Much of this week’s reading concerned paternalism, particularly the point at which beneficence overrides autonomy. One of the most significant examples of this is the right to commit suicide. Historically this has been something prevented at all costs, even to the point of being illegal. However things are changing, very few people in the modern world would suggest that it should be a criminal and prosecutable offence. Beliefs go all the way to the other end of the spectrum as well, four states having authorized physician assisted death, in certain cases. However there is still debate about the right of competent and autonomous patients to commit suicide.
First let us look at the necessary requirements in those states where it is permissible. To begin the process most states require at least 2 oral requests and a written request in a period of no shorter than 15 days. The common requirements across three of the states include at least 18, that the next-of-kin is informed, and informed knowledge of alternatives. The two crucial requirements are the diagnoses of a terminal illness with an expected life span of less than 6 months and clear evidence of complete competence. Both of these must also be certified by a corroborating physician.
These requirements are those required to actively end a life, by the hand of the patient. However, many cases involving suicidal patients do not require active interference by the physician or anyone else. Simply a passive lack of intervention will lead to the patient’s death. The moral dilemma then becomes whether to act or not to. This hinges on the idea that there is the possibility that there are situations that people have no wish to live through, and that this process is reasonable. Examples of this include incredibly painful or risky treatment that would be lifesaving. The exemplar case of this scenario is Dax Cowart, who was severely burned and underwent horrendously painful skin grafts to survive. He still insists years later that the doctors should have ceased treatment at his request and let him pass.
The important point here is that Dax did not meet the criterion that would allow a physician to let him kill himself, for the purpose of this argument we will ignore the anachronous nature of the rules compared to the case at hand. If these are the qualifications required to let someone end their life, would it not be morally wrong to do the same in a case such as Dax’s? He has given consent but suffers from no terminal illness and despite his declaration as competent by Dr. White, his judgment is ruled by his pain. This is the same effect that could be seen in broken torture victims. The patient only has the capability to make an informed choice after the completion of the treatment, when he is capable of understanding his quality of life and his judgment is not altered by pain. Given his probable recuperation and possibility to lead a functional and productive life, the doctor who follow the rules have a moral obligation to continue the treatment.
Works Cited
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.
“State-by-State Guide to Physician-Assisted Suicide.” ProConorg Headlines. N.p., Feb. 2015. Web. 20 Mar. 2015. <http://euthanasia.procon.org/view.resource.php?resourceID=000132>.