The very point of 'Advanced Directives' is in itself confounding issue as frequently it is the patient's imaginary fears about loss of body functions and pain that drives them to such conclusions.
So it is cleanly obvious that in palliative care settings it is not uncommon for patients to succumb to momentary pain and wish for euthanasia but very rarely such requests are persistent. Instead of legalizing euthanasia, efforts must therefore be concentrated on improving the palliative care. This could take the form of improving pain control measures and providing loving and caring service to patients.
Legalizing Euthanasia (Implications)
Very few nations in the world have legalized euthanasia. Holland was the first country to do so and euthanasia was quite common even in the 1970's. In 1985 the country made some amendments to the existing laws which made the procedure even easier. The 'terminally ill' clause was struck off from the laws that governed euthanasia and the immediate effect was shocking. In 1990 for example there were a total of 11,800 euthanasia induced deaths of which 1000 patients were euthanized without the consent of the patients. In all, euthanasia accounted for around 9% of all the deaths that happened in that year. [Pregnant Pause] in Netherlands, the law allows the physician legal immunity from criminal action. Instances of patients who are not terminally ill and incompetent to disclose their wishes being euthanized have been reported in some studies. In fact euthanasia has been extended for handicapped infants, comatose patients and even adults with severe depression which is really saddening. These statistics are indeed scary and explain the reasoning behind the anti-euthanasia group who have opposed legalizing the procedure.
In the United States Oregon' is the only state to have legalized euthanasia. The 'Death with Dignity act' of 1997 legalized the procedure in the state. Since then the number of physician assisted deaths have increased every year to a total of 171 deaths between 1998 and 2003. This is just around 1/7th of one percent of the total number of deaths in that state and pales into insignificance compared to the Dutch figures. However, a look at the 'end of life concerns' for these patients who opted for voluntary euthanasia, has raised questions about the validity of the claim that fear about 'unbearable pain' and 'loss of bodily functions' are the main concerns prompting patients to resort to euthanasia. As per the 2003 statistics, only 21% of the patients regarded insufficient pain control as their reason for choosing Physician-assisted Suicide while 57% quoted fear of loosing bodily functions. The astounding fact is that 93% of the people indicated loss of autonomy and inability to enjoy life as their important 'end of life concerns' that motivated them to opt for euthanasia. [DHS]
Legalizing euthanasia can lead to abuse of it by physicians. Though most physicians are loving, caring and good professionals committed to their Hippocratic Oath of healing people, there are some 'weeds among the wheat'. Instances of wanton abuse of the procedure in the recent past have only furthered our fears about the dangers involved. The notorious case of Dr. Kevorkian,...
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