ENG 111 Final Paper

Abbey Fulcer
ENG 111

Legalization of Physician Assisted Suicide

Imagine you’re laying in a hospital bed hooked up to countless machines. The doctors and nurses are constantly coming in to check up on you. They have told you that you have no chance of survival and that death is imminent; it’s just a matter of when. You’ve said your goodbyes and you’ve come to terms with dying. If you had the chance to choose how your life ended would you take advantage of it? In today 's society one of the most controversial issues is physician-assisted suicide for the terminally ill. Many feel as though it is wrong, regardless of their health condition to ask their health care provider to end their life. Others feel it is their right to be able to choose how and when they die. For those who believe physician-assisted suicide should be their choice, they feel it should be legal because: they don 't want to go through the suffering caused by the life-threatening illness, they fear the loss of their independence, becoming a burden to their family and friends, and the fear of dying alone. In 1990 physician-assisted suicide became known to the public when Dr. Jack Kevorkian, a retired pathologist, helped to assist his first patient. Kevorkian had created a machine known as the "suicide machine", which was made up of three glass bottles connected to an IV. In the three bottles were saline, a sedative, and potassium chloride. When the patient felt they were ready to begin the process, they turned the machine on themselves and were put to sleep by the sedative and then killed by the potassium chloride. The Detroit Press reported that on, June 4, 1990, Janet Elaine Adkins became the first patient Dr. Kevorkian assisted. The 54-year-old woman from Portland, Oregon, who was a former college instructor, decided to commit suicide the day she was diagnosed with Alzheimer 's disease. Adkins contacted Kevorkian after hearing about his suicide machine and asked for his help in assisting her into death. After hearing Adkins describe her illness, Kevorkian refused to help the patient and suggested that she try experimental drug treatments first. After six months had gone by, Adkins informed Dr. Kevorkian that the drug treatment had been unsuccessful; Kevorkian finally agreed to help with her request. Adkins and her husband flew to Michigan on June 3, 1990, for an interview with Kevorkian. The doctor concluded that Adkins ' euthanasia request was reasonable. The following day Adkins was hooked up intravenously to an inverted bottle of saline solution hanging from a metal frame in the back of Kevorkian 's parked van. After listening to Kevorkian 's instructions, Adkins pressed a button that shut off the flow of saline solution and opened the line of sedative causing her to lose consciousness. After one minute an automatic timer closed the sedative line and released the contents of the third bottle. Adkins ' heart stopped beating within six minutes (Worsnop, 1992). Due to Kevorkian assisting in the death of those that did not always fit into the “terminally ill” category, patients now have to be more informed about their illness so that they are aware of what their final options may be. When a physician has diagnosed a patient with a terminal illness it is important that the physician provides valid information. According to the Oregon Death with Dignity Act, " 'Terminal disease ' means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgement, produce death within six months.” The physician is also responsible for letting the patient know of any experimental drugs and treatments that may benefit the patient in any way. Another responsibility of the physician is to educate the patient as to what their final options may be. They are required to inform the patient about their diagnosis and also having the patient contact another physician to confirm the diagnosis. (The Oregon Death with Dignity Act, 2000). Some people feel that when a physician provides a patient with a deadly drug and instructions on how to use the medicine, they have as much responsibility as the patient themselves. Since the Oregon Death with Dignity Act was passed in 1997, more than 1,000 people have obtained life-ending prescriptions, almost 750 used them. Most feared a loss of autonomy, self-worth and decreasing ability to participate in activities that made life their enjoyable. These and other statistics on Oregon’s experiences are available because of data collection and reporting. This has allowed legislatures and courts around the world to assess Oregon’s experiences. Overwhelmingly, they have found it beneficial due to many safeguards in Oregon’s law, which only allows participation by defined categories (Gonchar, 2014). A recent survey shows that 7 out of 10 Americans polled supported physician-assisted suicide. It’s a substantial increase from just over 50 percent in the 1970s. Legislatures in Hawaii, Kansas, Massachusetts, New Jersey and Pennsylvania have recently introduced death with dignity bills - with votes in New Jersey and Pennsylvania expected this year (Zakaria, 2014). Religious conservatives disagree with assisted death because of their beliefs about the worth of life and the meaning of suffering, but none of these arguments are new. What is new, however, is the number of people who are engaged in the “right-to-die” debate because of Brittany Maynard’s decision; a 29 year old who recently chose physician assisted suicide due to be diagnosed with Stage 4 Glioblastoma, a deadly brain tumor. Maynard was given less than 14 months to live, and doctors told her that her death would be slow and painful. Since her diagnosis, Maynard has suffered excruciating headaches, seizures, neck pain, and even temporarily lost the ability to speak. She decided she didn 't want to suffer anymore, and she wanted to choose when it was her time to die. Maynard launched a campaign with Compassion & Choices to raise awareness about Death with Dignity laws. She stated the following in an Oct. 6, 2014 People Magazine article, "There is not a cell in my body that is suicidal or that wants to die. I want to live. I wish there was a cure for my disease but there 's not... My glioblastoma is going to kill me, and that 's out of my control. I 've discussed with many experts how I would die from it, and it 's a terrible, terrible way to die. Being able to choose to go with dignity is less terrifying... Right now it 's a choice that 's only available to some