Aid in Dying or Physician-Assisted Suicide - Research Paper Example

?Aid in Dying or Physician Assisted Suicide Table of Contents Introduction Background 2 Analysis 3 Conclusion 11 Introduction Physician aided suicide is where a doctor is directly involved in the bringing about of a patient’s death. A doctor may do this through providing the means to end a patient’s life either using drugs or equipments with the intention of allowing the patient to die with some dignity. This has been a great source of debate all over the world, especially in the legal, medical, and ethical fields where the practice has either received plenty of support or has been vilified as being unethical and at other times being inhuman. Others have come to take a neutral stand concerning the procedure, taking a wait and see approach to the issue because it is still one that is undergoing debate. Those who have opted to take a neutral stand believe that while physician assisted suicide may be unethical in some cases; there are certain cases that may warrant the doctor to take the necessary action to end the life of his or her patient. This is especially in cases where the patient himself demands that a doctor ends his life because it has become unbearable because of the pain they are enduring in their terminal illness. The legal and moral debate is currently going on and it seems that the stands that have been taken on the opposite sides of the debate are going to be reconciled any time soon. A brief discussion of the issues involved in physician assisted suicide needs to be discussed in order to come up with a suitable stand concerning the matter. Background There have developed strong arguments concerning the loosening of the legal constraints that prevent doctors from administering physician-assisted suicide to their patients. Surveys that have been conducted recently have shown that many people of the United States are in favor of the legalization of this practice.1 Those opposed to it are the conservative elements of the society such as religious people as well as moral conservatives who tend to equate the practice to murder. It should however be realized that some form of legalization of the practice is eventually going to be made because many people will most likely leave behind instructions concerning their being assisted to die in case something serious happens to them. It will no longer matter what the government and conservatives elements in society will have to say because the wishes of individuals will most likely be put first. There has, recently been a high prevalence in the number of people who have made requests to their doctors to have assistance with suicide. The doctors have to consider this difficult request because of the legal and ethical repercussions of the practice.2 It can safely be said that there is a high likelihood that many doctors accede to the demand of their patients, although secretly, and assist them in ending their lives. Despite it being illegal, especially in the United States, the possibilities of physician-assisted suicides taking place in the country are quite high. Such acts are most likely going to force the legalization of assisted suicides so that the government can have some measure of control over it. Analysis Among the arguments that have been made concerning the banning of physician, assisted suicide is that it is wrong in the eyes of God. The greatest opposition to the legalization of this practice has come from the religious establishment and religious texts and opinions have been used to justify its stand. It has been stated that only God has the ultimate power to take away life, and that doctors who assist their patients in dying are committing a sin.3 This argument has been strongly countered by advocates of physician-assisted suicide, who have stated that God is not so aloof that he allows people to suffer immense pain. Instead, they have argued that God has given human beings the knowledge and the ability to get rid of pain, and that among the means that God has provided is that of physicians assisting their patients to receive a dignified death. Among the arguments that have been made is that it helps to protect patients who know that they are dying but do not want to suffer deaths that are lingering and painful. Furthermore, it has been argued that physician assisted suicide is in line with respecting the independence of a patient in making decisions concerning their own lives. Furthermore, it has been stated that physician assisted suicide is very defensible as a policy because it can be performed on anybody who needs it and not just people from specific backgrounds. In other words, this procedure is very respectful of social diversity if looked upon as a policy. It can be argued that this way of ending the life of a suffering person protects them from the unnecessary attention of a physician as well as from unwanted treatment that does nothing to alleviate the suffering that they are going through. Moreover, physician assisted suicide helps to protect the patient affected by a debilitating condition that is not easy to manage using medicine and instead allows them to die a more dignified death. Despite the fact that it is logical for a physician to honor a suffering patient’s request to assist them to end their suffering through death, there is in reality very little ethical or legal support for it. In fact, this practice is one of the most frowned upon in the medical profession because the profession is based on the preservation of life and not its termination.4 Even the most enthusiastic supporters of physician-assisted suicide are very reserved when it comes to the argument of whether a physician should take part in the assisting of their patient’s death. This is not only because of the emotional impact on the doctor, but also because of the fact that getting directly involved in the suicide of a patient is illegal. The supporters of this action recognize that it is the right of the physician to decline to take part in assisted suicide for the various moral reasons that they may have. These moral reservations may be based either on their religious beliefs or on the belief that in taking part in the ending of their patient’s life, they may be breaking the Hippocratic Oath.5 It is however argued that whatever their own views about this issue, they should not disregard the wishes of their patients and they should instead refer them to other physicians who may be able t help them in whatever way the patients desire.6 Those organizations, which oppose the practice of physician-assisted suicide, state that there is no reason for conducting such a practice if the necessary resources exit for the provision of palliative care.7 They state that the reason why many people choose to have assisted suicide is not so much because of the pain, but because of the lack of the resources to make their illnesses more bearable. These organizations suggest that the best way to solve the problem is to ensure