The art of dying is an integral part of any culture and a quintessential subject of ethnoreligious matters. “Death is an old phenomenon in the history of humanity whose perception differs among different cultures” ( Blank, 2011. pg. 201) . One of the most controversial debated issues in the world today involves Physician-assisted suicide with polarized opinions on whether it should be allowed in the society. Some people feel that this practice is wrong and should not be legalized regardless of the circumstances of a patient. Others argue that “choosing a painless death is more humane for patients with incurable diseases going to immense pain, and it helps families who witness the pain of their loved one” ( Battin, Rhodes & Silvers, 2015. pg. 3) . Some reports have shown that this aided-dying practice may not always work as smoothly as hoped with a lag between ingestion and death, making it harder for families. This fear has been subject to debates among groups supporting or opposing the aid-in-dying practice. However, countries have been adopting aid-in-dying laws to legalize the use of physician-assisted suicide amid the raging debate on their legal and ethical perspectives.
Debate on Physician-Assisted Suicide
The debate on physician-assisted suicide is an essential topic in the United States that concerns all sectors of the population. The discussion is centered on whether individuals with terminal illness can request to die through the help of a physician. Arguments supporting this practice hold that “the government should enact laws that allow aid-in-dying when there is a near-death situation or when a patient has an incurable condition” ( Battin, Rhodes & Silvers, 2015. pg. 5) . For example, a large percentage of patients who die by physician-assisted suicide have cancer and want the procedure to avoid losing their independence, dignity, and enjoyment. In most cases, this debate is centered around the cultural beliefs and customs of people, which influences their position on the discussion.
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Cultural Influence on People’s Attitudes
“Cultural beliefs and traditions may strongly influence decisions made by patients and families” ( Fleming, 2003. pg. 67) . The differences in the perception of death among cultures and religious beliefs form the basis of a discussion regarding physician-assisted suicide. Some cultures argue that assisted suicide gives an impression of some lives being more valuable than others, which goes against the social fabric and definition of life. Other cultures believe physician-assisted suicide attacks the relationship that forms the structure of society as family members may start thinking of it as a solution to their elderly and terminally sick relatives. There are fears that communities may resort to using physician-assisted suicide when they are faced with financial and emotional difficulties in caring for them.
Every culture has a system of health beliefs that influences attitudes towards life and death. Studies have shown that “a person's ethnocultural and social-cultural identity, including the collective values and norms, gives them a unique view of life and death” ( Blank, 2011. pg. 201) . This view is what influences their attitudes towards aid-in-dying practice by physicians for terminally-ill patients. While pain and depression are a crucial factor that influences the decision for aid-in dying, the cultural and religious factors also play a factor in the decisions and attitudes towards this practice. These papers look at the Mexican Americans, African Americans, and Whites' cultural beliefs regarding physician-assisted suicide, as well as how support for aid-in-dying has been increasing in recent years.
Making decisions regarding life and death situations of a loved one is often a problematic experience influenced and motivated by several factors such as race, ethnic, and religion issues. Culture Influences health beliefs in people as well as their attitudes towards certain phenomena due to its deep ingrain into society. According to Blank, 201. pg. 203, “different belief systems and norms of behavior in the community affects people's views of physician-assisted deaths”. These views step from several factors, including the cultural and religious values, political orientations, and the economic situation of a person. Other factors such as gender also contribute to their attitudes towards physician-assisted suicide, with reports showing that “women and more-religious patients are opposed to the practice” ( Fleming, 2003. pg. 69) . The views also change when a person becomes older and have experiences related to death due to higher self-reported levels of spirituality.
Studies have also shown that people’s attitude towards healthcare is determined by their cultural affiliations. In most cases, the opinions of patients towards aid-of-dying practice is based on the cultural interpretation of the situation. “Western values, in particular, favor the idea of accommodating the patient's wishes in dying if they are reasonable enough” Perkins, Cortez & Hazuda, 2009. pg. 1245 ) . This is reflected in the cultures of Euro-Americans and the Caucasians; since they support the decision to relieve patients of the pain and suffering from terminal illnesses. In western society, “physicians sanitized dying and made it more acceptable to the survivors of the deceased” ( Kelly & McLoughlin, 2002. pg. 278).
