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Introduction:
The way that we carry on with our life, the way we are supported nearing the end of our lives, and our actual death affects individuals close to us. If there is one thing certain about life, it is the fact that we all will eventually die, the important question is, when? It is a fact that 60% of people will die in a hospital, and they usually die due to suffering from a chronic disease they acquired (Stanford School of Medicine). In the twenty-first century, there has been a trend where people would rather end their lives short to experience a good death, free of suffering. This raises an ethical dilemma that health professionals must face if they should withhold or withdraw life-sustaining treatment for their patients facing pain. Furthermore, the ability to request an assisted death, also known as euthanasia, has been a political topic of debate as this method of ending life is legal in many parts of the world, but illegal in others. In this paper, I will discuss the topic of assisted suicide, and the qualifications to have assisted suicide done in order to explain the ethical and unethical reasons for having this procedure done.
Methods:
I obtained my research for this paper with the use of many databases, including Google Scholar , and the University of Toronto Database . Some research terms I used in my searches included the words assisted suicide, physician, ethics, and euthanasia . Through my research, this paper was developed with the help of many research articles found in these databases, including; Sulmasys position paper: Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper, Frosts report: Should assisted Dyling be legalized?, and Wylies paper The ethics of forgoing life-sustaining treatment: theoretical considerations and clinical decision making.
Results and Discussion:
What are the Differences between the Three Types of euthanasia?:
In order to understand the ethical implications of assisted, it is important to understand each of the three types of assisted death, as they all have different pros and cons. The first type, known as Physician-assisted suicide, is requesting a medical professionals permission to assist in ending your life, through the prescription of lethal doses of medication (Ethics of Euthanasia). This method allows patients to choose when to end their life on their own time as they can die peacefully and painlessly in their own home (The Hastings Center). This method is much easier for the physician to administer as they are not the ones who end the patients life directly. (The World Federation of Right-to-Die Societies).
Active euthanasia is when the physician directly causes the patient’s death; for example, the physician injects the patient directly with a lethal dose of drugs to their death (BBC). On the other hand, passive euthanasia occurs when the physician indirectly causes the death of the patient, for example unplugging the life support machine causing the patients death, as the patient is unable to survive naturally (BBC). The method of passive and active euthanasia are more emotionally draining on the physician because they are directly causing the patients death with their own hands. The controversial reason for assisted death is when a patient requests assisted suicide without any apparent medical issues. This is where the ethical controversy occurs.
What are the Qualifications to receive a Physician-Assisted Suicide?
In order for a patient to be approved to undergo euthanasia, it is important to know the two qualifications physicians have to go through for treating a patient. The first qualification that a patient must fulfill is the problem must be medically indicated, meaning that they have to be medically diagnosed with a disease (Welie 2014). In the case of physician-assisted suicide, the medical issue must place the patient in excessive inevitable pain, such as incurable cancers and mental diseases. The second qualification is the patient must be aware of their specific diagnosis and they must consent to the treatment option necessary (Welie 2014). In this case, the patient has to give consent to the doctor to perform assisted suicide to end their inevitable pain. If one or more of these capabilities are not met, the physician will not go through with the procedure.
Why Physician-Assisted Suicide Could be Ethical:
Since the topic of physician-assisted suicide is an ethical dilemma, it has the possibility of being ethical. Patients make the decision to participate in assisted suicide because they are in serious pain and want to end their life to end their suffering. Patients face physical symptoms like pain and nausea and psychological conditions like depression, anxiety, and hopelessness (Sulmasy 2017). These symptoms result in a loss of dignity caused by immobility as patients who request assisted suicide since they are stuck in a hospital bed for weeks on end due to chronic conditions (Frost 2014). A study of terminal patients in Oregon showed that one of the most common reasons for requesting assisted suicide is because the patients perceive themselves as a burden to the family (Frost 2014).
The ethical principle of controlling one’s own death is relevant because human beings have the right to do almost anything to their body, therefore a terminal patient should be able to choose to end their life in order to avoid experiencing additional months of pain and loss of dignity during their final months of life (Frost 2014). This could prevent family members from experiencing their relative going through excruciating pain for months as it is emotionally draining. This is why in cases of terminal patients, I believe assisted suicide should be ethical and legal.
Why Physician Assisted Suicide can be Unethical:
As mentioned before, since physician-assisted suicide is an ethical dilemma, it has the ability to also be unethical and could potentially be avoided depending on the situation. The majority of pain that patients are exposed to can be treated through the use of pharmaceutical painkillers through proper treatment, which could inhibit suicidal impulses. It can be seen as unethical because suicide shouldnt always be the primary option to treat pain. It can be implied that the patient is speaking impulsively to commit suicide to deal with the pain quickly, but they should be consulted and negotiated that there are many other ways to treat pain. This is because the gift of life is precious and assisted suicide isnt always the best solution to pain. The physician must do everything in their own power to convince the patient to not undergo the procedure of active euthanasia (Welie 2014).
By legalizing assisted suicide, this method could be exploited by individuals and could influence the population to believe assisted suicide is a good method to rid the inconvenience of pain. It could pressure vulnerable patients into assisted dying due to the social, emotional, and financial strain healthcare could place on family and friends (Frost 2014). Studies in Oregon, located in the United States, revealed that once assisted suicide has been legalized, the requests for this method have increased from 17% to 25%. (Oregon Department of Human Services). The legalization of assisted death could devalue the gift of life as patients could view this method as an expected decision instead of a free one.
The belief that people should have the right to end their life whenever they want if they are facing pain, devalues the gift of life resulting in various problems. For example, people with chronic pain feeling like a burden to their family and friends could be extended to many other social groups who have similar attributes, such as people who are permanently disabled. Does that mean that anyone who has a disability should consider assisted suicide as they feel they are a burden, absolutely not, because that devalues the gift of life. Due to all these factors, assisted suicide can be seen as unethical due to the many problems which could occur from legalization.
Conclusion:
In conclusion, I believe that assisted suicide should only be legal and an option for those individuals who are diagnosed with a chronic condition where they are informed they have a timeframe left to live. I believe this because I have been through a situation like this with my grandfather. Four years ago he was diagnosed with pancreatic cancer and has been given a time frame of six months to live. Within those six months, it is difficult to say that he was even living because based on all the drugs he was put on to fight cancer, every day he would be experiencing nausea, depression, anxiety, and immobility and would always say he felt like a burden to the family as he would be in and out of the hospital every week. Although I am glad he didnt make the decision to end his life early so the family could spend all of his last moments with us, I wish he wouldnt have to go through all that suffering. This is why I believe chronic conditions like these should be an option for patients.
But for other patients who have disabilities and there are other methods of treating the pain, I believe this option should be illegal and unethical because it could lead to abuse and exploitation, potentially altering peoples perception thinking suicide is a viable option to pain. There needs to be advances in global health that provide healthcare professionals with better education and learn how to prevent the use of assisted suicide at all costs to alleviate pain. Furthermore, they need to learn how to support those going through feelings of depression and impending doom associated with physical pain. For instances where passive euthanasia has to be administered, machines should be programmed in order to terminate life when they detect the patient is invisible and unable to heal with the assistance of life support.
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