Death- an inevitable fate that most people try to ignore. After all, it is not the cheeriest of topics. However, for terminally ill patients, it is an unavoidable subject that they are forced to face every single day. It is much more than just physical pain, 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. They need the option 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). In today's times, euthanasia is a common option for pet owners to help terminate pain and suffering for their pets. Ironically, this practice is highly controversial and many times illegal among human beings. Many argue that euthanasia degrades human life through the act of medical termination. However, it is crucial to point out the circumstances in which euthanasia is issued. Euthanasia is for those who are mentally competent and in excruciating pain because of a terminal diagnosis. So far in the United States, there are five states that have legalized euthanasia: Washington, Oregon, California, Vermont and New Mexico. The rest of the states are slow to follow due to controversy among public opinion. Many countries around the world, such as The Netherland, Switzerland, and Belgium have also legalized euthanasia. There are a number of benefits that comes with legalizing euthanasia, including the end of pain and suffering for terminally ill patients, better allocation of money and medical resources, and the improvement of the patients' quality of life. These benefits will improve the general welfare of society. The major stakeholders in the legalization of euthanasia include terminally ill patients, medical care workers, pro-life organizations, and the federal government. 

Euthanasia can be carried out and decided in many ways. There are two main types of euthanasia: voluntary and involuntary. Voluntary euthanasia is conducted with the patient's consent. Involuntary euthanasia is conducted with another person's permission because the patient is unable to make that decision himself. There are 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 1). Voluntary euthanasia would be the best option for terminally ill patients or those with permanent, severe diagnosis. To successfully carry out the procedure, it is necessary to have both the consent of the patient and the judgement of a doctor.

One of the primary reasons for legalizing euthanasia is to end pain and suffering for terminally ill patients. Pain and suffering can range from illness symptoms to drug's side effects to treatment pains. With the advancement in medicine, many 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). The fact that the presence of pain, depression, and periodic confusion has increased over the past 10 years shows the horrifying circumstances patients have to experience near end-of-life. Instead of treating the pain, care units are extending the gruesome process of dying. More and more people are kept on ventilators and hooked up to machines, often with no mobility. This is not how humans are meant to live. Another major problem is that patients' conditions are often underestimated because it is end-of-life. "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 also be applied to the conditions patients are put through. There is a fine line between undertreatment and negligence, and the treatment of many end-of-life patients are not well monitored. Also, 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). When opiods fail to relieve pain, heavier dosages are issued, causing the patient to develop a reliance on drugs. This heavy reliance on opioids is not a feasible solution because of the terrible side effects that can worsen a patient's state of being. Common side effects of opioid include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. (Benyamin). Many opponents of euthanasia believe putting patients in end-of-life care is the best option for them. Some even state that continually putting attention on euthanasia will divert the resources of mental homes and care units (Emanuel 642). However, from these research facts, it can be easily seen that this type of treatment is not helpful nor beneficial for patients.  

The world in which healthy human beings live in contrasts greatly with the one terminally ill patients live in. Some might even say being terminally ill can be compared to a life sentence in an individual's own body. Many of these terminally ill patients are put in critical care units so that others can help sustain their living. The critical care nurses are people who terminally ill patients spend a majority of their time with. Thus, these nurses have credibility in describing the end-of-life care environment as well as patient interactions. A survey was conducted to evaluate the opinions of critical care nurses' and their involvement with euthanasia. After looking at his findings, researcher David Asch stated "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" (891). This speaks volume on the ethics of euthanasia from the perspective of medical professionals. These nurses have such strong empathy for these patients that they are willing to risk their jobs to help them. In fact,  "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 890). The testimonies of first-hand medical professionals give the public greater clarity on what tempts them to engage in euthanasia. It is not a way to harm the patients or make their jobs easier; it is a way for them to help the patients get relief.

Not only can end-of-life care be inadequate and painful for patients, it can also come at a high cost. A recent study found that out-of-pocket expenses for Medicare recipients during the five years before their death averaged about $39,000 for individuals (Wang). These expenses range from the cost of medications to treatments to hired caregivers. Depending on the condition of the patient, these can be necessary day-to-day expenses that add up quickly. Of course, there is no way to put a price tag on life and set a budget for an individual's survival. However, what has to be considered is whether or not these expenditures are helping the patient.  With the studies on the amount of pain and suffering that is caused by end-of-life drugs and general conditions, it seemingly is not. These funds are also typically spent on the patient's last days, essentially making no difference in their living condition. In a way, families are paying for the lengthened suffering of the terminally ill patient. The financial burden caused by end-of-life expenditures can affect families for years after the death of their loved ones. Aside from personal financial burdens, a large amount of public funds are spent on end-of-life care. In fact more than $125 billion, is spent on services for the 5% of beneficiaries in their last year of life" (Wang). The spending of public funds on patients is not the main concern, it is the fact that patients who do not wish to live are forced to on government money. There is already a shortage on funding in the health care system, and this is only depriving more funds from other medical fields. It is important to consider the allocation of funding between those who want to die and those who want to live. There are many patients with curable diseases that are denied care because of improper funding. They should be given the chance to receive the help that they need. Other stakeholders such as 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. 

