Physician Assisted Suicide Research Paper

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Human euthanasia is the medical practice of assisting an individual with suicide through medication. Per the Merriam-Webster dictionary definition, euthanasia is, “the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy” (Webster). This practice is commonly used with sickly animals whose quality of life has significantly deteriorated, so wouldn’t it be equally righteous to offer a human the same option? Albeit, the procedure is understandably controversial, one can argue that this practice is nothing more than humane.

As our animals grow older or become ill, their quality of life changes for the worse. Many times, our animals begin to go through immense pain, and even pain medications offer little to no comfort for the furry members of our family. Taking this into account some countries have legalized Voluntary Euthanasia (VE) and Physician-Assisted Suicide (PAS); according to Harrison and Silva’s article on euthanasia, “A dying patient, knowing that he has only a few months to live, may be tempted to request VE or PAS to spare his family not only the financial difficulties that come with palliative treatment but also the pain and suffering of witnessing his decay”(Harrison and Silva). As stated by Harrison and Silva these people with terminal illnesses will choose euthanasia to not just end their immense pain but also the emotional and financial burden on their family’s shoulders. Giving humans the option of lessening their anguish and pain as well as their family’s burden should be a logical and humane alternative, but many a time think the decision is made by the patient solely on emotions. This, however, is not the case, euthanasia is assisted suicide and the doctor in charge considers the patient's current and future quality of life.

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In most cases of euthanasia, euthanasia itself is the last resort and is common with terminally ill patients. One moral argument towards the support of euthanasia is as DePergola states, ”For assisted suicide proponents, there is little, if any, discernable difference between providing sedation enough to keep terminally ill patients unconscious while they die and simply assisting them to terminate their lives while they still possess the capacity to do so”. While many believe that euthanasia is a procedure handled whenever the patient just wants to die, they are wrong, because euthanasia is something both patient and doctor must agree on since certain conditions must be met in order to be qualified for PAD. The decision to be medically killed is a decision made throughout the patient’s terminal illness and is something a trained professional can see as a viable option since dying would be the better alternative before not being able to choose at all. This is another reason many people choose to be euthanized since many who do have illnesses that will probably progress even further eventually leaving them in a weakened or vegetative state; having this happen to patients their right to choose is forcibly removed, while on the other hand if they choose to be fatally injected or dosed they get to make their last decision or even the most important one on their own terms. Giving a person this final decision supported medically is the most humane thing to do rather than sedating them till their last day and allowing them to see their own decay.

Euthanasia not only removes the strenuous physical burden on a person it could potentially erase the financial difficulties that come along terminal illnesses. When a patient is dealing with a life-threatening condition the economic burden placed on their family exponentially increases, since medical treatment meant to alleviate the pain and provide some sort of comfort comes at a hefty cost. As shown in a study made by the Cancer Care Association “total expenditures of patients who died of advanced cancer ranged from less than $5,000 to more than $50,000 per patient, with an average cost of $21,718 ”(Scitoysky), considering the patient's economic background this amount of money will leave a huge burden on his/hers family which in turn increases stress on a patient leaving their last days more unpleasant than they should be. This economic burden is broadened as the patient’s family's future economic standing could be jeopardized by paying to prolong the inevitable. Further proven by an analysis made by Corby:

“The economic burdens go beyond the immediate costs of care (which will vary according to one’s access to health insurance, pensions, government support, etc.). These include the (irredeemable) “decimation” of the life savings of those afflicted and the circumscription of the future prospects of children of dependent parents” (Corby).

As explained by Corby allowing the continuation of a terminally ill patient’s life will only increase the amount of stress on their family by chipping away at life savings accumulated through hard work; which in turn could have helped the patient's children. These are the effects of outlawing euthanasia and erasing it as an option in the medical health world.

Compared to treatments given to cancer patients in a far stage the cost of physician-assisted death is quite affordable and leaves almost no financial burden on a patient’s family. The cost of euthanasia varies depending on what liquid or solution is given to the patient but the DDNC (Death with Dignity National Center) provides the following information on the prices:

“The phenobarbital/chloral hydrate/morphine sulfate mix produces a lethal dose that is similar in effect to Seconal. The cost of this alternate mix is approximately $450 to $500. A second alternative, consisting of morphine sulfate, Propranolol (Inderal), Diazepam (Valium), Digoxin, and a buffer suspension costs about $600. A compounding pharmacy will need to prepare each mixture” (ProCon)

with the information provided it is obvious to say that when it comes to alleviating a person’s pain euthanasia provides a cheaper and more humane alternative to that of dying imbedded with a constant pain. The economic point of view on euthanasia is further supported by Oregon which provided statistics on the financial burden if any caused by these lethal prescriptions, “From 1998 to 2016, only 3.4 percent of patients who died after receiving a lethal prescription under the Death with Dignity Act in Oregon self-reported “financial implications of treatment” (Freeman). Based on this information it is clear that the practice of legal euthanasia is beneficial to the patient's health and financial standing as almost anyone who qualifies for these lethal prescriptions can have the option to take them without the financial backlash; which would be normal in treatments that only provide pain relief rather than an actual solution. As stated by researcher Scherrens the more people are informed of euthanasia and its purpose it increases the percentage of euthanasia being the option in which people decide that this procedure is the last decision they will make.

