Although unavoidable, death is a topic most people avert. However, for terminally ill patients, it is a subject they are forced to face every single day. It is more than just physical pain for them, it is the anticipation, the mystery, and the unknown that slowly kills them. Terminally ill patients need a better option than just waiting it out. That is the primary push behind the legalization of euthanasia. Euthanasia, or mercy killing is "the act of putting to death painlessly or allowing to die, as by withholding extreme medical measures, a person or animal suffering from an incurable, especially a painful, disease or condition" (Euthanasia). It is often referred to as "physician assisted suicide" because a doctor is present when the patient ends his life. In today's times, euthanasia is a common practice among pets and animals to terminate their suffering and pain, however, is still a controversial concept among human. Many argue that euthanasia degrades human life through the act of medical termination. However, it is crucial to point out the circumstance in which euthanasia is issued in. So far in the United States, there are five states that have legalized euthanasia: Washington, Oregon, California, Vermont and Bernalillo County, New Mexico. The rest of the states are slow to follow due to controversy among public opinion. Many countries around the world, the most prominent include The Netherland, Switzerland, and Belgium have also legalized euthanasia. With the legalization of euthanasia, there will be many benefits, including the end of pain and suffering for the patient, better use of money and resources, and the improvement of the patient's quality of life. The major stakeholders in the legalization of euthanasia include terminally ill patients, medical care workers, pro-life organizations, and the federal government. 

There are a variety of ways in which euthanasia is decided and carried out. There are two main classifications of euthanasia: voluntary and involuntary. Voluntary euthanasia is conducted with the patient's consent. Involuntary euthanasia is conducted with the permission of another person because the patient himself is unable to. There are also two procedural classifications of euthanasia: passive and active. Passive euthanasia is withholding life-sustaining treatments while active euthanasia is using lethal substances to intentionally end the patient's life (Nordqvist). For my argument, I will be arguing for voluntary euthanasia for terminally ill patients or those with permanent, severe diagnosis. To make this work, it will have to involve both the consent of the patient and the judgement of a doctor. The role of the doctor will be to ensure the patient is in a state of being to where he is competent to make this decision for himself. 

One of the primary reasons why a person would choose euthanasia would be to end the suffering and pain near the end of life. This can range from side effects from their diagnosis to the pain of treatments. With the advancement in medicine, we would think there are better treatment and medicine available for patients. However, studies have shown the exact opposite, "after each participant's death, a family member was asked questions about the person's end-of-life experience, including whether the person suffered pain, depression or periodic confusion. Those three symptoms were all found to have become more prevalent over the 10-year analysis" (Gold). Instead of treating the pain, they are extending the gruesome process of dying. More and more people are kept on ventilators and hooked up to machines, often with no mobility. Patients' conditions are also often underestimated because it is near end of life. "even if effective treatments are available for 70% -- 90% of cases, undertreatment is well documented and can involve up to 40% of patients. Undertreatment is usually attributed to an inappropriate use of opioids for reasons often conceptualized in terms of barriers related to health care provider, patient, family, institution and society" (Deandrea). If ethics is in question for euthanasia, it should certainly be applied to the conditions patients are put through. There is a huge reliance on the use of opiods to relieve pain. "only 59.5% (95% CI 3.7% to 65.0%) received analgesic treatment with opioids for moderate to severe pain. Not surprisingly, pain was 'only partially relieved' or 'not relieved at all' in 54% of the patients with very distressing pain" (Constantini). However, opioids have terrible side effects that can worsen a patient's state of being. "Common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Physical dependence and addiction are clinical concerns that may prevent proper prescribing and in turn inadequate pain management" (Benyamin). From this, we can see that simply putting patients in pain management or end of life care is not enough. 

With many of us being outsiders, it can be hard to see what really goes on inside a care facility. Thus, a research was done among critical care nurses. Even with the option of end of life care, research shows that it may not be the best option for patients. A survey was conducted in the opinions of critical care nurses' and their involvement with euthanasia. "Apparently, many nurses in our study felt strongly enough about euthanasia that, in particular situations, they were willing to contravene legal and professional prohibitions against it." This speaks volumes on the conditions of patients. These are strangers who the nurses are taking care of.  "19% of the surveyed critical care nurses in the United States have engaged in euthanasia because they have a special understanding of the needs of critically ill patients who are not receiving adequate care, showing the flaw in the system" (Asch). 

As previously stated, end of life care can be inadequate and painful for patients, however, it also comes with a high cost. "A recent Mount Sinai School of Medicine study found that out-of-pocket expenses for Medicare recipients during the five years before their death averaged about $39,000 for individuals." When the patient passes away, the family members are left with a big bill on their hands. It would make sense if they are paying off dues for treatment that helped their loved ones, but in a way, they are paying for the lengthened suffering. These funds are also typically spent on the patient's last days, essentially making no difference in their living condition. Not only that, large public funds are also spent on end of life care. "One out of every four Medicare dollars, more than $125 billion, is spent on services for the 5% of beneficiaries in their last year of life" (Wang). It's the question of allowing funding between those who want to die and those who want to live. Those who are given treatment unwillingly and those who are denied because of improper funding. Hospitals, taxpayers, and the health system all take a financial hit when an unwilling patient is kept alive. With the legalization of euthanasia, funding and resources will be better allocated and utilized. 

