Over the last two decades, physician-assisted suicide (PAS) has received widespread attention in American society. The mentioned period has been riddled with controversy over the practice of assisting patients to die. The practice is meant to relieve patients of pain at the twilight of their lives. According to Jeffery (2009), the practice involves the intentional provision of terminally-ill patients with the knowledge or the means that would help them commit suicide. The practice includes counseling, prescription or enabling patients to access lethal drug doses. The practice differs from euthanasia in the sense that PAS has legal provisions whereas euthanasia depends on the decision of parties such as patients, relatives or the physicians and also involves administration of a lethal injection. The paper will explore the background of PAS, arguments against the practice, and the legalization of the practice from a consequentialist perspective.
The practice of PAS has been documented in ancient Greece. Although it was not done in the similar version of modern medicine, it was reflective of the intentions of current medical practices. In ancient Greece, persons seeking escape the pain of dying used poison to induce death. The poison was often in the form of a solution, and it was obtained from persons referred to as physicians (Weir, 1997).The procurement of medicine for suicide in the ancient Greek society led to the development of the Hippocratic Oath. This oath was meant to prevent patients from accessing death-inducing concoctions. According to Weir (1997), the oaths primary view was that physicians should not participate in causing harm nor help patients to harm themselves. Today, the oaths values and principles form the larger portion of medical ethics.
Arguments Against PAS
Most of the arguments against the practice have sought to provide the social, religious and medical basis for the rejection of legislations favoring PAS. Professionals in the medical field have shown a greater opposition to the enactment of PAS laws. Specifically, a majority of the doctor and nurses who specialize in palliative care reject legislations that support PAS since such laws go against the medical intuitions and the moral constitution of all medical practitioners (Jeffery, 2009).Jeffery argues that no form of care in the medical field that is free from pain. Patients suffer because that is part of the life of a sick person. For this reason, terminally-ill patients should be provided with palliative care so as to enable them reconcile with their lives and those of the families before they finally exit the planet. The rationale of the argument is that the terminal phase is a critical phase of ones life span and, thus, should not be hastened in any manner.
Researchers have argued that the legalization of PAS does not offer a solution to the problem of pain experienced by patients (Jeffery, 2009).According to Jeffery, patients with life-threatening conditions endure a lot of suffering which often hinders their judgment on the position that they should be assisted to die. The acute health situations that cause suffering may be as a result of factors that can be managed and, therefore reduce tendencies of suicide among terminally-ill patients. To this end, Cohen-Almagor (2015) argues that the obvious position that should guide healthcare professionals when attending patients at the end-of-life is that such patients would always opt for life. This position should inform all decisions made in regards to patient treatment.
The Legalization of PAS; Arguments from a Consequentialist Perspective
The consequentialist theory draws its standards of ethical behavior from the consequences of actions. The theory holds that morality of our actions should be influenced by the expected effects on other members of the society; what matters most is the result of our actions, and such results must yield value on the final recipient for them to be considered moral or ethical (Tanner, Medin, & Iliev, 2008). In the context of PAS, the practice should be legalized as it confers several benefits to patients, families and medical establishments that are charged with end-of-life care.
In the US, some states have enacted legislations that provide a legal framework on which PAS should be conducted. This option is enshrined in law in Vermont, Washington, Oregon, and California. In Montana, the option is protected by a court decision. The law applies to patients with a prognosis of six months or lowers to live. The method that is used varies depending on the provisions of each state. For instance, in Oregon, a physician, licensed to practice medicine in the state, is allowed to give death inducing prescriptions .Another provision of the law also requires that such doctors must be willing to participate in the act (CNN Library, 2016).
Statistics indicate that there were 1545 PAS prescriptions in the year 2015, and 991 recipients died from ingesting the drugs that had been prescribed to the under the provisions of the PAS law in the state of Oregon (CNN Library, 2016).This trend shows that there is value in the PAS law as it helps patients to ease the pain in own volition. Some diseases such as cancer inflict excruciating pain on the patients. For this reason, it important that states accord such privileges to patients so as to empower them to decide the fate of their suffering. Evidently, residents of the states where PAS is illegal endure pain against their wishes. As Cohen-Almagor (2015) argues, the appropriate treatment at the end-of-life must recognize the wishes of the patients who are suffering from terminal illnesses. Some of the patients of terminal illnesses live low-quality lives due to repeated pain. As a result, they consider death as an attractive option to ease the pain. From a consequentialist perspective, the result of the action confers more value to the affected person as it ends the suffering through death which is expected to happen especially with patients a prognosis of six months or below to live. Thus, the legalization of PAS in other states would expand the practice to other patients who consider the option as an attractive direction towards a pain-free life.
