Medically Assisted Suicide and Its Ethical Implications

Medically Assisted Suicide and its Ethical Implications

Traci Ryan

Philosophy of Ethics

November 2, 2011

Medically Assisted Suicide and it Ethical Implications

Physician-assisted suicide and voluntary euthanasia are topics of debate in many countries, including the United States. These methods of assisting someone who wishes to die are fraught with controversy. This controversy stems from the struggle for greater personal autonomy without interference from the government over end-of-life decisions, the harm that some perceive to come from such actions affecting physicians, those patients that may be subject to abuse, and the general public. Proponents want to be able to choose how long they must suffer, how much burden to place themselves and their families under due to the futility of trying to prolong their life when death is imminent anyway, and how they will ultimately die (Wilson et al., 2007). Opponents of such actions want to protect the perceived public trust that is established with medical practitioners as healers that agree to do no harm; they do not want to entrust any person, much less one with the essential knowledge and experience to easily do so, with the power to decide who lives or dies (Wilson et al., 2007). Opponents also feel it necessary to do everything they can to protect terminally ill patients from potential abuse at the hands of others as they face death (Dore, 2011). Anyone looking objectively at this topic must, upon reflection of the reasons presented by both sides, ask if passing legislation to withhold these choices from the patient is morally ethical. Utilitarian ethics will be used in this paper to answer this question. This paper will explain the moral reasoning that people on both sides of this debate give for supporting their stance on legalized PAS and voluntary euthanasia, and why this debate is significant in this country. Peer reviewed sources both for and against the issue will be referenced and their contributions to this debate espoused. The evidence will be considered and Utilitarian principles will derive a moral conclusion as to which proposal is more ethically sound. Finally, this paper will seek to provide insight on what consequences may result based on legislation taken from the ethical perspective that is derived.

I. Identify the problem

Physician-assisted suicide and voluntary euthanasia present alternatives in end-of-life decisions for patients who are terminally ill. Is withholding these choices from the patient morally ethical? For many terminally ill patients the choice of PAS or a form of voluntary euthanasia is a desired option as they near the end of their lives. Others believe these options to be ethically unsound and to place undue responsibility for taking another's life on the person helping the patient; especially considering that medical diagnoses can be wrong due to human error. This is an important issue as it struggles to give greater autonomy to individuals in deciding their own fate while at the same time protecting others involved morally, ethically, and legally; as well as protecting the patient from abuse. Those for and against PAS and voluntary euthanasia are as of yet unable to come into agreement on what, if anything, will be mutually beneficial for all concerned.

II. Clarify concepts

* Physician Assisted Suicide (PAS): the act whereby a physician prescribes a lethal dose of medication for a terminally ill patient to take when ready to die (Wilson et al., 2007).

* Voluntary Passive Euthanasia (VPE): an act such as giving increased opioids to a patient to relieve pain, knowing that this will lead to a hastened death (Wilson et al., 2007).

* Voluntary Active Euthanasia (VAE): an act performed by a physician that directly intends to take the life of the patient at the patient's request (Wilson et al., 2007).

* End-of-life decisions: decisions to be made by patients as they approach death about which treatments to continue or abstain, which may include PAS or voluntary euthanasia depending upon laws applicable to where they live (Wilson et al., 2007).

III. Identify possible solutions to the problem

A. Physician-assisted suicide and voluntary euthanasia are morally acceptable because it gives competent individuals greater autonomy in end-of-life decisions. These possibilities allow the patient a feeling of more control over their life in an otherwise bleak situation, giving them a choice in how they wish to die when terminally ill (Wilson et al., 2007). PAS, voluntary active euthanasia, and voluntary passive euthanasia should be made legal in the United States for terminally ill patients.

B. PAS, VPE, and VAE are not morally acceptable because it creates a situation in which an individual, usually a doctor, is put into the position of having to help, or directly act, in an effort to assist another in taking their life. This places an undue burden of responsibility on another person, and forces physicians to be torn between following the patient's wishes and breaking the oath they made when agreeing to do no harm and to use all efforts to heal others; not contribute to a patient's death intently (Wilson et al., 2007). PAS or voluntary euthanasia also has the potential for abuse of the patient as an ethical consideration which would make either option morally unacceptable (Brock, 2000). PAS and voluntary euthanasia should be made illegal in the United States.

IV. Assumptions and points of view

Side A - Physician-assisted suicide and voluntary euthanasia should be legal because it gives the patient a sense of control over their life and greater autonomy in making end-of-life decisions that may help lessen the burden to the patient and the family both financially and emotionally. Making PAS legal would also give others an option to die with dignity should they choose to make this decision when faced with a terminal illness and would free the doctors to assist their patients in this final wish without fear of legal prosecution (Wilson et al., 2007).

Side B - PAS and voluntary euthanasia should be illegal because society needs to protect the terminally ill from potential abuse by those seeking to help end their life, or from the patient's own mental instability that may be present as they near death (Rurup, Deeg, Poppelaars, Kerkhof, & Onwuteaka-Philipsen, 2011). PAS and voluntary euthanasia should also be illegal because physicians should be protected from having to break their Hippocratic Oath and should not have the burden of responsibility for intently taking the