Although euthanasia ends patients' life, it ironically improves their quality of life at the same time. It is common knowledge that when humans grow older, their bodies grow weaker. They might lose the ability to walk independently, eat normally, or talk continually. It is in this stage that humans experience the lowest points in life. These conditions are very common among terminally ill patients during their last months of living. They essentially lose the ability to be self-sufficient in the most basic activities. Their state of health, both physical and emotional, can be difficult for the public to understand. Thus, more and more euthanasia advocates have made national headlines telling their personal stories. Figures such as Tony Nicklinson, Brittany Maynard, and Peggy Battin have all made their case as to how euthanasia improved their quality of life. 

Tony Nicklinson was a Briton who fought for euthanasia until the day he died. He grew up healthy and had a normal life 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 stayed awake and aware of his disability. He could not feed himself, bathe himself, or even speak. He had total reliance on a machine and those around him. Because of this, he described 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, the public can see the desperation of some patients. Although Nicklinson did not have a terminal illness, the Locked In Syndrome hindered the way Nicklinson lived his day to day life. The illness trapped Nicklinson in his own body, giving him no control or freedom. For him, therapy could only help a certain amount, and euthanasia was his next best option. However, even in the 21st century, he was denied the right to take power over his life.

Brittany Maynard, who was diagnosed with terminal brain cancer, was also an advocate for euthanasia due to her personal health circumstance. Maynard fought for her right to go through with euthanasia and 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). Living with the brain cancer caused Maynard to experience 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. Thus, Maynard had pick her entire life in California and move to Oregon (where euthanasia is legalized), and establish residency. During the last few months of her life, Maynard got to travel and experience all that life had to offer. Though reaching euthanasia was a tedious process for her, Maynard said that she was happier because power was in her hands as to when and how she will die. It was not solely about dying, it was about having a peace of mind. She did not have to go through the fear of not knowing when she will pass away, how painful it will be, or if she will get closure beforehand. Euthanasia played a huge role in helping Maynard overcome her uncertainties and improving her life quality. 

 Philosopher Peggy Battin spent her life fighting for the rights of terminally ill patients to have more control over their death. Coincidentally, in recent years, her husband was involved in an accident that left him quadriplegic. When his conditions worsened, he knew he did not have the power to stop it, so he chose euthanasia. In her TED Talk, Battin described how and why her husband made this decision. Her husband knew the kind of death he wanted. He did not want to die on a hospital bed, under constant protocols, and remain impersonal to his friends and family. He wanted to die on his own terms (Battin). And when a physician agreed to administer the procedure, his life changed for the better. Euthanasia allowed Battin's husband to make the moral and legal decision for himself. 

With euthanasia being such an ethical issue, there are many arguments opposing the legalization of euthanasia. Most of these oppositions come from pro-life organizations, members of a religious sector, and disability organizations. One of the biggest argument is that euthanasia corrupts the value and sacredness of life. Some people believe that humans should preserve and value the life they are given as it is a sacred gift (Anderson). While life certainly is sacred, it is crucial to look at the circumstances in which people live in. Many terminally ill patients for example, live life with constant pain, fear, and uncertainty. Also, their day-to-day skills are compromised because of the illness. In some cases, choosing euthanasia is their way of appreciating what they have left of life. Every individual differs in the way he values life, and it is not fair to impose that value on someone else. Another opposing argument claims that euthanasia will only target the weak while giving too much power to doctors. In this context, they consider doctors to be killers instead of professionals. This argument is only valid when unethical procedures are committed by doctors and patients. Which is why 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 547). Instead, the doctor has to examine the patient's mental state to see if the patient is adequate to make that decision for himself. There should be a balance of power between physician and patient. Looking at the bigger picture, 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. 

People have many freedoms living in this country. However, having the freedom to choose one's way of death is severely limited. Many times, people have to simply "wait it out." Euthanasia, on the other hand, serves many benefits, especially for terminally ill patients as they need a way to end their pain and suffering. Having this option will put the patients in control of how they spend the end of their lives. It lets them control their body, instead of the other way around. With the lack of positive reviews from end of life care units, it is obvious that patients need a more painless option. Not only that, it would make financial sense as patients would not be funding the lengthening of the dying process. In result of allowing euthanasia in the medical system, more people can be helped. They can be freed from their life sentence. They deserve that much.

