Physician-Assisted Suicide

Physician-assisted suicide presents one of the greatest contemporary challenges to the medical profession's ethical responsibilities. Proposed as a means toward more humane care of the dying, assisted suicide threatens the very core of the medical profession's ethical integrity. Physician-assisted suicide occurs when a physician provides a patient with the medical means and/ or the medical knowledge to commit suicide ("Module 5: Physician-assisted,"). For example, the physician could provide sleeping pills and information about the lethal dose, while aware that the patient is contemplating suicide. In physician-assisted suicide, the patient performs the life-ending act, whereas in euthanasia, the physician administers the drug or other agent causing death. Although, the medical field has made great strides in improving end-of-life care through palliative and hospice programs, sometimes it’s just not enough. The care that is offered to the chronically ill and elderly is less than ideal and it is estimated that 40-70% of patients die in pain, another 50-60% die feeling short of breathe; 90% of nursing homes, where patients go to receive 24 hour nursing care, are gravely understaffed (Morrow, 2010).
Debates
Physician-assisted suicide is among the majority of debates in bioethical technology, in our time. Every reasonable person prefers that no patient ever contemplate suicide (with or without assistance) and recent improvements in pain management have begun to reduce the number of patients seeking such assistance. However, there are some patients who experience terrible suffering that can’t be relieved by any of the therapeutic or palliative techniques medicine and nursing have to offer, and some of those patients desperately seek deliverance. One of the prevalent debates that have raised uproar is “The reason terminally ill patients commit suicide” (Marker, 2011). Studies show that depression and hopelessness, rather than pain, are the primary factors motivating patients’ that wish to die. Many terminally ill patients fear that as their condition progresses they will lose physical function, mental function, and independence. They will lose their sense of autonomy and their ability to enjoy life. They fear being a burden to family, relatives, and friends. They do not wish for those closest to them to witness their physical and mental deterioration, and they do not wish to inconvenience them. They want the last memories of them to be fond memories. It is this sequence of thoughts that causes terminally ill patients to become depressed and experience a sense of hopelessness. It is these feelings that cause terminally ill patients to want a quick death. In fact, there is no significant association between the desire for a hastened death and the presence of pain or pain intensity.
Research shows that terminally ill patients suffering from depression are four times more likely to desire death than terminally ill patients not suffering from depression. Approximately twenty-five percent of terminally ill patients suffering from either depression or hopelessness have a high desire for a quick death (Marker, 2011). Sixty-seven percent of the terminally ill patients suffering from both depression and hopelessness have a high desire for a quick death (Marker, 2011). Because a patient’s desire to commit suicide is generally based on depression and hopelessness, the desire is often temporary. About fifty to sixty-seven percent of terminally ill patients interested in euthanasia or assisted suicide change their mind (Marker, 2011). This is especially true when a patient’s depression and sense of hopelessness is treated.
Another argument for physician-assisted suicide is that every competent person should have decision-making authority over his or her life ("Pro-euthanasia arguments," 2011). Every person should have the autonomy to decide the timing and manner of his death. Experiencing quality of life, avoiding severe pain and suffering, maintaining dignity, having a sense of control, and having others remember us as we wish to be remembered should be a fundamental liberty interest. Proponents of assisted suicide argue that this right to autonomy, especially at the end of life, is superior to any claim that life must be preserved ("Pro-euthanasia arguments," 2011). Moreover, the sacredness of life is dramatically diminished when an individual’s condition is terminal and death is imminent. One has made the argument that people should be permitted to die with dignity. A person’s last months of life should not be consumed suffering from severe physical pain; dependent upon others for nutrition, hydration, and bodily hygiene; with physical and mental deterioration; and experiencing declining vision, hearing, and mobility. Family members, relatives, and friends should not have to witness the deterioration and suffering of a loved one. Our last impressions of a loved one should be filled with joy and respect.
Conclusion
In my opinion I believe that physician-assisted suicide is ethically and morally wrong. However, there are very few incidents that could qualify for assisted suicide under proposed legislation does not justify demeaning the sanctity of human life, and experiencing the potential severe negative repercussions. I also believe that legalizing assisted suicide would quickly expand to acts of voluntary and involuntary euthanasia, whether legal or not. Thus, many people will prematurely and unnecessarily die when they could have been properly treated for their medical condition or at least for their depression and hopelessness. We all have days in which the pressure of life seems overwhelming. One can only imagine the feelings and thoughts that a terminally ill person, enduring extreme pain, must experience. Many such persons must have frequent thoughts of death, and the peace it can bring. If a physician were permitted to aid a person with ending life, the temptation to commit suicide would often be too appealing to refuse. It is one thing to think about death, and another thing to take your own life. The more recognized and accessible suicide is, the more likely a person will agree to perform it, especially in a fragile physical and mental state with government, medical, and family approval. A physician’s and family’s influence over a patient is tremendous, yet the physician’s and family’s recommendation to the patient is subjective and based on personal ideology. It is important to note that Americans have the right to withhold and withdraw life-sustaining procedures, and to receive powerful medication for pain relief and sedation. Virtually every state authorizes a person to establish a “living will” that documents his/her specific desire regarding future life-sustaining efforts. In my opinion, these remedies are more than sufficient to guarantee a person’s autonomy and freedom, without making the most important decision in someone’s life (whether to live) as convenient and quick as having a physician prescribe life-ending medication. While there may be a fine line between discontinuance of life-sustaining procedures and physician-assisted suicide, a line has to be drawn somewhere.

Reference
Marker, R. (2011). Euthanasia, assisted suicide & health care decisions – part 1. Retrieved from http://www.patientsrightscouncil.org/site/euthanasia-assisted-suicide-health-care-decisions/
Module 5: Physician-assisted suicide debate. (n.d.). Retrieved from http://endoflife.northwestern.edu/physician_assisted_suicide_debate/what.cfm
Morrow, A. (2010, September 14). about.com. Retrieved from http://dying.about.com/od/physicianassistedsuicide/a/why_PAS.htm
Physician-assisted suicide: The dangers of legalization.
Hendin, Herbert; Klerman, Gerald. The American Journal of Psychiatry, Vol 150(1), Jan 1993, 143-145.
Pro-euthanasia arguments. (2011). Retrieved from http://www.bbc.co.uk/ethics/euthanasia/infavour/infavour_1.shtml