Arguments for Assisted Suicide - Essay Example

The argument for assisted suicide Introduction In order to create a discussion about the idea of assisted suicide, one must chose a side in the debate and develop an ethical and moral choice. The difficulty in deciding how to frame this discussion, however, is in the rhetoric and language with which it is discussed. The name of the topic in itself is a problem. It is termed assisted suicide, automatically assuming all of the implications that the word suicide provides. However, in examining this concept, one can begin to understand that it is not framed appropriately by this type of language, thus the inflammatory political debates are not being approached in a medically beneficially manner. Thus, the concept of assisted suicide when done with the purpose of hastening the inevitable where disease has already prepared the body for death should become a part of a the standard for care that is given to individuals who wish to avoid the pain of disease, the loss of mental facilities when dying, or to avoid the expense of an unnecessarily prolonged extension of a life that is already lost. Language and Definitions The word suicide is defined as “the act of killing yourself” (Jeffers & Smith, 2007, p. 81). While this is a simple definition, it lacks the appropriate level of nuance in order to fully define the full reference to everything that it implies. Suicide is the act of taking one’s own life, but it is also an act that brings with it a series of cultural images that imply sin, socially adverse action, and culturally shameful action. In Western cultures, taking one’s own life is generally considered a sin and in the United States, it is an illegal act that has criminal consequences. This can be seen in the way that Cleave (2001) reflects her definition of suicide when she states that it is “the act of killing yourself, often while mentally unstable” (p, 146). This also becomes a part of the discussion in that it is assumed that in taking one’s life it is done under the influence of mental instability. Other terminology that can be used to describe the event of taking one’s life when placed in the position of having a disease that is going to take one’s life is to call the event voluntary euthanasia. This becomes a less volatile terminology that can be discussed on terms that do not suggest sin, mental instability, and can call into question policies of illegality. A definition of voluntary euthanasia is that it “takes place when a patient who is dying or who is in intolerable pain asks someone to help him or her to die to avoid any further suffering” (Cleave, 2001, p. 22). Most cultures, including the Western culture, is very linguistically affected by how different terminologies are used to define a topic. However, the word euthanasia is more often associated with the act of putting down an animal, so therefore that term is also not sufficient for the discussion. Suicide and Culture The event in question concerns helping someone who for one reason or another has decided to end their life. The most basic reason for suicide, that an individual is miserable and decides to end a life that has become unbearable purely for reasons that are based upon how they feel within their life, is a type of suicide that cannot be socially supported in Western cultures. According to Barnes, Golden, and Peterson (2010), men complete suicide more often than women, Montana has a higher rate of suicide over New Jersey, and people in the Eastern European country of Belarus have a higher rate of suicide than the United States. China, on the other hand, has a much higher rate of completed suicide by women than men. Culture is highly relevant to the rate of suicide and more importantly, 60% of all suicides are attributed to depression. Attributing suicide to depression, however, is based upon theory rather than medical evaluation and is a culturally based definition of why most people will take their lives (p. 36). Once again, it is how the topic is discussed that frames the event, the language that is used in forming the concept that defines its presence within society. The association to depression, while a clinically evaluated disease, is still a disease that is assessed through a determination and is often undiagnosed previous to the event of suicide. Therefore, the cultural assessment of suicide is that it occurs because individuals have been influenced by a feeling of despair that is caused by mental illness, therefore it cannot have been a decision made through sound and evaluative thinking. This social evaluation of suicide has influenced the way in which the choice to end one’s life because of terminal illness has been assessed. Society has yet to acknowledge the benefits of assisted suicide when the decision has been made to end one’s own suffering, but the event of suicide is best done under the care of a medical professional, or a friend who helps to ease the burden of self inflicting the event of suicide. Finding a relatively painless way to die when life has become unbearable is not a right that has been given in the United States. Assisting someone else to die is considered murder and is a burden to anyone who agrees to provide that service. Dr. Jack Kevorkian Dr. Jack Kevorkian is the most renowned physician to support assisted suicide. His beliefs extended to anyone who desired to end their own life. One of the more famous quotes from this doctor was simply that “dying is not a crime” (Wells & Quash, 2010, p. 329). He has reported that he assisted in the suicides of more than 130 patients and although highly criticized and even imprisoned for his actions and public discourse on the topic, his efforts have helped to promote the cause of physician assisted suicide to help end the suffering of those who are doomed by their disease. One of the criticisms of his methods, however, include too short of a period of counseling before the event and that some of his assists were done for people who were not, in the opinion of those in the medical and legal professions who assessed his work, suffering enough to qualify for such aid. Dr. Kevorkian was accused of not using stringent methods in determining