The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient’s failing lungs and medicines can sustain that patient’s physiological processes. For those patients who have a realistic chance of surviving an illness or accident, medical technology is science’s greatest gift to mankind. For the terminally ill, however, it is just a means of prolonging suffering. Medicine is supposed to alleviate the suffering that a patient undergoes.Yet the only thing that medical technology does for a dying patient is give that patient more pain and agony day after day. Some terminal patients in the past have gone to their doctors and asked for a final medication that would take all the pain away— lethal drugs. For example, as Ronald Dworkin recounts, Lillian Boyes, an English woman who was suffering from a severe case of rheumatoid arthritis, begged her doctor to assist her to die because she could no longer stand the pain (184). Another example is Dr. Ali Khalili, Dr. Jack Kevorkian’s twentieth patient. According to Kevorkian’s attorney, “[Dr. Khalili] was a pain specialist; he could get any kind of pain medication, but he came to Dr. Kevorkian. There are times when pain medication does not suffice”(qtd. in Cotton 363). Terminally ill patients should have the right to assisted suicide because it is the best means for them to end the pain caused by an illness which no drug can cure. A competent terminal patient must have the option of assisted suicide because it is in the best interest of that person.
Further, a dying person’s physical suffering can be most unbearable to that person’s immediate family. Medical technology has failed to save a loved-one. But, successful or not, medicine has a high price attached to it. The cost is sometimes too much for the terminally ill’s family. A competent dying person has some knowledge of this, and with every day that he or she is kept alive, the hospital costs skyrocket. “The cost of maintaining [a dying person]. . . has been estimated as ranging from about two thousand to ten thousand dollars a month” (Dworkin 187). Human life is expensive, and in the hospital there are only a few affluent terminal patients who can afford to prolong what life is left in them. As for the not-so-affluent patients, the cost of their lives is left to their families. Of course, most families do not consider the cost while the terminally ill loved-one is still alive.When that loved-one passes away, however, the family has to struggle with a huge hospital bill and are often subject to financial ruin.Most terminal patients want their death to be a peaceful one and with as much consolation as possible. Ronald Dworkin, author of Life’s Dominion, says that “many people . . . want to save their relatives the expense of keeping them pointlessly alive . . .”(193). To leave the family in financial ruin is by no means a form of consolation. Those terminally ill patients who have accepted their imminent death cannot prevent their families from plunging into financial debt because they do not have the option of halting the medical bills from piling up. If terminal patients have the option of assisted suicide, they can ease their families’ financial burdens as well as their suffering.
Finally, many terminal patients want the right to assisted suicide because it is a means to endure their end without the unnecessary suffering and cost. Most, also, believe that the right to assisted suicide is an inherent right which does not have to be given to the individual. It is a liberty which cannot be denied because those who are dying might want to use this liberty as a way to pursue their happiness. Dr. Kevorkian’s attorney, Geoffrey N. Fieger, voices the absurdity of curbing the right to assisted suicide, saying that “a law which does not make anybody do anything, that gives people the right to decide, and prevents the state from prosecuting you for exercising your freedom not to suffer, violates somebody else’s constitutional rights is insane” (qtd. in Cotton 364). Terminally ill patients should be allowed to die with dignity. Choosing the right to assisted suicide would be a final exercise of autonomy for the dying. They will not be seen as people who are waiting to die but as human beings making one final active choice in their lives. As Dworkin puts it, “whatever view we take about [euthanasia], we want the right to decide for ourselves . . .”(239).
On the other side of the issue, however, people who are against assisted suicide do not believe that the terminally ill have the right to end their suffering. They hold that it is against the Hippocratic Oath for doctors to participate in active euthanasia. Perhaps most of those who hold this argument do not know that, for example, in Canada only a “few medical schools use the Hippocratic Oath” because it is inconsistent with its premises (Barnard 28). The oath makes the physician promise to relieve pain and not to administer deadly medicine.This oath cannot be applied to cancer patients. For treatment, cancer patients are given chemotherapy, a form of radioactive medicine that is poisonous to the body. As a result of chemotherapy, the body suffers incredible pain, hair loss, vomiting, and other extremely unpleasant side effects. Thus, chemotherapy can be considered “deadly medicine” because of its effects on the human body, and this inconsistency is the reason why the Hippocratic Oath cannot be used to deny the right to assisted suicide. Furthermore, to administer numerous drugs to a terminal patient and place him or her on medical equipment does not help anything except the disease itself. Respirators and high dosages of drugs cannot save the terminal patient from the victory of a disease or an illness. Dr. Christaan Barnard, author of Good Life/GoodDeath, quotes his colleague, Dr. Robert Twycross, who said, “To use such measures in the terminally ill, with no expectancy of a return to health, is generally inappropriate and is—therefore—bad medicine by definition” (22).
