Abstract
This paper explores four scholarly articles that report on physician-assisted suicide. It draws its arguments from several sources that discuss the controversial decisions that doctors are expected to make. This paper examines Manning’s (1998) work on Euthanasia in relation to Gorsuch’s (2006) research.
Manning (1998) asserts that physician-assisted suicide is an act that requires a substantial amount of scrutiny before it is ever executed. Gorsuch (2006) argues that physician-assisted suicide should only be considered if the patient’s wellbeing is at stake. This paper highlights the different opinions within the fields of law and medicine. This paper also examines the moral and ethical decisions that doctors are expected to make with regard to euthanasia.
Introduction
The medical community is always at a crossroads when it comes to making life-threatening decisions. Physicians are not permitted to assist patients in committing suicide. Doctors are often forced to make morbid decisions. Nevertheless, they are guided by a code of ethics. However, the American Society of Internal Medicine does not encourage physician-assisted suicide (Gorsuch, 2006). Physician-assisted suicide challenges the norms of medical professionalism (Manning, 1998).
According to Gorsuch (2006), the Hippocratic Oath enables doctors to make logical decisions. Helping a patient to commit suicide is similar to a breach of contract. Encouraging or legalizing physician-assisted suicide is a decision that the medical community does not support. There is too much controversy involved. The Hippocratic Oath requires doctor to put the patients’ needs above their own (Manning, 1998).
According to Cauthen (1998), “It also forbids the taking of fees for teaching medicine. This tells us that we have to judge each tenet by its own merits and not regard it as a final authority in all matters. The American Medical Association has consistently condemned physician-assisted suicide as an unethical practice” (p. 1). As such, the courts and the medical community should institute structures that regulate such procedures. There are extreme cases, which may require physician-assisted suicide.
Literature Review
Statistical data has shown that public opinion favors physician-assisted suicide (Gorsuch, 2006). This is only evident in extreme cases, where the patient is likely to experience a slow and painful demise (Manning, 1998). The Hippocratic Oath often takes precedence over physician-assisted suicide. Doctors are expected to save lives. Taking a patient’s life is a decision that has not yet been determined by the courts.
Euthanasia refers to killing a person to ease their suffering (Manning, 1998). Manning asserts that there are two types of euthanasia. Active euthanasia is a process that occurs when a person administers drugs to ease the suffering of a terminally ill patient (Manning, 1998). Passive euthanasia is the act of withdrawing or withholding treatment that may sustain a given patient (Gorsuch, 2006).
Passive euthanasia is legal if when it corresponds to several medical procedures (Gorsuch, 2006). Passive euthanasia was performed in the case of Karen Quinlan (Manning, 1998). “Physicians argued that she was in an irreversible coma, caused by a drug overdose. Her life support system was withdrawn after the court ruled in her parent’s favor” (Gorsuch, 2006, p. 87).
Euthanasia is an established medical procedure (Manning, 1998). Most policy makers encourage doctors to act as caregivers and healers. Patient-assisted suicide goes against only one of these principles. A physician should tend to the needs of his patients. This may include withholding treatment if the patient decides that he does not want it.
Physician-assisted suicide refers to administering drugs to hasten a patient’s demise (Gorsuch, 2006). Most scholars argue that euthanasia refers to the act of killing a person o ease his suffering (Manning, 1998). The term loosely refers to taking a person’s life to ease their suffering.
Levin (2003) describes euthanasia as the act of killing a person who has an untreatable illness to ease their suffering. Voluntary active euthanasia is the process of injecting a patient with a deadly concoction upon their request.
“Involuntary euthanasia occurs when a medical provider or some other person administers a lethal dose of a drug to a patient without the patient’s specific request” (Levin, 2003, p. 1). This is a crime. It is an act of murder and the offender should face prosecution. A patient’s consent is paramount when it comes to withholding or administering treatment.
Physician-assisted suicide lacks unanimous support due to several conflicting factors. A patient may display some psychiatric symptoms (Manning, 1998). These symptoms may encourage the patient to seek medical assistance in committing suicide. The medical community does not stand for such behavior among its physicians.
