Physician-assisted Suicide – Issues and Attitudes

April 18, 2018

Photo by Simon King on Unsplash

 

Attitudes to death have been radically different throughout human history. From throwing unviable children off the cliff in Sparta, to honoring old age and death in traditional societies to elderly people going off into the woods to die in solitude in some other traditional cultures.

Physician-assisted suicide has come a long way in the recent decades. Consider the example of Dr. Jack Kevorkian, who was tried and convicted in 1999, and served 8 years of his term for physician-assisted suicide. It means that just very recently the same actions that constituted a criminal offense are currently slowly but surely gaining ground in legislation and mainstream attitudes.

Naturally, the very loaded question of physician-assisted suicide is still accompanied by an entire complex of difficult ethical and legal issues. There are currently several US states (Oregon, Montana, Vermont, California, Washington D.C., Colorado, Washington and Hawaii) that allow physician-assisted suicide. Voluntary euthanasia (which differs from the latter in the fact that in physician-assisted suicide the patient has to take the final action him or herself, self-administering the drug, while voluntary euthanasia does not require any action by the patient) is legal in Colombia, Belgium, the Netherlands, Canada and Luxembourg. There is also a public debate on the issue in numerous other countries.

The main issues that arise can be attributed to two types – legal and ethical. What are the current issues being debated?

Reducing suffering

With the advance of palliative care, pain is becoming less of a concern in the US, as it most often can be dealt with fairly successfully. On the other hand, such issues as loss of dignity, autonomy and enjoyment of life are being cited most often as the terminally ill patients’ reasons for wanting to end their lives.

Safeguards against abuse

The United States has very stringent procedures in place for physician-assisted suicide, from mandatory reporting to the state and medical board oversight, to the need for several doctors’ consensus and witness presence, several requests that need to be made by the patient with a waiting period between them, residency requirements that prevent “suicide tourism,” and so on.

Risk for vulnerable populations

This risk has proven to be unfounded, as proven by studies in the state of Oregon and the Netherlands, which are the longest-standing areas with physician-assistant suicide laws in place. A study published in 2007 demonstrated that there was no increased risk for the most vulnerable groups, such as the uninsured, poor, disabled, people with psychiatric illnesses, chronically ill, ethnic or racial minorities, women, elderly or those with low educational status.

Medical ethics

There are many questions raised as far as the compatibility with the very essence of the medical profession and the respect for human life. Most medical associations are strongly against allowing physician-assisted suicide.

Religious arguments

The sanctity of human life is a belief shared by all the major world religions, and for most of their adherents the issue of hastening death is out of the question.

In order for physician-assisted suicide to be less of a desperate measure than a weighted decision, palliative care must be readily available to those who are nearing the end of their lives due to the end stages of a terminal illness. In that case, the patient can exercise control over the choices that he or she makes. There are numerous issues that actually need much deeper elaboration and analysis, and there’s still a long way to go to the point where the society’s attitudes to euthanasia and physician-assisted suicide are not critically divergent, as they are now.

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