A person has the right to life, why not death? These are two topics that are debated everyday in some form or another. Death is something that we all will face, it is inevitable. There is no miracle cure to fix it and to keep the subject in the dark could be considered irresponsible. Thesis End of life discussion are to be used to talk about options available to patients as they face a terminal illness or just old age. The options available are many; from do not resuscitate orders to palliative care. There are a few places in the world that extend those options to physician assisted suicide (PAS) and Euthanasia.
These options should be discussed and even made available all over, to educate the public and to prevent things from happening behind closed doors. Euthanasia may be taboo but it should be made legal. For many years there has been a debate about palliative care, euthanasia and physician assisted suicide. (Darity 2008) The fact that people are seeking these options with or without a doctor’s help just reinforces the fact that peoples voices should be heard and that this should be approached in the hotly debated health care reform currently being discussed in the United States.
Most recently there was an attempted euthanasia case in Hawaii, a man tried to end the life of his terminally ill wife and himself. Hawaii has been having a debate about this for decades and some see this as a sign that the debate will resurface once again. This is just one recent occurrence that shows the extreme measures one will take to ease the suffering of a loved one. The fact that this man took these measures screams that there is a lack in communication, education and it is something that needs to be addressed soon. Vorsino) Anti-Thesis Those who do not support euthanasia have stated that there are too many advances in medicine to really need this option. There is power in medicine. It is closely related to ethics, Hippocratic Oath prevents a doctor from causing harm to a patient. This can also be interpreted to mean that the doctor has to do everything within his or her power to save a patient’s life or prolong it. (Orr 2009) Doctors already have the tools necessary to ease death.
One of the five categories of assisted death is the withholding of potentially life sustaining treatment; do not resuscitate orders. This allows the patient to decide if they want extreme measures taken to continue life; withholding CPR. This is a decision that the patient makes and for the most part all health care facilities address this with individuals prior to surgical procedures and other treatments. (Darity 2008) Physicians also offer the withdrawal of potentially life sustaining treatments.
This gives a patient the right to refuse or stop any treatment that may prolong a person’s life. An example of this would be the removal or refusal of a feeding tube. This is typically addressed with patients in a persistent vegetative state. Pain management is the biggest area where assisted death is common already. Under the five categories of assisted death this is the most closely related to PAS and euthanasia. This practice is the giving of suffering control medication in doses that may shorten a person’s life.
Morphine is the most common drug. Morphine has the potential to reduce respirations and potentially cause death. There is no precise amount that is considered too much. Levels of this drug are gradually increased as pain increases so there is no way to define exactly how much is too much and since it is generally used in patients in extreme pain; caused by terminal illness or complications of disease. (Darity 2008) These three are already considered legal and ethical treatments.
Doctors should not have to put their lively hood on the line just to satisfy those who give up on finding possible cures and life extending treatments for what are currently terminal illnesses or chronic diseases. These options are not forced upon the patient and if the patient does not want to take advantage of any procedures or treatments, patients have the right to change their mind at any time. There are policies and procedures in place to protect the rights of patients and physicians. (JAMA) There are reported cases of assisted suicide abuse in Belgium.
An example of this would be a patient who is in an intensive care unit. The average stay in an ICU is four days. There are ICU doctors that feel that the laws of Belgium do not apply to them and will make the decision to end life if they see no other options open to the patient, who is unable to make the decisions themselves. Terminal sedation is a treatment used by many; it does not require consent from the patient and has the same effect. The physicians reasoning is often mercy; mercy for the patient. Cohen) Even though involuntary euthanasia is considered to be illegal everywhere in the world the facts of studies show that it is already happened and there does not appear to be any prosecution of the doctors practicing it, the laws are already ineffective why open the doors to bigger problems. (Cohen) Synthesis This is a global subject not just local. Residents in Oregon, Washington and Belgium have the right to request death. Oregon and Washington have similar programs that protect the patients’ and doctors’ rights from start to finish. It is not about advancements in technology or medicine.
