Physician Assisted Suicide Analysis

Brooke Cox
Ms. Miller
AP Literature, Per 2
16 March 2016
Legalization of Physician Assisted Suicide As humans, we like to have options. We like to be in control. Physician-assisted suicide is meant to be an end-of-life option. It allows people with terminal illness to take control in how they die. In the United States physician assisted suicide is legal in only a small number of states (Oregon, Vermont, California and Washington). Oregon was the first state to pass the Death with Dignity Act in 1997, and since then other states have adopted the Act. Physician assisted suicide can easily be confused with euthanasia (which currently is illegal in all United States). The two are very different. Physician assisted suicide is “when a physician
provides either equipment or medication or informs the patient of the most efficacious use of already available means, for the purpose to end his or her own life”(Lachman, “Compassionate Liberation or Murder” 121) Euthanasia is when, under the request of the patient, the physician physically administers the medication or treatment which is meant to end the life of the patient (“Compassionate Liberation or Murder” 121). In this paper I will argue that despite the points against the legalization of physician assisted suicide, it should be a legal option for people suffering from a terminal illness in all of the United States.
LEGAL GUIDELINES Physician assisted suicide’s legal status is to be determined on the state level. In June of 1997, the United States supreme court decide there is no constitutional right to die”(Lachman, Compassionate Liberation or Murder” 121 ). For the current states where physician assisted suicide is legal, there are very strict guidelines and laws what must be followed for a patient is utilize the Death with Dignity Act or any form of legal physician assisted suicide. A patient requesting assistance in suicide must be a capable adult that is diagnosed with a terminal disease with less than six months to live. The current requirement in requesting physician assisted suicide are as followed: The patient must make two oral requests to his or her physician, separated by at least 15 days. The patient must provide a written request to his or her physician, signed in the presence of two witnesses. The prescribing physician and a consulting physician must confirm the diagnosis and prognosis. The prescribing physician and a consulting physician must determine whether the patient is capable. If either physician believes the patient’s judgment is impaired by a psychiatric or psychological disorder, the patient must be referred for a psychological examination. The prescribing physician must inform the patient of feasible alternatives to assisted suicide, including comfort care, hospice care,and pain control. The prescribing physician must request, but may not require, that patients notify their next-of-kin of the prescription request (qtd. in Durr 34).
The laws and requirements regarding physician assisted suicide are precise and there are no exceptions. UNETHICAL A main argument against physician assisted suicide is that it is unethical for a physician to take part in such a thing.
As a society we associate doctors and health care professionals with the idea of healing; and having physicians be able to assist in the suicide of a patient might alter people’s opinion on doctors as a whole. In Jon Fullers article, “Physician-Assisted Suicide: An unnecessary Crisis”, he states, “granting [this] power to physicians would sully subconscious image[s] of the healer” (Fuller 10). Fuller believes that allowing physicians to take part in ending someones life, would change how health care professions are viewed. Fuller also writes that participating in the,“ taking of life crosses a threshold and threatens the trust in beneficence that is the root of the physician-patient relationship”(12). It takes a strong relationship between doctor and patient to come to the consensus that there are no other options for that patient. There has to be a great deal of trust for a patient to believe the physicians profession opinion on their course of treatment is accurate. For the patient having the their doctor help them end their life is an act of beneficence. The laws for physician assisted suicide are clear on the fact that the patient must be terminal with less than six months to live. Many people choose physician assisted suicide because they don’t want those last six months to be full of suffering and the worse months of their life. To the patients
involved in physician assisted suicide it is ethic for the doctors to help them end their life on their terms. PROPER PALLIATIVE CARE Another valid argument against physician assisted suicide is that with the proper palliative care, patients wouldn’t feel the need to end their life. Palliative care is, “patient- and family-centered care in which an interdisciplinary team focuses on easing patient suffering; hospice is palliative care delivered near the end of life” (Schencker 22). Not all patients who chose physician assisted suicide chose it because of their pain. Many patients should aid in dying because of their “decreasing ability to participate in activities that make life enjoyable, losing autonomy, and losing dignity” (Lachman, “Compassionate Liberation or Murder” 123). Since physician assisted suicide was legalized in the few states it has there have been significant improvement in the palliative care industry (121). There has been notable improvements in the training of physicians in the field, better communication between patient and physician, and increase care in pain management (121). POTENTIAL ABUSE
Many people are concerned that allowing physician assisted suicide to be legal would cause the potential for abuse. People fear that certain minority groups might participate in physician assisted suicide for reason other that its intent. There is the fear that patients who are poor, uneducated, and mentally ill may use physical assisted suicide for the wrong reasons, whether it be financial, pressure from their family or other health care professions. “Data so far suggest coercion is limited, if it happens at all” (Sanburn 51). Research also has shown that people with a higher level of education are more likely to use physician assisted suicide. Specifically in Oregon, residents with a baccalaureate degree or higher are about eight times more likely to use physician assisted suicide than those without a high school diploma (Durr 35). In fact patients who are, “taking advantage of assisted suicide tend to be white, well insured, well educated, and well cared for”(qtd. Goodale 16). With the strict regulation to physician assisted suicide it seem that abuse would be rare.