that the best palliative care should be the standard type of care that the terminally ill should receive and that anything leaning towards suicide would be undesirable. While the argument made by such organizations may seem noble at first glance, they fail to recognize the fact the palliative care does not necessarily alleviate the pain and discomfort that many of the terminally ill patients feel.8 In fact, palliative care does not normally have the resources necessary to prevent the pain the patients feel. Instead, the very least that such care can do is to make a patient possible without necessarily providing relief. In such cases, the option of physician-assisted suicide becomes a something that can be considered in a bid to assist those who are terminally ill to end their pain. It has been found that the improvement of palliative care is responsible for a reduction in physician-assisted suicide because patients end up feeling more comfortable than they previously were, ensuring that they wish to live on for a little longer. In Oregon, where the practice is legally sanctioned, a surprisingly small number of fatally sick patients ever opt for it, and this has been accredited to the improvement of hospice and palliative care. For most terminally ill patient, dying has become a problem because of the recent advancement in the technology that enables the prolongation of life. This has not only enabled the prolonging of life, but it has also enabled the alleviation of pain, something that was not possible a few decades ago. While many find this to be a good thing, it has led to plenty of anxiety among the terminally ill and the elderly because of the indignity of having to be kept alive on life support not only for month, but also even for years. This has come to raise some extremely difficult questions, not only for policy makers but also for patients and their families.9 Among the questions that have come to be raised is whether it is right for a terminally ill person to be allowed to die, as they wish. The wish of an individual to end his or her life because they cannot bear the pain that they are feeling because of an illness has become the center of the debate concerning physician-assisted suicide. In the latter, a physician is responsible for providing his patient with the means to end their own life so that he or she may be able to escape the pain or incapacitation, which they are undergoing. The ethical question that arises from this is whether it is right for a doctor to provide the patient with the means to end their life, and if this is so, then under what basis should the doctor make his decision. A survey that was carried out in 1996 on physicians showed that quite a high number of them, about 36%, would be willing to hasten the deaths of their terminally ill patients if this process were legal. In addition, 24% of the physicians who were involved in the survey stated that they would be willing to administer a lethal injection as a means of ending the lives of their patients, if it were legal to do so. However, it was found that doctors in Europe, especially France, were more reluctant than their American counterparts do to participate in physician-assisted suicide.10 Doctors are often at the very center of physician-assisted suicides and plenty of studies have been conducted to determine the emotional impact of their participation in this act. It has been found that both the emotional and psychological impacts are quite substantial because it is a shift away from the basic rules of the medical profession. The aim the practice of medicine is to ensure the healing and the preservation of life, and this has been the guiding principle of physicians for centuries. Doctors who have participated in assisted suicides assert that they have been adversely affected by what they have done, especially being shocked by the suddenness of the death, which they have indirectly brought about.11 There are times when doctors are caught in their patient’s determination to end their life and these tend to put a lot of pressure on their doctors to assist them in achieving death. This leaves them in a dilemma because they do not know what to do in such situations; whether to accede to their patient’s request or not. One of the reasons why a doctor may agree to assist his patient to commit suicide is because of the feeling of helplessness that envelopes them when they realize that they cannot do anything more for their patient. Having to witness, the patient’s suffering on a daily basis may drive a doctor to provide the patient with the means to end his or her life. Many of those physicians who are opposed to this practice argue that to do so would be to destroy the trust that exists between doctors and their patients. This is because doctors would no longer be working towards the preservation of life and they will instead have turned themselves into willing executioners of their patients. Those who support assisted suicide, on the other hand, counter the above argument by stating that there is no evidence that shows that a doctor’s participation in any way undermines his or her integrity and that in fact, it works further to increase the integrity of the profession.12 The debate concerning physician-assisted suicide has become so controversial that it has come to be debated based on the constitutional law. When the case was taken before the Supreme Court in 1997, the court unanimously denied that those who were terminally ill had any right to commit suicide, whether it was physician assisted or not. This constitutional question affects very few people because when one considers it, one will find that those who are terminally ill or are mentally incompetent are in the minority. This is therefore not a question that was even considered constitutionally, and this may be the reason why there is so much debate concerning physician assisted suicide. Had the issue been fully addressed by the constitution, then there would have been little need for all the ongoing legal debate on the matter. Despite the ruling that terminally ill patients did not have the right to assisted suicide, the act of suicide itself is not an illegal one in the United States, and many law analysts have stated that the reason for this is that those who commit this act are not present to be prosecuted on account of being dead. Most of the states in America have been provided with the freedom to prohibit assisted suicide, with the sole exception of Oregon, Montana and Washington, which have legalized the practice. In the United States, only three states have made the practice of physician assisted suicide legal and this has been after very long legislative processes. Although the practice has been legalized in these states, strict guidelines have been put in place for physicians to follow when assisting the suicide of their patients. One of these is that the patients should take the death inducing drugs themselves because the physician is not allowed to administer the