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Physician-Assisted Suicide

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Physician-Assisted Suicide

SOC 120
Professor Harrison
29 July 2013

Physician-Assisted Suicide
Imagine a frail elderly woman laying in the nursing home in pain. This woman is 80 years old and has been diagnosed with terminal lung cancer and her heart cannot withstand treatment via radiation or chemotherapy. She has less than six months to live. Day in and day out you pass her room and hear her crying out from the immense pain. The pain medications are no longer working. She’s tired of fighting, tired of hurting, and tired of waiting to die. After consideration and discussions with her family she has decided to ask the doctor to help and end her life. The doctor feels remorse for the elderly lady and wants to help but cannot decide if it is the ethical thing to do because he knows that what he’s being asked to do is considered physician-assisted suicide.
How is physician-assisted suicide any different than regular suicide? Does the fact that a person is terminally ill make it right? Who gets to decide if it is right? These are questions people may ask themselves when deciding whether or not they think physician-assisted suicide is ethical. Whether it is requested or not, many would say it is unethical for a physician to deliberately cause death to a person. Physicians take an oath to first do no harm. Others may say that a person has the right to make his or her own decisions about his or her life. In this paper, I will explore each side of physician-assisted suicide and how it relates to virtue ethics, along with how I feel relativist would see the issue.
Does physician-assisted suicide differ from regular suicide? Physician-assisted suicide is when a physician aides in a patients death by providing the necessary means for a patient to end their life. This is usually done in the form of prescriptions. Regular suicide is when a person intentionally does something in order to end his or her own life. So, if I were asked, is there a difference. I would respond with no. The only difference I see between physician-assisted suicide and regular suicide is that the physician is condoning the act. But, suicide is something that is usually done by younger adults from the result of depression or the result of a teenager being bullied. Where physician-assisted suicide usually occurs in the terminally ill patients, usually elderly. Does the fact they are terminally ill or elderly make a difference? Not to most, most see suicide as suicide. How someone perceives the ethical view of any situation is dependent upon the person’s culture, religion, how he or she was raised, etc. Ethics is not the only thing to consider with physician-assisted suicide, many would argue the legal standpoint as well. Physician-assisted suicide is only legal in four states: Montana, Oregon, Vermont, and Washington. In the other 46 states where it is illegal, 39 states have laws prohibiting assisted suicide, three states suicide by common law, and the remaining four states do not have specific laws or are otherwise unclear on the legality of physician-assisted suicide (ProCon.org, 2013). Three of the four states where physician-assisted suicide is legal have minimum standards and protocols the physicians must follow. Each state minus Montana requires that the resident be at least 18 years of age, with six months or less to live. They also require three separate requests to do so, two oral requests at least 15 days apart and one written request (ProCon.org, 2013). Montana is the only state that no legal protocol is in place and the only requirement is you must be a resident of the state in order to request a physician to assist suicide.
The ethical theory that best describes physician-assisted suicide would be virtue ethics. Virtue ethics focuses more on what makes a person more virtuous instead of focusing on the consequences of the act (Mosser, 2010). People think of doctors as healers, someone who makes the pain go away and someone who makes you feel better. Doctors care for people who are sick and also the ones that are terminally ill. They make sure their patients receive proper care for their illnesses and they assess that the patients receive the proper medications for their illnesses. Doctors also try and keep their patients as free from pain and discomfort as possible. Most people take comfort in knowing that their loved ones are receiving the best care possible from their doctors. Not all individuals look down on doctors for respecting the wishes of the terminally ill, even if that desire is to end their lives so that they no longer have to deal with the pain and suffering. People like to feel as if their loved ones are protected by doctors, they do not want to think of the doctors as murderers. Should a doctor be considered a murderer if they are just fulfilling a patients request? Sometimes doctors are unable to convince a determined patient of any other options, which may lead to them fulfilling the patient’s requests. Is it right for a person to see the doctor as a murderer if they are giving the patient what they want? Just because a doctor try’s to give a patient what they want, does that make him wrong? Many may say that doctors should not have consequences because they are helping a patient out of his pain and agony. What a lot of people do not consider is how is physician-assisted suicide any different than a doctor taking someone off of life support or a physician respecting a person’s DNR and not resuscitating them? When a doctor respects the family’s request and removes a person off of life support they do not receive consequences. So, why are there consequences when the actual patient is making the request to be free of pain? Unfortunately, there are consequences because physician-assisted suicide is illegal in most states. As a society we make decisions upon what is right or wrong depending on the legal standpoint opposed to respecting the desires of the person in which the situation pertains to. When taking all the parts of physician-assisted suicide in to consideration, people still will not see eye to eye. Some may see it as ok, while others will always see it as wrong. This is where relativism comes in. According to Mosser (p.28), “Relativism is the idea that one’s beliefs and values are understood in terms of one’s society, culture, or even one’s own individual values” and “Rather than insisting that there are moral absolutes, moral claims must be interpreted in terms of how they reflect a person’s viewpoint; moral claims are then said to be “right in a given culture” or “wrong for a given society”” (Mosser, 2010). When reading the definition of relativism, I feel it fits the argument on whether or not it is ok for doctors to perform physician-assisted suicide. Regardless of the illness or the pain or suffering someone is facing; many people would argue it is morally wrong for a doctor to willingly end someone’s life. But, relativist would say that physician-assisted suicide is right for those who agree with it and wrong for those who do not. Most of the time when someone is diagnosed