Physicians-Assisted Suicide Physician-Assisted Suicide is a medical process where a physician supplies a terminally ill patient with a prescription for one dose of lethal medication. The prescription is given to a patient upon request only if the patient intends to end his or her own life because of suffrage from a terminal illness. Today, physicians-assisted suicide is more commonly known as the Death-With-Dignity Act. Recent stories of patients who have attempted to end their own life by lethal medication have made countless headlines concerning the topic throughout many informational sources. Currently, the states of Washington, Oregon, and Vermont are the only three states that have adopted the Death-With-Dignity Act.
Physician-Assisted Suicide is among many practices that aid in ending a patient’s life along with DNR’s, DNI’s, and AND’s, when life-sustaining treatments are denied. Physicians-Assisted Suicide is much more controversial than other life ending methods because it enables a patient to end her or her own life in a way that many individuals feel is immoral and unethical. The ethical issues of physicians-assisted suicide are both emotional and controversial, yet healthcare workers deal with a request for this alternative every day. Is physicians-assisted suicide the answer? The question doesn’t come by an easy answer. However, both sides of the debate, either for it or against it, provide strong, concrete points that help truly uncover where the controversy lies. This paper will discuss both sides of the argument followed by a research based conclusion.
The debate whether or not physicians-assisted suicide should be legalized or not seems to weigh heavier on the opposing side rather than those who support the idea. Individuals have argued that it is not ethically permissible because the concept behind physicians-assisted suicide contradicts the traditional duty of the physician to preserve life and to do no harm. The role of a physician is to use their skills to alleviate the medical conditions that cause suffering during a time where a patient is in distress or discomfort. These conditions can be both somatic, including symptoms like pain and nausea and psychological which involve anxiety or depression. Many physicians and patients have agreed that from a professional standpoint, there aren’t any levels of discomfort sufficient enough for a physician to justify assisting suicide. Individuals who feel that physicians-assisted suicide contradicts the traditional duty of the physician also argue that the practice goes against the Hippocratic Oath. The Hippocratic Oath is a widely known Greek medical text that requires new physicians to swear upon a number or healing gods that he or she will uphold a number of professional ethical standards. The Oath was written in the late 5th century BC, but the principle behind it still remains sacred to many doctors today. The Hippocratic Oath infers that physicians should not deliberately do harm to their patients. This means that they should not intentionally worsen the case of a patient who is ill if worsening of the case would potentially being upon death quicker than it would otherwise. When a physician takes the Hippocratic Oath, they adopt the concept that they will not take part in any practice related to assisting suicide. The oath specifically states, “I will not give a lethal drug to anyone if I am asking, nor will I advise such a plan.”
Another argument that is brought up from those who are opposed to physicians-assisted suicide is a concept known as slippery slope. Slippery slope states if one part of a practice or activity is allowed eventually it would lead to the acceptance of more and more parts of that activity that would usually be deemed unacceptable. Many argue that if physicians-assisted suicide were legalized, abuse would take place that could ultimately lead to euthanasia. Euthanasia is commonly misinterpreted and easily thought of as the same concept as physicians-assisted suicide. Euthanasia, unlike physician-assisted suicide is when the physician physically aids in the death of the patient by a lethal injection. This concept is not legalized anywhere. States who have adopted the Death-With-Dignity Act have done so because the patient is in full control of the consumption of the drug. The only aid the physician provides is administering the prescription for the lethal substance. Those who are opposed to physicians-assisted suicide feel that the concept of the practice enforces death that might not be fully supported by the patient’s choice entirely; but instead influenced by the physician themselves. This possibility could affect patients who might be in a vulnerable state, such as the elderly, to be pressured to choose physicians-assisted suicide over more complex and expensive alternatives such as a nursing home. Fallibility is another reason why some are opposed to physicians-assisted suicide. The argument here is that physicians could, and sometimes do, make mistakes. There could be a misjudgment in a diagnosis or a prognosis, errors in the treatment of depression, misguidance in the treatment of pain, and so on. The Death-With-Dignity Act has a list of requirements in place in order for a patient to qualify as a candidate for the drug in attempt to prevent the drug being misused. One requirement specifies that the patient must be diagnosed with a terminal illness that will lead to death within a six month time frame. Studies of autopsies have shown that doctors misdiagnose fatal illnesses about 20 percent of the time concluding that millions of patients are currently being treated for the wrong disease.Since so many misdiagnoses happen, those opposed to physicians-assisted suicide believe that physicians have an obligation to protect lives from these inevitable mistakes and to improve the quality of pain and symptom management during the end of life, but nothing further. Religious groups are also opposed to physician-assisted suicide because secular organizations view the concept as morally wrong because it diminishes the sanctity of life. Many churches feel that the period just before death is a spiritual time and they believe it is wrong to interfere with the process of dying because it would interrupt the process of the spirit moving towards God. Christianity also views those in a vegetative state to still be human beings, even though their mental state is impaired. Christians value their wishes the same as anyone else’s and they believe it would be immoral to treat those in a vegetation state as less worthy as those in a healthy state and to therefore conclude that they would be better off dead. Also Christians feel that the lives of patients, who are old or sick, facing the end of death, still share the same values as any other human being .
