The choice a terminally ill patient makes should be available to them in the event they no longer want to suffer. According to Dame Jill Macleod Clark, who sits on the Council of Deans of Health, states “those who have cared for terminally ill patients, friends or family know their greatest fears and anxieties are about intractable sufferings, and their desire for a dignified and peaceful death” (2011).
When patients who are terminally ill want to hear options the argument has been made that all options are not available because assisted suicide comes with scrutiny and consequences. On the other hand opponents of assisted suicide do not believe this is the only way to secure a good health alternative. Opponents believe that it is important to make a patient feel comfortable and help them improve their quality of life not end life just because it is an option or that they may feel they are a burden to loved ones. Assisted suicide can be performed by a physician or a person who is willing to help a patient end their life.
This paper will focus on physician assisted suicide (PAS), this has been a controversial issue in many countries and have many different opinions on the ethics behind assisted suicide. To further examine the data the utilitarian ethics approach will be used. It is important to remember that utilitarian ethics considers the consequences of actions. Indentify the Problem: Assisted suicide is it ethical or unethical? Is it right for a physician to assist a patient to kill themselves?
This is the main focus of assisted suicide and the justification of the situation has been at debate for a long time. The problem is if a physician assists a patient with suicide how are they holding up the oath they took as a doctor. Doctors are healers they are to help a person feel better, make them well, and give them treatment when necessary. “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.
Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life (Code of Medical Ethics, AMA (1994).” The opponents would say it is a physician’s duty to uphold what a patient may want, if the patient is terminally ill and in constant pain, why should they have to suffer? It is important for physicians to care for their patients and give them what they need to sustain a livable life.
To what extent should a physician go to ensure the patient is happy and satisfied with their treatment? At some point a person will know someone who was in constant pain and wanted to end their life only to have to continue with treatment because the attending physician was obligated to do his job, what he went to school for, to ensure the welfare of their patient. The debate is still ongoing as to how assisted suicide would benefit a patient, the pro’s and con’s as well as the consequences of the actions. Clarify Concepts: What is Assisted Suicide?
Assisted suicide can be done by a physician or a person willing to help assist a patient in taking their life. What is Assisted Suicide? Assisted suicide is also known as euthanasia and is defined by dictionary.com as also called , the act of putting to death painlessly or allowing to die, as by withholding extreme medical measures, a person or animal suffering from an incurable, especially a painful, disease or condition (2012).
There are several different kinds of euthanasia, the first can be drugs prescribed by a doctor which is administered by the patient to end life. The second type of euthanasia is by machine, if the patient is on a machine to keep them alive they would request the machine be unhooked to end life. The third and highly debated form of assisted suicide is by physician. A patient may request the help to end their life and this is how the assistance comes into play. A doctor or a person they trust will assist them in passing into the next life. Currently assisted suicide is illegal except in the state of Oregon, the Netherlands and Belgium (Clark, 2011). Indentify Possible Solutions:
Proponents and opponents speak out! According to proponents of assisted suicide terminally ill people who will die are in unbearable pain should not be held to continue to endure the pain against their wishes (Fenigsen, 2011). If laws were put in place to help those who are in this position have a choice, it could keep the cost of assisted living facilities and critically ill facilities down. When faced with a patient who requires knowing their options, the option of assisted suicide should be presented to the patient. How this can be achieved is with a guideline for doctors and nurses to follow when speaking to a patient on their options when having to live in constant pain.
Proponents believe assisted suicide is ethically justified because it is not fair to a patient to continue to endure endless suffering when there are alternatives if they were available. Opponents compare assisted suicide to abortion. There is no justification for ending a life. Pain could possibly bring on a sense of wanting to do more by a patient if shown they could go on and live their lives. Assisted suicide is not the answer to all problems and it is not an answer to a person living in pain. Give the individual a will to live and they will find a way to go on. Examination and Assumptions
Proponents assume that assisted suicide should be legal because it gives a patient the opportunity to determine how they want to end their life. They are given the chance to determine if they want to continue life as they are currently living. The patient would know that at any point in time during their illness they can ask a physician to help them with ending their life. By justifying assisted suicide patients and physicians do not have to fear being found out.
