Inthe recent decades, physician assisted suicide has become anincreasing controversial issue. Physician assisted suicide (PAS) isusually differentiated from euthanasia in the that, in physicianassisted suicide, the physician does not actually perform the actthat ends life, but provides a means through which a given patientmay end his life (Andre&Velasquez 1).In the US, there are only four states that have permitted PAS(Montana, Washington, Oregon and Vermont). In these states,terminally ill patient are given a chance to request and get aprescription from a physician that if taken will end life (Timothy& Greenlaw 138).Although each states has formulated different set of condition thatmust be met before a patient is accorded assistance by a physician,all the four states have a prerequisite that require that the patientmust be terminally ill, be in the right mental disposition (mentallycompetent) and have a couple of witnesses to the request as per therequirement imposed by each state’s particular statute (Levin1).There have been various cases in courts from proponents and opponentsof PAS, but the general agreement among their verdict appears to bethat, the state governments have the right to make a decision if toallow or forbid the practice of physically assisted suicide (ANA1).
ManyUS citizens support the right to PAS, although the number variessignificantly depending on how the issue about PAS is handled. By theend of 2014, the proportion of Americans supporting physiciansassisted suicide was about 71% when the term “end the patientlife through a painless means “ was used (Harris, Richard &Khanna 479).When researchers used the word “committed suicide” the numberreduced significantly by 20% to 51%. This means that the manner inwhich PAS is represented to Americans has huge influence on theirresponse, and the number of those that support and oppose physicallyassisted suicide. Based on information gathered in a survey conductedby Medscape in 2015 about 54% of physicians support PAS (Harris,Richard & Khanna 480).This paper will exemplify the controversy that surround PAS, and willtake the stand that terminally ill patient who make a request forassistance to end their life should be accorded total support andhelp from the physician since palliative care does not provideeffective remedy for terminally ill patient.
Thedebate whether terminally ill patient should be accorded help byphysicians to end their life and suffering has been a contentiousargument since antiquity. Even in ancient society, PAS had been amajor issue that sparked heated debate among scholars and doctors(Levin1). In the present era, there is notable evidence of a secret practiceof PAS and the law and the profession tends to let such issues pass,as long as they do not go into the public domain. The famous practicecarried out secretly was flaunted in the late 1990s when a prominentphysician by the name Kevorkian Jack helped more than 150 patients tocommit suicide (ANA1).Even though Kevorkian who served as a private pathologist lost hisprofessional license, it was not until the moment that it wasdiscovered he had offered active euthanasia to patient upon request,was he jailed for eight years. In the U.S, majority of jurisdictionshave proscribed physician assisted suicide through the use ofjudicial application of the general statutes or specific legalprovisions (ANA1).
Inthe recent past there have been concerted efforts to change suchprovisions through numerous methods. One of the main methods used byproponents of physician assisted suicide is legal challenge to theconstitution of the proscriptions, which include numerous SupremeCourt hearings, For example Quill vs Vacco), state referenda havealso been used to challenge the unconstitutionality of the provisionsprohibiting physician assisted suicide, although all of them have notachieved any meaningful change and have ended in total failure(Harris, Richard & Khanna 482). For example, the Oregon’s Deathwith Dignity provision which was passed in 1995 has been able tosurvive numerous legal challenges. There have also been numerouscases of civil disobedience where physician have continued to conductand support PAS, and have even admitted to breaking the provisionsprohibiting physician assisted suicide, thereby challengingprofessional and legal frameworks to arrive at the grips withinequities engulfing the secret practice (ANA1).
Patientssuffering from terminal illness and which have no cure, and thatcause immense psychological and physical pain have come to see deathas the only notable escape route, through which their can avoid theirsuffering, as well as the only way of self-preservation (Andre&Velasquez 1).The community remains largely divided regarding whether to allowphysician assisted suicide. In majority of the survey that have beenconducted in United States to establish the general public feeling,about two-thirds of the American populace has approved physicianassisted suicide as the most suitable option for terminally illpatients with obstinate suffering (Harris, Richard & Khanna 480).Nonetheless, when the issue of physician assisted death comes to avote, it is regularly closer to 50/50. The notable split decisionpossibly mirrors the intrinsic tensions pertaining the debate. On onehand, many people are conscious of the cases of severe suffering,even with exceptional palliative care, where the need for some banalescape is critically persuasive (Andre&Velasquez 1).On the other hand, there are immense fears from the fact that,physician assisted suicide can easily be used as a diversion thataverts the effective palliative care or as a way to remove thedistress of defenseless patients by the way of eliminating thesufferer (Andre&Velasquez 1).