Other religious groups share the same beliefs are Christians do. The Anglican Church states that “There is a very strong compassionate case for physicians-assisted dying, but the Anglican Church remains opposed to the practice.” Baptists feel that “assisted dying violates the sanctity of human life.” Eastern Orthodox states that “Physician assisted dying is morally and theologically impermissible because of God’s sovereignty and the sanctity of human life.”
Although the arguments are strong supporting why physicians assisted suicide should not be legalized, there are still many who are supporters of the legalization. Those who support physicians-assisted suicide believe that competent people should have the right to choose the timing and the manner of their death because decisions about death are a personal subject. In addition, those suffering from terminal illnesses suffer from tremendous pain and suffering. Many terminal diseases, such as cancers, can result in a slow, painful death.
Supporters of physicians-assisted suicide make the argument that patients should be able to die with dignity rather than have an illness entirely degrade them by disabling them from taking care of themselves. Sometimes, when patients are in a vulnerable state, a nurse has to attend to the patient for activities such as vomiting, drooling, urinating, and other bodily functions. Alzheimer’s patients, for example, suffer from dementia that gets progressively worse over time, causing memory loss and the patient could then become incoherent. Supports make the claim that those in that type of state want to be remembered by how they once were and not by what the disease has done to them, so if the patient chooses to die before facing those effects, they should be entitled to. Also, those who support physicians-assisted suicide argue that the decision to end one’s life is a personal and private manner that does not physically harm anyone else so the government and medical professions should find the concept permissible.
Patients already have the right to be taken off of life support when in a vegetation state. Some advocates of physicians-assisted suicide argue that physicians have enough experience and knowledge to understand how long a patient has left to live and that the patient shouldn’t suffer the months leading up until death. The right to die should be a fundamental freedom of each person. There is not a line in the constitution that implies that the government has the right to keep a person from committing suicide. Therefore, in a free country, physicians-assisted suicide should be a fundamental right. Brittany Maynard, a 29-year old suffering from stage 4 Glioblastoma, moved to Oregon from San Francisco, so that she would be eligible for the lethal prescription. She decided that she would consume the drug on November 1st, 2014. On October 6th, 2014 she released a statement saying “There is not a cell in my body that is suicidal or that wants to die. I want to live. I wish there was a cure for my disease but there's not... My glioblastoma is going to kill me, and that's out of my control. I've discussed with many experts how I would die from it, and it's a terrible, terrible way to die. Being able to choose to go with dignity is less terrifying... Right now it's a choice that's only available to some Americans, which is really unethical... The amount of sacrifice and change my family had to go through in order to get me legal access to Death with Dignity--changing our residency [from California to Oregon], establishing a team of doctors, having a place to live--was profound... There's tons of Americans who don't have time or the ability or finances [to move to a legal state] and I don't think that's right or fair... I believe this choice is ethical, and what makes it ethical is it is a choice. The patient can change their mind up to the last minute. I feel very protected here in Oregon" Some advocates feel that physician-assisted suicide should be legalized only if palliative care provides better assistant to those in need. The theory behind the connection between the two is that as the palliative care grows stronger and more efficient, the desire for physicians-assisted suicide will suppress. In the first wave of cases of physicians-assisted suicide that occurred since the process became legal in Oregon, patients were more concerned about their loss of autonomy and control rather than the fear of pain and suffering. Arguments supporting physicians-assisted suicide stress the importance to relieve patient suffering by understanding the duty to respect patient autonomy. The suffering of patients towards the end of their life can be extremely difficult. Studies have shown that the trust between patients and physicians is broken when physicians-assisted suicide is not an option for treatment or discussion. 72% of patients feel that they would be more open to discussing other options if they felt connected with the physician emotionally. From the advocate standpoint, physicians-assisted suicide is a form of compassion because it shows respect for the patient’s choices. A controversial argument made by those who support physicians-assisted suicide is that there are many potential cost savings from this alternative as compared to other medical care such as nursing homes and Medicare. The United States spends an excessive amount on health care for terminally ill patients. Expenses increase as death approaches and approximately 30 percent of the Medicare budget is spent on the 5 percent of Medicare patients who die each year. Many advocates of physicians-assisted suicide have made the connection that enabling the concept will reduce the high cost of death. One supporter from the medical field stated that “Many have linked the effort to reduce the high cost of death with the legalization of physician-assisted suicide. Managed care and managed death [through physician-assisted suicide] are less expensive than fee-for-service care and extended survival. Less expensive is better. Decreasing availability and increasing