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Physician-assisted suicide is the voluntary termination of a person's life with a fatal injection or lethal medication with the immediate or secondary assistance of a medical practitioner. The lethal medicine is provided with the patient's knowledge and agreement. Furthermore, Physician-Assisted Suicide, abbreviated as PAS, is the practice of giving a patient with sound reasons a prescription to take in order to end the patient's life.
PAS can also be defined as follows: the suicide committed by a patient, through a means, such as taking of a lethal drug, or information, such as the prescription of the deadly medication by a physician who is well aware of the patient's intention (Dees et al., 2015). PAS, as a practice has those who support it and those who disagree with it. Some physicians believe that it violates the vital aspect of medicine so that a doctor who assists in suicides goes against the primary role of a medic, which is to heal.
PAS is different from active or passive euthanasia. Active euthanasia refers to the administering of a lethal injection to a patient, to end their lives. This action is quite prevalent as a means of administering a death sentence, in the states that practice it. Conversely, passive euthanasia refers to the withdrawal of life support machines from a patient in the hospital's Intensive Care Unit (Dees et al., 2015). This act is usually done in response to the patient's advance directive, for them to get killed in such a manner. What arises is whether any of the above practices, including PAS, are ethical or they violate the rights of human beings. On the other hand, one can argue that the suicide is performed in the knowledge of its victim, and should therefore not get termed as a kind of violation of their right to live. Each country has its laws and regulations that govern the lives of human beings, and it is therefore upon the bill to establish if PAS should get practiced.
The Historical Perspective
In the past twenty years, several jurisdictions all over the world have made PAS legal, even with the changes in different regimes of the specific countries. Where PAS has become legalized, the principal intent is to ease the suffering of the patient, usually at an intolerable level, through pro-active medical intervention in a bid to hasten death. However, this has faced significant barriers, including difficulties in adequately interpreting legal requirement or lack of legal guidelines for the authorization of physician-assisted suicide (McLachlan, 2010). Consequently, doctors end up avoiding the practice, due to the fear of professional stigmatization or even legal action gets taken against them.
Medical advances have experienced dilemmas on these life-threatening issues. Suicide practice has a long history some being messy or getting done in crude non-medical ways. The current debate is whether the direct medical killings should have policies designed and approved by the state (McLachlan, 2010). This issue comes up when severe methods of preserving life get used pushing for the need to decide on the timing of death together with how it would get done. The public also expresses its concern about lack of control in the death process. There is a concern over loved ones whose death occurred through unnecessary medical procedures. However, public policies on health treatments used to preserve life advocate for patient autonomy and individual choice.
Patient autonomy faces criticism through legislation or courts. This action gets attributed to the treatment choices or emphasis put on individual rights. The law's recommendation on public policies on life treatment promotes autonomy on medical treatment. Patient independence gets viewed as a consideration of the patient's interests. In diverse medical situations, the patient’s opinion could offer guidance. However, medical practitioners respect the person as well as the religious beliefs of the individual especially in a world of different faiths. The law seeks to address the patient's best interest and consult the patient as much as possible. Legislation about the medical choices on the victim patient relies on the wish of the patient (McLachlan, 2010). However, the patient's opinion is not always regarded seriously by the task force.
Medical practitioners felt that justice should prevail over autonomy and a ban got proposed against multiple listing of patients. The law in New York does not prohibit suicide however criminal law forbids the help of committing suicide, more so the use of direct measures to terminate the life of the patient (McLachlan, 2010). The method of lethal injection to take the life of the patient can get termed as second-degree murder. Legalizing the practice of euthanasia would be a change in the public policies and a compromise on professional standards. Legalization would be a violation of the rights of the individual and a denial of mercy on the suffering patients although some individuals support the government in formulating policies that would help in the success of deaths.
While some people consider this death as a violation of social principles and medical ethics, others perceive it as being acceptable in some situations although such situations hardly occur. Despite the differences in ethical considerations, the task force recommends that the prevailing laws should not advocate for public assisted suicide. Legalizing physician-assisted suicide would put the ill individuals at risk. Members of the task force decided that the changes in public policies would have more adversity than benefits. Patients under poverty, those that lack access to quality healthcare, those advanced in age or within a discriminated social group could be at the most significant risk of harm when it comes to autonomy choices. Legalizing public policies on physician-assisted deaths would be lack equity since those with scarce resources or the socially disadvantaged would get directly or indirectly impacted by the system.
