Outline
Thesis: Is physician-assisted death ethically correct or a statement of moral obligations of physicians slacking in their duty and capacity to put efforts of improving health outcomes of patients?
Introduction
Contentious issues that have multi-opinionated perceptions trigger more personal subjective thoughts that influence support or opposing arguments about an issue.
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Supporting arguments give almost reasonable reasons for backing up the cause particularly due to the physical, financial, and emotional drain it has on patients and their families.
On the other hand, opposing arguments provide justifiable motives that eliminate medical involvement in aiding people to commit suicide.
Ethical Issue
While others maintain a strong stance on not having the authority to choose how to die, some argue that there is nothing wrong with physician-assisted deaths.
Clarifying Concepts
Morality is personal while ethics has a public consideration to it.
Physician-assisted deaths are recognized as the intentional act of killing with the aid of a physician after a patient gives consent
Possible Solutions
Fears could be addressed in advocacy in compassionate attention such as hospice and palliative care.
Ethical conflicts could be solved by having clear and understandable laws that allow individuals to exercise their rights freely without putting anyone in a dilemma.
Gather Information
The public has been gradually accepting the new trend with the defense of respecting individual rights to die.
The main argument lies with the principle of autonomy where patients have the right to make any medical decisions as long as they are competent to do so.
Analysis of the Assumptions
Supporters of the aided deaths argue that patients who are terminally ill go through a lot of pain and suffering with no hope of recovery.
From a clinical perspective, allowing patients to take their own lives permits physicians and other medical providers to commit their time and resources towards helping others who have a better chance of recovering.
In contrary, Anderson (2015) argues that physicians should not be legally or ethically allowed to help patients take their own lives.
The weak and vulnerable would be endangered when provided with a shortcut to ending pain through death.
Allowing physician-assisted deaths may also cause religious conflicts since some of the faiths believe that it is a sin to take one’s own life.
As a critical point to highlight, allowing physician-assisted deaths would permit doctors to give up on patients even when there is a chance of cure.
In my view, terminally ill patients or the disabled persons should not in any way be criminalized in their attempts to take their own lives.
However, despite the suffering and fear associated with terminal illness, doctors should not aid patients in ending their lives.
Moral Reasoning
For many, utilitarianism ethics support the argument of allowing physician-assisted deaths as it brings more happiness and good as opposed to negative results.
However, deontological ethics argues against consequences of actions defining what is morally right and wrong.
In this case, opposing to physician-assisted deaths is ethically right under deontological ethics.
Consequences
As a contentious debate that has been present for years, not legalizing physician-assisted deaths would encourage public trust in the system with the aim of preserving and valuing life as a critical sphere of our living.
More resources have to shift towards research and development in seeking alternative ways of bringing comfort to patients or curing terminally ill conditions.
At the same time, the healthcare society has to struggle in getting hospice and palliative care right and effective.
Physician-Assisted Suicide
Controversial topics more often than not tend to spark debates from the public as well as various institutions. Contentious issues that have multi-opinionated perceptions trigger more personal subjective thoughts that influence support or opposing arguments about an issue. Supporting arguments give almost reasonable reasons for backing up the cause particularly due to the physical, financial, and emotional drain it has on patients and their families. On the other hand, opposing arguments provide justifiable motives that eliminate medical involvement in aiding people to commit suicide. After all, healthcare’s main aim is to maintain and improve the quality of life without devaluing it. Therefore, is physician-assisted death ethically correct or a statement of moral obligations of physicians slacking in their duty and capacity to put efforts of improving health outcomes of patients.
Ethical Issue
One such belligerent topic has been physician-assisted deaths that have attracted numerous ethical concerns across the world. While others maintain a strong stance on not having the authority to choose how to die, some argue that there is nothing wrong with physician-assisted deaths. Despite ethical prohibitions, legalization of the issue has grown in recent years as people are gradually accepting the trend. As one of the most compelling issues in healthcare, critics argue that legalizing physician-assisted deaths damages trust within the system and potentially alters the role of medical professionals in the field ( Sullivan & Taylor, 2018). How people live, die, and are cared for when deciding on ending life has significant implications for not only individuals and their families but also the society as a whole.
