Physician-Assisted Suicide: For and Against
Andrew D. Boyd, University of Texas Southwestern at Dallas
The history of the debate for physician-assisted suicide has been long, even tracing back to the Greek and Roman times.1,2 The debate originally was centered around the Hippocratic oath and the condemnation of the practice. With the upsurge of Christianity, many physicians continued to condemn the practice. Within the last two centuries the public has spurned many discussions about Physician-assisted suicide and Euthanasia from many different historic perpectives1. Although this debate has been lengthy and many of the issues discussed over the centuries are repetitive, new ideas and concerns do emerge with the current debate. Many terms are used in the debate for Physician-assisted suicide, and in order to alleviate confusion through out the paper a few definitions will be given. Voluntary active euthanasia is the intentionally administering medication or other interventions to cause the patient's death at the patient's explicit request and with fully informed consent. Involuntary active euthanasia is the intentionally administering medications or other interventions to cause patient's death when patient was competent but without the patient's explicit request and/or fully informed consent. Nonvoluntary active euthanasia is the intentionally administering medication or other interventions to cause patient's death when patient was incompetent or not able to explicitly requesting it. Terminating life-sustaining treatments is withholding or withdrawing life-sustaining medical treatments from the patient to let him or her die. Palliative care or indirect euthanasia is administering narcotics or other medications to relieve pain with incidental consequence of causing sufficient respiratory depression to result in the patient's death. Physician-assisted suicide is a physician providing medication or other interventions to a patient with the understanding that the patient intends to use them to commit suicide 2. Although there are many terms, confusion can abound. However the discussion of physician-assisted suicide will be the focus of the paper, since most of the press and discussion has been about this subject 3,4,5,8,12,13. A few public advocates have spoken for physician-assisted suicide. Besides Doctor Jack Kervokian with his "death machine", Dr. Timothy Quill shows the compassionate side of physician-assisted suicide. In the story of Diane, Dr. Quill tries to convince physicians to take seriously the request of a patient to die 3. Currently Oregon is only state that allows physician-assisted suicide. Many of the supporters say there is a right to choose when and where one dies. Quill does speak in favor of legalizing physician-assisted suicide 4. However he brings up ideas about dignified death. The argument of the right to die comes from the right to terminate life-sustaining treatment. The authors of this argument say there is no essential difference between physician-assisted suicide and termination of life-sustaining treatment, since refusal of life-sustaining treatment is an upheld legal right. The analogy is one of a person sitting on a beach waiting for the tide to come in to drown and then another person walking into the ocean to drown.5 Before the Supreme Court ruling in 1997, some argued that the right to terminate care would be expanded to physician-assisted suicide and therefore making it a right.5 However, the Supreme Court did not say physician-assisted suicide is a right. (See later discussion of ruling.) In response to the claim there is a right to die, there was detailed article published in the Hastings Center Report about the evolution of rights. According to the original liberal thinkers on rights, the right to commit suicide goes against the idea of a natural right. The philosophical arguments go to show there is no historical precedent for a right to be made dead, let alone requiring others to help....
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