The word euthanasia originated from the Greek language: eu means "good" and thanatos means "death." The meaning of the word is "the intentional termination of life by another at the explicit request of the person who dies. Although these definition states that euthanasia must be initiated by the patient, some people define it to included, voluntary and involuntary termination of life. There are terms that need to be differentiated.
Passive Euthanasia
This is the quickening of a person's death by altering some form of support and allowing nature to take its course, i.e.,
1) Removing life support equipment. (respirator)
2) Stopping medical procedures, medication etc.
3) Stopping food and water, allowing a person to dehydrate or starve to death.
4) Not delivering CPR
5) The most common is the give patient a large dose of morphine to control pain but it will also arrest their breathing. These drugs have a dual effect.
Voluntary Passive Euthanasia
These procedures are performed on terminally ill, suffering persons so that natural death will occur.
CASE: Bouvia
Elizabeth Bouvia was born with severe cerebral palsy and was quadriplegic. She is physically helpless and could not care for herself. Elizabeth is totally dependent on others for cure and survival. These included feeding, washing, cleaning, toileting, clothing and movement.
At the time of her case, she was 28 years old and completely bed ridden. She was also suffering from degenerative and severe crippling arthritis. She had a permanent attached tube in her chest where morphine was injected to relieve pain.
Elizabeth was not only suffering physically but emotionally as well. She was a college graduated who had been married and abandoned by her husband. She also experienced a miscarriage. She lived with her parents until they were no longer able to care for her. She stayed with friends while looking for a place to live. But, without any income she was forced to accept public assistance.
She expressed a desire to die!
In 1988 she went to a hospital to be cared for where she attempted to starve herself. Against her wishes the hospital inserted a nasogastric tube to force feed her to keep her alive. Even though her intent was to die.
Elizabeth petitioned the court for relief by the removal of the nasogastric tube. Her petition was denied because it was needed for her survival and caused her no great discomfort.
In an earlier court case it had been established that an adult with a sound mind had control over their own body, therefore their right to refuse medical treatment was basic and fundamental. Both state and federal constitutions recognize it as a part of the right to privacy.
The findings in that court case compelled the courts to respect her wishes.
Involuntary Passive Euthanasia
This term is used when a patient has not explicitly requested aid in dying. This is mostly done in patients who have been pronounced brain dead and are in a persistent vegetative state and will probably not recover.
CASE: Quinlan
Karen Quinlan was 21 years old. She was celebrating her friends birthday. During the day she had been drinking and taking pills. That evening after one drink she passed out. Her friends tried to resuscitate after they had realized that she had stopped breathing and called the paramedics. She was rushed to nearest hospital emergency room. She was successfully resuscitated by unable to breathe on her own therefore placed on a respirator. She never regained consciousness.
The follow up visit showed that Karen suffered severe brain damage. She was not technically brain dead because there was minimal electrical activity though the waves were not normal and that she was not likely to regain consciousness.
Within 5 months she had shriveled into the fetal position and weighed only sixty pounds. At this time her father asked that she be taken off the respirator. He was supported by his parish priest.
The admitting physician refused to take her off the respirator. He stated that she was an adult and only she could release the physician from his responsibilities. He felt that it was one thing not to initiate life support, but legally and morally wrong to withdraw them once started. The doctor thought he would be susceptible to criminal prosecution.
Mr. Quinlan want to the Superior Court of New Jersey. The judge denied his request to take Karen off the respirator. He felt that, any possibility of recovery was enough to keep her on the respirator the level of life was not imported. He also felt that just because she expressed never wanting to be hooked up to a respirator while living might not be what she wanted facing death.
Mr. Quinlin appealed the judges decisions to the New Jersey Supreme Court in March of 1976, they overturned the lower's court decision. Karen was weaned from the respirator in May, but did not die. She lived for nine years in nursing home being fed and hydrated by tubes. She died on June 11, 1985 from pneumonia.
CASE: Cruzan
On January 11, 1983 Nancy Cruzan lost control of her car and overturned it. When found paramedics could not detect a pulse or signs of breathing. They were able to resuscitate her.
She was unconscious when she reached the hospital. A neurologist diagnosed her with having cerebral contusions complicated by lack of oxygen before paramedics arrived. Nancy remained in a coma for about three weeks and progressed to where she was unable to ingest nutrition. A gastrotomic feeding and hydration tube was implanted with the consent of her father.
When it became clear that she could not be rehabilitated and was in a persistent vegetative state her father asked the hospital to discontinue treatment. The hospital refused. Her parents went to receive authorization from the court. The court found that a person in Nancy state had the right to refuse or withdraw life support treatment.
Nancy had expressed in a conversation with a housemate, never wanting to be kept alive if she could not live a halfway normal life. The court found that the tube could be removed.
The case was appealed to the Supreme Court of Missouri, which reversed the lower courts decision in a 4 to 3 vote. They felt that a casual conversation was not enough to act like the Missouri: Living Will Statute.
