Physician assisted suicide or euthanasia should be a right granted to all citizens who are suffering from a degenerative, painful, or fatal condition that would cause them to be unable to enjoy to enjoy their lives as healthy people do. Although there are certainly several debates against this viewpoint on assisted suicide, it is not up to ethicists to make decisions that infringe upon the rights of the ill and infirm. As it stands, there is a solid argument in favor of human euthanasia or physician assisted suicide. As such, it should be recognized that “patients have a right to make their own decisions to preserve free choice and human dignity: this right includes the right to choose assisted suicide” (Ersek 48). Furthermore, having access to physician-assisted suicide allows the patient to maintain control over his or her situation and to end life in an ethical and merciful manner.
There are multiple definitions within both the medical and legal communities about assisted suicide but in general, the most contentious debate is when a suicide is assisted by a physician as opposed to a private citizen or family member. Even though the benefits of assisted suicide for the terminal individual are incredibly significant, the debate is not free from questions about the responsibilities of the medical community as well as those offered up by ethicists and more importantly, religious groups. It is necessary to take a balanced view of the issue and understand each side but realize that the rights of the individual in determining the course of his or her death, especially in terminal cases where pain is a major issue.
It should be noted that the more general term “assisted suicide” does not necessarily refer to the involvement of a doctor. To be an assistant to the death or suicide of another human being is another issue that is removed from physician-assisted suicide. For the purposes of this argument, the focus will be on the involvement of a medical professional in the oversight and management of a suicide or, in other words, physician-assisted, rather than simply assisted suicide. Assisted suicide is best defined as “the act of intentionally killing oneself with the assistance of another who deliberately provides the knowledge, means, or both. In physician-assisted suicide, a physician provides the assistance” (Gupta 2). Many have questioned the medical community’s right to offer this possibility to patients, arguing that it is their job instead to ensure that a patient lives a full life with access to all available medical treatments. These opponents to the argument supporting physician-assisted suicide believe that it is not within the rights of the medical field to help patients die, but to help them improve or at least continue life, no matter what its quality may be.
The main flaw in this argument is that it ignores the fact that some terminally ill patients suffer from a great deal of pain and no longer wish to have their lives artificially prolonged by expensive, painful, or debilitating treatments and would rather die quietly. For them, it would be most beneficial for the medical community to offer some kind of permanent solution to the pain and prolonged life as they may not wish to commit suicide themselves or worse, are physically incapable of doing so. As a result of these dueling arguments, the question of rights and responsibilities is posed, namely, what are the rights and duties of a medical professional versus those of an individual patient? While the medical community does have the responsibility to help patients as much as possible, if there is no possibility of hope or recovery, then it should be their duty to end pain and suffering by offering the terminally ill (if they have requested it, of course) an end to their plight. Connected with this idea is that every human being should have the right to decide when and in what palliative care context their life ends if they are in a situation such as this. Being kept alive by technology against one’s will seems cruel and inhuman, especially if pain is a constant factor. It should be the right of the patient to decide when he dies as well as his right to die without undue pain or more suffering. While a patient may choose to take his or her life by other means (such as disconnecting tubes or artificial life support networks) this might be incredibly painful and prolonged. Instead, doctors should offer freely the possibility for an easier solution.
Despite the arguments by assisted suicide opponents that claim a doctor’s involvement in the death of a patient is cruel and inhumane since they are designated with the role of healing people, it should be stated that the other side of the equation has more inherent cruelty as the terminally ill are forced to live against their will in unmanageable pain. Patients seeking a suicide that is safely monitored and administered by a physician often have terminal illnesses from which know they will never recover. According to one report by Exit, which is a Swiss organization that helps in about 100 suicides per year, “about 70 percent have cancer. Other common conditions are heart disease, AIDS, and neurological disorders such as motor neuron disease.
