Clinically assisted suicide triggered an intense debate around autonomy and the right of people to choose the type and manner of dying. The practice incorporates the supply of lethal dose of drugs to terminally ill persons. Euthanasia emanates from the modernist view of suffering as a disgrace in modern culture. The subject led to formulation of state laws in different states such as Death with Dignity Act of Washington, End of Life Options Act in Colorado and California, and Patient Choice at the end of Life Act in Vermont (Preston, 2017). In these states, for an individual to be declared as legitimate for euthanasia, he must meet particular legal criteria. Medical professions are tasked with doing good deeds and minimizing harm. A vivid exploration of the nuances of euthanasia opens up a debate on the soundest position of the physician. Notably, physicians are entrusted with safeguarding patient health. The primary issue at stake is whether the practice of ending life according to the wish of the patient can be part of the medical practice. A detailed analysis of euthanasia reveals that the most appropriate choice for physicians is to avoid involvement in the procedure.
The idea of euthanasia emerged in Europe in the Darwinian Theory of survival of the fittest and utilitarianism. The emerging literature of that time, including Alfred Hoche and Karl Binding “article “Permitting Destruction of Unworthy Life” introduced the ideas of eliminating lives presumed to have no value and perceived to be societal burdens. The publication became the landmark for the subsequent euthanasia program that led to supervised killing through lethal injections. Lives of several people, especially the mentally ill adults, disabled people, infants with mental retardation and congenital disabilities as well as those that were terminally ill, were exterminated. Surprisingly, it was expanded to children with antisocial behavior and patients in psychiatric institutions. When lethal injection lost popularity, patients were transferred to examination hospitals to be injected in a medical economics impetus. Eventually, the dictatorial regime, the Nazi government took advantage and engaged in impersonal and automatic killing leading to the Holocaust. Interestingly, all along, the physicians supervised the extermination.
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From history, the roles of sorcerers and healers were similar. In other words, the people who practiced sorcery had the power to heal and kill. With the advent of Hippocratic Oath in 500 BC (Vizcarrondo, 2013) ), the physicians were called to commit to higher standards of ethics. The oath of Hippocrates was the first attempt by physicians to create a set of ethical standards to guide the practice of medicine. The principles posited physicians as healers rather than spreaders of death (Pimum non nocere) hold in today’s medical practice. In particular, caregivers are required to dedicate their lives to save the life under all circumstances, regardless of intellect, age, and rank. More so, the professionals are tasked with respecting the integrity of the patient in all dimensions, including confidentially, life, and sexuality.
Presently, moralists support euthanasia and clinically-assisted suicide on the grounds of autonomy and sympathy. Concerning independence, the people allege that the moral standard of freedom is key to making decisions in healthcare and overrides all other ethical standards and in the medical profession. Therefore, the patient’s decisions about choosing the place, time, and manner of death should be respected by caregivers. For them, a good death is as important as a good life. Given this, asking for assistance with the death process aims at aiding peaceful and dignified death. Besides autonomy, those who support clinically-assisted suicide cite the ethics of compassion. However, it is important to note that the role of physicians should be limited to the dispensation of medication and monitoring their progress to alleviate pain. In light of this, euthanasia diverts the physician’s primary functions as guardians of life by permitting them to end their patients’ lives under their care (Roberts & Siegler, 2017) . Choosing to become a physician is at the sole discretion, hence adherence to the rules of providing medical services is mandatory. Ordinarily, patients put themselves in the hands of physicians with the belief that the professionals are committed to protecting life, which signifies trust. Engaging in clinically supported suicide is a sign of failure to acknowledge that the practitioner’s choice illuminates character, and in this case, it portrays a negative image of the untrustworthiness of medical professionals.
Concerning sympathy, Foley (2002) alleges that genuine compassion is achieved by suffering from the patient sharing his burdens rather than taking an innocent life. The desire for death emanates from stress, especially from anxiety and discomfort that a person experiences when he is experiencing distress. Relieving the pain and suffering using alternative means of care can facilitate dignity and comfort. The care acts as a proof for love and cares that physicians have for their patients. One of the unique human capacities to react, confront and succumb to suffering and pain as well as death. When such an attribute is suppressed, sympathy, compassion, solidarity, and heroism end as well. People that propose euthanasia are primarily those that have not confronted such pain. The ability to have such feelings connects people, including those that are dead.
Traditionally, the objectives of medicine are restoring health and reliving people from suffering. Such notable ideals have been a driving force behind medical research, which has paved the way for the discovery of novel therapeutic options. A decision to abandon such conventional goals to help the patients with existential suffering and resorting to assisting them to commit suicide can be deemed tragic. Existential suffering is when a patient is in a debilitating state that warrants all the care and compassion that medicine can offer. Then again, such a state is neither an ailment nor pathological process. Instead, it implies that the patient is not capable of finding meaning in their suffering leading to lack of hope for life and transcendent aspect of existence. When such patients cry for help, restoring the lost hope and purpose of life is more critical than terminating their lives. Before the surrender, the physicians have an option of seeking therapies cantered on life meaning, hope, dignity, and supportive-expressive treatments. Additionally, using the moralist view to support euthanasia is erroneous since imposing external laws on the profession leads to a compromise. As an illustration, in sports, soccer rules are determined by FIFA (Albaladejo, 2019) . Similarly, therapeutic procedures should be left to physicians rather than moralists. That is to say; medics should stick to their traditional roles of protecting life no matter the level of suffering of the patient. Otherwise, incorporating clinically-assisted suicide in medical practice requires a radical redefinition of the medical profession.
In the whole, involving physicians in euthanasia and clinically-assisted suicide is inappropriate. The principles of safeguarding health must guide the relationship between the patient and the physician. That is to say, the deep respect for the patient life must rank above the autonomy of the patients. In the same breadth, respect for life must rank above physician beneficence. While, healthcare professionals are obligated to respect choices made autonomously, including those involving life and death, autonomy, conflicts with other moral principles of no-maleficence, and beneficence. Above all, the admissibility of clinically assisted suicide erodes the confidence that patients have for doctors.
References
Albaladejo, A. (2019). Fear of assisted dying: could it lead to euthanasia on demand or worsen access to palliative care?. Bmj , 364 , l852.
Foley, K. (2002). The case against assisted suicide: for the right to end-of-life care . JHU Press.
Preston, R. (2017). Physician-assisted suicide—a clean bill of health?. British medical bulletin , 123 (1), 69-77.
Roberts, L. W., & Siegler, M. (2017). End-of-Life Care. In Clinical Medical Ethics (pp. 307-363). Springer, Cham.
Vizcarrondo, F. E. (2013). Euthanasia and Assisted Suicide: The Physician's Role.
