Each and every individual has the right to autonomy. Autonomy is defined as the right to self-govern or in other words, to make your own decisions. We have the right to choose where we work, who we marry, which medical procedures we undergo, and in the end, we have the right to choose whether or not we are resuscitated if something were to happen to us. So why do we not have the right to choose when and how we die?
Death and dying have been the topic of discussion for years however only recently has that discussion shifted focus to how people are dying. Towards the end of life, people often find themselves facing the decision of continuing on with aggressive treatments to prolong what little life they have left, or opting for palliative care and simply waiting for the day where they pass. People are now looking towards physician assisted death as a means to end their pain and suffering and as a way to die with dignity. Physician assisted death is when a physician provides or administers a lethal medication to a requesting individual with the sole purpose of ending that individual’s life. Many people view physician assisted death as wrong however, it is our right.
There are currently many treatment options available when it comes to end-of-life care. The first option is treatment based on the disease. For example, cancer patients have the option of chemotherapy, radiation, or surgery. When patients forgo these options, for one reason or another, they are forgoing one end-of-life treatment option available to them. Another option available is palliative care which can begin at the time of diagnosis and may occur at the same time as treatment. However, after treatment of the disease is stopped and it is unclear if the patient will survive, the patient must forgo palliative care and enter hospice care. During hospice care, opioids can manage pain, but cannot eliminate it all together. When opioids are insufficient and the suffering becomes unbearable, the patient is offered sedatives or other psychoactive medications in order to achieve complete unconsciousness until the patient dies, otherwise known as terminal sedation. If patients forgo all available options, depending on which state the patient lives in, a patient may opt for a fourth treatment option known as physician assisted suicide.
As stated above, each and every individual has the right to autonomy and that autonomy should be respected up until the end of life. If an individual has deemed their suffering to be intolerable, and they are ready to say goodbye to their loved ones, they should be able to do so without having someone else force them to continue living in agony. Individuals often times choose physician assisted suicide as a way to prevent or escape further suffering or pain. We do not get to decide when an individual is done suffering and we certainly do not have the right to force individuals to continue suffering.
Individuals choose physician assisted suicide for many different reasons depending on the situation they are in. A study conducted in 2017 showed that ninety-two percent of individuals choose physician assisted suicide because of the loss of autonomy while ninety percent stated they could no longer enjoy activities that made life worth living and seventy-eight percent perceived a loss of dignity. A book published in 2017 discusses palliative care options for terminal ill patients but also argues that palliative care may not be sufficient in alleviating one-hundred percent of patients’ pain and discomfort. When palliative care is no longer sufficient, individuals often chose to end the pain and suffering and lessen the burden on family members by opting for physician assisted suicide. A physician’s duty is to help relieve the suffering of individuals. By assisting in physician assisted suicide, physicians are committing an act of compassion and fulfilling their obligation of non abandonment. In other words, physicians are fulfilling their obligation to their patients by caring for them and respecting their wishes up until death.
As physician assisted suicide becomes increasingly more popular as a treatment option for terminally ill patients, safeguards and policies must be put into practice to ensure individuals are not simply using is as a means to commit suicide due to depression. For example, the Oregon Death with Dignity Act has certain requirements that patients must meet before committing physician assisted suicide. This bill requires that patients must have a terminal illness with less than six months to live. In addition, they must receive a second opinion from another physician. The patient must also be informed of other options available such as hospice, palliative care, aggressive treatment, or deep sedation. Patients are required to make a written request along with a verbal request for physician assisted suicide and the physician must wait fifteen days after the request before providing the patient with the prescription. Lastly, the patient must be able to swallow the medication themselves or inject themselves with the medication. The physician or nurse may not administer the medication in order for it to be considered a physician assisted death.
The main reasons why people consider physician assisted suicide to be wrong include religious or moral beliefs. However, due to the many different religions in the world with varying beliefs, religion should play no part in medical decisions. There are many different reasons why individuals choose to end their pain and suffering but the important concept to remember is no matter the reason why, the intention is always the same: End the agony. People should respect others’ autonomy and their decision regarding end of life care. Physician assisted suicide should be implemented as a final treatment option for individuals with terminal illnesses.
References
Blanke, C., LeBlanc, M., Hershman, D., Ellis, L., & Meyskens, F. (2017). Characterizing 18 years of the Death With Dignity Act in Oregon. JAMA oncology, 3(10), 1403–1406. doi:10.1001/jamaoncol.2017.0243
Orentlicher, D., Pope, T. M., & Rich, B. A. (2016). Clinical criteria for physician aid in dying. Journal of palliative medicine , 19 (3), 259–262. doi:10.1089/jpm.2015.0092
Simmons K. M. (2018). Suicide and death with dignity. Journal of law and the biosciences , 5 (2), 436–439. doi:10.1093/jlb/lsy008
Sulmasy, L. S., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: An American College of Physicians position paper. Annals of internal medicine, 167 (8), 576. doi:10.7326/m17-0938
Sumner, L. W. (2017). Physician-assisted death: What everyone needs to know . New York, NY: Oxford University Press.
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