Euthanasia: "Should physicians be allowed to assist in patient suicide?" (No)
Euthanasia is, quite literally, a "life and death" issue. It is no surprise, therefore, that it evokes heated debate among doctors, lawyers, philosophers, academicians as well as the general public all over the world. Although, recent developments in modern medicine have given it a new dimension, euthanasia is by no means an exclusively modern-day concern. Even the ancient Greeks had pondered over the issue centuries ago, albeit without reaching a definite conclusion about its merits or otherwise. In more recent times, euthanasia has been the subject of discussion in various forums including the Supreme Court of the United States with similar inconclusive results. Despite considerable debate and weighty arguments by either side, several key euthanasia questions remain unresolved such as "Should physicians be allowed to assist in patient suicide?" which is the subject of this paper. In the following paragraphs, I will explain the issue in detail, discuss its pros and cons, and argue against making such assistance legal since, in my opinion, the negative consequences of the act far outweigh its purported benefits.
Assisted Suicide and Euthanasia
Assisted suicide is the act of providing an individual with the information, guidance, and means to take his or her own life with the intention that they will be used for this purpose. When a doctor helps someone to kill him / herself, it is called "physician-assisted suicide."
Definitions of some other related terms are as under:
Euthanasia can be defined as "the merciful killing of another for the purpose of ending the pain and suffering."
Voluntary euthanasia: When the person who is killed has requested to be killed.
Non-voluntary euthanasia: When the person made no request to be put to death and gave no consent, usually because he/she was unable to do so.
Active Euthanasia: Intentionally causing a person's death by, e.g., giving a lethal injection.
Passive Euthanasia: Causing death by passive inaction, such as not providing medication, care or food and water.
While discussing 'Euthanasia' and 'Assisted Suicide' people sometimes fail to make a distinction between the two. There is, however, an important difference: in euthanasia the 'last act' of putting a person to death is performed by a third person while in assisted suicide, the patient himself performs the last act. A typical 'physician-assisted suicide' occurs when a doctor supplies information and/or the means of committing suicide (e.g. A prescription for lethal dose of sleeping pills, or a supply of carbon monoxide gas) to a person, so that the person can terminate his/her own life.
Arguments for Respect for "patient's autonomy" is the over-riding ethical principle in medicine and must have precedence over all other principles. Hence, if a patient "voluntarily" decides to end his or her life, then assistance by the doctor in doing so should be allowed because physician-assisted suicide is essentially voluntary. Moreover, assisted suicide should not be bracketed with 'active euthanasia' which can be performed without the patient's consent.
Suicide is a legal act that is theoretically available to all. But a person who is terminally ill or who is in a hospital setting or is disabled may not be able to exercise this option - either because of mental or physical limitations. In effect, they are being discriminated against because of their disability.
Death can sometimes be extremely painful and undignified, and in certain cases the patients need assistance in ending their lives to be relieved of their suffering. Compassion demands that we must not deny a patient his 'right' to relieve himself of pain and suffering. Despite advances in palliative care and pain management there would always be certain patients whose suffering cannot be relieved and who would prefer assisted suicide rather than any other treatment including palliative care.
Since euthanasia and assisted suicide take place anyway, it is better to legalize them so they'll be practiced under careful guidelines and so that doctors will have to report these activities.
Opposition to euthanasia and assisted suicide is just an attempt to impose religious beliefs of one group of people on another. Suffering patients should not be forced to follow the theological beliefs of a dominant religion or 'conservative faith groups' who are most vocal in their opposition to suicide.
Only 'anecdotal' evidence exists about patients changing their minds on suicide after treatment of depression; there is no reliable evidence to prove such a theory. Hence, the argument that most patients who request assistance in suicide do so due to their depression (a result of their terminal or serious illness like cancer) is unproven.
Doctors should be committed to providing the best possible care for a patient in accordance with his or her wishes instead of being wedded to an abstract, theoretical position that doctors must never participate in taking life. Similarly, requiring someone else (other than a patient's doctor) to assist with a requested suicide in order to honor such an unrealistic position amounts to 'abandoning of the patient.'
Arguments Against The right to commit suicide is recognized in most societies, since it is a tragic but private act. Assisted suicide on the other hand, is not a private act and involves the participation of a third person for facilitating the death of another. It is, therefore, morally wrong.
People requesting assisted suicide, are more often than not crying out for help. They deserve counseling, assistance, and positive alternatives for their problem rather than being nudged towards their death.
Depression, that often accompanies chronic and terminal diseases, is a major cause of requests for assisted suicide. Most people, after being treated for depression would withdraw their request for physician-assisted suicide.
Marker, Rita L. And Kathi Hamlon. (2003) "Euthanasia and Assisted Suicide: Frequently Asked Questions."
Advances in modern medicine have made it possible to alleviate almost all kinds of pain. Even when it is not possible to eliminate pain entirely, lessening it to a manageable level is almost always possible. The problem, therefore, is lack of proper pain management training for doctors and access to pain relieving medicine for everyone, rather than assisted suicide.
Many faith groups belonging to most major religions such as Christianity, Islam, and Judaism believe that God gives life and therefore only God should take it away. Suicide as well as assisted suicide and euthanasia is considered "as a rejection of God's sovereignty" from a religious point-of-view.
Assisted suicide can be a tempting alternative for containing health-care costs. Doctors are often being pressured by HMOs to reduce health care costs and if they have the legal option of providing assisted suicide, they would be tempted to use it for cutting costs. The poor, the disabled, the minority groups, and the marginalized would be the most vulnerable targets for such cost cutting solutions.
By making assisted suicide available and legal, some people will be pressured into accepting assistance in dying by their families and/or their doctors.
Why I believe that Assisted Suicide is wrong?
Despite the long list of arguments advanced by the supporters of physician-assisted suicide (most of which have been summarized in this paper), I believe that they do not hold up to searching, critical scrutiny. Some of these arguments may seem impressive at first sight, but their weaknesses become evident if we closely examine them closely.
For example, one of the major arguments in favor of physician-assisted suicide is that respect for "patient's autonomy" is the over-riding ethical principle and if a suffering patient "voluntarily" requests for assistance in committing suicide, the most humane thing is to respect the wish. The problem with this argument is that the supposedly 'voluntary' request made by the patient is often the result of the very state he or she is in. It is now widely recognized that most persons suffering from diseases such as AIDs and cancer suffer from depression and could be in constant pain due to inadequate pain management. Studies have shown that depressed patients who request suicide frequently change their minds after their depression is treated, even though their physical condition is not improved. Hence requests for assisted suicides cannot be taken at their face value and cannot be considered truly voluntary.
Marcia Angell in her article about physician-assisted suicide has dismissed the concerns of a "moral slippery slope" by asserting that experience in Netherlands and Oregon shows that such fears were unfounded. It is hard to accept this argument since many other studies indicate otherwise. For example, initially only voluntary assisted suicide for the terminally ill was legalized in the Netherlands, but was later expanded to include nonvoluntary euthanasia as well. The results are evident in a 1995 study, according to which Dutch doctors reported ending the lives of 948 patients without their request.
I believe that allowing patient assisted suicide devalues life, and once life is devalued in a society, it can lead to very serious consequences. The fear is that allowing mercy killings or ending of lives on the basis of compassion, may ultimately lead to assistance in the death of anyone whose life…