Composition
Physician Assisted Suicide (PAS) has been a controversial subject in the medical field for the past decade. It seems, however, that many people are unaware of the actual meaning of the phrase. PAS is commonly mistaken for euthanasia. Euthanasia is defined as 'a physician administers a lethal drug to a suffering patient'. A second action by physicians that is confused with PAS is called 'terminal sedation.' Terminal sedation is when 'medical care providers administer barbiturates or benzodiazepines to sedate a patient into unconsciousness to control physical suffering.' This slows respiration and can cause the patient to have an earlier death. Physicians might also withhold hydration and nutrition to speed up death (Behuniak and Svenson, 2003).
Suicide notes are the last words of a person, before committing suicide in a ‘selfish interest’ in my eyes. It is assumed by more people that a suicide note consists of solely or mostly someone who is in a negative mood, negative work environment, bad relationship, etc. For someone to analyze the justification of their actions, it may take days, if not years. If one wants to end their own life medically, its morally discouraged. When someone is dying, they don’t want to be dependent on medical equipment, pills, or therapy but rather given the option to withdraw from treatment based on their medical conditions. Being able to control assisted suicide for a patient can help those who are expected to die in a short time on a monitored and regulated standpoint.
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I think in the beginning of every diagnose, everyone wants a miracle; they want a cure for Cancer, Crohn’s, Progeria, Polio, etc., but when you sit down and look at the facts, will the treatments work? How long will I live if I chose to do treatments, or chose not to? What’s the cost? All the questions that might arise, you should be given the option to decide whether it is your time. Not one single person that loves you, wishes you’d be in pain and more suffering. Assisted suicide did not always carry such stigma it does today.
Oregon was among the first states in the United States to make it legal for doctors to prescribe life-ending drugs to terminally ill patients, who are of sound of mind. They must make the request and the patient must swallow the drug without any help because it is simply illegal for a doctor to administer it. Oregon had voter approved Death with Dignity Act (DWDA) in 1994, and therefore has had more than 750 terminally ill patients use the law. Although, Oregon is not the only state who allow patients to seek medical aid in dying, there are five other states and Washington, D.C. that have DWDS, Washington, Colorado, California, Vermont, and Hawaii. Montana currently does not have a statute safeguarding PAS as of a ruling in 2009 that banned the practice.
Although the debate over PAS is not new, it is vital for terminally-ill patients to end their own lives on their own terms. I’m not sure what the difference is in if a death row inmate is to get executed by lethal injection or other methods that is approved by the state. It’s not on the inmate to die but the state and they (the inmate) were put in that position for capital murder or worse. But we can give a lethal injection to murderers in New York but can give one to a baby. Why is it any different for a physician to assist in helping their patient end their life with dignity, if they are perhaps suffering with no other option of treatment?
Following Oregon’s DWDA should be a nationwide as patients from all over move to the state, so they can pass peacefully. It is said that euthanasia of any patient, including Oregon is illegal. Each request is supposed to be made oral, twice, separated by at least 15 days. A written request must be provided, signed and witnessed by two people, one of which cannot be related to the patient. Along with all this paperwork, you must have the confirmed diagnosis, whether the patient can make non-impaired health decisions, and patients must be referred for a mental health evaluation. Physicians must inform the patient of other alternatives such as hospice care. The many options that Oregon Heath Authority (OHA) offers and requires should be enough for most. To have the option and a physician (OHA does not recommend doctors to participate in DWDA) who is willing and consults in helping you, is remarkable. If a patient decides to go this direction, they also have options in donating their organs to others, science and so much more.
According to Randall (2009), “estimated 117 UK citizens to have made final journeys to the Dignitas clinic in Zurich, where it is not a crime to assist someone to die. Up to 1,000 people of all nationalities are reported to have died at the clinic, a succession of Zurich apartments used for the suicides, since Dignitas was founded in 1998. Dignity in Dying, the campaign group most identified with demands for a change in the law, wants the threat of prosecution removed only from those who help the terminally ill and mentally sound to die. Although the issue arouses passionate argument in other countries, Britain has been the source of some of the highest profile cases, including those of people who were not terminally ill.”
However, I partially agree with this statement. If you are choosing to die because of a ‘broken heart’ you are wrong. Dignity in dying should only be of those who are terminally ill and have no other way of means to care for themselves. Suicide is a selfish way to take your life. Dignity in dying should be nothing to be assumed of, but if you are in still living health, there should be no law in place that allows you to sign a waiver to take your life. I understand the concept of it, but it’s not the correct way to die, along with self-inflicting harm, i.e., suicide, vehicle accident, overdose, gunshot, etc.
History
The Hippocratic Oath goes all the way back to the Ancient Greeks and Romans. The most historic events to happen in history are based fully on noteworthy philosophers. Although these are just some events throughout history, they are important as some are firsts and others are following other states regarding PAS. Euthanasia (2013), explains the following events:
- “1973 – American Hospital Association (AHA) Adopts ‘Patient’s Bill of Rights’, recognizes the right of patients to refuse treatment.
- 1976 – Supreme Court rules in Quinlan case that respirator can be removed from a coma patient.