Cultural Views of PSA in the United States
In the United States, the ethnic minority groups are most opposed to this practice of assisted suicide compared to the Caucasians who are the white majority. A majority of white Americans have supported the idea of physician-assisted deaths due to their cultural beliefs. In contrast, “the black American culture appears to be oppose any idea of assisted suicide than the whites due to their strong religious affiliations” ( Fleming, 2003. pg. 68) . In most cases, Catholicism holds a lot of sway in Latin America, which means their views on the issues are reflected throughout the area. “Catholicism remains resolutely opposed to suicide and euthanasia, and it vehemently opposes the use of this practice as it interferes with patient’s opinion regarding their lives” ( Battin, Rhodes & Silvers, 2015. pg. 7) . However, this is an exception to Mexican Americans who are part of the minorities but tend to support the practice as reflected in the States passing aid-in-dying laws.
Most cultures opposing aided suicide believe it is morally wrong since there is no right to die. Other religions hold that physician-assisted suicide rips apart the social fabric of the nation by promoting the idea that some lives are more valuable than others. Such values believe the appropriate response to human suffering loves care and solidarity as opposed to assisted suicide. In this sense, the cultures advocate for counseling and protecting the sick as opposed to aided death that is hostile to human life. For example, “African Americans believe the use of assisted suicide creates controversy regarding patients who quality to be assisted in avoiding death or those assisted to die “( Blank, 2011. pg. 206) . Factors such as patient's age and the extent of their terminal condition come into play when discussing physician-assisted suicide for patients.
Studies have also demonstrated that African American culture does not support the use of physician-assisted suicide than those from European backgrounds due to significant social factors such as family and religion ( Tsou, 2013. pg. 465) . Several reason are given for this position, including an assumption that African Americans value the control of their lives and would not allow other people to determine their fate, and that they are rarely self-destructive. “The lack of trust may still be an important factor as well as the tendency for strong religious preferences in the African-American population” ( Fleming, 2003. pg. 71) . For African traditions, death, like life, is a sacred part of their customs and no one has a right to die through suicide. At the same time, African Americans are vehemently against aided suicide due to the history of the Tuskegee Experiment and the distrust of the medical system.
Cultural Interpretation of PSA
Different cultures have different interpretations assisted suicide because people identify and define themselves by their cultural and religious groups. As a result, there are wide variations between people of different ethnic, racial, religious, and cultural backgrounds, including their approach to physician-assisted suicide. “In some cultures, it is a taboo to openly talk about death and dying because it is considered disrespectful, lousy luck, and causing loss of hope” ( Blank, 2011. pg. 201) . As a result, bringing up the issue of aid-in-dying is not accepted in such cultures. For example, “Asian religions such as Filipinos forbid talks of dying because of the beliefs and are likely to oppose this practice” ( Fleming, 2003. pg. 71) .
In other cultures, the perceptions of physician status and past healthcare experience inform their decisions regarding physician-assisted suicide. African Americans were victims of racial discrimination, with the most notable example being the Tuskegee syphilis experiment conducted on blacks. This experiment led to the death of many people and affected the trust that black people have with American healthcare. As a result, most “African Americans do not trust health care professionals due to their lack of respect and devaluation of the African Americans” ( Kelly & McLoughlin, 2002. pg. 278) . In other instances, African Americans do not trust physicians to have goodwill when advising for aid-in-dying. They have the highest degree of distrust in the American health system, thus making it challenging to engage the patient regarding this decision. As a result, “the physician must pledge to match the care to family and patient beliefs regarding death” ( Perkins, Cortez & Hazuda, 2009. pg. 1245 )
The perception of pain is another cultural consideration when speaking about aid-in-dying since cultural beliefs shapes how individual measures and perceive pain. “Some cultures believe it is weak for a person to ask for relief out of pain, avoids public display of emotion, and may not agree with assisted suicide as a leeway out of the pain” ( Tsou, 2013. pg. 465) . At the same time, Latinos in the United States are attributed to having more pain sensitivity and low tolerance than non-Hispanic whites. This means they are likely to support the use of aid-in-dying to get rid of the pains and gain some relief.