The case was appealed to the United States Supreme Court which issued its landmark decision in 1990 where they stated that Missouri had the right to require clear and convincing evidence in a case of surrogate decision to refuse medical treatment on be of incompetent patients. They also stated that Missouri did not violate her rights.
The matter was taken back to Missouri. The judge listened to new testimony on Nancy wishes. The judge ruled that the feeding tube could be removed. She died 6 months later in December of 1990.
The Supreme Court was not willing to place this right under the "right to privacy" like the lower courts, but instead called it "informed consent".
After this case several states revised their laws to make some provisions for honoring advance directives, living wills and or health proxies. In 1990 Congress adopted a law requiring all hospitals supported by state funding to inform all patients of their state laws regarding advance directives and the correct procedures to insure their wishes about life support are honored if and when the situation presents itself
Active Euthanasia
Voluntary Active Euthanasia
This causes a person death through a direct action, in response to a request from that patient.
CASE: Kevorkian and Youk
Dr. Kevorkian was charged with first degree murder, violating the assisted suicide law and delivering a controlled substance without a license in the death of Thomas Youk Dr. Kevorkian was convicted of second degree murder and delivery of a controlled substance in the death of Youk, he was sentenced to 10 to 25 years in jail. Dr. Kevorkian insisted on representing himself during the trial.
Thomas Youk was 52 years and suffering from a terminal disease called Lou Gehrig's disease. His family wrote Dr. Kevorkian for help. They described the terrible pain Thomas was suffering and wanted help to end it. Thomas himself signed a notice stating that he wanted to die and chose direct injection.
Thomas' family has spoken out against the sentence that Dr. Kervorkian received. They were angry that they were not allowed to testify at the trial. They wanted to inform the courts of the pain and depression that Thomas was going through. They wanted to tell the courts that Dr. Kervorkian was not a murderer.
In his 20 years fighting for what he believes in, Dr. Kevorkian admits to helping more than 130 people die with dignity, but this was his first time ever administering the lethal dose. He was already acquitted at three trials. Dr. Kevorkian felt that it was time to give the cause: legalizing physician assisted suicide a big push. By video taping himself giving the lethal injection to Thomas Youk and giving it to CBS's 60 Minutes to air would cause society to take a look at what is being done and make a move in that direction legally.
Dr. Kevorkian states that any society that considers itself to be educated would not consider physician assisted suicide, murder. He also stated if ever convicted, and sent to prison, he would starve himself to death. Dr. Kevorkian's 1st lawyer has returned and filed his first appeal on an over severe sentence.
Involuntary Active Euthanasia ( Mercy Killing)
This causes a person death through a direct action without the request from the patient. Someone usually husbands or wives cannot stand to see their spouse suffer or being "less than whole."
CASE: Joseph Lasco
Joseph Anthony Lasco Sr., at the age of 62 was arrested for 1st degree murder in Florida. On February 1, 2000, killed his ex wife by shooting her in the neck and chest. This happened outside her doctors office. She had recently been diagnosed with terminal cancer and had been given 3 to 6 months to live.
Joseph confessed that he shot his wife in hopes of ensuring she didn't have to suffer because of her illness. He stated that he brought the gun with him to take her to the doctors in case the news was not good. He was first represented by the Public Defenders Office and now he has his own attorney. His attorney believes that the facts of the case does not support the charges and that the States Attorney Office did not give all information that was available.
The son of the accused and deceased is angry at the States Attorney Office for pursuing 1st degree murder where if convicted his father could face life or the death penalty.
CASE: Robert Latimer
Robert Latimer a farmer in Saskatchewan, Canada, killed his 12 year old daughter Tracy. On October 24, 1993 he put her on the cab of his truck and ran a hose from the exhaust to the cab, killing her by carbon monoxide poisoning.
Robert Latimer told police he could not bear to see her suffer any more.
Tracy had a severe form of cerebral palsy. She was a 40lb quadriplegic, who functioned as a 3 month old. She had many surgeries and was due for another at the time of her death. Tracy could not walk, talk or feed herself. She responded to affection and sometimes smiled. She was in constant pain and could not be given anything stronger than Tylenol.
Her father was charged with 1st degree murder, and convicted of 2nd degree murder on November 11, 1994.
The chain of events:
10/25/95 It was discovered that the prosecution interfered with the jury by asking them about religion, abortion and mercy killing.
11/27/96 Supreme Court hears Latimer's case.
2/6/97 Supreme Court orders new trial.
10/27/97 2nd trail begins
11/5/97 Jury finds Latimer guilty of 2nd degree murder and recommends eligible for parole after one year.
12/1/97 Judge Ted Noble gives Latimer " constitutional exemption" orders sentence less than 2 years with one to be spent in the community.
11/23/98 Saskatchewan Court of Appeals set aside " constitutional exemption" and upholds mandatory sentence of at least 10 years.
2/99 Latimer appeals to Supreme Court
5/6/99 Supreme Court says it will hear the appeal.
6/14/2000 Supreme Court hears the appeal.
1/18/2001 Supreme Court upholds life sentence with no parole for 10 years.