Patient's best interests

A serious problem for supporters of euthanasia are the number of cases in which a patient may ask for euthanasia, or feel obliged to ask for it, when it isn't in their best interest. Some examples are listed below:

· the diagnosis is wrong and the patient is not terminally ill

· the prognosis (the doctor's prediction as to how the disease will progress) is wrong and the patient is not going to die soon

· the patient is getting bad medical care and their suffering could be relieved by other means

· the doctor is unaware of all the non-fatal options that could be offered to the patient

· the patient's request for euthanasia is actually a 'cry for help', implying that life is not worth living now but could be worth living if various symptoms or fears were managed

· the patient is depressed and so believes things are much worse than they are

· the patient is confused and unable to make sensible judgements

· the patient has an unrealistic fear of the pain and suffering that lies ahead

· the patient is feeling vulnerable

· the patient feels that they are a worthless burden on others

· the patient feels that their sickness is causing unbearable anguish to their family

· the patient is under pressure from other people to feel that they are a burden

· the patient is under pressure because of a shortage of resources to care for them

· the patient requests euthanasia because of a passing phase of their disease, but is likely to feel much better in a while

Supporters of euthanasia say these are good reasons to make sure the euthanasia process will not be rushed, and agree that a well-designed system for euthanasia will have to take all these points into account. They say that most of these problems can be identified by assessing the patient properly, and, if necessary, the system should discriminate against the opinions of people who are particularly vulnerable.

Chochinov and colleagues found that fleeting or occasional thoughts of a desire for death were common in a study of people who were terminally ill, but few patients expressed a genuine desire for death. (Chochinov HM, Tataryn D, Clinch JJ, Dudgeon D. Will to live in the terminally ill. Lancet 1999; 354: 816-819)

They also found that the will to live fluctuates substantially in dying patients, particularly in relation to depression, anxiety, shortness of breath, and their sense of wellbeing.

Other people have rights too

Euthanasia is usually viewed from the viewpoint of the person who wants to die, but it affects other people too, and their rights should be considered.

· family and friends

· medical and other carers

· other people in a similar situation who may feel pressured by the decision of this patient

· society in general

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Date: 2015-01-02; view: 1159