‘DON’T keep me going like a vegetable!’ I’ve said it myself to loved ones after dealing with a serious situation with a friend of the family after a stroke. After being resuscitated three times in one week, another elderly friend with a pacemaker wanted her life to end in peace. And so it goes with many terminally ill patients; they plead to die. For the doctors and judges this is a debatable question and for relatives a painful choice. But who really has the right to make the decision?
Sometimes, there is a senseless prolonging of life within hospitals by the many machines that the patient is hooked up to and it seems like technology has taken over and these machines are the only thing keeping the person alive. When death is unavoidable and the prolonging of life is due extraordinary medical procedures and efforts, many questions arise regarding the right to die with dignity. I would like to think that I have some right in this regard to my final situation and have the option for my death to be agonizing or peaceful?

Demonstration Moral Reasoning

The utilitarian theory when applied to this very sensitive ethical question and topic offers a unique perspective. The overall general principles states that it’s a difficult task but morality should be guide and instruct each one of us so that our efforts are rational and not solely emotional. If this is the case with utilitarian theory I question, how is this possible with such an emotional issue? This theory further believes that “these questions are to be handled in the terms of rational calculation, not of what our feelings suggest.” Mosser, K. (2013). Understanding philosophy Chapter 6
One of the core principals of this theory is that this is a decision that will in turn create the greatest amount of happiness for the greatest number of people. When we look at utility this is a term defined and used for this theory. The most common way of thinking on this matter is that utility is the satisfaction one gets from something. In chapter six section one of our assigned text it states that “utilitarianism considers an act's consequences in assessing its morality, utilitarianism is also regarded as a consequentialist theory. The basic idea in consequentialism is to consider the consequences that will result from the choices one confronts: If the consequences of one act produce the greatest net well or the highest utility for the greatest number of people, this is the act one should carry out.” Mosser, K. (2013). Understanding philosophy
So, one could say and even form the argument that the utilitarian theory is the quality of life that a person has that suffers from dementia or brain damage is diminished due to the disease. The greater good would be accomplished by Non-voluntary active euthanasia because of the amount of suffering and reduced quality of life that the patient is accustomed to prior to the illness. Many of the symptoms of both dementia and brain damage include pain and unwanted physical breakdowns of the nervous system and even the loss of ability to even feed oneself or relieve themselves in the restroom alone for instance. It’s hard to imagine by an able bodied person to willfully suffer through these stages and be ok with the loss of dignity and the addition of physical pain. Though we are considering the topic of Non-voluntary active euthanasia the following example may shed some light on the issue. Singer stated “In other cases, people wanting to die may be unable to kill themselves. “In 1973 George Zygmaniak was injured in a motorcycle accident near his home in New Jersey. He was taken to hospital, where he was found to be totally paralyzed from the neck down. He was also in considerable pain. He told his doctor and his brother, Lester, that he did not want to live in this condition. He begged them both to kill him. Lester questioned the doctor and hospital staff about George's prospects of recovery: he was told that they were nil. He then smuggled a gun into the hospital, and said to his brother: 'I am here to end your pain, George. Is it all right with you?' George, who was now unable to speak because of an operation to assist his breathing, nodded affirmatively. Lester shot him through the temple.” Taking Life: Humans PETER SINGER Excerpted from Practical Ethics, 2nd edition, Cambridge, 1993, pp. 175-217
Though the aforementioned example is extreme so is this topic. At any given time this issue could face us personally with us or our families. So again I ask who really has the right to make that decision? It seems to me that the greatest good for all depends on what side of the situation a person is on and their opinions on this matter. The amount of good accomplished and the intentions are all subjective. Objection and Response

