PHYSICIAN ASSISTED SUICIDE

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Introduction

Problem Statement

Is there a right to die? The practice of which a doctor gives a patient a gravely damaging dose of a substance, which is the normally requested by the patient, that he or she has intentions of using to end his or her life is referred to as Physician Assisted Suicide. Some feel that a terminally ill patient should have a legal right to control the manner in which they die. Physicians and nurses have fought for the right to aid a patient in their death. Many families of the terminally ill have exhausted all of their finances taking care of a patient who is dying and would much prefer the option of assisted suicide to bankruptcy. While there are many strong views against Physician Assisted Suicide, one of the most compelling is that patients who are terminally ill have the right to die in not only a humane but also in a dignified manner. But in hindsight, can we assure that there is dignity in dying necessarily when the doctor who is so trusted by the patient and their family, and whose professional ethics are to further and sustain life, injects a patient who is terminally ill with a dose of medication that is so lethal it immediately puts an end to that individuals life? Each and every culture including our own have a taboo against murder. All across cultural and religious groups the practice of physician assisting with suicide is considered wrong. As stated by Leon R. Kass, 2008, even when requested by the patient, the taboo against doctors killing patients "is the very embodiment of reason and wisdom. Without it, medicine will have lost its claim to be an ethical and trustworthy profession." Obviously, the moral and ethical dilemmas surrounding the legalization of physician assisted suicide will be an issue for years to come. Dying is as much a natural process of life as birth. Families have fought to have their loved ones kept alive even when there was a DNR (do not resuscitate) or advanced directive. My position is against Physician Assisted Suicide because the decision of when and where the time of our death should occur is one that only God has the right to decide, because no person or doctor has the right to end a life.

Hypothesis

Independent Variable

Physician Assisted suicide comes into existence when a doctor supplies a patient with the ways and means of putting an end his or her life, most times with a prescription for a deadly dose of a medication or substance. The patient then takes the drugs without the assistance of the doctor. The way that this is done is different from euthanasia, which is when the doctor gives the lethal dose to the patient or he or she carry out some other act, such as administering a lethal injection that puts an end to the patient's life. In most states, Physician Assisted suicide is an illegal act

Dependent Variable

Physician Assisted Suicide runs directly opposite to the belief that the duty of the doctor is to save and prolong life. Furthermore, if Physician Assisted Suicide were to become legal, there is a possibility that some form of abuses would occur. For example, poor and other elderly individuals might be secretly burdened to choose Physician Assisted Suicide over more complicated and expensive palliative care options.

Review of the Literature

According to the New England Journal of Medicine, a survey was done nationally in the United States which showed that in 1996, 3102 questionnaires were mailed to a stratified probability sample of physicians in the 10 specialties in which doctors are most likely to get requests from patients for assistance with suicide or euthanasia. 1902 completed these questionnaires. Eleven percent of the physicians said that under current legal constraints, there were circumstances in which they would be willing to hasten a patient's death by prescribing medication, and 7 % said that they would give a lethal injection; 36% and 24%, respectively, said that they would do so if it were legal. Since beginning practice, 18.3% of the doctors stated that they received a request from a patient for help with suicide and 11.1% had been asked by their patient for a deadly injection. Sixteen percent of doctor's who received such requests, or 3.3% of the entire sample, reported that they had written at least one prescription to be used to speed up the death of a patient, and 4.7%, said that they had given at least one lethal injection (Meier et al, 1998). A second set of research done by Braddock, Tonelli, 1998 also noted that Physician Assisted Suicide is unethical for one of many reasons. First, there is the argument of the sanctity of life which details intense religious and worldly beliefs against taking the life of a human being. The argument is also that assisted suicide is also wrong morally because it is contrary to these traditions. Second, passive vs. Active distinction: The argument here is that there is a significant distinction between passively "letting an individual die" and actively "killing an individual." Of course there is the argument that refusing to treat someone or refraining from treating equals to letting the individual die (passive) and is excusable, while Physician Assisted Suicide equals to killing an individual (active) and is not excusable. Third, the potential for abuse which argues that particular groups of people who does not have the ability to obtain care and support, may be pushed into physician assisted death. Also, physician assisted death may become a strategy for cost-containment. Family members who are burdened and other health care providers may attempt to persuade the patient toward physician assisted death. To shield the patient from these deceptions, it is the argument that Physician Assisted Suicide should remain illegal. Fourthly, professional integrity in which those who oppose physician assisted suicide point to the historical ethical beliefs of medicine, strongly opposed to taking life. The general concern is that connecting Physician Assisted Suicide to the practice of medicine could damage the way in which the general public views the profession. Lastly, fallibility of the profession in which the worry is that doctors will make errors (Braddock, Tonelli, 1998). The University Of Washington School Of Medicine followed up with research to prove the illegality of Physician Assisted Suicide. Research by Meier et al, 1998 states that in most states, including the state of Washington, assisting in a suicide is considered a crime and the state of Oregon is the only state where Physician Assisted Suicide is presently legalized. In the case of Compassion in Dying v. Washington, the Ninth US Circuit Court of Appeals held that individuals have a right to choose how and when they die. Later, the Second Circuit Court found a New York law on Physician Assisted Suicide in conflict with the 14th amendment, which says that no state shall "deny to any person within its jurisdiction the equal protection of the laws." The Court held that competent patients were being treated differently than incompetent patients. The US Supreme Court has ruled that there is no constitutional right to assisted suicide, and made a legal distinction between refusal of treatment and Physician Assisted Suicide. However, the Court also left the decision of whether to legalize Physician Assisted Suicide up to each individual state (Braddock, Tonelli, 1998). Oregon's Death with Dignity Act which was established on October 27, 1997 permits terminally ill Oregonians to "end their lives through the voluntary self-administration of lethal medications, solely prescribed by a physician for that purpose."' The statute requires the Oregon Department of Human Services (ODHS) to collect information about patients and physicians who participate in the physician- assisted death (PAD) process. It also requires ODHS to publish an annual statistical report (Aungst, 2008). According to Oregon public health officials, by the end of 2001, doctors in the state had legally prescribed a lethal dose of barbiturates for 139 patients. Ninety of these patients ingested the medication and died Dr. Timothy Quill was investigated but not convicted for the part he played in the suicide of a patient after he made public his account of the incident. In November of 1998, 60 Minutes aired a tape of Dr. Jack Kevorkian administering a lethal injection. His patient, 52 year-old Thomas Youk, suffered from Amyotrophic Lateral Sclerosis (ALS), otherwise known as Lou Gehrig's disease. As a result of the show, Kevorkian was tried for first degree murder in Oakland County, Michigan. Prosecutors argued that, in giving a lethal injection, Kevorkian stepped over the line of Physician Assisted Suicide into euthanasia, and that his actions amounted to murder. Kevorkian was convicted of second degree murder, and is currently serving a 10 to 25 year prison sentence (Braddock, Tonelli, 1998). Since 1990 four Dutch government-sponsored surveys of end-of-life decision-making by Dutch doctors have been carried out (covering 1990, 1995, 2001 and 2005 respectively). The surveys have shown that in thousands of cases doctors have broken the legal and professional guidelines regulating Physician Assisted Suicide, not least the requirement that doctors report each case to the authorities. For example, the first survey showed that in 1990 over 80 percent of cases went unreported and were instead illegally certified by doctors as deaths from "natural causes." The latest survey shows that, in 2005, 80 percent of cases were reported, a significant improvement, but that 20 percent of cases were still illegally certified as death from "natural causes.

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