- 1976 – California is the first to sign the Natural Death Act into law and grant terminally ill patients the right to authorize withdrawal of life-sustaining medical treatment.
- 1977 – Eight states: California, New Mexico, Arkansas, Nevada, Idaho, Oregon, North Carolina, and Texas signed right-to-die bills into law.
- 1988 – The Unitarian Universalist Association of Congregations passes that nation resolution ‘The Right to Die with Dignity’, which is the first religious body to affirm this aid.
- 1992 – California’s Death with Dignity Act is defeated. The vote 54-46.
- 1997 - The Supreme Court rules in Washington v. Glucksberg and Vacco v. Quill that there is not a constitutional right to die.
- 2001 – The Netherlands officially legalizes euthanasia.
- 2008 – Luxembourg parliament adopts a law legalizing PAS and euthanasia.
- 2018 – Hawaii legalizes PAS along with eight other U.S. jurisdictions.”
Pro v. Con
As it is known, assisted suicide involves a lethal dosage of medication, or life support will come to an end, and letting a person pass on their own will. There are those that are opposed to this method as it takes on a religious, moral, and ethical ground of arguments but some only look at the negative impact PAS will take on their family and not the positive impact to help end the suffering of a family member. Let’s discuss some of the main arguments of those for and against PAS and euthanasia.
Pros: an end of suffering, death with dignity, and eliminating fear of financial burden. End of suffering focuses on the aspect of a timely and dignified death, rather than having a family member suffer in excoriating pain in their final days. DWDA offers those who are dying the opportunity to choose when and how they choose to die and it allows them to take control of their life in their final hours when they are in the last stages of their life. Now, elimination of financial burden is one thing I believe everyone fears, even when they are not terminally ill. Financial burden is to provide those with adequate pain management and hospice care in which it could improve the quality of life and eliminate the demand of PAS or euthanasia.
Cons: corruption, religious concerns, and a slippery slope. Some believe that PAS is not about the right to die but rather the right to kill. It’s said that it is to prevent suicide and to protect people against anyone who is truly suffering. Catholics express their beliefs clearly, and believe life is a gift and taking away the natural power that belongs to God should only belong to him and no one else. The slippery slope of PAS and euthanasia can go in either direction of being positive or negative, but some believe doctors many not need to ask for consent and go ahead and go about what is best for their patient without their knowledge.
The pros and cons of PAS will always be a topic people will be for or against.
Ethical Theories
There are two ethical approaches in Physician-Assisted Suicide, Utilitarian and Kantian. Ethical theories justify principles that can be employed as guides for making moral decisions; defines duties and obligations; explanations and justifications of actions. Some moral questions that some may ask are, is it right for a woman to have an abortion for any reason? Do people have a right to die? Does everyone have a right to medical care?
When someone asks to die, people find it vicious, but according to the utilitarian approach, this dilemma would allow mercy killing to be OK. However, utilitarianism is a theory of moral philosophy that is based on the principle that an action is morally right if it produces a greater quantity of good or happiness than any other action. It required us to look at the consequences to determine the morality of an action and claim that the morality of the action depends on the amount of ‘goodness’ that the action produces. Utilitarian can be based on what is best in a specific case (Act Utilitarianism) or on what is generally best in most contexts (Rule Utilitarianism). Utilitarianism argues that the only way to determine which behaviors are right or wrong is to assess their consequences.
Kant (German philosopher), unlike Mill (English philosopher), believe that certain types of actions prohibit the act of killing unless it is acceptable under certain conditions that are based under one universal rule, “all times, all places, and all people”. However, according to Kantian theory, if are a good person, you must be good. The problem with Kant’s theory is that specific circumstances must be involved when taking a life, and which it ignores the circumstances of a terminally ill person dying. They argue that it is acceptable to kill a killer in forms of retributive for the harm they have inflicted. It’s either right or wrong, nonetheless of the situations.
Conclusion
It is clear that Physician-Assisted Suicide is one of the most controversial ethical and legal issues. The pros and cons of this dilemma may be justified but what is the best way to reduce the intense suffering and pain that terminally ill patients go through? Though it is understandable for patients who are terminally ill to choose death over life, there are stipulations. There’s no doubt taking a family members life is hard, but we should all respect their wishes in regard to how they wish to live there last breaths on this earth. I believe it is important to follow Mill’s theory on PAS and it should be recognized all throughout the United States, like it is available in Belgium, Canada, Colombia, Luxembourg, the Netherlands, and Switzerland. Of course with stipulations and the right rules and regulations, I believe it could eliminate a lot of unrelated deaths.
References
- Behuniak, S. M., and Svenson, AG. (2003). Physician-Assisted Suicide: The Anatomy of a Constitutional Law Issue. New York: Rowman & Littlefiled Publishers, Inc. Retrieved from https://core.ac.uk/download/pdf/5014107.pdf
- Randal, C. (July 18, 2009). At the end of life, what is dignity? Retrieved from
- https://www.thenational.ae/world/europe/at-the-end-of-life-what-is-dignity-1.527519
- Euthanasia. (July 23, 2013). Historical Timeline: history of euthanasia and physician-assisted suicide. Retrieved from https://euthanasia.procon.org/view.timeline.php?timelineID=000022
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