viernes, 20 de mayo de 2011







P R E S E N T A:

María Eugenia Hernández Rosales

María Isabel Núñez Chambe

Leticia Candelaria Sánchez Culebro



Introduction ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...2
 Development of the subject ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4
 Conclusion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...11
 Sources ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...13


"One of the noblest functions of reason is whether or not, time to leave this world." (Marcus Aurelius, Book III)

In this essay on death with dignity, it is out the various arguments for or against this, seen as worthy or unworthy of human beings with opinions and actions as respectful of the dignity of them, without appeal to religious, political or ideological which each one, this is both inevitable and necessary in a society as pluralistic as ours. So hard to meet this challenge can only be an agreement, consensus, dialogue on both the basic ethical principles as about making procedures.

First is a brief explanation of its meaning, and then explain why they should or should not die with dignity. It also gives definitions and comments from people who have made allusions to the subject. I chose to speak of a dignified death (euthanasia) because it is a current issue that has caused much controversy and prejudice worldwide.

There are those who support the practice of euthanasia because they believe that every human being has the right to be recognized the possibility of having his own life in special situations simply because of the dignity that it can be, the recognition of a being enable people to define what to do in life is to respect the humanity of others (the humanity), is respect for freedom and life itself, and it helps us define what is a decent life, one can argue from this view, human dignity, the need to establish euthanasia (under certain conditions) as a struggle for recognition of the right to a dignified death, meaning that undignified death mercilessly prolonging life by artificial means, in life slowly leaking and there is a pure attachment to the physical body. On the other hand there are those who refuse to consider that we are nobody to prevent aging, which must fight for it until the last moment, clinging to the possibility of misdiagnosis, a quick decision, and so on.


The main right of every human being is the life, but when it is severely affected by health conditions appalling and horrible, which lead to the sufferer to be in an intensive care situation, which is not know if you will, where their existence is in the balance, where there may be an irreversible exit, where the future will depend on the existence of extraordinary means, connected to machines such as ventilators, may wonder if you are taking care of life or prolonging the agony that can lead to death. In a moment that we forget the death Euthanasia. So that means good death, sweet and free from suffering.

The word euthanasia comes from the Greek eu = good, thanatos = death. "Good death" a term that has evolved and now refers to the act of ending the life of another person, upon request, in order to minimize their suffering. The first used Francis Bacon in the seventeenth century.

In order to develop properly the subject, it is necessary to conceptualize the outset as follows: Death and Dignity.

Death is the termination of life, the physical earthly stage where we have been acting and becomes, therefore, the last and inevitable act of our existence. It is simply the usual price we pay for having lived. It said that as the famous French anatomist Xavier Bichat "life is not simply the set of functions that resist death." Resistance is inevitably vulnerable, ie it has a limit.

Life, on the other hand, belongs to us, is personal and not transferable. Similarly, the death is also something personal and not transferable. So I really think it can be said with propriety that the individual dies, his own life and lives his own death.

Human beings pass their own lives, encouraged or stimulated by small or large aspirations, which some call the "spurs", ie the incentive to live. But of these the least like any individual are: the misery and pain. The fact expect to see us not placed in circumstances that inspire pity and compassion in the eyes of others, establishing an attitude towards life, which is called dignity.

Dignity is a behavior with gravity and decorum, a "quality that enhances or maintains self-esteem and that of others." If we really consider ourselves not go to aspire to that we never feel sorry for our state of misery and pain. So, we have the right to live with dignity and therefore assumed to also have the right to die with dignity.

The death of Socrates, as described by Plato in Faidón and Alain de Botton on The consolations of philosophy, is the most beautiful example of death with dignity. The philosopher Socrates, a model of temperance and morality, just before the voyage without return thought it prudent to go swimming with it to prevent the women as usual, had, after death, to wash his body. Once clean drank the poison, until the last drop, and when he felt his legs and heavy, decent lay on their backs without complaining or showing any suffering, if he was not the most optimistic person who was there, since all the other people suffered to learn that Socrates would die with it the admiration of those around him.

In contrast, the great poet Porfirio Barba Jacob of misery and pain, physical and moral, said shortly before: "He apologized for this agony so little gallant" having lost their self-esteem and that of others, does not detract from the famous poet but offer no apologies for the dignified death she was living.

