Physician Assisted Suicide

Physician Assisted Suicide Arguments Both Sides
Introduction: Why Is Physician-Assisted Death Controversial?
Physician-assisted suicide, or physician-assisted death, is now legal in four American states as well as in several countries including Canada and the Netherlands (Appelbaum. 2016). Generally, physician-assisted death applies to patients diagnosed with a terminal illness. The request to terminate the life prematurely is based on the patient’s tremendous suffering. In Canada, for example, “pphysicians whose patients disclose a wish to die must always be listening for underlying deep sorrow,” (Chochinov, 2016, p. 253). However, it can be difficult if not impossible to determine whether a patient’s expression of sorrow is temporary, influenced by physical pain or exacerbated by underlying mental illness. Physician-assisted suicide can also be framed as a moral issue, with some physicians claiming that assisting a patient to die goes against the tenets of the medical profession (American Medical Association, 2018). This paper uses two scholarly articles to evaluate the two opposing views on the ethics of physician-assisted death.
Presentation of Argument In Favor of Physician-Assisted Death
In an article published in the Journal of the American Medical Association, Quill, Back & Block (2016) argue that physician-assisted death is justifiable under certain circumstances. The authors use a case study to prove their point that physician-assisted suicide is not a black-or-white ethical issue but one that involves situational variables and moral grey areas. The authors address the complexity of issues in this scholarly article.
Premise 1: Patients with a serious illness have the right to self-determination, and for “control over their own bodies, their own lives, and concern about...distress,” (Quill, Back & Block, 2016, p. 245).
Premise 2: Physician-assisted death is the best way to address these concerns in a legal and ethical manner.
Premise 3: The concerns about “coercion, vulnerability, and slippery slopes” have “not been borne out by experience with legal open access to physician-assisted death,” (Quill, Back & Block, 2016, p. 245).
Conclusion: Legalizing physician-assisted death eliminates some of the thorny ethical and legal problems, and prevents abuses of power and ambiguities.
Although the Quill, Back & Block (2016) study is not empirical and does not involve any quantitative data, it is a thoughtful presentation of multiple points of view on the issue. The authors ultimately come out in favor of physician-assisted suicide based on several concerns, namely that the practice does promote the ethical imperatives of patient autonomy, respect, and dignity. Moreover, the authors reason that when physician-assisted death is legal, it can be conducted in a straightforward fashion that eliminates subversion and possible dangerous consequences.
Presentation of an Article Against Physician-Assisted Death
In “Physician-assisted death for patients with mental disorders,” Appelbaum (2016) argues against physician-assisted suicide primarily on the grounds that it is a slippery slope. Published in the Journal of the American Medical Association, this scholarly source cites an abundance of data from surveys conducted in the Netherlands, where the practice of physician-assisted suicide is legal. The author’s arguments are as follows:
Premise 1: Legalized physician-assisted suicide “opens the door for people whose suffering is primarily due to mental disorders,” (Appelbaum, 2016, p. 325).
Premise 2: The Dutch data contains “red flags” that indicate physician-assisted suicide is being used in lieu of “effective psychosocial intervention and support,” (Appelbaum, 2016, p. 325).
Premise 3: Dutch law does not have sufficient safeguards in place, such as unanimity of the medical team.
Conclusion: Legal physician-assisted suicide is too dangerous a practice, and can be too easily abused to be considered ethical.
Appelbaum’s (2016) arguments are sound and logical, and are based on the citation of actual data collected by Dutch researchers. Because of the way the author presents this data, the article is persuasive. However, the underlying logical premise of Appelbaum’s argument is the slippery slope fallacy. Physician-assisted death does not necessarily serve as a means by which clinically depressed or otherwise mentally ill patients can have access to easy suicides, and does not preclude therapeutic interventions.
Evaluation of Arguments in Non-Scholarly and Scholarly Sources
Scholarly sources published in peer-reviewed journals tend to be more robust than their non-scholarly counterparts. However, these two JAMA articles are not based on any original research. These are opinion pieces written by physicians who want to steer their profession and persuade their colleagues to think a certain way about the practice of physician-assisted death. As such, the quality of the evidence is not appreciably different from the non-scholarly sources on physician-assisted death. Having said that, the articles published in JAMA are written for the primary stakeholder group of medical practitioners. The professional community does need to hear multiple and opposing viewpoints to make informed clinical decisions. Because physician-assisted death is an emotional issue for some practitioners, it is important to consider arguments from both sides. In this case, the arguments in favor of physician-assisted suicide remain stronger because they avoid any fallacies like the slippery slope.
Conclusion
This exercise shows how scholarly articles can also contain logical fallacies. Even if these two scholarly articles were based on original empirical studies, the authors could also have jumped to conclusions or made their decisions based on faulty evidence and slippery slope arguments. When conducting research, it is important to critically review all sources and recognize their logical fallacies, no matter where the studies are published.




References
American Medical Association (2018). Physician-assisted suicide. https://www.ama-assn.org/delivering- care/physician-assisted-suicide
Appelbaum, P.S. (2016). Physician-assisted death for patients with mental disorders. JAMA Psychiatry. 2016;73(4):325-326. doi:10.1001/jamapsychiatry.2015.2890
Chochinov, H.M. (2016). Physician-assisted death in Canada. JAMA. 2016;315(3):253-254. doi:10.1001/jama.2015.17435
Death with Dignity (n.d.). Terminology of assisted dying. https://www.deathwithdignity.org/terminology/
Quill, T.E., Back, A.L. & Block, S.D. (2016). Responding to patients requesting physician-assisted death. JAMA. 2016;315(3):245-246. doi:10.1001/jama.2015.16210
Whitcomb, D. (2018). California judge tosses state’s physician-assisted suicide law. Reuters. May 15, 2018. https://www.reuters.com/article/us-california-assistedsuicide/california-judge-tosses-states- physician-assisted-suicide-law-idUSKCN1IH00B