Physician Assisted Suicide in the United States - Research Paper Example

Physician Assisted Suicide in the United s Introduction Physician assisted suicide has long been a topic of controversy, creating a stream of theories that approach the topic from angles such as the psychiatric side of the event to the moral and ethical side of the debate. The issue of suicide has been one that has had proponents from both sides arguing the value of choice versus the impositions of a mind that is obviously not clear, thus for psychiatric reasons, is not in a position to make the decision towards such an end. One of the most common reasons for people to make the choice to end their life, outside of mental health issues, is because they have been diagnosed with an incurable disease or condition that will create a burden financially, create a burden of care on the family, and/or will cause a great deal of pain if life is not ended before full deterioration occurs. The primary debate on the legalization of physician-assisted suicide seems to be centered on the idea that if made legal, the use of it as an end treatment would be abused and patients would be vulnerable through the absence of alternative care. Because the nature of medical treatment has been commercialized and the availability of good care is often subject to the amount of money available to the patient, the use of physician-assisted suicide might become a focus of how to care for a number of patients who have no alternative resources, rather than providing substantive care where availability is decreased. The focus of the debate, in order to create a system in which the least possible harm is developed, is in the fear of the abuse of the treatment by doctors. Suicide Emile Durkheim in his discourse on the topic of suicide challenges the reader to consider if it is different for a person in a psychosis to hallucinate and walk off the edge of a building than it is for someone to take an action knowing that it will result in death. Both deaths are considered a suicide, but one is done with the conscious thought of death, while the other is done in a hallucinatory state that results in death. Furthering that course of thought, one must consider if it is different to simply stop eating, knowing that this passive act will end in death, or to take a violent, proactive step such as shooting one’s self in the head. The question then can turn to the reason for the action, whether passive or aggressive, that will end in death. One must contemplate whether or not it is always considered suicide if an action will inevitably end in death. If this is true, as Durkheim points out, then a soldier who bravely enters into a situation that is likely to end in death, but will save others, would also be committing suicide. However, the nature of the outcome is also not a part of the definition or the result of an action. In order to define a death a suicide, then, it is important to consider the intent of the action that will come to the result in death. In considering the different frames of action and thought when suicide is approached, it then shifts to consider the differences that can be appreciated in the reasons that one might wish to end their life. According to Holmes and Holmes, suicide is defined by taking an action that ends one’s life. They do not embellish or extend the discussion in the way that Durkheim does, but they simply define the term as an active pursuit of the outcome of death. They further clarify the ambiguity of the term by saying “suicide is a behavior that differs from one person to another and from one time to another and has different motivations and anticipated gains” (2). Therefore, in defining suicide, one must understand that no clear definition applies, but that it is fluid and flexible depending on the variables involved in the event or events that lead to death. Every year, an approximate 30,000 people commit suicide within the United States. Suicide is the 11th most common cause of death, with homicide ranking at 14th. Suicide is the third leading cause of death among people age 15-24, thus the problem of suicide is something that must be considered for its importance in the human experience. The differences that can be appreciated between those who have made this choice provide the context in which the debate must be made over how suicide can be acceptable, and when it cannot be acceptable. The theory that can be most relevant to the event of suicide is that of pleasure-pain principle. In this theory of motivation, a human being is motivated by whatever will “increase pleasure and decrease pain” (Weiner 356). Thus, where suicide is concerned, it is often considered that by ending life, the pain will end. One of the core questions in discussing suicide is in the possibility of the pain ending without the end of life being necessary. Of course, the person who commits suicide is of the belief that ending life is the only solution that is viable. One set of people who consider suicide is that of the terminally or chronically ill who have no hope of relief from the terms of their