Ethics of Physician-Assisted Death

Imagine enduring relentless pain each day—a stark reality for those with chronic conditions, overshadowing every aspect of life. The yearning to experience just a moment of relief becomes the sole desire. For many, this is not a hypothetical scenario but a grim reality. Despite advances in medicine, there are conditions that remain incurable, leaving patients trapped in a cycle of suffering. It is in these dire circumstances that the question of physician-assisted suicide (PAS) emerges—a practice where medical professionals provide a terminally ill or suffering patient with the means to end their life on their own terms.

This is closely related to euthanasia, where the medical professional directly administers the life-ending medication to the patient, offering a merciful escape from their agony (Gale Encyclopedia of Senior Health 1713-16).

Ethical and Moral Considerations

In a society that often avoids confronting the inevitability of death, discussions around PAS and euthanasia remain contentious. Andrew Solomon, in an NPR debate, emphasizes the difficulty in encouraging open conversations about mortality (npr.org). This reluctance is tied to deeply ingrained beliefs and moral considerations. The question arises: is choosing death a moral decision? Should individuals possess the right to decide their fate when faced with terminal illness? Death is an inevitable part of the human experience, whether it results from natural causes or external forces. For some, the right to die embodies dignity, allowing them to escape the clutches of a debilitating illness before it strips them of their autonomy and identity. It offers relief not only to the individual but also to their loved ones, sparing them the anguish of witnessing prolonged suffering. Moreover, PAS can facilitate organ donation, providing a legacy of life-saving potential for others. Therefore, I firmly believe that individuals facing terminal illness should have the right to choose a peaceful end with medical assistance—a view shared by a significant portion of Americans.

Legal Landscape in the United States

The legal journey of PAS in the United States began with Oregon, the first state to legalize the practice. The Oregon Death with Dignity Act, enacted on November 16, 1997, after initially passing in 1994 with a narrow margin, marked a pivotal moment in the conversation around end-of-life choices. The act survived legal challenges, securing a stronger mandate with 60% support in subsequent votes. Since its implementation, hundreds have exercised this right in Oregon. Washington followed suit in 2008, and Vermont joined the movement in 2013, each establishing legal frameworks for PAS. Although other states, including Connecticut, Hawaii, Kansas, Massachusetts, New Hampshire, New Jersey, and Pennsylvania, have considered similar legislation, they have yet to enact such laws (Starks, “Physician Aid-in-Dying”). Ultimately, the decision over one's life should rest with the individual, not the state.

Patient-Centric Ethics

The ethical considerations of PAS begin with the patient, as noted by Thomasma. In states like Washington, specific criteria ensure that the decision is informed and consensual. Patients must be at least eighteen, mentally competent, terminally ill, and capable of articulating their desire for a dignified end. They must also be informed of alternative options, notify their next of kin, and fulfill legal documentation requirements (Starks, “Physician Aid-in-Dying”). These guidelines serve to protect against hasty decisions and ensure that PAS is a carefully considered choice, not a product of temporary despair.

PAS can be particularly complex in cases where families cannot afford the prolonged care of a terminally ill relative. While some might view this as a selfish act, it is crucial to understand the context: when an individual can no longer perform basic daily tasks and faces inevitable decline, PAS can offer a compassionate escape. Importantly, the process involves multiple documented requests from the patient, allowing for reflection and reconsideration. In Oregon, for instance, out of 1,173 prescriptions issued, only 752 patients proceeded with PAS, illustrating the internal deliberation many undergo before making such a profound decision (Kliff, “California Has Legalized Physician-assisted Suicide. Here’s How the Law Works”).

Historical Context and Contemporary Debate

The controversial figure of Dr. Jack Kevorkian, often dubbed "Dr. Death," remains a focal point in the history of PAS in the United States. A graduate of the University of Michigan Medical School, Kevorkian's mission was to alleviate the suffering of his patients. By 1994, he had assisted in 21 deaths, leading to multiple legal battles and jail sentences. Despite his notoriety, Kevorkian's actions highlighted a critical issue: the need for compassionate options for those facing terminal illness. His legacy continues to provoke debate about the ethical responsibilities of the medical profession and the rights of patients to determine their fate.

As Stephen Hawking, a renowned physicist who battled a debilitating illness, poignantly observed, "I think those who have a terminal illness and are in great pain should have the right to choose to end their lives, and those that help them should be free from prosecution. We don’t let animals suffer, so why humans?” This analogy underscores a fundamental question about human dignity and compassion.

Conclusion

In conclusion, the debate surrounding physician-assisted suicide is not merely an ethical or legal issue; it is a deeply human one. At its core, it touches on the fundamental rights of individuals to make autonomous decisions about their lives and deaths. While the path to legal acceptance of PAS is fraught with challenges, the underlying principle remains clear: individuals facing insurmountable pain and terminal illness should have the option to end their lives with dignity and compassion. As society continues to grapple with these complex issues, it is imperative to foster open dialogues that prioritize empathy and respect for individual choice. The journey toward a more humane approach to end-of-life care is ongoing, and it requires a collective commitment to understanding and addressing the needs of those who suffer.

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