A patient is in incessant pain and has an incurable illness. The patient can only be kept alive on machines or by enduring this pain. A patient who is in these circumstances does not have the choice in most instances to choose death over this life. A patient who wishes to make a conscious decision to end their own life does not have many choices under the current laws. Physician assisted suicide is illegal in most states.
Identify the problem
At the time of this writing, three states have made physician assisted suicide legal, California, Montana and Washington (Lachman, 2010). Physician assisted suicide is when a physician prescribes a medicine that when used will end a patient’s life. Physician assisted suicide is considered to be the same as murder in the thoughts of some people. Physician assisted suicide is seen as a service of mercy for terminally ill patients for other people. A patient that chooses death in this manner is exercising the right to govern his own life. The question will involve the considerations of the patient’s right to self rule. The decision to make this legal will rely on the question of self-rule and the answer will lead to
Some terms that will appear in the discussion are defined here. Physician assisted suicide (PAS) it the process of a doctor giving the patient a prescription for a medication that will end his life. The patient chooses when to administer the medicine.
Active euthanasia is a conscious decision to end a life.
Passive euthanasia is the process of removing medical machines and allowing the disease or illness to take the patient in death.
Palliative care is the procedure of keeping a patient comfortable through pain medication and other medical services when facing death.
Identify Possible Solutions to the Problem
If physician assisted suicide is made legal physicians could prescribe the medication necessary to end a patient’s life without worry of legal consequences. Patients who are terminally ill would have recourse to a way to end their suffering.
If physician assisted suicide continues to be illegal patients would rely on passive euthanasia to bring about their death or seek to go against the law in order to bring their death. Physician assisted suicide would be considered the same as murder. This would be considered the same as taking a human life in any other capacity.
Examine Assumptions and Points of View
Janine Fiesta says, “A growing number of Americans have begun to call for the legalization of euthanasia and assisted suicide” (Fiesta, 1997). Fiesta is an author, speaker and Health-Care Director. Fiesta feels that more Americans are intimidated by medical technology and being able to choose the time and place of their death gives them some have power over this technology. The natural fear of death and pain may also have a bearing on the call to make physician assisted suicide legal (Fiesta, 1997). As Americans face the thought of being kept alive by machines the thought of physician assisted suicide grows in popularity.
Some people have the opinion that if physician assisted suicide is made legal it may be abused. That poor or uninsured people and the elderly would be targeted along with other groups. Many people who are religious are against assisted suicide stating that God has dominion over death. A survey conducted between 1977 and 1996 showed that more people are agreeing with assisted suicide. The numbers of people who favor the right to die have grown from 36% to75% in the intervening years (Reiner, 2007). This confirms the opinion that the American people are requesting the right to a dignified death over a life ending in pain and suffering.
Many physicians oppose physician assisted suicide they believe that medical technology has been developed enough to make palliative care a reasonable end-of-life deterrent to assisted suicide. These doctors believe that controlling the pain at the end-of-life is sufficient and believe that with excellent care people ask for assisted suicide less often. The legal options for ending life is to stop eating and drinking and allow the disease to take the patients life in the normal course of events.
A concern that physician assisted suicide would spill over the mentally incompetent is expressed by Janine Fiesta a nurse and author of several books on the subject of dying and death. She stresses that the words competent and terminally ill could be construed to mean different things by different individuals. Safe guards against the mentally incompetent would have to be seriously discussed to ensure the safety of these people (Fiesta, 1997).
The States that have made physician assisted suicide legal have reported that there are severe regulatory practices in place to keep this from happening and report that abuse is not a problem. The States also report that is has improved the end of life options and care. End of life options are palliative care and having physicians discuss and inform the patient of what palliative care and the process that happens during the end of life time. Through palliative care the decision to stop eating and drinking in order to allow death to make its normal progress would take several weeks before death would occur. Weeks that the patient would continue to suffer in pain and the uncomfortable feeling that not eating and drinking would cause. The regulations in place are rigorous. The patient has to have two written requests, with two witnesses. Two physicians must confirm the diagnoses and make the patient aware of all the options available for palliative care. The pharmacist must also be made aware of what the prescription will be used for (Darr, 2007). These precautions are in place to protect the physician, the patient and the pharmacist.
The arguments to make physician assisted suicide legal are that it is a mercy to the patient, that it would shorten the suffering the patient must go through. The cost of keeping the patient on machines for the remainder of their life this would include the medical cost to insurance and the patient’s family. The patient’s right to do with their life as they desire at the end of their life. Another consideration is that making physician assisted suicide legal would allow the government to use regulations and laws for control. By making physician assisted suicide legal it would put an end to secretive assisted suicide. An example of secret assisted suicide that is well known is the story of Dr. Jack Kevorkian who by his own admission has help in 130 assisted suicides (Darr, 2007).
Oregon is one of the States that has made assisted suicide legal and the reports on patients who utilize the law suggest that it is not abused. Most patients were under the care of hospice, had insurance and many were dying of cancer. The reasons offered for the request from patients for assisted suicide was not for the relief of pain but the worry that as the disease progressed the patient would not be able to make decisions for themselves and this would leave the family with the responsibility of making the decision. Making this decision for someone you love is a hard choice and the courts are full of cases in which one side wants to allow the patient to die and the other side wishes to keep the patient alive through machines and other medical procedures. Many people desire to have the right to choose but also the right to prevent their families from having to make this decision and avoid the guilt and second guessing that may come with the decision.
