Physician assisted suicide (PAS) is a practice that involves a physician painlessly putting to death someone that is suffering from an incurable and painful disease or a physical disorder. It can be done through the mixture of drugs to create a lethal injection at the request of the patient. Physician assisted suicide has become a debated topic in the recent years as many argue about its legal, moral, and ethical issues. The given scenario involves having PAS being legalized in the state where the physician works. However, the physician firmly objects to this and is not ready to administer the act to any patient. Even after the legalization of PAS, the physician should be firm and defend their ethical point and choose not to engage in the practice even with the changing professional expectation. The reason for the objection is because PAS is unethical as it goes against the basic ethical duty of the physician by not advocating for improved and better care for the patient.
Physician assisted suicide is unethical because it contradicts the basic duty of the physician which is to protect the life of patients and to do no harm. The act of PAS is a process of causing harm even when it is at the request of the patient. Therefore, it violates the ethical principles of beneficence where nurses and doctors should strive to do good and that of non-maleficence which observes that nurses and doctors should strive to do no harm. Although the doctor can let the patient make their own decision and let them choose to end their life, the doctor would not be engaging in an activity that promotes goodness and reduces harm.
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PAS can also be regarded as a wrong answer to the right question from the patient. PAS has mostly been advocated for patients that are facing increased suffering and pain as a result of being terminally ill. Even for such patients, the answer is not always death. Physicians are tasked with the role of striving to improve care even at the end of life. Therefore, while PAS attempts to help the suffering person, it simply eliminates them and this shows how this approach is entirely wrong (Rutledge et al., 2019). The right answer to the question of terminally ill patients facing increased pain and suffering should thus involve the need to improvement medical treatment for terminally ill patients. As a physician, choosing to engage in PAS can thus be regarded as a shortcut to completely cut the provision of care.
PAS also destroys the relationship and trust established between the patient and physician. At the root of PAS is the assumption that some lives are simply not worth living. It shows that one does not have value for life even when one is going through suffering. Acting in an ethical manner would thus involve showing that every life is important even when one is chronically ill or severely disabled. Additionally, the physician-patient relationship is based on the fact that the physician acts as a healer and a comforter but not one that is tasked with the role of taking life. The physician should thus view the request for PAS not as a process to eliminate the patient but as a process to explore the fears and suffering of the patient (Goligher et al. 2017). The physician should foster to improve the relationship with the patient and not agree to the request of the patient for PAS.
One of the objections regarding the view that PAS should be made illegal is that patient autonomy is critical and should always be respected. The view is also supported by the fact that the physician plays a passive role by only providing lethal drugs and the patient then is tasked with making their own decision regarding their life. However, even though autonomy should be respected, one should observe that autonomy is not absolute in itself but should be placed at balance with other ethical principles.
As a physician that objects PAS, an argument can also be made that one should quit one’s profession when they cannot work under a state that has legalized PAS. However, this would be an escapist approach and would not advocate for the care of the patient. The physician should thus be ready to take a firm approach and show that PAS does not align with their practice. De Lima et al. (2017) observe that there should be legal accommodations to physicians to decline PAS when they consider it unethical. Such an accommodation will ensure that the ethical views of the physician are accommodated even when PAS is made legal. While PAS can be made legal, the physician still has the right to decline medical treatment and such a process would not be acting unethically as it would result in the death of the patient.
In conclusion, physician assisted suicide is unethical even though the assistance of the physician could be passive. The given scenario involves PAS being legalized in the state but these contradict with the views of the physician. The analysis showed that PAS is unethical as it contradicts the basic duties of the physician of protecting the life of the patient and striving to do no harm. PAS was also identified as a wrong answer as it acts as a shortcut by eliminating the patient and not providing care. The process also devalues the life of the patient and can hinder the progress of the physician-patient relationship. After PAS has been legalized, the physician should be ready to face legal issues as they take a firm stand against the unethical act.
References
De Lima, L., Woodruff, R., Pettus, K., Downing, J., Buitrago, R., Munyoro, E., ... & Radbruch, L. (2017). International association for hospice and palliative care position statement: euthanasia and physician-assisted suicide. Journal of palliative medicine , 20 (1), 8-14.
Goligher, E. C., Ely, E. W., Sulmasy, D. P., Bakker, J., Raphael, J., Volandes, A. E., ... & White, D. B. (2017). Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues. Critical care medicine , 45 (2), 149.
Rutledge, S., Komrad, M., Kyrillos, E., Lau, T., Leiva, R., Leong, R., ... & Quinlan, J. (2019). Euthanasia and Physician-Assisted Suicide are Unethical Acts. Medical World Journal , 34 .
