Physician-assisted suicide: ethical and legal considerations

¶ … Ethics - Assisted Suicide

THE LEGAL and ETHICAL ISSUES of PHYSICIAN-ASSISTED SUICIDE

Suicide has always been a very controversial subject, mainly because of traditional religious teachings equating it with "sin." However, since U.S. law is not supposed to be influenced by religious beliefs, the ethical issues and legal ramifications of physician-assisted suicide must be defined by objective moral principles and legislative criteria addressing the potential for misuse and abuse.

Problematic Issues:

The Hippocratic Oath prohibits physicians from harming their patients, but it was formulated long before the era of modern medicine at a time when very few patients faced the prospect of outliving debilitating diseases. Today, modern technology, pharmacology, and surgical intervention enable physicians to treat disease and prolong patients' lives, sometimes even beyond their ability to appreciate. Particularly in the case of ailments associated with old age, such as many forms of cancer, modern medicine enables physicians to extend life even when the patient might prefer to die instead of enduring constant physical pain or continual gradual physical deterioration that ultimately leads to death, only with greater suffering in the meantime.

The easiest situations for the physician involve patients whose medical prognosis already defines their condition as terminal, in which case physician-assisted suicide only hastens the same outcome, and usually for the sole purpose of palliative relief from symptoms whose pain cannot be relieved by other means. However, many patients suffer just as much from symptoms associated with non-fatal illnesses and conditions that may not be addressed through physician-assisted suicide under Hippocratic principles.

Proponents of physician-assisted suicide point out (rightly) that neither the government nor any other person or entity has a legitimate moral right (much less any obligation) to interfere with the autonomous choice to end one's life, especially when the motivation is to avoid prolonged pain and suffering.

Legislative Regulation:

Legitimate legal concerns arise where the patient is not completely capable of expressing his or her wishes directly, because any situation where surrogates do so on behalf of patients raises the specter of ulterior motivation, abuse, and conflicts of interests. Therefore, strict legislative controls must ensure against such potential for misuse and abuse. Similarly, both legislative oversight and updated modern principles of medical ethics must establish criteria for distinguishing between the desire to end one's life that reflects only the genuine desire to avoid pain and discomfort from any such desire that is a function of transient perspectives. Both acute depressions (such as over the loss of a spouse or other companion or loved one) and clinical depression have the capacity to influence a patient's will to live.