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Why Euthanasia Is Not Legalized

The idea of legalizing euthanasia in Belgium was born in the early 80s of the twentieth century from the action of two associations for the right to die with dignity. However, unlike the Netherlands, Belgium did not have a long history of euthanasia and prosecuting doctors, and it could not establish appropriate guidelines and led legislators to react more quickly. At the same time, this does not mean that there were doctors who practiced in the shadows and supported the idea of euthanasia (34). According to some studies, these were carried out in the late 90s of the last century, about 5% of the total number of deaths concerned euthanasia, that is, the use of drugs with the aim of shortening the patient`s life. Particular attention has been paid to the fact that the 3.2% to 3.8% deprivation of life occurred without the express will of the patient (38). In this article, we will examine the factors and highlight the historical contexts and influence of language that have helped activists who aim to sanitize «euthanasia» by associating it with medicine. We address the question of whether euthanasia can be considered a medical treatment by emphasizing the incompatibility of euthanasia with the healing mission of medicine. The rapid increase in the number of euthanasia performed has led to a questioning of its legalization, mainly thanks to the activities of the Dutch Society for Voluntary Euthanasia (NVEEJ). In the winter of 1993, the Dutch Parliament reached a compromise between the two opposing views on the question of euthanasia (24). Parliament passed the law, which is usually a kind of codification of the rules and procedures under which euthanasia is practiced about three decades before the law came into force. It is the most liberal law in this area in Europe. These norms and procedures are applied in medical practice and the practice of courts prosecuting crimes of deprivation of life by pardon, and there is no comprehensive theoretical and legal doctrine on the subject that provides guidance for understanding the act of euthanasia (25, 26).

Therefore, the law is only the «tip of the iceberg» (27). What underlies the medical profession`s reluctance to accept euthanasia? There are several explanations. In addition to ethical, moral and religious beliefs, one of the most important and convincing concerns the idea of medical mission, especially with regard to healing. Healing is a difficult term to define. Many in our institution (McGill University School of Medicine) consider it «a relational process involving movement towards an experience of integrity and wholeness».32 It has been surgically defined as «the personal experience of the transcendence of suffering».33 One characteristic of healing that is important to our thesis is the idea that healing does not require biological integrity. Although it may seem counterintuitive at first glance, it has been pointed out that if a sick person is able to construct a new meaning and is able to achieve a greater sense of wholeness, that person may die «cured».32 This is undeniably a completely different concept from healing, although they are not in opposition to each other. Most physicians accept the role of healer as a fundamental and enduring feature of the profession.34 In our undergraduate medical studies, this concept is taught under the term «medicine»; It refers to the dual complementary role of the physician – the physician as healer and professional.35 It could be argued that one can remain «professional» even if one serves as a collaborator in the requested death. On the contrary, many commentators—the American Medical Association is a prime example36—believe that it is impossible to do so as a «healer,» someone who focuses on accompanying the patient on a transformative journey toward personal integrity that goes beyond the embodied self.

Psychiatrists and medical ethicists who do not oppose euthanasia are expected to focus on seeking the patient`s perspective, exploring options, and assessing understanding, competence, and voluntariness – that the patient is free from coercion, coercion, or undue influence in her decision. provided that this is possible. The profession has begun to equip itself with tools to deal with this new emerging clinical reality in jurisdictions that authorize euthanasia. In the United States, physicians were given an eight-step algorithm to help them discuss assisted suicide with patients who wanted it.25 These guidelines were developed immediately after the legalization of SAP in Oregon. It is reasonable to expect that additional decision-making aids will emerge if the practice finds wider social acceptance. The possible consequences for medical education, should it include protocols to end patients` lives, have also been studied.26 The epigram on euthanasia guidelines cited above is fascinating. It reads: «One summer evening, Mr. J-M L, who was suffering from Charcot`s disease, died peacefully after seeking and receiving help from a doctor.

When he left the house, he didn`t think, «What did I do?» but rather, «Did I do it right?» 21 This formulation reveals a unique way of thinking. The affective and moral attitude expressed in this quote is closely related to a technical perspective in which the emphasis is on performing tasks with self-efficacy, as opposed to a task with critical reflection. Meta-reflection is an important aspect of medication. What we do and the conversations we have regularly shape who we become; They become habitus. The clothes we wear can also influence our thought processes. For example, a recent article documents the effects of donning a lab coat on cognition.22 While simply wearing a white coat can affect thought and action, it is easy to imagine the harmful effects of regular discussions about euthanasia as they creep into the ethics of medical care.