PASshould be allowed because it would be honoring the autonomy of thepatient. It is important to note that physicians play a crucial rolein a person’s life right form birth. In this case if physiciansassist at birth, then it is only appropriate that they should alsohelp at death (Harris, Richard & Khanna 481). If individualsdecide to end their life, in the circumstance where the death isinevitable, then there is no compelling reason that should prevent aphysician from helping. Every individual has a right to end theirlives on their own terms and without suffering and pain (Levin1).There should be no limitations imposed by the law, because somerights are unalienable. Individuals should be accorded the right tomake life and death decisions without interferences from any quarter(Andre&Velasquez 1).
Theburden that terminally ill patient may exert on their families andthe horrible pain and anguish of being hooked in permanent situationof hopelessness and emotional drain is another reason why PAS shouldbe permitted (Levin 1). Even though there may be some principles thatgovern healthcare practice and that might call upon physicians to actin a certain way, there is no justification of letting a terminallyill patient suffer unnecessarily and unreasonably at the end of theirlife (Harris, Richard & Khanna 482). If PAS was permittedindividuals would at least have a way out of their suffering and painin the final days. It is worth noting that suffering sometimes canoccureven with excellent care, and rather than having a poorquality life, PAS would solve some of these challenges upon therequest of the patient. For example, about 89% of patient who havedied through assisted suicide in the state of Oregon had receivedhospice care (Levin 1). This means that some terminal cases cannot betotally addressed through palliative care and as such PAS is anexcellent remedy.
Thesame constitution provisions that guarantee important rights such asright to marriage, procreation and termination of life-savingtreatment, should also be used to permit the right to die undercertain circumstances (Andre &Velasquez 1). A compassionate anddignified death is important especially in the face of a challenginghealth condition that does not have any cure. There is no point incontinuing to give care to an individual that wants to die and thatdoes not have any chance of pulling through an illness. Suicide underdebilitating environment would limit anxiety and allow an individualto enjoy life more fully. In reality, making PAS legal might make itmuch easier to regulate and monitor (Harris, Richard & Khanna480).
Ina country that is governed by rule of law and respect of humanrights, there is no better way that this principle can be upheld thanallowing patients to choose what they want. All individuals has amoral right to choose without coercion what they want to do withtheir lives, provided in so doing they do not inflict harm orinfringe on the right of other people. In this light, the right tofree choice encompasses the right to brings one’s own life to ahalt (Harris, Richard & Khanna 480). To most of the people, theright to terminate one’s life is a right they can effortlesslyexecute. Nonetheless, there are many who want to die, but whose stateof health (handicap, condition and disease) renders them totallyunable to achieve their wish in a dignified way. In the event thatsuch people, and in the full realization that illness has totallydebilitated them, ask for help in exercising their right to die, itis only rational that they wish should be respected. Moreover, it isimportant for every human being to respect the dignity of others andto have a duty to relieve the anguish of our fellow human beings(Levin 1).
Lyingin both private and public health institutions today are patientswith excruciating pain and incurable illness and conditions that haverendered them permanently impotent and incapable of functioning inany decorous human fashion. Permanently confined in their death bed,and with no hope of ever regaining their health the only thing tolook forward to in their lives is more suffering, deterioration anddegradation. When such individuals plead for a merciful end to theirpain, anguish and indignity, it is very inhumane and cruel to refusetheir appeal (Harris, Richard & Khanna 481).
Opponentsof physician assisted suicide contend that the society has a moralobligation to safeguard and preserve life. In this vein to provide apath through which people can destroy their lives is a totalviolation of our fundamental obligation to respect and protect life.A community or society totally dedicated to protecting and preservinglife should never commission others to destroy life.
Opponentsof physician assisted suicide also cite the violations of somefundamental principles as the premise behind their verdict. One ofthe most salient principles that opponents of PAS highlight is thewrongness of killing (Timothy & Greenlaw 138). The idea is that,the very notion of physicians assisting a sick patient to commitsuicide would contravene the health professional’s mission ofexcellent palliative care. Helping patients to overcome difficultiesimposed by ailments is an important duty for healthcareprofessionals. Such an act would not only contravene the code ofconduct and principle of doing no harm that guides healthcareprofessionals but would also taint the integrity of the physicians.Physicians tack a sacred oath of protecting life and never to harmany patient knowingly, and as such a PAS would undermine the trustthat is supposed to exist between the physician and the patients andthe professional standards (Harris, Richard & Khanna,482). .
