Whether Physician-Assisted Suicide Is Ethical for Terminally Ill Patients - Coursework Example

SUICIDE The current report looks at the question of whether physician assisted suicide is ethical for terminally ill patients. This is a complicated question, because although the patient and their relatives may even wish for this, the physician is often compromised because they feel that through the Hippocratic Oath, by assisting patient suicide they are going against the oath by doing harm. But the alternative is often a long death that is known to be more drawn out and painful for the patient, if there is no assisted suicide, which from this perspective could be defined as mercy killing. By looking at existing literature on physician assisted suicide and attendant debate, one can become more informed about this issue and reach more logical conclusions. It is often difficult to reach logical conclusions on issues that are surrounded by a lot of debate, especially when the debate is political. People remember names like Terri Schaivo and Jack Kervorkian, and they have a certain sensationalist image of the process. But overall, this is a process that may be best seen on a case to case basis. Ethics is the way that people feel about a certain issue based on their opinions. Ethics is not the same as religion but it is the same purpose in some ways. The issue of euthanasia or assisted suicide is an ethical issue. It involves the way people feel about ending their lives in a medical situation with a doctor, when to go on living would cause them too much pain or mean that they would be in a vegetative coma, or a state where they cannot communicate or move or have brain function, and want the doctors to discontinue saving them through life support. Ethics also involves something that doctors take called the Hippocratic Oath, which is what medical ethics comes from, the abovementioned promise that the physician takes in the oath, not to do any harm to the patient. “In many respects, the modern death-with-dignity debate is an extension of the ethical, legal, and medical arguments surrounding the New Jersey Supreme Court's unanimous ruling on March 31, 1976, that allowed Julia and Joseph Quinlan to remove their daughter Karen from life-support equipment” (Hallock, 1999). There are many different individual cases. As noted above, there are many arguments about euthanasia because it is an ethical issue and many people disagree on ethical issues. Euthanasia is often also defined as mercy killing, n which a doctor or another person permits someone to die because they are seen to be hopelessly sick or injured. “Assisted suicide, particularly in the health care context, exists amid a continuum of end-of life interventions. Any analysis of the ethics… must begin by making clear… Assisted suicide refers to making available to an individual, the means to take his or her own life” (Mathes, p. 261). Many people think that euthanasia is favorable because it spares people of pain and suffering and lets people make their own choices about whether to die or not. People see this as democracy working to let individuals make their own decisions. Other individuals may state that these individuals are not always capable of making these decisions due to their conditions. “Even if someone sincerely wants to be euthanasia this may well be due to depression or to a misapprehension of their true prognosis” (Snort, 2004). The moral significance of euthanasia is mixed. Everyone has heard a story about a patient’s miraculous recovery, when doctors and even relatives have given up hope. This is not to say miraculous in a specifically religious way, but to say that no one expected the patient to live, and thought that they were a terminal case, but they recovered. This happens all the time and doctors are confounded. To quote Dr. Paul Byrne, “The law should protect a citizen from being determined or pronounced dead before death has occurred” (Snort, 2004). We hear these stories of recovery and are more positive as a society. Patients should naturally trust their doctors in the society we live in. This relationship might be compromised morally by assisted suicide or euthanasia. But more important is the relationship between patients and their families with assisted suicide as an option for them. Families might even advise the patient to consider assisted suicide because of financial reasons- it is not impossible. Euthanasia is very cheap compared to the complex procedures that are required to save someone and keep them living. There are many perspectives on the issue of physician assisted suicide. For example, also the patient might accept assisted suicide because they feel guilty morally for being such a burden on their family. This might make them change their minds and decide that they want assisted suicide just because they do not want to continue to be a burden and feel less guilty. This does not mean that they really want to die. And it also does not mean that dying is the same thing as dead. “If brain death and death were identical and equivalent, there would have been no need to coin ‘brain death’” (Snort, 2004). And it especially does not mean that we should kill them off or induce these thoughts because they are seriously ill. In terms of arguments in favor of euthanasia, there are many points of view. In existing studies, one of the most effective arguments for active euthanasia involves the potential erasure of future pain and pointless struggle in a patient who is beyond help and has chosen euthanasia as an option to end their pointless suffering, not continue it unnecessarily. As sources display in several clear examples, passive euthanasia often involves a drawn-out period of suffering for the patient, who dies naturally, unaided, and often in great pain. Using the example of a Down’s Syndrome baby left to die naturally over an agonizing period of time, one author appropriately asks, “Why should anyone favor letting ‘dehydration and infection wither a tiny being over hours and days?’” (Rachel 535). There is no one who stands to gain emotionally from this process of drawn-out death, while active euthanasia would have both erased the future pain of the baby and eased the suffering of the parents and the troubled feelings of the doctors involved. These doctors are in any case being made to give up a struggle against death that they undoubtedly felt very strongly about. It seems especially cruel to make doctors face the fact that they are giving up to their enemy, death, and to enforce this fact by making them leave the patient alone to die slowly and in agony. Active euthanasia would perhaps give the doctor less of a feeling of having been made to consciously give a patient up to death. One can see clearly that passive euthanasia and active euthanasia are respectively promoting increased pain and the erasure of future pain. “Some medical ethicists warned then that the ruling was the beginning of a trend--the so-called slippery slope--which, followed to its logical conclusion, could lead to decisions to end a person's life being made by third parties not only on the basis of medical condition but also on such considerations as age, economic status, or even ethnicity.” (Hallock, 1999). It only makes rational sense that doctors would want to see less pain being suffered by the patient, but unfortunately, conventional notions of morality get in the way of the legalization of active euthanasia, connecting it inappropriately with the same murder that doing nothing to help the patient equally achieves. In terms of arguments against euthanasia, there are also many perspectives and points of view. Some