Physician-assisted death brings up moral, ethical, and legal questions.
Source: Couleur/Pixabay, used with permission
Although September is designated National Suicide Awareness Month, there are those who are thinking about suicide 12 months of the year. They may be survivors of suicide loss—the family and friends of those who have taken their own lives—or they may be people who often contemplate suicide or have already made attempts. Articles and anecdotes of suicide published during the month of September and, at other times, most often focus on prevention. But there’s another side to the story.
Many people believe that ending one’s own life is a human right, particularly for those who are terminally ill and suffering from indescribable pain or impairment. In the United States, however, it is only a right for those in one of nine places where physician assisted death is now legal when strict guidelines are followed. In Oregon, Washington, Vermont, Maine, Hawaii, California, Colorado, New Jersey or the District of Columbia, eligible, terminally ill patients can legally seek medical assistance in dying from a licensed physician. And in all of these areas, a physician can decide whether or not to provide that assistance. At the same time, many states—Alabama, Arizona, Georgia, Idaho, Louisiana, New Mexico, Ohio, South Dakota and Utah—have, in recent years, strengthened their laws against assisted suicide. In 2018, for instance, Utah amended its manslaughter statute to include assisted suicide.
In a nutshell, it works like this: The patient orally requests legal medical assistance in dying from a qualified physician. That physician must assess and confirm the patient’s eligibility and also inform the patient of alternative treatments that provide pain relief or hospice care. At that point a second physician must confirm the patient’s diagnosis and mental competence to make such a decision. If deemed necessary, either physician can require the patient to undergo a psychological evaluation. The patient must then make a second oral request for assistance. Once approved, the original physician writes a prescription for lethal medication (usually a high-dose barbiturate powder that must be mixed with water) that the patient can self-administer when and where they choose, as long as it is not in a public place. Some people never fill the prescription or, they fill the prescription but never take the medication. Those who do generally fall asleep within minutes and die peacefully within a few hours.
Several organizations exist that both support and oppose physician-assisted dying for moral, ethical and legal reasons. Groups such as Death with Dignity and Compassion and Choices are in favor of what they like o call “medical aid in dying” and work to provide assistance and lobbying efforts to initiate legal “right to die” programs in every state. They support patient autonomy and choice, particularly in the case of terminal illness. To these groups and their supporters, most of whom come to this side of the issue as a result of agonizing personal experience, death with dignity is a human rights issue and those who are suffering are entitled to a peaceful death.
On the other side of the debate, groups like the Patients Rights Council and Choice is An Illusion work to tighten laws against euthanasia and medical aid in dying. They fear a complete lack of oversight at the moment of death, as well as normalization of the process to the degree that patients will feel they must relieve their families of the burden they are inflicting by living with their illness. They are concerned that decisions will be made by others on behalf of those who are too ill to speak for themselves. These groups believe the job of a physician is to find ways to eliminate their patients’ suffering, not to eliminate the patients themselves. They do not believe a physician is qualified to make the decision to assist in ending a life.
In the end, no group really wants assisted suicide to be the final answer, but those who favor medical aid in dying see little recourse for those who are living with unbearable chronic pain, who are terminally ill, and who have no hope of improving the quality of their lives because medical science has not yet caught up with our modern potential for longevity.