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Our lives have always been the most prized possession of humanity. Each birth is a miracle and each death is a tragedy. As we wade through the tides of life, people strive to live the best life possible. There is a problem with maintaining the dignity of life “because not everyone agrees about the nature and grounds of human dignity” (Kass, 15). Though a subjective goal, the universality of it undertones every individual in every society. We want to live well and hold our heads up high when we come to death.
No one wants to die without dignity. “Dominant Western notions of dignity are tied to prevailing views of physical beauty; to the values of youthfulness, independence, and self-control; and to the quantity and quality of one’s possessions” (Weir, 125). When our bodies fade, our spirit lives on through the memories we leave behind. Yet the reality of life is that it is fragile and unpredictable. The unfortunate souls who suffer from disease, genetic defects, or accidents have the course of their lives changed dramatically.
Amongst loved ones and care-gives, doctors and physicians, the question of the right to death poses an ethical dilemma. When considering the continuation of life, the dignity of that life must be considered in order to maintain more than just a living body.
Many people throughout the world hold a belief that some fundamental rights are inherent in human nature. To be free, to be happy, to be autonomous, and, most of all, to be alive; principles such as these are found in every culture.
In America, these kinds of rights are pronounced in the Declaration of Independence, where it was stated: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness”.
While far from perfect, the American system has many organizations aimed to improve the lives and health of the poor and sick. In 2010, President Barak Obama helped pass the Healthcare Act to ensure that all Americans were within reach of the vital medical treatments needed to live healthy lives. And they are just now catching up. Countries such as Canada and France have been applying universal healthcare long before America ever enacted such a system. It seems apparent that the right to a healthy, dignified life is understood as inherent to human life. A question that has arisen, however, is whether we as humans also have the right to death?
Although the right to live seems inherently obvious, the question of the right to die is rather startling. Often, instinct or reflex jump to the conclusion of “No!” There is a distinct rejection of the idea of death as an unfortunate eventuality, to be postponed until inevitability takes over. Yet, there is an opposing voice in the crowd from those who hold the right to live and the right to die as inseparable. Within the United States, this movement has been slow in coming. With the passing of the Death With Dignity Act, Oregon set itself apart from the status quo, being the first state to officially and explicitly establish the right to death as a legal option in 1994 (Munson, 573; Snyder and Caplan, 57). The specifics of the Oregon law, some of which will be discussed in further detail later in this essay, were established to protect the dignity of a life rather than life at any cost. Although the right to live allows us to experience great fulfillment and joy, the nature of reality may also bring pain and misery. “The loss of dignity is frequently expressed by people who are dying and is tightly bound to feelings of being a burden, low self esteem, and loss of any sense of worth” (Weir, 125). For some, when the pain becomes too much to bear, death can be a sweet relief.
Pain, the experience of it, the threat of it, can be remarkably persuasive. Though everyone experiences pain at one time or another, those who are overcome by it seek a way out, a resolution to their suffering. And yet, even when death would be considered a blessing to the victims of such pain, ignoring the requests for death. Dax Cowart experienced firs hand the horrors of insufferable pain and the agony of being forced to live. When he was only 25, Donald “Dax” Cowart was already living a successful life. He was healthy and had a good career as a pilot. While working with his father, tragedy struck in the form of a gas explosion that claimed the life of his father and left burns on 65% of his body. Although he begged for death on multiple occasions, he was forced to go through treatments including a suspended bath in highly chlorinated water, which cause him excruciating pain. Looking back upon the tragic events, Dax states, “I’m enjoying life now, and I’m glad to be alive… but I still think it was wrong to force me to undergo what I had to, to be alive”(Munson, 6).
