Physician assisted suicide is one of those moral and ethical questions that are destined to remain..
Physician assisted suicide is one of those moral and ethical questions that are destined to remain as controversial and contested as abortion. It is often easy to make moral judgments on aspects of humanity when one is not in the situation themselves. It has to be taken into account that a number of variables are present in the argument then merely whether or not someone has the right to their own lives. It is an issue that is beyond legal parameters and extends to the philosophical.
We are able to argue that life is not our own, that it is a God given purpose, until we are beset with burdening pain and suffering. One cannot argue that it is simply a religious or moral standpoint, and one cannot argue it as a legal issue either. Many physicians themselves stand for the rights of individuals to choose a dignified and unlabored death and this is where the crux lies: the fact that they see far more than the average ignoramus has the right to contribute.
In this case, far more evidence weights for the legal right to choose physician assisted suicide, than it does to deny the right. Physician assisted suicide is defined as the “voluntary termination of one’s own life by the administration of a lethal substance with the direct or indirect assistance of a physician. ”(Medterms, 2008). University of Washington School of Medicine offers us two examples of the moral case for suicide: Skip and Angela. Skip is 50 years of age, male and suffers from metastatic nonsmall cell lung cancer.
He has had complications with the chemotherapy to the point where he is not sure it is worth having, but is also afraid not to have it (UWSM, 2008). Angela is 72 years of age and is in the final stages of congestive heart failure, having suffered to heart attacks. She is exhausted simply from living and her condition is unpredictable (UWSM, 2008). In these cases we have to take into account that there are more than one issue we are dealing with. In Skip’s case, he is destined for almost certain death while Angela may have one year or ten years ahead of her and we are never certain when she will die.
In this case we have to evaluate what the quality of life will be like for each of them in the event that they do, by some miracle, live for another ten years. Granted, the outsider may argue that Angela should not give up on life especially if her time is indeterminate, but will her quality of life be such that she wishes to continue? Skip on the other hand is terminally ill, he knows he is going to die and again, the medication makes him so uncomfortable that one wonders if he wants to suffer through it.
The University of Washington School of Medicine determines three types of physician assisted suicide: terminal sedation (sedation until unconsciousness and allowing them to die during this constant sedation); withholding of life-support or sustaining treatments (the patient decides not to take the treatments necessary to keep them alive) and pain medication that hastens death (doses of pain drugs that decrease respiration or speed up the dying process) (UWSM, 2008).
We have discussed what physician assisted suicide is and seen possible cases where it may be augmented, but now the argument is whether or not it is legal and whether or not the law really has a right to an opinion on it. A cat is ill and even though it is beloved of the family, it is taken to the veterinarian and put ‘to sleep’. This is seen as merciful. However, if a human is suffering unbearably, they do not have the same luxury of hastening their death. The difference is, of course, that the cat did not have a choice.
In the one case where a person is capable of understanding death and their condition and capable of voicing what they want, they are unable to do so. Eleven years ago, Oregon State became the first to initiate the choice to a dignified death. Last year 341 terminally ill took advantage of the option. On the 4th November Washington will decide whether they will implement their own Death with Dignity Act (Yardley, 2008). Prior to this attempt to secure the law, they had failed to implement it because voters refused to vote in favour of the movement (Yardley, 2008).
The truth of the matter is that the voters were not those who were going to make use of it. Strangely enough, a democratic society should by definition allow the rights of all people, not just those who are healthy. We could describe the situation as follows: Martin Luther King fought for equal rights to all citizens of the United States and so the liberated African American came into being. Susan B Anthony and Emiline Pankhurst became women’s rights activists fighting for the rights of women to be treated as equals and today we have the liberated woman.
The Battle of Little Bighorn and several others fought for the rights of Native Americans to lands and equal rights and to an extent (only an extent), they have their freedom too. Now, place in the equation, the dying man or woman: cast into the same bracket as women, African Americans and Natives. Included in this bracket is the homosexual. The comparison here is that the choice to live or die is actually more morally decent that gay marriages are in the religious sector. Despite this, more emphasis is placed on homosexual rights than the right to die with dignity.
