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Bio medical ethics has advanced immensely in the last few years, yet some topics in it are extremely controversial and thought provoking at the same time, and physician assisted suicide is one such topic which has been constantly exposed to debates and controversy to such an extent that it poses an ethical dilemma not only to laypersons but to professionals as well.
Before seeing the different perspectives of the picture let us see what actually is physician assisted suicide. Also known as mercy killing it is an act of killing someone painlessly (especially someone suffering from an incurable illness)
'Physician assisted suicide' is a moral dilemma, that is it presents circumstances in which moral obligations demand or appear to demand that a person adopt each of two or more alternative but incompatible actions, such that the person cannot perform all the required actions. Before proceeding to see the different sides of the morally and ethically challenging concept of 'physician assisted suicide' let us bear in mind that the Hippocratic oath clearly expresses an obligation of non maleficence and an obligation of beneficence: "I will use treatment to help the sick according to my ability and judgment, but I will never use it to injure or wrong them."
Ethical arguments for 'Physician assisted suicide':
The question posed is "Under what conditions, if any, is it permissible for a patient and a health professional to arrange for assistance in intentionally ending the patient's life?"
Individuals have the right to decide about their own lives and deaths:
The argument is that every individual must be given the authority to decide what to do with one's life, which is that each person has the right to decide either to go on living or terminate life.
Counter argument: This right like every other right has its limits which are defined in that it is given 'only to the extent permitted by law'. Therefore every person cannot dispose of himself as per his/her wish.
The period of suffering can be shortened:
A terminally ill patient suffers not only physical but also emotional and mental agony. This method can shorten human suffering.
Counter argument: It is worthier to save a human life than to save a human from pain. It is a case of life versus death.
People have a right to die with dignity:
Terminally ill patients have the right to refuse life-sustaining treatment when their dignity, self-concept and self-respect are at stake and they are being reduced to a sub-human existence.
Counter argument: There is nothing undignified in fighting against death and pain. In fact it is courageous and heroic to face suffering for survival. The indignity is in capitulation.
Ethical arguments against 'Physician assisted suicide':
We should not play God:
God is the giver and taker of life. When man adopts this role and takes it upon himself to end a life, it is as if he is trying to play God.
When man tries to prolong human life he is trying to play God, who didn't plan for humans to be immortal.
We cannot be sure consent is voluntary:
It is not possible to take consent from terminally ill patients either when they are under drug effects or when they are suffering from excruciating pain.
This is not true in cases when consent is given prior to terminal illness and confirmed during illness.
Diagnoses may be mistaken:
Doctors may be mistaken in their diagnosis that the patient is going to die.
Every diagnoses from the simplest to the most complex carries a chance of error and with it the possibility of needless treatment. However, the correctness of diagnoses is a separate issue from the individual's right to request and receive treatment.
There is always a chance of a cure or some new relief from pain:
Chances of a 'wonder drug' may make a death decision precipitate and therefore wrong.
This seems unlikely to apply in final stages of terminal illness, the point where such decisions are usually taken.
Allowing death decisions will lead to abuses:
Such decisions could lead to nonvoluntary death decisions especially of defective infants, old and senile people and the hopelessly insane.
There seems no causal connection between taking death decisions and abuses especially concerning defective infants, old and senile people and the hopelessly insane. This however doesn't demonstrate that voluntary death decisions are immoral only that they shouldn't be legalized.
Subjecting ethical arguments to a 'GRAND SEZ WHO' analysis:
Before subjecting our argument to a 'GRAND SEZ WHO' type of analysis let us examine the central ideas of Arthur Allen Leff in his article "Unspeakable Ethics Unnatural Law". Herein he states that we want "To be perfectly ruled and perfectly free, that is, at the same time to discover the right and the good and to create it." The crux of his thesis is that in order to comprehend the written documents about present day law we shall have to specify the difference and conflict between found law and made law. Therefore it is apparent that in searching for an evaluation, it will be mandatory to find an evaluator: a sort of mechanical device possessing the capacity to pronounce judgments on the current status of affairs. Moreover if we want that the evaluation must have the capacity to be unquestionable, then we must compile the evaluator and its evaluative process in an equivalent manner. Who could this evaluator be but only the Omniscience HIM. The forthcoming task would be to search and identify the articulation of the evaluator. As it so happens in a system wherein the infrastructure is a God-based system, the sayings and commands of God cannot be questioned. Each and every pronouncement is a mandatory performance command, and it is the result of the interaction of definite rules and laws on proviso that the Promisor has the power of capacity. Arthur deliberates the existence of God and questions whether it is possible for Him to classify such a structure for the purpose of our reference. He questions rightly as to what exactly are the situations under which any other person's uncharted will would be able to survive the cosmic "SAYS WHO" and be accepted in a like manner. It can therefore be concluded that God alone can be the unquestionable assessor of good and evil. On the other hand if we make up our mind to do away with God then our position will be that of a double edged sword that is we will be free of God and yet at the same time we will be desolate and hopelessly wavering in unknown directions.
All ethical arguments are mere arguments in the light of this article. This means that no one's word can carry weight unless it is a Holy Word for who can have the power or authority to decide where to place the power that is ultimate, unchallengeable and normative at the same time. Arthur argues that who is it on whom we can put the responsibility of ultimately being the unquestionable evaluator, an authority who "ought to be able to declare "law" that ought to be obeyed?" except the authority figure in a God based supernatural system who is none other than God Himself.
Personal Reflection on analysis:
Personally I also seem to feel that arguments, in order to bear weight must be bound in the Holy Word as far as possible in order to avoid discrepancies or give power to 'might ' over 'right' or vice versa. Let me conclude by expressing the ideas of Arthur Allen wherein he feels that if we go in search of governing law and if our search hands over to us something that is "what we find is not as authoritative Holy Writ but just ourselves, just people, making the law" then how can we accept to be ruled by something that we have discovered. As far as Western Secular Ethics is concerned that is the reason it is subject to so much challenge and controversy for the term "the law" illustrates behavior but does not differentiate between good or right behavior. So we cannot claim that something is absolutely right but as right as is possible in comparison to anything else.
I can only agree with Arthur Allen when he says" Only if ethics were something unspeakable by us, could law be unnatural and therefore unchallengeable" for the question "SEZ WHO?" will remain unanswered.