To feel pain is to be alive, but to live in pain is torture. Although there are countless cases in the medical field in which temporary pain is necessary to produce the best resulting health. But to prolong the experience of pain beyond the limits of human tolerance is cruel, especially against the will of the patient. To live in perpetual pain is suffering enough and yet when the request for death is denied, the right to live (or die) with dignity is also denied. The heartbreaking story of Dax Cowart provides the reports of a man begging to maintain his dignity, only to have his pleas fall on deaf ears. His mother was the one who continued the treatments, only having been vaguely informed of their true nature. She considered the requests of her son, but concluded that he would change his mind when the treatments were over (Munson, 4). But the later testaments of Dax Cowart show quite the opposite. Nonetheless, his mother raises a good point. What if death is just a desperate attempt at relief and an uninformed decision?
Medical ethics hold to the belief that almost any procedure requires the patient to give their informed consent. What this means is that the physician has told the patient of all necessary information needed to make an informed, uninfluenced choice. For this to be a possibility, doctors need to practice full disclosure with their patients. The idea of full disclosure has raised the concerns of many people who believe that some things are better left unknown. In cases concerning a patient who is asking for death, however, this argument falls short. Because what is in question is the very life of the patient, physicians should be obligated to disclose any and all information concerning the patient. In the law passed by Oregon, this fact is recognized with the claim that “the attending physician would be required to inform the patient of the diagnosis, prognosis, and potential risks of the prescribed medication” (Hillyard and Dombrin, 69). If the prognosis is hopeless and the future is bleak, it is the natural right of the patient to maintain the dignity of their life. Without full disclosure, the censorship of the physician produces a bias in the choice of the patient, thus misleading the victim into unnecessary prolonging a painful life. The legitimacy of the informed consent makes all the difference in decisions to end a life. If the patient gives informed consent to, or requests for, death, the dignity of that life requires that the request be honored.
Hypothetically, one would assume that the request to be let pass with dignity would be considered enough consent to be respected and have your wishes upheld. However, there are in fact realistic concerns when it comes to acquiring informed consent. Because the right to death is a relatively new wave of thought, the accounts of it are examined with a fine tooth comb. Therefore it is understandable why informed consent often comes with a few extra requirements. In the law passed by Oregon, the lawmakers took care to insure that informed consent was properly acquired. In this system, one must give both an oral and a written request (Hillyard and Dombrink, 69; Munson, 573). This precaution serves two main purposes: to protect the physician from prosecution and to ensure that the choice of the patient is certain and completely understood. While the former plays a practical legal role, the latter fulfills a much more important role: to have the patient express the opinions of their death through multiple means. Id the dignity of life is to be respected, then the request and justification for death needs to be considered more than a simple yes or no, live of die. The dignity, in this case, is derived from respect for story of those sufferings and incentives prompting such a decision. Thus, while requiring informed consent to be explicitly expressed in multiple forms serves the practical duty of protecting the physician, it also fulfills the deeper need of restoring dignity to life by paying due attention to the depth of the victim’s pain.
There is a particular dilemma in regards to the dignity of the lives of those who can no longer pronounce their own sufferings. Sometimes, tragedy strikes in ways that scar, not the body, but the mind. In cases of PVS, a persistent vegetative state, the patient no longer has the mental capacity to express informed consent to death, though it may be the preferred alternative to a vegetative life. Here, the importance of a living will or a proxy become critical. In the Case of Terri Schiavo, a woman diagnosed with PVS and hospitalized, her husband became the proxy for her care (Munson, 565). Establishing one’s exact specifications as to the manner in which to be treated in the case of an accident provides the doctors and physicians the means by which to maintain the dignity of life when the capacity to explain has eroded. Without a living will, doctors turn to loved ones and next-of-kin to understand what the patient would have wanted and how the family would like to handle the situation. This method has met serious opposition in circumstances where no proxy was explicitly determined and there are opposing opinions within a family on how to respond to the tragedy. Terri Schiavo’s case is the perfect example of this. Although the power of proxy fell into the hands of her husband, her parents relentlessly opposed the choices he made in regards to her health. Resulting in messy court cases and unnecessarily prolonged suffering between 1990 and 2005, Terri’s family fought against her husband for the power of proxy (Munson, 567). The proxy has a particularly influential role. Because the victim can determine who their proxy will be before the event of a tragedy, their trust can be honoured by giving the proxy power of choice over their care. When a proxy is not determined beforehand, the power of attorney should lie with the spouse or next-of-kin. Although this presents a potential dilemma in cases where the family and loved ones will fight for the power to control the patient’s care, the power of proxy should only be given to the individual closest to the patient. A proxy should be the person who understands the patient the most and would respect their wished in life and in dead, putting aside personal beliefs. If the proxy decides that a permanent vegetative state does not uphold the dignity of their loved one, the decision to remove all artificial life support should be well within the rights of the proxy. Even still, tragedy has a way of avoiding our safeguards, effecting those who were never given the chance to choose their own path.