illness or condition. When considered where the pleasure-pain principle is concerned, the patient has decided that the pain of their disease and the worsening of that condition can only be resolved by decreasing the pain through ending life. Physician-Assisted Suicide Physician-assisted suicide is defined as physicians who provide “the knowledge and/or means” through which the patient commits suicide (Hayry 21). Physician-assisted suicide is a social policy, a framework of thinking in which either one approves or disapproves of the concept of the use of a professional doctor in order to efficiently end life. As a society, the policies that define how the public will address the topic is not as simply defined from a perspective of right and wrong. Both sides of the debate claim their own righteousness and condemn the opinion of the other side of the issue. In 1997, the US Supreme court brought down the decision that the decision for physician-assisted suicide was not a constitutional issue, thus placing it within the jurisdiction of the states. Justice Sandra Day O’Conner stated as a summary of the opinion that “no legal barriers (should exist) to obtaining medication from qualified physicians to alleviate that suffering, even to the point of causing unconsciousness and hastening death”(Hendin and Foley 2). Even though the issues was tossed back into the states for clarification on whether to legalize or make illegal physician-assisted suicide, the justices did clarify that the patient had a right to be alleviated from pain by whatever extent the physician had available to him. One of the debates against the idea of physician-assisted suicide is because there is a belief that it will open the door to abuses. The state of the terminally ill is such that they are vulnerable and this could mean that by legalizing physician-assisted suicide, some people who actually do not want to die, would be ‘assisted’ to the other side in order to alleviate the burden that is placed on the community where services and assistance in managing many illnesses is unavailable or too expensive (Hendin and Foley 1). From this perspective, the true desires of the patient would be subverted to a system in which assisted suicide was a viable course of treatment, thus creating a pressure on patients to make use of this treatment. According to Hendin and Foley, “the World Health Organization recommendation (is) that governments not consider the legalization of physician-assisted suicide and euthanasia until they have demonstrated the full availability and practice of palliative care for all citizens” (2). This perspective of the argument does not completely deny the use of such assistance, but does suggest that because of inadequacies in the current system, the potential for abuse of assisted suicide does not allow for its use as a treatment. Doctor Jack Kevorkian became the symbol for the other side of the debate in which the idea of helping people to pass more quickly when faced with a long term illness with no hope found a leader and a face in which to center the debate. In 1990, his first assisted suicide was conducted in which an Alzheimer’s patient named Janet Adkins was helped by Dr. Kevorkian to die. His methods were centered on devices that he built that made it easy for patients to push a button and deliver a dose of medications that would end life. Therefore, when he was charged with murder tin the death of Adkins, Michigan, which had no laws against suicide at the time, had to release him as he did not, himself, deliver the medications that killed her (Nicol and Wylie 151). Dr. Kevorkian aided more than 130 people towards self directed deaths and became known as ‘Dr. Death’ because of his activism and participation in assisted suicide (Nicol and Wylie 24). Because of his strong beliefs and the nature of his flamboyant personality, Dr. Kevorkian often become an adversary to the opposing opinion on the topic. In 1998, he allowed one of the taped sessions of his assisted suicides to be aired on an episode of 60 minutes. In this film, Dr. Kevorkian was shown giving a shot to the subject, a 52 year old man with Amyotrophic Lateral Sclerosis. Because he gave the shot to the man, he was arrested and charged with murder. Dr. Kevorkain was arrested and charged with second - degree murder and was not released until 2007 after being denied parole on several occasions as it was believed that he would continue his activities after release. In 2007 he was granted a compassionate parole because of failing health. Legal Issues While a bit eccentric and can be termed as out of his mind, he did have a way with creating controversy around his cause. In going to prison to support his belief systems, the issue of physician-assisted suicide raged in a debate that still exists. In Washington v. Glucksberg, the issue of the legality of physician-assisted suicide was brought into question in regard to the Fourteenth Amendment. The argument was made that “the existence of a liberty existence protected by the Fourteenth Amendment which extends to a personal choice by a mentally