AGAINST THE DOCTOR OATH Another argument against physician assisted suicide is that it violates the oath that all doctors must take, the Hippocratic Oath.
The Hippocratic oath, “specifically notes that the physician will give no deadly medicine”(Fuller 11). Just like any other document with mandating guidelines, there is room for interpretations. If a physician is following the letter of the ‘law’, they would follow the literal interpretation of the words in the oath but not necessarily the intent of Hippocrates. Following the spirt of the ‘law’ in this case, could be not to cause a patient intentional harm or pain. The over arching idea of the Hippocratic oath is to “do no harm”. Josh Sanburn writes, “Since Hippocrates, doctors have taken their credo to do no harm. But what if a patient believes the treatment to keep them alive is more harmful than death?”(Sanburn 50) In the award winning documentary, “ How to Die in Oregon” Dr. Katherine Morris sheds light on a new outlook on “do not harm”. The documentary follows the last months of a terminal ill patient, Cody Curtis’s, life. Dr. Morris states, “ I think Cody taught me that first do no harm is going to be different for every patient. Harm, for her, would have meant taking away control and saying no, no, no, you’ve got to do this the way your body decides as opposed to the way you as a person decides”(Dir. Peter Richardson). Do no harm is different for every patient and stay alive though continual suffering can cause unnecessary harm to a
terminal ill patient thus violates the Hippocratic oath.
ALTERNATIVE OPTIONS
 There are very few alternatives to physician assisted suicide. The alternatives are voluntary stop eating and drinking, withdrawing life-sustaining interventions, and various types of sedation (Lachman VSED 56). Voluntary stop eating and drinking is simply described as “forgoing artificial nutrition and hydration”(56). The main purpose for physician assisted suicide is to end the suffering for the patient, and staving and dehydrating ones self to death does not sound like the end of suffering. For physician assisted suicide, death occurs in the moments (minutes to hours) after ingesting a prescribed lethal medication. Voluntary stopping eating and drinking on the other hand takes anywhere from one to three weeks (57). There are no laws that prohibit a patient to voluntary stopping eating and drinking. Withdrawing treatment and not allowing life saving intervention, such as CPR, artificial ventilation, et cetera, should not be seen as a feasible solution to physician assisted suicide. Its stopping treatment without taking control or action in how the patient dies. Physician assisted suicide is used mainly because the patient wants control in how their life end. Simply withdrawing treatment isn't a valid alternative for people who want control in how they leave this earth. Another alternative option to physician assisted suicide is continuous sedation. With continuous sedation a, “physician uses sedatives to reduce or take away the consciousness of a patient until death follows”(Raus, Kasper, Sigrid Sterckx, and Freddy Mortier 32). Like voluntary stopping eating and drinking, continuous sedation is a waiting game. There isn't a set time frame on when the patient would die with these options. All the alternative options just drag out the patients life and many of the patient take part in physician assisted suicide to avoid just that.