After taking both the economic and physical deterioration of a patient the question asked is, should euthanasia be considered a morally accepted medical solution? Canadian euthanasia law states euthanasia is a beneficial and medically sound option that should be taken by the patient but under the circumstances of:

“grievous and irremediable medical condition that causes them enduring and intolerable suffering,” it conforms to the language and an assumption that most people implicitly, and perhaps unconsciously, make about the body. The proper functioning of the body’s members constitutes goods. A grievous and irremediable lack of these goods may involve enduring and intolerable suffering, which is bad” (Gamble)

Without putting the patient’s health into account most people who oppose euthanasia believe they have the moral obligation to not allow a person to kill themselves. This opinion and argument should be invalidated because euthanasia is not in the category of emotional-based suicide but a medical decision after careful thinking while taking everything into consideration as well. Taking this into account euthanasia is a beneficial option for the patient's health as his health at this point should be the ability to choose and function properly and since their deterioration is inevitable euthanasia should be a medically beneficial option that a patient should make together with their family and medical professionals

An example of euthanasia in practice is in the Netherlands where it has been legalized. The legal process of euthanasia in the Netherlands provides evidence of the ability of euthanasia to be an organized and well-documented procedure with certain things taken into accord before, during, and after the procedure. An example of the Netherlands keeping data on the euthanasia performed is as follows “The physician who performs euthanasia has to report every case to a Regional Review Committee on Euthanasia (RTE), of which there are five in the Netherlands” (de Jong, Antina and Gert Van Dijk). Keeping this information and requiring physicians allows the government to monitor the deaths occurring not due to natural causes; by documenting this procedure it’s also possible to see which of the procedures have been authorized. Another example of euthanasia being practiced in the real world to prove its effectiveness is in the United States but only in certain states. Oregon is one of the states that has legalized euthanasia in the United States. Though the process into which an individual can self-administer a dosage is highly safeguarded and the Death with Dignity Act states “A variety of safeguards limit the conditions under which the prescription can be written. Two physicians, one of whom will write the prescription, must confirm that the patient has a terminal illness (likely to cause death within six months), is competent to make the decision, and is doing so voluntarily” (Ganzini). When euthanasia is in practice in the real world many steps are set in the process to ensure that this decision is the healthiest choice for the patient at that moment. Having these steps allows euthanasia to be performed with the utmost respect for the patient and their family.

There are not many countries that accept euthanasia for it is illegal and categorized as murder rather than a form of suicide. However, the practitioner in charge to be highly informed about the patient’s condition, as well as the family must be made aware of the patient’s condition. An argument made from the prior statement that discourages people from accepting euthanasia is as stated:

“Typically, patients are not medical doctors, so they rely on their physicians to obtain information regarding their condition. Patients must also rely on their families for information about the extent to which they are a burden to them because only the family knows whether a patient is indeed a burden or rather if the patient's survival is only for a few more months, more than outweighs whatever burden might exist. Patients can certainly attempt to obtain this information by communicating with their families, but it is not obvious that such interaction will be informative. It is easy to conceive of a scenario in which a suffering family might hide this from the patient precisely to prevent him from requesting VE or PAS.” (Harrison and Silva)

Even with this information this argument objecting to euthanasia is only valid when the family is not truthful to the patient, but this also means that in the information exchange throughout the process of euthanasia should be improved. Another argument that has been made against euthanasia is the promotion of self-harm or suicide, an example of this is:

“Brittany Maynard had been diagnosed with terminal brain cancer. Realizing that the coming months would likely bring bodily deterioration and physical disability, she decided to seek physician-assisted suicide. Since in 2014, it was not legal in California, Maynard moved to Oregon— which had legalized assisted suicide in 1997—where she received a prescription for life-ending drugs and died in November 2014.7” (Glenn)

People believe that legalizing euthanasia would lead to the promotion of suicide as shown by Glenn; in which Brittany Maynard tried to take her own life in California but was stopped and she moved to Oregon where euthanasia is legal. This example leads people to think that her physician-assisted suicide was done on impulse which is incorrect because since the option for euthanasia was not legally available for her, she had to go somewhere they would allow it and make her final decision in life. In general, the attitude towards euthanasia is as researcher Stolz states “Furthermore, previous studies have consistently identified the level of education as a positive and religiosity as a negative empirical correlate of acceptance of euthanasia in adults”(Stolz), this means that as we advance more and progress euthanasia will become more accepted giving people the chance to have this option in the future further expanding their personal liberties.

In conclusion, euthanasia is a health right that should be recognized and legalized internationally. Legalizing such an option for patients around the world allows them to make their own decision in whether they want to continue living with a terminal illness or to die a dignified death. Through this process, many families could have the economic and emotional burden laid upon them, and the patient can die peacefully having in mind that their family would be spared of seeing them slowly decaying in pain. Euthanasia in contrast to what some people think is a barbaric procedure, is the most humane thing we can do for our loved ones in their last moments.

