The Debate Over Assisted Suicide
Dr. Dee Griffin
Should assisted suicide be legal in hospitals? Those who are against assisted suicide argue that it goes against the Hippocratic oath that medical personnel take when they get their license. They also say that, a patient could feel pressured by other sources affecting the decision for assisted suicide and that doctors could possibly give a wrong death prognosis ending a patients life to soon. On the other hand, those who are in favor of assisted suicide insist that as a human we should have the right to choose to die. They also argue that, assisted suicide can prevent more painful deaths caused by desperation and that it could be a great opportunity to donate vital organs to other patients in need. We as humans are all responsible for our own decisions in life, so we should at least have the right to choose how we want to die. The Debate Over Assisted Suicide
On a Wednesday morning in 1997 Penny Schleuter, a 56 year old former economics teacher in Oregon knew she was nearing death. She was in her last stages of cancer, and it was spreading further and further into her system. Penny knew she was going to die soon, she didn’t know when, but she new it was going to happen. She proclaimed to the Chicago Tribune News crew, “It’s the last big decision I will make. No one has any right to tell me how to die” (Graham & Peres, 1997). Penny eventually was able to have her last dying wish when in October of 1997, Oregon had made the first groundbreaking move in fight for the right to assisted suicide by creating Death with Dignity Act. The Death with Dignity Act allowed physicians to give a lethal dose of medication that would allow terminally ill patients to pass away the way they wanted (Eckholm, 2014). Many people may agree with legalizing assisted suicide because they believe that every person should have the right to choose the manner of their death. Others disagree with legalizing assisted suicide because they feel that there will be too many people who will abuse it. Should assisted suicide in hospitals be legal in hospitals? Background
In June 1997, U.S. Supreme court decided that there was no constitutional right for a human to die by assisted suicide. However, justices did not forbid the states on passing a law that could give a person the right to die by request (Lachman, 2010). Currently the United States, 46 states have classified assisted suicide as illegal on the grounds that it is considered second-degree manslaughter. However, in four states, it has been legalized if the patient has 6 months or less to live due to a terminal illness. These states are Montana, Oregon, Vermont, and Washington. In these 4 states a physician can prescribe a lethal dose of medication to a patient only if the patient is of age, competent, and has had a psychological examination (State-by-State Guide to Physician-Assisted Suicide, 2013). Many people think of the removal of feeding tubes or euthanasia to humans in a vegetative state, when they hear the term assisted suicide. However, assisted suicide applies to people who have been diagnosed with a disease that has classified them as terminally ill because the disease has no known cure. The debate about assisted suicide is actually a rather new controversy that has been going on for the past two decades (Pickert, 2009). It is an argument is related to the debate about a human’s right to live, and whether or not they should have the right to make that decision (Cheyfitz, 1999). Many physicians disapprove of this practice (Pickert, 2009).
Support for Assisted Suicide
Should Have The Right to Die
First, those who support assisted suicide say that terminally ill people should have the right to die because it connects with our basic declaration for human life. These advocates believe that if one can have the right to live, they should also have the right to end their life (Shultz, 2013). The Gallop Poll in May of 2013 reported 70% of the general public agreed that physicians should be allowed use the assisted suicide procedure if a family member and the family both wanted it. Many believe that it should be a basic human right for a person to choose how they pass away, especially if it is going to happen to all of us. The right to die movement started around the 1970’s which was long before the assisted suicide debate started in the 1990’s. In 2006, a poll from the Pew research center reported that 84% of Americans supported the right to die movement. However, the right to die movement is not supported by the states legislators despite the beliefs of the general public (McCormick, 2011, p.119). The right to die movement is fighting for a person’s control over his or her life, and to not let other human’s decisions dictate their own life. Prevents Alternative Painful Deaths
Second, those who support assisted suicide also say that it could prevent terminally ill patients from finding other, more painful ways in ending their lives. Medical technology has greatly improved over the past 50 years, with great advancements in prolonging life in dire situations. This may be great for someone who has just been in a car accident or fallen off a building, but when it comes to terminally ill patients, this can be a curse. It creates a life for these people that only elongates their agony when they are here in this world (Esther, n.d.). Many terminally ill patients become desperate to take the situation into their own hands and end their lives themselves. For example, Percy Bridgeman a Nobel laureate in physics had shot himself in 1961 because he did not want to suffer a life worse then death with metastatic cancer. Percy had written in his suicide note before he put the gun to his head, “ It is not decent for society to make a man do it himself”(Angell, 1997, p.53). In Switzerland, It has been found that one of the most painful terminal illnesses was the most used for assisted suicide. There have been a reported 54% of assisted deaths relating to cancer (Judd & Seale, 2011). Many of the patients who wish to have the assisted suicide procedure have a terminal illnesses with the worst outcomes and side effects. Provides Organs For Other People
