- Area: Health Sciences
- Program: Health Sciences
- Type of Writing: Essay (Analytical, Interpretive)
- Course Level: 2000
- Year: 2017
- Paper ID: HS.H.S.E.2.2.8
Extending Euthanasia and PAS to Children
Should children have the right to die? This is a question that has been quite controversial over the years. Euthanasia is defined as the “painless killing of a patient that is suffering from an incurable or painful disease.” Physician-assisted suicide (PAS) is similar to euthanasia, except the patient is provided with the means and information by a physician to knowingly end their life. These types of means for ending one’s life are illegal in most parts of the world. In the United States, PAS is only legal in Washington, Oregon, Colorado, Vermont, Montana, Washington DC, and California.
Euthanasia and PAS are controversial enough when it comes to adults who have their own autonomy. For children, it has become a much touchier topic. The ethical dilemma that comes with extending euthanasia and physician-assisted suicide to children is that it is difficult for us to truly understand and agree on what age is appropriate for a child to decide that they no longer want to live and the protocol for carrying out such practices. With that being said, it is important for us to look at both arguments and stances of this topic, and carefully evaluate the consequences and benefits of each. If children were allowed to decide for themselves if they would like to end their lives, then problems for families could arise all over the world. Children should only be euthanized when they are suffering from painful and incurable diseases and with their parent’s consent. Granting them the option of physician-assisted suicide could potentially cause mayhem for families across the globe as well as religious outbreaks and resistance. An analysis of the ethical and moral issues facing euthanasia and PAS for children is characterized by the severity of pain the child is in, if they are terminally ill, and if their parents give consent to their requested death.
Children are often viewed as unable to make educated and ethical decisions for themselves. Because of this, there are many age restrictions that prevent children from making their own decisions. For example, in America, you have to be at least 18 years old in order to buy cigarettes. You also have to be at least 18 to buy a rated R movie ticket. When it comes to healthcare, minors almost always have to have consent from a parent or guardian. If a child is terminally ill, it is best that the parent has the power over euthanasia or physician-assisted suicide. Children who are suffering from an incurable and painful disease or illness should always be given the option to be euthanized, but it should only be fully considered when the parent of the child has exercised their right to consent to this course of treatment.
The goal of euthanasia and physician-assisted suicide is the allow people to have a dignified death (Chazan, “Terminally ill child becomes first euthanized minor in Belgium”, 2016). Some may view this practice as unethical and immoral, but many people believe that allowing someone to suffer from an agonizing disease is just as unethical. Euthanasia and PAS was created to help those in pain to be able to leave this earth on their terms. Suffering day in and day out can become quite uncomfortable and unbearable. With euthanasia and PAS, people can end their lives with dignity and put an end to their misery and suffering. It is important that we express equality for all and extend these practices to minors, only under strict scrutiny.
When deciding if it is ethical to extend euthanasia and PAS to children, we need to be sure there are certain criteria to be met. Some people might find it difficult to believe that a child is fully capable of making such a big decision regarding their life. In order for this course of treatment to be ethical, the child needs to be thoroughly informed of what will happen. They need to also be aware of the risks and benefits that come with euthanasia and PAS. Some benefits of this means to an end are that the patient will no longer feel any physical pain and that they will be able to end their suffering. It is also beneficial that the procedure itself is painless. The risks of euthanasia and PAS are death, of course, and also the grief and mourning that the patient’s family will have to endure. Another risk that directly affects the patient and the patient’s family, is that results are irreversible. Unlike a tubal ligation that can be reversed or undone, unfortunately death cannot be.
For a child to be eligible for this kind of treatment, they need to be examined by a psychiatrist and be proven mentally stable and in the right mind. After they have been evaluated and properly informed, the physician must receive the patient’s consent as well as the parents’ consent. After their informed consents have been received, only then should the physician begin his/her own evaluation to approve this request. The physician needs to be sure that the family and the patient are 100% sure that this is what they want to be done. A second physician should also be required to evaluate the patient’s pain and competency, and approve the procedure as well. If the minor proves to be incompetent or unwilling, then the procedure should not be performed (Kirkey, 2015). Euthanasia and PAS for a minor should only be performed at the child’s request and with parent’s consent, but never at only the parent’s request.
Quality of Life
In 2014, Belgium became the first country to legalize euthanasia for minors. A couple of years after that, there was a terminally ill child that became the first euthanized minor in Belgium. There have been a lot of controversy regarding their decision to legalize euthanasia, and they are still receiving heat from it. Currently, Belgium is the only country that allows euthanasia for children of all ages, provided they have parental consent (Chazan, “Terminally ill child becomes first euthanized minor in Belgium”, 2016). The child who was euthanized was a 17-year-old who was critically and terminally ill. Regarding this law in Belgium, in order for a child to be considered for euthanasia, they must be facing “unbearable physical suffering.”
