[Client’s name]
The word suicide implies self-killing, and it may be either assisted or unassisted. Physician-assisted suicide falls under the category of assisted suicide where the person providing backing is the doctor. A doctor assisting a patient of terminal cancer in taking his own life by providing him with the means or the information necessary for committing self-killing would be an example of physician-assisted suicide. The word euthanasia, also referred to as mercy killing, is often used synonymously with assisted suicide. It is a Greek word where ‘eu’ means right, and ‘Thanatos’ means death. The word euthanasia therefore adds up to the real end. Euthanasia and assisted suicide both connote the same thing, except for a trivial difference between the two. Whereas in physician-assisted suicide, the physician provides the necessary information or means and the patient himself commits the act, in euthanasia, the case is a bit different. In euthanasia, the physician performs the act of ending the patient’s life, by using several means one of which would be giving the patient a lethal dose of an injection. There are two main classifications of euthanasia, active and passive euthanasia. In active euthanasia, the patient’s life is ended though physical intervention, that is steps are taken to end his/her life. In passive euthanasia, the patient’s death is brought about withholding life-saving treatment or artificial life support. Examples include removing an incurable patient from ventilators or bypass.
As requests for physician-assisted suicide mount coupled with an increase in medical development, the debate regarding the moral footing of such suicide grows more and more frenzied. Our laws and moral values have always safeguarded human life and any peril or loss by any person has been punished with the most severe inflictions, regardless of whether it is in the form of murder or suicide. While presenting arguments in favor of assisted suicide we often contest that every patient should have the autonomy to choose when and how he wants to die. Also, since the act of bringing about one’s death by withholding treatment isn’t considered illegal or unethical, how then is active killing of oneself by taking toxic medication any different? The arguments in opposition to assisted suicide however are more convincing. A lot of people give the religious argument. Many religions including Christianity, Islam and Jewish believe that since God gives life, only He has the power to take it. Those who practice religion ambitiously consider assisted suicide an atrocity. Also, many are concerned that legalizing euthanasia could bring changes to the medical field we might later come to regret. In addition, requesting a doctor or a nurse to carry out euthanasia or request assistance in suicide could violate the fundamental ethical rights that members of the medical profession stand by.
Let us discuss the standings of the US law on the matter. While doctors in the states have been permitted to advise lethal doses of medicine to patients in five out of the 50 states, Euthanasia remains illegal. The law was first legalized in the US in the state of Oregon and was implemented in 1997. This law became the basis for laws in the other U.S. states and the state of Washington approved a law that was modeled on the same one. Then during the last year i.e.: 2013, the legislature of Vermont passed a similar law and thereafter, the practice was legalized in Montana and most recently in New Mexico . A few conditions need to be fulfilled before assisted suicide could be considered to have taken place legally. Firstly, a certification provided by at least two physicians shall state that the patient has a terminal illness and that he may have less than six months to live. Secondly, the formal request for suicide shall be made by the patient himself and should be a witness by at least one person who is not the patient’s relative. Finally, the patient should be afforded a waiting period giving him an opportunity to revoke his decision. When we talk about the legal situation around the world, it is safe to say that very few countries have taken the initiatives to legalize assisted suicide or euthanasia. Many fear the adverse consequences that are likely to result from legalizing any of the two acts and many fears that doing so may let loose many abominations in the world. The legal system in Australia does not recognize either assisted suicide or euthanasia. Canada, India, Israel, Italy, Russia, Spain and the UK are on the same standings as Australia where both acts are punished with the most severe consequences. A few countries however have laws regarding euthanasia that are not clearly defined, but where assisted suicide is illegal. These include Colombia and Japan. In addition, in a few countries, both the laws are legal which include Belgium where both actions are legal since 2002, Luxembourg, where both are legal since February 2008 and the Netherlands where both laws are legal since 2001. Laws of Germany and Switzerland do not permit euthanasia but assisted suicide is legal in both countries.
The country of Switzerland has since an extensive time had assisted suicide legalized. A study published in the Journal of medical ethics has found for the same reason an increase in the number of people travelling to Switzerland for assisted suicide. From 2008-2012, researchers stated that 611 people had committed assisted suicide of which 60 percent were women. Majority of those 611 people had come from Germany, Britain and France, and Twenty-one of these people had arrived from the United States . The question that is relevant here is why? Why do patients request assisted suicide, and why did these particular patients go through the trouble of crossing various number of borders to fulfill a death wish? The patients’ choice to commit assisted suicide or request euthanasia could be attributed to an extensive number of logic. Those who study assisted suicide as well as euthanasia have divided the reasons into three broad categories. Most patients fear Illness related experiences. They might have concerns regarding feeling weak, tired and uncomfortable; or losing the functions of their body; or pain or unacceptable side effects of the pain medications. The second category involves concerns regarding threats to sense of self. Patients usually have despaired for losing their sense of self, or losing their desire for self-control; or they may even request death due to long-standing beliefs in favor of hastened death. The third category covers fears about the future. This category involves fears regarding the future quality of life; and negative past experiences with fear of dying; and lastly the patients may be overwhelmed by the anxiety of living as a burden on others .
