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Essay on Ethics of End of life decisions for terminally ill
The bases of arguments for or against physician-assisted suicide and physician aid-in-dying are found within the classification scheme of euthanasia. Euthanasia, from the Greek, implies the idea of a kind, good, or pleasant death. Forms of euthanasia include voluntary or involuntary and active or passive. Voluntary euthanasia is the withholding or withdrawing of medical treatment with the patient's consent. "Involuntary" euthanasia occurs when medical treatment is withheld or withdrawn without the patient's consent. Active euthanasia is synonymous with mercy killing and indicates that an action is performed that will promote death for the patient (such as injecting a lethal medication). Passive euthanasia is simply a decision to do nothing, or to withhold or withdraw interventions (ie, mechanical ventilation or renal dialysis), allowing the patient to die.
Double-effect euthanasia is another term that describes a direct medical action resulting in the patient's death. Double-effect euthanasia is defined as "the provision of a palliative treatment which may have fatal side effects." The intent of the treatment is to relieve pain and suffering, but the patient's death is a foreseeable potential effect of the treatment. Treatment such as gradually increasing the dosage of narcotic analgesics to lethal levels would be considered double-effect euthanasia.
Acts of euthanasia are performed to eliminate suffering and to allow the patient to die with dignity. Death with dignity refers to one's choice of dying in a humane and dignified fashion, without extension of suffering through the technology of modern medicine. Personal control over death implies that the individual will decide when and how death will occur. Voluntary passive euthanasia has been legally sanctioned in most of the United States and currently is used to assist patients' realization of death with dignity.Voluntary passive euthanasia cases in the critical care setting most commonly involve the removal of life support measures, the withholding of medications, and the following of do-not-resuscitate orders.......
