Should Assisted Suicide be Legalized

Should Euthanasia be Legal?

Abstract

Euthanasia, as Math and Chaturvedi (2012) point out, is a Greek word which means a peaceful or merciful death. Euthanasia can be induced by a doctor or it can be voluntary. Debate about the legality or morality of euthanasia has been raging on for a long time. While some are convinced that the same is immoral and ought to be considered illegal, there are those who are of the opinion that euthanasia should be legalized. This text delves into the debate revolving around the legality of euthanasia. More specifically, it explores whether euthanasia should be legalized.

Introduction

From the onset, it would be prudent to note that in basic terms, euthanasia is a medical act to end of life. A physician removes supportive measures or withholds treatment or introduces a lethal substance upon the consent of a patient (Math and Chaturvedi, 2012). Voluntary euthanasia is medically and legally accepted but it creates ethical dilemmas to physicians as there are ethical principles that clearly highlight their role in as far as advancing the wellbeing of patients is concerned, i.e. in relation to protecting and ensuring that no harm befalls patients. The issue of euthanasia is regarded as the act of making death easier via the cooperation of a doctor and not the act of ‘good dying’ as it was formerly deemed. Others view the issue as unethical and immoral since they believe that with the legalization of euthanasia, physicians are given the right to ‘murder’ patients at will. Such ethical debates arising from this debate lead to the question of whether euthanasia should be legalized or not.

While there are those who agree that it should be legalized, others take a hardline position that it should be not. It has been argued that euthanasia is a better option when a patient has a long terminal illness or has been in coma for a long time. Some argue that euthanasia is a form of murder and is against the rights and beliefs of patients and/or their kin. There are various ethical issues in health care that come into play on this front (Math and Chaturvedi, 2012). In this paper, I will discuss the issue of physician assisted suicide and whether it should be legalized or not. Physician assisted suicide-PAS refers to the move by a physician to end the life of a patient by prescribing lethal medications to the said patient – upon request (Banovic, Turanjanin, and Miloradovic, 2017). In addition, I will discuss historical perspective on past and present ethical and legal issues relating to physician-assisted suicide.

Literature Review

In case of a serious medical illness, there are jurisdictions around the world that permit physicians or in some instances nurses, to administer a lethal medication to a patient so as to end suffering – and hence end life (Gerson et al, 2019). Some countries such as Switzerland allow non-physicians to assist in end of life undertakings unlike in other countries whereby such assistance ought to emanate from physicians only. Jurisdictions that have passed laws on assisted dying are from countries inclusive of, but they are not limited to; “various US states, state of Victoria in Australia, Quebec, and Canada, Luxembourg, and Belgium” ( Gerson et al., 2019, p. 113). However, such jurisdictions have passed laws that prevent misuse and abuse of the said practice by putting in place the relevant procedures, criteria, and safeguards. Such procedures and criteria also vary across different states. According to Gerson et al. (2019), people may hasten their death with or without assistance. Further, the authors suggests that assisted dying can either be administered by a physician or an individual can administer the lethal dose by himself after a prescription from a physician as long as there are legally sanctioned reasons for such administration.

First, physician assisted suicide in all allowing jurisdictions requires that the request be persistent over time, informed, well-considered, and voluntary (Pereira, 2011). The law in such jurisdictions also requires that the person requesting PAS be competent at the time of request and have a written consent. However, even with such safeguards, some people could still manage to access assisted suicide without a written consent (Pereira, 2011). The author further suggests that attempts to bring such cases to trial, i.e. in relation to those involved, usually fail. In other cases, an individual may have the capacity but has not provided consent due to coma or dementia, in which case the case is non-voluntary. In such instances, Pereira (2011) points out that physicians assist in suicide with the belief that it would have been in the best interest of the person. The author further argues that a written consent is very important if abuse and misuse is to be avoided.

Second, it is important that all jurisdictions that permit assisted suicide report those cases to the relevant agencies, i.e. the Federal Control and Evaluation Committee. This is crucial in efforts to ensure proper follow-up if need be and minimize instances of abuse. There may also be need for a second physician to be consulted before PAS is conducted. In other countries such as Belgium, a third physician should be consulted (Pereira, 2011). The author suggests that in the case that a consulted physician finds fault in the patient’s judgment, a psychologist is recommended.

In the past, cases of euthanasia were only allowed for terminal illnesses and the option was the last resort when other forms of treatment were unavailable. In the modern society, the various day-to-day challenges that people experience or mere challenges associated with the aging processes could be presented by some as valid reasons for assisted suicide. In the case of ageing, Pereira (2011) suggests that the change is due to the fact that the elderly people feel isolated and they also consider themselves to be a burden to their families. Such people might be more likely to consider PAS. It is also important to note that even in those instances whereby terminal illness is involved and cited as reason for PAS, physicians might be reluctant to find alternatives to PAS, i.e. suggesting experimental medicine.