Patients seek relief from symptoms such as unremitting severe pain, breathing difficulties such as choking and suffocation, and nausea and vomiting” (Spinney 46). To further complicate the stress of a terminally ill patient is the constant worry and concern about the well-being of their family members who are often spending time taking care of the dying loved one and in some cases, paying the bill for the artificial extension of life. Although to many opponents of the perfectly valid argument in favor of a patient’s right to die, it may seem callous to consider the financial implications of keeping a loved one alive against his or her will, this is a valid concern. As one study notes, “The last month of life [of a terminally ill patient] can consume 40% of the total spent on healthcare during the lifetime of an individual” (Stringham 193). If the patient has already told family members that he wishes to die and discontinue burdening himself and his family members, assisted suicide should be permissible—especially if the whole family and friend network is in agreement. Again, this broaches the question of individual rights, both in terms of pain and financial management.
By means of providing the prescription necessary, a doctor can allow a terminally ill patient to end his or life in a safe, effective, and painless way. For many patients suffering from chronic, painful, and fatal conditions that would eventually bring death, the only option for relief (both in terms of themselves and their family members) is suicide. Before the possibility of physician-assisted suicide existed, at least some of these patients would attempt their own suicide, an act which was not as merciful or painless as the “cocktail” that a physician could prescribe to allow for a quick and painless death. As one study notes, “Medical illness was a factor in half the suicides of people ages 50 and older and 70 percent of those 7- years of age and older. Increased life expectancy, chronic illnesses, technological advances, and expanded treatment options have all complicated the process of dying” (Mackelprang 315).
Although it is a rather grisly thought, there is always the possibility that an attempted suicide could go wrong and have even more devastating consequences for the patient. Although a botched suicide is a worst case scenario, it should also be noted that many suicide attempts are not at all painless. For patients who decide to remove life support systems, the suffocation process is excruciatingly slow and is far from a humane way to end one’s life. If these patients who might otherwise attempt suicide on their own were offered a more merciful, effective, and proven way to end their lives this might bring far greater peace to not only the dying, but to their relatives who might otherwise wonder if there was suffering involves. As it stands now, people are living longer lives and suffering from more age-related complications, some of which are fatal and chronic and would lead the patient to consider that they might be done living. Aside from these concerns, it must be noted that many cancers and other degenerative and fatal conditions often cause a great deal of pain—both because of the disease and the treatments being given. If a patient feels that these treatments are unnecessary, who are the courts to say that they should not have the right to end treatment and die without a great deal of suffering? Instead of feeling forced into a suicide of their own design that may prove painful or not even be successful, it seems to be the most humane option to allow them a more guaranteed painless result. After all, it should be the right of every citizen to escape unnecessary pain and suffering if at all possible.
While the assisted suicide proponents look at the issue as a matter of personal freedom and private choice, many on the other side of the debate think about the issue in terms of ethics and religion. In the medical profession, many doctors and nurses have expressed concerns about assisting someone as they die since they consider it to be their duty to help people live instead. They do not see this as a responsibility or an ethical act as medical personnel. Still, despite these reservations, the statistics of doctors interviewed in a questionnaire-based study did make it clear that recognized the importance of a patient dying with some dignity. In this study, “60% [of physicians] agreed that physician-assisted suicide should be legal in some cases” (Gupta 4). Others outside of the medical field propose that taking a life, even for purposes that seem to have valid reasoning, is wrong. For many Americans, the most potent argument against physician-assisted suicide is not based solely on more empirically-centered questions such as the role and duties of the medical establishment, but rather on more vague notions of morality and religious doctrine. “The states cannot legislate on the basis on religious faith but they can legislate on ethical grounds. They may reasonably conclude that the legalization of assisted suicide would dangerously corrode society’s moral fabric” (Marsh 4). These opponents refer to the bible and Christian tradition’s understanding of suicide and murder as grave sins. Furthermore, many of the religious groups claim to hold all life as sacred and by taking a life, even though it may ease someone’s pain, is not an acceptable act in the eyes of God or within Christian tradition. Like other debates, stem-cell research in particular, the concept of life is God’s gift and despite any political or social claims we have to personal freedom, such freedoms are trumped by ethics, morality, and religious belief. The right to die with dignity is trumped by the need to adhere to religious code and although one cannot criticize individual belief, it should be noted that the benefits of seeing someone die (who might have committed suicide anyway) with peace and grace is also something that is, in some ways, holy and justified.