What course of actions should then a physician take if faced with the request to aid in assisted suicide, or to carry out euthanasia? The doctor should explore the patient’s request and discover the underlying reasons for such appeal, and work out if the patient’s request could be resolved using any other means. It is often possible and simple to work out another way to fulfill the patient’s wish. The physician could, therefore, pursue the following steps when responding to a patient’s request for assisted suicide. The first step is to discuss with the patient various ways of addressing his/her pain and fears. The patient’s request should not be responded to before taking the said course of action and making sure that the patient is not hazy or indecisive about his decision. The second step is to evaluate the patient for any signs of depression or other psychological indications and treat for the relevant concerns. The third step involves addressing the patient’s decision-making competencies. This could be done by engaging the patient in discussion about the patient’s diagnosis, prognosis and the purpose of care to assess the patient’s mental capabilities. The doctor should appraise the patient’s physical, mental and social suffering as the next step. The fifth step involves discussing with the patient alternative course of action including alternative medication or medical treatments. As the sixth step, the doctor should discuss the case with his fellow colleagues and obtain other necessary consultations. The last step would be to help the patient complete all the documental formalities before he could be giving any life claiming medication or advice.
There are a few social issues associated with the legalization of assisted suicide. A patient could very effortlessly be coerced or pressured by family members or other relatives into committing suicide and the patient alone may not be responsible for taking this decision. The patient’s autonomy could very easily become his death sentence. In addition, the patients could be misinformed regarding their medical condition and many deaths could occur due to misdiagnosis or miscommunications. Conjointly, the excuse of euthanasia and assisted suicide could without trouble be used as an excuse as getting away with murder. Attributing to the legalization of assisted suicide, the differentiation between suicide and murder could become hard to perceive. In a like manner, the decisions for assisted suicide could be made irrationally. On top of all this, the restrictions imposed on assisted suicide could very conveniently be broadened to include suicides for less acceptable reasons. There could be a number of ambiguous medical cases to which conditions of euthanasia may not apply . What follows hereafter is the story of Barbra Mancini who lived in Philadelphia at the time of the incident. Barbra allegedly handed her 93-year-old father a bottle of morphine. Did Barbra want to relieve her sick father of the pain and suffering that came from his sick health, or did he want for him to die and rest in peace, it is very hard to say. Joe Yourshaw, Barbra’s father, died for days later. At the time of his stay at the hospital, Yourshaw was awoke after being given an antidote, and after he was told that his daughter might be in trouble, “Don’t hurt Barbra” was his cry. Barbra later told the Police Captain that her father wanted to die, and for that reason, she gave him the morphine. Now, at 57 years of age, a mother and a wife Barbra faces trial while her supporters attack the state attorney General for pursuing the case.
After presenting all the arguments in favor of as well as against physician-assisted suicide, we are no closer to settling the debate regarding the ethical standings of the matter and its impacts on the society. No person could confidently claim the morality or sinfulness of assisted suicide, probably because the matter is not as black and white as we would like for it to be. Therefore, in my opinion, the matter of legality of mercy killing would always remain under debate in one part of the world or another. Yet, among the general masses, majority of the people stand in support of assisted suicide or mercy killing. The ratio nonetheless drops significantly when people are informed of the other alternatives and treatments for pain as well as life support. It is shocking how many people are forced to suffer pain resulting from treatable illnesses, just because they have no access to medical or health facilities, or because they cannot be diagnosed. So rather than advancing to killing of human beings, we should be more focused on finding more modern and innovative ways of diagnosing. In addition, we should focus on broadening the availability of medical services to the less fortunate people as well. It is also of utmost importance that we study and analyze the negative impacts of assisted suicide in the states where it is legal. In addition, before making any legal further advancement, analyze the benefits of legalizing mercy killing against the social atrocities that it could impose upon us.
References
Basics, H. (2009, June 4). Assisted Suicide: Moral and Ethical Dilemma. Retrieved from Hubpages: http://healthcarebasics.hubpages.com/hub/Assisted-Suicide-Moral-and-Ethical-Dilemma
Belluck, P. (August 20, 2014). Switzerland: More Foreigners Drawn by Assisted Suicide Law, Study Shows. The NewYork Times, A6.
Emanuel, L. Q. (1998). Facing requests for physician-assisted suicide: Toward a practical and principled clinical skill set. Journal of the American Medical Association, 643-647.
Gambino, L. (2014, July 17). Euthanasia and assisted suicide laws around the world. Retrieved from The guardian: http://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world
Robert Pearlman MD, M. H. (2004). Why Do People Seek Physician-Assisted Death? In M. P. Timothy E. Quill, Physician-Assisted Dying: The Case for Palliative Care and Patient Choice (p. 94). JHU Press.
Sobsey, D. (n.d.). 12 Problems With Assisted Suicide. Retrieved from BroadReach Counseling and Medication: http://www.broadreachtraining.com/advocacy/euth12rsns.htm