“Since 1992, proposed legislation authorizing physician-assisted suicide has failed in Alaska, Arizona, Colorado, Connecticut, Hawaii, Iowa, Maine, Maryland, Massachusetts, Michigan, Nebraska, New Hampshire, New Mexico, Rhode Island, Vermont, and Washington” (Levin, 2003, p. 1). Patients suffering from psychosis should be given other modes of treatment such as counseling and rehabilitation (Gorsuch, 2006).
Some patients cannot afford to pay their medical bills. They would rather die than live in abject poverty. Some patients cannot afford to clear their medical expenses.
Such patients seek physician-assisted suicide. “According to recent surveys, a majority of doctors in some areas — 60% in Oregon, 56% in Michigan, and 54% in Great Britain — favor the practice in extreme circumstances” (Cauthen, 1998, p. 1). Gorsuch (2006) asserts that physician-assisted suicide is a practice that should only be acceptable if the patient is likely to die from the disease.
Withdrawing life support is an example of euthanasia (Gorsuch, 2006). It is not a form of physician-assisted suicide. Patients on life support are often given the chance to sign a Do Not Resuscitate Order if the need to do so should ever arise (Manning, 1998).
This disclaimer ensures that the patient does not receive life support when it seems necessary. Sometimes the decision falls on the patient’s spouse or next of kin. The person responsible for signing the document takes part in the process of euthanasia. This is only performed if the patient has little chance of surviving certain medical procedures.
Unrelenting discomfort encourages most patients to seek physician-assisted suicide (Manning, 1998). Some medical procedures employ the use of painkillers. Physicians may lower the dosage of such drugs to ensure that the patient does not become addicted to the medication (Gorsuch, 2006).
Such patients may continue to experience unrelenting discomfort. They may even seek physician-assisted suicide as a means to escape their seemingly torturous experience. According to Cauthen (1998), “most people recognize that taking the life of a violent aggressor to preserve one’s own life is permissible if this is the only way to keep from being murdered” (p. 1)
Manning (1998) argues that old patients suffering from untreatable illnesses should be given the right to choose physician-assisted suicide. Cauthen’s (1998) study states the following:
The restricted argument for physician-assisted suicide does not logically authorize the killing of all innocent people but only those whose who meet all three requirements stipulated. It is illegitimate to abstract some remote generalized feature and make deductions from it as if all the other factors don’t matter. They do matter. Circumstances alter cases. Hence, each situation must be taken up on its own with all its necessary features intact. Each situation has a configuration of components that are essential to it — all of which must be honored.
To show that a slippery slope is present, it would be necessary to show that no relevant differences exist between a first step that is justified and subsequent steps that are not. If no relevant differences arise, the subsequent steps should also be acceptable.
If relevant differences are present, they must be taken into account to determine whether they draw a line that should not be crossed. A more formidable version of the slippery slope argument contends that the more general postulate in the defense of assisted death is the principle of individual autonomy.
If one believes that an individual has an unlimited right to determine when life has become intolerable, then obviously this cannot logically be restricted to cases in which the patient is dying and in intractable physical distress. People in all sorts of conditions might conclude that life had become hopelessly intolerable and opt for death (p. 1).
Terminally ill patients are major candidates for physician-assisted suicide. Some scholars have argued that such a patient reserves the right to choose how they intend to die (Gorsuch, 2006). A terminally ill patient engaging in physician-assisted suicide saves his family from escalating medical costs.
Some medical procedures only delay the inevitable. Doctors often inform the patients whenever risks are involved. Physicians are also advised to inform the patient of the potential risks involved when carrying out certain procedures. Physicians should also discuss procedures that may only prolong the patient’s suffering. They should help the patient to choose from a certain number of options.
Patients have the legal right to decide what kind of treatment they prefer (Manning, 1998). This depends on the options that are offered by the physician. Withholding or withdrawing life-sustaining treatment is a practice that is well established within the medical community (Gorsuch, 2006). In such cases, patients are expected to sign a disclaimer. This document ensures that no legal action is taken against the doctor should any complications arise (Manning, 1998). It also protects the patient’s interests.