The issue of physician-assisted suicide is complex because sentiment about the practice ranges greatly from strong support for personal freedoms to religious backlash that insists it is murder and against the teachings of God. At this juncture, it seems that the debate will need to be settled before progress towards an agreeable solution will take place. Human euthanasia was approved in Oregon and this action, along with the related case of Terri Schaivo, prompted talk on both sides. “For some, this [Oregon] law represents a unique and important example of personal freedom while to others, this qualifies as a terrible and insidious form of state-sponsored murder, along with abortion, cloning, and stem-cell research” (Miller 106). With such opposing arguments, it is worth exploring each individually in order to gain a better understanding of the positions of each side. According to several reports and statistics on physician-assisted suicide and public opinion, “one of the strong arguments in support of legalizing it is that people should be allowed to die with dignity. In support of this argument is the idea that, for certain diagnosed conditions, medical treatment and nursing interventions are insufficient to ensure a dignified life” (Pang 2006). This is a straightforward and in many senses, medically provable stance. One can observe that a patient is suffering from a condition that is terminal and realize that there is little the medical staff can do to prevent or stop such pain. Sometimes these conditions can take away one’s dignity by rendering them helpless or in a vegetative state. With legalized physician-assisted suicide, those suffering from terminal, painful, and largely untreatable chronic conditions would be able to die with “dignity” which means it would be on their own terms, timetable, and hopefully with the support of friends and family. Instead of being forced by law to endure a life that will be ending but until that moment is unbearable because of pain, persons with such illness will be able to exercise their freedom to make individual choices and die with dignity rather than waste away in a hospital that is not equipped to give respite to the pain and suffering.
In sum, this debate is so complex because the core values of each side are rooted in two entirely different areas. There have been thousands of argumentative essays on both sides and those who approve of physician-assisted suicide are more likely to support their ideas with comments about individual freedom and dying with dignity as a release from great pain while those on the other side use more ethereal and spiritual arguments. In general, it seems more reasonable to base our decisions about this practice on more empirical matters such as the right of the individual in deciding not to suffer rather more philosophical questions about religious doctrine and code. While this is not to say that religion has no place in the debate, it must be understood that many patients with chronic conditions are suffering greatly without the possibility of a guaranteed form of relief. In addition to this, it should not be up to the states or federal regulatory commissions to decide the individual fates of citizens in such a personal matter. Even though there should certainly be a vast amount of regulation in terms of physician-assisted suicide (in terms of consent especially) we should let the experiences of those suffering decide the next course of action rather than more vague ethical and religious notions. This is a difficult point to make without seeming insensitive to the needs and beliefs of religious groups but when viewed as a whole, physician-assisted suicide offers great relief to those suffering. The rights of the individual to die with dignity and not suffer undue pain or hardship are of the utmost concern and should be realized by the public, the medical community, and groups with ethical concerns.
Other essays and articles in the Arguments Archive that are related to this topic include : Argument in Favor of Euthanasia or Physician Assisted Suicide (Annotated Bibliography Included) • Biomedical Ethics and God: A Lack of Universals • Right to Die Issues : Rationality over Religion • The Multifaceted Argument for Advancing Stem Cell Research ˚ Palliative Care: An Examination of Theory and Practice
Works Cited
Ersek, Mary. “Assisted Suicide: Unraveling a complex issue.” Nursing 35.4 (2005): 48.
Gupta, Deepak. “Euthanasia: Issues Implied Within.” Internet Journal of Pain, Symptom Control & Palliative Care 4.2 (2006):2.
Mackelprang, Romel W. “Historical and Contemporary Issues in End-of-Life Decisions: Implications for Social Work.” Social Work 50.4 (2005): 315.
Marsh. “At the Hour of Death.” America 193.16 (2005): 4.
Miller, Nora. “Death with dignity or a criminal act?” A Review of General Semantics 63.1 (2006): 106.
Pang. “Editorial Comment.” Nursing Ethics 13.2 (2006): 103.
Spinney, Laura. “Last rights.” New Scientist 186.2496 (2005): 46.
Stringham, Edward. “End of Life Decisions and the Maximization of Length of Life.” Journal of Social, Political & Economic Studies 30.2 (2005): 193.