Works Cited

    1. Corby, Paschal M. “The Fear of Being a Burden on Others: A Response to the Rhetoric of Euthanasia and Assisted Suicide.” National Catholic Bioethics Quarterly, vol. 19, no. 3, Sept. 2019, pp. 369–376. EBSCOhost, doi:10.5840/ncbq201919327.
    2. de Jong, Antina, and Gert van Dijk. “Euthanasia in the Netherlands: Balancing Autonomy and Compassion.” World Medical Journal, vol. 63, no. 3, Oct. 2017, pp. 10–15. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=126203764&site=ehost-live.
    3. DePergola II, Peter A. “Euthanasia, Assisted Suicide, and Palliative Sedation: A Brief Clarification and Reinforcement of the Moral Logic.” Online Journal of Health Ethics, vol. 14, no. 2, May 2018, pp. 1–9. EBSCOhost, doi:10.18785/ojhe.1402.04.
    4. “Euthanasia.” Merriam-Webster, Merriam-Webster, www.merriam-webster.com/dictionary/euthanasia?src=search-dict-box.
    5. Freeman, Lindsey M., et al. “Poverty: Not a Justification for Banning Physician‐Assisted Death.” Hastings Center Report, vol. 48, no. 6, Nov. 2018, pp. 38–46. EBSCOhost, doi:10.1002/hast.937.
    6. GAMBLE, NATHAN. “Can Euthanasia Be Classified as a Medically Beneficial Treatment?” Ethics & Medicine: An International Journal of Bioethics, vol. 34, no. 2, Summer 2018, pp. 103–111. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=130172407&site=ehost-live.
    7. GANZINI, LINDA. “Legalised Physician-Assisted Death in Oregon.” Queensland University of Technology Law Review, vol. 16, no. 1, Jan. 2016, pp. 76–83. EBSCOhost, doi:10.5204/qutlr.v16i1.623.
    8. Glenn Foster, Catherine. “The Fatal Flaws of Assisted Suicide.” Human Life Review, vol. 44, no. 4, Fall 2018, pp. 51–61. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=133918477&site=ehost-live.
    9. Harrison, Rodrigo, and Francisco Silva. “A Game Theoretic Analysis of Voluntary Euthanasia and Physician-assisted Suicide.” Economic Inquiry, vol. 58, no. 2, Apr. 2020, pp. 745-763. EBSCOhost, doi:10. 1111/ecin.12859.
    10. Inbadas, Hamilton, et al. “Declarations on Euthanasia and Assisted Dying.” Death Studies, vol. 41, no. 9, Oct. 2017, pp. 574–584. EBSCOhost, doi:10.1080/07481187.2017.1317300.
    11. Kessler, Chiara. “A Completed Life.” Survival (00396338), vol. 60, no. 3, June 2018, pp. 231–234. EBSCOhost, doi:10.1080/00396338.2018.1470782.
    12. McGowan, Carter Anne. “Conscience Rights and ‘Effective Referral’ in Ontario.” National Catholic Bioethics Quarterly, vol. 18, no. 2, Summer 2018, pp. 255–268. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=131356922&site=ehost-live.
    13. ProCon. “How Much Do Physician-Assisted Suicide Drugs Cost? - Euthanasia - ProCon.org.” Euthanasia, 12 June 2018, euthanasia.procon.org/questions/how-much-do-physician-assisted-suicide-drugs-cost/.
    14. Scherrens, Anne-Lore, et al. “What Influences Intentions to Request Physician-Assisted Euthanasia or Continuous Deep Sedation?” Death Studies, vol. 42, no. 8, Sept. 2018, pp. 491–497. EBSCOhost, doi:10.1080/07481187.2017.1386734.
    15. Scitovsky, Anne A. “‘The High Cost of Dying’: What Do the Data Show? 1984.” The Milbank Quarterly, Blackwell Publishing, Inc., 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC2690284/.
    16. SILVERMAN, ALEXI. “Physician-Assisted Suicide: Removing Residency Requirements in the U.S. to Comport with an International Right to Health.” San Diego International Law Journal, vol. 19, no. 1, Oct. 2017, pp. 193–224. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=128263233&site=ehost-live.
    17. Smith, Patrick T. “Distinguishing Terminal Sedation from Euthanasia.” National Catholic Bioethics Quarterly, vol. 15, no. 2, Summer 2015, pp. 287–301. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=108306933&site=ehost-live.
    18. Stolz, Erwin, et al. “Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.” PLoS ONE, vol. 10, no. 4, Apr. 2015, pp. 1–15. EBSCOhost, doi:10.1371/journal.pone.0124320.
    19. Wand, Anne Pamela Frances, et al. “Rational Suicide, Euthanasia, and the Very Old: Two Case Reports.” Case Reports in Psychiatry, Oct. 2016, pp. 1–5. EBSCOhost, doi:10.1155/2016/4242064.
    20. “What Is Palliative Care?: Definition of Palliative Care.” Get Palliative Care, getpalliativecare.org/whatis/.
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