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For years, there has been much controversy regarding physician-assisted suicide/euthanasia and the patient’s right to die. Thus far there has not been a concrete decision in all states as to whether or not a doctor can provide the means or administer a lethal dose of painkillers to a dying patient. This practice is looked down upon by some as a form of murder and opposite the duty expected of a physician. However, this practice also extolls the very basic virtue of body autonomy and the right to do as one pleases as long as no harm shall be done to another human being.
Physician-assisted/euthanasia should become legalized for reasons of quality of life, economical and societal implications.
Physician-assisted suicide and euthanasia are not entirely the same thing; the former involves a doctor who, usually, will prescribe a lethal dose of barbiturates or painkillers that are administered by patients themselves, hence the word suicide. The latter, euthanasia, is characterized by the doctor solely injecting a lethal dose of medications at the discretion of informed consent by the patient.
Arguing for one and not the other wouldn’t make any sense in the case of a terminally ill patient requesting to die. If one already supports the patient’s right to die, to argue that euthanasia is wrong discredits the original position. If physician assisted suicide and euthanasia are legalized in America, it would be most appropriate to the leave the final decision to the patient.
For ease of rhetoric, physician-assisted suicide and euthanasia will be used synonymously and denoted as “PAS”.
PAS in this aspect is limited to patient-doctor interaction and not referring to suicide outside hospital/clinical environment such as the notorious Kevorkian “Thanatron”. Though, Dr. Kevorkian himself is recognized for his clinics called orbitoriums in which physician-assisted suicide was carried out (discussed in class). Additionally, PAS will only be observed as a voluntary practice to mentally competent- legal adults. PAS will not consider passive methods such as terminal sedation or withholding life support unless, for example, someone in a vegetative state made an advanced directive. Otherwise, the patient will be informed of all the guidelines and must consent prior to the procedure. Non-voluntary and involuntary acts of euthanasia are not considered under any discretion. Lastly, PAS includes injection of barbiturates by a doctor, ingestion of painkillers, removing nutrition or respirator/ventilator.
The state of Oregon in 1997 introduced the Death with Dignity Act (DWDA) which allowed physician-assisted suicide under the mandated condition that the patient be a legal adult, mentally competent, and have a determined life expectancy of less than six months This law distinctly prohibited the act of euthanasia and to those who are not given six months to live irrespective of an illness (Oregon Health Division 1). Proponents of PAS will generally agree with the DWDA on a number of aspects, but overall will argue that the patient is ultimately the one that has the right to request a doctor a prescription to ensure lethality. This could imply that a patient who has suffered severe trauma, who doesn’t have a pre-determined life expectancy of six months, can request to die. PAS, under mandated guidelines, should not restrict the option to only those who have a six month time period.
The quality of life is a characteristic unique to every individual; a hospital cannot say that a patient will be better off in a vegetative state than they would if a lethal dose of drugs were administered. A patient has the utmost right to receive the treatment desired (painkillers or lethal injection) if the quality of life determined is not worth living. One has the right to die with dignity at one’s own discretion. A person should not have to endure a painful treatment or years of psychological transformation following a traumatic event. PAS must not be restricted to maladies such as cancer or any terminal illness, but rather to include bodily injury and extreme burn wounds. It’s unethical as a physician to have a patient begging to die, as the pain endured has far exceeded endurance; most will argue that its to inhumane to see someone suffer like so. Granted, the hospital and doctor’s job is to stabilize and mitigate an illness or an injury.
Autonomy is one of the greatest qualities humans possess. We can’t hurt or harm ourselves as we please, and not physically affect those around us. As an innate behavior, humans strive to find homeostasis and comfort. Of course, these two goals are subjective and are what contribute to individuality. As some will argue, an infringement upon these values is considered an intrusion of privacy. Such is in the case about Dax Cowart, a man who sustained severe burns throughout his body following a propane explosion. Cowart was in such excruciating pain he pleaded incessantly to the doctor to let him die. Dax’s mother, Mrs. Cowart, was given authority for Dax’s treatment, and not surprisingly denied his request to die. The doctor also at the time refused Dax’s request because he was presumed mentally incompetent to make decisions due to the heavy intake of narcotics. As discussed in lecture and in the article Taken to the Limits, Cowart was unaware as were the doctors about the future of his predicament. Psychologically speaking, Cowart wanted to be in control of his treatment and to find a homeostasis even if that meant death (Dr. Winslade 116-18). That is something the hospital and doctor find trouble accepting due the policies they uphold, especially when they believe the patient has a strong chance of recovering. Ultimately, Dax’s future would be inevitably changed as he underwent major transformations on both his body and his identity. From the documentary in class, Dax mentions, “No human should ever have to go through that pain, a quality of life is considerably important.” Although Dax has healed and has achieved success in his career, he still believes the doctors were wrong to not honor his wishes. Dr. Winslade makes an important note at the end of the article: “Most importantly, he [Dax] emphasizes the competent individual’s right to choose — even mistakenly—may be the most significant value we can endorse in the face of unpredictable events an uncertain outcomes in the drama of individual lives” (Winslade 129). Stories such as Dax’s that are described in detail present the rational and moral validation for PAS. It’s understandable to assume the wrongdoing of PAS from the definition, but given a first person account of an incident and the pain experienced like Dax did; proponents argue its subjectivity and circumstantial viewpoint. Specific cases evoke the important exercise of autonomy in each individual whom shall decide the quality of life, treatment, and right to die (Assisted Suicide, Dr. Winslade 1).
