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Introduction It is a controversy so complex and powerful that it perforates not only the core of society? s public policy, but individual ethical and moral principle. It is a soul searching burden placed upon the minds and hearts of all into the depths of the integrity of quality of life and the sanctity of death. It is the issue of physician-assisted suicide. This unpleasant inevitable dilemma of balancing the right and wrong of physician-assisted suicide is met by many with great anguish. Many medical professionals view PAS as jeopardizing the boundaries of their field.
Many patients and families hold the view that it allows for an autonomous death. Religious doctrines are entangled into the controversial web of the pros and cons of PAS. Concept of PAS Placing to one side the fears and guilt associated with the issue of PAS, along with the legal ramifications, perhaps a better understanding of the basic concept of PAS would aide in the balancing process that has to be met before one can accept or reject PAS. Euthanasia is? an easy death or means of inducing one and as the act or practice of putting to death persons suffering from incurable conditions or diseases. ? (Humber, Almeder and Kasting 75) Passive euthanasia differs from active euthanasia in that one allows nature to take its own course of natural death, and the other is the direct killing of a patient. Involuntary euthanasia is an act which the patient does not give consent to.
When a competent individual gives consent and approval, then the act is voluntary euthanasia. The concept of PAS dates back to ancient Greece during fourth or fifth centuries BC. The belief of the majority then was that assisting seriously ill patients in committing suicide was acceptable only? if (the patient) asked for it. ? (Weir vi) PAS was a means of escaping suffering and painful illness that resulted in death. However, as far back as the fifth century BC in ancient Greece, not all agreed. Many physicians upheld the belief of the Hippocratic Oath throughout their professional career. ?
I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. ? (Beauchamp and Childress 329) The Hippocratic Oath has been considered the most influential document governing the decisions of modern medical societies during the past two hundred years. (Weir vi) DATA The National opinion Research Center in a 1990 survey declared 60 % of United States citizens said persons with incurable diseases had a right to end their own lives. (Gest 22) The Hemlock Society, an euthanasia advocacy organization, personally interviewed two thousand adults and found 63 % felt physician-assisted dying was an acceptable practice. (Roper 25) Physicians have also been surveyed about their viewpoints at different times. Overwhelmingly, almost one half of the nine hundred plus physicians surveyed in a 1987 Australian university-based anonymous survey had requests from their patients to hasten their death. Of those doctors, 30 % admitted to assisting their patients in dying. The requests of patients to terminate their lives is increasing in today? s society to preserve the dignity of one? s death, and to spare the emotional trauma inflicted on loved one.
The American Bar Association in 1988 revealed 57 % of its lawyers supported legalization of active euthanasia for competent terminally ill patients. (Reidinger 20) The legal issues of PAS has been rarely tested by the United States Supreme Court. Twenty-six states have already passed legislation prohibiting assisted suicide. Only nine states have no interdiction regarding any form of suicide. ? The present debate over physician-assisted death can be nothing more than speculative musing unless the patient has a legal right to command assisted death and the physician is, at least, legally permitted to assist. ? (Humber 47) Euthanasia and the Law The ethical issues of physician-assisted suicide are a heavy burden for standards to be set and guidelines to be followed by our courts. Without such standards and guidelines, the legal exposure to physicians and individuals is much too great to risk.
Prudent judgment must be determined on a case by case basis, taking into account all circumstances while balancing the right of an individual to exercise choice based on competent reasoning. Cruz vs. Director Missouri Department of Health is the only? right to die? decision the Court has had to make. The Court voted to uphold a Missouri Supreme Court ruling that evidence of the incompetent patient?
s wishes needed to be present in order to grant refusal of treatment request made by Cruz? s parents. This decision let to the precedent for living will to be signed in the event an individual would request hastening their death or refusal of treatment. Here, the Court specifically did not deal with the issue of euthanasia by its decision, or one? s right to privacy and choice in the hour of their death.
Yet, it provides for living wills by patients to set forth their intentions in meeting their death. Griswald vs. Connecticut in 1965 is a case that deals with the Constitutional right to privacy that protects the right of the individual to be secure from governmental intrusion into matters of PAS based on religion and / or moral nature. Justice Douglas in his majority opinion wrote, ? Specific guarantees in the Bill of Rights have penumbras, formed by emanations from those guarantees that help give them life and substance. ? (Griswald vs. Connecticut, 381 U.
S. 479) The First, Third, Fourth, Fifth and Ninth Amendments have been called into play on the issue of PAS. Justice Brandeis in a 1928 case, Olmstead vs. United States summarized the principles of the Constitution? s guarantee to privacy. His profound words of wisdom should be weighed heavily into the scale of balance in determining the acceptance or rejection of one? s right to PAS. ?
The makers of our Constitution undertook to secure conditions favorable to the pursuit of happiness. They recognized the significance of man? s spiritual nature, of his feelings and of his intellect. They knew that only a part of the pain, pleasure and satisfactions of life are to be found in material things. They sought to protect Americans in their beliefs, their thoughts, their emotions and their sensations. They conferred, as against the Government, the right to be let alone-the most comprehensive of rights and the right most valued by civilized men. ? (Bradeis. ) Autonomy Rights The Bill of Rights protects an individual from the American Government.