Finally, those who support assisted suicide say that it can help provide organs to save lives of other patients who are not terminally ill. In the United Kingdom, over 5000 terminally ill patients die every year (Wilkinson & Savulescu, 2010). If only one of those patients donated their organs when they were still transferable, they could possibly save 3 to 5 lives. In Belgium, organ donations after euthanasia are legal and are pretty common in the country (Symons, 2013). However, in the United States organ donation after assisted suicide has not been legalized in any of the four states that have legalized assisted suicide (Penokie, 2013). Approximately 12.8% of all euthanasia organ donations in Belgium are lung donations (Symons, 2013). The only way someone could donate vital organ is if they were about to die, because a surgeon cannot remove transferable organs from a completely dead body. Organs can only be taken from a body that has had a circulatory death or brain death. When the body dies any other way, then the organs inside the patient are not capable of being used in transplant surgeries. This is why donations from people who are about to die are so important. Vital organs that can be donated include the heart, lungs, liver, kidneys, and pancreas. Only 1% of people are willing to donate vital organs because usually that means they have to end their life in order to do so (Barber, n.d.). In Southfield, Michigan there was a woman who was near her death and is in the last stages of multiple sclerosis. She has been begging the state to allow her to donate her organs and to have an assisted suicide. She said she wanted to be able to have control of her life and how she decided she wanted to give back to the world. However, organ donation after assisted suicide is still not legal in the united states (Penokie, 2013). Opposition to Assisted Suicide
Goes Against Hippocratic Oath
First, those who oppose assisted suicide say that it goes against the Hippocratic oath that all physicians make when they get their license. The Hippocratic oath was created nearly 2400 years ago, and has been held sacred to people in the medical field for centuries (Jonsen, 2004). The Oath lays out the standards of professional ethics in the medical field for physicians taking care of patients. In current times all medical schools require students to recite this oath when completing their degree. The oath is a way of creating uniformity between all personnel in the medical field (Tyson, 2001). In modern society, people have been debating about abortion and assisted suicide. These topics are not permitted in the Hippocratic oath because it states that a physician is to do no harm, and to never give any lethal drug to patients if asked or suggested (Rockett, 2012). The oath also states that a physician should not give a woman a destructive peccary (Sokol, 2008). The former president of the American Medical Association, Dr. Lonnie Bristow, believes that assisted suicide is completely inconsistent with the Hippocratic oath that was made by physicians when they started their career. The American Medical Association in general believes that because these procedures go against the oath that the procedure should not be allowed at all (Rockett, 2012). Pressured in Decision of Assisted Suicide
Second, those who oppose assisted suicide also say that patients might feel pressured to take that option. Any decision that a human makes in their lifetime can be influenced by something else other than their own feelings. It could be the family members encouraging them to have the procedure done because they feel like a burden to the family. The families medical bills could be adding up due to the costly procedure that need to be done to keep them living as long as possible. It could even be because of the fact that in our society we value youth, health, and beauty. For instance, Zeno, the founder of stoic philosophy, had committed suicide on his own at 98 years old because he had fallen down a flight of stairs and pulled his toe. Zeno had been so tired of his life at 98 that he had made any excuse to no longer stay alive, and he didn’t even have a terminal illness. In the United States, the suicide rate is approximately 12.5 people per 100,000 people commit suicide on their own, 2% to 4% of those suicides account for those who have a terminal illness. People who are against assisted suicide are afraid that if we make it an option, if could make this suicide rate all that much more in the United States (Osgood, 1995). Physicians Wrong with Death Prognosis
Lastly, those who oppose assisted suicide say that physicians can be wrong about a patients estimated time of death. A terminal prognosis allows a physician to create a plan of action for his or her patient and to create an easier dying process. Prognosis estimates are very rarely accurate, only 20% of estimates are usually correct. A Physician can predict a patients death by seeing if they have, a failing functional status, high number of white blood cells, extreme weight loss, dysphagia, etc. (Daugherty & Hlubocky, 2008). It is found that 63% of all death prognoses are overestimates and only 17% are underestimates. When an estimate is to high patients may have unnecessary treatments given to them, while when an estimate is to low there could be severe consequences of delayed intervention for the patient. On average, physicians overestimate 5.3 times longer than the time the patient actually lived (Easton, 2000). The accuracy of a death prognosis increases about 70% when it is less than a 14 day estimate. The inaccuracies in a patient’s prognosis could be a huge problem especially when a patient is deciding whether or not they want to have assisted suicide. Both families and patients have a hard time when the death prognosis is accurate (Daugherty & Hlubocky, 2008). Helping to aid in someone’s death without completely accurate information could take away an unnecessary amount of time that the patient may have to live. Conclusion
It is clear that the practice of assisted suicide is highly controversial and it is very hard for facilities to see them primary motivation for their choice in death. However, it is impossible to look past the fact that as citizen of the United States, someone should have the right to choose their own death. As I pointed out earlier, if a person has the right to live the life they want, then they should have the right to die the way they want. If penny didn’t have to wait until assisted suicide was legal in Oregon, she could have chosen the death that she had wanted instead of fighting for her right to have it. All patients are ultimately responsible for the decisions they make in life, and if one of the decisions they have is to end their life with dignity, they should at least have the option.
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