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Euthanasia is a broad term for mercy killing taking the life of a hopelessly ill or injured individual in order to end his or her suffering. Mercy killing represent s a serious ethical dilemma. People do not always die well. Some afflictions cau se people to suffer through extreme physical pain in their last days, and euthan asia may seem like a compassionate way of ending this pain. Other patients may r equest euthanasia to avoid the weakness and loss of mental faculties that some d iseases cause, and many feel these wishes should be respected. But euthanasia also seems to contradict one of the most basic principles of mora lity, which is that killing is wrong. Viewed from a traditional Judeo-Christian point of view, euthanasia is murder and a blatant violation of the biblical comm andment Thou shalt not kill. From a secular perspective, one of the principal purp oses of law is to uphold the sanctity of human life. Euthanasia is so controvers ial because it pits the plight of suffering, dying individuals against religious beliefs, legal tradition, and, in the case of physician-assisted death, medical ethics. This moral dilemma is not new. The term euthanasia is derived from ancient Greek, and means good death. But while the debate over mercy killing has ancient origins, many observers believe that it is harder today to achieve a good death than eve r before. Advances in medicine have increased people s health and life span, but t hey have also greatly affected the dying process. For example, in the early twen tieth century the majority of Americans died at home, usually victims of pneumon ia or influenza. Today most people die in the hospital, often from degenerative diseases like cancer that may cause a painful, lingering death. Most observers trace the modern euthanasia debate back to the court case of Kare n Ann Quinlan, and her story is a poignant example of medical technology s ability to prolong life. In 1975, after consuming alcohol and tranquilizers at a party, Quinlan collapsed into an irreversible coma that left her unable to breathe wit hout a respirator or eat without a feeding tube. Her parents asked that she be r emoved from the respirator, but her doctors objected. The New Jersey Supreme Cou rt case that followed was the first to bring the issue of euthanasia into the pu blic eye. In 1976 the court allowed Quinlan s parents to have the respirator remov ed. Although Quinlan lived for another nine years (her parents did not want her feeding tube removed), the case set a precedent for a patient s right to refuse un wanted medical treatment. In 1990, this right was further expanded in the case of Nancy Cruzan. Cruzan had gone into an irreversible coma in 1983 after a severe car crash, and her parent s wanted the machine that was keeping her alive removed. However, in this case t he machine consisted of intravenous feeding tubes that provided Cruzan with hydr ation and nutrition. Her parents viewed the removal of the machine as the termin ation of unwanted treatment. However, the state of Missouri argued that to remov e the feeding tubes would be to intentionally kill Cruzan through starvation. In a controversial vote, the U.S. Supreme Court ruled that the provision of artifi cially delivered food and water is a treatment which patients may legally refuse , even if doing so will result in death. The cases of Quinlan and Cruzan helped develop a social policy that recognizes t hat some lifesaving treatments are not always appropriate, and permits the remov al of these treatments as a form of passive euthanasia. But shortly after the Cruz an case more active forms of euthanasia became the focus of public attention. On e of the persons most responsible for this is Timothy E. Quill, a physician who in 1991 described in the New England Journal of Medicine the case of Diane, a long time patient of his who was suffering from acute leukemia. She asked Quill for t he means to end her life should she find it intolerable, and, unable to dissuade her, he prescribed sleeping pills, telling her how many were necessary to cure insomnia and how many were necessary to commit suicide. Four months later Diane

killed herself. Quill s article provoked immediate and heated discussion over the legality of phys icians assisting in suicide. Quill s selfproclaimed goal is to improve the care dyi ng people receive rather than to legalize any form of euthanasia. Nevertheless, he became a central figure in a court case that challenged the constitutionality of state bans on assisted suicide Quill and other right-to-die advocates essentia lly argued that terminally ill patients have a constitutional right to assisted suicide. In 1997, however, the Supreme Court disagreed, ruling that states may l egislate for or against physician-assisted suicide as they see fit. (Currently, over 35 states have laws against assisted suicide; only Oregon has legalized the practice.) Ironically, however, the person most responsible for bringing euthanasia into th e public eye is one from whom most right-todie activists have tried to distance themselves: former pathologist Jack Kevorkian, who has admitted helping over 130 people die since 1990. Whereas Quill is regarded as a reasoned, thoughtful spok esman for the terminally ill, Kevorkian is seen as a renegade. Many of the peopl e he has helped to die were not terminally ill, and he did not know them before they requested his assistance in suicide. He holds some bizarre opinions: In his book Prescription: Medicide, Kevorkian advocates experimentation on patients be fore they die and nonvoluntary euthanasia for anyone whom physicians deem to hav e an extremely low quality of life. Many of his views and methods have been cond emned by right-to-die leaders, yet Kevorkian is the name people most associate w ith euthanasia. Prior to 1998, Kevorkian only assisted in suicides. He rigged so-called suicide machines that allowed patients to self-administer a lethal dose of drugs. Howeve r, on November 23, 1998, 60 Minutes aired a videotape of Kevorkian participating in a more active form of euthanasia. For the first time, he administered the fa tal injection himself, ending the life of Thomas Youk, a fifty-twoyear- old who suffered from Lou Gehrig s disease. On March 26, 1999, a Michigan jury, faced with this videotape evidence, found Kevorkian guilty of murder. The judge in the cas e did not allow the defense to present testimony about Youk s pain and suffering, and emphasized that whether the victim consents is legally irrelevant in murder cases. Kevorkian plans to appeal the verdict. Kevorkian s is the latest in a series of contentious euthanasia cases that have ch allenged and, in some cases, changed Americans beliefs about death, mercy, and ki lling. Less than three decades ago, many people considered the removal of a coma tose patient s respirator a shocking act of passive euthanasia. Today, the most di visive euthanasia cases concern physician-assisted suicide and Kevorkian s direct mercy killing. The authors in Euthanasia: Opposing Viewpoints debate these incre asingly complex topics in the following chapters: Is Euthanasia Ethical? Should Voluntary Euthanasia Be Legalized? Would Legalizing Euthanasia Lead to Involunta ry Killing? Should Physicians Assist in Suicide? The viewpoints in this book hel p shed light on the legal and ethical problems that Americans continue to face i n their quest for a good death. Did this raise a question for you? .