Should Physician Assisted Suicide Be Legalized?
Julia Schulenburg
PHI103 Informal Logic
Professor Robert Paixao
September 2, 2013

Should Physician Assisted Suicide be Legalized?
In today’s society there are many so many controversial issues one of the biggest being Patient Assisted Suicide, or PAS. PAS is defined as: “suicide by a patient facilitated by means or information (as a drug prescription or indication of the lethal dosage) provided by a physician who is aware of how the patient intends to use such means or information.” Merriam-Webster Dictionary (n.d.). Let us not get PAS confused with Euthanasia, this is different, to be euthanized is when the doctor himself physically administers the lethal dosage into the patient causing their death. PAS is just the doctor prescribing the drugs for the patient to give to themselves to cause them to die. There are people who are in favor of allowing a doctor to prescribe a lethal dose of medication or machinery for the patient to administer to themselves to end their own life due having a terminal illness. Then there are those who greatly oppose it, some being doctors, moralists, the general public, as well as some private groups. They claim physician assisted suicide to be immoral, ethically wrong, against religious beliefs, and unnecessary with proper palliative care.
While PAS is a controversial topic in modern day society, it originally stemmed from ancient civilizations, which defended the rights of citizens to kill themselves. At this present time there are currently four states; Oregon, Washington, Montana, and Vermont, along with four European countries that exercise the legal right to administer Physician Assisted Suicide. In the online article “Physician-Assisted Suicide: Death with Dignity?” Mary Friend (2011) points out that “ many ancient Greeks believed voluntary death was preferable to endless suffering. In fact, physicians upon request often gave their patients poison” (p.110). In another article in “Annals of Internal Medicine,” Emanuel, (1994) stated “Francis Bacon argued in the seventeenth century that a physician’s duties included ending pain even when the outcome was death” (p.793).
It seems as though we in the twenty first century are debating and arguing over something that was quite the norm back in the earlier centuries. There definitely is no need to poison those whom wish for assistance in ending their lives, that would be a harsh and painful way to kill yourself, but being able to prescribe them something to put them out of their misery and send them peacefully to their death is not asking for too much. Especially since some of these terminally ill people are in unbearable pain and would rather be dead than to live another day in pure pain and despair. They should have the option to choose to get their doctor to prescribe something lethal, in the helping to end their life.
Nobody can force a terminally ill patient to end their own life, not the doctors, the family, the spouse, or any other medical professional. The patient has that right to decide what to do with their own life and when to do it. According to an article from the Washington Post, Janet Good (1996) states “Pain is not the main reason we want to die. It is the indignity. It is the inability to get out of bed or get onto the toilet […] they have had enough when they cannot even go to the bathroom by themselves […] People have their pride. They want to be in charge” (as originally cited in The Real Hemlock Society, 1997). If this is not a prime example of what some of these dying patients are going through, and who only want to end their suffering then I do not know what is. Another piece of real life evidence is from the first woman to die from Physician Assisted Suicide in Washington, Linda Fleming, 66. Linda Fleming was told that she had Stage 4 pancreatic cancer with a month to live and that “she was actively dying.” Ms. Fleming states, “I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death. The powerful pain medications were making it difficult to maintain the state of mind I wanted to have at my death” (Yardley, 2009).
Patients that make that final decision to ask for PAS are most likely suffering and do not want to wait out a long and painful death. They are trying to leave this world with some sort of dignity still intact, because at this point they are most likely a terminal case with less than six months to live. This just goes to show that people who know they are going to die a painful death want to get it over with. Especially while they are in a clear and conscience state of mind without any coercion request assistance in dying they should be granted that one last wish.
The way that a physician is involved in hastening in the patient’s death is really about ethics and in the way in which the physician helped. According to an article of Ethics in Clerkships from the University of Illinois at Chicago College of Medicine, “Ethics has drawn up a specific vocabulary in order to clarify different kinds of action. A physician’s involvement in the death of patients can fall into the following categories: a. Active, involuntary: the physician intentionally kills a patient contrary to the wishes of the patient. b. Active, voluntary: the physician intentionally kills the patient in accordance with the wishes of the patient. c. Passive, involuntary; the physician lets the patient die by refraining from interventions contrary to the wishes of the patient. d. Passive, voluntary: the physician lets the patient die by refraining from interventions which would be useless in any case, in accordance with the wishes of the patient” (www.uic.edu/depts/mcam/ethics/suicide.htm).
Passive, voluntary is the most used and the more ethical choice of a method of assisted suicide. The disease is what essentially kills the patient. The drugs and the treatment were just prolonging the inevitable; death. It is however the choice of the physician if assisting the patient in their death is within their own personal beliefs and morals. If they are not comfortable they are to refer the patient to a doctor who will assist them.
