Sue Rodrigues, a Canadian citizen, has amyotrophic lateral sclerosis. Sue decides to enjoy life as she can. However, as the time has passed and she began to experience difficulty to physically enjoy her life, she began to explore the possibility of suicide. She is determined in physician assisted suicide and she bring this case to court which demands the physician to set up certain “technological means” for determining her terminated life. As Sue argued to the higher court, as suicide itself is not a criminal, her determination to end life should be considered legal as well. But lawmakers and physicians obviously still held in doubt about this issue for reasonable causes: First, the act of “aid or abets a person to commit suicide is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years”. Second, there a few guideline existed with relevance to this topic.
It is important to honor her autonomy rights and human dignity. From a patient’s perspective, Sue made the decision based on her own self interest. As she has stated in her conscious state, she wish to have control over when she died and spare herself from the pain she is destined to experience. She made the rational decision which consisted of her careful planning. As a physician and law maker, it is important to respect individual’s decision. As the medical care professional, they could request Sue to revisit her decisions by poses her more open ended questions. Sue should also always keep in mind her given informations, like: her health condition, her family member’s well being, her influence on other people and her funeral arrangement.
With the given guideline for assisted-suicide, it is far less enough. From the perspective of court and physician, it is hard to kill. As stated by Hippocratic Oath, “Thou shalt do no harm”, it is against ethics to kill or harm people not only as a physician but also as another human being on earth. For the court, it is hard to make decisions because every single cases are so different. Its ruling would insist on the given law because once the law is broken it is hard to know the boundaries. And it is hard to predict if there are going to be cases which used the allowance of assisted suicide as a criminal method. Fear also appear that the individual might be influenced over the process of her decision making. For example, the patient would not want her/his family to be broken because of the illness dragged along. I personally know a relative who jumped off the hospital window because he wish not burden his family further. This tragic event is a reflection of the lack of managed system which cause more trauma to the family and public than ever.
In Sue’s case, I believe we should respect the individual’s decision more than evaluating the current legal system. While it is important to acknowledge the concern of the court and physicians. Individual’s decision should be prioritized. As Sue has made such clear statement about her situation, it is important to support her as a friend, family and medical care professionals. There could be definitely more assessment and guidelines to be developed in the future years. It is important not to follow blindly of the patient’s interest but it is not right to secondize their needs or determination. After all, it is Sue’s life and it deserved to be respected and dignified.
Citation:
Valente, Sharon M. “End-of-Life Challenges.” Cancer Nursing 27, no. 4 (2004): 314-19. doi:10.1097/00002820-200407000-00008.
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and good: a case study approach to health care ethics. Peterborough, Ontario: Broadview Press, 2014.
Hi Tianqi
I find this to be an excellent post. I like how you argued for the honoring of autonomy for Sue. It is well known that as a patient, she made her own decision and in fact was fully cognitively aware of her own decision. You also take into consideration the “Thou shalt do no harm” cause and the difficulty of balancing non-maleficence with autonomy. I also sympathize with your personal anecdote about the event of the suicidal illness.
Here are just some questions to ponder on. You talk about fear of the individual not wanting to hurt his/her family due to the dragged along illness. Would that in a sense be the principle of non-maleficence of the patient? We often talk a lot about the physician and the hospital’s intent of non-maleficence but as you know the principles of morality are all universal in every individual. The patient also supposedly does not want to inflict harm on his/her family members. Though it’s not physical harm, it is mental harm as the patient’s family members are in a way restrained to constantly needing to give attention. However, at the same time if the patient decides to suicide, the family may be in grief and that in a sense “harms the family”.
The confliction between the “Thou shalt do no harm” cause along with Sue’s autonomous decision is indeed a very tricky concept. I agree in that there should definitely be more assessment and guideless developed to this case specifically as well as many future cases that are similar.
Citation:
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and good: a case study approach to health care ethics. Peterborough, Ontario: Broadview Press, 2014.
I agree with the importance of respecting Sue’s autonomy and giving her control over the determination outcome if her quality of life deteriorates to a point where living is no longer bearable. You bring up a point that I had not considered, which is that physician may view her request to be in violation of the Hippocratic oath. This then begs the question of fully defining “harm,” comparing Sue’s death as the hands of a physician against the suffering as a result of her continuing living. This is not something that can be quantified, nor can the comparisons between death and suffering be analyzed in an objective manner, as the suffering is subjective, while the implications of death and ending consciousness are merely speculative and unknown to the living.
Because of the subjective nature of assessing Sue’s suffering and the emotional damage inflicted on her family — either through physician assisted suicide or witnessing the deterioration of her health — no one is truly equipped with the knowledge and understanding to make any decision with full confidence. The decision lies with Sue, as she ought to have full autonomy over her life. No one else can claim to have superior judgment based on objective knowledge or experience with ending life, and thus no one should impede on Sue’s decision. Also, with more countries and states adopting laws that liberalize the use of physician assisted suicide, trends in the law indicate a growing respect for the people facing this predicament.