Physician Assisted Suicide
The issues surrounding the practice of Physician-Assisted Suicide (PAS) are contentious for most people. In the last few years, the issue of PAS has elicited a passionate debate in both the United States and the rest of the world. PAS was first entrenched into the country’s legal system in 1997 when ‘The Oregon Death with Dignity Act’ became law (Emanuel 510). In the following year, the law was put into practice when a woman who was suffering from cancer killed herself using a lethal dosage of drugs.
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Since 1996, PAS has been used as a tool for terminating the life of many ailing people especially those who suffer from terminal illnesses. Nevertheless, PAS does not cover the patients who are in life support or the ones who do not have the ability to ask their doctors for assistance. The debate on PAS brings together a variety of stakeholders including medical practitioners, religious scholars, politicians, human rights activists, and law practitioners among others (Emanuel 507). A majority of the people who voice their support towards PAS argue that “it is a patient’s right to end his/her suffering with a quick, dignified, and compassionate death” (Beauchamp & Childress 56). It is also argued that PAS issues are not different from marriage, abortion, and procreation matters. Opponents of PAS cite the doctor’s Hippocratic Oath as the main defense against PAS. Also, opponents of PAS contend that suffering of any magnitude is part of human existence and it should not justify the ending of human life. This paper is an argument against the use of PAS as a tool for ending human suffering. It is important to note that a doctor’s main goal is to ‘fix’ his/her patients and it is not to ‘end’ their existence. The Hippocratic Oath covers the doctors’ life purpose by alluding to the ancient premise of ‘nonmaleficence’. The underlying principle in the doctor’s Hippocratic Oath is that any healthcare provider “should use treatment to help the sick according to his/her ability and judgment and should not use it to injure or hurt his/her patients” (Volker 154). A doctor’s main purpose is to avoid harming his/her patients but PAS goes against this core medical principle. It is hard for anyone who has taken a Hippocratic Oath to justify the killing of a patient. Those who support PAS argue that it is not a doctor’s right to decide whether a certain patient lives or dies. Also, a patient has the right to make decisions concerning his/her own life. This argument is a generalization of facts because, in several areas of jurisdiction, suicide is illegal. On the other hand, a patient entrusts a doctor with all treatment-related decisions concerning his/her life. Under no circumstances is a patient supposed to give professional medical practitioner directions about how he/she should be treated. Consequently, a patient should not be at liberty to issue PAS related directions to a doctor. It is also important to note that the Hippocratic Oath does not put into account the wishes of the patient.
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It is common for people to misuse laws and initiatives that might be instituted in good faith. Therefore, PAS might be misused to substantiate cases of involuntary euthanasia. Laws are usually formulated gradually and PAS might just be a prelude of things to come. Medical practitioners have expressed their concern that PAS might open the floodgates of unethical medical practices. Nevertheless, those who support PAS feel that these claims are exaggerated. On the other hand, research indicates that in areas where PAS is being practiced there are several instances of misuse. For example, “a study that was conducted in the Netherlands found that roughly 1,000 patients die due to the result of an end-of-life decision made without their explicit consent” (Dieterle 128). To ensure that some patients do not meet their untimely deaths in the course of their treatment, it is important to do away with the practice of PAS. The protests against PAS are not solely based on hyperbolic claims but they are also backed up by scientific research studies. Most patients only make PAS related requests as a result of various psychological distresses. Consequently, some patients will often rethink their decisions when they are subjected to a healthy amount of psychotherapy. When most people are suffering from terminal diseases, they tend to be bombarded by a wave of negativity that is manifested in depression and hopelessness. A psychological study that was conducted in New York found that “a dying patient’s thinking is preoccupied with negative reactions that relate to his/her critical condition” (Dieterle 130). Therefore, a terminally ill patient is most likely to request for PAS because he/she is feeling hopeless about issues such as lack of treatment options, expensive treatment options, and guilt of being a burden to his/her family among others. It is unlikely that a person who is going through these psychological issues is in a position to make a well-informed and independent decision concerning PAS. It is more effective to subject terminally ill patients to psychotherapy before presenting them with the PAS option. Studies have indicated that after patients are given enough therapy and counseling they mostly decide to do away with PAS. Proponents of PAS have argued that the patients who seek PAS are very determined in their resolve (Kamisar 895). However, research has indicated that this ‘resolve’ is only temporary and it is greatly undermined by therapy and counseling.
