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My Ethical Views on Physician Assisted Suicide
Physician assisted suicide is immoral in the case of people who are alive and desire to terminate their life. However, there are extreme cases when hastening the dying process is justified in the circumstances of individuals who are in intense physical impairment.
Physician-assisted suicide is defined as the practice where a physician provides a patient with a lethal dose of medication, upon the patient’s request, which the patient desires to use to end his or her life. The Harvard Medical School conferred that we are “dead” when there is permanent loss of consciousness in the higher brain, even though one may not be flat lined. The idea for physician assisted suicide is for a medical doctor help someone die who is still alive but desires to terminate their own life due to an impairment or illness which causes suffering upon the individual. The question we must consider is where do we cross the line between suicide and murder.
Although suicide or attempted suicide is legal in every state, assisting in a suicide is considered illegal in every state except Oregon. Additionally, the Code of Medical Ethics section 2.211 declares that physician assisted suicide is “fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.” There are too many risks associated with physician assisted suicide that managing such a factor would be impossible to control. Even the best medical professionals are human beings with the potential for error. An undiagnosed or untreated mental illness can add to a patients desire to die, which in the case of physician assisted suicide, would be a type of murder since the patient is not in a state of mind to make such a decision. “Improperly managed physical symptoms” can add to physician error and end a life too early when an individuals suffering can be eased in other manners that could prolong life. Death is one of the most feared experiences a person will ever face. The suffering that is associated with death may outweigh the actual suffering the patient feels, and doctors may overlook this due to the fa?ade the patient may play in order to exercise their “right to die”.
Another aspect of physician assisted suicide is this procedure devalues the lives of those who are disabled. A family may feel that it would ease their financial burden if their loved one committed suicide and desired to aid them in the process. However, if those are not the true wishes of the individual, how can we put a price on a person’s life, the only chance we will ever have to partake in this experience? For a medical doctor, there is a sense of obligation to the individual to ease their suffering. The conflicting problem is that the assisted suicides cannot be effectively and properly regulated; the lines are too fuzzy as to where we can draw the limitations.
A rights ethicist would argue the moral questions that it is the duty of physician’s to “do no harm…and those rules are justified by reference to a general conception of personal and social welfare.” The rights that are weighed desire to balance the risks to be taken against the possible good that could be attained through other physical therapy. Anesthesia is used to dull the pain during a surgery, in attempt to ease the pain of the patient. Yet, in most cases anesthesia does not deliver death as the final result. There is an enormous difference between giving a patient anesthetics and assisting them commit suicide. The Oath that doctors must take reaffirms “I will not never give a poison to anyone to cause death, not even if asked.” I believe that this affirmation suggests that physician assisted suicide is committing a murder. Keeping in mind the best interest of the patient may subdue the doctor to assisting a patient who is not “ready to die”. The type of respect and trust that medical practitioners hold over their patients contains too much room for abuses and mistakes on their behalf to go ahead with an assisted suicide. The “Respect for Human Life” can also be inferred to mean “sancticity of life”. Life will become so devalued that people will focus their attention on death. There would no point at all to life and no reason for us to be here.
From a utilitarian point of view, physician assisted suicide can appear to be morally justified in all cases. The death of the patient would not only ease their suffering but the suffering of the family too. It would also eliminate the financial burden and could put that money to work in other advancements in medicine. A rule-utilitarian would produce the most good according to “individual acts [which] are right, then, when they conform to the moral code that would produce more overall good than would alternative moral codes”. Additionally, the focus is drawn to the nature of the consequences of the action not necessarily the individuals’ action. This easier to put under a generic rule since the focus is on the outcome, not what the action is.
Even though assisting a suicide may seem like it is producing the most good for the individual involved, it could lead down the “slippery slope” to even greater misery in the future. “Utilitarians leave some room for rights, but ultimately they reduce rights to utility.” A rights ethicist would argue that the rights of the person outweigh the consequences of the action. First, we must address our basic human rights, which are right to life, property, and the pursuit of happiness. If a physician intervenes and offers the means to destroy another life, that is clearly violating a human life. On the other hand, one could question the quality of life. If the quality of a person’s life is so miserable, it seems that committing suicide would ease the suffering. Nonetheless, a rights ethicist confers that the right to life is greater than any desire to help someone end that life. There are too many rights that can be violated along the way when a person assists someone commit suicide.