There is no greater sadness to a parent than to watch the suffering of their own child. Infants who are born with severe deformities, illnesses, or mutations were never given a chance to leave a living will, assign a proxy, or to express their views of life. Instead, the parents are automatically assigned the role of decision-maker for the newborn. This terrible position often asks of the parent whether or not to sustain the life of their child. Bente Hindiks was a baby girl born with a genetic disorder that caused her skin to blister and slough off. Although the child was in excruciating pain, the doctors refused to end her life because of the threat of prosecution (Munson, 506). If the child lives, the parent must watch it live in a state of constant pain. If it dies, then the parents have to burry their own child. No option is right. However, if a parent view the life of their child as more than just a heartbeat, as instead an experience that has, and always will be, of suffering, then the parents should be protected in their decision to end the life of the child. The Hindriks took their baby home, where it died in its father’s arms. Though the death certificate stated natural causes to death, the parents acknowledged that the death was most likely due to an over-application of morphine intended to relieve the pain of their child: an act that ultimately succeeded (Munson, 507).
The alternative to this choice, not inherently wrong, does present the risk of losing sight of the child’s right to a dignified life. Instead, the choice is made from selfish reasoning and an attachment to life, regardless of the tattered dignity of the sickly infants. A young girl, only known as Ashley, was the victim of such treatment. Due to unknown circumstances, Ashley suffered brain damage that would permanently hinder her mental capacity to that of an infant. She would never be able to understand her own life or function properly without the aid of her parents. Not only did Ashley’s parents decide to maintain her life, but they also put her through a series of surgeries and treatments to ensure that she never had a period, never developed breasts, and never grew too large. Through several invasive procedures, Ashley’s parents were able to ensure that her care-taking was convenient and practical. Unable to move without aid, or help herself in any way, Ashley became their “Pillow Angel” (Munson, 528). Allow me to make a disclaimer: I am not so quick to assume that the prolonged life of a seriously ill newborn is automatically a purge of dignity. When well-informed parents make the choice to sustain the life of their child in hopes of recovery, the best interest of the child is accounted for and the dignity is maintained. But when the dignity of life is shattered, the mind not functioning and the body deformed, a parent is well within their rights to protect the dignity of that life, even if this means allowing the child to pass away to avoid the pains and sufferings destine for their life.
Throughout time, humanity has praised the value of life. Incredible medical advances and technological investments have been aimed at maintaining a health life. The right to life is considered inherent to all people. In recent years, a question has arisen as to whether or not we have a right to die as well as live. As the medical system evolves, it is necessary to take into account the dignity of a life while making choices regarding its outcome. When a patient is in excruciating pain and has given informed consent, as well as an informed request for death, it should be reasonable for them to act upon their right to death. While situations arise in which informed consent cannot be attained, such as in the case of persistent vegetative states or seriously ill newborns, it is imperative that the proxy and caregivers take into account the dignity of the patient when making a decision about prolonging their lives. Dignity has a vague essence that exists in the hearts of all men and women. Though it may be subjective, it is still an imperative part of life. Thus, the medical field needs to place a high concern onto the dignity of a life, not simply the prolonged function of the body.
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