Physician-assisted death: ethical and legal considerations

¶ … Alternative to Physician-Assisted Suicide" by Bernard Gert et. al.

In Part III of the book, Contemporary Issues in Bioethics (6th ed.), Bernard Gert, Charles Culver, and K. Clouser provided an analysis of how voluntary passive euthanasia (VPE) can serve as an effective form of an alternative to physician-assisted death in the article, "An Alternative to Physician-Assisted Suicide."

The authors also discussed in the article the process of VAE (voluntary active euthanasia) as a form of PAS, particularly focusing on the morality of the said method as compared to VPE. Gert et. al. posits that VPE as a form of PAS is another method that can be subsisted, especially is VAE is unacceptable according to the moral standards of the patients. Through VPE, patients will not be fed with water and any kinds of food. The authors also state how VPE is not a form of killing (as compared to VAE), since "not treating (which is characteristic of VPE) is not killing, unless there is a duty to treat." Thus, for cases where the patient agrees to VPE, and has a moral view that suicide is acceptable, then PAS via VPE can be conducted.

Furthermore, Gert et. al. also argues that VPE is an effective alternative to PAS because "dying because of a lack of food and fluids is not physically unpleasant or painful, if there is even minimal nursing care." As to the morality of VPE as an alternative to PAS, the authors assert that every physician administering VPE has an obligation (not necessarily moral) to grant a patient's request to undergo VPE. However, if the physician's beliefs do not agree with the patient, it is recommended that the physician should find someone who will be able to perform VPE without feeling compelled.

The authors' article illustrates the sensitivity of the issue of euthanasia, where society, especially people who have strong religious beliefs against euthanasia, often view it as an undesirable process to end a suffering patient's life, equating it to killing. However, Gert et. al. cautions that physicians' moral views must be able to be compatible with the patient's views. This means that in order to administer VPE, the physician must be (a) compatible with patient's moral views about euthanasia; or, in the event that the patient disagrees to VPE, (b) must at least inform the patient's right that s/he has the right to physician-assisted suicide/death (PAS).