Writing a Claim of Policy Essay
Claim- There should be a universal standard regarding the legality of physician-assisted suicide.
1. Overview, Purpose and historical background
Definition of Terms
Some of the key terms in this paper that the reader needs to be conversant with include, suicide, assisted suicide, and physician assisted suicide. Kopelman and De Ville write that suicide is the taking of one’s life without being forced by from one’s self will. This means that when a suicide is committed, the victim has the willingness to die with him or herself. Kopelman and De Ville continue to explain that an action is considered as physician assisted suicide when medical personnel is involved in the process of making a patient to end his or her own life. This would be in terms of the prescription of drugs or being involved in the administration of lethal injection that leads to the death of the patient (Loretta, 2001, p.13).
Overview
Physician assisted suicide is a contentious topic in the medical field today. Aiding a suffering patient to commit suicide, write Snyder and Kaplan that though the execution of physician assisted suicide might be viewed as a way to relief paper in the ailing victims, the passing of a universal policy that allows both nurses and physicians to be involved in the practice might produce detrimental outcomes to the medical field (Lois, 2002, p.130). The greatest concern within the society to today is whether physician assisted suicide should be allowed in any form. Bachman et al, of the Massachusetts Medical Society, write that the people who are in support of physician assisted suicide argue that the exercise of this medical practice is able to reduce the suffering that is experienced by patients. In addition, physician assisted suicide is able to reduce the dependency of patients on nurses and other personnel which might either cost money or may at times produce emotional stress in the part of relatives and patients. Supporters of physician assisted suicide also claim that the failure of various nation-states to legalize the practice might increase the number of underground dealing because the urge to die is an increasing need in the patient fraternity in the contemporary hospital environment (Jerald, 1996, p.303). On the contrary, Bachman et al explains that those who are opposed to the presence of a universal policy regarding the legality of physician assisted suicide argue that the legalizing of the medical practice would lead to the change of moral values which have a great respect for life. Bachman et al writes that as much as nurses and other medical personnel would be willing to see to it that the needs of the patient fraternity are met, the fact remains that the legalizing of physician assisted suicide might produce unintended consequences that could be prevented in the first place. To the opponents of the practice, it is worthy protecting life through the considering of the practice illegal than putting the life of many patients at stake due to the needs of a few people who do not value the fundamentals of morality (Jerald, 2003, p.331).
Historical background & Current Situation
The first incidence of physician assisted suicide in the United States took place in Oregon in March 1998. In this incidence, a woman from the state of Oregon was suffering from breast cancer was in the verge of death when she asked her physician to give her a kind of medication that would be help her to terminate her life faster so that she could reduce the amount of pain that she was going through. Seeing the agony that the patient was going through at the time, the doctor did not have any other choice that grants the patient what she had asked for. After a period of one month the woman took the drug and died peacefully. This became the first incidence in the United States where a physician had legally been able to carry out the practice of physician assisted suicide (Pretzer, 2000, p.1). In the United States, physician assisted suicide is legal only in the states of Oregon, Washington, and Montana (Brad, 2010, p.1). Some of the countries that have legalized physician assisted suicide in Europe include Belgium, Luxembourg, the Netherlands, and Switzerland (Bosshard, 2008, p.1). Most of the countries in Africa and Asia consider physician assisted suicide as being illegal.
This paper intends to conduct a survey in order to determine the attitudes of the general public towards physician assisted suicide and the factors that shape these attitudes. Some of these factors include age, religion, level of education, support for existing legislation towards physician assisted suicide, culture , and the past experience of the respondent with a patient considering physician assisted suicide. This survey involves a total of 186 participants. 55 participants are from the United States while 131 are from 5 metropolitan areas in the city of Nairobi, Kenya.
2. Review of Literature
Emanuel et al, write that there is has been no research that has been conducted to determine whether relative of the people considering PAS are comfortable with the choices that their family members make regarding the practice. (Ezekiel, 2000, p.2461). This means that there is a general agreement among many researchers that PAS is gaining acceptability among patients, physicians, and the general public over time. In fact, writes Cohen et al, most studies have shown that though PAS has been considered as a practice that puts morality at stake, there is a reasonable proportion of the general public that is interested in the legalization of the practice. In addition, there are many factions and organization working towards lobbying for the legalization of the practice in many countries (Cohen, 1994, p.89). Some of the flaws that exist in studies trying to determine the exact attitudes of the general public are that attitudes are sometimes unstable. For example, a given participant may be a strong supporter of PAS but some occurrences like having a close relative who is considering PAS might change their attitudes over time. Wolfe et al, writes that there has not been any studies that have been carried out to investigate whether there is consistency in the stand of patients and the general public with regards to the legality of physician assisted suicide (Wolfe, 2003, p.1275).