the suitability of assisted suicide in the cases that he attended. According to his own structures of assessing patients, he intended on having in place extensive psychiatric evaluations, chronic pain management potentials examined, and the use of minimum waiting periods in order to allow for impulsivity to not be present within the decision. In an article for the Detroit Free Press, Kirk Cheyfitz reported in 2007 that Kevorkian was not following his own guidelines and was violating the process that Kevorkian himself had put into place. However, Dr. Kevorkian’s lawyer admitted to these problems and blamed them on the fact that most of the work that Kevorkian had done had been done under the threat of prosecution, thus limiting the amount of pre-evaluation that could be done. The point of violating the law and assisting in these suicides was to reveal to the world that this was an important part of the rights of the ill, thus his scramble against the law prevented much of the work he intended applying to his structures. According to Dr. Kevorkian’s lawyer Geoffrey Feiger “it is often (was) not practical for Kevorkian to follow the safeguards he has publicly embraced. Psychiatrists and pain specialists are frequently reluctant to cooperate” (Cheyfitz, 2007). Therefore, like many social problems where law has not caught up with the realities of the situation, back room deals about the subject do not adequately support the safety of those who desire and/or need the service that is in question. With the varieties of legal problems that exist about the issue, it is very difficult for those who are trying to support the rights of the ill to end their suffering face inadequacies in providing for services leading up to the event. Dr. Kevorkian spent eight years of a ten to twenty-five year sentence for second-degree murder. After the broadcast of an incident of assisted suicide in which he televised the event on the news program 60 Minutes where he injected Thomas Youk with a lethal injection. Youk was suffering from the terminal illness of amyotrophic lateral sclerosis. Up to this time, Dr. Kevorkian had never administered the lethal drug, but has been present while his patients administered their lethal dose on their own (Rae, 2009, p. 226). Arguments Against Assisted Suicide According to Rae (2009) the idea of assisted suicide is morally wrong. The argument against assisted suicide begins with a belief that the ability to control pain and suffering is available to almost all those who have illness and that there are relatively few people who are in such dire straits to need to end their lives to end their suffering. In addition, there are ways to induce sleep or coma so that suffering is not felt or experienced by the patient, thus early death is not necessary. According to Rae (2009) “it is morally justifiable under what is called “the law of double effect” to prescribe a sufficient dosage of medication to relieve the pain even if one of the possible side effects is hastening the death of the patient” (p. 227). In other words, if a physician ups the dosage of morphine in order to relieve the pain of a patient, this is morally acceptable even if this places the patient in a state that will bring about death from overdose. In this type of thinking, it is the intent that is central to the morality of the action. An additional argument against assisted suicide is made in regard to the public good. Rae (2009) suggests that in sanctioning assisted suicide, the social implications are far too dangerous in balance with the individual autonomy or individual good that can be accomplished. In sanctioning the right to die, society is then devaluing human life. The idea that has been promoted suggests that in providing positive consequences for the individual, one may not be promoting the overall good of society; therefore the deontological morality is violated. The morality of the event is not related to the consequences of the action, thus just because assisted suicide provides a positive outcome for the individual, it is immoral as it affects the philosophically established morality of society. The third area of argument that Rae (2009) brings to the discussion is that in opening the door to assisted suicide for those who agree to the procedure, it allows physicians to kill those who are terminally ill, but not able or willing to give consent. In other words, if the legality of assisted suicide is made available, it will encourage the use of murder to end the suffering or to terminate patients who are terminally ill. These three arguments against the legality of assisted suicide are once again rooted in rhetoric, discourse being twisted in order to find reasons against allowing this type of legalized service to be legalized. The concept of the sanctity of life is so deeply rooted in the morality of some social groups that any legalized venue for ending life is a moral outrage that cannot be tolerated. Therefore, the reasons become rooted in the abstract without the realities of conditions being considered for the potential that they provide. Counter Arguments for Assisted Suicide The first argument presented by Rae (2009) suggests that from a philosophical point of view, assisted suicide is morally and ethically wrong due to the intent of taking life rather than an intent that is defined by relieving suffering. Because the idea of taking human life is considered wrong through all moral and ethical standards, the intent to end one’s life due to a bleak future from illness is considered a wrong action. To decide that to end a human life is wrong is a decision, not an absolute. Christian belief systems have developed to believe that suicide is an affront to God and to the gift of life and to the challenges that have been assessed through His will. It is through Augustine that this belief system was created. According to Brody (1989), “Although there is little reason to think that Augustine’s position is authentically Christian…it nevertheless rapidly took hold and within an extremely short time had become universally accepted as fundamental law” (p. 80). Brody (1989) argues that this was built upon a foundation of patristic literature that was