Still other people argue that if the right to assisted suicide is given, the doctor-patient relationship would encourage distrust. The antithesis of this claim is true. Cheryl Smith, in her article advocating active euthanasia (or assisted suicide), says that “patients who are able to discuss sensitive issues such as this are more likely to trust their physicians” (409). A terminal patient consenting to assisted suicide knows that a doctor’s job is to relieve pain, and giving consent to that doctor shows great trust. Other opponents of assisted suicide insist that there are potential abuses that can arise from legalizing assisted suicide.They claim that terminal patients might be forced to choose assisted suicide because of their financial situation.This view is to be respected. However, the choice of assisted suicide is in the patient’s best interest, and this interest can include the financial situation of a patient’s relatives. Competent terminal patients can easily see the sorrow and grief that their families undergo while they wait for death to take their dying loved ones away. The choice of assisted suicide would allow these terminally ill patients to end the sorrow and griefof their families as well as their own misery. The choice would also put a halt to the financial worries of these families. It is in the patient’s interest that the families that they leave will be subject to the smallest amount of grief and worry possible.This is not a mere “duty to die.” It is a caring way for the dying to say, “Yes, I am going to die. It is all right, please do not worry anymore.” Further, legalization of assisted suicide will also help to regulate the practice of it. “Legalization, with medical record documentation and reporting requirements, will enable authorities to regulate the practice and guard against abuses, while punishing real offenders”(Smith 409).
There are still some, however, who argue that the right to assisted suicide is not a right that can be given to anyone at all. This claim is countered by a judge by the name of Stephen Reinhardt. According to an article in the Houston Chronicle, Judge Reinhardt ruled on this issue by saying that “a competent, terminally-ill adult, having lived nearly the full measure of his life, has a strong liberty interest in choosing a dignified and humane death rather than being reduced at the end of his existence to a childlike state of helplessness, diapered, sedated, incompetent” ( qtd. in Beck 36). This ruling is the strongest defense for the right to assisted suicide. It is an inherent right. No man or woman should ever suffer because he or she is denied the right. The terminally ill also have rights like normal, healthy citizens do and they cannot be denied the right not to suffer.
The right to assisted suicide must be freely bestowed upon those who are terminally ill. This right would allow them to leave this earth with dignity, save their families from financial ruin, and relieve them of insufferable pain. To give competent, terminally-ill adults this necessary right is to give them the autonomy to close the book on a life well-lived.
Barnard, Christaan. Good Life/Good Death. Englewood Cliffs: Prentice, 1980.
Beck, Joan. “Answers to Right-to-Die Questions Hard.”Houston Chronicle 16 Mar. 1996, late ed.: 36.
Cotton, Paul. “Medicine’s Position Is Both Pivotal And Precarious In Assisted Suicide Debate." The
Journal of the American Association 1 Feb. 1995: 363-64.
Dworkin, Ronald. Life’s Dominion. New York: Knopf, 1993.
Smith, Cheryl. “Should Active Euthanasia Be Legalized: Yes.” American Bar Association Journal April 1993. Rpt. in CQ
Researcher 5.1 (1995): 409.
--Esther B. De La Torre
In the world today there are arguments for everything, ranging from matters of great importance to things that may seem ridiculously trivial. However, there are always different sides to every case and right and wrong is in the eyes of the person involved in the dispute.
This argumentative essay is based upon a very serious situation that faces our medical community. The topic of assisted suicide and/or euthanasia is a highly debated subject with many issues and sides. In this essay, each topic will be discussed and analyzed and the arguments for and against this topic will be debated. I will discuss my reasons for advocating physician-assisted suicide and I will also provide objections to my argument, but even though these counter arguments have merit, I will provide enough evidence to support my thesis.