A good example where PAS has received public support in New Zealand, yet it has also gotten accompanied by considerable controversy. Surveys in this country have shown a strong and highly increasing federal support of making PAS legal. According to the research carried out in New Zealand, several doctors did admit that they had administered lethal drugs to their patients, in a bid to hasten their death (Quill, Timothy, Christine, & Diane, 2012). Since nurses are the people responsible for giving medicine to the patients as per the prescription provided by doctors, they got identified as having participated in PAS indirectly. In view of this, the organisation responsible for nurses in the country deemed it necessary to have rules and regulations addressing the practice of PAS, to cover nurses from any consequential implications. However, most of New Zealand’s professional medical and nursing bodies refused to take their stand on the subject of PAS.
Several reasons can be used to argue why PAS should get legalized. For instance, every individual has an independent right to have decided at the end of their lives to avoid unnecessary pain and suffering. This action is irrespective of what physicians believe, what philosophical experts have in mind or what people perceive. In addition, the victim requesting for PAS may have seen other people suffering due to unending pain (Quill et al., 2012). On the other hand, some medics fail to concede to lack of medical success. In such a case, they tend to prolong a patient’s life despite their being in a state of despair, yet it would be the patient’s wish not to go through such excruciating pain.
All the reasons mentioned above are with the support of why PAS should be legalized and included in a public charter. The ideas reflect the fundamental principles of medical practitioners, including giving the patient benefit, ensuring that one does not fail in their line of duty and holding the interests of one’s patient with utmost care and importance, so that one as a medical practitioner is ready to give anything to ensure that the patient gets well and does not go through unnecessary suffering. A majority of respondents would say that medics do not consider patient autonomy and effective decision when it comes to when the patients are terminally ill. Such cases are referred to as medically futile treatments so that in as much as both the patient and the patient are very well aware of the suffering that the patient is gets subjected to, they physician persists in giving treatment (Quill et al., 2012). In the ultimate period, the patient dies, having gone through in explainable pain.
Some public debates arose opposing the views fuelling the general policies on physician-assisted suicides. In ideal situations, cases that recommend safeguarding would get satisfied. Patients could get screened for mental illness and receive treatment with suitable pain relievers. All patients would get personalized and adequate care from the doctors. The argument is therefore that not all medical institutions could meet these expectations although guidelines could get structured (Quill et al., 2012). This reality would make the legalization of physician-assisted suicide-prone to error or abuse by the public and not just for the less privileged. The support for mercy killing becomes complicated. It gets difficult to come up with an ideal case suited for public policy when there is little relevance in medical practice.
The support for physician-assisted suicide gets tough as most individuals prefer to have their lives terminated other than enduring a low standard of living. The complexity further occurs since the life of the patient seems more precious as they continue getting weakened by the illness. It is not easy to terminate that valued life. With the application of appropriate pain relievers, some individuals may change their mind about the sudden death of the patient in return for a prolonged life of endurance with suitable treatment. The control of life towards the end comes with shared emotions (Quill et al., 2012). The society seeks better control ways to relieve the suffering individuals other than making it simpler for the ill to get their life terminated through physician help. Patients together with their families require assistance in the realization of the chances to reject life-sustaining actions by humane public policies. There should also be proper pain administrative standards and appropriate palliative care for all patients without bias.
However, despite the particular patient having a right to decide whether or not they should go through such kind of suffering, they belong to a specific family and community who have been living and interacting with them. The individual's family, in particular, may have the feeling of belonging to the patient (Austin, Amy, Corinna, & Roger, 2013). They will probably not want to lose their loved one. It must, therefore, be considered that for the peace of mind of the individual's family, the patient in question ought to survive for the most prolonged period, as this will give hope for the family. According to ordinary human emotional nature, a human being would never want to lose their loved one despite the health condition they may be.
