Editorial Euthanasia and assisted suicide: The physician's role (original) (raw)

2013, The Linacre Quarterly

The American Medical Association's Council on Ethical and Judicial Affairs defines euthanasia as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy. Voluntary euthanasia is euthanasia that is provided for a competent person with his informed consent. Involuntary euthanasia is euthanasia performed without a person's consent. Assisted suicide is to provide the means whereby a suffering person may kill himself. Euthanasia was practiced by the ancients, the term means "good death." It was the practice of dying in peace and with dignity. For the physician, it meant caring for the patient with compassion and alleviating pain and suffering. However, the physician of ancient times could also cause the death of his patients. One physician would heal with compassion, another would provide the poison draught to cause death of the patient. The sick person did not know whether to expect to be healed or to be killed by the physician. The Oath of Hippocrates (500 BC) was the first attempt from a group of concerned physicians to establish a set of ethical principles that would guide the practice of medicine. This set of moral principles defined the physician as a healer, rejecting the role of purveyor of death. The principle of "primum non nocere," first do no harm, became one of the guidelines in the doctor-patient relationship and remained for 2500 years (Cameron 2001; Porter 2006). By the late nineteenth century, supported by utilitarian philosophy and Darwinian survival of the fittest, the concept of a right to death surfaced in Europe. Articles appeared in the German medical literature. In 1920, Karl Binding and Alfred Hoche published the manuscript "Permitting the Destruction of Unworthy Life." Members of the intellectual elite; Binding was a prominent jurist and Hoche a professor of psychiatry. With the intent to benefit society, the authors advised eliminating those whose life was devoid of value and a burden to society. The victims were those near death who requested to die, "idiots," whose life was without a purpose, and those in a comatose state due to trauma with little chance of recovery. The publication was a landmark for the euthanasia program that would follow; widely discussed in academic circles. Advocates of euthanasia, few at first, gradually increased in number, many were academic physicians and professors at medical schools. The systematic, organized killing began in the 1930s. It started with the killing of infants and children with congenital defects and mental retardation followed by disabled and mentally ill adults and the terminally ill. The killing criterion was subsequently expanded to include adults and children with 'antisocial behavior' and those with minor handicaps. Children and adults from psychiatric institutions were killed by lethal injection. When this method proved costly and awkward, gas chambers were built in some hospitals. Patients were transferred to these