Physician Assisted Suicide “The Dilemma In The American Health Society”

Physician Assisted Suicide

“The Dilemma in the American Health Society”

Introduction

The need to have an understanding of the moral, legal and ethical issues facing clinicians dealing with end of life issues. Those who treat patients approaching the end of life often face moral, ethical, and legal issues involving shared decision-making, futility, the right to refuse medical treatment, euthanasia, and physician-assisted suicide. This paper will address the following; An overview of the topic, the Pros and Cons., Existing states laws, Dr. Kevorkian's role along with patient autonomy, Sanctity of life- pain and suffering, and Doctor-patient relationship, and potential abuse.

Medicine's technical advances of the past few decades have cast a shadow over its long-held ethic of compassionate care. The main problem has been the appropriate use of technology at the end of life. Should it be used on everyone, regardless of the chance of a successful outcome or the burdens it imposes? If not, what ethical parameters guide the use and non-use of medical interventions? These questions are most sharp at the end of life because the burdens of intervention are often high, the benefits are marginal, and quality of life is markedly diminished.

This paper reviews the ethical principles that guide medical practice and then focuses on end-of-life ethical issues such as the right to life-sustaining therapy, medical futility, the distinction between killing and allowing to die, and physician-assisted suicide.

Problem

The principal problem involves the appropriate use of technology at the end of life. While developments in technology have enhanced our ability to prolong life, issues have also arisen regarding the resulting quality of life, the sometimes-marginal benefits to our patients, and the burdens that this technology imposes on patients, families, and society.

Legal and ethical issues continue to confront patients, courts, and physicians. A better understanding of these issues and an awareness of the availability of effective palliative care will help physicians, patients, and families adequately address the end-of-life issues that are an intrinsic part of medical care (Leone, 1999).

Pros & Cons

Contained herein are the arguments for and against the legalization of doctor assisted suicide, as well as where the state courts stand in respect to this most delicate of issues. Euthanasia can be ethical, while many terminally ill patients can indefinitely relieve their suffering using effective pain management techniques; there are some patients whose pain cannot be mitigated. Rather than and/or great pain and suffering for the remainder of their life, the patient should have the applicable choice to and airlines. Despite justifiable concern of the potential abuse of euthanasia and assisted suicide, competent patient who are suffering should not be denied the option of assisted death (Rifkin, 1997).

Supporters attempt to justify euthanasia, because it is done with good intentions. After all is said and done, there's a fallacy and this argument- to kill oneself or someone else is wrong, regardless of the motivation or circumstances. Rather than being motivated by good intentions, attempted to defend euthanasia is founded corrupt values. Society must strive to understand why euthanasia is wrong and why it cannot be justify by good intentions (Budziszewski, 1997).

Existing state laws

Oregon states' Death with Dignity Act, which had passed by voters in 1994 but had been blocked by federal legal challenges ever since, permits terminally ill patients to request lethal drugs to haste and their death - provided they are mentally competent and considered by two doctors to have less than six months to live. Prior to the United States attorney general Janet Reno's decision, the Supreme Court had ruled on June 26, 1997, that there is no constitutionally protected right to die.

The Court's decision overturned two early U.S. courts of appeals' rulings. In Washington State vs. Glucksberg, the Ninth Circuit court had ruled that Washington state law prohibiting assisted suicide was unconstitutional. The court had concluded that the right to control the manner and timing of one's death is protected under the fourteenth amendment.

In New York vs. Quill, the Second circuit court had rolled similarly that a New York state law prohibiting individuals from aiding and suicides was unconstitutional. In both cases, the courts' decisions and recognize the eye constitutionality protected right to die (Quill, 1993).

The New Jersey State Supreme Court first deemed the 'passive' form of euthanasia legal in 1976 In re Quinlan. In the Quinlan case, the court allowed a competent patient to terminate the use of life-sustaining medical machines to prolong life. Since New Jersey's decision, all fifty states have enacted similar statutes, which contain living will provisions. However, although the United States Supreme Court upheld the Quinlan decision in re Cruzan, it changed the parameters of passive euthanasia. With the Cruzan decision, the Supreme Court held that passive euthanasia was legal but only for competent adults or those who are incompetent but have previously procured a living will. However, if the patient is without a living will and incompetent, it becomes the burden of the family to prove that there is 'clear and convincing evidence' to the effect that the patient does not want to continue living in a vegetative state (Armstrong, 1979).

As to active euthanasia, there has been no Supreme Court ruling determining whether the right to die, as understood in passive euthanasia cases, can be bound over to active euthanasia. The decision is thus left to the individual states. Currently, thirty-one states have criminalized explicitly the act of assisted suicide.

Physician-assisted suicide is generally recognized as illegal under the parameters of homicide, however it is very difficult to meet all of the elements of the crime and conviction subsequently becomes nearly impossible. The fact that the U.S. Supreme Court has not reviewed a physician-assisted suicide case, which would create precedent, constitutes a dilemma for the state courts in that there is no uniform test or ruling by which to decide.

Dr. Kevorkian's role, Sanctity of life- pain and suffering

The Case for Euthanasia, Should