It is about a person’s right to make decisions concerning their life and options. Studies have shown that making decisions about life and death expectations have lessened the burdens on not only the patient but the family as well. By having choices and end of life discussions we have control, just as we should have control over our own death. A patient has control over what we deem is necessary or unnecessary care or treatment. We have control over what we want; to be kept comfortable in a hospital or at home. To have the legal right to say enough is enough. (Jama) Having options can potentially lead to a better quality of life.
Patients were able to take the burdens off of family member by having made decisions before they were needed, resulting a shorter and less traumatic grieving period for surviving family members. (Jama) Having made the decision for themselves they have been able to enjoy the time they have left without feeling like a burden to family which translates to a better quality of life for the patient. Since there are positives with just have the options to choose where a patient wants to stay why could there not be a similar benefit for extending the options into PAS and euthanasia.
So why do we not look at the options of physician assisted suicide? Is it just too much for the general public to deal with? This is not a subject that everyone will be open to for discussion, but it should be an option. This is a moral dilemma, suicide is wrong in some circles and to have a doctor assist is debated even by doctors themselves. (Darity 2008) The American Heritage Dictionary defines suicide as the “act of intentionally killing oneself”. (AM Heritage pg1287) There is a completely different definition of euthanasia; it is the “act of inducing the painless death of a person for reasons assumed to be merciful”.
Physician assisted suicide is defined as being the voluntary termination of one’s own life by the administration of a lethal substance with the direct or indirect assistance of a physician. Physician assisted suicide is the practice of providing a competent patient with a prescription for medication for the patient to use with the primary intention of ending his or her own life. (medterms. com) These are the three options that allow a person to end their life by performing the act on their own within the confines of the law. Part of the problem with these options is a lack of education or clear communication.
If there is a legalization of these practices theoretically there is more control over them. Bringing the subject up before necessary makes the patient’s wishes clear and unarguable. (Darity 2008) A person who is full of life and has not felt the fear of diagnosis still thinks about death, purchases life insurance, makes out a will, why not add an additional step. Take charge of the situation while still competent. I want to be able to choose, quality or quantity. It is a personal choice, so why not be able to decide enough is enough and end it all? It is legal for a person to refuse treatment for disease.
It is legal for a patient’s family to decide when to terminate life support and it is legal to keep a patient comfortable with nearly fatal dosages of morphine. (Darity 2008) With these two states taking action it is only a matter of time before others will follow and the federal government will have to address it as well. So now is the time to take the lead and add it to the end of life discussions proposed by the new health care bill. It is not an option that will be forced upon the patient and if the patient does decide to take advantage of the procedure they have the right to change their mind at any time.
There are policies and procedures that must be adhered to in order to protect the patient and the physician. (Cohen 2008) All three of these topics have one common denominator; they are all controversial in one way or another. Culture plays a role in all three as well. A persons religious beliefs can affect how they make decisions for advanced care, suicide of any kind is generally frowned upon in many cultures (Lipson) There is debate about treatments such as artificial hydration and nutrition, are they treatments or just a way of prolonging death.
Doctors have a variety of views on these subjects as does the general public, some say it goes against the Hippocratic Oath to maintain life and health of individual and others say that they are following the oath by upholding their patient’s wishes. (Cohen) Regardless of a person’s beliefs or upbringing, the end of life discussion should be viewed as a good thing. It gives a patient the opportunity to express their wishes while they are still considered competent and be able to create a plan of care that will adhere to their own personal belief system.
It will also give a patient the opening to discuss options like euthanasia and physician assisted suicide. Although these options are not available everywhere in the world they should be discussed so that an individual can make their own educated decisions thus maintaining the gift of personal choice. If we take the subject out of the closet and look at it from a real position we may find that perhaps PAS and euthanasia are not taboo and should have been legalized quite some time ago. Anything that has been debated over for more than twenty years obviously has some positive to it and should be put to the people to decide.
Courtney from Study Moose
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