Implications of Physician Assisted Suicide

Euthanasia, more commonly referred to as physician assisted suicide, is the act of "intentional termination of life by another at the explicit request of the person who dies" (Robinson, 2002). There is much debate over whether or not the act of physician assisted suicide should be legal and whether or not it is ethical or not. As with any controversial debate, there are at least two viewpoints on this issue. First, there are some important terms that must be laid out.

Passive euthanasia is the act of letting nature take its course by changing or removing some form of support, such as removing life support, taking away medications, taking away food and/or water to let the patient starve to death or become dehydrated, and not giving CPR or other courses of revival when the heart stops (Robinson, 2002). Passive euthanasia can be broken down into two separate groups, passive voluntary euthanasia and passive involuntary euthanasia (Wall, 2003). Passive voluntary euthanasia is the act of removing or stopping treatment at the request of the patient, and passive involuntary euthanasia is the act of removing or stopping treatment at the request of someone other than the patient (Wall, 2003).

Another example of passive euthanasia is giving the patient large doses of morphine to control pain, even if it is a known fact that the dose delivered can cut of respiratory function and cause death sooner than it may have otherwise happened (Robinson, 2002). The different procedures of hastening death are done on terminally ill patients who are suffering, and also on individuals who are in a vegetative state (those with brain damage who are in a coma with no chance of regaining consciousness)(Robinson, 2002).

Active euthanasia is the act of killing a person through some direct form as a request from the patient (Robinson, 2002). Once again, Wall breaks this down into two categories. Active voluntary euthanasia is the act of intentionally killing the patient at the request of the patient themselves and active involuntary euthanasia is the act of intentionally killing the patient at the request of somebody other than the patient (Wall, 2003).

Physician assisted suicide can definitely be a complicated issue, which is probably why there is so much debate over it. Terminally ill patients have many reasons for wanting to end their life by this form of suicide. One reason may be that they know they are suffering a terminal disease and do not wish to incur the medical debts associated with trying to keep them comfortable (Robinson, 2002). Some feel that their disease has largely affected their quality of life and they no longer wish to continue living (Robinson, 2002). When patients come to the decision that they wish to end their life, some of them turn to their physician for aid in doing so, rather than simply doing it themselves. Physician assisted suicide helps the process by allowing them to die under the conditions and at they time they wish to (Robinson, 2002). The only state in the United States where physician assisted suicide is legal is in Oregon, and then only under strict guidelines (Robinson, 2002).

The Death with Dignity law in Oregon went into effect in 1997 and it allows some terminally ill patients to request the assistance of their physician to commit suicide (Robinson, 2002). The Death with DignityAct allows physicians to aid in the death of a requesting patient by prescribing a lethal dose of medication (FAQs about physician assisted suicide). This act was a citizens' initiative that passed twice by Oregon voters, first in November 1994 and then again in October 1997. During the general election that same year, there was a ballot to repeal the Death with Dignity Act but voters chose to keep the act with a margin of 60% to 40% (FAQs about physician assisted suicide). Patients wanting to participate in physician assisted suicide must be "18 years of age or older, a resident of Oregon, capable of making and communicating health care decisions for him/herself, and diagnosed with a terminal illness that will lead to death within six months" (FAQs about physician assisted suicide).

Probably one of the most common connections to physician assisted suicide is the news coverage of Dr. Jack Kevorkian, a Michigan physician. In the early 1980's, Kevorkian published many articles outlining his beliefs on euthanasia and the ethical implications. He outlined his proposed system of planned deaths in suicide clinics, including medical experiments on patients (Wikipedia: Jack Kevorkian, 2006). He got much public attention due to his articles and the American media labeled him as "Dr. Death" (Wikipedia: Jack Kevorkian, 2006).

In 1987, Dr. Kevorkian advertised himself as a consultant for death counseling in local Detroit papers. Kevorkian assisted in the suicide of more than 100 terminally ill patients between 1990 and 1998, of which all were considered voluntary euthanasia because the patients took the final action themselves (Wikipedia: Jack Kevorkian, 2006). Kevorkian only assisted the patients by hooking them up to the machine he had made, and the patients then pushed a button which administered the lethal dose of drugs or chemicals which would in turn end their life (Wikipedia: Jack Kevorkian, 2006). Two of these deaths were due to a device with a needle which delivered the drugs through an IV needle, but most others were assisted by a gas mask that was fed by carbon monoxide. The first was deemed the "Thanatron" (death machine) and the latter was called the "Mercitron" (mercy machine) (Wikipedia: Jack Kevorkian, 2006). The Mercitron became necessary because after the first two deaths by IV needle, Kevorkian's license was revoked and he could no longer get the drugs needed to run it (Wikipedia: Jack Kevorkian, 2006).

Kevorkian allowed a video tape of the voluntary euthanasia of Thomas Youk to be shown on the November 22, 1998 broadcast of 60 Minutes. Youk was an adult male in the final stages of ALS (Lou Gehrig's disease) with full capability of his actions, although it was Kevorkian himself who administered the lethal injection which in turn cased the death. This is the case that brought Kevorkian to trial, represented by Geoffrey Fieger, because people became skeptical of his treatment due to the fact that Kevorkian had caused the death rather than Youk himself (Wikipedia: Jack Kevorkian, 2006).

Prior to the Youk incidence, Kevorkian was tried many times for assisted suicide in the courts of Oakland County, Michigan but was always acquitted (Wikipedia: Jack Kevorkian, 2006). He actually gained many supporters during this time. On March 26, 1999 Kevorkian was charged with second-degree murder due to delivering a lethal injection to Thomas Youk (Wikipedia: Jack Kevorkian, 2006). He is currently in a Michigan prison serving a 10-25 year sentence and was denied parole on December 22, 2005. He claims that if he is granted parole (eligible in 2007) that he will not work to help people die but instead will work to change the laws regarding physician assisted suicide (Wikipedia: Jack Kevorkian, 2006).

I used to be completely against assisted suicide, but that was before I really knew what it was. Wall goes into a lot of detail on the pros and cons of each viewpoint in the chapter on physician assisted suicide, and it only reinforced my beliefs. I think that a lot of thought and consideration goes into the decision, but I think it can be the right decision for the patient if it is truly what they want, and if they meet the criteria. If a person is suffering from pain, often times medication can help ease that, but they are still in emotional turmoil and distress. I am not saying that it is right or that it is wrong, only that it should be looked at more closely and not looked down upon without further knowledge of what it truly is.

References

FAQs about physician assisted suicide. (n.d.). Retrieved Mar. 26, 2006, from Physician Assisted

Suicide Web site: http://oregon.gov/DHS/ph/pas/faqs.shtml.

Robinson, B. (2002). Euthanasia and physician assisted suicide. Retrieved Mar. 26, 2006, from

Euthanasia and Physician Assisted Suicide Web site: http://www.religioustolerance.org/euth1.htm.

Wall, T. (2003). Thinking critically about moral problems. Belmont, CA: Thomson Learning.

Wikipedia: jack kevorkian. (2006). Retrieved Mar. 26, 2006, from Wikipedia: Jack Kevorkian

Web site: http://en.wikipedia.org/wiki/Jack_Kevorkian.