Euthanasia, or physician-assisted suicide is often not a personal decision consciously made. The patient is usually beyond saving and it becomes the choice of family by the suggestion of doctors to end life support. The choice is not, in the Kantian (Philosopher Immanuel Kant) sense motivated by self-love where suicide is a selfish means that will cause pain to others. Rather it is a medical need where sustaining life any longer would only result in further physical pain of patient and suffering in their family.
When considering the philosophical basis for most moral dilemmas and the laws that pertain to them, they often strive towards individual happiness. In the case of euthanasia then it is important to ask if in artificially supporting a life, the individual will be capable of happiness or giving others happiness? For someone who is comatose or in a vegetative state, is sustaining their life maintained in hopes that they will regain the ability to realize happiness? Then it must also be considered whether or not the state or federal government has a say in how an individual or their family, assisted by a doctor, may choose to end their life.
It seems that each individual should be entitled to will such a personal decision in the sense of a need and not only a want. As such, it is a need when the person ends their life because it is physically unbearable with incurable ailments and not just a selfish want of suicide. This approach is only relevant when an individual has stated beforehand their wish to be relieved from a vegetative state. Several philosophers and lawyers in a Brief of the Amici Curiae (Friends of the Court) argue that individual or familial entitlement to such decisions should not be influenced by the government demanding valid evidence to support the decision.
Even still, historic cases of euthanasia reveal government intervention had a pivotal role in the “right to die.” In 1976 a young 22-year-old woman, Karen Quinlan, was deemed comatose in a vegetative state by medical testimony and permitted use of euthanasia. Karen’s Father and his legal representatives sought sole medical custody in deciding to end her hopeless life and defended this in court from prosecution by the state of New Jersey. The court awarded her father guardianship and set a historic precedent in the State’s ability to demand sufficient evidence for euthanasia beforehand. Another case reached the Supreme Court in 1990 when a court order was required by physicians to end the life of Nancy Cruzan. The case of Cruzan set a precedent in that evidence must be provided before a court even if the individual willed euthanasia beforehand.
On the other hand the Supreme Court’s decision in Washington v. Glucksberg, from 1997 reflects the importance placed by the state to protect patients from malpractice or a misinformed decision on the part of family and doctors. Acceptable euthanasia it seems, according to the Majority Opinion of the court, is used only when all possible treatments have been explored or considered and it is a last resort for the party involved. The argument in favor of euthanasia contests that in death we are entitled to dignity and we may choose to ease our passing with medical assistance. Those in favor of euthanasia claim that personal liberties in matters of life or death should be protected by the state.
The state’s role of regulator becomes necessary when, medically, there is widely accepted use euthanasia. Opponents of use stick some of the argument on matters of principle so that an accepted view of something related to suicide is not made commonplace. It is argued that an outright ban, as opposed to regulation prevents an over-misuse of the practice. For instance if specialized physicians compete to stay in practice it requires promotion of their services encouraging those not truly in need to possibly be convinced into suicide. A ban thus, would also prevent those who are ill, but not terminally ill from committing an accepted form of suicide to prevent comparatively minor suffering.
The basis for the right to die is argued as a constitutional right reserved for the individual’s proven prior request or familial guardianship under medical supervision. As this scenario is quite common, more so than malpractice of assisted suicide, a ban would impose the denial of this right. For now the right is reserved to the state and an outright ban would only hold on a federal level. In Washington v. Glucksberg, regulation by the state for euthanasia was challenged as a violation of the 14th Amendment. The Majority Opinion denies such violation and former Chief Justice Rehnquist relied on legal precedent that continues in Washington as a firm rejection of assisted suicide.
Though, as seen in the case of Karen Quinlan the court’s decision did recognize that certain rights of privacy are guaranteed under the Constitution, even though most cases receive government intervention. The decision cannot rely upon a patient’s prior request entirely because they are incompetent at the time. A family’s decision should be guided by medical testimony, but given a second opinion and presented before the court. Just as the medical profession treats the potential of use on a patient-to-patient basis, so the courts must treat it case by case. There is no one way about it as long as medical advancements revive patients from comas and constitutional rights of the state are protected. Historical precedent can help speed the legal process in deciding, but cannot override the potential for new evidence giving further reason to take it case by case.
This could become increasingly difficult with scientific advancement in life sustaining capability. A greater difficulty comes in that there is no way to standardize the prior wishes, as in a will, for euthanasia. Should there be another box to check next to Organ Donor at the Department of Motor Vehicles? The medical profession must establish a firm definition of terminally ill in order that judicial interpretation of constitutional rights have a scientific base, not moral principle alone. To sum up, euthanasia has many moral arguments, both religious and not, but for practical laws to meet the needs of citizens then cases must be treated individually and judged scientifically.