Euthanasia- Physician Assisted Suicide

Physician-Assisted Suicide

Is euthanasia right or wrong? Is it an act of kindness driven by a sense of compassion and respect for the individual? Back in history, ancient Greeks and Romans saw euthanasia as "voluntary death" (Manning, 6) that spare the dying person from an agonizing death. While the topic euthanasia is very broad and an antique dilemma, physician-assisted suicide is a relatively recent phenomenon that has risen and become a very popular argument as a result of improved diagnosis and treatment in medicine. The legalization of physician-assisted suicide remains an important ethical and community issue, supporters of physician-assisted suicide have tried to legalize it in America for many years; however, Oregon is today the only state in America where physician-assisted suicide is legal. A century ago, people died at home from illness that medicine could not do much about. Today, with the fast development of medicine, dying has become more complicated; most people die in hospitals where they are kept alive suffering until there is nothing that can be done. Physician-assisted suicide should become legal and accessible for any terminally ill patient that wishes to die instead of waiting for the disease to take its natural course.

Today, euthanasia is mostly characterized as physician-assisted suicide; however, physician-assisted suicide is very different from euthanasia. The Merriam-Webster Dictionary defines euthanasia as good death or mercy killing, a term based on the Greek meaning of the words "eu"-meaning good, and "thanatos"-meaning death (2004, 247). Euthanasia is the deliberate killing or permitting the death of a helplessly sick person, with the recognition that death is in the best interest of the patient and that his or her pain overweigh the benefit of any additional duration in life. In the other hand, physician-assisted suicide refers to the procedure whereby a physician prescribes a lethal drug; the patient, not the doctor, it the one who performs the act that leads to death. Since the patient is the one who administers the drug, physician-assisted suicide is more accepted than euthanasia for the reason that it is suicide rather than killing. The American Medical Association has, however, ruled out any mercy killing.

From the time of Hippocrates, father of medicine, the code of professional ethics prohibited euthanasia by doctors; one of the fundamental principles that are taught to medical students is "primum non nocere" (Manning, 81), which means "first, do no harm".  Euthanasia is seen as a violation of the Hippocratic Oath that states: "To please no one will I prescribe a deadly drug, or give advice which may cause his death;" (BBC News, Health). The book Biomedical Ethics Review states that "arguments in favor of voluntary euthanasia and physician-assisted suicide usually turn on the patient's right to autonomy and the physician's compassionate obligations to relieve suffering" (9). Many arguments talk about terminally ill patients that are no longer responding to their medication and are in great suffering; some have lost their functional capacity and independence and others have lost their ability to breathe by themselves. In many of these cases, some physicians overlooked terminal ill patient's wishes of dying and resuscitate or "trap" them on life-support because of the fear of loosing their medical license. However, there are some physicians that are already involved in some processes that ease death. In some instances, administration of adequate pain medication will have another effect and sometimes suppress the respiration and hastening death; this is called "double effect." When a terminal ill patient in the ICU is in severe pain, a physician order is put in that say "morphine drip, titrate to comfort," this means gradually adjusting the dose until the patient is sedated and calmed. Some terminally ill patients receive a larger dose of morphine to ease their pain, causing severe side effects such as acute respiratory depression and cardiac arrest that can easily kill the patient.

Many opponents of physician-assisted suicide and euthanasia often worry that if doctors have the power to kill patients, they may use it too freely. The worry is that doctors may be too willing to euthanize patients even without making sure that it is the right thing to do. However, advocates for physician-assisted suicide argue that it is a voluntary act from the patient to ask. One example of this is former pathologist Dr. Jack Kevorkian, most known as "Dr. Death" and for openly defend the terminal patient's right to die via euthanasia. He cast euthanasia and physician-assisted suicide into the spotlight in the early 1990's when he stated that he had helped at least 130 patients. In the late 1980s he created a machine called the "Mecitron" that helped people commit suicide by giving them a narcotic followed by a lethal dose of potassium chloride. This machine had a mechanism that allowed the patient to start the machine by pushing a button, put on the gas mask and the machine would administer the lethal drug or carbon monoxide to the patient.

Janet Adkins was Dr. Kevorkian's first public assisted suicide. Dr. Kevorkian had just invented the "Mercitron" and tried it on Adkins. She, a 54-year-old woman from Oregon, was newly diagnosed with Alzheimer's disease when Dr. Kevorkian assisted her in committing suicide in June, 1990. Since at that time there were no laws outlawing suicide in Michigan, Dr. Kevorkian was not triad for murder. After all, Dr. Kevorkian was not the one directly killing the patients; he committed physician-assisted suicide by giving the patient a way to die. But, a few years after Janet Adkins death, when Dr. Kevorkian had helped more suicides, the law changed in Michigan and the Supreme Court tried him numerous times, stripped him off his medical license and convicted him for murderer (Opposing Viewpoints, 42). He spent some years in prison but is now on parole; in the beginning of this year he spoke at the University of Florida where he stated: "My aim in helping the patient was not to cause death...My aim was to end suffering. It's got to be decriminalized." (St. Petersburg Times)

In 1994 Oregon approved Measure 16, the Death with Dignity Act, by a margin of 51 percent to 49 percent, which allows terminally ill patients to obtain a lethal prescription (Physician-Assisted Death, 81). Oregon is currently the only U.S state that permits physician-assisted suicide; no jurisdiction has legalized euthanasia and it is specifically prohibited. The Oregon Death with Dignity Act became effective in 1997 and allows physician-assisted suicide under very restricted conditions stating that the medical exit of life should be open for competent patients who are dying (Physician-Assisted Death, 81). A study made among Oregon physicians provides one indication regarding physician-assisted suicide: "While 60 percent say physician-assisted suicide should be legal, only 46 percent said they would be willing to prescribe lethal medicine to a terminally ill patient" (Contemporary Issues Companion, 20-21). Under the Act, ending one's life in accordance with the law does not constitute suicide. To request lethal medication from a physician, according to the Death  with Dignity Act the patient must at least be 18 years of age, resident of Oregon, capable of communicate, diagnosed with ha terminally illness determined on a prognosis of no more than six months to life (Ideas in Conflict, 41).

There are legal and political issues to consider when talking about physician-assisted suicide. Since the early 1960's, many parties has gone to court in attempt to resolve these issues; some of these cases have made a change in the history of terminally ill patient care. Cases in court regarding euthanasia and physician-assisted suicide cite the Constitutional right to liberty and privacy, using it in the context that any person has the right to decide how and when ones death will occur. In countries like the Netherlands and the United Kingdom, physician-assisted suicide and voluntary euthanasia has become more liberal; however, other forms of euthanasia are illegal and punishable for up to twelve years in prison. The acceptance in the Netherlands of a right to physician-assisted suicide for terminally ill has led to expand and embrace the physician-assisted suicide for the chronically ill, the elderly and those who are suffering mentally (Ideas in Conflict, 22).

"The goal of medicine is to address the suffering of patients. When pain and suffering be...