Sunday, September 15, 2019
Death is Definitely Not Justified With Physician-Assisted Suicide Essay
Doctors dedicate their blood, sweat and tears to achieve the ultimate goal of their profession ââ¬â to preserve the health and well-being of their patients. Doctors positively intervene with life processes in order to maintain and preserve the lives of many people. However, when doctors negatively intervene with a natural process like death, problems can arise because they are caught in a dilemma of whether to forego life and help end the suffering or to preserve it and torment the patients suffering with terminal illnesses. This is why, physician-assisted suicide is not just perceived solely as a medical problem because it also involves legal, ethical, social, personal, and financial considerations. Physician-assisted suicide remained as one of the most controversial types of euthanasia because it violates the Hippocratic Oath. Physician-assisted suicide literally means that the physician provides the medication for suicide to a competent patient who is capable of carrying it out. It is not just morally reprehensible for a physician, or any medical practitioner, to assist the patient to conduct this procedure because it negates their responsibility to preserve life, physician-assisted suicide also devalues the life of the patient as their fate is put entirely in the hands of a human being. Indeed, there exists an unprecedented debate over physician-assisted suicide (also called euthanasia) because involves medical professionals, as well as the patients and their families. The arguments range from determining the dignity of the patients, the quality of their lives, their mental state, and sometimes their usefulness to society. For example, the patient who is in a vegetative state is considered dead by some but not by others, and this case presents substantial moral and ethical problems. The Oxford Dictionary of English (2005) defines euthanasia as ââ¬Å"the painless killing of a patient suffering from an incurable and painful disease or in an irreversible comaâ⬠. However, euthanasia means much more than a ââ¬Å"painless deathâ⬠, or the means of procuring it, or the action of inducing it. The definition specifies only the manner of death, and if this were all that was needed to achieve it ââ¬â a murderer, who is careful to drug his victim to death, could claim that he or she did an act of euthanasia. We find this ridiculous because we take it for granted that euthanasia is ââ¬Å"deathâ⬠itself, not just the manner of death. How can someone administer a ââ¬Å"medical procedureâ⬠to the one who dies in the end? The spate of recent public and philosophical controversy has been over voluntary active euthanasia (VAE), especially physician-assisted suicide. Supporters of VAE argue that there are cases in which relief from suffering supersedes all other consequences and that respect for autonomy obligates society to respect the decisions of those who elect euthanasia. If competent patients have a legal and moral right to refuse treatment that brings about their deaths, there is a similar right to enlist the assistance of physicians or others to help patients cause their deaths by an active means. Usually, supporters of VAE primarily look to circumstances in which (1) a condition has become overwhelmingly burdensome for a patient, (2) pain management for the patient is inadequate, and (3) only a physician seems capable of bringing relief (Dworkin, Frey & Bok, 1998). A much publicized case of physician-assisted suicide came into the headlines when it shocked people with the bizarre activities of Dr. Jack Kevorkian in early 1990s (or ââ¬Å"Dr Deathâ⬠as the media have dubbed him) in the USA. Dr. Kevorkian, a retired pathologist, assisted over forty people to commit suicide in recent years in circumstances, which were somewhat beyond normal from regular medical practice. These people travelled to Kevorkian from all over the USA to seek his assistance in suicide. Kevorkian assisted their death by ending their suffering. He even attached his patients at the back of a dilapidated Volkswagen van, where a ââ¬Å"suicide machineâ⬠can be found. This machine automatically injects patients with lethal doses of drugs, as patients themselves activate it. Despite being prosecuted for assisted suicide on several occasions, Kevorkian escaped conviction and continued his personal campaign for relaxation of the law in his peculiar way. It was only when he moved from assistance in suicide to euthanasia that he was finally convicted. He filmed himself administering a lethal injection, and the film helped secure his conviction for murder (Keown 2002, p. 31). Of course, his actions provoked discussion of the thin line separating passive euthanasia, which is legal in this country, and active euthanasia. Opponents of Kevorkianââ¬â¢s actions state that he is practicing physician-assisted suicide, which is illegal. Proponents of Kevorkianââ¬â¢s actions argue that the patientââ¬â¢s right to control his or her medical treatment is sufficient justification for assisted suicide. Unfortunately, most Americans seem to agree with physician-assisted suicide. A nationwide survey by the Gallup poll in 2004 showed that 69% of Americans believed that physicians should be allowed to help terminally ill patients in severe pain commit suicide. These results were consistent with those of Gallup polls over the past two years, where ââ¬Å"Americans have shown slightly higher levels of support for doctors ending patientsââ¬â¢ lives by painless means than for assisting patients to commit suicideâ⬠(Lyons, 2004). Allen et al. (2006) suggest about the reasons for these statistics. They said that ââ¬Å"one explanation could be the increase in education and awareness of advances in both medical technology and research on various chronic diseasesâ⬠. As more Americans are becoming more aware of the devastating psychological effects