Person Is in Inexorable Pain,

¶ … person is in inexorable pain, suffering physically and even mentally, with no hope for recovery, should they be able to seek surcease through death? What is the physician's responsibility when they can not assuage their patient's suffering? Is their duty to prolong basic bodily functions, or is their duty to stop pain? If a patient seeks death, and is unable to obtain the means to bring an end to their suffering themselves, does their physician have an ethical obligation to provide them with those tools, even if these tools bring about the patient's death? According to John Lachs, Peter Singer, and others, the case for answering yes to the questions above, from both a hedonistic utilitarian and preference utilitarian perspective, is strong. Physician-assisted suicide should be legal and patients suffering from intolerable pain should be free to choose death over a life of agony.

The right of self-determination. How far does a human being's autonomy extend? Certainly, it would be foolhardy to state that a person's right to self-determination is absolute; society would cease to function smoothly if we respected the rights of robbers to be robbers and murderers to be murderers. It is safe to say a person's right to self-determination ends when their actions impinge upon another person's right to autonomy. However, the decision to end one's own life does not interfere with another person's rights or liberties in any way. From a utilitarian perspective, an act is morally right, "If the consequences of that action are more favorable than unfavorable to everyone." (Internet Encyclopedia of Philosophy). Certainly if an otherwise healthy person chose to end their life on a whim, it could be argued that the consequences of that choice would be negative to that person's friends, family member, employers, people in his or her employ, etc. However, when a patient with a terminal illness or terminal pain chooses to end their life, the distinction is less clear. Terminal illness devastates not only the patient, but their loved ones who have to witness the suffering helplessly. When the end result is death, and the interim is only agony, hastening death in a peaceful way benefits everyone. If the patient wishes to end their life, therefore, from a utilitarian perspective, this act would be morally correct.

It can be argued that in the case of physician-assisted suicide, that because the doctor is the one bringing about the death, this is, "a fundamental moral wrong' -that of one person giving over 'his life and fate to another." (Lachs, 4). But people assign others their rights all the time, and they are free to do so; this is part of autonomy. If a person is a homeowner, they are free to let whomever they wish live in that home, with the occupant enjoying all the benefits of that home. Similarly, one allows schools to act in loco parentis with their children. Are we to say that a terminally ill patient surrenders the ability to assign their rights simply because they are in pain? If a terminally ill patient has the desire to die but lacks the means to do so, the obvious person to deliver those means is their physician. Furthermore, the patient has already assigned the rights of care to their physician; it is an extension of that care to end the patient's suffering if they so choose. The modern version of the Hippocratic Oath reads, "But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God." What could be more defined as "playing God" than denying a patient's own wishes to end their suffering, even when the physician is unable to alleviate their anguish and pain?

If allowing a terminally ill patient to end their life is morally right in the utilitarian view, why do we prevent physicians from aiding their patients to the best of their ability by providing them a peaceful death? Why must they often do the opposite -- prolong life by incredible means and technologies unheard of years ago? Obviously, legal ramifications in today's society keep physicians from actively participating in a patient's euthanasia, but does this imply that they must then do all in their power to keep a patient alive against their will? Statutory law is not natural law. Certainly in nature, one who was too ill to move would not last long. They would certainly not be placed on a feeding tube, having a machine breathing for them, mechanical devices doing all but forcing their heart to beat. Does having the power to extend life mean that physicians then have a duty to do so? According to Lachs, "Medicine does not surrender its vocation in serving the desires of individuals: since health and continued life are among our primary wishes, its career consists in just this service." If the primary duty of a physician is to honor their patient's wishes for health, then if a patient desires death as an end to suffering, that physician does not have a duty to prolong that patient's life. Rather, prolonging life against the wishes of the patient breaches the duty of the profession.

Why, then, do physicians continue to take incredible measures to prolong the life of those who wish to die? What would happen if we were to legalize euthanasia? Critics of euthanasia state that decriminalizing euthanasia would lead us down a slippery slope; that this would lead to the mass killing of all those deemed too poor, or too disagreeable, to warrant continued life-saving measures. These critics paint pictures of "Little Johnnies" in hospital rooms across America encouraging their grandmas to pull the plug or take the nice injection the doctor is offering, so that they can stop being such burdens. Is this criticism supported by evidence in areas where euthanasia is legal? No. According to Peter Singer, "The outcomes of open practice of voluntary euthanasia in the Netherlands, and of physician-assisted suicide in Oregon, do not, however, support that allowing patients voluntary euthanasia or physician-assisted suicide leads to a slippery slope." If the practice of permitting euthanasia has not lead to negative consequences in areas where it is legal, perhaps other jurisdictions should allow physicians to do their jobs, and patients to make their own choices regarding their care.