These findings lay the ground work for my research in that my survey seeks to determine which factors affect the attitudes of the general public. In my survey, it is evident that factors like having a close relative or friend considering PAS might cause members of the general public to be more opposed to the practice. The structural functionalism paradigm shapes my research design. This is because, this survey takes into consideration that the each society works maintaining its stability. This means that every society is in the process of gaining a social equilibrium. Some of the factors that determine the stability of a society include the stability of social values and social norms. This paper considers the increased debate over the legality of PAS, as a process of society stabilization because the society is moving towards obtaining a common ground on the issue of PAS.
3. Methodological Design
Population
The sample population in this Survey came from both the United States and Nairobi, Kenya. This survey chose these two distinct populations due to the following factors. First of all, the population from the United States was expected to be well off economically which means that it would be easier for this population to get better medication and at the same time afford the expenses. On the other hand, the population from Nairobi, Kenya was considered as being lower in terms of economic power and the ability to afford continued medication for terminally ill patients.
Another important reason why this survey chose these two populations is because of the difference in culture. The United States, as a country in the West, is more likely to have more flexibility in terms of their take on social issues. This means that it was expected that more people from the United States were more likely to be supportive of PAS compared to the participants from Nairobi, Kenya. The population from Nairobi Kenya was expected to be more against PAS since many would see it as a western idea which contrary to the African culture that centers on morality and the value of life.
Sample size and Data collection methods
This survey targeted a total of 200 participants. However, only 186 responded to the survey. Out of the total respondents 55 were from the United States while 131 came from Nairobi Kenya. Some of the sampling methods that were used in conducting data during this survey include: survey monkey, face book, email, one on one talks, and phone calls. Out of the total population sample, 11 were reached using survey monkey, 164 through face book, 4 via email, 4 via one on one talks, and 5 were contacted through phone calls. Fig 1.1 below shows the sampling methods used in collecting data and the number of respondents reached using each sampling method.
Appendix A:
Fig1.1. Pie Chart Showing the number of respondents reached by each sampling method.
Completion rate
Out of all the data collection methods used, face book seemed to be the most efficient in terms of collecting large amounts of data using a short time. This is because most people are likely to visit the social media more than they check there email. This is because the social media not only provides the ability to communicate but also offers other pleasures like looking at photos from all over the world, commenting on people’s statuses, and catching up with friends. Using face book was also more efficient compared to other data collection methods because one can ask the respondent more questions like the reason why they support or do not support PAS. In addition, face book was economical compared to other data collection methods like phone calls that require the purchase of calling cards. Therefore, it was easier and faster to complete the surveying process compared to other methods of data collection.
Though one on one talks are also efficient in terms of thorough interviewing of respondents, one had to reserve interviews and meetings. Using face book saved those meetings because it is possible to ask people question using face book even at time when they are in the middle of other activities. In fact, the mere fact that a person has logged on their face book page indicates that the person is not very busy.
Time dimension & Unit of Analysis
This was a quantitative survey because it involved the comparison figures in terms of which segment of the general public; based on factors like education, religion, level of education; would be more likely to support or oppose PAS. This survey was also cross-sectional because it did not have a time dimension to it. The survey focused on the attitudes of the participants at the time that they were being surveyed.
The independent variables in this survey include age, religion, level of education, and the fact that a respondent has a close relative who has performed or considered PAS. The number of respondents in support or against PAS based on the above independent variables is the dependent variable.
4. Results and Data Analysis
Age & Physician assisted suicide
The age of the sample population ranged from 15 to 47 years. According the survey, majority of the people between 15 and 17 years seemed to be against PAS. When asked the reasons why they opposed PAS, some of them explained that their bringing up and parental advice played a role in their opinion regarding PAS. This indicates that those between the age of 15 and 17 have not yet begun to think independently. Their ideas and perception of social issues is based on that of their parents and guardians. In addition, a fraction of those of supported PAS also explained that their opinions were shaped by the fact that there parents supported PAS.
However, between the age of 18 and 29, it seemed that majority of the population supported PAS. When asked some of the reasons why they supported most of them argued that it is important to move past the moral fabric while looking at some of the social issues. Though their individual arguments about the reason why they supported PAS differed, it was evident that they were independent in their reasoning. The support for PAS begun to reduce between the age of 40 and 47. Some of the arguments that people within this age group gave for opposing PAS is the fact that today’s generation is so radical and liberal. Most of them were concerned that legalization of PAS showed that the current generation does not value human life. Taking a generation as having a life span of 20 years, it seems that the population over the age of 40 is in a completely different generation. Fig 1.2 shows the support and opposition of PAS based on the age of the sampled population in this survey.
Appendix B:
Fig 1.1: Graph showing the support and opposition of PAS based on age.
