May 05, 2013
Instructor Kimberly Artis-Pearce
Death with Dignity
Lying in his bed within the nursing home day- to- day; he has no family to visit, no friends to come by to pass the time with. He has become dependent on feeding tubes, a colostomy bag, adult diapers, and virtual strangers to attend to his every need. He lived a full life with no regrets, only memories that keep him company. Most of his skull and brain has been either removed by a surgeon or by the cancer; he is tired and ready to join his wife in death. He is matter of fact about it, no tears, and no doubts- only a government that prevents him from a death with dignity. His wishes echo that a balanced view and understanding of each side will give terminal ill individuals the freedom to choose to pass away with dignity.
Physician-assisted suicide (PAS) is a debated ethical issue worldwide, but more so in the United States. PAS is a process of the legal administration of prescribed lethal medication under the supervision of a licensed physician. The first compelling movement toward legalizing PAS in the United States began in the early twentieth century. In 1906, Jacob Appel had documented the political debate to legalize PAS in Iowa and Ohio. Legislation for PAS began with an heiress by the name Anna S. Hall, when her mother had died painfully from cancer. Despite her efforts, Ohio rejected the bill by a vote of 79 to 23. The well-known Dr. Kevorkian was brought to the public’s attention in the 1990s. In 1992, Proposition 161 was introduced in California. The proposition offered more criteria than Washington’s Initiative 119 but was turned down with a 46 percent vote. It is reasonable that society wants that no individual ever deliberate suicide. Recent advancements of pain management have lowered the number of patients seeking PAS (History and facts, 2011). There are patients experiencing extreme suffering that is not relieved by any of the palliative techniques. PAS is not about physicians killing their patients. PAS is about patients whose suffering that cannot be relieved. It is about not turning away from the terminally ill asks for help in ending the suffering. There are physicians who feel they cannot ethically perform PAS, and they should not be obligated to do so if that is their choice. However there are physicians who consider PAS merciful by simply writing a prescription when conditions are met. Because of this, it is unreasonable to place the physician liable of criminal reprimand, or other penalties for doing so (Emanuel, Fairdough, Daniels, & Clarridge, 1996). Statistics from a combination of the Gallop poll, Angelfire, and Nightingale Alliace shows that 54% of physicians, while 86% of the public support PAS (Statistic Brain, 2012). There are arguments for continuing the prevention of PAS, but these arguments are invalid because of two important factors that support ending prevention: patient autonomy, and the physician’s duty to provide relief from suffering (Aswegan, 2007).
It is also argued that those that request PAS come largely from patients that have not received adequate palliative care, are clinically depressed, or have not been properly treated. There are no arguments against proper management that would significantly reduce the number of requests for PAS; any request of PAS should be considered if prior management of pain and depression has failed (Schafer, 2013). More important is that controllable pain is not the reason the terminally ill request PAS, nor a common reason that patients seek to end their suffering. Severe atrophy affecting the body, total dependence on caregivers, urinary and bowel incontinence, and immobility are recognized to be more important than the pain when considering a dignified death. The awareness that loss of dignity and the loss of control of basic body functions are the reasons that most patients are brought to a state of desperation...