Euthanasia has been defined as assistance to die assisted suicide or those who can not do it yourself, it is ethically legitimate. There are two kinds of passive euthanasia means allowing the person to die, stop medical treatment, or not keep alive artificially. And there is active euthanasia which consists in doing something for the person dies, as the administration of a lethal poison or drug.

All human beings have the right to freedom itself implies tolerance, acceptance of the freedom of others even when we do not like what they do. Forced to live in suffering is worse than allowed to die in peace. Legislation prohibiting euthanasia is against the weaker, which wants to die but can not commit suicide, causing the continuation of suffering. The penalty of being punished severely those who make a lot of good relevant as subjective assessment of the person receiving the relief of death. Those who are against the legalization of euthanasia may change their minds if they were in a desperate situation and need someone to help them die. Participate in euthanasia can be an act of piety.

As mentioned at the beginning, life is a right, but not a duty or obligation. Each person has the exclusive right to life because it can not be transferred to any other, but can afford it and extinguish it at will. Life is not a duty.

The practice of a dignified death has been both supported and rejected from the principles of humanity, as many consider it to take the place of God, when it is not because God gave us the ability to dispose of what we do, including our life, and if they say that God always wants the best for us not think I want to see us in a deplorable state of suffering.

While there have been many people who have supported this practice by using different arguments that are considered very valid.

The Stoics (Seneca, Epictetus and Marcus Aurelius) and a dignified death are:

Seneca says that "suicide is preferable to a meaningless life and suffering."

Epictetus preaches death as an affirmation of free will. That is life and has no bearing whatsoever and only causes suffering for the patient and family for him, so that the patient has the right to decide. It has also been endorsed by Plato and he says that "death is better left to non-healthy body." While I believe that this is not true in general, as there are many people who can not be completely healthy but is helpful and happy as this.

But utilitarians say that any morally good when it produces more good than harm and a better balance of good consequences for any other alternative action.

Bentham identifies the "good" in question with pleasure or happiness, and evil with pain or unhappiness. Therefore, the utilitarian support "The greatest good for the greatest number." I definitely do not cause more good to have a person dying, that a dead person who died in a good state, without suffering a lot and in a dignified manner. Utilitarians say that the greatest good for the greatest number, then I think there will be more good and happiness for both the patient and his family if he helps to die in a dignified manner, and there is a greater evil and pain if it helps prolong the suffering. So euthanasia is good, given the pains that removed him to whom is suffering, it decreases the damage to society and ends with a "burden" for the family. Who is retiring from life is not harmful to society, at most stops producing property.

Another defender of a dignified death is Thomas More, who says: "When the incurable diseases are added atrocious suffering, judges and priests, are patient and try to urge him to see who is already deprived of property and vital functions, and since life is pure torture, should not hesitate to accept the death, do not hesitate to free himself or allow others to release that is, death does not depart from the sweetness of life but the execution and perform a pious and holy work, this type of death is considered an honorable thing. "

Although my position is in favor of the practice of a dignified death also recognize that there are several valid reasons against this and that by accepting euthanasia is to give freedom and at the same time to end it. And could increase the number of deletions to weak and feeble-minded people if applied in an unethical manner euthanasia, likewise, increase the pressure on the performer (doctor) of the act by the family. And there may be homicide death mask perhaps worthy to collect an inheritance.

As shown, the sea of ​​questions draws us is still large, however, there is already some awareness in our time for her to be accepted in some way, the values ​​have been changing gradually and is already coming, that someday soon, approving the right to die really fair. Individuals are taking more seriously their role in this historic moment and begin to ask about the existence transcendental aspects of being.

Obviously, there are people for one thing and people in favor of another. I think the die "with dignity" has many drawbacks, for example, should die in pain? Should we help someone who wants to die?, Etc. My opinion is that I do believe that help should not feel pain when you die, do not agree to live connected to a machine to do so, but do not die with excruciating pain. Here comes into play euthanasia, which is death at the request of the patient, and that raises a great debate: Some people say yes, other people put conditions, the Church refuses because it argues that life is not something that we own and therefore can not decide about it, the Church is currently fighting.

We must also take into account that in our society, suicide is frowned upon, then what Euthanasia is suicide? Well, yes and no. Yes, and you yourself decide to die, not because the circumstances are special. But do we really want a dignified death? I think many people who are in favor of it would have to do with the situation and before you have to take into account that each case is different and peculiar, and vice versa, people who favor must know all the cases because I think none are alike.