It embraces a theory that everyone has a right to pursue one? s own? vision of a good life. ? (Humber 54) This includes the right to make your own decisions regarding your own body. Without committing itself to the legality of the issue of PAS, the Supreme Court of the United States has recognized the right of privacy in individual choices. However, some lower courts have addressed the issue of PAS head-on. The Massachusetts Supreme Court in Superintendent of Belchertown State School vs.
Saikewicz ruled the guardian ad litem had the right to refuse medical treatment on the behalf of a retarded elderly leukemia patient. California? s District Court in Bouvia vs. Superior Court (Glenchur) gave a non-terminally ill quadriplegic the power to remove anasogatric feeding tube from their body, thus leaving the way to death. (Bouvia) Research reveals that courts have been proactive in many cases, deciding in favor of many? privacy issues, ? without directly declaring an acceptance of active euthanasia. ?
The state should take every reasonable precaution to avoid the unnecessary and regrettable loss of life, but it should never insist that a competent adult remain alive against his or her own will. ? (Humber 62) Guidelines of PAS Society judges is people on their actions in their lifetime, and holds each adult responsible for same. Our behavior and performance on the stage of daily life, through our personal triumphs, achievements as well as our misfortunes and disappointments, reflects who we are and what we believe. Recognizing unique individualism during a person? s lifetime should also be recognized in their death time.
We are held responsible for our own life? s choices and decisions; why not the same standard in our death choices and decisions? This does not in anyway open the door to give its stamp of approval to the healthy individual who simply can no longer deal with the pressures of life and feels suicide is an option. The great distinction between simple suicide and physician-assisted suicide sets the boundaries between the two. The physician-assisted suicide is a last resort, after every avenue of hope to save one?
s life has been pursued and death is eminent. It should be based on physical data rather than only emotional facts. PAS is not an aide to escape from life? s burdens, but rather an aide to escape from the intolerable pain and suffering prior to eminent death?
s burdens. It should only be considered as an option to meeting death with a dignity when no hope for any quality or comfort of life exists. PAS leaves no margin of error. Safeguards are essential in achieving 100 % of certainty.
Clear documentation of each condition is required. (Humber 123 - 4) The physician? s diagnosis must be approved by more than one qualified in its field. All avenues of care and comfort and hope must be exhausted. The patient? s condition must be incurable. The request to die must be initiated by the patient more than once.
A patient must be declared competent to choose PAS. Franklin Miller and John Fletcher? recommend legalizing PAS for competent patients suffering from terminal illnesses who autonomously choose to end their lives. (Humber, Almeder and Kasting 75) With such criteria in place, relief from PAS is afforded to those who are inclined to partake without fear of legal ramifications to those who are left behind. Physicians Role Several doctors have come into the limelight regarding the issue of euthanasia, PAS and respect for autonomy. Dr.
Jack Kevorkian, a retired pathologist in Michigan, and Dr. Timothy Quill, an internist in New York, are two of the more prominent figures on the issue. The price to be paid for their assistance has been high. Nigel Cox, a practicing physician in England, was convicted of attempted murder for lethally injecting Lillian Boyes, a seventy-year old women with rheumatoid arthritis not relieved by morphine or heroin, with potassium chloride. (Humber 110) Patricia Rosier sought the aid of her husband, a certified physician, in ending her long battle with cancer. He now faces the electric chair for his role in their death. Conclusion Preservation of the quality of life is directly linked to the sanctity of death.
Personal choice is the key factor that must overshadow this controversy. An intelligent well thought-out decision based on known factors of a given situation balanced against religious, ethical and personal moral beliefs by a competent patient should not be dismissed as unacceptable. Choices in life determines our destiny, and choices in death determines how we meet our inevitable departure from this world. It is no less noble to do nothing but meet our hour of death with pain and suffering than to do something in assisting one? s acceptance that death is near.
Physician-assisted suicide should be looked at as an act of compassion in honoring one? s last choice in their life. 1. Beauchamp, Tom and James Childress, Principles of Biomedical Ethics. New York: Oxford University Press, 1983. 2. Bouvia v. Supreme Court (Glenchur) 179 Cal.
App. 3 d 1127, 225 Cal. Rptr. 297 (Ct. App. 1986) rev. Den (Cal. June 5, 1986) 3. Gest, T. ?
Changing the Rules on Dying. ? U. S. News &# 038; World Report 9 July 1990: 22 - 24. 4.
The Hemlock Society. (1988) 1987 Survey of California physician regarding voluntary active euthanasia for the terminally ill. Feb. 17. 5. Saikewicz. Superintendent of Belchertown State School vs. Saikewicz. 373 Mass. 728, 370 N.
E. 2 d 417 (1977) 6. Humber, James M. , and Robert F. Almeder, eds, Biomedical Ethics and the Law. New York: Plenum Press, 1976. 7. Weir, Robert. Ethical Issues in Death and Dying.
New York: Columbia University Press, 1977. 8. Humber, James M. , and Robert F. Almeder and Gregg A. Kasting, eds. Physician-Assisted Death. Totowa: Humana Press, 1994. 9.
Reidinger, P. (1988) Law poll. ABA Journal. June 1, 20. 10. Center for Health Ethics and Policy, University of Colorado. (1988) Withholding and withdrawing life sustaining treatment: A survey of opinion and experiences of Colorado physician. Graduate School of Public Affairs, Denver, CO,
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Research essay sample on Physician Assisted Suicide Choices And Decisions
