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Physician-assisted suicide as an option for the terminally ill

By southerbroadway Oct 28, 2013 1978 Words
Physician-assisted suicide as an option for the terminally ill

Physician-assisted suicide, often confused with euthanasia (differences to be addressed shortly) provides an incredible amount of relief to both patients and the families of those suffering from terminal illnesses, by allowing patients to choose to end their life with dignity, on their own terms. Without the option of physician-assisted suicide, terminal patients would succumb to their afflictions over time. This could potentially involve prolonged periods of pain, both physical and emotional. In the eyes of those who wish to practice assisted suicide, this is interpreted as unnecessary suffering. Those who oppose physician-assisted suicide often claim that their opposition stems from religious beliefs whereas others simply feel, morally, that physician-assisted suicide equates to murder. I personally believe that physician-assisted suicide is a service of compassion for those whose life is cut painfully short my disease or disorder. For the benefit of terminally ill patients, whose quality of life is severely deteriorated due to their afflictions, physician-assisted suicide should be a legalized, standardized, and acceptable practice. The most vital part of this argument is the understanding of terminology; specifically, the difference between physician-assisted suicide and euthanasia.

According to the Encyclopedia of Elder Care, euthanasia is defined as, "the intentional termination of one's life" by someone other than the patient, whereas physician-assisted suicide, "requires that the patient actually perform the final act of taking the lethal dose of medication that has been prescribed by a physician" (2007). Euthanasia, while usually performed by a medical professional , does not technically have to involve anyone trained in the application of medicine and can vary in its means and outcomes. Physician-assisted suicide, as it currently being used, involves careful and meticulous planning with a physician regarding the means, and then the act is left up to the patient to perform on his or her terms and timing. There is a considerable difference between euthanasia and physician-assisted suicide. Euthanasia carries a heavy, negative connotation that should not be applied to physician-assisted suicide because, in contrast to euthanasia, physician-assisted suicide allows the patient to have complete control over the time, place, and significance of their passing. Control is often a keyword for those researching physician-assisted suicide and it's a major buzzword for groups that support and promote physician-assisted suicide as a viable option for the terminally ill. "In, theory, patients retail ultimate control in cases of assisted suicide, whereas control rests with the doctor in euthanasia" (Black's Medical Dictionary, 2010). The main point of physician-assisted suicide is that the patient has complete control over when, where and how they administer the lethal dose of medication. This is designed to give the patient time to be at peace and to manage all of their closing affairs. In giving control over death to the terminally ill, physicians are empowering them to be active participants in their passing. This alleviates some of the stress and fear that these patients deal with. These doctors are performing a service that is pleasurable for both those that are ill, and their surviving family, allowing them to experience closure and peace, and to prepare themselves, their legacy, and their estate. The legality of physician-assisted suicide is a matter of great debate, but at least three states in the US have decided that it is an acceptable option.

Oregon was the first state where physician-assisted suicide became legal. According to the ProCon.org page on State Laws on Physician-Assisted Suicide, three states have active and functional laws concerning physician-assisted suicide, the earliest of which have been in place since 1997. Additionally, four states either do not legally address or do not prohibit physician-assisted suicide. There are no federal laws regarding physician-assisted suicide (ProCon.org, 2012). In two of the three states that support physician-assisted suicide, there are strict guidelines implemented to ensure that this process cannot be rushed and that patients receive adequate and diverse guidance before being allowed to access lethal-dose medication. If at any point in this process a medical professional feels that the patient is not in an acceptable state to continue with the process, that medical professional has the ability to pause or stop the request pending further review (ProCon.org, 2012). The laws in place in states that have legalized physician-assisted suicide, are sound and should be considered as models for federal regulations that would apply in all 50 states. This will ensure that terminally ill patients all over the country, that are eligible, would have access to medical professionals for evaluation as candidates for physician-assisted suicide.

Smith et al, surveyed 149 people in Oregon and discovered that, "those receiving [physician-assisted death] prescriptions had higher quality ratings on items measuring symptom control (e.g., control over surroundings and control of bowels/bladder) and higher ratings on items related to preparedness for death (saying goodbye to loved ones, and possession of a means to end life if desired) than those who requested but did not receive a lethal prescription" (Smith et al, 2011). According to the study, there was an increase in contentedness among those whose loved ones had achieved a physician-assisted suicide. most people seek to control their environment and their path in life. It is logical that we would seek to control our deaths (as much as we can) as well. This study supports my argument that physician-assisted suicide should be legalized throughout the US with empirical data. Using the system established in Oregon, a national system for the standardization of physician-assisted suicide can be formed and enacted with expected success. Of course, for every point-of-view, there exists a counter argument.

Those who oppose physician-assisted suicide insist that it is an immoral and unethical practice that violates both governing and religious laws, and should be legally punishable. Some of those opposed will reference religious text that warns against any act that directly results in the death of another human being, many also have rules forbidding the taking of one's own life. The majority of religions in the US equate physician-assisted suicide to murder. From my personal experience, I know that Catholics believe that people who take their own lives go to Hell, with no hope of redemption. They believe that, "suicide is a tragedy, not a personal choice" (Masci, 2007). The vast majority of Americans keep to one religion or another. The majority of religions condemn physician-assisted suicide. Others simply hold that it is "wrong" or immoral to end one's own life or to help one end their life. They cite no religious or legal text, they simply do not agree with it on a personal level. "Opponents of physician-assisted suicide argue that the role of the doctor is to relieve the patient's suffering, not to kill or assist in killing" (Kevorkian, 2010). Some doctors that hold to this theory insist that it betrays the Hippocratic oath in which doctors swear to do no harm. Often, two doctors will not agree on a life expectancy prognosis (patients seeking physician-assisted suicide must have a prognosis of six months or less). Some may argue that there are an abundance of cases in which doctors have been wrong and patients have lived well beyond the time given. In all, those opposed to physician-assisted suicide believe that it should not become an accepted practice in the US and should not be legal.

