Example Of Memorandum Essay - Death with Dignity
Type of paper: Essay
Topic: Assisted Suicide, Doctor, Nursing, Euthanasia, Suicide, Law, Medicine, Patient
Death with Dignity is a movement that has been ongoing since the early 1990s (DeathWithDignity.org). Since that time, the debate has raged concerning whether the decision for a terminally ill patient to not only deny treatment, but to ask for euthanasia is socially acceptable. Since suicide is forbidden in most major religions, the patients may ask another person to administer lethal doses of drugs. In some cases, that person is the patient’s doctor. Whoever administers the dose, either orally or by injection, must be protected by law against charges of murder. It must be emphasized that PAS differs from euthanasia in that the doctor provides the medication for the termination of life in PAS, but does not administer it (Medicinenet). Euthanasia is another person administering the medication than the patient, changing the definition from “suicide” to “euthanasia”. In addition, the medication muse be obtained by prescription and the physician knows the intended use. Physician-assisted suicide (PAS) is a patient’s voluntary termination of his or her own life by accepting the administration of a lethal substance either directly or indirectly with the help of a physician.
Some doctors feel PAS is a violation of the Hippocratic Oath to uphold ethical standards. However, many modern medical schools no longer require physicians to take the oath, or there are modernized versions of it. Interpretations of the oath on one hand states the doctor cannot take a life, but on the other hand he is supposed to relieve suffering. Surveys find that half of the questioned doctors believe PAS is ethically justifiable in certain cases. The surveys also state that approximately one in five will be asked to participate in PAS at some point in their career. Of those requests, between five and twenty per cent will be accepted.
In terms of religion, most faiths consider suicide to be murder of self and it is forbidden (religioustolerance.org).
Some opponents feel that if euthanasia is sanctioned for terminally ill patients, the next steps will be disposal of disabled individuals, people with mental illnesses, indigent populations, and so on (DeathWithDignity.org).
Most medical facilities allow patients the option to place a “Do Not Resucitate” order on themselves, which is another issue involved in the controversy surrounding euthanasia (Brauhard).
The term “end-of-life” applies to individuals who know their prognosis is poor for survival and there is an approximation of the amount of time they have left before they die. Concerning the PAS issue, this period is physically painful and very expensive. Medicare figures state that $170 billion annually is spent on the last six months of life for a terminal patient.
PAS is legal in four states in America, but the patients must have a terminal illness with a prognosis of less than six months to live and be a resident of the state (CNN). Oregon has had a PAS law that prevents prosecution of doctors involved on the books since 1997; numbers have steadily increased in both the number of prescriptions doctors are writing knowing they are for euthanasia and in the number of deaths. A number of other states have had bills introduced addressing PAS and either have been defeated or are pending. Euthanasia is legal in Belgium, the Netherlands and Luxembourg with PAS legal in the Netherlands, Luxembourg, and Sweden. The United States citizens are steadily gaining acceptance of PAS and as a country, America is in the middle of the number of countries as far as statistics concerning approval of euthanasia (see Graph 1).
Graph 1. Conditions of acceptance of physician-assisted suicide in the United States, Canada, and Great Britain (gal5.piclab.us).
Graph 2. American approval for physician-assisted suicide (Gallup).
A Gallup poll in 2014 found that 51 percent of Americans approve of PAS while 45 percent do not; the remaining people surveyed felt it either depended on the situation or they had no opinion on the topic (see Graph 2).
Concerning the topic of physician-assisted suicide, policies for medical institutions must comply with state and federal law. In terms of the facility, policies should be instituted only in eligible states to allow the termination of the life of the patient who is a resident of the state with drugs supplied by a doctor with whom they have had a significant relationship. Facilities in states that do not allow legal PAS, the policy should reflect that doctors will not participate in any activities related to suicide or euthanasia. In the case of the facility being in a state allowing PAS, proper documentation of a prognosis of less than six months of life and the patient’s wishes is vital, including a “Do Not Resuscitate” order. Proper authorities should be notified of the pending event. The person administering the lethal medication should be designated by the patient and documented for legal reasons. It is recommended the policy of the facility prohibit the physician from being the person administering the lethal dose of medication. It is strongly recommended the policy be reviewed by the facility’s legal counsel prior to approval.
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