The American Medical Association (AMA) defines physician-assisted suicide as the facilitation of the death of a patient by a physician through the provision of the needed means or the information that can be used to performing a life-ending action (AMA, n.d). For a considerable number of years, people have been engaged in debates regarding the issue of physician-assisted suicide. Most of the people supporting this life-ending process consider the act as a peaceful one that can ease a patient's pain, while those in opposition believe that the process can create permanent ethical consequences. Life and death choices have become more complicated in contemporary society, considering the advancements in different fields such as science and medicine. The developments have complicated the issue of physician-assisted suicide further, which means that healthcare providers are forced to deal with this ethical dilemma directly.
Several laws and regulation should be followed in cases that involve physician-assisted suicide. Considering the idea that a state has the authority to legalize physician-assisted suicide, the difference between the legal and ethical provisions of the issue should be highlighted. Regardless of the existing laws and regulations regarding the issue, the prerequisites for contemplating the provision of assistance to an individual towards death should include the idea that the request for physician-assisted suicide should not emanate from a treatable depression (Lagay, 2003). On the other hand, the foundation of the request should not be based on treatable discomfort or pain, including the idea that the exploration of a request for physician-assisted suicide should occur in the context of the intimacy, depth, and the duration of the relationship between a physician and a patient (Lagay, 2003). Regardless of the existence of these prerequisites, the ethical dilemma posed by the issue also factors in the physician's value system, which should be explored and defined.
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The complicated interpretation of the legal and ethical provisions surrounding the ethical dilemma can create confusion, as it involves the interplay between a jurisdiction's legal system and the interpretation of the action by society. In spite of this complication, the legal principle attached to this ethical issue follows the established provision of patient autonomy. In this case, the law provides that an adult with the sound mind has the right to determine what a physician should do to his body after receiving and understanding the information provided by the physician regarding his or her health (Sulmasy & Mueller, 2017). Even though adults can give consent for a physician to carry out physician-assisted suicide, he or she should have received and understood the medical information provided by the doctor to consent. However, the law is guided by the prerequisites identified earlier, which means that they have to be met for euthanasia to be considered as an option.
One of the cases on physician-assisted suicide was Washington v. Glucksberg (1997) . In the landmark case, the Supreme Court of the United States held that the Due Process Clause did not protect an individual’s to physician-assisted suicide. The court held that the Fourteenth Amendment did not offend Washington's ban against causing or assisting suicide (Batlle, 2003). However, the decision to legalize euthanasia is subject to state laws, an example being Oregon’s Death with Dignity Act (Batlle, 2003). The U.S. Supreme Court allowed the state of Oregon to institute the Act, thereby indicating that the Constitution did not prohibit or support physician-assisted suicide. However, Oregon’s law is clear, as physicians are not allowed to carry out the act unless the patient is terminally ill. Conversely, the physicians in the state can only provide adult patients with the lethal dose of sedatives only if their prognosis indicates that the patient has less than six months to live (Batlle, 2003). Conversely, the adult has to be mentally capable for the physician to write the prescription.
The impact of the death with dignity law on the provision of healthcare includes the improvement of procedures required in making decisions regarding physician-assisted suicide. The decision-making process of whether to consider physician-assisted suicide is determined through professional discussions. A considerable number of healthcare providers expect to have conflicting views regarding whether to follow through with a patient’s request for physician-assisted suicide. For this reason, the governing board members of a healthcare facility, administrators, and advisory committees understand and follow their roles, considering the policies and procedure developed to tackle this ethical dilemma. In this case, the law has altered healthcare practice in the sense that the healthcare provider has to explore all the alternatives provided for in evidence-based care research to consider that a patient can only live for up to six months (Batlle, 2003). For this reason, it is possible to argue that death with dignity law has improved the provision of care.
An individual could argue that death with dignity laws have increased patient autonomy, which is a provision that has an impact on the provision of health care in future. Some people can question the claim that terminally ill patients might not have the ability to decide on requesting physician-assisted suicide. On the other hand, others might argue that physicians might be wrong when indicating that a patient has a given period to live, citing that some of the patients might have lived longer than predicted by their physicians. These considerations inform idea that some patients might consider dying even with the knowledge that they have few months to live, but others might also hasten their deaths as they cannot be able to wait and find the period left to live unbearable (Lindsay, 2009). In the light of these provisions, one can predict that the future of healthcare delivery is likely to improve, as clinical practitioners will have to exhaust all options availed through the evidence to determine whether a patient can live longer than anticipated or not.
The topic of the ethical issue of physician-assisted suicide is relevant to my job in the health care sector, as it provides information regarding what healthcare practitioners should know when considering end-of-life requests from patients. In this regard, the issue focuses on the idea that the ethical dilemma should inform the intention of providing end-of-life care, which should be based on the established duties of a patient. For this reason, I believe that the issue should be considered adequately, as it informs the need to consider implementing the ethical principle of beneficence, regardless of the presence of patient autonomy. Following the provisions or dictates of the ethical issue in consideration, I believe that I can ensure that the judgment of the patient when requesting for physician-assisted suicide, should be consistent with the goals of the ethical principles of beneficence and nonmaleficence, including the goals of the patient, which is to realize positive health outcomes.
Technology has had an impact on the ethical dilemma regarding physician-assisted suicide. In this regard, advances in research activities have led to the introduction of life-sustaining technologies. For instance, a considerable number of patients have life-sustaining devices that include implantable cardioverter-defibrillators and ventricular assist devices (Sulmasy & Mueller, 2017). Whenever physicians meet terminally ill patients with conditions that might require the use of such devices, the option of physician-assisted suicide is usually not considered. Instead, the terminally ill patients are likely to live longer than predicted by a physician using technological tools, which might also improve their well-being. Life-Prolonging technologies have significantly assisted physicians in terms of enabling them to avoid euthanasia as an option for terminally ill patients.
In conclusion, it would be essential to take note of the fact that physician-assisted suicide presents a serious ethical dilemma to physicians and other healthcare givers. However, when a patient requests for the procedure, the physician has to determine whether the patient is an adult of sound mind to follow through which the request. Additionally, the prerequisites that should be met before conducting the procedure include the idea that the request should not emanate from a patient with treatable depression, it should not be a derivative of treatable pain or discomfort, and the exploration of the request should occur within the context of the relationship between the patient and physician. In this regard, their relationship has to have lasted for a given duration, even though the duration is not clearly defined, it has to have some depth, and the relationship should be intimate. Only after these prerequisites are met should the request to die can be treated seriously.
References
American Medical Association (AMA). (n.d). Physician-assisted suicide. Retrieved from https://www.ama-assn.org/delivering-care/ethics/physician-assisted-suicide
Batlle, J. (2003). Legal Status of Physician-Assisted Suicide. JAMA: The Journal of the American Medical Association , 289 (17), 2279-2281. doi: 10.1001/jama.289.17.2279
Lagay, F. (2003). Physician-Assisted Suicide: The Law and Professional Ethics. AMA Journal of Ethics , 5 (1), 17-18.
Lindsay, R. (2009). Oregon's Experience: Evaluating the Record. The American Journal of Bioethics , 9 (3), 19-27. doi: 10.1080/15265160802654137
Sulmasy, L. S., & Mueller, P. (2017). Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper. Annals of Internal Medicine , 167 (8), 576. doi: 10.7326/m17-0938
Washington v. Glucksberg. (1997). Oyez . Retrieved July 1, 2019, from https://www.oyez.org/cases/1996/96-110