Clarifying Concepts
Morality depends on our cognitive dimensions and thought processing that enables conceptualization of what is right or wrong thereby governing our conduct. On the other hand, ethics refers to the ideals or established standards that govern behavior. In this case, the expression of ethics is grounded on the set standards of physician practice and constitutional rights of individuals regarding the issue ( Payne, 2016) . Therefore, moral beliefs are not the same as ethical considerations in choosing the end of life. Morality is personal while ethics has a public consideration to it.
On the other hand, physician-assisted deaths are recognized as the intentional act of killing with the aid of a physician after a patient gives consent. In this case, doctors can provide means for people to take their own lives after meeting certain criteria ( Sullivan & Taylor, 2018) . In other words, patients can take their own lives if they are terminally ill and have physical and mental capacities to make sound decisions. In most cases, patients are often terminally ill or disabled while facing severe pain and suffering. While this may be based on their moral responsibility of helping patients eliminate pain and suffering, it conflicts with the ethical responsibilities of physicians exercising beneficence.
Possible Solutions
The sympathy and support of physician-assisted suicide could be understood and misguided. The concept is driven and propelled by the fear of pain, isolation, technology, loss of independence, as well as impoverishment. In most instances, pain cannot be controlled, and illness brings loneliness. As a result, fears could be addressed in advocacy alongside the right action instead of heightening powerlessness and despair associated with being sick. Care should be reflected in a positive manner to dispel any fright or confusion that may contribute to wanting to end life ( Sullivan & Taylor, 2018) . In the same regard, pain could be controlled to manageable levels through aggressive pain therapies, therefore, eliminating despair or fear of having a physical and psychological intolerance to pain. On the other hand, the isolation that accompanies illness could be reduced by gaining support from families and community members.
Additionally, dependency and loss of control that patients fear could be reduced through a comprehensive education and awareness program that encourages patients to fight on. Most importantly, the ethical conflicts could be solved by having clear and understandable laws that allow individuals to exercise their rights freely without putting anyone in a dilemma ( Sullivan & Taylor, 2018) . This means that the law should emphasize living wills or powers of attorneys for patients in the event of incompetency due to an illness. This would create autonomy and reduce the burden of healthcare professionals in making difficult decisions that may question their moral standpoints and work ethics ( Sullivan & Taylor, 2018) . For those who fail to have formal wishes written down, the law should allow loved ones to make care decisions. However, physician-assisted deaths should demonstrate heroic efforts of trying to save an individual’s life. At the same time, the law should ensure that all medical options of treatment have been exhausted before enabling patients to take their own lives ( Sullivan & Taylor, 2018) . Hospice care should also be availed at affordable costs to patients who have a terminal illness in order to reduce the fear of dependency or overburdening family members with their illness.
Gather Information
Since the legalization of physician-assisted deaths in Oregon for patients who are terminally ill in 1977, the public has been gradually accepting the new trend with the defense of respecting individual rights to die. The Death with Dignity Act enacted in the state allowed terminally ill patients to end their life if they had a 6-months timeframe to live ( Sulmasy & Mueller, 2017) . Since the notion of the mercy killings embarked, there are still sharp and divided opinions on whether the process is legal , ethical, or morally right. Within the context of providing palliative and hospice care to terminally ill patients and the disabled, a few U.S. jurisdictions have legalized the process. Despite the American College of Physicians having some of its members openly practicing t he process, it does not support the validation of the physician-assisted suicide.
The main argument lies with the principle of autonomy where patients have the right to make any medical decisions as long as they are competent to do so. Therefore, respect of autonomy in the medical profession forces care providers to permit the wishes of patients at the end of life to be realized. As a result, the public fears that allowing physician-assisted deaths would be an ethical slippery road with no clear boundaries of how the process should be applied ( Sulmasy & Mueller, 2017) . As it is, people with terminal illness are losing reasons as to why they should fight on in finding treatment to the issue. The fear of losing autonomy surpasses pain, depression, lack of social support, as well as financial demands. At the same time, the ethical dilemmas on whether to respect patient autonomy or breach their professional oath continue to mount.
