Emotional Issues in the Field of Biomedical

¶ … emotional issues in the field of biomedical ethics is the issue of patient assisted suicide. Proponents on both sides of the issue believe strongly in their arguments and the discussions surrounding the issue often become quite acrimonious. Yet, it is an issue that demands some measure of agreement but remains unresolved and caught in the middle are the patients who are actually suffering from conditions that initiate the discussions (Faber, 2000).

A variety of terms have been used to describe the process of when a terminally ill uses lethal medications for the purpose of ending his or her life but for purposes of this paper it will be simply identified as patient assisted suicide. Implicit in the use of the word suicide is the understanding of a premature death that is being generated out of despair. This is an extremely sensitive point in the discussion of patient assisted suicide and many professional organizations object to the use of the word suicide for this very reason (American Public Health Association, 2008). For many, suicide infers mental illness and proponents of assisted suicide argue that there is a distinction between deciding to terminate one's life to avoid the pain and distress of the inevitable and terminating one's life as part of some form of mental defect.

Regardless of how the process is defined, the act of terminating the life of a terminally ill person is to be distinguished from the act of euthanasia. Euthanasia is illegal in all states in the country and involves the act of a third party administering medication directly to a patient that ends the patient's life. Assisted suicide, on the other hand, refers to someone providing the medication but allowing the patient to decide whether or when to ingest the lethal medication.

The ethical arguments for patient assisted suicide begin with the belief that an individual should be entitled to make a rational choice to escape unbearable suffering at the end of one's life. These arguments are based on the respect that society has for the right of the individual to make life altering decisions on a personal level (Snyder, 2000).

Beyond this rudimentary argument proponents of patient assisted suicide offer a variety of other arguments. One such argument is based on the simple concept of justice. Presently, terminally ill patients have the undisputed right to refuse treatment that might prolong their lives. These patients can refuse life support such as respirators or dialysis but those patients who are not dependent upon such devices but patients who are suffering equally and facing the same fate are not free to make the similar decision. The taking of medication to end one's suffering should not be distinguished from the turning off of one's respirator or refusing dialysis treatments. Justice demands equal treatment.

Aside from the justice argument is the one related to compassion. Individuals suffering from many forms of terminal illness are not only experiencing intense pain their lives are affected in many other ways as well. Such individuals suffer from the loss of independence, loss of dignity, and other psychological burdens that make their lives unbearable. Under such circumstances, assisted suicide is a compassionate response.

There is also the political response. Libertarians would argue that the individual's right to self-determination should take priority over the state's right to control such matters. Such argument places a higher value on personal liberty than on the state's right to regulate certain behaviors. Another, similar argument, is that allowing patient assisted suicide is simply an exercise in intellectual honesty. This argument states that society should formally recognize what is already occurring. Assisted suicide is already occurring in secret and legalization would allow open discussion of the issue and provide for better end of life decisions for everyone.

Arguments against the ethical value of patient assisted suicide include the belief that life is sacred and that it is the duty of everyone to preserve as such. This argument is taken further by the belief that if patient assisted suicide was to be allowed abuses would take place in the process, that is, a slippery slope is created where eventually the circumstances where assisted suicide is permissible would be greatly expanded. The thinking on this issue is that there are vulnerable members of society who lack the resources for quality care and support in their waning years will be, therefore, pushed into assisted suicide as a cost saving measure or that greedy family members will coerce such decisions.

Opponents of assisted suicide also argue that there is a sharp distinction between allowing nature to determine when and how someone dies is much different than allowing someone to make such determination. For adherents to this view, one approach, allowing nature to make such determination, is a passive act that does not involve human discretion while the other, allowing human input, is in actuality an act of killing. This argument is offered to refute the distinction between withholding treatment and the taking of medication to end life. Withholding treatment, for supporters of this argument, is a passive act and, therefore, justifiable but allowing the use of medication is an active enterprise that is not justifiable.

Opponents of assisted suicide also argue that such process impinges on the integrity of the medical profession and anyone else who involves themselves in the process. The medical profession, in particular, and society, in general, has the responsibility to preserve life and the act of assisting in suicide is a violation of this responsibility. Similarly, there is an expressed concern that the inherent fallibility of all human beings may cause irreversible mistakes to be made. As an example, misdiagnosis and mistakes in prognosis are made frequently. The effects of suicide are obviously irreversible and there is no room for mistake. Add in the fact that apparent unexplainable events occur when patients recover from what were believed to be terminal illnesses and this argument is afforded additional strength.

The issue of patient assisted suicide is a difficult one regardless of which side one finds himself. The wonders of modern medicine have served to make the matter more complicated. New life-sustaining techniques and practices are placing physicians, terminally ill individuals, and families with questions and decisions that never needed to be asked before. In essence, the question is: "How far must society go to save a life?"