An Ethical Argument For Physician Assisted Suicide Essays Examples
The issue of physician assisted suicide is a highly sensitive one with extremely opinionated voices dominating both sides of the argument. Passionate conversations about this issue take place between lawmakers, Facebook friends and family members across the dinner table. There are the people who believe that legalizing physician assisted suicide is playing God and immoral, placing doctors in the crosshairs of breaking the Hippocratic Oath. On the opposing side, there are the people who believe that every human has the right to die with dignity. Recently a twenty-nine year old woman named Brittany Maynard became the face for the death with dignity movement. In an essay she described the horrifying physical misery she was in from her terminal brain cancer: “I am light-sensitive, noise-sensitive, suffer chronic pain, balance issues, unpredictable seizures, (post-seizure) speech interferences, nausea and more the meds themselves have led to uncontrolled water retention, weight gain, skin changes, bruising I could go on.” (2014, para 9). Maynard’s first person account of her painful battle with a disease that was going to kill her no matter what she did effectively takes a subject that is conceptual in nature and places it square in the context of reality. It is one thing for a perfectly healthy born-again Christian to quote the book of Job as a source of inspiration to stoically manage the devastating course life can sometimes take. It is quite another to be in the position of facing unfathomable pain and astronomical medical bills with the only possible end result being death. Ethically, the only option is to legalize physician assisted suicide. The state of Oregon has legalized physician assisted suicide and done so in a manner that it ethically appropriate. The Death with Dignity Act ensures that it complies with ethical standards as it allows physicians to prescribe medication that will end the life of patients who are suffering. The act is very specific in its wording to uphold ethical standards: “An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner in accordance with ORS 127.800 to 127.897.” (Death with Dignity Act, 2013)
Ethics is the label used to describe the decision making process humans make when leading their lives. At its core, ethics is necessary to create a foundation from which to lead a life worth living. The question is, in a situation as nebulous as physician assisted suicide what is the ethical thing to do? Levy et al describe the difficulties surrounding the issue succinctly: “these are clearly questions of existential medical ethics including exploring issues of the value of life, the value of death and the value of the individual’s autonomy in any given society.” (2013, pg. 403) To create a meaningful foundation from which to make an ethical decision in support of physician assisted suicide, value must be assigned to life, death and autonomy. How does one assign value to such broad ideas? Does all human life have value regardless of quality? Was there value to Hitler’s life regardless of the horror he inflicted on so many innocents? Is the value of death simply something to avoid at all costs? Or is death simply a part of the life cycle which current society places far too much emphasis on? And what value can life have if there is not total autonomy – including the freedom to choose when, how and why to end the human life? Ethically the answers to the questions of value for life, death and autonomy can lead to no other conclusion than justifying physician assisted suicide.
The value of life can best be determined by a simple mathematical equation. Does the pleasure one experiences in life outweigh the pain? And if the pain outweighs the pleasure is it temporary or is the rest of the human experience going to be more pain than pleasure? In cases such as Brittany Maynard it becomes clear that the pain far outweighs the pleasure and will do so for the rest of her life. In situations in which life circumstances result in the remainder of life to be spent in a downward spiral of pain the most humane thing society can do is provide options to avoid the suffering. Though physician assisted suicide differs from euthanasia in that the doctor is an active participant in the latter and only a means to the end in the former, the two are similar enough as they both relive suffering: “Euthanasia is a profoundly humane, merciful, and noble humanitarian gesture because it relieves suffering.” (Boudreau & Somerville, 2015, pg. 8) Ethically, decisions should be based on what action has the least amount of negative consequence. In situations in which a person is going to die because of an illness or other failing of the body there are far fewer consequences to physician assisted suicide than in allowing death to take its natural course. Physician assisted suicide alleviates the suffering that comes with the deteriorating of the body. The person is going to die, there is no stopping that, the most humane thing to do is give people the chance to avoid the pain that can come with it. Additionally, there are tremendous costs involved in a prolonged death. There are the medical costs, the loss of income for family members who are taking care of the person who is dying and the cost of hospice. That is not even taking into consideration the emotional and mental turmoil both the person dying and the loved ones go through during a long, drawn out process. Ethically, it is clear that the value of life is reliant on the level of pleasure or enjoyment a person can experience and the necessity for the joy of life to outweigh the pain. If joy doesn’t exceed pain there is suffering and a life filled with pain does not offer value to the person living it. Therefore the question about the value of life raised when contemplating the ethics of physician assisted suicide is answered in the affirmative, allowing physician assisted suicide as an option is the only ethical option. Add in the overwhelming amount of negative consequences resulting from allowing a drawn out death take its sweet time and no person capable of critical thinking would be able to deny that the option of physician assisted suicide is required for a civilized society that relies on a solid foundation of ethics from which to make decisions. As important as assigning value to life is to the ethical debate about physician assisted suicide, assigning value to death is just as important.
