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When an animal is growling in severe pain and refusing to eat, most people would say that the moral thing to do would be to kill it mercifully. Even if the lives of human beings cannot be equated to those of animals, why can we not extend this same grace to people who wish to die? It is important to revisit the topic of physician-assisted dying because it affects everyone in society. You could be the one in need of assistance in dying or you might watch your loved one undergo insufferable pain. Physician-assisted dying (PAD) should be federally legalized to permit terminally ill people to end their suffering if they desire, promote individual and patient autonomy, and ensure proper regulation.
I have keen interest in this topic because I witnessed first-hand the final living moments of a close friend. I watched helplessly as she battled incurable cancer. I have done extensive research on the topic and read both arguments for and against the matter and concluded that PAD should be permitted. First, I will explain how medical aid in dying (MAID) alleviates patient pain and suffering. Next, I will examine physician-assisted dying from the standpoint of autonomy. Finally, I will describe the regulations in place to ensure MAiD is performed safely and ethically.
Physician-assisted dying should be permitted in all states to bring relief to patients who have symptoms that cause existential pain or suffering. Sometimes, people suffer so much pain that they wish to die. This is common when a patient has a terminal condition, such as cancer. According to a study conducted in the Netherlands by Evenblij and his associates, Patients suffering unbearably may wish to hasten their death (Evenblij, Pasman, Van Der Heide, Hoekstra, et al., 2019, p. 2). The findings of this study are corroborated by a literature search conducted by Krikorian, Maldonado, and Pastrana.
They concluded that the desire for death is a well-documented phenomenon in patients with advanced chronic illnesses (Krikorian, Maldonado, & Pastrana, 2020). If patients are in so much pain that they wish to die, physician-assisted dying should be legalized to facilitate this. Aside from physical pain, physician-assisted dying is necessary to relieve patients of existential suffering. The Netherlands study found that patients 75.4% of patients requested PAD because they experienced severe symptoms other than pain (Evenblij et al., 2019). Psychiatric conditions such as depression can also cause existential suffering, leading an individual to experience a sense of purposelessness. When psychiatric conditions are so severe that they cause unbearable suffering, it is acceptable for the individual to be assisted in dying. Therefore, MAiD should be allowed to give people the option of death when living is excruciating.
Aside from a patients agonizing signs and symptoms, another reason to permit PAD is individual autonomy and sense of control. Patients should be accorded the right to decide how and when to die. One of the principles of biomedical ethics is autonomy, which means that patients should be allowed to decide which medical interventions they want to undergo or forego. Additionally, death is a private matter that should be free from state interference. In their opinion piece in The Conversation, Symons and Schüklenk (2017) write that when the state infringes on autonomy rights, it regress all the progress that people have worked to achieve in terms of individual freedoms.
In addition to autonomy, physician-aided dying gives a person the power to control their situation. As explained by Li and her team of doctors in their paper published in the New England Journal of Medicine, The primary reason for which patients in our setting sought MAiD was to relieve distress over the loss of autonomy (Li et al., 2017, p. 2088). Furthermore, many sick individuals feel they are a burden to others and lack control over their own lives. Choosing when and how they die gives them a sense of control over at least one aspect of their lives. It is critical for human beings to have autonomy, control, and dignity even in death.
In addition to reasons related to patient needs, assisted suicide should be permitted because it can be easily regulated or monitored. Opponents of MAiD argue that permitting it will be inadvertently lead to people being coerced to pursue PAD. However, there are regulations that govern how PAD is conducted in nations that permit assisted dying. Evenblijs team lists the statutory due care criteria that physicians must meet, including informing the patient about their prognosis and consulting at least one other physician (Evenblij et al., 2019).
In countries where PAD is permitted, there is usually a wait period before the wish is granted. In addition, the process is transparent because it involves a lot of steps that are closely monitored. In a journal article, Gamondi, Pott, Preston, and Payne (2018) narrate that assisted suicide is characterized by practical organization. They report that, assisted suicide appeared to be predominantly the result of a thoughtful, complex, and negotiated decision based on personal values and characterized by intense and prolonged discussions (Gamondi, Pott, Preston, et al., 2018, p. 1090).
Moreover, the process is usually initiated by the individual who wishes to die and supported by their family members. In his 2017 paper in BioEthics, Schuklenk (2017) states that, Evidence from jurisdictions that have decriminalized [MAiD] shows that there has been no slippery slope to abusive practices (p. 422). This refutes the argument that PAD would be used unethically by medical staff. Physician-assisted dying has numerous checks and safeguards to ensure that it is not abused.
In conclusion, physician-assisted dying is helpful for people with unmanageable pain or existential suffering. Where a persons health condition is so severe that they wish to die, they should be granted their wish. In addition, PAD is in line with the principle of autonomy. It enables people to exercise control over how they die. Finally, PAD should be allowed in all states because it can be regulated to ensure ethical practice. Evidence from places such as Switzerland, Netherlands, and Canada where physician-assisted dying is legal shows that the practice is beneficial. Considering how much the United States boasts of being the nation of the free, maybe it is time to reconsider our stance on physician-assisted dying.
References
Evenblij, K., Pasman, H. R. W., Van Der Heide, A., Hoekstra, T., & Onwuteaka-Philipsen, B. D. (2019). Factors associated with requesting and receiving euthanasia: A nationwide mortality follow-back study with a focus on patients with psychiatric disorders, dementia, or an accumulation of health problems related to old age. BMC Medicine, 17(1), 1-12. Web.
Gamondi, C., Pott, M., Preston, N., & Payne, S. (2018). Family caregivers reflections on experiences of assisted suicide in Switzerland: A qualitative interview study. Journal of Pain and Symptom Management, 55(4), 1085-1094. Web.
Krikorian, A., Maldonado, C., & Pastrana, T. (2020). Patients perspectives on the notion of a good death: A systematic review of the literature. Journal of Pain and Symptom Management, 59(1), 152-164. Web.
Li, M., Watt, S., Escaf, M., Gardam, M., Heesters, A., OLeary, G., & Rodin, G. (2017). Medical assistance in dyingimplementing a hospital-based program in Canada. New England Journal of Medicine, 376(21), 2082-2088. Web.
Schuklenk, U. (2017). New frontiers in endoflife ethics: Scope, advance directives and conscientious objection. Bioethics, 31(6), 422-423. Web.
Symons, X. & Schüklenk, U. (2017). Viewpoints: Should euthanasia be available for people with existential suffering? The Conversation. Web.
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