state that the practice of assisted suicide also goes against the statement of the Hippocratic Oath that all doctors must take to help people and do them no harm. Even if it is a mercy killing, it is still a killing. Overall, some believe that assisted suicide is an important issue that addresses our society in the way it thinks about being positive and helping people and protecting their lives. Some do not think that assisted suicide reflects these ideals and do not agree with the practice of killing to prevent what may or may not be future conditions in the unknown by doctors who have sworn to protect life and therefore not to murder people, even if they think it is for good. Many people classify people who are against euthanasia as religious people who are extremists and have opinions about other issues but this is not always the case. There are many arguments against euthanasia that are not religious in nature but reflect on society and individuals without thinking of God or the idea of “playing God.” These are the most sound arguments because they use logic and understanding instead of spiritualism to pronounce their opinions. Overall, you don’t have to be religious to see society as something that is positive and individuals who should strive to help each other out in every way possible to get along best. This also means protecting life as individuals and not harming each other or destroying human life by direct actions of killing. This is especially true of those who are very sick: we are not like animals in that we cast off our sick and weak to the predators when we have the ability to save their lives. Those who are against euthanasia argue that we are not supposed to be a society that endorses the killing of innocent people just because they are vulnerable and that we should not stand by and watch people kill themselves by euthanasia. In terms of my opinion, I think that the Hippocratic Oath is taken by doctors who swear that “The health and life of my patient will be my first consideration” (“First Do”). They swear that they will not do any harm to a patient intentionally. Therefore euthanasia goes against these principles set up by the Hippocratic Oath directly. Doctors who follow a person’s choice to die when they could be kept living are not considering the health or life of the patient. In fact, they are discounting both. Further than this, the fact that people can choose to die is making saving their lives less important to doctors. We could have a lot more research now about how to cure diseases if people couldn’t choose to be killed instead of being treated, which could turn out for the best. What kind of progress can be made in fighting disease when the doctor doesn’t have to fight the disease anymore? Doctors take their struggle against death very seriously as reflected by the Hippocratic Oath. They view death as the enemy, and with euthanasia, the enemy is winning. A patient who is suffering naturally will want to put an end to their suffering. But it is the doctor’s job to reduce this suffering and find new ways to cure the patient, and this cannot be possible when the patient can choose to die and the doctor has to give them up to death. With euthanasia this is not the case. Doctors do not want to kill people. They do not want the responsibility of assisted suicide, even though “Older Americans are less likely to favor legalization than younger ones. Those who are more educated are more likely to be in favor of legalizing physician-assisted suicide” (Final Request, 2001). It creates serious stress because it goes against their training and oaths and this can even affect a doctor’s psychology. Overall I do not think that assisted suicide reflects the ideals of a society that is positive where people help each other and protect life. I do not agree with the practice of killing people especially because these people may elect to die without knowing their true prognosis or they might have been misdiagnosed. It is too much risk. Mercy killing is still killing and doctors who have sworn the Hippocratic Oath to do no harm are compromised by assisted suicide. “The debate over assisted suicide will continue to be waged at the ballot box, in legislatures, in courts of law and in the court of public opinion. Its importance merits not only meticulous examination, but also the commitment and dedication of those who seek to protect individuals, families and society” (Rachel). Many people think that assisted suicide is democratic and fair but to me it is more like the system of a dictator or fascist than one that is found in a democratic republic. It makes me wonder if sometime soon it will not just be voluntary and that it will start killing people who are too sick to live no matter what, in a nightmare future society. Perhaps the most persuasive argument is not when one is arguing about the physical effects of active and passive euthanasia, but when one is arguing about the thoughts and philosophies behind these two polarized actions in an attempt to show the their essential similarities. Time and again in the extant literature, authors prove to be deep thinkers with a rational frame of mind that is keen on the uses of logic to aid in persuading the readers. Some sources show that while killing and letting die may be dissimilar in their means, that both men had the same ends in mind when they performed, or did not perform, their actions. Did the difference in their actions matter morally? One asks, “Did either man behave better, from a moral point of view? If the difference between killing and letting die were in itself a morally important matter… but does one really want to say that?” (Rachel 537). This effectively showed that both men shared the same motive and same ends, and only the physical nature of their actions separated them. In this way, they prove action and inaction to be, if not the same, the inconsequential gray area between defining motivations and ends, which are ultimately what matters. Thus, active and passive euthanasia are shown to be the same basic decision regarding the motivation, which is the cessation of suffering, and the ends, which is death. Whether or not the patient suffers unnecessarily between the supposed cessation of suffering and death seems to be really the only difference between the two forms of euthanasia. It is the same ultimate result, and with active euthanasia, the result comes more quickly and with less pain for the patient. “We have in effect recognized, most certainly in the case of competent patients ... that people have a right not to be made to suffer if it is their competent choice that death is preferable. So, if we're going to talk about physician-assisted suicide, the only thing we're talking about is a different means of accomplishing the same end” (Hallock, 1999). When it comes down to logical arguments, there are many different sides to be taken. Although this report has argued against physician assisted suicide, it is also something to think about, that the erasure of future pain is something that might benefit everyone in the situation, including the patient, the physician, and the patient’s support system. Ultimately, it should be the choice of the person and their family, not the doctor or insurance. WORKS CITED Hallock, S. “Physician-assisted suicide: "slippery slope" or civil right?” Humanist, 1999. Mathes, M. “Assisted Suicide and Nursing Ethics.” MedSurg Nursing 13(4), 2004. Rachel, James. “Active and Passive Euthanasia.” AORN Journal pp. 532-42. Snort, William Bradford. “The Healing Philosopher.” Issues in Law and Medicine 20(2), 2004. “Final Request.” American Demographics, 2001. Read More