Physician Assisted Suicide and Ethics

Is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?

In the U.S., the Supreme Court ruled in Washington v. Glucksberg (1997) that physician-assisted suicide is not protected by the Constitution. However, in other parts of the world, physician-assisted suicide is accepted socially and legally; and in the U.S., a patient who is terminally ill may engage in assisted-dying procedures, which are legal in six states and are legally differentiated from suicide (Buiting, Dieden et al., 2009). If one sets aside the legalistic parameters differentiating physician-assisted dying from physician-assisted suicide, can one say that the former is more ethical than the latter?
In other words, is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?

In spite of what is permitted under the auspices of physician-assisted dying procedures, this paper will argue that physician-assisted suicide is, ultimately, unethical because it goes against the essence of the Hippocratic Oath that is at the heart of care giving.

The Hippocratic Oath maintains that a care provider will do everything in his or her power to sustain life. Deliberately causing the cessation of life is a violation of this Oath and goes against the essence of care giving. Even if the patient wants to die, suicide is defined by the DSM-5 as self-destructive and therefore should not accepted as a rational act or desire. From a philosophical standpoint, the preservation of life can be seen as the greatest good that can be achieved. To willfully and deliberately set about destroying life, even if it is at the will of a patient and the life is the patient’s only and no other person can be identified as a victim, the care giver should still be viewed as philosophically, morally and ethically prohibited from engaging in any type of behavior that will result in the deliberate and willful termination of life.

Someone who might like to oppose this argument may counter with the objection that a person has the right to determine his or her own quality of life. A person who is terminally ill in body may be no different from one who feels terminally ill in mind or in soul. Such a person should have the right to decide to end his or her life, because it is no different from a physically terminally-ill patient deciding to end his or her life. Physician-assisted suicide should be judged ethical from this perspective, therefore, because it allows for a safe and effective termination of life to be conducted, at the will of the patient. Since the patient alone can determine his or her quality of life and what treatment to accept or reject, a physician who is willing to participate in an end-of-life procedure even for one who is not physically terminally ill should put him or herself at the service of the patient. Physician-assisted suicide is thus perfectly ethical.