Assisted Suicide: Ethical or Immoral

Assisted Suicide, also known as mercy killing, occurs when a physician provides the means (drugs or other agents) by which a person can take his or her own life. This assistance is one of the most debated issues today in society followed by abortion. Physicians are frequently faced with the question of whether or not assisted suicide is ethical or immoral. Although assisted suicide is currently illegal in almost all states in America, it is still often committed. Is assisted suicide ethical? Studies have found that the majority of Americans support assisted suicide.

One must weigh both sides of the argument before they can decide. On July 26, 1997, the U. S. Supreme Court unanimously upheld decisions in New York and Washington State that criminalized assisted suicide. These decisions overturned rulings in the 2nd and 9th Circuit Courts of Appeal, which struck down state statutes banning physician-assisted suicide. Those courts had found that the statutes, which prohibited doctors from prescribing lethal medication to competent, terminally ill adults, violated the 14th Amendment.

In striking the appellate decisions, the U. S. Supreme Court found that there was no constitutional right to die, but left it to individual states to enact legislation permitting or prohibiting physician-assisted suicide. As of April 1999, physician-assisted suicide is illegal in the majority of states. Over thirty states have enacted statutes prohibiting assisted suicide, and of those that do not have statutes, a number of them arguably prohibit it through common law. Currently, Oregon is the only state that has legalized assisted suicide.

The Oregon statute, which came into effect in October 1997, states that a doctor may prescribe, but not administer, a lethal dose of medication to a patient who has less than six months to live. It is required that two separate doctors must agree that the patient is mentally competent and that the decision was voluntary. As of April 1999, 23 patients were given drugs legally under the statute, and 15 of them used the drugs to commit suicide. What makes assisted suicide legal in Oregon? Is it fair that individuals in Oregon are allowed to end their suffering painlessly?

Unfortunately, numerous people throughout America have terminal illnesses that cause tremendous personal suffering. These people do not want to continue living, they are aware that their health will not improve and the pain will not come to an end so in turn they want to end their lives peacefully and painlessly. These people feel as if they have no control over their pain and disease and they wish to gain control over their lives by ending them.

One notorious individual who took the law into his own hands and is known for his frequent involvement in assisted suicide is the former Dr. Jack Kevorkian (he has lost his right to practice). Kevorkian also known as “Dr. Death” by many has been linked to over 120-assisted suicide cases, many of which occurred by use of a death machine he invented in his infamous white van. His patients’ personal profiles vary tremendously, however all the patients have one thing in common, a terminal illness and unbearable pain that had no hope of getting better. His patients’ age ranged from 21 to 89 years old, each of them having a diverse illness varying from AIDS to Quadriplegia. These people sought Kevorkian out as if he was a savior.

They needed assistance for their suffering and could not find it anywhere else. Kevorkian sympathized with them and agreed to aid them in their planned deaths. He told reporters that his mission in life was to stop the suffering that no one else would. Before actually going through with the process of suicide Kevorkian made sure that the people were fully aware of the consequences and that they made their decision after knowing all the details and in a correct mental state. He tape-recorded various patients giving a testimony of their wishes. They begged the doctor to help them die.

Jack Lessenberry, in his 1994 article, Death Becomes Him for the magazine Vanity Fair writes on the popular belief that no jury will ever convict Jack Kevorkian. Polls had consistently showed Kevorkian with strong support in Michigan, generally around 60 percent. And his fame was nationwide: roughly 94 percent of Americans knew who he was; only the president and First Lady have higher name recognition. You can’t talk against him to most people, especially if they’ve had someone die in horrible agony, says State Senator John Kelly, a maverick liberal on most issues. In fact, Kevorkian was soon stopped.