PAS’s benefits are not limited to the individual; its effects are seen in economical sustainability. PAS contributes to a financially sound solution to patients who are terminally ill or have been in a traumatic accident. If someone has been in a persistent vegetative state (has an advanced directive and doesn’t have a promising positive prognosis, there really isn’t a point to keep dragging out the resources sustaining his/her life. The money and resources instead can be put forth into research on brain damage, cancer, diseases, etc. Individual life, of course, must be respected and the PAS itself cannot be viewed solely for financial gain. However, if and when patients request a PAS, collectively the resources otherwise spent on keeping them alive can possibly in the future find cures for the maladies they were inflicted with; simultaneously the patients’ wishes to be at peace are respected. This is supported by a journal article in the book, Hospital Topics, which agreed, “… [an] Earlier death, as the ultimate cost reduction, may provide an attractive economic alternative for HSOS” (Kurt Darr 2). Someone who has been in the hospital for more than a year who has shown no sign of recovery can incur a debt in the hundreds of thousands that most likely the financial burden will be passed on to the family. PAS also can possibly can provide a substantiate amount of vital organs that can be transplanted into other patients in the case patients are willing to donate them.
Lastly, PAS helps facilitate a positive outlook to society that the actions are those of consideration. PAS is a compassionate decision that can put both the patient and the family at ease. It takes away the burden of having to frequently watch a close family member slowly die. A patient also can relieve himself of the burden of guilt of having the family members be a part of the illness or injury for an extended period of time. It’s interesting to note that doctors in the past already have assisted patients illegally. In Clinics of Geriatric Medicine, Susan Wolf J.D emphasizes that; “ …some physicians have publicly revealed that they have provided such assistance to patients.” (Wolf 1-2). The doctors have done so in these cases because of compassion, they see the patient suffering and they know too the patients are better off dying. PAS then would provide a systematic regulation of what has already been done off the grid in the past and currently. PAS seeks to mitigate the harsh reality of a dying loved one; it strives to comfort each and every individual. PAS illustrates to society an acceptable solution to those who are suffering. However, PAS is not the only solution; if a patient would like to live, then by all means they should exercise that liberty.
There are those who still believe PAS is morally wrong and should not be permitted. Some claim that PAS violates doctors’ religious upbringing and integrity. PAS will cast a shadow of guilt on doctors, reminding them constantly of a moral misconduct. The mental competency of patients can appear ambiguous and the decision they make may change after a week. PAS inhibits the chance patients might recovery and lead fulfilling lives. To relieve themselves of a financial burden, insurance companies will coerce doctors to encourage PAS to their patients. Palliative care may no longer serve as a viable solution as patients will be determined to kill themselves upon realizing an uncomfortable and unknown future. Lastly, opponents argue that PAS dismantles the fundamental existence of hospitals and doctors. As quoted in the Hippocratic Oath: “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan” (Translation by Michael North Par. 4) These arguments do in fact reflect the cons PAS is faced with. Like abortion, PAS is highly controversial issue and there is and won’t always be definitive answer. Instead, PAS is looked upon with an ethical and moral standpoint, while constantly being tugged by both ends. If a doctor feels his moral religious values are prohibiting him from such an act, he can transfer the patient to another doctor if guilt is overwhelming. It’s also interesting to note a 1995 study done in Michigan that showed an approval percentage of 56 for doctors and 66 of the public for the legalization of physician assisted suicide (Bachman, 2). As Michigan illustrated, this study evinces that PAS is divided, yes, but not opposed by a majority of doctors. Insurance coercion and miraculous recoveries are realistic but do not present an inevitable consequence for what should be, instead, looked upon as anomalies. These both are effects already seen today in healthcare aside from PAS. PAS is not an impeccable solution; however, as it becomes more prevalent in health care, the more its mechanics can be adjusted to accommodate society’s interest. One can argue that a doctor’s responsibility is to provide pain relief. In this case, a patient who deems dying is the only pain relief, then a doctor considering the circumstances should keep in mind and honor that request. The Oath is not limited to keeping a patient alive but respecting their wishes.
Overall, PAS brings about another major transformation in today’s already revolutionized health care. It may appear that with today’s life saving technologies and advanced medicine that PAS is a primitive solution. However, PAS shows to society that we must keep moving forward. PAS is a solution, while simultaneously a reason for people to find permanent cures for brain injury and cancer to mention a few. As of now PAS represents the basic foundation of human nature to make decisions we think are best for us. It’s best for PAS to be represented as kindheartedness rather then merely a loss of life. The legalization of PAS will nonetheless contribute to emphasize individual rights, economical and societal positivism.
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