The four basic ethical principles from a standpoint of bioethics and very accurately mark a dignified death are:

Principle of Non-maleficence: You must avoid causing physical, mental or moral harm. To do this you must avoid making incorrect diagnostic or therapeutic interventions or contraindicated from the standpoint of scientific-technical and clinical, unsafe, or without sufficient evidence and protect their physical integrity and privacy.

Principle of Justice: Must obtain a fair distribution of benefits and burdens, facilitating non-discriminatory access, adequate and sufficient for people to available resources, and efficient use of them.
Principle of Autonomy: People must respect that manage their own lives and make decisions about their health and disease.

Principle of Charity: You must promote the welfare of people, trying to make their own lives and happiness as far as possible.

An important point to note is that these 4 principles are not all placed on the same plane, but in two different but complementary. The first level is occupied by the principles of non-maleficence and justice, and has to do with the structural framework that takes place the clinical setting. Basically have a public dimension. Down the boundaries between what can be decided whether or not the background. So the first thing they have to ensure health organizations and professionals is that attention to citizens as possible to avoid the risk of harm and makes available the most effective technologies and procedures for the protection and promotion of health ( Principle of Non-maleficence).

The second thing we have to ensure is that the investment of public resources in such proceedings and efficient technologies and, once they are made available to the public, access to them is fair (Principle of Justice).

On a different level are the obligations stemming from the content of the clinical relationship. Here the private meeting between professionals and patients will specify what is meant to improve or safeguard the health of people, and establish, from the indicated procedures will be finally and no. The only limit is not exceeded that which is established in the previous level, non-maleficence and justice.

Professional benefícienle bring to the clinical setting technical scientific knowledge and clinical experience in order to help the patient choose from among the available alternatives, setting the appropriate advice (Principle of charity).

The autonomous patient will contribute to the clinical setting of their values, preferences, beliefs and subjective assessment of quality of life (Principle of Autonomy).

Therefore, what we call "informed consent", the key to modern health relationships, not simply the result of a process of deliberation about the ethical obligations arising from the autonomy and beneficence, within a predetermined by no -maleficence and justice. A clinical decision should always start by confronting the framework principles (non-maleficence and justice), and only if the above must be weighed in terms of content (autonomy and beneficence).

But moral judgments about the ethical legitimacy of a given performance is not only the beginning. The complexity of real life is often so enormous that no system of rules or ethical principles can adequately respond to all situations.

Sometimes, paradoxically, we must justify exceptions to the principles because we understand that a blind application of the same, disregarding the real context, may be more harmful than break them. In such cases we chose the lesser evil and justify exceptions.

Any system of principles and standards inevitably carries a list of exceptions. This does not discredit the principles or standards, which remain valid, but relocates to a humanizing perspective, provided the justification for the exception is correct. All this is essential for analyzing the dignified death from the point of view of bioethics.

Contrary to what has long been that the main ethical problem of euthanasia and assisted suicide is not acceptable whether or not a person wants to die and ask another to end his life. Although this may pose problems from the point of view of religious morality, from the standpoint of civil bioethics is perfectly legitimate, something derived from the principle of autonomy. The reference in order to be taken into account only has to meet the conditions demanded autonomous actions: to be free and voluntary, to be informed and be done in terms of capacity. The problem comes after this request has been formulated and is to determine what the obligations of others, particularly health professionals regarding this request. That is, the question is whether this request is configured as a right that creates an obligation on professionals, such as health institutions and in society in general.

So far the majority response was that this request can not be addressed because it breaks another ethical principle, one that establishes the framework of legitimacy in any healthcare: the principle of non-maleficence. Professionals can not do things contrary to good clinical practice, much as they ask the patients. And yet, in our country and the vast majority of countries, causing the death of patients is something considered maleficent, medical malpractice, something contrary to professional ethics and civil ethics. So much so that, as already stated, such behavior usually punished by law, as happens in our country.

