arguments for and against physician assisted suicide

Introduction Physician-assisted suicide, or physician-assisted death, refers to “the process that allows terminally ill adults to request from their physician, receive from their pharmacist, and take a lethal dose of medication to end their life,” (Death with Dignity, n.d.). Although seemingly similar to euthanasia, physician-assisted death is different in that it tends to refer to situations where the patient does not act with autonomy. Physician-assisted death is still controversial and is illegal in most states.

However, Oregon, Washington, Vermont, California, and Colorado have legalized physician-assisted death, and several other states have pending legislation to do so as of 2018 (Quill & Sussman, 2018). The medical community itself is divided on the practice of physician-assisted death. Arguments for physician-assisted death include the rights of patients to self-determination. Arguments against physician-assisted death include the obligation of the physician to heal, not kill, the potential for ambiguous situations where there is some risk for abusing the system, and administrative fears of litigation resulting from familial disputes.

This paper presents multiple sides of the physician-assisted death debate, with an analysis of the reasoning used by both sides. First Argument: Physician-Assisted Death is Wrong Many, but not all, arguments against physician-assisted suicide are based on moral reasoning. Those that are based on morality refer to the presumed sanctity of life, the belief that “purposefully helping a patient die is categorically wrong under any circumstances,”and the corollary that the role of the physician or healthcare worker is as healer (Quill & Sussman, 2018).

A physician who believes that the ultimate objective of the profession is to preserve life will therefore believe that physician-assisted death is wrong and would instead ask that the patient use other methods to alleviate suffering. For example, Appelbaum (2016) claims that physicians “traditionally have been dedicated to sustaining life,” (p. E2). The doctor presumably knows what is best for the patient, and as long as the patient is under the doctor’s care, the patient cannot receive any treatment that would hasten death.

Physician-assisted suicide is therefore said to undermine the life-affirming moral tenets of the medical profession. Another extension of the moral argument is that physician-assisted death would “undermine trust between physician and patient,” (Quill & Sussman, 2018). Finally, arguments against physician-assisted suicide warn that the practice could be too easily abused and that persons who are not capable of making an informed choice about their end of life may be euthanized.

Opposing Argument: Physician Assisted Death Can Be Right The argument that physician-assisted death is morally permissible is also dependent on situational variables; no claims for this position are universal. In other words, there are no arguments that would say physician-assisted death is always permissible for patients, even for all patients experiencing a terminal illness. The position is contingent on the capacity for the patient to make the decision to seek physician-assisted death consciously, and with the support of a medical care team (Quill, Back & Block, 2016).

Moreover, the patient eligible for physician assisted death is presumably already in palliative care; that is, the patient is terminally ill and death is inevitable (Chochinov, 2016). Arguments in favor of physician-assisted death focus on patient autonomy above all, but also on the beneficence of alleviating unnecessary suffering. Beneficence is in fact one of the pre-eminent moral objectives of the medical profession.

Likewise, respect for patient autonomy and the right of the patient to dignified treatment have led to the “death with dignity” movement that precipitated the Oregon Death with Dignity Act (Death with Dignity, n.d.). If autonomy, dignity, and respect are to remain cornerstones of the medical profession, then physician assisted suicide must remain a right for patients who are terminally ill and who have the mental capacity to make such a decision in conjunction with their medical team.

Analysis of Reasoning The side opposing physician-assisted death uses several logical fallacies that should be addressed. The first is a false dilemma fallacy, which is used when referring to the interpretation of the duties of the medical profession. When healing the body from a terminal illness is impossible, and when suffering is great, the physician lacks the ability to further help the patient within the limitations of modern medicine. Therefore, the goal of treatment shifts from prolonging life to maximizing patient comfort.

Physicians are bound by the ethical obligation to treat patients with dignity and respect, and to respect patient autonomy in decisions surrounding their own health and wellbeing. “Patients with serious illness wish to have control over their own bodies, their own lives, and concern about future physical and psychosocial distress,” (Quill, Back & Block, 2016, p. 245). When physician-assisted death is denied, the patient lacks personal autonomy and is effectively forced to suffer. A second logical fallacy used by the opposing side is the slippery slope argument.

Some physicians claim that physician-assisted death “poses too high a risk to vulnerable patients,” (Quill & Sussman, 2018). The argument is sometimes directly presented as a slippery slope, as when Appelbaum (2016) claims, “the door has been opened for people whose suffering is primarily due to mental disorders to seek assistance in dying,” (p. E1). That door can be easily shut with strong policies and procedures in place.

In fact, all physician-assisted suicide laws protect against abuses of power by requiring certain standards be met including assessing patient competence (Quill & Sussman, 2018). Finally, the opposing side also uses a begging the question logical fallacy when stating things like physician-assisted suicide will “undermine trust between physician and patient,” (Quill & Sussman, 2018). There is no reason why the practice of physician-assisted suicide will undermine trust. On the other hand, the position that physician-assisted suicide is morally permissible in certain circumstances is logically sound.

First, the argument points to the multiple ethical objectives of the medical profession including patient autonomy. The argument also acknowledges the truth that physicians are not miracle workers, and when they have exhausted every means possible to find a cure or otherwise help the patient, they must realize that death is inevitable. Refusing a patient request to hasten death only prolongs patient suffering, and for no reason other than so that the physician and the hospital can avoid possible litigation or complications due to dissenting family members.

Conclusion When the topic of physician-assisted death is analyzed from a logical perspective, it becomes.