Everything today comes from the fact that our society is based on autonomy. Autonomy refers to an individuals’ right to be self-governing, to exercise self-direction, freedom, and moral independence. It is autonomy that has started to take a bigger role in dying patients. Autonomy is one of the biggest bases of a doctor-patient relationship. Today autonomy has come to be more respected by doctors and hospitals than ever before. Generally patients have already decided before being on their deathbed what sorts of actions they would want their doctor to take, should they be at their end stages of life. More patients than ever before have a living will. A living will is an advance notice to the doctor or the hospital, notifying them not to use life-sustaining devices, or extraordinary measures in the event of the person facing absolute death. Living wills are not the only things that patients are filling out. A recent trend has started to boom through out many medical facilities. In fact many patients admitted into a hospital end up filling out Do-Not-Resuscitate (DNR) forms. This form tells the medical facility that the person wishes not to be resuscitated in the event that their heart or respiratory functions cease.

It is technology that has also put a scare in some patients. Some feel that technology has interrupted the natural process of death, they feel as if it has helped prolong the ultimate end. It is technological machinery, tubes, and sounds that make most patients uncomfortable in the hospital. In a way most patients have a queasy feeling, like they are not human. Some have fears of spending their last hours on machinery that will pump their blood, or breathe for them. Your modern Intensive Care Unit includes machines such as the heart-lung machine, dialysis machine, oxygen tank, an electrocardiogram machine, and miscellaneous items such as iv bags, needles, etc. It is atmosphere like this that has increased the number of living wills, and DNR’s within the hospital. Some patients’ feel they wouldn’t want to lie in the hospital like a vegetable, hooked up to all sort of machines that are keeping them alive. Most patients have decided they would want to die, rather than be in a persistent vegetative state (PSV) or coma where they cannot function on their own. Some patients have taken the issue of Euthanasia up with their doctors. Some patients have asked their doctors to play a key role in their death, where the patient has actually asked the doctor to inject them with a lethal drug that would help them die. Although this sort of euthanasia is known as active, it is illegal in most states. Passive Euthanasia on the other hand gives more power to the patient, where the patient decides to cut off treatment that would otherwise keep them alive.

There are those who argue that autonomy leaves too much power in the hands of the patient. But there are those that say a doctor should take whatever actions necessary to keep his or her patient alive. It is arguments like this that have brought a big shift in our society. Ethics has long been at the center of these types of arguments. Some people would argue who are we to interfere with the natural process of death, if god has called us then it is time to go. The same people would argue that it is not up to the medical community to decide who should live and who should die. But the other side would argue life support should not be cut-off just because the heart has ceased to function, they feel that the brain is still functioning, thus the person is still alive. Some would also argue to keep the person alive even if there is no brain activity. Some would also blame the medical community for not providing a clear and precise definition of death. But put yourself in the shoes of a doctor, it is people like this that are trained to keep a person alive for as long as they can. What rights do you have as an individual?

In my own personal opinion, I think when my time comes I will be ready to go. Although I agree that both sides have some extreme key points that need to be considered. I strongly believe in the notion that it is my life and I should be able to choose whatever I want to do with it. I would not like to see myself hooked to all sort of machinery in my last hours of life. I would have to say the whole process of dying in hospital is not an easy one. At the end stages of life people are left with many decisions and those decisions have to be respected and obeyed. I would have to say that in the end today’s technological age has give us so many options, but the ultimate choice should still lie within the hands of the individual.

1) Mercy or Murder, edited by Kenneth R. Overberg, SJ

2) The Last Dance, by Lynne Ann DeSpelder and Albert Lee Strickland

3) Ethical Issues in Death and Dying, by Robert F. Weir

4) Medical Center Lab, by Melvin Berger

5) Along with notes, ideas, and feedback from the lecture on 3/09/99