The topic of my paper is physician-assisted suicide. Sometimes it is incorrectly referred to as euthanasia, but however subtle, there is a difference between the two. Euthanasia is when the doctor provides the means with which the patient may end his own life whereas physician-assisted suicide is when the doctor causes the patient's death, for example through a lethal dose. In his own words, the infamous Dr. Jack Kevorkian describes the difference between euthanasia and his own profession: "It's like giving someone a loaded gun. The patient pulls the trigger, not the doctor. If the doctor sets up the needle and syringe but lets the patient pull the plunger, that is assisted suicide. If the doctor pushed the plunger, it would be euthanasia." (McCuen 1994 p.54)
Both euthanasia and physician-assisted suicide will be discussed in this paper as they pertain to the arguments for and against this subject.
There are many arguments for both sides of this case. In this part of the essay I will discuss the argument against assisted suicide. The Bible reads, "Thou shall not kill". The American Nursing Association (ANA) position statement reads, " A nurse must not act deliberately to end a person's life." These are two of the very basic arguments against euthanasia. However, the subject is much more complex than these two defining pieces of literature suggest - there are many reasons why it is morally wrong and unethical to take a patients life away, even though they may have requested it.
The religious argument is one of the strongest and most powerful opponents to assisted suicide. It is based on two main points, the first defining the sanctity of life. "All life, but particularly human life, is recognized as a direct gift from God, one that never becomes personal property. It is ours not to give away, to damage, or to destroy at will, but to preserve intact until the moment when it is taken back" (McKhann, 1999, p.
63). The second point is entrenched in the Christian belief that suffering can be beneficial in its own right. Suffering should be looked at as a positive thing when it is unable to be avoided because it means the entry to something good. "An extension of this thinking is that suffering is a result of guilt that leads to repentance. The greater the suffering, the greater the guilt, hence the greater the need for repentance" (McKhann,
1999, p. 63).
Besides the religious case against physician-assisted suicide, another argument would be that it violates medical ethics. The American Nurses Association (ANA) position statement reads, "A nurse must not act deliberately to end a person's life" (Sullivan, 1999, p. 31). The Hippocratic oath also states; "I will give no deadly medicine
to anyone if asked, nor suggest any such counsel" (Woodman, 1998, p. 162). Taken from two of the most prestigious and important documents in the medical field, these statements strictly forbid the taking of a patient's life or aiding a patient in his or her death.
One of the most important things in health care is the relationship between the health care worker and a patient because it is the health care worker's job to provide not only medical care but also support, hope and a caring relationship.
If a patient were distressed enough to bring up
the subject and the physician were to agree that
the choice is a rational one and that assisted
suicide is a reasonable alternative, would this
not reinforce the patient's feelings of despair
and worthlessness? Even a suggestion of
agreement might undermine any remaining hope.
McKhann, 1999, p. 150
The last argument against assisted suicide that I am going to deal with is the patient's state of mind. When making any important decision in life, one must give it plenty of thought and be completely unbiased. When something tragic has happened to make one consider death, their state of mind must come into question. Are they considering death for the 'right' reasons? If a physician assisted death is to be considered, a patient must be considered mentally competent. There are many issues that interfere with a patient's mental capacity to make such a drastic decision. The patient may be temporarily depressed or may undergo a change of mind. Patients should be given
sufficient time and counselling in order to enable them to make sure their decision represents their true wishes.
Guilt is another reason a patient's state of mind may come into question.
Patients might feel guilty for staying alive and choose death to lift the financial burden or the strain on loved ones. Desperate and emotionally exhausted, families may give up too quickly and eagerly lend their support to the termination of a relative's misery, as well as their own.
In the preceding paragraphs an extremely convincing argument has been made
against assisted suicide. After all, it violates personal and medical ethics and it undermines the relationship of patients with their health care workers. Besides, what happens if a miracle cure is found after the patient has already made the decision for assisted suicide and gone through with it? Once suicide has been committed it is irreversible. What's done is done and there is no changing it.
If the Hippocratic Oath and the ANA states that it is wrong, and the ever influential Bible argues against assisted suicide, then who are we to question it? Instead of trying to help end patients' lives, people and physicians would be better served by improving all patients' state of life and mind so that they can live out their last days free from pain and enable them to gain a sense of spiritual fulfillment.