They would be able to perform the suicide without feeling they did an injustice. No injustice to the patient and no injustice by the patient would equal a favorable outcome to assisted suicide. Opponents assume that assisted suicide should not be legal because a physician should do what it takes to ensure a patient is being cared for. There should not be an easy way out of a situation when faced with pain or the idea of knowing one is terminally ill. There are hospices in place to take care of these patients, there are ways to maintain pain and keep it at a minimum.
Life can go on even for those living with pain with the help of family, friends, and a physician. A patient can continue life and possibly have a normal life without ending it suddenly with assisted suicide. Opponents of assisted suicide assume doctors and nurses who support assisted suicide are failing their patients. Opponents assume that if doctors or nurses even give a hint to a patient that assisted suicide may be an option it could give a patient who was looking for support a sense of hopelessness.
This is something that the medical community wants so desperately to avoid. Stephen Wright, who is the chair of the Sacred Space Foundation, put it best when he stated “the debate about assisted suicide is a slippery slope” (2011). Those who are in favor of a change in the law state there is no evidence that legalizing assisted dying leads to vulnerable people being killed against their wishes (Wright, 2011).
But an example of how this did not exactly pan out was in the Netherlands in the 1980’s where it was determined it was legal to let one end one’s own life. With this decision thousands of Dutch patients wanted to have someone help them with assisted suicide requests. Information on assisted suicide and ethics
Dr. Gary Black and Dr. Ronald M. Levine, were physicians licensed to practice medicine in Connecticut. The two doctors put forth to the Connecticut courts a request to be protected from prosecution because they wanted to counsel patients on assisted suicide. Both doctors felt that they should be able to at least counsel patients about the option of assisted suicide because the patients they dealt with had life threatening illnesses such as HIVor other terminal issues.
The courts did not think the two had a basis to change the law or even the wording of the law. The Connecticut courts gave this as the reason as to why they would not change the law for the two doctors: “The court noted that Connecticut citizens have raised a myriad of concerns at public hearings on unsuccessful bills that would have amended [section] 53a-56 to permit physicians to assist their patients in ending their lives.
As one individual testified at a public hearing on Conn. House Bill 6928, "An Act Concerning Death With Dignity" (1994): Is assisted suicide the kind of choice, assuming it can be made in a fixed and rational manner, that we wish to offer a gravely ill person? Will we not sweep up in the process some who are not really tired of life, but think others are tired of them?
Some who do not really want to die, but who feel that they should not live on because to do so when there exists the legal alternative is a selfish and a cowardly act[?] Will not some feel an obligation to have themselves eliminated in order that the funds allocated for their illness might be better used by their families? Or financial worries aside, in order to relive the families of the emotional strain involved[?] (Bostrom, B., 2011).
“The Decision to Leave a Person Alive. The case of Mr. and Mrs. S became well known in Holland because of press reports and TV broadcasts. As a result of an error in anesthesia, Mrs. S had been in a coma for years. Her husband did not abandon her, visited her every three months, and had been very involved on her behalf. He had devoted all those years to intense reflection, and many times had requested the doctors to put an end on her life. "No one wanted to make this kind of decision." But--so reasoned Mr. S--to keep a comatose patient alive is also a decision, and one that needs to be justified” (Fenigsen, R. 2011). Moral Reasoning
We will apply utilitarianism to this dilemma by asking, what solution leads to the greater good? “Utilitarian ethical theory judges the rightness and wrongness of an act in the terms of its consequences in particular, whether it produces the greatest balance of pleasure over suffering for everyone involved (Waller, B., 2011).”