A hospital can save on time and resources if physician-assisted suicide is applied in extreme cases. Manning (1998) argues that doctors and orderlies should spend most their resources on patients who may have a higher chance of survival. This process can save the lives of more healthy patients. It may seem cruel but it is effective. Doctors would rather save lives than waste valuable resources.
Terminally ill patients are often treated in the Intensive Care Unit. They need more medical resources than other patients do. Those who choose to engage in physician assisted suicide save both time and resources, which other patients may need.
Terminally ill patients and their relatives experience a lot of emotional pain and discomfort. Physician-assisted suicide can give them the closure they need (Gorsuch, 2006). Keeping the patient alive can be a slow and traumatizing experience for all the parties involved. According to Manning (1998), “patients would rather die with dignity than be reduced to a slow and painful death” (p. 114).
Doctors can harvest the vital organs of terminally ill patients who have engaged in physician-assisted suicide (Gorsuch, 2006). Gorsuch (2006) argues that these transplants can save the lives of other patients with curable conditions.
Manning (1998) argues that laws can be constructed to meet the needs of terminally ill patients. Legislative incentives can be put in place to regulate the use of physician-assisted suicide.
Other scholars argue against the use of physician-assisted suicide. Gorsuch (2006) argues that despite its many advantages, physician-assisted suicide violates the Hippocratic Oath. It can be used as an excuse to commit suicide under false pretenses.
Passing a law that permits physician-assisted suicide can encourage patients and doctors to abuse of its principles (Gorsuch, 2006). Patients suffering from psychosis may use physician-assisted suicide to escape from their own treatable illnesses (Manning 1998). Irresponsible doctors may use it to justify their mistakes.
Physician-assisted suicide does not correspond with several religious beliefs (Gorsuch, 2006). Most religions do not condone suicide. Religious groups argue that life is sacred (Manning, 1998). Medical miracles have occurred on several occasions. Terminally ill patients have a sliver of hope. Doctors can sometimes, misdiagnose a patient. In such situations, physician-assisted suicide may not be an option. “Fewer abuses might occur if current practices were open to scrutiny and regulation” (Cauthen, 1998).
Terminally ill patients take risks whenever they ask their physicians for assistance in committing suicide. Levin (2003) states that, “physician-assisted suicide became legal in the state of Oregon on October 27, 1997. From the date of legalization through December 31, 2000, there have been seventy reported cases of people utilizing the law to end their lives” (p. 1).
Conclusion
Most people who commit suicide suffer from depression and anxiety (Gorsuch, 2006). Terminally ill patients are in a class of their own. Manning (1998) asserts that adequate pain relief is not responsible for the decisions that patients make with regard to physician-assisted suicide. Gorsuch (2006) agrees and argues that physicians should always prioritize the relief of their patients’ suffering.
“The main abuse now existing, however, is that by denying terminally ill patients a choice in hopeless situations, we consign those whose misery cannot be relieved to pointless, needless agony” (Cauthen, 1998, p. 1). Physician-assisted suicide is a complex and sensitive topic of discussion (Manning, 1998). Legislation is a possibility that needs to be scrutinized before an actual law can be passed (Gorsuch, 2006).
Such a law should protect the rights of terminally ill patients as well as comatose patients on life support (Manning, 1998). Cauthen (1998) argues that physician-assisted suicide should only be legalized if it corresponds to the following conditions; “1) The patient must be hopelessly ill and near death, (2) mentally competent, (3) in great and uncontrollable pain or discomfort, and (4) make a voluntary request to be given assistance in hastening death” (Cauthen, 1998, p. 1).
If all the necessary steps are taken, both active and passive euthanasia can be adopted as ethical medical procedures (Levin, 2003). Patients reserve the right to end their suffering (Levin, 2003). The procedure can offer a permanent solution to the problem.
References
Cauthen, K. (1998). Physician-Assisted Suicide and Euthanasia. Web.
Gorsuch, N. M. (2006). The future of Assisted Suicide and Euthanasia. New Forum, 21(1), 227-308.
Levin, M. (2003). Physician-Assisted Suicide: Legality and Morality. What is Physician Assisted Suicide? Web.
Manning, M. (1998). Euthanasia and Physician-Assisted Suicide. Killing or Caring?, 47(1), 102-125.