This research examines the moral, ethical, and legal aspects of euthanasia, especially as they have an impact on nursing practice. The research will set forth the historical and moral context in which the issue has emerged then discuss legal, philosophical, social, and practical elements that figure into what has become a feature of discourse of medical care in general and nursing practice in particular.
One of the most notorious news stories of 1976 centered on New Jersey, where Karen Ann Quinlan's physicians disconnected artificial life-sustaining equipment from her body. For nearly three years, Karen's parents had sought permission to have the equipment turned off. Drama and conflict had surrounded the case, partly because Karen had been in her photogenic twenties, partly because the Quinlans were fighting the full weight and authority of the hospital that as a matter of custom, practice, and prevailing social policy refused to allow withdrawal of life support, characterized as passive euthanasia. But by the time comatose Karen Ann Quinlan died in 1985, if the withdrawal of artificial life support was not an ordinary hospital protocol, it was nonetheless a more usual practice in hospitals around the country.
In 1976, California's Natural Death Act legalized use of the living will. By 1977, the year after the Quinlan decision, "fifty bills were introduced in thirty-eight states, and in Arkansas, California, Idaho, Nevada, New Mexico, North Carolina, Oregon, and Texas, they were signed into law" (Humphry & Wickett, 1986, p. 108). By 1991, 28 states had enacted living-will statutes or laws that otherwise guaranteed patients the right to refuse life-sustaining treatment (McCord, 1993). That same year, the Patients' Self-Determination Act required federally funded hospitals to tell patients at the time of admission about their rights to accept or refuse medical treatment and to create advance directives, which can take various lega...