clarified through Augustine by using values that had been implied within the Biblical resources. One must look at the medical profession as it exists, however, to find a way to balance these beliefs. When Augustine was writing the methods to prolong life during illness were almost non-existent. In this age, life can almost always be prolonged well past the point of having true value to the individual when illness is being treated and diagnosed. The nature of having an illness has changed dramatically, thus the belief systems associated with how to define life must also change. Those who suffer from illnesses that steal the quality of life and if left to nature would end far sooner than with medical treatment must naturally be considered for medically ending them when the pain, suffering, and quality of life has been extended in such a way to leave the patient suffering for longer than God might have intended. In other words, if an individual takes courses of chemotherapy that extends their life beyond what nature would have allowed, should not the medical community then assist if those treatments fail to support a cure and will provide a long period of suffering until death? If life is artificially extended but a cure is not provided and treatment extends the life into longer periods of pain, the medical community should be able to counterbalance that effect through a choice to end life before the long period of illness creates far greater devaluation of the quality of life. If examined through the utilitarian philosophy of ethics, the value of the act of assisted suicide to the individual provides the moral foundation for supporting the legality of assisted suicide. The social problems that some perceive relevant to assisted suicide are based upon the idea that it devalues human life to support any form of the taking of life. Gorusch (2009) quotes Judge Posner who said “respect for human life must have something to do with the perceptions of the value, not wholly metaphysically, of that life” (p. 160). Additionally, Gorusch (2009) quotes Ronald Dworkin who said that a person who has Alzheimer’s, as an example “no longer capable of the acts that can give [life] value. Value cannot be poured into a life from the outside; it must be generated by the person whose life it is, and this is no longer possible” (p. 160). In speaking to anyone with the illness, one would be certain that the value of life has escaped them; they are no longer present within their life and incapable of expressing themselves as themselves. If an individual chose to end their life before this happened when a diagnosis of Alzheimer’s has been made, it is clear that this decision is made to preserve the value of their life as it had been lived and not surrender it to the devaluation that might come from the disease. The choice to live is valid, but so also is the choice to not live. The third argument is a moot point. The idea that assisted suicide will lead to blatant murder is inconsistent. Just as Dr. Kevorkian set guidelines that he wished he could have followed to assure the value of the event of assisted suicide, so too would the state set guidelines and laws that would define the difference between assisted suicide and medical murder. In supporting assisted suicide, the medical community would still be placed under strict guidelines that provide for proof of the desires of the patient. If assisted suicide was extended to family members, then proof would need to be provided that the patient had agreed to the procedure. This argument does not have sufficiently viable reason behind it as it is based upon suppositions that allowing one circumstance provides an allowance for a completely different event. Conclusion The concept of assisted suicide for those who are suffering as a result of illness provides for a discussion about how culture creates a language about concepts that provides for moral and ethical implications. In discussing the concept of suicide, notions of sin and mental instability are evoked. In discussing the idea of voluntary euthanasia, the idea of putting animals down is evoked. Therefore, the debate first begins in understanding the problems with the language used to discuss the problem. Dr. Jack Kevorkian used social disobedience in order to support his beliefs, even going as far as to go to prison for his actions. In supporting the issue, he was forced to abandon his own guidelines, but showed the importance for those guidelines which supports the need for social control over the event. While the issue can be argued for its moral and ethical implications, the autonomy of the individual and the need for relief when illness is not going to provide for a high quality of life is a socially important issue. A society that not only provides medical care for those in need, but provides for relief when medical care cannot support the value and quality of life will show that philosophical evolution and cultural enlightenment is in effect, giving the individual importance enough to both serve them in their health and ease them when the end is near. References Barnes, D. H., R. N. Golden, & F. L. Peterson. (2010). The truth about suicide. New York: Facts On File. Brody, B. A. (1989). Suicide and euthanasia: Historical and contemporary themes. Dordrecht: Kluwer Academic Publishers. Cheyfitz, K. (25 May 2007). Suicide Machine: Kevorkian rushes to fulfill his clients’ desire to die. Detroit Free Press. Retrieved from http://www.freep.com/article/20070527/NEWS 05/70525061/SUICIDE-MACHINE-PART-1 Cleave, Joanne. (2001). Christianity: behaviour, attitudes & lifestyles. Oxford: Heinemann. Gorsuch, N. M. (2009). The future of assisted suicide and euthanasia. Princeton, N.J: Princeton University Press. Gorsuch, N. M. (2009). The future of assisted suicide and euthanasia. Princeton, N.J: Princeton University Press. Jeffers, Steven L., & Harold Ivan Smith. (2007). Finding a sacred oasis in grief: a resource manual for pastoral care givers. Oxford: Radcliffe. Rae, S. B. (2009). Moral choices: An introduction to ethics. Grand Rapids, Mich: Zondervan. Wells, S., & Quash, B. (2010). Introducing Christian ethics. Chichester, West Sussex, U.K: Wiley-Blackwell. Read More