Assisted Suicide California Once Again

¶ … Assisted Suicide

California once again has written a bill to legalize assisted suicides. The last two died, but the legislators keep on trying. The proposed law is modeled after the one that passed in Oregon, which in 2006 resulted in 46 residents, most of them suffering from cancer, killing themselves after their physician gave them a prescription for a lethal amount of drugs. Should such a law become national? Should everyone in the country be allowed to have assisted suicides? Given the Supreme Court's recent ruling and some of the studies that have been conducted, I believe that this is a right people should have, but it is necessary for the patient to talk with more than one doctor when making the decision.

The issue of assisted suicide became newsworthy in 1990 when Dr. Jack Kevorkian helped Janet Adkins, a 54-year-old Alzheimer's patient, take her life. He met Adkins in a Volkswagen van he had outfitted with a "suicide machine" consisting of three chemical solutions fed into an intravenous line needle. Dr. Kevorkian is not the only one who supports doctor assisted suicide. The Hemlock Society is a group committed to promoting the legalization of euthanasia. In 1994, Oregon passed the "Death with Dignity" act, which allows the terminally-ill to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician.

In 1997 the Supreme Court unanimously ruled that people have no constitutional right to die, upholding state bans on physician-assisted suicide. That opinion, by then-Chief Justice William H. Rehnquist, said individual states could decide to allow the practice. Thus, it is now left to the states to decide.

Although much of the controversy revolves around whether or not the assisted suicide should take place, given the Supreme Court ruling, perhaps it is better to go the next step and determine when a person has this right. For example, Oregon states that, in order to participate, a patient must be: 1) 18 years of age or older, 2) a resident of Oregon 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that will lead to death within six months. It is up to the attending physician to determine whether these criteria have been met (Moskowitz, 2003, p. 46).

Is this enough? Some say that it is important to give more attention to the patient's reasoning before making a decision. Muskin argues that not discussing a patient's motivation for assisted suicide is the real violation of his or her rights. Varghese and Kelly agree, saying that legal and ethical debates about suicide focus on "rational" decision making, the patient's psychiatric condition, and determination of "competency" to make decisions. However, they believe "These issues are less important at the clinical level than understanding the nature and degree of suffering for patients with terminal illness and the ways in which psychological and social factors influence decision making in this setting."

It is normally thought that patients who have been diagnosed with severe illnesses such as cancer will consider suicide. However, research shows that even though suicide risk may be increased in cancer patients, it only accounts for only a small minority of deaths (Storm et. al., 1992). When cancer patients do try to commit suicide or actually commit the act, they have some major psychiatric disorders, particularly depression (Breitbart, 1990) study of 100 men with AIDS, the "interest" in physician-assisted suicide was predicted by high levels of psychological distress and the experience of terminal illness of a friend or relative, as well as a perception of lower levels of social support. No significant association existed between interest in assisted suicide and severity of the disease (Breitbart, 1990). Chochinov et. al analyzed the desire for death with over 100 terminally ill cancer patients and found only 8.5% had a lasting and clinical desire for death, and of these 59% were depressed, compared with 8% of those without a stated desire for death.

Another concern besides the mental state, say Varghese and Kelly is that the doctor's own belief regarding the suicide may become a factor on whether or not the person decides to go ahead. Hendin (1994) argues that doctors may presume that decisions can be based on what they themselves would wish if they were in the patient's situation, bringing the doctor-patient relationship to a new dimension: the wishes of the doctor for the patient are presumed to be identical to those of the patient.

As can be seen by the above information, states are now allowed by the U.S. Supreme Court to pass legislation for doctor assisted suicide, and several states in addition to California are considering the law. Given the fact of the Supreme Court ruling and my own personal belief that a person should have control over his or her life, I support doctor assisted suicide.