In her Oh, the Water… In Stoned Me to My Soul (2006), Mary Faith Marshall states, that in some cases using euthanasia is not violence, but compassion and mercy. She argues that the discussion of euthanasia should be more versatile. Thus, the key issue of this discussion is whether there a moral dilemma can exist in the exact science of medical ethics.
“I would rather my child die the gentle death administrated by Szwajger at Warsaw Children’s Hospital than die a violent death at the hands of soldiers”. This moving statement by Marshall does give an injection of doubt into one’s heart. Indeed, if the destination of a doctor is to bring relief and to ease the suffering, then the possibility of exceptions for the prohibition of euthanasia sounds not so groundless. However, the detached cases described by Marshall seem not sufficient to bring such dramatic changes into the system of medical ethic statements. Detailed analysis of this issue shows that allowing euthanasia cases will bring more tragedy than relief.
By introducing exceptions to the generally accepted values it is possible to perturb the principles of medical ethics. Making exception always implies defining criteria of cases that deserve breaking a rule. Is there anybody who has a right to define them? The key statement of Robert Donnel’s A Bright Line (2006) says, “If we allow exceptions to the prohibition of euthanasia, how should the exceptions be defined and applied?”
Making exceptions in euthanasia will trigger numerous cases of “mistakes”, both conscious and not premeditated. In disaster conditions, a doctor is rather suppressed by the terrific atmosphere; it is easy to assume, that decision-making is especially difficult at that moment. Thus, having no more restraint to euthanasia, he may not premeditatedly abuse this possibility, having overrated the heaviness of the cases. In the difficult situation, the doctor should rely upon a definite, regularized “code of practice”, which will not put a burden of decision making onto the shoulders of an embarrassed medic. As for the intentional abuse, it is necessary to mention, that legislative regulation of euthanasia cases is almost an unsolvable question: it is impossible to give an exact notion of “indications” for a mercy killing. There is no need to say that such a situation forms a perfect screen for premeditated murder.
At the same time, it is reasonable to recollect the traditional values of medical ethics. The statement of the Hippocratic Oath is cited within Donnel’s article. It says that the doctor cannot give a lethal drug to anyone or advise euthanasia to others. The Oath contains several principles which are quite challenging to follow in the real life. Particularly, the principle which implies not spreading patient confidentiality can be also argued: for example, cases of not spreading the information about a crime committed by the patient, or about the threat of epidemic, etc. Indeed, numerous exceptions come to mind when analyzing this principle. Another principle implies that a doctor should prescribe regiments “according to his ability and his judgment”. There is no need to say how much can the words “ability” and “judgment” be speculated. It is necessary to remember, that the Hippocratic Oath is a core of a system of a doctor’s ethical principles. Its essence puts it to the level of state law. That is why the principles of the Hippocratic Oath should be never betrayed.
This leads to the effect that the notion of medical ethics becomes quite indistinct. Every statement of the system of medical ethical principles can be argued and doubted, which gives birth to a rather dangerous tendency. Medical ethics should stay an exact science, with its centuries-old principles, which provide universal ethical rules and principles of relations between a doctor and a patient, instead of trying to play the role of God.