The Right to Choose Your Fate Physician assisted suicide, also referred to as (PAS), according to medicine.net is the “the practice of providing a competent patient with a prescription for medication for the patient to use with the primary intention of ending his or her own life.” This controversial topic challenges America to question the ethical, religious, and cultural values and beliefs that have been around for centuries. Many argue that it is not up to the patient to choose how or when they die while others argue that, in fact, it could prevent years of pain and suffering. It may be easy to hear the definition of physician assisted suicide and assume it is not morally acceptable, however, there are several educated arguments defending a patients right to choose. According to Dr. Quill, in most surveys, approximately two-thirds of the United States approves of (PAS) as as option for the terminally ill yet when the time comes to legalize (PAS), the vote splits at 50/50. The controversy of (PAS) erupted in 1990 when Dr. Jack Kevorkian, a pathologist, assisted his first patient into death (Landau 80). His first client was Janet Adkins who was a sufferer of Alzheimers. Kevorkian reported the death to police but no prosecution followed (BBC News). Before the story of his assisted suicides hit national news, these issues were not a topic of public discussion. According to the judge that sentenced Kevorkian to twenty five years behind bars, “He brought to the forefront end-of-life issues” (BBC News). Dr. Kevorkian assisted others in death who suffered from cancer, alzheimers, arthritis, heart disease, emphysema, and multiple schlerosis. Despite his many critics, Dr. Kevorkian insisted that he was simply helping patients ease their suffering. He had hoped that euthanasia would be legalized by the time he passed but unfortunately the topic still remains highly controversial in society. Dr. Ezekiel Emanuel is well-known for his outspoken opposition of (PAS). Unlike Dr. Kevorkian, he believes that “counseling and caring” for a terminally ill patient is sufficient in order to improve their quality of life. Dr. Emanuel published an article titled, “Four Myths About Doctor- Assisted Suicide,” through the New York Times where he addressed topics directly related to (PAS). In his article, he stated that contrary to popular belief, very few terminally ill patients who died between 1998 and 2009 were in pain or afraid of pain. Although pain may not be the leading factor in a patient’s decision to be assisted into death, it is still a factor. In a study done by Dr. Emanuel and two of his associates, pain was a factor associated with being more likely to consider euthanasia or (PAS). In response to the doctor’s article and the topic of pain, Dr. Jeff Menashe, an oncologist from Portland, OR, stated that the pain the patient suffers is not necessarily just physical. He continues to state, “The inevitable stresses- psychic and physical- endured by people at this time in their lives are rarely fully palliated by medication or even the caring hand or ear of a nurse or doctor” (Menashe). Emanuel also acknowledges that the advancement of technology does not play a role in (PAS). According to Dr. Emanuel, many presume (PAS) has a mass appeal, however, he states that not many terminally ill patients choose euthanasia. Although this statement may be true, there are still patients who would like to utilize what little control they have left. In both Oregon and Washington combined, between 1997 and 2011, approximately 837 patients have consequently died when issued a lethal prescription (Quill). These numbers may seem small, however, those people were allowed a chance to control their fate. Dr. Emanuel’s last argument was expanding on the “myth” of a good death. He briefly explains that, “nothing in medicine.. is without complications.” If this statement is true, then isn't it also true that palliative care can at times have these equally painful “complications”? Dr. Jeffrey Menashe responded to this claim with personal experience by writing, “Oregon’s law has enhanced the possibility of a ‘good death’ for all of our citizens” (NY Times). This statement goes to show that the term ‘good death’ is certainly not just a myth. In closing, Dr. Emanuel states that, “The appeal of (PAS) is based on a fantasy.” If this doctor is so profoundly opposed to (PAS) then why would he refer to it as a “fantasy”? Why would a terminally ill patient look at death as a fantasy unless they wanted tranquility. Law plays a major role in the debate of physician assisted suicide. The act of a physician aiding patient into death has only been legalized in four states after approving the “Death with Dignity Act” including Oregon, Washington, Montana, and Vermont (Assisted Suicide Laws in the United States). In both Oregon and Washington, it has been said that this act, “transformed the crime of assisted suicide into a medical treatment if the assistance is approved by a physician” (Assisted Suicide Laws in the United States). Although the support for (PAS) is rising in these four states, the right to be assisted into death still remains illegal in 46 states. Some states such as California, Florida, and Georgia finds anyone who aids in a suicide guilty of a felony where as some states are more lenient and only convicts them of manslaughter. Abuses of this act, much like abuses on every law in place, are feared. Although the fear of abuses regarding (PAS) are justified, there are many ways of regulating it just as the United States has to regulate other laws. Most importantly there should be appropriate criteria created for eligibility. There is also a possibility of a third party regulator that could be assigned to help reduce the risk of any abuses as far as the physician goes. Lastly, there is the option of a psychiatrist being designated to the patients to determine the reliability of their mindset and to also prevent any hasty decisions. As one can see, there are easy regulations to put in place to attempt to prevent any abuses, however, there will always be abuses when it comes to law. After Oregon passed the “Death with Dignity Act” in 1997, four doctors performed a survey throughout the state that in conclusion found that, “the choice of (PAS) was not associated with level of education or health insurance coverage” during the first year of legalization and they concluded the same in the second year. This statement alone proves that, if legalized, (PAS) will not necessarily be abused. As this controversial topic continues to make the American people question a myriad of values that have been in place for so long, there are several arguments, both supporting and opposing (PAS), that come into play. Despite the different religious and cultural views that spread across the United States, there is a blanket rule of which our country’s foundation began. That “blanket rule” is that every citizen is born with the freedom of will and the right to choose. If a pregnant mother has the right to choose whether to terminate the life of her unborn baby, what is stopping a bed ridden, cancer patient from terminating his/her life? Unlike abortion, the patient who is considering (PAS) actually gets to choose. On the topic of religion, a person may choose to practice whatever he/she prefers. If a patients religious views prevent them from participating in (PAS), then that is their choice, however, if a citizen does not practice a religion, why is the government stopping that citizen, who was born with the freedom of will, from controlling their fate? It is not politically correct to force personal beliefs onto others who, in this case, would prefer peace at the time of their death. Also, there is arguments of the mental state of the patients when they are so close to death. Some physicians are worried that their depressive state may play a major role in influencing them into choosing (PAS) as opposed to a physician’s palliative care. In rebuttal to the common physician’s idea that these patients are too depressed to make such a big decision, Dr. James Hawthorne, stated that, “As a retired clinical psychologist, I must note that there is a vast difference between the depression of a terminally ill patient, who realistically perceives his situation to be hopeless..” than that of a, “healthy patient who is clinically depressed,” and have, “inaccurate perceptions of self and circumstances” (NY Times). In a terminally-ill patient’s case, death is inevitable. If they are depressed due to the fact that their quality of life is diminishing, it is realistic. They are simply accepting the fact that they are dying. Dr. Ezekiel Emanuel suggests that “counseling and caring” of a patient who is dying will be enough and physically, that may be sufficient, however, palliative care does not necessarily improve the patients quality of life. As a response to Dr. Emanuel, Dr. Hawthorne wrote, “While the ‘counseling and caring’ Dr. Emmanuel recommends can provide physical comfort to the terminally ill patient, they cannot change the reality of a patient whose quality of life has diminished” (NY Times). In conclusion, it is safe to say that the legalization of (PAS) may take months, years, or even decades to pass. It is also safe to observe that our nation remains divided on the topic. But when taking into consideration the patients that are suffering daily, both physically and emotionally, is it appropriate for governments to effectively force people to live through their pain by denying them the right to (PAS)? Isn't society supposed to prevent the government from stripping the American people of their freedom or more specifically their freedom of will? America is a democracy for this simple fact; to allow society to help shape our world as the population continues to increase and technology becomes more advanced. Although (PAS) is supported by not only fact but citizens all around, it is up to our society to aid in the advancement of America and also to compromise and stand united on decisions such as the legalization of physician assisted suicide.