competent, terminally at will adult to commit physician-assisted suicide” (Stephens and Scheb 448). The results of the suit continued the support for maintaining the illegality of the use of physician-assisted suicide, but did help to raise questions and inspire debate on the topic. While in Washington v Glucksberg the Supreme Court held that a person did not have a right to commit suicide and therefore did not have the right to assistance in committing this act, there was nothing that would prevent a state from taking a stance in support of physician-assisted suicide and making it legal for a physician to provide this kind of assistance. A state has the right to declare that it be legal to conduct an event such as a suicide and to allow for such events to occur. Gonzales v. Oregan challenged the state rights to permit physician-assisted suicide in relationship to the federal laws. However, it was upheld that the state of Oregon had the right to permit such a use of medication, thus supports the right for the state to allow for the humane treatment of people who would desire to end their life when the quality of life had become so low, or the potential of that quality of life to diminish beyond bearable levels (Pollock 156). According to Pollack, “Research …indicates that many people who request physician-assisted suicide withdraw that request if their depression and pain are treated. Thus, lawful physician-assisted suicide could make it more difficult for the State to protect depressed or mentally ill persons, or those who are suffering from untreated pain, from suicidal impulses” (158). The dilemma on how to frame the nature of the future is at the core of the debate. To a patient who sees an unending future of pain that lingers long past the point of quality of life, the idea of suicide might be appealing. However, there is no way in which to fully assess how a patient will react to drug therapies. The pain could not be as bad as anticipated, thus the patient would not have chosen to die rather than endure with family and friends for as long as possible. In allowing for physician-assisted suicide, the nature of the future is then defined by what is suspected, rather than what is experienced. Conclusion The nature of freedom where life is concerned is defined by the laws of the United States through the ability of a person to support his or her belief that the choices that have been made are based upon what is reasonable and within the boundaries of healthy and informed consent. The problem with consent where physician-assisted suicide is concerned is that the individual who is committing the act may not be making this decision through a clear mind, their thoughts clouded by the pressures of mental illness that does not allow for a clear choice about ending life. Depression often accompanies many illnesses, thus clouding the judgment of the one who suffers from it. Therefore, the dilemma is centered on the capacity for the individual to make a choice when they are hampered by mental diseases that specifically target their ability to make a clear choice about their future. The pleasure-pain principle of motivation is the basis for the choices that most people will make concerning ending their life. Therefore, it can be observed that when pain is managed, people will decrease their desire to end their life. Providing adequate pain management is the key to decreasing the number of people who are interested in physician-assisted suicide and it has been shown that it is a right of individuals to seek care that will relieve their suffering. According to the WHO, nations should not allow for the legalization of physician-assisted suicide unless their healthcare systems are capable of full patient care that allows for all manner of management of their illnesses. If physician-assisted suicide is legalized, abuse is easily possible. Works Cited Behuniak, Susan M, and Arthur G. Svenson. Physician-assisted Suicide: The Anatomy of a Constitutional Law Issue. Lanham: Rowman & Littlefield Publishers, 2003. Print. Durkheim, Emile. Suicide: A study in sociology. London: Routledge, 2002. Print. Hayry, Matti. Bioethics and Social Reality. Amsterdam [u.a.: Rodopi, 2005. Print. Hendin, Herbert, and Kathleen M. Foley. The Case against Assisted Suicide: For the Right to End-of-Life Care. Baltimore: Johns Hopkins University Press, 2002. Print. Holmes, Ronald M, and Stephen T. Holmes. Suicide: Theory, Practice, and Investigation. Thousand Oaks: Sage Publications, 2005. Print. Nicol, Neal, and Harry Wylie. Between the Dying and the Dead: Dr. Jack Kevorkian's Life and the Battle to Legalize Euthanasia. Madison, Wis: Univ. of Wisconsin Press, 2006. Print. Pollock, Earl E. The Supreme Court and American Democracy: Case Studies on Judicial Review and Public Policy. Westport, Conn: Greenwood Press, 2009. Print. Stephens, Otis H, and John M. Scheb. American Constitutional Law: Volume Ii. Princeton, N.J: Recording for the Blind & Dyslexic, 2008. Sound recording. Weiner, Bernard. Human Motivation: Metaphors, Theories, and Research. Newbury Park, Calif: Sage, 1992. Print. Read More