In order to address the arguments in opposition to physician-assisted suicide, let us first look at the root of both arguments (religion opposition and moral opposition). Both arguments are based on perspectives that are inconsistent or immeasurable among its participants. They cannot be proven as true or false. Religion is a matter of personal taste, best evidenced by the fact that some religions (including Unitarian Universalists), "support immunity from prosecution for those who, with proper safeguards, honor the requests of terminally ill patients" (Death with Dignity National Center, 2012). It should not be allowed to condemn an act as illegal. Concerning those that oppose the six month life expectancy requirement, lawmakers in Oregon and Washington have enacted the following timeline for requesting a physician-assisted suicide, made available by the Death With Dignity National Center: 1. First oral request to your physician

2. 15 day waiting period
3. Second oral request to your physician
4. Written request to your physician
5. 48 hour waiting period before you can pick up your prescribed medications 6. Patient may pick up prescribed medications from the pharmacy (2012). Logic and empathy tell us that physician-assisted suicide offers an empowering and painless way for terminally ill patients to take control of their death just as illness or injury has taken control of their life. As the Death With Dignity National Center proposes, "The greatest human freedom is to live, and die, according to one's own desires and beliefs" (2012).

When it comes to death, people have many options in their approach. Some don't have the luxury of being able to plan for their deaths. Their lives are cut to short and many families feel that their loss is deepened by the lack of closure and the fear that their loved ones suffered unnecessarily. For those whose death is a long and foreseeably painful, physician-assisted suicide can offer comfort and peace. Imagine if you had the chance to say goodbye to those you love and so long to those you dislike, imagine taking the time to enjoy the sunrises and paint the sunsets. Finally, imagine that you could make sure that your affairs are in order, that your loved ones won't have to worry about wrapping up your estate, that your final arrangements were made and you can spend your last days with dignity, enjoying the company of those around you until your mind is at ease and you are ready to drift away, painlessly, in your sleep... To structure this argument in the form of our text; Premise - Physician-assisted suicide is not euthanasia

Premise - Legal systems for physician-assisted suicide are effective and sound in practice Premise - Physician-assisted suicide provides a high quality of death Counter-premise - Most religions do not condone physician-assisted suicide Counter-premise - Physician-assisted suicide is immoral

Counter-premise - Some patients may live longer than the diagnosed six months ---------------------------------------------------------------- Conclusion - Physician-assisted suicide is in the best interests of the terminally ill and should be offered as a legal option to those with less than six months to live. In conclusion, as the practices in Oregon and other states have shown, physician-assisted suicide continues to be a preferable, accountable, and acceptable option for terminally ill patients nearing their deaths. The federal government should create a standard operating procedure for physician assisted suicide so that the terminally ill in all 50 states will have the opportunity to consider this as an option.

References
Assisted Suicide. (2009). In Encyclopedia of Death and the Human Experience. Retrieved from http://www.credoreference.com.proxy-library.ashford.edu/entry/sagedhe/assisted_suicide Death with Dignity National Center. (2012). Religion and spirituality. Retrieved from Death with Dignity National Center website: http://www.deathwithdignity.org/historyfacts/religion Kevorkian, Jack. (2010). In Culture Wars: An Encyclopedia of Issues, Viewpoints, and Voices. Retrieved from hppt://www.credoreference.com/proxy-library.ashford.edu/entry/sharpecw/kevorkian_jack Masci, D. (2007, October 9). The right-to-die debate and the tenth anniversary of Oregon's death with dignity act. Retrieved from http://www.pewforum.org/science-and-bioethics/the-right-to-die-debate-and-the-tenth-anniversary-of-oregons-death-with-dignity-act.aspx Physician-Assisted Suicide. (2006). In The Encyclopedia of Aging. Retrieved from http://www.credoreference.com.proxy-library.ashford.edu/entry/spencage/physician_assisted_suicide Physician-Assisted Suicide and Euthanasia. (2007). In The Encyclopedia of Elder Care. Retrieved from http://www.credoreference.com/proxy-library.ashford.edu/entry/spenelderc/physician_assisted_suicide_and_euthanasia ProCon.org. (2012, December 3). State Laws on Physician-Assisted Suicide. Retrieved from http://euthanasia.procon.org/view.resource.php?resourceID=000132 Smith, K.A., Goy, E.R., Harvath, T.A., & Ganzini, L. (2011). Quality of Death and Dying in Patients who Request Physician-Assisted Death. Journal of Palliative Medicine, 14(4), 445-450. doi:10.1089/jpm.2010.0425 Suicide. (2010). In Black's Medical Dictionary, 42nd Edition. Retrieved from http://www.credoreference.com.proxy-library.ashford.edu/entry/blackmed/suicide

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