician should be informed

of this will and be given a copy of it; and, if the physician is not

willing to comply, another, more sympathetic physician should be

chosen. Family and close friends should have copies of the " living

will " or, in its absence, be aware of the individual's desire, in the

event that at a terminal stage the person is incapable of

communicating with others.

When a living will has not been written or an intention stated before

the onset of an incurable disease, the patient's expressed request

for euthanasia should be respected. Preferably, this should be a

reflective judgment stated over a period of time. In all of these

cases, euthanasia is voluntary, and it follows from a person's own

free conscience to control both his life and, to some extent, the

time and manner of his death.

Passive and Active Euthanasia

For those who have reached the point of such acceptance, there is yet

another distinction of major importance: that between passive and

active euthanasia. Passive euthanasia is the withdrawal of

extraordinary life-prolonging techniques, such as intravenous feeding

and resuscitation, or not initiating such treatment, when the

situation is hopeless. Given the tremendous advances in medical

science, it is now possible to keep terminal patients alive far

beyond the time they might ordinarily die. Active euthanasia is the

administration of increasing dosages of drugs (such as morphine) to

relieve suffering, until the dosage, of necessity, reaches the lethal

stage. On the basis of a compassionate approach to life and death, it

seems to us at times difficult to distinguish between passive and

active approaches. The acceptance of both forms of euthanasia seems

to us implied by a fitting respect for the right to live and die with

dignity.

Cortical Death

The most difficult questions of euthanasia may arise when individuals

are in an unconscious state or coma and are unable to convey their

wishes. We believe that, when a medical pronouncement of cortical

death has been made, the healthcare delivery team in consultation

with the patient's family and friends, and with proper legal

protections, should suspend treatment calculated to prolong life.

Euthanasia should here be administered only in carefully defined

circumstances and as a last resort and with all possible legal

safeguards against abuse.

Attitudes of Physicians

Often physicians and families, unable to bear a terminal patient's

torture, permit acts of euthanasia to occur, but with great fear and

secrecy. It is time that society faced this moral dilemma openly.

For some physicians the problem of euthanasia arises primarily

because of a certain ambivalence in the Hippocratic Oath. We should

point out that, by this oath, a physician is committed both to the

treatment and cure of disease <i>and</i> to the relief of suffering.

A physician's own theology or philosophy will often influence the

decision about which horn of this " doctor's dilemma " to choose.

Often, too, consciously or subconsciously, a doctor's choice will be

determined by his unwillingness to " lose " a patient, especially in

cases where there is close personal identification. But the physician

has no moral right to frustrate the patient's reflective wishes in

these circumstances. For an ethical humanist, the physician's primary

concern in the terminal stages of incurable illness should be the

relief of suffering. If the attending physician rejects this attitude

toward the patient, another doctor should be called in to take charge

of the case.

Conclusion

We believe that the practice of voluntary beneficent euthanasia will

enhance the general welfare of human beings and, once legal

safeguards are established, that such actions will encourage human

beings to act courageously, out of kindness and justice. We believe

that society has no genuine interest or need to preserve the

terminally ill against their will and that the right to beneficent

euthanasia, with proper procedural safeguards, can be protected

against abuse.

SIGNERS

(Affiliations, as of 1974, are given for identification only.)

Nobel Prize Laureates

Linus ing, Stanford University

Sir Thomson, Fellow of the Royal Society, England Jacques

Monod, Institut Pasteur, France

Physicians

Maurice B. Visscher, M.D., Regents Professor, Univ. of Minnesota

Medical School

Jules H. Masserman, M.D. Pres., Int. Assoc. of Social Psychiatry

Louis Lasagna, M.D., University of Rochester

W. Furlow, M.D., University of Virginia Medical Center

Eliot Slater, M.D., British Voluntary Euthanasia Society

Religious Leaders

Jerome son, Chairman, Board of Leaders, N.Y. Society for

Ethical Culture

ph Fletcher, Professor of Biomedical Ethics, Univ. of Virginia

School of Medicine

Edna Ruth , Editor, The Churchman

Algernon D. Black, Fraternity of Leaders, American Ethical Union

Tilford E. Dudley, Director, Washington Office, United Church of

Christ

Rev R. Scotford, former editor of Advance (the national journal

of Congregational Churches)

Rev. Henry, Unitarian Minister, President of Good Death

Fellowship

Rev. L. Peet, Glide Memorial Methodist Church, San Francisco,

CA

Rev. Gardiner M. Day, Rector Emeritus, Christ Episcopal Church,

Cambridge, MA

Rabbi Friedman, Congregation Beth Or, Board of Directors,

Society for Humanistic Judaism

Rev. D. R. Sharpe, Baptist Minister and author Rev. H. L. MacKenzie,

United Church of Christ

Philosophers

Marvin Kohl, Professor, State University College, Fredonia, NY

Kurtz, Professor, State University of New York at Buffalo

Sidney Hook, Professor, New York University

Ernest Nagel, Professor, Columbia University

el, Professor, Columbia University

Lawyers and Businesspeople

Cyril C. Means, Ir., Professor, New York Law School

Arval A. , Professor, School of Law, University of Washington

R. Barrington, Solicitor of the Supreme Court of Judicature of

England and Wales

Lloyd Morain, Vice President, International Society for General

Semantics

V. Pahl, Counselor, American Humanist Association

Academics

C. Maguire, Associate Professor, Marquette University

O. Ruth , Professor of Psychology, Western land College

Chauncey D. Leake, Professor, University of California

Roy P. Fairfield, Coordinator, Union Graduate School

Lee A. Belford, Chairman, Dept. of Religious Education, New York

University

Additional Signers

Farmer, President, Council on minority Planning and Strategy

Morain, Board of Directors, Association for Voluntary

Sterilization

Bette Chambers, President, American Humanist Association

Sicco L. Mansholt, Former President of the Commission of the European

Economic Community

H. J. Blackham, President, British Humanist Association

My question is this: why keep someone who suffers from 8 or 9

devastating diseases alive? Why let vegetative masses of flesh live?

Hasn't anyone seen million dollar baby? Some people don't want to be

fully conscious of a " mandated voluntary physician assisted suicide " .

They want someone to help them see something like their favorite

memory or something and be halfway conscious of the fact that the

person helping them to relive that experience is also pushing a dose

of pure norepinephrine into his veins that will in a few seconds

cause sudden cardiac arrest with no pain. Would helping such people

die painlessly and peacefully be an act of senseless violence and

against human rights?

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