Every individual commands the zeal to live no matter the circumstances. Research has shown that patients, whether in critical conditions or otherwise, would always opt to stay alive. When patients decide that their lives be terminated, it shows that all the determination to live has been exhausted and making such decision cannot be considered irrational (Cohen-Almagor, 2015).If the means of receiving assistance are not available, Jones and Paton (2015) conjecture that non-assisted suicide rates are likely to be higher. From this perspective, legalization of PAS in other states would save residents depression associated with extreme suffering as well as reduce cases of suicides associated chronic conditions since people would be more comfortable endure suffering or invoke the option when necessary.
From a consequentialist viewpoint, the value of the process of termination of life should not be made expensive through legislation as a way of depicting the outcome as less valuable. For instance, the legalization of PAS in the state of Oregon has proved that residents of other states continue to suffer due to the laws that prohibit the practice. These restrictions may lead to migration of residents to seek the services in states where the practice is legal (CNN Library, 2015). This phenomenon can be illustrated in the case of Brittany Maynard who moved to Oregon to secure the right die. The right was granted in 2014.The outcome of the case shows that outlawing of PAS is some states increases the cost of end-of-life treatment. In her account, the decision to die saved her depression and intolerable side effects of brain cancer treatment methods, stress to her family as well as the costs of hospitalization (CNN Library, 2015) .As a consequence, the outcome of the decision appears more valuable than staying alive.
A majority of the opponents of PAS offer predictions of extermination of vulnerable persons in the society. This argument follows that the law would be abused, leading to mass authorization for death of critically-ill patients and disabled persons. Additionally, patients with chronic illnesses may not be rational in making PAS decisions. However, research findings from studies of Pearlman et al. (2005) show that patients who procure PAS make the decision after a long, thoughtful process. As a result, the issue of mass killing of patients cannot arise. To this end, all states should legalize PAS since the fears extermination as provisions of the law would provide mechanisms to conducting PAS as evidenced in other states.
The legalization of PAS would prevent illegal deaths and negative consequences of such deaths. Evidence suggests that PAS happens in hospital facilities despite its legality. Patients with dementia and psychological disorders fail to make their wishes have been documented, and the decision to end life is made by physicians or relatives (Cohen-Almagor, 2015).This will reduce the cost of end-of-life care through minimization of prosecutions against physicians who conduct the procedure under illegal circumstances. Such scenario can be illustrated by the incident involving American pathologist Jack Kevorkian. The pathologist was judged with murder and not PAS charges (CNN Library, 2015). His imprisonment increased the cost of suicide and, therefore, legalizing PAS would lead to outcomes that conform to the postulations of the consequentialist theory.
Legalization of patient-aided suicide remains a controversial issue in American health care. Opponents of the legalization of the practice offer a raft of reasons against PAS. Contravention of the oath of medical ethics is one of the reasons given for such stance. Additionally, the legalization would result in the mass killing of vulnerable groups such as the disabled and those with psychological disorders. However, it is evident from the discussion that terminally-ill patients favor PAS. Except for patients with mental disorders, most patients show that the choice to terminate ones life is often a well-thought process whose sole purpose is to reduce the suffering of the patient. The legalization and practice of PAS in states such as Oregon emphasize that the practice offer net benefits to the patients, relatives, friends and families. Evidently, the costs far outweigh the expenses. Thus, it should be legalized in all states and territories to offer all Americans a chance to die in dignity as well as decriminalize the PAS practices of physicians in the country.
Cohen-Almagor, R. (2015). An argument for physician-assisted suicide and against euthanasia. Ethics, Medicine and Public Health, 1(4), 431-441. doi:10.1016/j.jemep.2015.10.011
Jeffrey, D. (2009). Against Physician Assisted Suicide: A Palliative Care Perspective. Radcliffe Pub.
Jones, D. A., & Paton, D. (2015). How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide? Southern Medical Journal, 108(10), 599-604.
Pearlman, R. A., Hsu, C., Starks, H., Back, A. L., Gordon, J. R., Bharucha, A. J., Battin, M. P. (2005). Motivations for physician-assisted suicide. Journal of General Internal Medicine, 20(3), 234-239. doi:10.1111/j.1525-1497.2005.40225.x
Physician-Assisted Suicide Fast Facts [Television series episode]. (2015). CNN Library (Producer), Antanta, AL: CNN.
Tanner, C., Medin, D. L., & Iliev, R. (2008). Influence of deontological versus consequentialist orientations on act choices and framing effects: when principles are more important than consequences. European Journal of Social Psychology,...
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