Another quite viable approach, which has high grounds for argument is the point of spiritual and religious beliefs. A majority of people believe in the existence of a supernatural being, who can perform miraculous acts, including healing (Austin et al., 2013). When a person is sick, even to the point of death, those believing in the healing power of God pray and ask Him to touch the lives of those suffering. Although this fact may invoke mixed feelings and perceptions from different backgrounds owing to philosophy and religion, it does hold water.
Therefore, the practice of PAS defies the laws of faith and religion, so that one who believes that a patient who may be at a desperate point in their lives can live is considered irrational. Similar to the evidence on the existence and power of God, the viability of His miraculous power cannot get disputed (Austin et al., 2013). Many people have experienced, heard and seen the supernatural and healing power of the all-powerful and Sovereign God. Given religion, PAS also defies ethical and humanitarian standards. No single individual has the right to take away another persons’ life, whatever the reason may be. The right to take away life solely lies in the hands of the Supernatural God. Not even the individual himself should think of ending their own life, as it belongs to the author of life. God, being all sovereign, is the only one who can decide how and when an individual will die.
Medics that provide suicide assistance regardless of the restrictions on the law claim that they did it following persisted requests from patients. In this case, the patient initiates dialogue with the practitioner. Legalizing physician-assisted deaths would make requests by the patients to become an option for the medical practitioners. The use of euthanasia would be solely the business of the medical practitioner with no need to involve patients in the decision (Andrew, Louise, & Brenner, 2015). As much as we advocate for patient autonomy, the repercussions for mercy killing could get very severe. Illness makes an individual vulnerable as they lose faith in their body and the future. Critical illness would also cause one to lose their sense of independence and involvement in activities that define the individual. The patient is at the mercy of the physician who may reserve the knowledge needed by the patient.
The patient relies on the doctor's word about their condition. The manner in which the doctor passes the information to the patient would determine the choice of the patient about their life. In this case, the physician would be indirectly pushing the patient to commit suicide. A majority of patients adhere to the physician's instructions. Regardless of good intentions, the doctor could advocate for euthanasia, and the patient takes this as the final word with the belief that they do not have any other options (Andrew et al., 2015). Such a patient could lack awareness of the pain-relieving methods and opportunities to control the symptoms. On the other hand, some patients could be informed but fear that they would have to do without the medical support they require to stay alive. Somehow, the inpatients would get more disadvantaged than the outpatients that could get help out of the hospital.
Allowing physician-assisted suicide would be a terrible mistake. Doctors are expected to help in easing the pain of the patients and not harming them on the contrary. Physician-assisted deaths are not merciful but the assistance of the patient to be in less pain that would prolong their life is what can get seen as a gracious and compassionate act by the medical practitioners. Many people desire a respectful death near their loved ones or a doctor by their side. This scenario is not the case for physician-assisted deaths where the patient gets a prescription for overdose drugs without any medical officer in supervision (Andrew et al., 2015). Death follows and usually the patient would be alone. This kind of killing is on the extreme side. Human beings do not deserve intentional killing. Medical practitioners could assist the patient to die a natural and dignified death other than killing the patients or helping the patients to commit suicide.
Andrew, Louise B., and B. E. Brenner. "Physician suicide." Medscape Drugs & Diseases (2015).
Austin, Amy E., Corinna den Heuvel, and Roger W. Byard. "Physician suicide." Journal of forensic sciences 58.s1 (2013).
Dees, Marianne, et al. "Unbearable suffering of patients with a request for euthanasia or physician‐assisted suicide: an integrative review." Psycho‐Oncology 19.4 (2010): 339-352.
McLachlan, Hugh V. "Assisted suicide and the killing of people? Maybe. Physician-assisted suicide and the killing of patients? No: the rejection of Shaw9s new perspective on euthanasia." Journal of Medical Ethics 36.5 (2010): 306-309.
Quill, Timothy E., Christine K. Cassel, and Diane E. Meier. "Proposed clinical criteria for physician-assisted suicide." Medicine Unbound: The Human Body and the Limits of Medical Intervention: Emerging Issues in Biomedical Policy 3 (2010): 188.
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