expense in health care and the uncertain impact of managed care may intensify pressure to choose physician-assisted suicide and the cost effectiveness of hastened death is as undeniable as gravity. The earlier a patient dies, the less costly is his or her care. Indeed, the Supreme Court noted the potential for cost-saving motives to influence the legalization and use of physician-assisted suicide, speculating that “if physician-assisted suicide were permitted, many might resort to it to spare their families the substantial financial burden of end-of-life health care costs. The drugs necessary for physicians-assisted suicide also only cost about $75-$100.” After extensive research on physicians-assisted suicide, I have to conclude that the practice should be permissible. The majority of the research that I found against physicians-assisted suicide shows countless claims from individuals stating how the practice should be impermissible because it goes against moral, ethical, and religious guidelines. Also, they claim that physicians-assisted suicide goes against the Hippocratic Oath of doctors because physicians agree to never give a patient a lethal drug. Some protestors against physicians-assisted suicide have made claims about fallibility and the slippery-slope possibility. The reasons I feel that these arguments aren’t enough to persuade me to agree to choose that physicians-assisted suicide should be impermissible is because the claims are dominantly about a person’s feelings and beliefs. Although there was research to support the fallibility claim by showing the amount of times physicians make mistakes, I feel the bottom line only because a trust issue which relates to one’s feelings towards the practice. Also, the slippery-slope concept can happen with any situation. The risk of matters becoming worse from allowing a situation to take place happens in almost every situation in life. That concept is not enough by itself to prove the high degree of fault in allowing physicians-assisted suicide to take place. The research doesn’t show enough factual evidence to support why allowing physicians-assisted suicide would be damaging. The feelings and beliefs standpoints are not concrete and powerful enough to truly enforce why the practice of physicians-assisted suicide should be impermissible. The majority of the research that I found for those who feel that physicians-assisted suicide should be permissible provides strong supporting evidence for the decision. Surveys have shown that the majority of patients feel that they can’t communicate with their physicians enough on a personal level. Testimonies have proven that patients feel that if physicians-assisted suicide was an open topic for discussion and treatment, they would be more inclined to listen to alternative options because they would feel like the physicians truly care about giving them the best care possible. The statistics showing how many patients would feel more comfortable by knowing physicians-assisted suicide was an option is significant enough for me to consider the practice being permissible. The research I found regarding the cost benefit of physicians-assisted suicide as compared to Medicare and nursing homes plays a big part in why I feel the practice should be permissible. Putting feelings and right from wrong aside, the lethal drug only cost $75-$100 and it’s a one-time payment. Medicare costs hundreds and thousands of dollars each month and is only available to patients 65 or older. Physicians-assisted suicide’s target market is any patient suffering from a terminal illness no matter the age. Also, nursing homes cost thousands of dollars each month as well. When I researched the Brittany Maynard story, I discovered a lot of information about the cancer she suffered from; Glioblastoma. Glioblastoma is a brain cancer that usually starts out as stage four and there is not currently a cure. The cancer usually kills the patient within the same year they’re diagnosed with the disease. The side effects are horrific and patients have documented some of the most unbearable pain on record. Brittany Maynard’s research of her disease showed that she would’ve suffered an extremely painful death if she waited for the cancer to end her life. By choosing to consume the lethal drug associated with physicians-assisted suicide, she was able to have a less painful death in a state of mind where she could still maintain control of her motor skills and consciousness. The research that this case presented showed significant information how by allowing physicians-assisted suicide, it allowed a patient who was without a doubt going to die within a couple months, suffer less pain.
The medical field is designed to help a patient while keeping their best interest in mind. Moral and ethical standpoints are not sufficient enough to support a person’s best interest. Moral, ethical and even religious standpoint, in reality, reflects really only the person who is stating their opinion. What someone feels is right might not actually be what is the right choice for the patient. That is I have disregarded the research and information I discovered for why physicians-assisted suicide should not be allowed. In my opinion based on my research, physician-assisted suicide is permissible.

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[ 5 ]. Hedlund, S. (2005, March 1). Death with Dignity: The Oregon Experience. p. 16. Retrieved October 25, 2014.
[ 6 ]. Leonhardt, D. (2006, February 22). Why Doctors So Often Get It Wrong. The New York Times.
[ 7 ]. BBC News - (n.d.). Retrieved October 25, 2014.
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[ 10 ]. Gorsuch, N. (2009). The Future of Assisted Suicide and Euthansia (pp. 35-41). Princeton Printing Press.
[ 11 ]. Miles, S. (2005). The Hippocratic Oath and the ethics of medicine (p. 16). Oxford: Oxford University Press.
[ 12 ]. Dobie, M. (n.d.). Brittany Maynard's choice to die. Newsday, p. A33.
[ 13 ]. For more information search for “Brittany Maynard”
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