The value assigned to death varies in different cultures. In third world countries death is more common than it is in first world countries so it isn’t something people are as afraid of. They don’t expect to live long, fulfilling lives so they are not as devastated when lives are cut short. Some countries have such a population problem that baby girls are cast out in order to make way for boys. Cultures that believe in reincarnation see death as an often welcome transition as it means that the person with good karma is going to be reborn into a higher status of life. In the past, some cultures celebrated death and welcomed it. Vikings would kill the wives of kings who pass away so she could pass into Valhalla with him. The ancient samurai would commit suicide rather than face the shame of losing a battle. Taking into account these different views of death, there is not an objective right or wrong value to assign to death. The influence of the secular humanist view which embraces the belief that this human experience is all there is have increased the urgency for avoiding death at all costs. The other prevalent view is based on a belief in a higher power, a God who has gifted each person with life. This is the predominant argument that the people who protect physician assisted suicide use, the idea that human life is not owned by the individual who is living it but is owned by God. Therefore, no one can rightfully end a human life other than God. This argument holds no water ethically in the debate over physician assisted suicide because it is based on belief rather than fact. How can one possibly defend forcing people to endure unimaginable suffering based on a belief? If the person suffering chooses to suffer based on a belief that is one thing, it is quite another to have suffering forced upon someone due to other people’s beliefs. Ethically, it is only right to give physicians the choice as to whether or no he or she wants to be able to assist in the suicide of a dying person. This quote exemplifies the peaceful option a physician can give to a patient and his or her family: “and he said ‘I want to do it. I have had a beautiful life, I have had a loving wife, and it is my time. I said goodbye to this earth.’ We handed it to him; he took it and turned to his wife and said to his wife, ‘I love you very much. We had a good life.’ In five minutes he was in a deep coma, and died in seventeen minutes.” (Hendin & Foley, 2008, pg. 136) Clearly, there is value to a person getting to choose how, when and where he or she dies. The Death with Dignity Act in Oregon also included language that would allow a physician to choose whether or not to participate in a suicide: “No health care provider shall be under any duty, whether by contract, by statute or by any other legal requirement to participate in the provision to a qualified patient of medication to end his or her life in a humane and dignified manner. If a health care provider is unable or unwilling to carry out a patient's request under ORS 127.800 to 127.897, and the patient transfers his or her care to a new health care provider, the prior health care provider shall transfer, upon request, a copy of the patient's relevant medical records to the new health care provider.” (2013) Ethically, this allows physicians to make decisions that suit him or her best. The right to die with dignity and the ability for physicians to decide how best to proceed with a patients care are some of the most important choices people who are a part of a society that believes in autonomy.
Autonomy boils down to each individual’s natural right to live life the way he or she sees fit. The founding fathers of the United States of America based the government they built on the concept of autonomy. Americans are to have the right to liberty, the freedom to live as they choose, and the pursuit of happiness, whatever that means to each individual. This foundation of rights has been the cornerstone for many of the laws that are currently is place. It is why the laws segregating blacks and whites were abolished. It is why the feminist movement has made such headway over the last fifty years. It is why there are states that have legalized same-sex marriage in so many states. The right for all individuals to live life however he or she wants to, the right to autonomy, is one of the greatest gift Americans have. This right should extend to the citizens right to choose death with dignity: “Autonomy is often treated as an ‘uber”’right trumping all other rights. It renders moot many obligations, commitments, and considerations beyond the risks, harms, and benefits to the individual involved.” (Boudreau & Somerville, 2015, pg, 5) If an individual wants to make a choice to do harm to oneself, including asking a physician to subscribe medication that will end his or her life, ethically he or she has the right to do so. The consequences of restricting the autonomy of a person’s right to choose death in the face of unspeakable suffering far outweigh the benefits, this is where the ethical answer becomes clear. It is unethical to take away a person’s right to choose to die the way he or she wants to die and it is unethical to not give doctors the right to choose their own approach to treatment. Dr. Jack Kevorkian put it best by stating: “If you don't have liberty and self-determination, you've got nothing, that's what this country is built on. And this is the ultimate self-determination, when you determine how and when you're going to die when you're suffering.” (n.d.) Ethically, it is inappropriate to strip people of the natural rights, such as when and how to die, based on religion. As always, there is the slippery slope argument to contend with.
