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The Right to Die

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Free will is a luxury that every citizen has. Every person has the free will or opportunity to decide issues for themselves; especially those pertaining to their own bodies and their own health. When should this free will be taken away? Should one's desires be followed even if it is a matter of life and death? Should everyone have the right to decide his or her own fate regarding the right-to-die when faced with the possibility of life on life support? Should the law interfere with your rights to decide actions for yourself?

What is the right to die? The dictionary defines the right to die as "relating to, expressing, or advocating a person's right to refuse extraordinary measures intended to prolong life after a physician has deemed that person to be terminally or incurably ill." If you were terminally ill or on life support should you or should you not have the right to decide for yourself when you life should end or when no more medical efforts should be made to preserve your life.

Recent issues involving the case of Terry Schiavo have brought the issue to new light in the media. Issues have been made raised regarding a person's right and the rights of their family to decide to end life support if the person has been deemed to have no chance or recovery and no chance of a normal life.

For most Americans dying is no longer a natural event, an event that simply happens to us. For the most part people die in hospitals where physicians and nurses make every effort to keep patients alive using all of the latest technologies. Often the wishes of the patient and their families are often overlooked or physicians try to decide on medical, legal, moral and economic factors. The rulings of the court system have firmly established a patient's legal right to discontinue life-sustaining treatment such as respirators or artificial nutrition. This has helped to clarify some of the legal issues regarding the right to die.

Another way to ensure that your wishes are met for any life-sustaining measures is through a living will. A living will is a document that states the kind of medical care an individual wants if he or she cannot communicate their wishes due to injury or disease. These kinds of treatments include restarting the heart (a do not resuscitate order) and artificial feeding. Living wills are enforced when the patient is near death or in a coma with no chance of recovery. To be legally valid in the United States, a living will must be written, signed an witnessed as determined by the laws of the appropriate state. It is called a living will because it becomes effective while the person is still alive. Unless instructed otherwise by a living will, physicians assume that patients want to be kept alive as long as possible. A living will therefore is the preferred method to ensure that wishes are met in the event of medical intervention resulting in a coma or induced feedings.

What happens though when a person does not have a living will? Who ultimately has the right to decide for the patient? Should it be the family, the doctors, or the legal system? Many arguments have been raised and issues discussed in support of each.

The legal side of the right to die issue began over 30 years ago. Three notable cases set legal precedents in this issue. The first case was in 1975 in New Jersey. A 21-year-old New Jersey woman passed out at a party and suffered severe brain damage. She was revived and survived but was in a persistent vegetative state. She depended on a feeding tube and a respirator to live. She lost nearly 50 pounds and was curled into a permanent fetal position. Months passed and she got no better. Her father asked to be her legal guardian so that he could ask to taken her off the life support machines. The hospital, St. Clare's Catholic in Denville, N.J., objected to his wishes. At this time no other court cases existed on how to handle this problem. The New Jersey Supreme Court ruled that the right to privacy under the United States Constitution was broad enough to allow the patients family to end medical treatments. Her respirator was removed in May of 1976 and she was able to breathe on her own. She lived on just the feeding tube in a nursing home until she died of pneumonia in 1985.

The second major case was in 1983 in Missouri. On January 11, 1983, Nancy Cruzan lost control of her car and was thrown from the car face down in a ditch filled with water. Paramedics were able to restore her breathing and heartbeat. She was diagnosed in the hospital of brain damage from the loss of oxygen. Cruzan could breathe on her own, but was kept alive on a feeding tube. Doctors said that she would never improve. Her parents went through the court system in their small town to have her feeding tube removed. The court found in their favor but the state appealed the decision. The Missouri Supreme Court reversed the decision and refused to have the feeding tube removed. They stated that they needed clear and convincing evidence the Nancy would have wanted to have the feeding tube removed and to not live in a persistent vegetative state. The Cruzan's appealed to the United States Supreme Court. The Supreme Court further clarified legal and medical issues in the right to die issue. It clarified that a feeding tube was still life support. It further clarified that withdrawing nutrition and hydration was no different than refusing or taking away any other form of life support. It also placed the burden of proof of a patient's wishes an issue of the state and not a federal one. The court ruled that the Cruzans hadn't provided sufficient clear and convincing evidence that Missouri required. The family returned to a Missouri courtroom with new witnesses and friends of Nancy's who testified that Nancy would not want her body to be kept alive after her mind was gone. This testimony met their burden of proof and the feeding tube was removed on December 14, 1990. Nancy died the day after Christmas.

The third right to die case came from Pennsylvania from a man named Daniel Joseph Fiori. Joey Fiori crashed his motorcycle in 1971 at the age of 20. He was first in a coma for months. After coming out of the coma, he was brain damaged and partially paralyzed with limited abilities. His mother cared for her son at home for 5 years. In 1976, some time of malfunction with his medication further damaged his brain and left him in a persistent vegetative state. He lived in a nursing home. His mother visited him every day bringing gifts and flowers, talking to him and holding his hand. In Valentine's Day of 1992 she finally realized that the person that she visited every day was no longer her son. She saw nothing of the son that she had loved



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