June 20, 2007

The Ethics of Medicine

Euthanasia should at least be partially legal.

Earlier this month, Dr. Jack Kevorkian, also known as Dr. Death, was released from prison after serving eight years of his ten year sentence. Kevorkian was a pathologist who was a avid and vocal supporter of the practice of euthanasia.

He claimed that it was the duty of doctors to help terminally ill patients to painlessly end their lives. He invented the Kevorkian euthanasia kit, a device which injects morphine and cyanide at the push of a button. He lost his medical license when he published the details of this device, and no longer had access to the drugs required for its construction. He then constructed another device, a gas mask with a canister of carbon monoxide.

He claims to have "helped" over 130 people to their deaths with these devices, which earned him the moniker of "Dr. Death". Some of these 130 were not terminally ill, but manic depressives with suicidal tendencies. He was convicted in the death of one such individual.

While Kevorkian decidedly went overboard, euthanasia is still a hotly debated topic. Wouldn't a terminally ill patient prefer a quick and painless passing as opposed to a prolonged period of suffering ? Does it make sense to sustain a vegetable on life support if they do not have any scope of recovery ? And in such cases, shouldn't the doctor be the one who helps the patient ?

The ancient greek physician Hippocrates is considered the father of modern medicine. He laid down the rules of the profession roughly around the fifth century BC. Medical doctors, even today, take a suitably modified version of this oath, called the Declaration of Geneva, on the receipt of their license.

Some clauses from the Hippocratic oath read:

  • To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them.
  • Never to do deliberate harm to anyone for anyone else's interest.
  • To keep the good of the patient as the highest priority.

The relevant clauses from the updated Declaration of Geneva are:

  • I solemnly pledge to consecrate my life to the service of humanity;
  • The health of my patient will be my first consideration;
  • I will maintain the utmost respect for human life;
  • I will not use my medical knowledge to violate human rights and civil liberties, even under threat;

In both cases, a doctor pledges to NOT cause deliberate harm. While the former expressly prohibits euthanasia, the latter remains sufficiently vague to allow euthanasia as a loophole. Indeed, in some countries, most notably the Netherlands, euthanasia is legal if consented to by both the doctor AND the patient. In India, it is completely illegal. Further, Indian law requires that any death, including one in a hospital, must necessarily be referred to the police who will perform an investigation.

I, personally, feel that euthanasia must be made legal in certain cases. It is extremely difficult to watch a loved one suffer through the final stages, so much so that death, when it does come, seems like a relief. Good people, having lived good lives, do not deserve pain and misery to their last breaths. When the doctors can do no more, I feel they must perform that one last procedure, if consented to.

This shall always remain a very controversial topic.