Physician-assisted suicide is controversial in the medical world due to the conflicting ethical principles of autonomy, beneficence and nonmaleficence that could be argued both for and against such a procedure. This form of voluntary euthanasia has caught media attention after the District of Columbia passed its Death with Dignity Act as of February 20, 2017, marking it the sixth jurisdiction in the United States to have a policy allowing physician assisted suicide. According to this new act, certain individuals with terminally ill diagnoses can “voluntarily and legally request and receive a prescription medication from their physician to hasten their death in a peaceful, humane, and dignified manner” (“District of Columbia Current Status”). It appears as if this act prioritizes patient autonomy and respecting the wishes of the terminally ill individual; however autonomy in this case is at odds with the duty of the physician to do no harm and help the individual. Or is it?

In the case of Sue Rodriguez, a woman suffering from ALS, she petitioned to the court to legalize physician-assisted suicide so that she could end her life in a humane way when she was no longer able to enjoy it. Rodriguez was aware of the specifics of the condition and knew that by the time her life was too painful and miserable to tolerate, she would be physically incapable to end her life. All she wanted was to try as best she could to enjoy the life she had before the disease fully took over and made life unbearable, at which point she wanted to have the option to have access to “’technological means by which she might, by her own hand, at the time of her choosing, end her life’” (Thomas, Waluchow, Gedge, 214). When it comes to life-ending issues, it is important first to assess the competency of the individual. Although suffering from ALS, Rodriguez appears to be a mentally competent individual who is fully capable of making her own decisions regarding the course of her life and consequently death. If the patient is competent, which she appears to be, is that enough to override the physician’s duty to protect the patient’s life at all costs?

With respect to this scenario, I believe that patient autonomy should trump the duty of the physician to “do no harm” and keep the patient alive regardless of her wishes. The truth of the matter is, physicians and Supreme Court Justices who are making these decisions do not know what it is like living with the unbearable pain and life restrictions that individuals suffering with ALS or other terminal diseases face every single day, and if that is the case who are they to decide if such an individual should live or die? I do not believe that every terminally ill person should opt for assisted suicide; however I do believe that they should all have a choice. In class we discussed the shift from Sanctimonious Life (SL) to Quality of Life (QL) with regards to end of life issues and deciding when it is acceptable to withhold or withdraw treatment. I believe that the shift to focusing on quality of life is a huge stepping stone in medical practice because it allows the patient to have a choice; a choice to end their life in a peaceful way rather than endure unbearable suffering when they no longer wish to live.

On that note, is it possible that by not allowing the patient to peacefully end her life, the physician is acting against the principles of nonmaleficence and beneficence? If a patient is suffering, a physician’s job is to ease their pain; therefore if the state of living is the cause of unwavering suffering, is it the duty of the physician to end the pain and subsequently end the patient’s life? As I said earlier, I am not advocating that all those who, on a daily basis, suffer extreme amounts of pain should end their life, but I can also follow the argument that for some such individuals, being able to end their life with dignity by the hand of a doctor would fall in support of the principles of beneficence and nonmaleficence.

Ultimately I believe that physician-assisted suicide should be an option to certain individuals with terminal conditions that cause excessive amounts of pain and suffering with no hope of recovery. If the patient is deemed competent enough to make the decision, patient autonomy should overshadow the idea that physicians must prolong the life of a patient at all costs. Those who are opposed to physician-assisted suicide argue “individuals can always find the means to kill themselves without a Doctor’s assistance” (220). While this argument is technically true, I believe that as a society we should not force suffering, terminally ill individuals to take matters into their own hands and end their lives in less humane ways. Whether physician-assisted suicide is legal or not, it will happen and some individuals may choose to commit suicide themselves, cutting their life shorter than they would if they knew that they could engage in a dignified, assisted suicide later.

Citations:

“District of Columbia Current Status.” Death With Dignity. Death With Dignity, n.d. Web. 23 Feb. 2017.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well And Good: A Case Study Approach to Health Care Ethics. N.p.: Broadview, 2014. Print