A simple act such as physician assisted suicide may seem simple the patient is suffering, and the patient wants to end their suffering, therefore why not help them end their life. This simple act would come with consequences as with any act. The medical community would be frowned upon; physicians are no longer keeping to an oath they took to be a doctor. The utilitarian would say that we should consider what specific act would produce the best overall consequences (Waller, B., 2011).
The act of a physician assisting in suicide could not possibly have a positive outcome, after all a life has been taken. On one side we have these positive outcomes if we allow assisted suicide, the civil right of a person who is terminally ill and wants to end his and his family's suffering once and for all would be protected. A person will get the right to die without pain and with dignity. Finally allowing assisted suicide would protect patients who are terminally ill because only those who really need it will be helped whiles others will not.
But there are also many negative outcomes if we allow assisted suicide. Assisted suicide is against majority of religions. The elderly could become a target for assisted suicide by physicians or even family members. Depressed people who are not fully aware may want assisted suicide and not realize the task they are asking to be performed. Assisted suicide may at some point be taken for granted by healthcare.
The cost of taking care of a terminally ill patient can decrease if assisted suicide was available. Also the fact that some patients may not be able to pay for the medical treatment and the patient may feel ending his or her life would stop the mounting costs. Given these two lists, it would be hard to say which one outweighs the other. For assisted suicide to be justified and legal both sides would have to be carefully considered.
A utilitarian would not agree if the assisted suicide was based on the patient’s request. The utilitarian would remind us that other people are affected by a patient’s decision. Even if assisted suicide would be in the best interest of the patient, it may be considered wrong because of the effect it could have on loved one. If loved ones were to support the patient’s decision to terminate their life then the utilitarian would agree that the decision would be beneficial. If we are to use the utilitarian point of view as to whether assisted suicide should be legal, then if it is legal the moral way to ensure that the legal system works is to ensure the best consequences come from the action.
Consequences Assisted suicide could work for the patient who is critically ill. It would give them a sense of ending the pain. The patient would no longer have to live in pain or be a burden on family who may be taking care of them. Morally physician assisted suicide could not be justified because. Assisted suicide could pose a problem for the patient because family members may not be aware of their loved ones wish. Doctors and nurses could be held liable by the family for assisting or even suggesting assisted suicide.
Those patients wanting assisted suicide could increase if a law was passed allowing patients to ask for help with killing themselves. Currently it is not actable to help a patient in committing suicide but if the law was to take affect and it has in Oregon and other countries, it would pose the ultimate issue. Is it right to kill a person because they are in pain, terminally ill, or have Alzheimer’s? This would open doors for people to ask for assisted suicide when it is not necessary.
Others who want to help people kill themselves would want the right to assist in suicides. If the laws are not governed properly and studied the death rate could be higher than normal. Finally the moral idea of taking a life for no other reason than they wanted it and it was warranted because they had the entire item listed on a checklist completed does not seem ethically correct. Not politically correct but ethically correct, there are no morals or scruples considered when taking a life this way, it is the law so be it.
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Retrieved from Baker Academic One File Euthanasia | define euthanasia at dictionary.com. (2012). Dictionary.com | Find the Meanings and Definitions of Words at Dictionary.com. Retrieved January 28, 2012, from http://dictionary.reference.com/browse/euthanasia Fenigsen, R. (2011, Spring). Other people's lives: reflections on medicine, ethics, and euthanasia. Issues in Law & Medicine, 26(3), 239+.
Retrieved from Baker Academic One File Kendall-Raynor, P. (2011). The legal options open to nurses when patients are ready to die: guidance from the RCN sets out how nurses should respond when a patient raises the issue of assisted suicide. Nursing Standard, 26(8), 14+. Retrieved from Baker Academic One File Opinion 2.211 - physician-assisted suicide. (2012). American Medical Association. Retrieved from http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page Wright, S. (2011). Life on the precipice: beware the unexpected consequences of legalizing assisted suicide and euthanasia. Nursing Standard, 25(36), 26+. Retrieved from Baker Academic One File