Euthanasia and Physician Assisted Suicide

Euthanasia and Physician Assisted Suicide

Introduction

The history of the debate for physician assisted suicide has been long, tracing back to the Greek and Roman times. The term euthanasia is actually a Greek word meaning "good" or "noble death," which was coined in the seventeenth century by Francis Bacon (1, 2, 3, 4, 5). The term was later abused, when German physicians willingly participated in the killing of more than 200,000 helpless people. Anyone that was physically disabled, had mental illness, babies born with birth defects, senile elderly, and even wounded German soldiers were all intentionally killed because of their disabilities (1,3,5). All of which turned the word meaning "good death" in to a bad one. Over the years, religion, as well as the Hippocratic Oath caused many physicians to condemn the practice. However, since people are now living longer, euthanasia and physician assisted suicide (PAS) are starting to become more accepted.

In writing this paper, I will discuss some of the terms used and why it is important we understand them. In addition, I would like to attempt to show the readers some of the reasons why euthanasia or PAS is becoming more accepted as well as some of the reasons individuals oppose this issue. I plan to discuss the different methods of suicide and why we have to resort to them. Since Oregon is the only state where PAS is legal, I want to take a closer look at the laws as well as some of the statistics on individuals that have taken advantage of this controversial issue. Then follow this up with where we stand legally on this debate today.

Common Terms Used

Part of the reason, individuals have so much trouble understanding this issue is because there are so many different terms used. Depending whether you are speaking to someone who is for legalization or someone who is against it will determine the types of terms you hear. Some of the most common terms heard today are: Passive euthanasia, active euthanasia, physician assisted suicide, voluntary passive euthanasia, involuntary euthanasia, and sometimes mercy killings.

Passive euthanasia refers to altering some form of support and allowing the patient to die of natural causes. The removal of life support, stopping medical procedures and medications, stopping food and water, and not delivering CPR are all forms of passive euthanasia. The most controversial case where this was used was when Terri Schivo's husband decided to have his wife's feeding tube removed allowing her to die of starvation.

Active euthanasia, which is sometimes referred to as mercy killings, involves the death of a person through a direct action, in response to a request from that person. Since PAS is not legal, many people have no choice but to resort to this method when ending a loved ones life. However, in most cases the person left behind risks going to jail as a result of their actions. The question most asked, "Is it mercy or murder" and should the person suffer in jail (1)? Until the laws start to change, jail time is the consequence. This is the situation that Dr. Jack Kevorkian was placed in when he assisted in the death of an ALS patient by use of lethal injection. As a result, he is now in jail. (5)

Physician assisted suicide, which is sometimes referred to as voluntary passive euthanasia, is when a physician supplies information and/or the means of committing suicide. Oregon is the only state where this method is legal under strict restrictions.

Involuntary euthanasia is referred to when person is killed who has not requested aid in dying. Persistent vegetative state is one example of this. Terri Schivo's case could also be placed under involuntary euthanasia.

Why is Euthanasia Such a Controversial Issue?

Euthanasia and physician assisted suicide has always been a controversial subject. Years ago, people feared that they would get some infectious disease and die at an early age. Because of modern medicine, most people now fear lingering deaths, that may include years of being incapacitated and in nursing homes. The fact is that modern medicine and technology has helped increase the age in which people live. The problem is that even though they are alive, their quality of life may be gone (1, 2).

There are many reasons why someone might consider ending their life. For instance, most people fear dying of a bad death. This consists of having cancer, Aids, ALS, a neurological disease, Dementia, or Huntington's disease and many more, where people fear that they will end up at the mercy of family or worse, put in a nursing home (1, 2, 4, 8, 9). A study was conducted with 988 patients that were all terminally ill, and found out that 60.2% supported permitting euthanasia or PAS in certain situations. Out of those same patients, 54.8% supported euthanasia for terminally ill patients that were in a lot of pain, and 32.7% supported euthanasia or PAS for patients that were not in a lot of pain, but thought they were a burden to others (8). It is not hard to see why so many patients might feel this way. Diseases like multiple sclerosis or ALS can linger on for years. Most people feel useless and that there quality of life has been taken away. Most patients do not consider physician assisted suicide until late in the disease. Many of the patients stated that if they had known that their symptoms were going to be so bad, they would have ended their own life. Later they were unable to do it themselves (1, 2, 6). My father, Frank Cano, was diagnosed with multiple sclerosis and one of his biggest concerns is that he does not want to end up stuck in a bed year after year. When his quality of life is gone, he no longer wants to live. This is a big issue that I will be faced with at some time in my life. We already know his wishes, but if physician assisted suicide is not legal, than other measures will have to be taken. What it all comes down to is that terminally ill patients want to control when and how they die and they want to die with dignity.

Some people are tired of living their life with so much pain and suffering. Of course pain medicine is out there, but at a huge cost and it does not always take away the pain. Some individuals do not have any health care coverage and cannot afford the pain killing medicines. Therefore suicide starts to become their only option.

Dignity, quality of life, and autonomy are some of the main reasons patients prefer assisted suicide. Dignity is an important factor especially for a person who has always been independent. The idea of having someone take care of you because you can know longer do it yourself is very depressing for most individuals. Quality of life