On April 13, 1999 he was convicted of second-degree murder and delivery of a controlled substance in the death of Thomas Youk, who suffered from Lou Gehrig’s disease. A Michigan judge sentenced Kevorkian to 10-25 years in prison. He would be eligible for parole in six years. Kevorkian plans to appeal. Not everyone agrees with Kevorkian’s “mission”. Some people denounced Kevorkian’s actions because they dislike his manner and attitude about assisted suicide. Since the doctor had gotten away with the majority of his actions he in turn let the fame get to his head and became some sort of an uncontrollable monster.

Others, especially members of religious groups strongly opposed “Dr. Death” mostly because he took peoples lives into his own hands. He took on a role similar to that of God, no one should have the final say on whether or not someone should stay alive—God should be in charge of a person’s life. These people often also are strong Pro-Choice advocates. They use similar reasons for the rejection of assisted suicide. Many medical arguments have also risen on why assisted suicide should not be committed, such things like the possibility of recovery or the discovery of a new medical cure.

Many research groups have performed studies on the populations’ acceptance and attitudes pertaining to assisted suicide. In almost all of the studies the majority of people responded for the right to end one’s suffering by either euthanasia or assisted suicide. In one study done in Michigan, random groups of physicians and members of the general public were mailed questionnaires asking them to choose between the legalization of physician-assisted suicide or an explicit ban.

The end results were 56 percent of physicians and 66 percent of the public supported legalization, 37 percent of physicians and 26 percent of the public preferred a ban, and 8 percent of each group was uncertain. No person should have to suffer and live when there is no hope of recovery. The opinion on assisted suicide lies solely in the individual. People who are affected by the illness consider it their personal right to live or die, those loved ones around them also agree because they do not wish to see the person suffer.

People on the outside looking in do not understand the situation entirely because they are not faced with it on a personal level. Because of this they should not be in charge of passing laws and restrictions on what a suffering person can or cannot do with their life. Several sympathetic articles have been written to guide physicians who receive requests for assistance in dying, and all of these address the major medical, psychosocial, and spiritual issues facing dying patients who wish to end their own lives. Even though these works significantly help with the physician’s battle on how to act they leave large gaps in many areas.

Since each person’s situation is unique it is difficult to produce guidelines that can be followed universally. The ethical framework for discussions about assisted dying begins with informed consent. Physicians must discuss the risks, benefits, and likely outcomes of assisted suicide before they agree to the action. They must also discuss alternatives to suicide, including the possibilities of sedative care. This model assumes rational decision-making and also assumes that when patients raise the possibility of assisted dying, they are in fact, asking for a hastened death rather than using the request to manipulate their situation.

Furthermore, it assumes that the patient desires and is capable of rational decision making at this emotionally difficult time. In some cases, however, none of these assumptions may be true. Recently, terminal sedation and voluntarily stopping eating and drinking have been proposed as legally acceptable alternatives to physician-assisted suicide for persons whose suffering cannot be addressed by standard pain management and cessation of life support.

When a patient expresses the wish to die, exploration of the adequacy of palliative care should begin, including assessment of pain management, depression, anxiety, family burnout, and spiritual and existential issues. For patients who are genuinely ready to die, for whom suffering is intolerable despite comprehensive palliative efforts, an exploration of methods for easing death can begin. The methods will be determined by the patient’s clinical situation; the values of the patient, family, and physician; and the status of current law. Many practices have been accepted as ways to hasten death.

Four options can be practiced openly, with good documentation and consultations are as follows: standard pain management, forgoing life sustaining therapy, voluntarily stopping eating and drinking and terminal sedation. Other options such as physician assisted suicide and voluntary active euthanasia must be carried out covertly, except in Oregon. Clinicians faced with these difficult decisions should be aware of all of these options, including their indications, risks, benefits, and likely outcomes, and how to discuss them with patients and families.

Doctors that are asked to aid in the suicide of their patients are faced with tremendous pressure and stress. It is difficult to turn someone down when they are begging for mercy and on the other hand it is difficult to go against the law and commit a crime with the risk of the loss of license or even imprisonment. The only sure way that people will stop suffering and be allowed to die peacefully because of their own decision is if assisted suicide becomes legal in the United States.

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