Americans, which is really unethical... The amount of sacrifice and change my family had to go through in order to get me legal access to Death with Dignity--changing our residency [from California to Oregon], establishing a team of doctors, having a place to live--was profound... There 's tons of Americans who don 't have time or the ability or finances [to move to a legal state] and I don 't think that 's right or fair... I believe this choice is ethical, and what makes it ethical is it is a choice. The patient can change their mind up to the last minute. I feel very protected here in Oregon” (People Magazine, 2014). Maynard’s campaign has gone global, shedding new light on physician assisted suicide - she became an inspiration to many. Ed Newman, a well known writer, states that one of the arguments in favor of assisted suicide is the mercy argument, which states, “The immense pain and indignity of prolonged suffering cannot be ignored. We are being inhumane to force people to continue suffering in this way” (Newman, 1992). Another source states, “And at the risk of finding myself out on a theological limb, I say that if it is playing God to reduce human suffering, then I do not believe that the God of mercy and compassion would mind if we mere mortals play God under such circumstances” (Barnard, 1980). The most literal translation of the word 'euthanasia ' would be 'a good death. ' So who could be against that, except an extremist who would argue that terminal suffering should be accepted, unchanged by human intervention, as 'fate ' or 'God 's will’?” (Siebold, 2014). A vital argument that many feel should be considered to make assisted suicide legal, is the economic argument. This dispute notes the cost of keeping someone alive and on life support, although they are in a vegetative state. Our healthcare system is based off of an infinite progress model, in which cures are sought after. We invest money and resources in costly research, technology and end-of-life care. End-of-life care is extremely expensive, to such an extent that a cap to end-of-life expenses has been proposed. This too, while morally and ethically difficult, confronts the reality of the high costs of care. It is said that almost 50 percent of patients admitted to an Intensive Care Unit are terminally ill. It costs almost $10,000 a week to keep a person on a respirator in an ICU. This money is often spent on patients who have no chance of recovery. Also, approximately 25 percent of Medicare costs are to treat 5 percent of Medicare users to cover end-of-life care. I am not advocating that we shouldn’t spend money on end-of-life care, but in many instances, these costs are unnecessary. In some instances it is spent on surgeries that do not improve the quality of life of the patient, but only extends their life for a couple of months. From my perspective, how valuable are these few months of being hooked up to ventilators and IVs, if you are still going to die in the near future? Doctor Wagner wrote, “In many cases, intrusive and complicated machinery is wheeled in to keep vital signs going, to give treatment of no benefit and tremendous cost, depriving others of treatment while dignity disappears.” (Gardner, 1992). According to Margaret Battin, a professor at the University of Utah, assisted suicide would not mean that society would be giving up on the elderly and those with terminal illnesses. It would in fact do them a good deed by letting them choose when they have had enough (Battin,1999). One source feels that today 's technology is to blame, “We die more slowly today, and what’s even worse, is that we do it in hospitals, surrounded by technology rather than by friends and family. And this is what makes it especially frightening to some people” (Vanderpool, 1997). Another critical reason people believe physician-assisted suicide should be available for those who request it, is because people fear the loss of their autonomy. In the book, Lawful Exit: The Limits of Freedom, Derek Humphrey quotes Archibald MacLeish by saying, "Freedom is the right to choose: the right to create for yourself the alternatives of choice. Without the possibility of choice and the exercise of choice a man is not a man but a member, an instrument, a thing.” The Oregon Health Department said, "The fact that 79% of people who chose physician-assisted suicide did not wait until they were bedridden to take their lethal medication provides further evidence that controlling the manner and time of death were important issues to these patients" (Oregon Health Department, 2000). The right to die is not laid out in the Constitution — but neither is the power to draft for the military. The word “equality” is not written in the Constitution — does this mean we should run as a prejudiced nation? Maybe the right to one’s own death is never stated in our Constitution because it is implied that the decisions for one’s own life should only lie in the hands of the individual themselves. Not everyone wants to die rather than face the natural course of their illnesses, but not everyone wants to live through them either. Patients should be given the option to take a lethal dose of medication to escape their pain and face their future with dignity and closure, and the government should support this as an option. Not every physician has to sign off on the papers if they are not comfortable, and no patient should ever be coerced into it. But it should be available to any individual. This entire argument boils down to a premise: who is in charge of our lives? Doctors? Politicians? Religious leaders? Or Us? Are so weak minded that we cannot be trusted to be responsible for our own existence? The answer is no, yet that 's exactly what the people in power have us believe. The states have the power to allow and regulate assisted suicide or to prohibit it, and with enough pressure from critical thinkers we will someday have the freedom to end our lives with dignity. Because physician-assisted suicide can be constructed to have reasonable laws which still protect against its abuse and the value of human life, alleviates patient suffering nearing the end of life, and help the terminally ill exercise their fundamental freedoms to the right of death, physician-assisted suicide should be legalized in the United States. The patient 's right to self-determination gives the patient the power to decide not only when they die, but also how, because it is in fact their body, their pain, and their life.