of disease on a personââ¬â¢s well being; ââ¬Å"they may be more willing to make informed decisions on end-of-life careâ⬠. Armed with knowledge of how painful and grueling pains that patients suffer, Americans think that sometimes the best option for a terminally ill patient is physician-assisted suicide or some other form of euthanasia. Strangely enough, a group of doctors also support physician-assisted suicide. Known as the Hemlock Society, these doctors advocate the legalization of euthanasia (Snyder, 2001). This organization believes that the final decision to terminate life ultimately is oneââ¬â¢s own, although it does not encourage suicide for emotional, traumatic, or financial reasons, or in the absence of terminal illness. Conversely, the National Hospice Organization supports a patientââ¬â¢s right to choose, but believes that hospice care is a better choice than euthanasia or assisted suicide (Snyder, 2001). Despite the salient points made by the supporters of physician-assisted suicide, we should not forget that this process essentially negates the purpose of a doctorââ¬â¢s profession. The Hippocratic Oath, which dates back in the 400 B. C. E. states that ââ¬Å"I will give no deadly medicine to anyone if asked, nor suggest any such counselâ⬠. Not only that it is in clear opposition to the oath of their profession, it is also morally and ethically reprehensible. According to Somerville (2006), there are two major reasons why people should not allow euthanasia to be legalized. First reason is purely relying on principle that it is not right for one human to intentionally kill another (with the exception of justified self-defense cases, or in the defense of others). Somerville (2006) stated that the second reason is utilitarian, as legalizing physician-assisted death has harmful effects and risks to people and society. In fact, the harms and risks far outweigh any benefits of physician-assisted suicide. While Mak, Elwyn & Finlay (2006) reasoned that ââ¬Å"most studies of euthanasia have been quantitative, focusing primarily on attitudes of healthcare professionals, relatives, and the publicâ⬠. Most people perceive pain as the major reason for requesting euthanasia, while other factors that convince people to choose it are impairment of functions, dependency, being a big burden, being isolated to people, depression, losing hope, and losing autonomy or control. This is why, Mak, Elwyn & Finlay (2006) thought that legalizing euthanasia is a ââ¬Å"prematureâ⬠move when research evidence from the perspectives of those who desire euthanasia is not yet proven to be necessary. The researchers suggested that there needs to be additional qualitative patient-based studies in order to broaden the physicianââ¬â¢s understanding of patients. They deemed that there should be the ââ¬Å"inclusion of medical humanities, experiential learning, and reflective practice into medical education should help ensure doctors have better communication skills and attitudesâ⬠. Thus, doctors and healthcare professionals should focus in examining ways to improve cure and care at all levels so that they can trash out the ââ¬Å"side effects of poor end of life careâ⬠. In this way, physician-assisted suicide would not be necessity anymore. In 1997, the U. S. Supreme Court ruled that the Constitution does not guarantee Americans a right to physician-assisted suicide and returned the issue to the state legislatures for continued debate. In its decision, the Court placed emphasis on the American tradition of condemning suicide and valuing human life. In its ruling, the Court made it clear that the states have a legitimate interest in banning physician-assisted suicide, but it also left it open to them to legalize the practice. As a result, the practice has been legalized in Oregon. Although the law is rather unequivocal in regard to the practice of active euthanasia, the court decisions have been quite ambiguous. This may be a proper stance for the law in that its adamant negative position provides a deterrent to all considerations of the practice and forces deliberation of the merits on a case-by-case basis. But under what circumstances is euthanasia justifiable? Is it permissible to kill the terminally ill? How about those who are not terminally ill but have only lost their appetite for life? Even if society decides that citizens have a right not only to life, liberty, and property but also to death, what part do health care practitioners play in this right? Would the role of physician who conducts euthanasia have a chilling effect on the medical profession? What law cannot answer, ethics and morality could provide the answers of what needs to be done by health professionals when faced with a difficult dilemma, such as physician-assisted suicide. As medical practitioners, medical code of ethics should not just become theoretical concepts, because ethics are important references in the application of oneââ¬â¢s moral and value system to a career in health care. Ethics involves more than just ââ¬Å"common senseâ⬠, which is an approach for making decisions that most people in society use. Ethics goes way beyond this: It requires a critical thinking approach that examines important considerations such as fairness for all consumers, the impact of the decision on society, and the future implications of the decision. In the end, as doctors, the central issue remains caring for the dignity of the patient, which involves respecting the patientââ¬â¢s wishes, protecting the integrity of the profession, and sparing the life of a person under all conditions which are generally understood to be extremely burdensome. Thus, all forms of physician-assisted suicide are ethically and morally reprehensible because it promotes intentional killing. This principle does not require the preservation of life at all costs, which is essentially the role of all physicians.
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