Perhaps the most reasonable objection to physician-assisted suicide relates to the subjective element of quality of life and the degree to which that perception (on the part of the patient) is susceptible to temporary influence, such as from clinical depression or temporary physical pain or disability. To overcome that objection, it would be necessary to outline objective principles and guidelines capable of allowing physician-assisted suicide in justifiable situations while also prohibiting potential misuses and abuses.
Reconciling the Issues:
On one hand, there does not seem to be any legitimate justification for preventing a sane, healthy, competent individual from choosing death over prolonged agony, particularly where the condition responsible for the patient's pain is already terminal. On the other hand, the decision to end one's life is irreversible and should not be permitted to be implemented as a result of temporary conditions or states of mind. Medical error exists in all areas and specialties; error in this particular area would result in monumental consequences.
Therefore, the emphasis of legislators and the bioethical community should incorporate both recognition of the legitimacy of the right to end life with professional medical assistance and simultaneous concern for the importance of doing so within a system capable of eliminating error. For example, one objective criterion might be that the patient already be suffering from a terminal illness. However, that criterion does not recognize the...
For that reason, some component of multidisciplinary evaluation must be included to quantify the subjective perception of pain. Similarly, because a patient's psychological state and temporary emotional perspective can result in temporary suicidal tendencies, extensive psychological evaluation must also be part of any permissible form of physician-assisted suicide.
Finally, because end-of-life decisions can involve family members of the patient who may have conflicts of interest with the best interests of the patient, physician-assisted suicide must also include a disinterested patient advocacy component as well. Ultimately, the patient must have the legal right to decide matters of life and death subject only to measures imposed by the state to prevent mistake, misuse, or abuse of that right.
References
Humphry, D. (2002). Final Exit: The Practicalities of Self-Deliverance and Assisted
Suicide for the Dying. Grand Junction, CO: Norris Lane Press.
Martindale, M. "Kevorkian: Jail Reform Is His New Cause" The Detroit News, Nov 17,
2007. Retrieved, June 30, 2009, from: detnews.com Web site, at http://www.detnews.com/apps/pbcs.dll/article?AID=/20071008/METRO/710080323/1409
Sharma, N.R. "Ethical and Practical Principles Underlying the End of Life Decisions"
The American Journal of Forensic Medicine and Pathology; Volume 25(3): 216-
219 (September 2004).