Analysis of the Assumptions
Supporters of the aided deaths argue that patients who are terminally ill go through a lot of pain and suffering with no hope of recovery. As a result, the right to die should be a basic human right that is similar to refusing treatment. Also, they believe that assisting a terminally ill to die peacefully according to their wishes prevents them from watching their deterioration and suffering from their loved ones ( Richards, 2017). Perhaps the most populous reason that supports the process is the decrease in health care costs to both individuals and the care system.
From a clinical perspective, allowing patients to take their own lives permits physicians and other medical providers to commit their time and resources towards helping others who have a better chance of recovering. Preventing a person’s right to life also violates religious freedom in maintaining the value of human life. Additionally, allowing the deaths would protect both physicians and patients from public scrutiny and possible legal lawsuits that may oppose their actions ( Richards, 2017) . Finally, supporters believe that permitting the process prevents patients from taking their own lives in horrific ways that would result in trauma to the patient and the family.
In contrary, Anderson (2015) argues that physicians should not be legally or ethically allowed to help patients take their own lives. This is because physicians and other medical professionals would violate their Hippocratic Oath that every doctor must accept before being licensed to practice. The oath bounds doctors to preserve human life with every effort to ensure the sufficient care is offered to patients. In the same regard, assisting patients to commit suicide devalues human life thereby opposing their founding principle of encouraging them to get better regardless of their situation. Instead of discouraging people from taking their own lives , physician-assisted deaths places no value over human life. The dignity and equality attached to human life would be betrayed and lose its critical importance before the law .
The weak and vulnerable would be endangered when provided with a shortcut to ending pain through death. Instead of seeking ways of medical treatment or other therapeutic means of reducing suffering, Anderson (2015) asserts that the practice of medicine would be corrupted. The doctor-patient relationships would also be compromised as there would be no point of encouraging and giving hope to the sick. In the same manner, intergenerational commitments would be broken as loved ones would be forced to comply with the legality of patients’ wishes of dying. Suffering and pain experienced by terminally ill patients would be managed and controlled through the provision of compassion and support. Physicians should, therefore, not help patients take their own lives. Instead, they should dignify their deaths through natural causes.
Allowing physician-assisted deaths may also cause religious conflicts since some of the faiths believe that it is a sin to commit suicide. According to Beaman & Steele (2018), legal enforcement of constitutional laws has shifted from the significant influence of religion when making policy decisions. In most cases, religion determines how hoe physicians carry out their practice. While human life is considered important, many religious institutions disagree with the physician-assisted deaths. This is because many believe that human life is divine and precious to be determined by humans. Only divine authority has the right to decide who lives and who does not.
As a critical point to highlight, allowing physician-assisted deaths would permit doctors to give up on patients even when there is a chance of cure. In some instances, misdiagnosis and not providing the right type of care would deteriorate a patient’s health and hope of recovery. Cure may be availed at the last minute despite the long wait. Allowing the killings also threatens the integrity of the healthcare systems. Political pressure and insurances will force physicians not to perform heroic medical measures with the aim of saving costs ( Sulmasy & Mueller, 2017). As a result, the value of human life would be controlled by not only doctors but also politics, corrupt family members who are money-oriented and insurance companies.
In my view, terminally ill patients or the disabled persons should not in any way be criminalized in their attempts to take their own lives. The pain and suffering they go through both physically and emotionally cannot be well understood by those who have not gone through the same. While certain religious prohibitions may hinder the deaths, it could be argued that certain circumstances would justifiably contribute to the mercy killings.