As mentioned in my thesis statement, I support assisted suicide. I want
to make a cautious argument because I believe that under some carefully limited circumstances, it is permissible for a physician to assist a person in taking his or her own life in order to put an end to unwanted and unnecessary suffering. This includes
providing medicines or other means the patient can use to commit suicide or by directly administering these medicines themselves.
As stated earlier in the religious argument against assisted suicide, life is a gift. However, in a time of suffering "the gift may no longer be wanted and the loan gladly repaid" (McKhann, 1999, p. 63). If it is God's place to give and take away life, then an implication of that objection is that we should not interfere at all with any life threatening condition because it is God's will. After all, what would happen if a person is bleeding to death from an accidental cut? To interfere and help would mean to interfere with God's prerogative to determine time and place of death.
The religious argument is also flawed for two other reasons. What if a
person has no faith or what if that person's faith suggests something different? With so many religions in the world, there are bound to be conflicting views on almost everything including suicide. The second reason is challenged "by those who do share the faith when the suffering seems out of proportion to any possible spiritual benefit. Even the most devout Christian will ask, "what have I done to deserve so much pain?" (McKhann,1999, p. 64). The religious argument against assisted suicide is quite strong but if one were to take a closer look, large holes in this argument can be blatantly seen.
It is true that the physician-patient relationship is important. However, I feel that a patient's trust would not be undermined with the implement of assisted suicide. I would want to be able to trust my doctor to do what is best for me in every situation. If my life has become so unbearable that I feel I need to end my life, I would want my
doctor to help me die a painless, peaceful death and not one racked with pain and misery. I would want to trust that my physician will respect my every wish.
Dr. Charles F. McKhann concludes, " most patients interviewed in my study felt that knowledge that their physicians had helped others to die would either have no effect or would enhance their respect for their physicians" (McKhann, 1999, p. 150). The role of the physician is to do what is best for the patient, and in some extreme situations this may include hastening death upon the voluntary request of the dying. If the role of the physician is defined solely in terms of healing, then, of course, this excludes assisting someone to die, but this is the wrong way to go about defining a doctor's role. I feel that a doctor's role is to do the best thing for the patient, whatever the circumstances may be. In nearly every case the answer will be to heal, to prolong life, to reduce suffering, to restore health and physical well-being. However, in some extreme circumstances, the best service a physician can render may be to help a person end their life in order to end intolerable pain as judged by the patient. This would be an enlargement of the physician's role, not a contradiction to it. Sometimes ending suffering takes priority over extending life.
I feel the most powerful argument comes from the families of those who have witnessed loved ones die in extreme agony, helplessly watching as they slowly and painfully deteriorate in front of their eyes, their bodies ravaged by pain and suffering. Meanwhile, the medical profession has done all it can to help but has failed to ease the suffering. I feel in these extreme cases that assisted suicide would provide a way for patients to end both their suffering and the suffering of their loved ones who are forced to
sit by, helpless and powerless to do anything.
It seems unfair that after living their whole lives independently, making important decisions everyday, that a person is required to leave much of the responsibility of their death and dying to someone else. Given the chose, most people would want to live to old age, accomplishing what they could along the way, then die a peaceful, satisfying death. That is not always the case. A persons life can be marred by severe disability, incurable disease and may come to a conclusion with a slow, painful, agonizing death.
After taking into account the arguments presented in this essay, I feel there is only one conclusion to draw. Assisted suicide is an idea that needs to be explored further and given serious consideration. If assisted suicide and/or euthanasia is to be legalized than very strict regulations would have to be used to insure that it would only be used as a last resort after all other options had been exhausted. If the patient is so overcome with pain and suffering then it is best that they should be given the option to end their suffering. The job of the people in the medical field is to do what is best for the patient and sometimes ending the suffering is the best option.
McCuen, G.E. (1994). Doctor Assisted Suicide and the Euthanasia Movement. New York: Gary E. McCuen Publications Inc.
McKhann, C.F.(1999). A Time to Die: The Place for Physical Assistance. Connecticut: Yale University Press.
Sullivan, M. (1999). Are We Prolonging Life or Extending Death?, 30(3), 31-33
Weir, R.F. (1997). Physician-Assisted Suicide. Indiana: Indiana University Press
Woodman, S. (1998). Last Rights: The Struggle Over the Right to Die. New York: Plenum Publishing.