Some people argue that legalizing physician assisted suicide reduces the value of human life. The slippery slope argument is reliant on the potential that normalizing suicide, and what some constitute as doctors being in accomplice to murder, for those who are terminally ill could lead to normalizing it in other situations. Suicide could wind up being a reasonable option for people who are depressed or people whose lives are in a mess or people who just don’t really feel like living anymore. If society is open to the idea of doctors assisting in the deaths of those who are already dying what is to stop people from being open to doctors assisting in putting people who are seriously disabled but not technically dying out of their misery or relieving the pressure parents of developmentally challenged children by providing them the option to put their kids to sleep. If a society starts to place a higher value on some human life, such as a person who is physically healthy, than on other human life, such as a person who is dying, then what is to stop society from being open to one race being superior to another, what is to stop another Holocaust from happening? The ethical answer to this argument always comes down to doing the action that has the most benefit for the most people. In the case of physician assisted suicide in the cases of terminally ill people it is clear that the action that has the most benefit for the most people is allowing the option. In the other cases, the consequences outweigh the benefits. People suffering from depression can recover and live a fulfilling life, and in the case of Oregon there is specific verbiage excluding those who suffer from depression: “If in the opinion of the attending physician or the consulting physician a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling. No medication to end a patient's life in a humane and dignified manner shall be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. [1995 c.3 s.3.03; 1999 c.423 s.4]” (Death with Dignity Act, 2013) there is a specific people whose lives are in a mess can figure out what they need to do to make life worth living again and if people really don’t feel like living anymore why shouldn’t they be free to commit suicide? A physician wouldn’t need to assist, as that would be problematic, but why on earth shouldn’t a person who is not depressed and ready to die not have the freedom to do so? Clearly the consequences of normalizing or legalizing helping disabled people die or killing developmentally disabled children far outweigh the benefits as well, this is a silly argument. In addition, the world is still aghast at what occurred in Germany under Hitler, there is no way any contemporary society would go down that path. Arguing these issues as a reason to not legalize physician assisted suicide is like comparing apples and bananas. There really is no reasonable ethical argument against physician assisted suicide.
“You're basing your laws and your whole outlook on natural life on mythology. It won't work. That's why you have all these problems in the world. Name them: India, Pakistan, Ireland. Name them-all these problems. They're all religious problems.” (Kevorkian, n.d.) Appropriate ethical decisions must be made on a foundation of sturdier stuff than belief, faith and religion. Ethical decisions must be made based on what results in the most good for the most people. What is in the best interest of most people is the ability to determine one’s own destiny: “The Oregon law deserves to be upheld. It forces us to examine the question of what is special about human life. The answer, I think, is the autonomy and dignity inherent in our individuality -- in making hard decisions for ourselves and determining our own destinies. Oregon honors that vision of what is sacred about life.” (Kristof, 2004, para 15) Physician assisted suicide is the ultimate ability to determine one’s own destiny. If a person wants to suffer through a painful death in support of their faith he or she should have the right to do so. And in the same vein, if a person would rather die on his or her own terms he or she should be able to have that option as well.
Boudreau, J. Donald, and Margaret A. Somerville. "Euthanasia And Assisted Suicide: A Physician's And Ethicist's Perspectives." Medicolegal & Bioethics 4.(2014): 1-12. Academic Search Complete. Web. 10 Apr. 2015.
Death with Dignity Act. Oregon Revised Statute. Oregon.gov. Web 10 Apr. 2015. Retrieved from: https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx
Hendin, H, and K Foley. "Physician-Assisted Suicide In Oregon: A Medical Perspective. Reprinted With Permission From The Michigan Law Review, June 2008, Vol. 106, No. 8. Copyright © 2008 By The Michigan Law Review Association." Issues In Law & Medicine 24.2 (2008): 121-145. CINAHL Plus with Full Text. Web. 10 Apr. 2015.
Kevorkian, Dr. Jack. “Jack Kevorkian Quotes.” Brainy Quotes. Web. N.D. Retrieved 10 Apr. 2015: <http://www.brainyquote.com/quotes/authors/j/jack_kevorkian.html>
Kristof, Nicholas. “Choosing Death” The New York Times. Web. 14 July, 2004. <http://www.nytimes.com/2004/07/14/opinion/choosing-death.html>
Levy, T. B., Azar, S., Huberfeld, R., Siegel, A. M., & Strous, R. D. (2013). Attitudes Towards Euthanasia and Assisted Suicide: A Comparison Between Psychiatrists and Other Physicians. Bioethics, 27(7), 402-408.
Maynard, Brittany. “How to live well when death is so close. Today.com. Web. 16 Oct, 2014. <http://www.today.com/health/brittany-maynard-how-live-well-when-death-so-close-2D80216420.>