There are only two countries, Belgium and the Netherlands, that allow euthanasia to be performed on children. In these countries, the minors who opt for euthanasia must be experiencing a great deal of pain. The quality of life for these minors is slim to none. In order for this practice to be ethical, the children who request it need to be suffering an unimaginative amount of pain or be diagnosed with an incurable and untreatable disease. It would be unethical to let them suffer day in and day out. There are many different ways for a physician to decide what the right amount of suffering is in order to be eligible for euthanasia. In fact, it would be very beneficial to have at least two physicians evaluating the patient’s situation. The patient needs to be in a great amount of pain, and they need to be able to express that they are in pain. The physician should also be able to judge their remaining quality of life, and if it is acceptable for them to result to euthanasia. There should also be thorough communication about what options the patient has about improving their quality of life. No one should jump into the idea of euthanasia without first weighing all their options about possible treatments. When the patient has fully considered all of their possible outcomes and still chooses euthanasia, only then should actions be taken toward this procedure.
In one of their articles, the Canadian Coalition for the Rights of Children (CCRC) talks about how in a perfect world, children would not endure such intractable pain and suffering. However, taking away their autonomy to pursue euthanasia or PAS inhibits them from making their own decisions regarding their bodies, and therefore takes away their liberty. (“Physician Assisted Dying and Children”, 2016) The practice of euthanasia and PAS is viewed as “very, very, dangerous” by a top medical ethicist. It is thought of as a slippery slope that will eventually lead to people with questionable competence requesting a physician-aided death. (Kirkey, 2015) Not only are there concerns regarding what this could lead to ethically, there is also the financial concern. Many wonder about how much it costs and how it is to be paid for. If those who are on welfare insurance seek this treatment, then it is taxpayers who are ultimately funding it—some of which don’t agree with such practices.
As far as religion goes, many different religions have their different views on euthanasia and PAS, most of which are against these kinds of practices. Many religions view human life as sacred, and that participating in euthanasia means disrupting God’s plan. Religious groups have shown strong beliefs regarding many different medical practices such as abortion, for example. If euthanasia and PAS becomes legalized everywhere, there will be many religious outbursts and resistance regarding this matter.
The only alternative option that someone might consider when it comes to a terminal illness, is to just wait it out and let life run its course. When someone is dying a painful death, the only logical option would be to end it, however some people may see this is an easy way out. The option of waiting it out until it is your time to leave this earth may very well be a painful and difficult journey, however, it is still an option. Another alternative would be to take palliative medication and do everything possible to alleviate the pain until your time comes. Being around family and close friends could help the dying process and make one feel more comfortable in their last moments.
Euthanasia and PAS is a tough topic to talk about for anyone, not just for children. It is essential that we take the proper precautions when extending these practices to minors, and that we take this on in a case-by-case basis. If the physicians do everything in their power to fulfill their patient’s needs and wishes, while meeting specific criteria, then it may be possible for euthanasia and PAS to be accepted everywhere. Although it may be hard for a physician to assist someone with dying because their sole purpose in life is to do the exact opposite, it is still their job to alleviate any type of pain that someone may be in—even if that means ending their life. Evaluating the patient’s level of pain, properly informing and evaluating them, and receiving consent from both the patient and the patient’s parents will ensure that this practice is executed professionally and effectively.
Chazan, D. (2016, September 17). Terminally ill child becomes first euthanized minor in Belgium. Retrieved April 27, 2017, from http://www.telegraph.co.uk/news/2016/09/17/terminally-ill-child-becomes-first-euthanised-minor-in-belgium/
Kirkey, S. (n.d.). Proposal to extend euthanasia to children ‘is very, very dangerous,’ top medical ethicist says. Retrieved April 27, 2017, from http://news.nationalpost.com/news/canada/proposal-to-extend-euthanasia-to-children-is-very-very-dangerous-top-medical-ethicist-says
OPINION: Do children have the right to die? (n.d.). Retrieved April 27, 2017, from http://america.aljazeera.com/opinions/2014/2/child-euthanasiabelgiumrighttodiehealthbioethics.html
Physician Assisted Dying and Children. (n.d.). Retrieved April 27, 2017, from http://rightsofchildren.ca/vulnerable/physician-assisted-dying-and-children/
Keywords: medical, ethical dilemma, pediatric