Cultural Views On Euthanasia Essay

1. Introduction

Questions about life and death will always be among the major issues people have to answer both collectively and individually – by every member of society. The ageing population, the increase in deaths from cancer and the expected deaths from AIDS, the development and expansion of life-prolonging technologies, the possible generational and cultural changes in the attitudes of patients, and care of the dying are fast creating grave moral dilemmas for society.

These matters have created a serious need to re-examine the ethical and legal status of euthanasia and physician-assisted suicide [1, 2] in South Africa. Such a re-assessment essentially also needs to address ethnic diversity [3, 4], because different belief systems and norms of behaviour [5] will affect people’s views of euthanasia. Although their culture presents people with norms and guidelines according to which their lives may find meaning [6], attitudes towards euthanasia are more complicated than simply voicing an opinion for or against it. This complex situation is the result of various factors which have a great influence on most people’s view of euthanasia. These factors include their cultural and religious values and customs, political orientation, economic situation, the latest developments in medicine and legal issues [4, 7, 8, 9, 11, 12].

Attitudes toward life and death are socio-culturally based and culturally specific. [3, 4] According to Comaz-Diaz and Griffith [13], a person’s ethno-cultural identity, that is, the collective values and norms of a specific ethnic group within a specific culture, gives a member of the groupa unique view of life and death. It is therefore important to include ethnicity in a study that assesses attitudes towards euthanasia.

1.1. Ethnicity and Euthanasia

Various authors [8, 9, 14, 15, 16, 17, 18, 19] find that people from an African background are more opposed to euthanasia than those from a European background. MacDonald [15] suggests that a possible explanation for this lies in the fact that members of the African ethnic groups are less likely to relinquish their control of their lives and hand it over to others. Other explanations are that Africans are not self destructive because they direct their aggression outwards rather than inwards and that they expect life to be harsh [9, 19, 20]. Early and Akers [14] are of the opinion that major social factors, particularly religion and family, provide a buffer of social forces which prevent self-destruction in any form.

Within the South African context, African communities have an effective social support system and are stereotyped as ‘looking after their own’. [20] For Africans, death and dying form an integral part of their everyday existence. [21, 22] According to the African belief system, the soul of the departed person passes to the world of the ancestral spirits where it continues to live. [21, 23, 24] However, the soul ofa person who has committed suicide is doomed and becomes an evil spirit. [25] It was found [25] that only 14,3% of the African respondents – compared to 10% according to Mayekiso [26] –find it acceptable for somebody to end his or her own life in the event of unbearable illness. The remaining 85.7% [25] or 90% [26] find it totally unacceptable because of the view that all problems can be solved and one does not collapse in despair in the face of difficulty.

Coloured people, on the other hand, are not part of a tribal system and speak no unique language. [27] Even though they have acquired most of the prominent norms and values of the European community [20, 28], the Coloured community are still characterised by a great amount of inter-group coherence and a strong religious belief system. [20] There is, however, no literature regarding the attitudes of members of the Coloured community concerning euthanasia.

1.2. Profile

South African society is characterised by a complex array of economic, cultural, class and ideological factors, many of which are in sharp contrast with one other and conflict with one another. [29] One dimension of this complexity flows from the contrast between the First World and Third World orders in South African society [21, 30].

Until recently, under the apartheid system, the South African population was loosely defined in terms of three racial groups, namely African, Coloured and European. According to Rabe [20], these racial groups did not necessarily represent meaningful cultural groups, especially since the classification of Africans included a wide range of different ethnic groups, such as the Nguni, Sotho, Venda and Ndebele. Groenewald [28] furthermore explains that, according to Proclamation 123 of 1967, the Coloured ethnic group included any person who wasa descendant of a Cape Coloured, a Malaysian, Griqua, Chinese, Indian, or other Asian immigrants or slaves. The entire social, political and legal structures of South Africa were designed around these racial categories [20].

For the purpose of this article, the term Africans will refer to members of the Xhosa group and Coloureds to all people classified as Coloured in terms of the Population Registration Act (Act 30 of 1950). According to this act, a Coloured is any person who is from neither European nor from African descent, or any person with mixed bloodlines [28].

The estimated population of the Western Cape forms 11.25% of the total South African population and is proportionally represented by 26.7% Africans (mostly Xhosa), 53.9% Coloureds, 1% Indian/Asian and 18.4% Europeans. [31, 32] In terms of life expectancy, the Western Cape has the highest average life expectancy (59.9 years for males and 65.8 years for females) [33].