I believe that there are certain cases when physician assisted suicide can be justified ethically. One example is when the quality of life has deteriorated to the point where a peaceful and painless death would ease the suffering of the individual. The individual must have loss the ability to care for themselves in the most basic ways and be terminally ill within a short time span of death (no more than 3 months). I think that a physician can help speed up the dying process by prescribing medication for the individual to take in a specific dosage, which will progress death for the individual. This preserves the rights of the individual to choose death over their quality of life while maintaining the value of life.
In my experience with my father’s death by cancer, I think that towards the end of his illness, medical intervention would have been appropriate had he chosen that option. During the last two months of his life, he had little to no control over most of his bodily functions. His body was extremely thin and weak, having no desire for food and his mentality was wearing as the days took their toll on his physical strength. I think that in cases such as these, the body itself has started to shut down and physician assisted suicide can be a justified option because it hastens the dying process that has already started. The way this can be handled is through strong pain medication, which may hasten death. The patient must be terminally ill and suffering where a doctor may prescribe dosages of pain medication that impair respiration or have other effects that may hasten death. Most professional societies and court decisions have found that this is justifiable as long as the principal intent is to relieve suffering. For these types of individuals, I do not consider this suicide, only a helping hand to what nature has started.
I believe there are certain types of prerequisites that must apply to a patient in order to qualify for medical intervention. The motive and degree of suffering: are there physical or emotional symptoms that can be treated? If the patient has a family, he must have discussed the plan with them. The accuracy of treatment or suggested prognosis: every consideration should be given to receiving a second opinion to validate the diagnosis. Finally, the patient must understand the state of the disease and expected course of the disease. This is the most important factor since the patient could be misinformed or misunderstand about clinical information. Therefore, if a physician helps someone slip into death who is already dying, it is moral as long as it meets my set requirements.
In comparison, those who feel that physician assisted suicide is justifiable in other terms tend to believe that the decision to die is derived from the patient and the physician is another tool for the patient to use. First, there is respect for autonomy. A “healthy” person can decide where, when, and how he will die if he chooses to take control over this aspect. Justice implies that for patients who refuse treatment, suicide may be their only option to achieve control over their life. Through death, end of suffering is achieved. Suffering refers to pain, physical and psychological problems. As exemplified throughout the medical profession, suffering calls upon the compassions of the affected individuals.
The first problem with the above list is that most “healthy” people do not try to commit suicide unless they are extremely depressed and see no future in a normal life. The medical profession should seek to show people the value of a normal life and define that most people go through tragedies and hardships, however that suffering can be overcome in time and through proper medication if needed. They are in a difference between passive and active distinction as well. We need to be able to differentiate between passively “letting die” and actively “killing.” Physician assisted suicide may equate to actively “killing” and is in no way justifiable. One renowned example of this is Dr. Kevorkian’s murder of his patient so that he could attain publicity for his cause. The potential for abuse can be prevalent for certain groups of people who are lacking access to care and support and may be pushed into assisted death. To protect against these abuses, physician assisted suicide cannot be justified in all cases. Patients who refuse to be medically treated show signs of loss of hope and faith in humanity. I believe that a patient has a choice, to suffer without medical treatment or to try the alternative and see if it helps.
Death is a one-way ticket, once you decide to choose death, there is no returning to the world we know as living. Physician assisted suicide is contradictory to the traditional duty of the doctor to preserve life. Besides, many abuses would take place if this were legal. In certain cases, I believe that it is ethical based upon a rights ethicist viewpoint to provide medicine that will ease an individuals’ suffering and hasten death. There are too many risks involved which could deprive people of life, this one chance we get to experience it. When a person commits suicide, there is always the uncertainty of whether or not it was the appropriate time for the individual to die. Physician assisted suicide creates too many problems within the system and reflects a shadow of doubt upon our own values of life. It projects our own doubts of life and the reason to live is diminished. Everyone will die; it is part of our aspect of being mortal. Through medication, we are able to ease the suffering yet respect the “sanctity of life” by giving a person the greatest opportunity to feel and experience. We must be careful to realize that having a right to choose does not necessarily mean the right to cause harm upon oneself or terminate the life of someone else out of compassion.
Crane, Diana. The Sanctity of Social Life: Physician’s Treatment of Critically Ill Patients. Transaction, 1977.
Jonsen, Albert R. A Short History of Medical Ethics. Oxford, 2000.
Martin, Mike. Everyday Mortality. 3rd Edition. Wadsworth, 2001.
Mill, John Stuart. “Utilitarianism”. Moral Philosophy. Edited by Louis P. Pojman. Hackett, 1998.
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