Read the article below and answer the questions that follow.

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Does Euthanasia or physician-assisted suicide (PAS) mean to end a good
death or allow a quality dying experience? The current debate has focused on
whether euthanasia or PAS is appropriate, whether passive euthanasia is the same
as active, or whether providing morphine for pain relief with the risk of respiratory
depression and premature death is the same as euthanasia. However, the issue that
prevails most in the United States (US) for the past five to ten years is the
legalization of euthanasia or PAS. This issue is not about the morality of the care
of an individual patient, but the ethics of having a particular social policy and
practice. Ultimately, the ethical question that should be considered is: Will
legalizing or permitting euthanasia and PAS promote or thwart a good death for
the 2.3 million Americans who die each year in the US? Will people who die be
helped or harmed by having euthanasia or PAS available to them?
Legalization would inevitably generate abuses. There are cases in which
peoples lives were intentionally ended when they should not have been because
they were coerced, they were not provided with appropriate palliative measure or
because they did not consent to it. Similarly, opponents must acknowledge that if
neither euthanasia nor PAS is permitted, some patients experiencing unremitting
pain will be prevented from ending their lives and will suffer needlessly. Other
patients who might not use euthanasia or PAS but would receive some reassurance
by knowing there are possible options, would not have this psychological benefit if
they remain illegal.
Proponents of euthanasia identify four main benefits to legalization. First,
realizing individual autonomy. Autonomy is an essential American value and
should not be dismissed. It is controversial whether permitting euthanasia or PAS
is essential to realizing individual autonomy. But it is worth noting that polls
indicate that most people do not find securing individual autonomy sufficient
justification for legalizing euthanasia or PAS. Unintentionally, ending a persons
life is an act that requires another persons participation and requires giving that
other person a good reason to participate. Indeed, the notion that individual
autonomy is not a sufficient justification is mentioned in the safeguards
incorporated into most proposals for legalization. The key safeguards require that
the patient request freely and repeatedly for euthanasia or PAS. Next, there is
unremitting pain or uncontrolled physical suffering that cannot be relieved except
by euthanasia or PAS. Finally, a second physician needs to be consulted on the
case in order to be sure of the patients prognosis and to ensure that the patient is
acting voluntarily and understands his or her decision.
On the same note, regulating euthanasia reduces needless pain and suffering.
If we legalize euthanasia, how many people will have their needless pain and
suffering relieved? To determine this number, we need to know a few factors like
the number of dying patients, the proportion of these patients who would be
competent to request euthanasia and the proportion of these patients who would
have unremitting pain that would justify euthanasia. It is estimated that each year,
out of the 2.3 million Americans who die, approximately 5,000 to 25,000 patients
might have a distinct dying process with significant and unremitting pain, desire
euthanasia and be competent to repeatedly request and consent to euthanasia. This
is 0.5 percent to 2.5 percent of the 1 million people who have a dying process and
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are competent to request euthanasia. This data suggests that if euthanasia or PAS
were legalized, fewer than 20,000 dying Americans might use these interventions
to end their lives for reasons of unremitting pain. Therefore, legalizing euthanasia
would benefit by relieving unremitting and excruciating pain of 25,000 or fewer of
the 2.3 million Americans who die each year.
Legalizing euthanasia also provides psychological reassurance to dying
patients. No one has directly asked sick or terminally ill patients whether having
euthanasia available as an option would be reassuring. The closest available data
revealed that 41.6 percent of cancer patients, not all of whom were terminally ill,
and 44.4 percent of the public thought that discussions with their physicians about
end-of-life care that included discussion of euthanasia would increase their trust in
their physicians. Overall, the benefit of legalizing euthanasia would be to relieve
the excruciating and unremitting pain of 25,000 or fewer dying Americans each
year. To put this into proper perspective, 1 percent or fewer deaths would be
improved by legalizing euthanasia. In addition, approximately 40 percent of
Americans might get some psychological reassurance knowing that euthanasia is a
possible alternative if their pain becomes unbearable.
Finally, there is a point of equity that hardly gets mentioned in the debate
about the legalization of euthanasia. There is such a rush to legalize euthanasia that
the benefits and the harms are not likely to be fairly distributed. The advocates
might reap the benefits while avoiding most of the harms. The pressure to legalize
euthanasia comes from relatively educated, well-off, politically vocal people. Polls
consistently demonstrate that supporters of legalization of euthanasia and PAS
tend to be financially well-off, well-educated, white, non-religious, and under sixty
five years of age. It is ironic that this socio-demographic description fits most
federal judges, philosophers and other academics. These are people who have
positions of authority in society, who control their work and home environments,
and who are used to realizing their life plans. If euthanasia or PAS were legalized,
they would receive the benefits, especially the reassurance of knowing these
options are available. Furthermore, they could be protected from the harms of
legalization. They tend to have good health insurance, supportive families and the
skills to get what they want from an increasingly bureaucratized health care
system.
Conversely, the harms of legalization most probably fall on vulnerable
members of the US population. This group will likely be the financially less welloff and comparatively powerless patients who may not be insured or maybe
underinsured. They cannot get all the medical services they need, for whom the
costs of care are likely to constitute a large financial burden and also those who
may not have the social skills to navigate the health care system. The polling data
suggests that the poor, African-Americans and older people tend to oppose
legalization of euthanasia. They know their interests and the fact that they are most
vulnerable to abuse. The benefits and harms of legalizing euthanasia may reinforce
inequities in the delivery of health care services and the disparities of wealth and
power in our society.
Will legalization of euthanasia significantly improve the care of the 2.3
million patients in the US who die each year? There is no compelling evidence that
the answer is in the affirmative. Focusing so much attention and energy on
debating, campaigning, litigating and studying euthanasia is beginning to detract
from the primary goal of improving end-of-life care. There are important
challenges to providing better end-of-life care. These include providing better and
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more mental health care, home care and spiritual care. The health care system has
scarce resources, especially scarce time, money, attention span, managerial talent
and so forth. The euthanasia debate has been useful in focusing some of these
100 limited resources on the dying and in improving care of the dying. However,
constant attention and resources focusing on euthanasia is likely to impair instead
of improving the care of the 2.3 million patients who die yearly.
Adapted from Emanuel (2012)

