Background:

In Case 6.2, “Sue Rodriguez: Please Help Me to Die,” the patient, Sue, is suffering from amyotrophic lateral sclerosis (ALS), which is also known as Lou Gehrig’s Disease. As per the ALS association, this disorder involves the progressive degeneration of motor neurons, which affects cells in the spinal cord as well as the brain. This degeneration results in diminished muscle movement, and the muscles atrophy. Symptoms include muscle weakness in the arms, legs, swallowing, etc. The average life expectancy for patients with ALS is two to five years after diagnosis although it varies from person to person. After being diagnosed with ALS, Sue has asked for a medical professional to help her with committing suicide before the disease takes her life.

Dilemma:

In Sue’s situation, one moral dilemma that is especially important to consider is, after the court ruled that doctors helping Sue were legally justified to do so, whether a physician should or should not assist her in committing suicide. While the physician knows that he or she is legally permitted to aid Sue with ending her life, the question involves whether the doctor is morally justified to participate. This issue revolves around the principle of nonmaleficence.

Discussion:

The first objective should be to determine whether the physician is violating the principle of nonmaleficence. Beauchamp and Childress present the obligation of nonmaleficence: “One ought not to inflict evil or harm” (151). By participating in a procedure that directly leads to the patient’s death, the physicians are clearly inflicting harm. The next topic to address is whether this violation of nonmaleficence is justified. Sue would be requesting this assistance when she believes it is the right moment for her: “The dilemma she faced was that “by the time she no longer [was] able to enjoy life, she [would] be physically unable to terminate her life without assistance.” In light of this, Rodriguez petitioned the courts for an order “which [would] allow a medical practitioner to set up technological means by which she might, by her own hand, at the time of her choosing, end her life”” (Thomas et al., 214). Overall, Sue’s decision would be entirely autonomous, and the physician would only be helping her achieve her goal. In addition, unlike the case with Tracy Latimer in which Tracy did not explicitly express her wishes to die, Sue has clearly declared that she would be ending her life. Furthermore, the alternative to respecting Sue’s wishes would most likely only slightly prolong her life, and consequently, her extensive suffering after which she will inevitably pass away. One could argue that by causing Sue to suffer with the symptoms instead of allowing her to take life, the doctor is also inflicting harm. Therefore, this situation, for a doctor, does not involve a decision where one option leads to inflicting harm whereas the other results in the physician not causing harm. Ultimately, the violation of the nonmaleficence principle is justified, in this case, despite directly leading to the patient’s death, and the physician should assist Sue with ending her life on her own terms.

References:

ALSA. “What Is ALS?” The ALS Association. N.p., n.d. Web. 10 Mar. 2015.

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th ed. New York: Oxford UP, 2013. Print.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. New York: Broadview, 2014.

Image Link: http://www.visembryo.com/images/ALSneuronMuscle.gif