Legality or merely creating an argument where there needn’t be one? Dr David Stolinksy considers the legal wrangle to be indecent. “An ethical question must be answered by reference to ethical standards such as the Hippocratic Oath. This oath has been taken by young physicians for 2400 years. ”(Stolinsky, 2006). Stolinksy voraciously attacked articles he read about the essence of physician assisted suicide, saying that what is often read about the issue is packed to exploding with references to court cases, legal procedures and rulings, but that their never an ounce of ‘ethical wisdom’ contained in them.
In his view, it is an ethical issue and never has been a legal one (Stolinksy, 2006). Stolinsky does not himself defend the physician assisted suicide, but makes a crucial point in saying that the law really has no idea what they are talking about (given that they have little to do with emaciated and uncomfortable terminally ill people). Dr Jack Kevorkian is a Parkinson’s sufferer and an activist for the right to die with dignity. In his case, he knows that one day he will be in an unbearable state and hopes that the choices he can make will help others to make similar decisions (Ferguson, 2007).
Dr Ferguson believes that “Working at HospiceCare, where honoring every patient’s end-of-life choices is a core value, I have no dispute with Governor Gardner’s desire to make his own decisions as life draws to an end. ”(Ferguson, 2007). Indeed seeing the dying on a daily basis, her argument is to allow as many choices as possible for the patient, not deny them any. Although she believes that proper pain management can be accomplished and that patients need not die in unbearable pain, she does believe the ultimate choice should be theirs.
Let us be certain here of one thing and that is the difference between normal suicidal ideation and physician assisted suicide. Suicide due to self-mutilating circumstances (drugs and self hate), or even pure depression are situations that can be reversed and treated and there is the potential for the person to live a happy, healthy and full life. Physician assisted suicide is where the light at the end of the tunnel has been blocked off and the future is not so bright. Perhaps the most controversial and least comfortable argument is that of the death sentence.
Simply put, if the death penalty is considered humane, then why is not humane to allow the choice to die with dignity. Furthermore, we have to look at the ethical argument that has been applied to the death sentence: by some rather twisted logical inception, the ability to take a life has been granted to a few people who believe it is their right to decide a criminal should die. If we are to use this as a comparative argument for physician assisted suicide then we can use the following example: A man rapes and murders several women.
He is tried and found guilty with the sentence of death. The argument is that he is likely, by psychological profiling, to commit further atrocities and due to the severity of his crime, deserves to die. The question is, what if he never commits another crime and completely reforms himself? In the same light, a patient given 6 months to live and chooses the suicide route. He could very well have lived another ten years but who can say that he would have? In both cases there is a shadow of doubt – a risk.
Lawrence Hinman of University of San Diego puts forward the awkward question too that the death penalty follows the lex talionis principle of an ‘eye for an eye’ and by extension a ‘life for a life’. He asks why then it is not applied to torturers (Hinman, 2008: 5). Evidently the principle does not work. By logic, this makes the lex talionis not only unfair but also impractical. A cancer sufferer is not a criminal, although they are not exempt from the disease, but if it appears to be ethical to take a life-for-a-life, then surely it is even more ethical to take ones own?
You have more right to your own body then the judge on the podium does. So what the argument therefore entails is that if it is both legal and ethical (doubtful) to sentence someone to death, then it should be legal and ethical to let someone choose to die if they are ill. With regards to the argument that the patient may actually live, the same could be said for the rapist who may actually be able to donate blood or stem-cells for a leukaemia patient if he is given the right to live. Neither case can be proved or disproved.
Are we left at square one again? It depends very much on which side of the proverbial fence you fall. A person can only really decide if something is ethical or moral really when they have experienced it themselves. The right to physician assisted suicide should be given. It is no more or less ethical than any other moralistic standpoint. Consider the debacle that still descends on gay marriages, abortion, and even forced prostitution: are they any more morally sound then physician assisted suicide?
Consider if prostitution is legalised and the countless women held under torturous circumstances under that very law? Is that any more ethical? Given that the majority of voters in the United States are those that are not in the position where they have to face their death, the intentions are a little selfish. They are concerned for their own loss, not for the suffering of those who are about to die. The loved ones are more fearful of losing those close to them then they are concerned for the dignity and suffering of those who are dying.