Background: One of the biggest issues that I see in our society is the unwillingness of the populace to engage with their beliefs that they hold so dear. The issue of physician assisted suicide is one of the most under discussed and consequently least understood issues of our time. The Society’s inability to separate from its dogmatic beliefs leads to a very myopic discussion about the ethics of physician assisted suicide. This problem has very harsh consequences on patients that are suffering from incurable and often very painful diseases. The case of Sue Rodriguez is such and I find it rather troublesome that the court decided against her wishes. Sue suffered from amyotrophic lateral sclerosis (ALS), a decease that leaves its victim unable to speak, walk, and ultimately kills by paralyzing the respiratory system (Thomas).
Moral Issues: The case presents several moral issues regarding the issue of physician assisted suicide. Arguments against it as listed in Well and Good book are:
- Pain can always be managed through strong analgesics.
- It will result in diminished efforts to improve end of life care for other patients.
- It is a form of killing and inconsistent with physician’s duty to never harm.
- Slippery slope to involuntary euthanasia.
Discussion: One of the greatest advocates of physician assisted suicide, Dr. Kevorkian often said that it is absolutely inhumane for an advanced society to not allow its members who are suffering from incurable and painful diseases to not end their lives. The biggest and the foremost argument in favor of it would be respect for patient autonomy. Choosing what happens to one’s life is very fundamental to being autonomous and the government should not have any say in that regard. Another not so straightforward argument would be the principle of non-maleficence. While aiding to someone’s death is clearly contrary to the principle, I would argue that intentionally forcing patients to suffer though extreme pain, especially when they do not have any potential to get better clearly violates the principle of non-beneficence. Of all the arguments against physician assisted suicide mentioned above, I would like to focus more on the last one as it presents quite unusual challenge when it comes to public policy. The issue is that it will blur the line between right to die and the expectation to die. Opponents argue that if society legalized the act of assisted suicide, it will gradually become an expectation for terminal patients to go through with the option of committing suicide. This claim does have some legitimate merits to it and should be carefully studied and discussed. However, a study from Netherlands, where physician assisted suicide is legal, showed that for the past few years there has been a decrease in the number of people opting for physician assisted suicide, partly because of the change in approach by the Dutch doctors in pain management strategy (Van). A system that adequately addresses this issue must be set in place for carrying out the practice of physician assisted suicide. I encourage you guys to have these conversations with people around you and spread awareness regarding this issue so that we address it and do justice to all the helpless patients throughout the country.
Work cited:
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. 214-22. Print.
Van Der Heide, Agnes. “End-of-Life Practices in the Netherlands under the Euthanasia Act.” ProQuest. N.p., 10 May 2007. Web. 18 Feb. 2017.
Mihir,
This is a very well written discussion about physician assisted suicide and I agree entirely that it is a subject that we should be openly discussing a lot more, especially since it is actually legal in some countries. For starters, the two most opposing arguments here are a patient’s autonomy versus a physician’s promise to “do no harm” or non-maleficence, as you brought up in your post. These two ideas make a very strong argument on both sides, as a patient should be able to decide if they want to live or not and a physician should be able to decide if they would like to assist in making the passing easier. The biggest issue we face here is whose values win out, the patient or the doctor?
It is important to address the counter arguments, one of which comes from advocate groups of persons with disabilities. One organization in particular, Not Dead Yet, “insist that people should be given the right to live well before they are given the right to die with assistance” (Jaret, 2016). While this statement is not entirely wrong, a person of full mental capacity should be able to know that he/she obviously has an option to live before they ask for an assisted suicide. Where these cases often get complicated is when a patient is not of full mental capacity or is mentally strained by their disease and could possibly make a rash decision.
In our case specifically, Sue is in a well and healthy state of mind to make a decision about her life and autonomously, that decision should be upheld by the courts. On the physician side, it is a doctor’s duty to help a patient to the best of his/her ability. If that help just so happens to be an assisted suicide, then no harm has technically been done and the argument of non-maleficence is invalidated. As far as physician-assisted suicide is concerned, as long as the patient is of a full and clear mental competence, then no harm is being done. Writing a particular policy for the act of physician-assisted suicide may be near to impossible because of the sheer number of differences in the types of cases this argument could be presented. On a case to case basis, though, I strongly believe that if a physician, a family, and a patient agree on a decision, then a court has no right to intervene and the process should be carried out, as in Sue Rodriguez’s case.
Works Cited:
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.
Jaret, Peter. “Physician-Assisted Suicide: Is It Ethical?”. Berkley Wellness. Berkley, California: University of California at Berkley, 26 Apr. 2016.
Thomas, John E, et al. “Case 6.4: Sue Rodriguez Please Help Me to Die.” Well and Good: Case Studies in Biomedical Ethics, Broadview P, 1987.
Hi Mihir,
I really like your post and the points you bring up. Personally, I am right there with you on the idea that people suffering from terminal illnesses that cause painful suffering should be allowed to elect to end their lives (with the help of a physician if needed). However, I would like to probe your thoughts on a slightly different scenario that is related to what we have been discussing in class recently.
Let’s say there is a patient that is terminally ill but still has the capacity to perform actions. This patient would like to be euthanized. Do you think that the mechanism for this euthanasia is a relevant point of moral debate? Here are my thoughts:
I feel like physicians administering the euthanasia is a bit of a slippery slope, as it kind of blurs the line between killing the patient and granting the patient’s request to be allowed to die. If a physician actively performs some procedure or administers some substance to kill the patient, then I feel like that patient has been killed. This is because I take the action versus inaction approach to deciding whether someone has been killed or allowed to die. Because of this, I feel like the best way to avoid moral dilemmas in the physician assisted suicide situation is for the physician to prepare some means for death but have the patient administer it to him- or herself so long as he or she is able to.
In light of this, I still totally and completely agree with your idea that the autonomy of the terminally ill patients is vitally important and must be respected. However, the point I am trying to make is that I do not know how morally right it is to bring the physician into this picture, as killing someone, whether they wanted to be killed or not, still has severe moral consequences. Killing is a social taboo for a reason, and because of this I believe it is important to tread carefully with the issue of physician assisted suicide so as to be beneficent to the patient by respecting his or her autonomy while also allowing the physician to keep his or her moral obligation not to actively kill others.