But that does not mean that in the future things may not change. We have already noted that many individuals, groups, etc. believe that euthanasia can be compatible with respect for the dignity of human beings. This requires two processes of legitimation different but can be complementary: one is to reconsider the idea that causing the death of patients with conditions that have been exposed to define the term euthanasia is contrary to the principle of non- -maleficence and that, therefore, health professionals can not do it. This reflection requires a strong sense of social maturity on which are the contents that define the role of health professionals. We must accept that, although the order of these professionals is, in general, to protect health and life, sometimes in certain situations this can lead to professionals, paradoxically, to produce death. At heart this is the reflection made by countries such as Holland, Belgium and Luxembourg. This route opens the door to legalization processes of this practice, as has happened in these countries. The other route is the exception. That is, is to accept that as a general rule, is part of non-maleficence principle of the prohibition of causing the death of patients. But at the same time consider that in certain extreme situations, the lesser evil is to break that principle and to justify an exception. This requires careful definition of the specific situations in which such action can be done, and be rigorous in its application to prevent abuse. This route opens the door to legalization processes in which the practice of euthanasia is still considered a crime, but is acceptable in certain cases.


After discussing the controversial issue came to the conclusion that life is a natural phenomenon, not a transcendent mystery and a gift from god as they have done some religions believe. The termination of life can be for any accident, fatal illness, exhaustion, or by the will of the living. If man does not decide the timing and circumstances of his death, they are the random or uncontrollable circumstances which determine it, and not an imaginary divine entity. An ethical life is about being alive, but does not mean wanting to be alive. A living person can argue with interest about life because you want help or permission, for himself or for another person to cease to exist. We never gave ourselves life does not mean we do not have the power to take it away. The man is full of his own life, not just a manager, and not have to give to anyone of your use of it.

Dying with dignity would then die free of pain, with analgesics and tranquilizers needed for anxiety and drug delivery are required against the discomforts that may occur, eliminating where possible the suffering of death in life. Although not only reducing the pain, which is worth a life with some autonomy and freedom. Dying with dignity is to respect the dignity of dying, there are cases where the patient craves death somehow, but because of medical meddling, protected by a moral duty, the patient must endure a degradation so that they did not equals how terrible it might be the way to death, destroying the dignity of the person, so these measures can no longer remain a human being. What to preserve the physician is the whole human being and not just a mere vegetative existence. In our current era, with different interests, different rhythms of life, with much larger horizons of life, with a more evolved, with increased technological advances and recognizing one could conceivably go euthanasia.

I also believe that it should be understood that to euthanasia and murder are essentially different. Euthanasia is not equivalent to the elimination of unnecessary or burdensome elderly, the mentally handicapped and undesirable members of society. Legalizing euthanasia is not to decide who can live and who not. Have the right to help someone to die as they will not mean to kill him against his will. The fear of the danger of abuse, the law evolves so that the doctor can kill the patient against his will, is equivalent to believing that legalizing sex or prostitution would lead to legalized rape. Confusion between euthanasia and murder in some debates seems to consciousness as a distraction caused by the lack of arguments that the ban.

Also not to be confused with a doctor and a murderer. Since a is a professional murderer who kills a person against the will of the victim and the victim wishes euthanasia death. The medical profession has no immutable missions established by a Hippocratic oath, but has knowledge that can be useful for others: most patients want to stay healthy and stay alive, a few want to help them die with dignity . It does not seem wise to fear a doctor because he has helped other people die. Doctors have always had skills that give them power to kill, but that does not mean legalizing euthanasia easier with the murder of his patients.

To conclude this issue is important that in our country like Mexico, could be dignified death that causes less damage than benefit, because the conditions are not conscientious, legislation, and coverage may be necessary to have somehow taken into account in this country but now already legalized in the Netherlands and other countries in developing, this could be an incentive to legalize in the future in our country.


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4.   De Miguel Sánchez C, López Romero A. Eutanasia y Suicidio Asistido: donde estamos y hacia donde vamos (II). Med. paliativa.2007; 14:40-9.

5.   Gracia D. Historia de la Eutanasia. En: Urraca S editor. Eutasia hoy: un debate abierto. Madrid: Noesis; 1996.p. 67-91.

6.   Manual de publicación “APA” al alcance de todos. Ernesto I. Marín A. Ángel G. Rincón G. y Oscar A. Morales.

7.   Torres, P.,M.E. (2000). La comprensión lectora desde la perspectiva andragogica (Versión electrónica). EDUCERE, 4(11), 171-179. Recuperado el 18 de marzo del 2003 en
8.   Antología del Instituto Mexicano de Tanatología A.C.
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