Euthanasia originated from Greece and means a good death. It is the medical practice that involves intentionally ending life to relive a patient of suffering or pain. Ever since it was legalized, Euthanasia has been a controversial topic globally. While a majority stand in opposition to this medical practice, medical practitioners, patients with incurable chronic conditions and their relatives have found a lot of comfort in the legalization of euthanasia. Euthanasia was first legalized in 2002 in the Netherlands (Cuman and Gastman 838). The same year, Belgium followed suit in legalizing this controversial medical practice. In the Netherlands, Euthanasia is extended to minors older than 12 years of age. In 2014, Belgium also legalized euthanasia for minors who possessed the capacity of discernment. As such, sparked heated debates and uproar. Many ethical questions regarding the competency and discernment of minors have been raised (Unguru, 118). Critics of euthanasia argue that the practice of morally impermissible and extending it to minors acts to extend a morally reprehensive practice. Other arguments against the practice site the implication of the decision, pressure and sensitivity, lack of intellectual capacity and the principle of beneficence. Supporters of the practice on the other hand focus on the principle of patient autonomy as well as the right to die initiative that allows a patient to die a dignified death.
Critics of euthanasia argue that children lack the experiential knowledge and the intellectual capacity necessary to formulate a complex and sophisticated judgment and this renders them incapable of making specific decisions regarding euthanasia. Children lack the fundamental capacity of discernment because of their incapability to understand the concept of informed consent and the consequences of their choices
Moreover, allowing euthanasia in minors is both sensitive and complex than euthanasia in adults. As a group, minors are perceived as highly sensitive and more prone to pressure (Bovens, 634). This can influence their autonomous decision-making ability. Pressure has a greater effect on minors than in adults. When children feel they are a burden to their families, they are likely to feel pressured into choosing euthanasia even though this might not be what they may have wanted. Additionally, parents may pressure minors in less subtle ways to opt for euthanasia and relieve them from the financial and emotional pain they have to live with.
Presumably, palliative care is regarded as more preferable that euthanasia. Life is a substantial and primary benefit, and it's therefore impossible to have benefits in death. Death is not part of palliative care. Euthanasia on minors is harmful because it fails to protect them.
The principle of autonomy in medical practice applies to all patients. This principle emphasizes on competent individuals being allowed the permission to make decisions for themselves. Respect for autonomy has been an issue of debate amongst medical practitioners and scholars, with some arguing that minors are not capable or competent to make autonomous choices due to their sensitivity and their young age. Regardless, many medical practitioners have supported the legislation of euthanasia for competent patients above the age of 12. Practitioners argue that minors above the age of 12 understand their conditions and the consequences of their actions. Moreover, the choice of euthanasia can only be successful when the medical practitioner and the parents' consent alongside the child in question. The minor must not be subjected to any external pressure and must be aware of his condition and the possibility of death.
Scholars argue that competency and capacity are not dependent on age. In the face of end life decisions, minors tend to show more maturity and capacity of discernment than adults, especially when facing incurable chronic illnesses. To ascertain whether or not a minor has the capacity of discernment, his decision must be authoritative, respected and should not be subject to overrule.
On the contrary, euthanasia is a weighty issue. Many critics of euthanasia argue that just as minors are not allowed to vote, buy alcohol or cigarettes, they should not be allowed to make decisions as weighty as euthanasia since they lack the intellectual capacity and the competence to comprehend the consequences of their decisions (Bovens 03).
In 2002, the Netherlands extended euthanasia to competent minors above the age of 12 years. In 2014, Belgium took up the move to amend the Belgian Act of 2002 and legalize euthanasia to minors who possessed the capacity of discernment. A majority of healthcare practitioners supported the move to include competent minors in the euthanasia law. The justification for euthanasia is supported by the principles of autonomy and beneficence which allow a patient to decide what is best for him and prioritizes the best interest of the patient respectively. In the United States, Euthanasia is considered illegal in a majority of states. The state of Washington D.C, Vermont, Colorado and Oregon and California are the only places where the practice is legal.
The conditions for euthanasia in minors is more restrictive than they are for adults. As aforementioned, the minor's condition must be incurable and caused by an illness or accident, the suffering has to be a physical condition and impossible to improve. Also, the anticipation of death must be short term. The minor's legal representative's consent must be considered, and the youth psychiatrist or psychologist must determine that the patient is capable of discernment. Under this condition, the minor has the right to make an informed consent of opting for euthanasia. The presence of a psychologist in this scenario ensures that the minor's consent is free from all pressure and sensitivity and that he/she wants a way out through euthanasia. A recent study revealed that a majority of minors felt less alone and more prepared for death when they were involved in the decision-making process.
Furthermore, the principle of beneficence emphasizes a patient's best interest. Its action is perceived to promote the best interest of the patient and at the same time relive suffering and preserve a patient's dignity (Cuman and Gastmans 842). When dealing with euthanasia amongst minors, the best interest of them in or must be considered by the medical practitioner and the legal representatives.
Summarily, euthanasia in minors has been a controversial topic over the years, garnering support and criticism from scholars, medical practitioners, and activists all over the world. Euthanasia in minors promotes the occurrence of a dignified death by ending suffering and pain which would have been unbearable for a patient. However, the discernment and competence of children to decide on a weight matter like euthanasia remain questionable to date. On the issue of autonomy, children's autonomous decision-making capacity can be affected by external pressures and their sensitivity to their families rather than their own wishes making euthanasia a sloppy slope when it comes to minors. Euthanasia in children who have been tested and proven to have the discernment capacity required for a patient to make such a decision should be permitted with the consent of their parent and the medical practitioner involved. Euthanasia is controversial today as it has always been. Extending it to minors must be a gradual process, and an eligibility criterion must be strictly observed to ensure that it relives rather than harms a minor.
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Works Cited
Bovens, Luc. Child Euthanasia: Should We Just Not Talk About It? Child Euthanasia: Should We Just Not Talk About It? Journal of Medical Ethics. Vol. 41, no. 8. 2015, Pp. 630-634.
Cuman, Giulia And Gastmans Chris. Minors and Euthanasia: A Systematic Review of Argument Based Ethics Literature. Springer-Verlag Berlin Heidelberg. 2017.
Unguru, Yoram. Decision Making for Children with Life-Limiting Illnesses: A Clinical Approach. Berman Institute of Bioethics Johns Hopkins University. 2012. Print.
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