The role of religion and faith is also a crucial influencing factor when speaking about aid-in-dying. Different religions have their reservations regarding suicide and their place in humanity. Nearly all religions preach against taking of a person’s life through any form whatsoever due to their religious beliefs and customs regarding sacred human life. Studies have shown that “people who are strongly religious are less likely to support aided suicide by physicians” ( Blank, 2011. pg. 207) . This is because most faith traditions have a negative attitude towards suicide, and religious societies still do not support the act of deliberately hastening death. For example, Christianity traditions prohibit any form of suicide and condemn individuals who die through suicide. Islam and Jew religions, among other faiths, oppose suicide, which is why overly religious participants opposes this practice. As a result of these religious affiliations, blacks are less likely to envision asking for patient-assisted suicide due to their strength of religious commitment. Most black people are known to be overly religious compared to the whites due to their history with slavery, and this has translated to their attitudes and beliefs about societal things.
Physician-Assisted Suicide Law across Countries
Apart from cultures, the issue of physician-assisted suicide also varies across countries and states around the world. “Attitudes regarding death and dying may vary considerably between countries” ( Fleming, 2003. pg. 67). Different countries around the globe have changed laws regarding this whole issue of physically-assisted suicide, including who may request for it, what prognoses they must have, and how old a person must be to request for the aid. There are also discrepancies regarding how doctors administer the death-dealing medicines, whether a person takes them himself or the doctor is responsible for managing the drug. Today, several countries are accepting physician-assisted suicide as it becomes possible for patients to make decisions regarding their way out of this world.
Switzerland was one of the very few countries that allowed assisted suicide in healthcare, a decision that has been taken up by numerous other countries. Countries such as Belgium, Netherlands, Colombia, Luxembourg, and Canada have also legalized the use of physically-assisted suicide in cases where it is appropriately needed. For example, Canada passed laws that allowed patients to decide towards assisted suicide in limited circumstances. “Euthanasia and physician-assisted suicide has also been tolerated and practiced openly in the Netherlands over 20 years” ( Fleming, 2003. pg. 70). Several States in American have also permitted this practice in healthcare, including California, Washington, Montana, Vermont, and Oregon states.
The aid-of-dying law as passed in some parts of the United State allows patients to stop life-sustaining treatments through the help of physicians. The practice is described by “a physician prescribing a suicide pill for a patient who is in a near-death situation” ( Blank, 2011. pg. 210) . Arguments for physician-assisted suicide around the world believe human beings of sound mind should be allowed to choose any avenue of evading the pain and burden associated with their terminal conditions, even if it involves death. Columbia has been the latest country to legalize this practice among countries moving with the wave. This decision is a big deal considering the culture of Hispanics towards death. However, the United Kingdom still criminalizes assisted suicide in healthcare, as the country is yet to legalize its usage.
Changing Views Regarding PSA
There seems to be a cultural change in the attitudes of individuals regarding physician-assisted suicide in recent years. Cultures that were strongly opposed to this practice have been having a change in mind as several countries and states legalize its use. Factors such as the aging population, increase in deaths from terminal diseases as well as expected deaths from these conditions such as cancer and AIDS have played a role in the cultural changes and perceptions. At the same time, activists have been agitating to expand as opposed to prevent physician-assisted suicide by calling on states and governments to legalize this practice. “The most crucial benefit of this aid-in-dying practice is its ability to transform end-of-life care the same way it changed childbirth care” ( Callinan , 2018. Pg. 1 ) .
Questions over euthanasia and assisted suicide are raised based on its legal and ethical status. “There are further clinical, ethical and legal issues that complicate the issue of PAS in psychiatric rather than medical practice” ( Kelly & McLoughlin, 2002. pg. 279) . Until recently, the practice has been considered too controversial for legislatures to tackle, but this has been changing gradually. States and countries are today implementing aid-in-dying laws that allow conversations around this pressing societal issue. These laws improve care by prompting conversations between patients and doctors regarding the practice. “In the United States public and professional sentiments lean in favor of legalization for aid-in-dying method” ( Fleming, 2003. pg. 70) .
Conclusion
Cultural and religious factors play an essential role in understanding the attitudes towards physician-assisted suicide. This is often a sensitive subject of debate that comes down to cultural beliefs and their traditions regarding death. Recently, the use of the aid-in-dying practice is increasingly becoming accepted within medicine as countries and states. There is a growing global movement towards acceptance of assisted suicide for extreme health conditions such as terminal illnesses ( Fleming, 2003. pg. 69) . However, as more countries pass the aid-in-dying laws, there is need to consider the cultural beliefs and traditions of people and their influence of attitudes towards physician-assisted suicide. For example, while Americans share some beliefs about the physician-assisted dying, they differ by the ethnic group over theories about the practice.
References
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