The case for voluntary euthanasia has some common ground with the case for non-voluntary euthanasia, the very death of the one suffering is considered the benefit because it is the end of the suffering. We discussed previously how I would prefer to have a choice and the example of Lester above. The euthanasia offered to Lester for example involved voluntary euthanasia which means the killing of a person. A rational and self-conscious person may reason that the being is more than a merely conscious being so taking under consideration that only rational and self-conscious beings can consent to their own deaths, they may not be rational and self-conscious at the time euthanasia is planned. So, Kass argues against euthanasia and claims “that doctors have a duty not to bring about the deaths of patients, even when those patients desire to die.” Kass, L. R. (1991). Why doctors must not kill. Commonweal, 118(14), 472-476. Retrieved from https://www.commonwealmagazine.org/
Take under consideration that the doctor may, just may be acting on a prior written request for euthanasia now if this is the case, through accident or illness, one's rational faculties could be lost. I personally think this is a great idea for myself I’m personally a fan of leaving some sort of a written directive behind while I am of sound mind to do so. There are countless examples of illnesses that destroy life, the question is if it was you suffering would you want continue living that way?
A relevant objection to the above mentioned position is that no one has the right to play God with the life of someone else. Socrates maintains “that no one would continue to act justly if they had the power to freely do otherwise.” Plato. (2010). Glaukon’s Challenge (Republic 2). (C. Woods, Trans.). Retrieved from http://dx.doi.org/ 10.2139/ssrn.1661519 No matter who, everyone has the right to live and the decision to terminate life is not in the hands of humans. What greater good is accomplished? The answer can be said that the good accomplished is to the caregivers and the relieving them of the burden of continued care for the ill individual. I think many feel that it is considered ethically and morally wrong and even thoughtless to make such a decision for another human being. The utilitarian theory has a few flaws in its position. Let’s look at first, if we just look at the concept of how the hospice care is set up we see that great care is taken to make the last moments as comfortable as possible. The best palliative care for an individuals are not exact in the science to a great degree it involves trial and error. It seems like the term Practice really applies to medicine during this time. The suffering is unavoidable and often we are told or the family is told that they are going to make the patient as comfortable as possible. This comfort is a realitive statement because no one really knows how much pain the patient is really in. So where exactly is the greater good in this example? Take under consideration the effects of the strong medications and the side effects on the patient. Many suffer from nausea, loss of awareness because of extremely strong medication and drowsiness is just the beginning of the suffering but this is all part of the help they receive. But by making palliative care sound pleasant it makes the end result seem more humane and lets face it, this sounds better to everyone else not the patient. Let’s face it as mentioned before only the person suffering knows how much pain they really feel. I would like to state though the sort of care provided through hospices is to be recognized as being a noble work, but it is care that is given is available only to a small amount of terminally ill people and then usually this is at the very end of the life course. In many cases the issue of assisted suicide takes place in hospice. I can only speak for myself but I imagine that everyone is not a fan of hospice care. For those who prefer to die on their own terms such as myself it seems that there is no option that is agreeable. As mentioned earlier if you were in this position how you would prefer your last hours of life?

Conclusion
Part of the problem with this issue is that a conversation about the final care for ourselves and a loved one is often avoided. And yes, this is extremely awkward conversation and I mentioned earlier that I stated quite loudly that I didn’t want to be a vegetable. I still feel that there is a senseless prolonging of life within hospital by the many machines that the patient is hooked up to and it seems like technology has taken over. But I also now think that the question should be asked and considered weather “the greatest amount of good is being accomplished by an action or decision. On the other hand, as stated in the Columbia Law Review, “there is widespread recognition that a courtroom is not the proper forum for making treatment choices. . . . Courts are ill-equipped to assume the role of substitute decision maker.” May 26, 2008, http://columbialawreview.org/?s=Active+euthanasia
We have to keep in mind that each state and the federal government has limitations and the state can not be expected to step in and make this personal decision for everyone. The state have the power to make individuals calls but generally the courts will try to accomplish a judgement that is to the most good for all people.
The dilemma grows because there is no agreed upon uniform definition of terms such as alive and dead. What is extraordinary care really depends on time, and specialist’s skills. And these conflicts can pop up between the interests of patients, relatives, and even the medical staff. These problems pose a serious problem for the conscience of doctors who feel they are obligated to observe moral, ethical, and even religious convictions of their patients. So for the physician, wouldn’t it be unethical for him to force his own personal or religious convictions upon the patient? He should recognize and stay the direction of the patient’s wishes, religion or just remove themselves from the case if this is too difficult. It was certainly my intention to make my conclusion brief but this topic hit hope a bit. I just wanted to mention in my conclusion that my Mother In Law has Dementia and this desease has all but destroyed her mind all together. To see personally how this illness robs a person of their ability to live life in the most basic of ways and then render them helpless to the point that they eventually forget to remember how to take a breath is heartbreaking. Now take under consideration how we remember her personality before the illness, how independent she was and how proud she was.

We now compare those memories to the shell of a woman we now know and the fact she has no knowledge of where she is, who we are and what date it is.
Often the team approach is best, meaning all involved such as the physician, minister if involved, and family all cooperating with the patient for a decision that reflects the best interests of the one suffering is best. The communication needs to happen before the event for a more satisfying outcome for all involved. In times of soon to be death emotions run high and strong. Many are not in favor of Non Voluntary Active Euthanatia and many feel that this is a right of the individual. This by no mean is meant to make a decision or judgement for others, but I can say that I look at this topic differently know in the sense of considering the utilitarian theory and how the overall general principles states that the task of morality should be to instruct us on how to pursue those objectives most rationally. Well with this in view the best way to be rational during an extremely difficult time like this is with communication as mentioned earlier. I hope this paper has objectively examined both sides of the issue but also made clear my position as well.

References:

Mosser, K. (2013). Understanding philosophy

Taking Life: Humans PETER SINGER Excerpted from Practical Ethics, 2nd edition, Cambridge, 1993, pp. 175-217

May 26, 2008, http://columbialawreview.org/?s=Active+euthanasia

Kass, L. R. (1991). Why doctors must not kill. Commonweal, 118(14), 472-476. Retrieved from https://www.commonwealmagazine.org/

Plato. (2010). Glaukon’s Challenge (Republic 2). (C. Woods, Trans.). Retrieved from http://dx.doi.org/ 10.2139/ssrn.1661519