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Medical practitioners have a lot of influence when it comes to decisions concerning PAS. Consequently, most of what is considered a patient’s decision is, in reality, a physician’s decision. This hypothesis brings up the issue of some patients being duped into accepting PAS. For example, PAS could provide some interested parties with an avenue for coercing patients into choosing life-terminating options. It is apparent that most terminally ill patients are in a great deal of pain and it disorients them (Ersek 47). Therefore, some of the PAS choices that are made by terminal patients are mostly influenced by third parties. This anomaly gives ‘interested parties’ such as hospital administrations, health insurance companies, and estranged family members a chance to forward their agendas. Furthermore, PAS can be used to target the most vulnerable members of the society including disabled persons, minorities, the elderly, and poor people. Most of these groups lack the necessary ammunition to defend themselves in cases of PAS-related victimization. Therefore, to ensure that PAS is not used to victimize some members of the society, it should be done away with entirely. Proponents of PAS use the provisions of the American Constitution to support their arguments. For instance, PAS proponents cite the provisions of the Fourteenth Amendment of the United States’ Constitution that prohibit any party from depriving persons “life, liberty, or property without due process of the law: nor deny any person ….the equal protection of the laws” (Gannon and Garland 129). The inclusion of free will in the American constitution is interpreted to mean that people are at liberty to choose death over life. However, this assumption is overruled by several other constitutional clauses. For example, the American constitution also calls for the preservation of life. Therefore, the Fourteenth Amendment cannot be used to support a patient’s decision to end his/her life with the help of a medical practitioner. Some individuals can use PAS as an easy way out that serves their selfish interests. Some patients use PAS to service their insecurities when it comes to individual health. The availability of the PAS option in medical care undermines the purpose of the profession and its professionals. Traditionally, medicine is a profession that champions for the wellbeing of individuals and not the surrender of practitioners and their patients (Ersek 50). Interestingly, some of the patients who have been considered terminally ill have gone ahead and regained their health. Cases of patients ‘beating’ terminal illnesses have mostly been referred to as ‘medical miracles’. The sheer existence of these medical miracles eliminates the need for PAS because each terminally ill individual has a chance to live a healthy life in the future.
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There are various arguments and counter-arguments that surround the debate on PAS. However, most of the presented arguments indicate that “the idea of PAS does not fit into the modern medical practice” (Ersek 50). PAS is contradictory for the doctors who have taken a Hippocratic Oath, and it undermines the traditional institution of medicine. Also, the laws that govern the institution of PAS can easily be misused by parties who might be seeking to serve their selfish interests. Therefore, the practice of PAS does not fit into the institutions of modern medical practice. Instead of propagating PAS, stakeholders should pursue other life-affirming practices such as palliative care (Kamisar 895). Works Cited Beauchamp, T. L., and J. F. Childress. Principles of Biomedical Ethics, New York: Oxford University Press, 2009. Print. Dieterle, J. M. “Physician assisted suicide: a new look at the arguments.” Bioethics 21.3 (2007): 127-139. Print. Emanuel, Ezekiel. “The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians.” Jama 280.6 (2008): 507-513. Print. Ersek, Mary. “The continuing challenge of assisted death.” Journal of Hospice & Palliative Nursing 6.1 (2004): 46-59. Print. Gannon, Craig, and Eva Garland. “Legalisation of euthanasia and assisted suicide: a professional’s view.” International journal of palliative nursing 14.3 (2008): 127-131. Print. Kamisar, Yale. “On the meaning and impact of the physician-assisted suicide cases.” Minnesota Law Review 82.1 (2007): 895. Print. Volker, Deborah L. “The Oregon experience with assisted suicide.” Journal of Nursing Law 11.3 (2007): 152-162. Print.