Religion & Physician Assisted Suicide
Many Christian denominations maintain that life is for God. Therefore, man does not have the right to terminate his life at his own will. The majority of the sampled population which was against PAS, quoted the sixth commandment in Deuteronomy 5: 6-20, King James Version which states that “thou shall not kill.” Despite the high value of life in Christian denominations, it was evident that there was a population in these churches that supported PAS. However, majority of this population was composed of the youth. This means that the higher the number of youth in a given denomination, the more likely the denomination supports PAS.
Appendix C
Fig 1.3: Graph showing the support and opposition of PAS based on religion
Physician assisted suicide & level of education
According to the survey, the more educated a person is educated the more they were likely to support PAS. However, more support for PAS was evident among college students. This relationship is however not linear because majority of the people past graduate school were less likely to support PAS. This can be attributed to the fact that people past graduate school are older which means that they are part of another generation that might not be as liberal as the current generation between the age of 18 and 29.
Appendix D:
Fig 1.4: Graph showing support and opposition of PAS based on education
5. Ethical Issues
Some of the ethical risks that were involved while conducting this survey include the fact the I had to assure my sample population that any information that they provided would remain protected. I did this by assuring them that their names would not appear in any document. However, a fraction of my population did not care much about their confidentiality though I still intend to keep their comments and contributions to the survey confidential. Another ethical challenge that I encountered was the fact that some people were shy to give information regarding PAS especially due to their religious commitments. I therefore had a difficult task trying to convince them that their opinion would be protected even though it was against their denomination’s doctrines and dogmas.
6. Conclusion.
In conclusion, physician assisted suicide is a controversial topic in society today. Every side of the divide has strong arguments to support their opinions. Despite the existing debate over the topic, the fact remains that PAS is gaining acceptability within the society today. However, the support for PAS is based on a couple of factors. These factors include but not limited to, age, level of education, religion, culture, and whether or not a respondent has had a close relative who has performed or considered PAS. It is therefore worthwhile to conclude that it is expected that more states are going to legalize PAS as the acceptability for the practice continues to increase within the today’s society.
Bachman, J G, Kirsten H Alcser, David J Doukas, Richard L Lichtenstein, Amy
D Corning, and Howard Brody(1996). "Attitudes of Michigan Physicians and the
Public Toward Legalizing Physician-Assisted Suicide and Voluntary
Euthanasia." New England Journal of Medicine 334, no. 5 : 303-309.
Bosshard, G, B Broeckaert, D Clark, L Materstvedt, J, B Gordijn, and H C
Müller-Busch.(2008) "A role for doctors in assisted dying? An analysis of legal
regulations and medical professional positions in six European countries ."
Journal of Medical Ethics 34, no: 28-32. doi:10.1136/
jme.2006.018911 .
Cohen, Jonathan S, Stephan D Fihn, Edward J Boyko, Albert R Jonsen, and Robert W
Wood(1994) "Attitudes Toward Assisted Suicide and Euthanasia Among Physicians in
Washington State." The New England Journal of Medicine 331, no. 2 (June
Emanuel, Ezekiel, J, and Diane L Fairclough.(2000) "Attitudes and Desires Related to
Euthanasia and Physician-Assisted Suicide Among Terminally Ill Patients and
Their Caregivers." The Journal of the American Medical Association 284, no.
19 2460-2468. http://jama.ama-assn.org/content/284/19/
2460.
King James Version(1995) New York: American Bible Society.
Knickerbocker, B. (2010) "Montana becomes third state to legalize physician-assisted
suicide." The Christian Science Monitor,
http://www.csmonitor.com/USA/2010/0102/
Montana-becomes-third-state-to-legalize-physician-assisted-suicide.
Kopelman, Loretta M, and Kenneth Allen De Ville(2010). Physician-Assisted Suicide:
What Are the Issues? Norwell, MA: Kluwer Academic Publishers.
Pretzer, Michael(2000) "Assisted suicide Should it be legal." CNNHealth, January 25,
http://articles.cnn.com/2000-01-25/health/
assisted.suicide.wmd_1_physicianassisted-suicide-terminally-ill-patients-deadly-d
rug?_s=PM:HEALTH.
Snyder, Lois, and Arthur Caplan, L(2002)Assisted Suicide: Finding Common Ground.
Indianapolis, IN: Indiana University Press.
Wolfe, Joanne, Diane Fairclough, L, Brian Clarridge, R, Elisabeth Daniels, R,
and Ezekiel Emanuel, J.(1999) "Stability of Attitudes Regarding
Physician-Assisted Suicide and Euthanasia Among Oncology Patients,
Physicians, and the General Public ." Journal of Clinical Oncology 17, no.
4): 1274. http://171.66.121.246/content/17/4/1274.full.