Anotherimportant point that is always cited by opponent of physicianassisted suicide is the risk of abuse that would emanate if PAS waspermitted. Allowing healthcare professionals to assist patients endtheir lives would pose too much risk to susceptible patients (Timothy& Greenlaw 137).This might lead to other unintended effects such as the terminationof patient’s lives against their will, or when alternative methodsmeant to relieve pain and suffering might be too dear or when thesuffering is difficult to manage and treat.
Moreover,opponents of physician assisted suicide contend that the society hasa duty to oppose any legal provision that poses a risk to the livesof innocent patients. The general feeling is that provisions thatsanction physician assisted suicide invariably will pose such a risk(Timothy & Greenlaw 138). Those who challenge PAS indicate thatif PAS is permitted on the grounds of compassion and mercy, then whatwill prevent healthcare providers from “assisting in” andconceivably enthusiastically urging, the death of anyone whose lifethey deem undesirable or of no value? In same vein, what wouldprevent the inconvenienced relatives of a terminally ill patient fromconvincing such patients to voluntarily request for assisted death?(Timothy & Greenlaw 139).
Thequestion also arises of what would become of individuals whotranspire in a special situation where the suffering patient who hassigned request to receive assistance to die, changes their mind, butdue to the prevailing condition are not in a position to make theirwishes known by the relatives and physicians? And, then there is thecontentious question that once we accept that only life of particularquality is merit living, where are we going to stop? (Timothy &Greenlaw 140). In this respect the guiding principle is that when we devalue onelife, ultimately we are going to devalue all lives. The situation ismade even more complex by the fact that there is no one to speak onbehalf of the handicapped children and senile men and women.
Finally,opponents of PAS vie that permitting assisted suicide wouldcontravene the right of others. Physicians and other healthcareprofessionals might find themselves under insurmountable pressure tocooperate in a patient’s suicide mission (Andre&Velasquez 1). In a framework that sanctions assisted suicideunjust demand might be made that may coerce physicians to go againstthe deeply help principle and values, in a bid to satisfy the desiresof a patient wishing to die. It is evident that the case made byopponents of PAS is reasonable because it places the fundamentalreverence for life and the risk of going down the slippery slope thatmight lead to the reduced respect for life (Andre&Velasquez 1).
Thephysician assisted suicide debate is not an issue that create ascenario that calls upon us to choose which values and principles aremore important to us, like it has been projected by many theopponents. It is a situation that places immense weight on therational interpretation of the principles that guide our interactionsand shape our duties. The numerous unreal situation created todiscredit PAS are pegged on very shaky premise. First, the notionthat providing assistance to suffering patient to end their life doesnot contravene the fundamental principle of ‘cause no harm’(Harris,Richard & Khanna 480). In fact, this is one special occasion when assistance haltssuffering and prevents harm to eternity. If it was possible toquantify harm and suffering, perhaps the PAS debate would be easy,but the fact that each patient has a different experience from agiven condition or disease means that, the patient is the only personwho can be in a position state when “enough is enough” and callfor assistance.
Second,the idea that sanctioning PAS would pose risk on susceptible patientsdoes not hold water. The main assumption is that a patient must bethe one who will initiate the process by posing a request. This meansthat until a patient calls for the physician’s assistance, othermethods of palliative care should be provided as deemed necessary(Harris,Richard & Khanna 482).
Theconcern that physicians would fail to provide excellent palliativecare and urge for death for patient whose life they deem undesirableis also tenuous. There are principle that guide healthcareprofessionals, and it is expected that in all situation all methodsshould be summoned to address health problems.
Opponentsof PAS forget that Laws that will permit PAS shall be detailed andspecific in a bid to avert abuse. This means that even in a situationwhere the physician might opt to circumvent the structuralsafeguards, there will be adequate remedies provided by the medicalmalpractice law (Harris,Richard & Khanna 482).Even though it is true that total number of suicides is likely toincrease significantly if PAS is permitted, such concerns have notbeen witnessed in states that have allowed PAS.
Terminallyill patient who make a request for assistance to end their lifeshould be accorded total support and help from the physician. Evenwith the massive strides made in the realm of palliative care, thereare those terminally ill patients that will request for PAS. It isevident that modern palliative care may provide relieve from pain andreduce terminal suffering. Nonetheless, it does not offer totalrespite of stressful symptoms and it is these patients that mightcall for assisted death. In the coming days, the PAS controversy willbe tabled on numerous arguments relating to medical, ethical, legaland religious factors. If physicians can use fundamental bioethicalvalues and principles to show the import of PAS, legislators and thegeneral populace might change their stance. Until then, terminallyill patient will continue to grapple with debilitating symptoms andhopelessness as stakeholders decide then next course of action.
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