2. Sample and Methodology

Through simple random sampling, an equal number of respondents, 40 from the African (predominantly Xhosa), 40 from the Coloured and 40 from the European communities were identified – 120 in total. All the respondents were older than 65 years of age and resided in the Greater Cape Town area. The reason for choosing the target population was to investigate Cicerelli’s [9] argument who points out that it is significant that a large proportion of older people strive to live as long as possible, no matter how onerous life becomes, and therefore would oppose euthanasia. This argument is supported by Twycross [41] who showed that older people tend to disapprove of euthanasia because of the fear that their lives may be ended against their will when they are no longer in complete control of their circumstances.

A qualitative field study was conducted through interviews, and participation in this study was voluntary. In addition, each respondent’s anonymity was assured and the interviews with the participants were conducted in private. No names or any other personal information was recorded. Once a participant showed any distress or discomfort with any of the questions, the researcher suspended the interview and re-assured the participant. The researcher read each question and statement, explained any uncertainties and recorded the responses in written format.

A basic demographic questionnaire and the full version of the Euthanasia Attitude Scale of Holloway et al. [34] were used. The Euthanasia Attitude Scale was developed to assess a person’s general attitude towards end-of-life decisions. This scale further investigates issues concerning patients’ rights, the role of life-sustaining technology, the physician’s role, and values and ethics. The questionnaire consists of thirty-five questions to be answered on a seven-point Likertscale, of which half were written from a positive perspective, i.e. they were affirmative (pro-euthanasia) and half from a negative perspective (anti-euthanasia). The questions furthermore deal with a variety of issues concerning both active and passive euthanasia, such as the status of brain dead people, life-extending technology, ethics and legal issues. [34] Higher scores indicate more positive, accepting attitudes towards euthanasia. The questionnaire has excellent psychometric properties, such as stability, internal consistency, discriminant validity, and test-retest reliability. Although the test was standardised for the American population, the reliability score for this specific study using the Euthanasia Attitude Scale had an Alpha of 0.55.

2.1. Statistical Techniques Used

An analysis on the raw scores of the collected data was done by the computer software programme Statistical Package for Social Sciences[35].

3. Results

Table 1 indicates the mean and standard deviation of the demographic variable, ethnicity, towards euthanasia, while Table 2 shows the results of an ANOVA analysis of the total Euthanasia Attitude Scale and Ethnicity.

There is not much difference between the scores of each group within the ethnicity demographic variable. Table 2 also indicates that there are no statistical differences between any ethnic group and the person’ sattitude towards euthanasia. The application of the one-way A nova presupposes variance equality (homogeneity) and the high p-value (0.311) therefore strongly indicates that the null hypothesis that older adults do in fact favour euthanasia should be accepted.

The mean and standard deviation of the scores for the subjects of this study relating to euthanasia, as well as each individual scale are presented in Table 3.

Table 3 indicates the average score of the total population on the Euthanasia Attitude Scale, as well as of each individual scale. This, in itself, proves helpful if it is taken into account when looking at Table 3. Table 4 compares the means and standard deviations of those favouring euthanasia and those opposing it.

Table 4 indicates that people who favour euthanasia have higher scores on the scale than those who oppose it. Consequently, people opposing euthanasia also had lower means on each of the five sub-scales. The differences between the two groups on the Euthanasia Attitude Scale and the sub-scales were significant (p< 0.01).

4. Discussion

While various authors [3, 4, 13] argue that attitudes toward life and death are socio-culturally based, culturally specific, and influenced by a person’s ethno-cultural identity, this study found no statistically significant differences between the opinions of people from different ethnic backgrounds. Since only 33% of the population included men and 67% female the gender differences of their attitude was not included in the study.

The social reality in South Africa is such that few Africans are untouched by the pressures and demands caused by a shift away from traditional beliefs, values, social structures, customs and the influences of acculturation. [36] Urbanisation and industrialisation have had a profound impact on family life amongst the different ethnic groups. Among European groups, it has led to the break-up of the traditional, extended family network and the emergence of the nuclear family system. [29, 37] For the Coloured population, urbanisation has resulted in less stable family life. To some extent, this is also true of the African population [29].

According to Rautenbach [37], an important characteristic of urbanisation is that the members of families have become more isolated within their own nuclear families, and that this affects their interaction with the broader ethnic-social group. In addition, the extended family and broader ethnic group usually prescribe the norms and values. [37] However, urbanisation restricts the influence of the extended family, with the result that members of the specific ethnic group receive less guidance on how to approach certain situations. Thus they are alienated from their extended family’s morals and values. [37] Rautenbach [37] illustrates this point by focussing on the change in urbanised Africans’ social, religious and legal structures, which area direct product of the acculturation process. She explains that indigenous laws no longer apply, the hierarchy of authority is becoming less effective, parenting approaches are changing from authoritarian to become more permissive, the extended family structure is being replaced by the nucleus family – which is a result of a change in economic status - and the influence and importance of ancestral spirits are declining. According to Frankl [38, 39] and Havenga [40], the result of these fading forces of religion, traditional morality and values is that people fall prey to conformity and this leads to the disappearance of definite differences between different ethnic groups. Furthermore, the transformation process in South Africa has lead to the amalgamation of cultures, resulting in the loss of cultural identity and uniqueness.