The arguments to keep physician assisted suicide illegal are that a patient who is depressed or living a life without full use of their bodies would choose this way to end their life. Physicians are medical doctors not psychologist and would not be able to make the determination if the decision was a result of extreme depression for the patient. This could result in a case where a patient should have been treated for depression instead of allowing assisted suicide. Physician assisted suicide is thought to bring about distrust in doctor-patient relationships. Another proclamation of those who wish to keep physician assisted suicide illegal is the fear that the old and infirm would see it as their duty to choose assisted suicide in order to relieve others who care for them from the responsibility of that care. One last objection is the patient who could not verbalize their wishes would be put to death without the ability to say what their wishes would be. Americans are living longer lives and when they become incurably ill or in constant pain some are seeking a way to end this life
Palliative care is an option instead of assisted suicide. Some medical professionals are of the opinion that with extensive knowledge of palliative care will convince patients that palliative care would be the better choice. The patient would not seek assisted suicide if they knew that the pain could be controlled and a more natural death would take place.
The American College of Physicians does not support assisted suicide, their claim is that it is unethical and is afraid that it will destabilize other EOL care (Meyer, 2009). The U.S. Attorney John Ashcroft declares that giving a patient the medication to end their life is not a legitimate medical practice in 2001 (Darr, 2007). With the information available it appears that the answer to the question of physician assisted suicide will be a long debate. Each of these concerns is valid and deserves to be examined.
There are good reasons to examine physician assisted suicide. As Americans we have had many freedoms, this is another freedom that the people are seeking from the government. There are several nurses and doctor organizations that believe that palliative care is enough and assisted suicide is unnecessary. That comfort and pain control should be enough. Religious organizations are divided on the choice of assisted suicide.
Physician assisted suicide is judged as a misuse of medical technology by some, by others a mercy for the terminally ill patient. Physician assisted suicide is not fully understood by the general public. Before examining this topic more closely and during research I came in contact with many who did not understand that physician assisted suicide was available to only terminally ill patients. The explanation that physician assisted suicide is not a way out of a life that has become different due to age allowed people in the conversation to think differently.
The concern that assisted suicide would be abused if made legal is a coin with two sides. If it is not made legal the practice will continue in secrecy. Having laws that regulate PSA would be better than secrecy. If it is made legal the laws will keep abuse from happening. The government does not have the right to take away the self-rule of our lives and death. If made legal the government would be the overseer. Death would not be sought for psychiatric patients or the old and infirm.
Investigating physician assisted suicide I would use the teleological theory which is using the consequences of an action to argue my position (Waller, (2008). The consequences of the action of physician assisted suicide for terminally ill patients are that the inevitability of death would be hastened.
This would allow the patient to choose to die with their dignity still intact. It would prevent the patient from suffering through constant pain. This would also have an impact on the patient’s family; the trauma associated with a long illness for the family would be eliminated. The family would not be burdened with the decision of keeping the patient alive in unnatural circumstances hoping that a miracle would take place. The cost of maintaining medical treatment would also be a factor. The cost could easily deplete any savings the patient has and then it would be a question of who would pay to keep the treatment going. Medical costs can skyrocket in a small amount of time when continual care is required.
Conclusion and Consequences
The consequences of physician assisted suicide have different meaning for different people. Some see this as a crime and others as a mercy. Those who have reasons to believe that physician assisted suicide should never be legal have sought out the ways that it could be abused or misleading. Some believe that is a pronouncement only God should make. There are ways that physician assisted suicide could be used to benefit people as well as ways that it can be abused.
If a patient who is terminally ill, in constant pain is offered the choice of physician assisted suicide. The choice that would eliminate the expensive treatment that would keep him alive attached to machines. Eliminate the suffering of not only the patient but the suffering of the family that is involved. The choice would discontinue the life of the patient in a way that would not involve the agony of waiting for the disease to take the patient’s life.
If physician assisted suicide were made legal in all of the United States it would alleviate the pain and suffering of the terminally ill. A mercy that would allow a medical procedure that would legally end their life. There would be no criminal proceedings for physicians that chose to help these patients. People who are terminally ill would not have to ask in secret for a medication that would end their life. People would not have to move to one of the three states where physician assisted suicide is legal to be able to use this method of death.
Hospitals and doctors would have to come to terms with this law and would have to deal with the new ethical dilemmas this would bring to their hospitals and offices. A decision on who would be allowed to give this treatment and what requirements would be for patients who make this decision.
In my decision that physician assisted suicide should be made legal I used the concepts of critical thinking to absorb the facts and analyze the thoughts of experts in this field. When I first began this research I would have said that physician assisted suicide was morally unethical. After examining the opinions and facts I have changed my mind. With laws and regulations put in place to control the terms and conditions of physician assisted suicide I think that it is a moral solution for terminally ill patients.
If the laws for the United States are changed to make physician assisted suicide legal it should be considered ethical for those who choose to take their life in this way. For those who do not feel that this is an ethical choice for them there should not be any persuasion to change their minds. I feel that this is a right of choice not a mandatory right.