Medical treatment and the good death: an ethical analysis of euthanasia, physician assisted suicide, and the right to die

Frequent advances in medical technologies have brought fonh many innovative treatments that allow medical teams to treal many patients with grave illness and serious trauma who would have died only a few years earlier. These changes have given some patients a second chance at life, but for others. these new treatments have merely prolonged their dying. Instead of dying relatively painlessly, these unfortunate patients often suffer from painful tenninal illnesses or exist in a comatose state that robs them of their dignity, since they cannot survive without advanced and often dehumanizing forms of treatment. Due to many of these concerns, euthanasia has become a central issue in medical ethics. Additionally, the debate is impacted by those who believe that patients have the right make choices about the method and timing of their deaths. Euthanasia is defined as a deliberate act by a physician to hasten the death of a patient, whether through active methods such as an injection of morphine, or through the withdrawal of advanced forms of medical care, for reasons of mercy because of a medical condition that they have. This study explores the question of whether euthanasia is an ethical practice and, as determined by ethical theories and professional codes of ethics, whether the physician is allowed to provide the means to give the patient a path to a "good death," rather than one filled with physical and mental suffering. The paper also asks if there is a relevant moral difference between the active and passive forms of euthanasia and seeks to define requirements to ensure fully voluntary decision making through an evaluation of the factors necessary to produce fully informed consent. Additionally, the proper treatments for patients who suffer from painful terminal illnesses, those who exist in persistent vegetative states and infants born with many diverse medical problems are examined. The ultimate conclusions that are reached in the paper are that euthanasia is an ethical practice in certain specific circumstances for patients who have a very low quality of life due to pain, illness or serious mental deficits as a result of irreversible coma, persistent vegetative state or end-stage clinical dementia. This is defended by the fact that the rights of the patient to determine his or her own fate and to autonomously decide the way that he or she dies are paramount to all other factors in decisions of life and death. There are also circumstances where decisions can be made by health care teams in conjunction with the family to hasten the deaths of incompetent patients when continued existence is clearly not in their best interest, as is the case of infants who are born with serious physical anomalies, who are either 'born dying' or have no prospect for a life that is of a reasonable quality. I have rejected the distinction between active and passive methods of euthanasia and have instead chosen to focus on the intentions of the treating physician and the voluntary nature of the patient's request. When applied in equivalent circumstances, active and passive methods of euthanasia produce the same effects, and if the choice to hasten the death of the patient is ethical, then the use of either method can be accepted. The use of active methods of euthanasia and active forms of withdrawal of life support, such as the removal of a respirator are both conscious decisions to end the life of the patient and both bring death within a short period of time. It is false to maintain a distinction that believes that one is active killing. whereas the other form only allows nature to take it's course. Both are conscious choices to hasten the patient's death and should be evaluated as such. Additionally, through an examination of the Hippocratic Oath, and statements made by the American Medical Association and the American College of physicians, it can be shown that the ideals that the medical profession maintains and the respect for the interests of the patient that it holds allows the physician to give aid to patients who wish to choose death as an alternative to continued suffering. The physician is also allowed to and in some circumstances, is morally required, to help dying patients whether through active or passive forms of euthanasia or through assisted suicide. Euthanasia is a difficult topic to think about, but in the end, we should support the choice that respects the patient's autonomous choice or clear best interest and the respect that we have for their dignity and personal worth.

Opting out of oppositionality : toward an informed and engaged "third wave" feminism

I begin by citing a definition of "third wave" from the glossary in Turbo Chicks: Talking Young Feminisms at length because it communicates several key issues that I develop in this project. The definition introduces a tension within "third wave" feminism of building and differentiating itself from second wave feminism, the newness of the term "third wave," its association with "young" women, complexity of contemporary feminisms, and attention to multiple identities and oppressions. Uncovering explanations of "third wave" feminism that go beyond, like this one, generational associations, is not an easy task. Authors consistently group new feminist voices together by age under the label "third wave" feminists without questioning the accuracy of the designation. Most explorations of "third wave" feminism overlook the complexities and distinctions that abound among "young" feminists ; not all young feminists espouse similar ideas, tactics, and actions; and for various reasons, not all young feminists identify with a "third wave" of feminism. Less than a year after I began to learn about feminism I discovered Barbara Findlen's Listen Up: Voices From the Next Feminist Generation. Although the collection nor its contributors declare association with "third wave" feminism, consequent reviews and citations in articles identify it, along with Rebecca Walker's To Be Real: Telling the Truth and Changing the Voice of Feminism, as a major text of "third wave" feminism. Re-reading Listen Up since beginning to research "third wave" feminism, I now understand its fundamental influence on my research questions as a starting point for assessing persistent exclusion in contemporary feminism, rather than as a revolutionary text (as it is claimed to be in many reviews). Findlen begins the introduction with the bold claim, "My feminism wasn't shaped by antiwar or civil rights activism ..." (xi). Framing the collection with a disavowal of the influence women of color's organizational efforts negates, for me, the project's proclaimed commitment to multivocality. Though several contributions examine persistent exclusion within contemporary feminist movement, the larger project seems to rely on these essays to reflect this commitment, suggesting that Listen Up does not go beyond the "add and stir" approach to "diversity." Interestingly, this statement does not appear in the new edition of Listen Up published in 2001. And the content has changed with this new edition, including several more Latina contributors and other "corrective" additions.