Ironically, euthanasia improves the quality of life for patients. It is no surprise that when we grow older, our bodies grow weaker. We might lose the ability to walk, eat, or talk. It is in this stage that we experience the lower points in life. This is usually how terminally ill patients spend the last months of their lives as their bodies deteriorate. They lose the ability to be self-sufficient in the most basic activities. As healthy beings, it can be difficult for us to empathize the way patients feel when in their own circumstance. However, with the topic of euthanasia gaining more media attention, many figures have stepped up to discuss how they feel.

Tony Nicklinson was a Briton who fought for euthanasia until the day he died. He grew up as a healthy being until he had a stroke at age 35 and developed locked in syndrome. This syndrome changed his life drastically as he lost all motor functions in his body yet stay awake and aware. He cannot feed himself, bathe himself, or even speak. He has total reliance on a machine and those around him. Because of this, he describes his condition as a "living nightmare." In hopes to free himself from this nightmare, he argued in court for the legality of euthanasia in his situation. However, the court ruling came back opposing Nicklinson's wishes. He later died at age 58 of natural causes (Burns). Through looking at Nicklinson's case, we can see the desperation of some patients and why they would choose euthanasia. Clearly, the lock in syndrome hinders the way Nicklinson lives his day to day life. There is only so much therapy can help, and euthanasia is his next best option. 

Brittany Maynard, who was diagnosed with terminal brain cancer, was also an advocate of euthanasia due to her own conditions. Maynard did not think of her situation as suicide as she stated, "I am not ending my life, cancer is ending my life. I am only making the process faster and a lot less painless" (CompassionChoices). Because of her terminal brain cancer, Maynard often found herself with intense headaches, the inability to speak, and the inability to put a name to her husband's face. California, where Maynard resided, had not legalized euthanasia at that time. Therefore, she had to pick up her entire life, move to Oregon (where euthanasia is legalized), and establish residency. Though a tedious process, Maynard said that she was happier because power was in her hands as to when and how she will die. She got something bigger than an escape from her condition, she got a peace of mind. She did not have to go through the fear of not knowing when she is going to pass, how painful it is going to be, or if she would get closure beforehand. During the last few months, Maynard got to travel and really experience all that life had to offer. She took advantage of the time she had while still having the ability to move and think. Euthanasia played a huge role in giving her happiness. Maynard's story highlights the fact that sometimes, the worst part about death is the uncertainty, and euthanasia will help patients overcome this uncertainty. 

 Philosopher Peggy Battin spent her life fighting for the rights of terminally ill patients to have more control over their death. Coincidentally, years later, her husband was involved in a life that left him quadriplegic. He then decided that he will end his life with euthanasia. Peggy, who was alongside her husband the entire time, described how positive her husband was during the last weeks of his life but also how hard it was to let him go (Battin). From Battin's story, we can see the role family members play in the decision of euthanasia. Although it can be heart-wrenching for those around the patients, the ultimate decision is still up to the patient. Their happiness is dependent on their own decisions and they have the power to choose.

There are many arguments against the legalization of euthanasia. One of the biggest argument is that euthanasia corrupts the value and sacristy of life (Anderson). However, in the case of a terminally ill patient, life as we know it is different from how they experience it. The value of life depreciates when basic skills are compromised because of a disease. In some cases, choosing euthanasia is their way of appreciating what they have left of life. Another argument that opposes the legalization of euthanasia is giving too much power to doctors in deciding life or death. This is a complicated issue as with one wrong move, doctors can be considered as killers. This is why the procedural work towards euthanasia has to be direct and concise. To go through with euthanasia, there must be an explicit request made by the patient followed by a doctor's judgment on the patient's state-of-being. The doctor should not be there to make a judgement call as to whether the patient should die or be kept alive (Lillehammer). Instead, the doctor has to examine the patient's mental state to see if the patient is adequate to make that decision for himself. Looking at the bigger pictures, doctors already have a lot of power in the medical world. Surgeons practically have the patient's lives in their hands. In the case of euthanasia, doctors are there to help the patient carry out their wishes. 

Euthanasia is a necessary option for terminally ill patients. It should be seen as a viable option for terminally ill patients for them to stop their pain and suffering. Having the option of euthanasia also puts the patients in control of how they spend the end of their lives. With the lack of positive reviews from end of life care units, it is obvious that patients need another way out. Not only that, it would make financial sense as patients would not be funding the unnecessary pain. Most of the treatment given to terminally ill patients are only prolonging their time on the death bed. Lastly, euthanasia improves how patients live their last days. Instead of waiting for their death to come, they can get closure and be in a somewhat healthy state when they depart the world. For the rest of the world, death can certainly be an unfamiliar subject, sometimes even scary. However, for terminally ill patients, death is what they face every day for a long period of time. Not giving them the option of euthanasia denies them the chance to take control and have power over their bodies. 