SECTION A (6 marks)
Circle Fact or Opinion for each of the following statements. Write the word or phrase from
these sentences that led you to the answer.
1.

Polls indicate that most people do not find securing individual autonomy
sufficient justification for legalizing euthanasia or PAS. (Para. 3, Line 25-27)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)
2.

It is estimated that each year, out of the 2.3 million Americans who die,
approximately 5,000 to 25,000 patients might have a distinct dying process
with significant and unremitting pain, desire euthanasia and be competent to
repeatedly request and consent to euthanasia .(Para. 4, Line 43-45)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)
3.

The closest available data revealed that 41.6 percent of cancer patients, not all
of whom were terminally ill, and 44.4 percent of the public thought that
discussions with their physicians about end-of-life care that included
discussion of euthanasia increase their trust in their physicians.
(Para. 5, Line 54-58)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)
4.

The advocates might reap the benefits while avoiding most of the harms.
(Para. 6, Line 66-67)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)

5.

Conversely, the harms of legalization most probably fall on vulnerable

numbers of the US population. (Para. 7, Line 80-81)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)
6.

Polls consistently demonstrate that supporters of legalization of Euthanasia

and PAS tend to be financially well- off, well-educated, white, non-religious
and under 65 years of age. (Para. 6, Line 68-71)

Fact / Opinion
Word / Phrase: _________________________________________________
(1 mark)
TOTAL SECTION A:

/6 marks

SECTION B (14 marks)

Answer the following questions in the space provided.
1.

In lines 13-16, infer the meaning of There are cases in which peoples lives
were intentionally ended when they should not have been because they were
coerced, they were not provided with appropriate palliative measures or
because they did not consent to it.

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(1.5 mark)

2. In lines 25-27, infer the meaning of But it is worth noting that polls suggest that
most people do not find securing individual autonomy sufficient justification for
legalizing euthanasia or PAS.
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(1.5 mark)
3. Will legalization of euthanasia significantly improve the care of the 2.3 million
patients in the US who die each year? There is no compelling evidence that the answer is
in the affirmative. Focusing so much attention and energy on debating, campaigning,
litigating and studying euthanasia is beginning to detract from the primary goal of
improving end-of-life care. There are important challenges to providing better end-oflife care. These include providing better and more mental health care, home care, and
spiritual care. The health care system has scarce resources, especially scarce time,
money, attention span, managerial talent, and so forth. The euthanasia debate has been
useful in focusing some of these limited resources on the dying and in improving care of
the dying. However, constant attention and resources focusing on euthanasia is likely to
impair instead of improving the care of the 2.3 million patients who die yearly. (Para.8)
From the paragraph above, what is the authors point of view regarding Euthanasia?
Provide two arguments from the paragraph above to support your answer.
Write the answer using your own words in about 50 words.
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(4 marks)

4. Write a 1 (one) paragraph opinion based response on the topic given below in about
150 words. Your paragraph should contain a brief introduction, which includes a
specific topic sentence, a development of ONE main idea and a concluding statement.
You have to demonstrate the ability of using at least 2 of the APA citation
techniques.
Euthanasia should be legalized in Malaysia.
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( 7 marks )
TOTAL SECTION B:

/ 14 marks

SECTION A + B

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