drugs directly. Another guideline that has been put in place states that a physician can prescribe an overdose of a drug to certain patients to induce their deaths without any fear of legal reprisals.13 It is, however, too early to say whether these three states have opened the way for the legalization of physician assisted suicide in the other states of America. While it is still too early, one would suggest that the right to do this would come to be recognized all over the nation. It is the constitutional right of everyone to make decisions concerning their own destiny and this should not be dictated by either the government or any religious institution.14 This right also applies to those terminally ill patients or those patients who are in such severe pain that cannot be treated. If these patients make the choice to end their lives to stop their suffering, then no one should question their decision or the action taken by their physician to fulfill their wishes. While the Supreme Court may have ruled that assisted suicide is illegal, the ruling sparked a lot of debate concerning the issue at the state level. The debate was set to be because many of the terminally ill tended to choose physician assisted suicide as an alternative to the inadequacy in the quality of the health care that offered to them. The legal question, which was raised in the Glucksberg case, was whether the Due Process Clause of the Fourteenth Amendment of the Constitution was able to give the terminally ill the right to physician-assisted suicide.15 This clause forbids the states from depriving the people of any of their rights and certain physicians used it to argue that they were deprived of their fundamental rights. This was because the law of the state of Washington at the time stated that an individual was culpable if he deliberately aided the promotion of a suicide attempt. At the time (1997) if a person was convicted of such a crime, was subjected to up to five years imprisonment and could be fined up to ten thousand dollars. Some people believe that it is morally right for physician-assisted suicide to be done under certain limited circumstances and because of this, there are both political and judicial lobbies which are working hard towards making this practice legal all over the United States and in many parts of the world, especially in Europe. Therefore, it can be said that a physician-assisted suicide is a very necessary thing for those patients who are incurably ill and request their doctor’s assistance in dying. Not only does this allow them to die a more dignified way than if they were to die naturally, but it also allows them to escape their pain earlier. Although some argue that the suicide of such patients is wrong, they should be made to understand that it is immoral of them to allow a person, who obviously wishes to die due to severe pain, to continue living through artificial means. This is because doing so would not only cause this person severe pain, but it would also defeat the purpose of keeping him alive, because death will eventually catch up with him anyway. Physician assisted suicide has ceased to be just a moral issue that can be discussed only by those who practice medicine. It has come to become a legal and national issue as well because it is something that is likely to affect the lives of almost everyone in the nation at one time or the other.16 The legalization of this practice in the state of Oregon can be used as a test case for its legalization in the rest of America. Since the legalization of physician assisted suicide in Oregon, for example, it has been seen that there has been a reduction in the number of cases where terminally ill patients have requested their doctors to assist them in achieving death. This has been attributed to the ever-increasing improvements in the palliative care of the fatally sick patients.17 Moreover, there seems to have been some improvements in the medications available for the reduction of extreme pain, meaning that some patients no longer wish to end their lives just because they cannot stand the pain anymore. While there has been a reduction in the number of patients who wish to commit suicide, the calls for the legalization of physician-assisted suicide have continued to grow strong, and in fact, lobbies for it are increasingly becoming stronger and plenty of pressure is being put on state governments to make this practice legal.18 With growing support for the practice, one would say that it is only a matter of time before it becomes legalized in all the states of America. Conclusion In conclusion, as it has been said above, physician assisted suicide is one of the practices that are shrouded in plenty of controversy because of the debates concerning it. The controversy surrounding it has been so great that sometimes, it has come to spill into courts, such as the Kevorkian case that took place in 1998. Cases such as the latter end up inflaming the debate concerning this practice because, otherwise when done secretly, it seems not to attract any attention. The only time when attention is given to the issue is when it has media attention, in such cases where an individual is fighting for the right to end his life because he is terminally ill. The debate about the legalization of physician assisted suicide as a means of ending a patient’s suffering remains controversial to this day and the history of this debate suggests that it is periodically given intense attention. Because there is always the fear that a physician might misunderstand their patient’s wishes, there is currently very little support for physician-assisted suicide, but this support is slowly growing. However, physicians need to know how to respond to a request from their patients because whether they like it or not, the requests will keep on coming and some cases may be so bad that they will have no other choice other than assisting them to die. Works Cited Braun, Kathryn L., et al. 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Quill, Timothy E., and Cassell, Christine K. "Professional Organizations' Position Statements on Physician-Assisted Suicide: A Case for Studied Neutrality." Annals of Internal Medicine 138.3 (2003): 208-11. Stevens, Kenneth R. "Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia on Participating Physicians." Issues in Law & Medicine 21.3 (2006): 187-200. Sullivan, A. D., Hedberg, K., & Fleming, D. W. Special report: Legalized physician-assisted suicide in Oregon--the second year. The New England Journal of Medicine, 342.8 (2000): 598-604. Wellman, Carl. "A Legal Right to Physician-Assisted Suicide Defended." Social Theory and Practice 29.1 (2003): 19-38. Ziegler, Stephen J. "Physician-Assisted Suicide and Criminal Prosecution: Are Physicians at Risk?" The Journal of Law, Medicine & Ethics 33.2 (2005): 349-58. Rubin, Edward. “Assisted Suicide, Morality, and Law: Why Prohibiting Assisted Suicide Violates the Establishment Clause.” Vanderbilt Law Review 63.3 (2010): 767 – 810. Read More