References

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Religious Tradition view of Euthanasia

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Religious Tradition view of Euthanasia

State One Religious Traditions View Of Euthanasia

Euthanasia is described by the Oxford English Dictionary as ‘The bringing about of a gentle and easy death, especially in the case of incurable and painful diseases’ .

The Christian view of Euthanasia is that it is wrong. They understand, the pain and emotional suffering, caused in the case of terminally ill, but believe that a hospice is a better solution and that to commit Euthanasia is murder and a degrading act upon human life.

The most common argument for Euthanasia, is the idea of quality of life. This term was first created in the 1970’s as a term used to describe, the general welfare of a individual. This was gradually adopted as a term to describe a persons overall existence. This ideology, has practically become the argument used to morally justify the killings of hundreds upon thousands of unborn babies, who have genetic defects such as down syndrome and the international starving of brain damaged adults and terminally ill patients. To Christian, this argument has no meaning as we were all created in the image of God and it is believed that each human has a purpose to serve. They see each human as having its own intrinsic worth and to destroy any life, whether a young born child or an elderly person is the murder of a potential. The Christians also mock the quality of life argument as they believe that it is a biased opinion and we have no grounds or framework to judge by. The book of Job, argues against the quality of life argument. In this book, Job claims that suffering is part of being human along with happiness, sadness and anger. This points that if you are suffering, you should live through it and it will make you a stronger person. Paul says in Corinthians 2, For when I am weak then I am strong. He says this when he is trying to describe how he appreciates his “problem/thorn in his flesh” because although he wanted God to take it away he realises that it helps to make him a stronger person and a good Christian, because it reminds him to be humble. It is based upon this that he refuses to take his own life. The Christian sees a good life in respects to a persons response, to a particular situations, whereas the humanists will see only in terms of suffering and pain experienced.

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This can often mean that judgements are given by a third party, rather than from the individual themselves and as a result can lead from voluntary to involuntary Euthanasia. It is the Christian belief that once some of these practices such as Euthanasia become common place, then much more degrading and immoral practices will become common.

The Catholic view of Euthanasia is extremely strong against Euthanasia. They are with the rest of the Christian church in believing Euthanasia to be degrading and a against the moral law of the God. The Pope issued this statement on Euthanasia.
Euthanasia is a grave violation of the law of God, since it is a deliberate and morally unacceptable killing of a human being. This doctrine is based upon the moral law and upon the written word of God.

In modern day society autonomy or the ability for us to be independent or self governing, is given a great emphasis. Yet autonomy itself is not without restrictions.
In every society, ones autonomy is limited, not necessarily by religion, but simply through the desire to allow the society to operate normally. In a Christian society our autonomy is limited by Gods moral law. Humanists will argue that it is autonomy that is necessary in the individual capacity which means a person should have the right to chose whether they wish to have themselves aided into death. Yet people who are terminally ill in 85% of cases (statistics taken from a Christian response-a U turn) are not in control of their mind and this can irrevocably lead to mis carriages of the patients wishes.

God made us as autonomous beings, that are bound within his law. This means that although we are allowed to chose and control our own destiny it is the one given to us by God and so it means that we must obey Gods law within all of the our actions. The bible teaches Christians that it was God who created all beings, and so only he has the right to take it away. Therefore Christians conclude, that it is wrong to play God in destroying a life or a potential life. As well each life has a purpose, and to commit Euthanasia you are destroying a life which has a potential that is yet unknown. They also believe that to make life, something, that is humanly expendable degrades and cheapens life. It removes the sanctity of life and means that it loses its importance and the respect that surrounds the issue of life and death.

Jesus taught compassion such as love thy neighbour and turn the other cheek and his compassion, which is at the centre of the Christian living should be applied here. The problems created like this are is it more compassionate, to ease someone to easy death or to keep them alive even if they are in a lot of pain. But when this is coupled with the idea that God created that all life, and only he has the right to take it away, means that it is the Christian duty to ease the suffering of a person, but not to kill them as it will destroy the sanctity of life.

In conclusion Christians believe that Euthanasia is wrong, not just to be picky, but because the issues that surround life and death and Gods morally law are clear in their distain towards anything which endangers the sanctity of life . It is focused mainly from the view that God created all life, therefore all life is sacred and humans have no right to take it away. Because God gave man the precious gift of life. This dictates therefore that life is in the hand of God and we therefore have no right to Euthanasia.



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