Issues in Debate on Euthanasia

There are four ways in which the lives of the terminally ill can be brought to an end (Quill, Lo and Brock, 1997, p. 2099). The patients can voluntarily stop eating and drinking, and die from dehydration or starvation. This is considered acceptable by many, but can also lead to abuses if family members deprive those who are ill of nourishment against their will. Terminal sedation is also quite acceptable, and renders the patient unconscious and thus also susceptible to death by dehydration or starvation. Physician-assisted suicide occurs when the physician gives the patient a lethal dose of some medication, but the patient administers it him/herself. Euthanasia occurs when the physician carries out the final act.

The generally agreed upon care for the terminally ill is palliative, but for some patients intolerable suffering still exists. Voluntary cessation of eating and drinking does not challenge current laws, and so is considered by many to be the best alternative. The problem with this approach is that, while it is entirely voluntary, and requires no participation by t

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bered by the traditions that make many doctors reluctant to perform euthanasia. Elliott believes this may be away to avoid the dreaded "slippery slope" leading to morally objectionable forms of euthanasia which so many fear. The National Association of Social Workers Code of Ethics defines the ethical responsibility of social workers as making "every effort to foster maximum self-determination on the part of the clients" (Wesley, 1996). The issue of self-determination is central to the debate regarding end-of-life decisions. In terms of end-of-life decisions, Wesley believes social workers should advocate for public policy and practice strategies that respect the client's right to self-determination, and support the common good. Social workers are uniquely positioned, she says, for advocating respect for the individual and also for the common good. She believes they should foster a socially just public policy that promotes quality of life for all periods of the life cycle so that "death with dignity" can flow naturally from a life with dignity. A 1996 survey of critical care nurses found that some had given drugs to hasten a patient's death, but the questionnaire used unclear terminology, as it implied that increasing the
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