Not even the patient knows just how much life they have left in them. They are being physically, mentally, spiritually, and emotionally drained from their terminal illness with no set date on their death. Most of these patients are fully dependent on someone else to do normal everyday tasks, feel like they are a burden to their family, have no hope, or sense of self-worth, and they are probably worried about the bills that are continually piling up the longer that they are in the hospital. Are they just supposed to wait it out and suffer with agony? PAS would allow the patient the choice in ending their life on their terms and by their own hand and most of all with a sense of dignity.
According to the article “Patient Should “Assist in Suicide” When it is Appropriate,” Dr. Timothy Quill (2012) points out that “….genuine request for assisted dying stem from irreversible, overwhelming suffering toward the very end of life” (p.57).
PAS should only apply to those who are terminal and who are on life support machines such as ventilators, feeding tubes, as well as who are intravenously being kept alive. Eventually all of those with debilitating diseases such as ALS, Cerebral Palsy, Alzheimer’s, Parkinson’s, Multiple Sclerosis, and Muscular Dystrophy, should have the right to choose PAS as well. Physician Assisted Suicide should not be allowed for those who are incompetent of making a rational decision.
Since the patient is more than likely going to die from their illness we might as well allow them to go peacefully on their own terms. Allow them make one last important decision of their life, and not let the illness win by taking them first.
There are quite a few groups of people that are against PAS. More than likely those groups and individuals that are against Physician Assisted Suicide are focusing on the religious, moral, ethics, and most of all the basic right of human life. Sanctity of life, Passive vs. Active distinction, Potential for abuse, Professional integrity, and Fallibility of the profession are some of the most used arguments against PAS.
Although the Hippocratic Oath is not a requirement by most medical schools, every person who went through medical school all know of it and conform to it in some way especially when it comes to the verse that states “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan;…..” (as cited originally by Hippocrates, n.d.).
Physician Assisted Suicide is incompatible with the healing goals of medicine. If patients are given the right palliative care such as in a hospice or somewhere where they are cared for 24/7 and given what they need to suppress enough be comfortable through the pain, then PAS is not necessary.
These particular people and groups claim that if Physician Assisted Suicide were to become legalized everywhere it would eventually lead down a “slippery slope” to indiscriminate killing of the ill, weak, old, the poor, the lonely, and the disabled who cannot care for themselves. This idea that they have is a bit extreme and their thoughts on the matter are a little farfetched. This would be taking it a little too far.
It is understandable from both parties’ feelings and aspects on the matter of legalizing Physician Assisted Suicide or not. The number one main focus and priority should ultimately be on what is the best alternative in helping rid the patient’s pain. These patients are the ones who are in pain and they are the ones who cannot fend for themselves anymore because their illness has taken over their body and is slowly killing them from the inside out. They have lost the ability to do anything by themselves from feeding to bathing; they surely feel like a burden to those who have to tend to them around the clock, and therefore making the ill patients feel completely worthless as a human being. The bottom line is to allow the patients to choose for themselves how they want to live their last days, whether it is weeks, months, or hours left on Earth.
The patient should have the right to decide when it is their time to die. The topic of legalizing Physician Assisted Suicide will be an ongoing debate and will always be very controversial in the matters of ethics, religion, morals, and beliefs. Regardless of that, everyone deserves the right to decide for themselves what they want done in the case of becoming terminally ill.
Nobody should have to live in such pain that the pain itself is what ends up killing them. Allow the legalization for Physician Assisted Suicide for all of the terminally ill, in any sense of the term. Let us grant those ill patients the ability to decide for themselves on choosing to allow Physician Assisted Suicide especially in the United States if not the entire World. Legalizing would be a great opportunity for the terminally ill to get the opportunity to make that one last final decision in their pain stricken lives.

References
Coleman, D., Drake, S., & Longman, P. (1997). The Real Hemlock Society. Retrieved from http://www.broadreachtraining.com/articles/indxarti.htm#Euthanasia
Emanuel, E. (1994). The history of euthanasia debates in the United States and Britain. Annals Of Internal Medicine, 121(10), 793-802.
Friend, M. (2011). Physician-Assisted Suicide: Death With Dignity? Journal of Nursing Law, 14(3-4), 110-116. doi:10.1891/1073-7472.14.3.4.110
Miles, S. H. (2004). The Hippocratic Oath and the ethics of medicine. Oxford: Oxford University Press.
Physician-assisted suicide. (n.d.). Merriam-Webster online dictionary. Retrieved August 3, 2013 from http://merriam-webster.com/dictionary/physician-assisted suicide
Quill, T. E. (2012). Physicians Should 'Assist in Suicide' When It Is Appropriate. Journal Of Law, Medicine & Ethics, 40(1), 57-65. doi:10.1111/j.1748-720X.2012.00646.x
Yardley, W. (2009, May 22). Linda Fleming, 66, First Death for Washington Assisted Suicide Law. New York Times. p. A10.