Physician Assisted Suicide

Physician Assisted Suicide

Physician assisted suicide is an issue that has been debated over for many years. Many argue that people have the right to die by any means possible while others argue that human life should be held in high regard and protected at all costs. While active euthanasia is forbidden, currently in the United States courts and physicians in cases of the terminally ill and those who are in a chronic vegetative state generally accept passive euthanasia. By definition passive euthanasia is "the withholding or withdrawing of life support in certain types of cases and allowing a deadly process to proceed without intervention,"1 but this is where the controversy begins. Many people do not agree with any form of physician-assisted suicide and go so far as taking their arguments to the Supreme Court. In recent Supreme Court ruling, physician-assisted suicide has stirred up much controversy. This is not the first instance in which the courts have had to deal with end of life cases. There has been a back-and-forth struggle for many years. In 1990, the Supreme Court ruled that the terminally ill had the right to refuse treatment that may otherwise keep them alive, while in 1997 a ruling stated that people have no constitutional right to die.2 Now, the associated press released an article that declared the Supreme Court's agreement with the Oregon assisted-suicide law. The law states that it is sanctioned to use federally regulated drugs to assist in the process of physician-assisted suicide.3 Now that it is federal law this basically means that the Bush administration cannot stop doctors from helping terminally ill patients kill themselves. The question now is will congress sit aside and let the new federal law block the Bush administration or will they pass a new law that will give power to Bush's administration to stop physician assisted suicide? This issue is not going to be laid to rest that easy. There are many groups, individuals, and health organizations that are either for or against physician assisted suicide and neither group is going to just take a back seat on what they believe is right. Those who believe that physician assisted suicide is ethical, justify their reasoning based on various arguments: Respect for autonomy that argues any fit person has the right to choose death, justice which argues that physician-assisted suicide should be allowed in certain cases where treatment refusal is not enough, compassion from which the argument of ending unbearable suffering arises, and individual liberty vs. state interest that argues "a complete prohibition on assisted death excessively limits personal liberty."4 For instance the American Medical Student Association (AMSA), the largest organization of independent medical students, concurs with the decision of the Supreme Court. The AMSA places high regard on patient autonomy and the physician-patient relationship. They believe in patient autonomy, that the patient is to have the final say in any of their medical decisions, which includes the right to death if they so choose. It must be said that yes the AMSA believes in physician assisted suicide, but only as a last resort. Along with this they have strict criteria or guidelines that they adhere to in making a proper judgment as to whether or not physician assisted suicide is the final option.5 According to the AMSA,

the patient must be terminally ill, deemed competent, and self-defined as undergoing unbearable physical, mental and/or emotional suffering, whereby his/her quality of life is such that life is no longer worth living. In addition, an independent physician must be consulted to review the case, and every step must be documented.5

Other arguments for physician-assisted suicide are expressed in utilitarian and duty-oriented terms. In utilitarian terms concern and compassion for the painfully and/or terminally ill is the basis for argument.1 One ethicist who believes strongly in this view is Joseph Fletcher. He feels,

it is harder morally to justify letting someone die a slow and ugly death, dehumanized, that it is to justify helping him to escape from such misery. This is a case at least in any code of ethics, which is humanistic or personalistic, i.e., in any code of ethics, which has a value system that puts humanness and personal integrity above biological life and function.1

Duty-oriented terms focus primarily on personal autonomy.1 It poses the question "if we can live our lives according to our own inner vision, then should this aspect of human dignity based on free choice also be extended to the termination of our lives?"1

While there is strong support for physician-assisted suicide there is also strong opposition. Those who argue against physician-assisted suicide hold arguments such as the sanctity of life, potential for abuse, professional integrity, and professional imperfection.4 Those who are in opposition for religious reason, base their argument on the sanctity of life. This is the basic view that our lives are not ours but a gift from God and the act of taking our lives is destroying the gift, which was given to us.1 Although active euthanasia is not condoned by Judeo-Christian teachings some forms of passive euthanasia are. The belief is that while acts that permit death are allowed, acts that cause death are morally wrong. Religious reason is not the only argument against physician-assisted suicide; there are nonreligious arguments as well. Nonreligious arguments generally tend to follow the slippery slope or wedge theories.1 In the text book the parable of the camel is used to explain this theory. The underlying message behind the principle and basis for the theory is that if you give someone an inch they want a foot. They can never be satisfied with what they have. The fear associated with the nonreligious reasoning is that if any degree of physician assisted suicide is allowed there will be no hesitation from the opposition to try and take advantage and want more that what they are given. An extreme example of this was the Nazi "final solution" that is traced back to necessary euthanasia legislation, which was to be used only on the mentally ill, eyesores, and those who were incurable and became a burden to the state.1

Another issue brought up with physician-assisted suicide is that of patient confidentiality. There are many aspects of confidentiality that must be explored when dealing with physician-assisted suicide. From the