Works Cited
"Assisted Suicide Laws in the United States." Patients Rights Council. N.p., 6 Feb. 2012. Web. 22 Apr. 2015.

Chin, Arthur, Dr., Kathrina Hedburg, Dr., Grant Higgison, Dr., and David Fleming, Dr. "Legalized Physician-Assisted Suicide in Oregon - The First Year's Experience — NEJM." New England Journal of Medicine. N.p., 18 Feb. 1999. Web. 22 Apr. 2015.

Emanuel, Ezekiel, Dr. "Four Myths About Doctor Assisted Suicide." NY Times. New York Times, 27 Oct. 2012. Web. 22 Apr. 2015.

Hawthorne, James, Dr. "The Debate About Assisted Suicide." The New York Times. The New York Times, 04 Nov. 2012. Web. 22 Apr. 2015.

"Jack Kevorkian: How He Made Controversial History - BBC News." BBC News. BBC, 3 June 2011. Web. 22 Apr. 2015.

Landau, Elaine. The Right to Die. Chicago, Illinois: Franklin Watts, 1993.

Menashe, Jeffrey Dr. "The Debate About Assisted Suicide." The New York Times. The New York Times, 04 Nov. 2012. Web. 22 Apr. 2015.

Works Cited Continued

Timothy E. Quill and Jane Greenlaw, “Physician-Assisted Death,” in From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns, ed. Mary Crowley (Garrison, NY: The Hastings Center, 2008), 137-142.