Annotated Bibliography
1. Barnard, Dr. Christiaan. Good Life Good Death: A Doctor 's Case for Euthanasia and Suicide. Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1980.
Dr. Christiaan Barnard offers critical opinions and well thought out research throughout his work. He takes an honest approach to why he believes physician assisted suicide should be legal. Barnard gives great examples, making it easy to be persuaded due to the fact that he dealt with similar situations throughout his career as a cardiac surgeon in South Africa.
Barnard’s information and views on physician assisted suicide fit perfectly into my persuasive paper. His work supported my beliefs on why this topic is so controversial.

2. Battin, Margaret P. "Margaret P. Battin, PhD - Euthanasia - ProCon.org." ProConorg Headlines. N.p., n.d. Web. 09 Dec. 2014.
Dr. Margaret Battin is a distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine. She firmly believes that physician assisted suicide should be an option to those who are terminally ill. Battin is significantly involved in end-of-life issues.
Battin has written several books and has had involvement in the medical field for over 40 years. Her views on physician assisted suicide are very sincere and ethical, making it easy to add her work into my paper.

3. Gardner, Christine J. "Severe Mercy in Oregon: How two dying patients dealt with a new right-When to die." Christianity Today. June 14, 1999.
Christine J. Gardner is a professor at Wheaton College. Gardner is also a journalist - her articles have been frequently published in Christianity Today.
Although Professor Gardner is a strong Christian, she also believes that physician assisted suicide should be available to those who are terminally ill. It was critical for me to use her work because it shows that not all those who are fully devoted to religious groups are against legalizing physician assisted suicide.
4. Maynard, Brittany. "My Right to Death with Dignity at 29." CNN. Cable News Network, 02 Nov. 2014. Web. 08 Dec. 2014
Brittany Maynard has recently become famous due to her powerful message on physician assisted suicide. She was 29 years old when she became diagnosed with Stage 4 Glioblastoma (a deadly brain tumor), ultimately she decided on physician assisted suicide to end the slow suffering.
Maynard’s story was a great addition to my speech because using personal stories of those who decided on physician assisted suicide is a great persuasive strategy. She gave interviews for several well known talk shows and magazines, becoming an inspiration to many.

5. Newman, Ed. "Part Five: Making the Final Choice: Should Physician-Assisted Suicide be Legalized?" Yahoo. 1992, http://www.cp.duluth.mn.us/~ennyman/DAS-5.html.
Ed Newman wrote several articles on ethical, medical and legal issues surrounding physician assisted suicide. Newman gives a humorous spin to the not so humorous situation. Due to the fact that physician assisted suicide has been such a controversial topic, his work made it easier to talk about.
I used Newman’s views on physician assisted suicide because he did a great job at lightning the mood. He gave several reasons as to why it should be legalized and did a great job at giving details.

6. Siebold, Steve. "Keep Brittany Maynard 's Legacy Alive." The Huffington Post. TheHuffingtonPost.com, 29 Oct. 2014. Web. 08 Dec. 2014.
Steve Siebold is one of the world 's foremost experts in the field of critical thinking and mental toughness training. He challenges conventional wisdom by cutting through the psychological delusion of the masses, allowing us to understand key issues for what they are. He also has written several books.
I used Siebold’s views on physician assisted suicide due to his extensive background. He is knowledgable on human emotions and understands why people who are terminally ill choose physician assisted suicide.

7. Vanderpool, Harold Y., Ph.D., Th.M. "Doctors and the dying of Patients in American History." Physician-Assisted Suicide. Ed. Robert F. Weir. Indianapolis: Indiana University Press, 1997.
Harold Vanderpool was a Professor in the History of Medicine at Harvard University. His research on the use of physician assisted suicide was informative and crucial to my paper.
Vanderpool has been working in the educational/medical world for many years, making me believe his work would be reliable. I agreed with a lot of his thoughts on physician assisted suicide, which is why his work fit well into my paper.

8. Worsnop, Richard L. "Assisted Suicide." C Q Researcher. Washington D.C.: Congressional Quarterly, Inc., 1992.
Richard Worsnop is an associate editor for the CQ Researcher, he gives weekly reports on public policy issues. Worsnop is also known for writing several children 's books, making him relatable to many.
Due to Worsnop’s extensive background in researching, I found his work refreshing and understandable. He had several valid points and great quotes that helped make my paper stronger overall.

Bibliography: 1. Barnard, Dr. Christiaan. Good Life Good Death: A Doctor 's Case for Euthanasia and Suicide. Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1980.  Dr 3. Gardner, Christine J. "Severe Mercy in Oregon: How two dying patients dealt with a new right-When to die." Christianity Today. June 14, 1999. 4. Maynard, Brittany. "My Right to Death with Dignity at 29." CNN. Cable News Network, 02 Nov. 2014. Web. 08 Dec. 2014 Brittany Maynard has recently become famous due to her powerful message on physician assisted suicide 8. Worsnop, Richard L. "Assisted Suicide." C Q Researcher. Washington D.C.: Congressional Quarterly, Inc., 1992.