This month on the 16th comes the one-year
anniversary of the Colorado End of Life Options Act going into effect. This act
allows “an eligible terminally ill individual with a prognosis of six months or
less to live to request and self-administer medical aid-in-dying medication in
order to voluntarily end his or her life” (1) This act also allows a physician
to prescribe aid-in-dying medication and makes it a criminal act to tamper with
a person’s request for aid-in-dying medication (1). The passing of Proposition
106 made Colorado the sixth state that allows for the legal prescription and
consumption of aid-in-dying medication.
Physician assisted suicide, otherwise referred to as death
with dignity or physician aid-in-dying, is the “act of intentionally killing
yourself with the aid of someone who provides the knowledge or the means to do
so” (2). Physician assisted suicide is different from euthanasia. Euthanasia is
the administering of life ending drugs by a doctor or other individual. This
act is illegal in most the United States, however Colorado has discriminated
it, with other states possibly following suit. In other countries, such as the
Netherlands, Belgium, and Luxembourg allow it under certain restrictions (2).
With the number
of countries and states considering similar litigation allowing physician assisted
suicide, the ethics of physician assisted suicide is once again in the spotlight.
Those that are for physician assisted suicide claim autonomy- the independence
and the right to make their own life, or death, decisions. Supporters say that in many cases, it could
relive physical pain and suffering that would continually worsen for the
patient. Diane Rehm, a former NPR host, is an advocate for physician assisted
suicide after her husband starved himself death in Maryland, a state where physician
assisted suicide is illegal (3). Rehm believes that the way her husband had to
die was inexcusable, and since become a high-profile advocate working with
Compassion & Choices (4). Rehm believes in this cause so strongly that if
asked to testify before congress, she would (4).
While there is support for physician assistant
suicide, opponents argue that helping take lives is ethically wrong. Many
people justify their argument against this legislation on religious grounds. In
the Catholic church, suicide is a one-way ticket to hell. Therefore, many
members of the Catholic church view physician assisted suicide as the ultimate
sin and must therefore be protected against (5). Activists in the disability
community have largely critiqued the language used in the debate (3). Some
claim that the “right-to-die” is discriminatory because “life isn’t worth
living if you’re disabled” (6). There is also concern within the opposition
that legalization now leads to a moral slippery slope. The assumption is that
people will become to quick to use the physician assisted suicide option, or
that the guidelines will become too lax (3).
In the United States, there are no federal laws
regarding physician assisted suicide, thus, states are passing their own laws
(3). With other states following the lead of Oregon, California, and Colorado,
there may soon be pressure to address the rising issue of physician assisted
suicide and euthanasia on a national level.
The idea of physician assisted suicide has been controversially even before the Death with Dignity Act of Oregon was passed in 1994 and had divided the United States (Purvis, 2012). As a future health care provider I can't help but look at the ethical considerations. Physicians must be aware of the four main ethical principles of autonomy, non-maleficence, beneficence and justice. The main controversy of physician assisted suicide seems to be whether the physicians responsibility to do no harm, or non-maleficence, out weights the physicians responsibility to do good for the patient. It must also be considered whether one considers assisting in removing a patient from a state of pain and low quality of life is considered harming the patient. I believe that in a state where physician assisted suicide is legal the ethics must be weighted out for each case.
ReplyDeletePurvis, T. E. (2012). Debating Death: Religion, Politics, and the Oregon Death With Dignity Act. The Yale Journal of Biology and Medicine, 85(2), 271–284.