with a terminal illness, they live the rest of their lives in pain and either in hospice care or in the hospital. Usually, they don’t get to live the rest of their lives the way they intended; instead they just basically wait to die. Some even end up in the hospitals with machines keeping them alive. Sometimes family members selfishly keep the patient on the machines for themselves instead of just letting the patient go. Looking at the other side of the situation, some people would agree that the patient who is suffering should have the right to make the decision about their own health, even if it means ending their life. If a person is in the right sound of mind and can make choices about other things, then why are they not allowed to choose to not suffer any longer? In Oregon, a patient may request to obtain a prescription for a lethal medication as long as they are “capable” of making the decision and “expected” to die within six months. According to the law in Oregon, a patient must make three request for the medicine, two verbally and one in writing (Chin, Hedberg, Higginson, & Fleming, 1999). But in other states where it is illegal, doctors could face serious consequences. Then when you look at a patient who is relying on a breathing machine or on life support, and a family member chooses to take them off the machines and they die. How is that not the same thing? Personally, my position on physician-assisted suicide is indifferent. I can see and understand where both sides are coming from. I have seen quite a few family members suffer and in pain from cancer. So, when I actually see them suffer, I think they should have a choice. But, I also believe that suicide of any case is morally wrong. I am the type of person who can understand that just because something goes against my morals or ethics, does not mean I cannot see the other side of things. Do I believe that a doctor should have to face consequences for respecting patient’s wishes? No, as long as the doctor made a full disclosure to the person and the person was fully “capable” of making the decision. Just as relativist would see it, I feel that if a person is for physician-assisted suicide than it is morally acceptable for them and if a person is against it then it is morally unacceptable. Why should I get to tell someone that they should or should not live? Even with everything I have read on physician-assisted suicide, I cannot say 100% that I agree with it nor can I say 100% that I do not. What I can say is that I believe that every person has the right to make his or her own decisions. In the article Physician-Assisted Suicide: Death With Dignity? (p.111), talks about how “physicians should consider a patient’s quality of life as being equally important as their quantity of life when determining who should live” (Friend, 2011). I feel this is something everyone should think about and consider before passing judgment on physician-assisted suicide. For instance, we have Jane. Jane was in a car accident and suffered severe brain damage. She is in the “vegetable” state with machines keeping her alive. The doctor shares this information with Jane’s family. Jane’s family decides this is not the life Jane would want for herself, instead she would rather be set free. So, the doctor removes Jane from life support. Then we have Karen. Karen is an 80-year-old woman dying from terminal cancer. She has decided on her own free will that she ready to die and asks the doctor for help. Many would see the first scenario as morally right but see the second one as morally wrong. I see it as at least the lady is getting to make her own decision and it is not being made for her. Many elderly with terminal illnesses see physician-assisted suicide as a chance to die with “dignity”. Some advocates of physician-assisted suicide see it as (p.114) “expiring without unnecessary physical suffering” (Friend, 2011) and that patients have the right to die and not have to have dependency on others. Many elderly fear being a burden on there loved ones. They do not like having to be cared for as if they are children again. When they become helpless, it becomes embarrassing to them. As stated in Physician-Assisted Suicide: Death With Dignity? (p.114), “Pain is not the main reason we want to die. It’s the inability to get out of bed or get onto the toilet” (Friend, 2011). Sometimes when distraught from the conditions they are facing, elderly lose their dignity when they become dependent on others. At least physician-assisted suicide is a decision they can make in order to “die with dignity”. Some people do not see physician-assisted suicide as a desirable option; instead they see it as a last resort. If the distress of the pain and suffering are alleviated they may not choose to end their lives. Should our terminally ill elderly receive better, more palliative care when dying, assisted suicide may become less significant. Physician-assisted suicide would be less important with the right alternatives (Dworkin, 2000). There are alternative to physician-assisted suicide. An alternative to assisted suicide would be proper pain management. Some would say that palliative medicine addresses all aspects of the patients needs. Palliative care is the medical care provided by a team of doctors and nurses that not only specializes in the relief but, it also focuses on alleviative the stress of an illness. Specialist in palliative care believe that if all patients had access to detailed assessment and optimal symptom control with supportive care, then most people suffering from life-threatening illnesses will be less likely to desire for hastened death. Palliative care improves the quality of life while providing an extra layer of support to the patients (Center to Advance Palliative Care, 2012). With the proper medications and support there are alternatives to physician-assisted suicide. Should a person choose to not continue suffering and is without a doubt ready to die, then that should be their decision. We should allow someone suffering and in pain the opportunity to choose his or her fate and be able to die with dignity. Shall a person choose to end their life, then the doctor should not be held accountable for it and have to face consequences. I feel that the doctors who are asked to assisted in the death of a person, should fully disclose any information to the patient and try to get the patient to fully consider there decision. All in all, just like everything else in life, we should be able to make our own decisions. Unfortunately, whether anyone believes it to be morally right or morally wrong, it is illegal in most states.

References

Arthur E. Chin, M., Katrina Hedberg, M. M., Grant K. Higginson, M. M., & David W. Fleming, M. (1999). Legalized Physician-Assisted Suicide in Oregon- The First Year's Experience. The New England Journal of Medicine , 577-583.
Mosser, K. (2010). Ethics & Social Responsibility. San Diego: Bridgepoint Inc.
ProCon.org. (2013, May 28). State-by-State Guide to Physician-Assisted Suicide. Retrieved July 12, 2013, from ProCon.org: http://euthanasia.procon.org/view.resource.php?resourceID=000132

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