However, despite the suffering and fear associated with terminal illness, doctors should not aid patients in ending their lives. The Hippocratic Oath is a serious moral and ethical vow that binds doctors to preserve life. The authoritative influences and possibilities of encouraging patients to end their own lives are overwhelming and could contribute to unnecessary killings or premeditated murders. The ethical dilemmas of doctors would tend to lie one side that is mainly not right. It would be fairly easy for them to help patients kill themselves with the perception that they are not worthy of life which deviated from the original intent of preventing further pain and torment of being ill ( Sulmasy & Mueller, 2017) . The pressures might force physicians to enable patients to take their own lives as a means of saving the costs of healthcare. In the end, the public will lose trust in the care provision as doctors would be given the mandate to violate their professional ethical codes of practice. At the same time, violation of oaths is by itself illegal and a display of immoral conducts of practice ( Sulmasy & Mueller, 2017) . Life is too precious to be ignored or lose its invaluable worth even in the event of unending suffering. In this case, opposing physician-assisted deaths has a better argument than supporters of the process.
Moral Reasoning
For many, utilitarianism ethics support the argument of allowing physician-assisted deaths as it brings more happiness and good as opposed to negative results. However, deontological ethics argues against consequences of actions defining what is morally right and wrong. Unlike utilitarian and virtue ethics, deontological ethics recognizes an action as being moral once the conduct adheres to duty and obligations that bind a person to practice ( Payne, 2016) . Depending on the system, the moral obligation may come from natural, religious, or personal values that may conflict with personal desires. In this regard, Immanuel Kant argues that the right way is one where people act from duty or obligation under utmost respect for the law . However, the consequences of an intentional act are not good if it brings harm to a person. At the same time, Kant's philosophy is similar to the divine command theory where the action is deemed to be right is God has decreed it as good.
In this case, opposing to physician-assisted deaths is ethically right under deontological ethics. A physician’s duty to care of patients until the end while adhering to Hippocratic Oath that supports truth is morally and ethically correct in the medical practice. They are obliged to provide care and make every necessary effort to help patients with terminally-ill conditions maintain a positive hope of recovery and peace of mind ( Payne, 2016). This also means that are required to provide support and compassion while displaying encouragement to patients instead of providing them with a solution to take their own lives. Additionally, opposing physician-assisted deaths aligns with God’s divine law of not having the authority to take or help another take their own life. If God commands that the right to life is a divine authority, eliminating physician-assisted deaths would then be ethically correct.
Consequences
As a contentious debate that has been present for years, not legalizing physician-assisted deaths would encourage public trust in the system with the aim of preserving and valuing life as a critical sphere of our living. Professional ethics on the role and responsibilities of doctors would also not be questioned and misguided. However, providing a comprehensive solution through compassion and support instead of mercy killings to terminally patients would require constant research on medical and treatment options in the management of pain and suffering. This means that more resources have to shift towards research and development in seeking alternative ways of bringing comfort to patients or curing terminally ill conditions. At the same time, the healthcare society has to struggle in getting hospice and palliative care right and effective. This is to improve the quality of life and honoring near the end of life experiences without breaking the Hippocratic Oath. Such care improves access to affordable and specialty care while encouraging advanced care planning processes. In the end, human life will continue to be valued, and doctors and affected individuals would not be faced with political pressures and insurances to save their costs of maintaining life.
References
Anderson, R. T. (2015). Always care, never kill: How physician-assisted suicide endangers the weak, corrupts medicine, compromises the family, and violates human dignity and equality.
Beaman, L. G., & Steele, C. (2018). Transcendence/religion to immanence/nonreligion in assisted dying. International Journal of Human Rights in Healthcare , 11 (2), 129-143.
Payne, R. (2016). Life and death considerations in chronic pain: secular and theological-ethical considerations. In Ethical Issues in Chronic Pain Management (pp. 49-58). CRC Press.
Richards, S. M. (2017). Death with Dignity: The Right, Choice, and Power of Death by Physician-Assisted Suicide. Charleston L. Rev. , 11 , 471.
Sullivan, D. M., & Taylor, R. M. (2018). The Ethical Landscape of Assisted Suicide: A Balanced Analysis. Ethics & Medicine , 34 (1), 49-3.
Sulmasy, L. S., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper. Annals of internal medicine , 167 (8), 576-578.