Discussion

There is a difference between what is legal and what is not in PAS as highlighted by some of the states that have legalized the same. In some instances, there is the general perspective that legalizing physician assisted suicide does not reduce the number of vulnerable persons, and does not lead to increase in cases of PAS (Pereira, 2011). Further, some jurisdictions hold the belief that there is no difference between assisted suicide and withholding life-saving treatment. Proposers of physician assisted suicide argue that it should be legalized given the benefits it has on a patient and to the families of the patient – i.e. in terms of reduced pain and medication costs where an ailment has no known cure.

To start with, it is important to acknowledge that most persons are in agreement that life is valuable. However, when an individual is in great agony or suffering, then the value of life could lose meaning to some – hence the desire for relief, i.e. from pain (Goligher et al., 2017). It is also worthwhile noting that life should not be prolonged at any cost in such circumstances. This is more so the case owing to the fact that the suffering may be prolonged with no hope of recovery as it is in the case of some terminal illnesses. In such a case, it may be beneficial to the patient if the pain is relieved. To some patients, as Goligher et al. (2017) point out, physician assisted suicide is not a pleasant experience. However, the authors hold that in cases of extreme or intense suffering, it may be the only best option. The authors further suggest that when the suffering is too much, the burden of dying outweighs that of living. This an assertion that is also indirectly supported by Bernat (1997) who observes that some patients sometimes feel that the burden of their illness is causing unfair suffering and/or difficulty to their families. These patients are likely to make decisions to end life owing to save their families from financial ruin. On this front, as Lorenze and Lynn (2003) observe, patients consider the financial situation of the family at the time of illness and find it worthy to relieve them the burden of paying medical bills for an illness that they may never recover from. Also, the said patients may also make such decisions to relieve their families of the burden of taking care of them in case of immensely limiting physical challenges.

An argument could also be made to the effect that there is a religious basis to the desire to end life. For believers, death means transitioning from the physical to the spiritual realm. The spiritual realm is deemed tranquil and peaceful (Goligher et al., 2017). For this reason, amongst those in great pain and agony, PAS can be regarded as an alternative to the physical life/reality of suffering.

Further, there are those who argue that there is no difference between withdrawal of treatment and physician assisted death. For instance, Goligher et al. (2017) argue that if it is ethical to withdraw a life supporting treatment during a therapy, then physician assisted suicide should be ethical since in both situations, the main aim is to provide comfort; the only difference being the instrumental act. The authors further suggest that the two acts may seem different but physicians are morally responsible since in both cases, they determine the timing of the act. Moreover, some people do not consider PAS as ‘murder’ when a patient gives consent. Goligher et al. (2017) argue that it is irrational to respect the consent of a patient to treatment plans such as withholding treatment yet we do dot respect the consent of the same patient when it is a case of PAS. This is more so the case given that both are intended to convey respect and minimize suffering to the said patient. If a physician does dot respect the rights of the patient at the moment, then he would be going against the autonomy of the said patient - which could be considered unethical. The authors further suggest that a patient should be allowed to die at their chosen time rather than sacrificing quantity for quality of life. In addition, it should be morally right to give lethal medications for self-suicide since the request of a competent patient is also morally right.

On the other hand, there are those who have in the past opposed legalization of PAS. For instance, Goligher et al. (2017) indicate that some are convinced that it is not morally right to end the life of a patient intentionally given that it is against the basic moral foundation in healthcare. Geomally (1997) agrees with the above author by indicating that PAS undermines certain patients with the thought that such patients are not worth living. The authors further suggest that it is not right to diminish the value of a person’s life even when the said person thinks that their life is unworthy. It is important to note that the life of a person is important than his or her preferences. Physicians should respect the principle of beneficence in ethics which creates trust between the patient and the physician. Unless doctors inspire trust in their patients, such patients will not have confident in them.

Geomally (1997) argues that legalizing physician assisted suicide would be against the legal system. This is more so the case given that a legal system should not discriminate. By allowing some people to be ‘killed’ via PAS, it would only mean that the legal system is discriminative of such persons. The legal system believes in dignity and worth of every person and it has the fundamental mandate to protect such people. It would be prudent to note that legalizing PAS would lead to the view that it is a less personally demanding and cheaper solution compared to other forms of treatments (Geomally, 1997). It should also be noted that legalizing PAS would put the lives of the less fortunate in the society at risk since it would be regarded as the only option available to relieve them of emotional and financial stress. Another concern raised for not legalizing PAS has got to do with the fact that if it is legalized, some conditions would remain undiagnosed given that PAS could morph into an easier route towards ‘treatment’ (Pereira, 2011). In the long term, this could have the effect of harming the entire medical research field. Closely related to this particular assertion, physicians should always be encouraged to explore all possible treatment avenues and to discuss other treatment alternatives as well as medical interventions with their patients before settling for assisted suicide (Goligher et al, 2017).