Physician-Assisted Suicide:
Perfectly Acceptable Substitute
Helen had cancer. Breast cancer that had metastasized to her lungs and she was considered terminally ill. She was in her eighties and ready to die. Helen is the first case in Oregon of legal physician-assisted suicide. Helen had to request 3 doctors before she found one that would administer the procedure. “She then took a mixture of barbiturates (nine grams) and syrup followed by a glass of brandy. She is said to have died within thirty minutes” (quoted in…Hedin and Foley 1616). Helen was afforded the choice most other Americans do not have: a choice to die, peacefully, in a comfortable setting, surrounded by their loved ones. There are many people just like Helen, who are terminally ill but not allowed this option. Helen was able to pass on her own terms. Helen did not choose to die; Helen simply chose when to die. Physician-assisted suicide is not choosing to die, but when to die and should be legalized in the United States.
Death is something that no man can avoid. Socrates once said:
Wherefore, O judges, be of good cheer about death, and know of a certainty, that no evil can happen to a good man, either in life or after death. He and his are not neglected by the gods; nor has my own approaching end happened by mere chance. But I see clearly that the time had arrived when it was better for me to die and be released from trouble [. . .].
The hour of departure has arrived, and we go our separate ways, I to die, and you to live. Which of these two is better only God knows. (qtd in Hooker)
Dying can be a release of troubles. Likewise, terminally ill patients seeking physician-assisted suicide only want to end their life when they choose to release themselves and their loved ones from further “troubles” (qtd in Hooker). Many states have the death penalty and put a criminal to “justice” by euthanasia, yet they will not allow someone who is in pain and suffering to end their life. We as a society view death as a punishment, but when should it be viewed as just an end to living? Often terminally ill patients spend months in hospice in pain and cause their loved ones to endure emotional pain and costly expenses. Many times, these patients lose all of their cognitive and physical abilities while waiting to die. To many of these people, death is not a punishment but a welcome ending to their suffering.
Death does come; it comes for us all. You cannot choose to not die, but you should be able to choose when. When is the appropriate time to choose to die? Oregon state law provides the option for physician-assisted suicide to those who are terminally ill with less than six months to live and who are competent enough to make the decision (Gill 53). Physician-assisted suicide is not for the depressed or disabled as is claimed by some opponents of the law (Radtke 58-60). When a person has been diagnosed with a terminal illness and informed they have less than six months to live they should be given all options of life care. People should be counseled about their disease, it’s progression and what to expect in the time to come. Hospice, along with all other options for care/treatment should be explained fully. Patients should then be screened for competency, and if they pass, they should be able to make an informed decision for themselves.
Death is inevitable. There is no argument over whether or not terminally ill people die. However, one of the arguments made against physician-assisted suicide claims, “we will lose a lot of people who can make a difference. We cannot even dream of what those losses might be right now; we would never know” (Radtke 59). This type of statement is just emotionally based bad logic. According to statistics three years after legalizing physician-assisted suicide in the state of Oregon only fifteen people choose this option (Miller 264). This number averages out to five people per year, hardly an excessive amount when you compare it to the number of terminally ill. This data proves that most people will not choose physician-assisted suicide, however it was their choice to make. Also, patients with less than six months to live will not typically be contributing to society in a way that would “make a difference.” Granted, someone could learn more about himself or herself going through this process, but when we learn something, we are able to grow and become a better person for our future. Terminally ill patients have no future, so enriching their spiritual or psychological lives by enduring those last six months serves no purpose.
There are also many religious arguments against physician-assisted suicide. However, religion is personal and a belief that is not based in science and does not belong in legislation. Legislating morality is wrong. The Bill of Rights clearly says, “Congress shall make no law respecting an established religion, or prohibiting the free exercise thereof” (Dawson 1). Moral issues are religious issues, and prohibiting physician-assisted suicide based on morality would be unconstitutional. It has been argued, “Americans regard themselves as autonomous possessors of individual rights” (Jelen 2). Thus, legislating morality would be a direct violation of autonomy, something American’s value more than morality. But legalizing physician-assisted suicide does not take any religious side. Legalizing it is not the same as encouraging it or requiring it. It allows everyone to choose their own side based on their own religious values. There is no religious debate to be had because if you are religious, simply don’t ask for physician-assisted suicide. Religious groups would be free to advocate hospice and create hospice centers that discourage physician-assisted suicide and assist in palliative care. Those supporting legalizing physician-assisted suicide still see the benefits for hospice and realize that not everyone will want to pursue ending their life (as the Oregon statistics show).
There are those that claim that if we allow physician-assisted suicide for the terminally ill, we will one day allow it for healthy people as well (Radtke 59). But this is absurd. Oregon law would certainly set a standard the rest of the nation would follow. In order for healthy people to terminate their life this way, the law would have to be revised. It is highly doubtful that such a law would be passed. However, if it were, it would be based on autonomy and a person’s right to choose and not terminal illness which is the key component of today’s laws. In 1997, the Supreme Court decided that, “physician-assisted suicide could prove extremely difficult to police and contain” (qtd in Mariner 2059). So they left the decision to the states (Mariner 2059). The Supreme Court did decide, however, that physician-assisted suicide is not a constitutional right. Based on this decision, the thought of healthy people legally obtaining physician-assisted suicide is highly unlikely. There are more than 30,000 suicides every year in the United States (Mariner 2058). Suicide is not illegal. There is no law preventing anyone from committing suicide (Mariner 2061). What is illegal is anyone (physician in this case) assisting in suicide. If a physician assists in a suicide in states where it is prohibited, he or she is “subject to up to five years in imprisonment and a fine of up to $10,000” as well having his license revoked (Mariner 2058). Those compassionate enough to offer assistance to the dying face criminalization. In those states, not only is death a punishment in the judicial system’s eyes but, compassion is criminal.
It is the role of a physician in the suicide that is illegal and up for debate. A physician’s job is to heal or to comfort once healing is no longer an option. Some physicians argue, “This approach is a violation of the Hippocratic Oath” (Girsh 189). If that were true, hospice would also be a violation of this oath, and once a patient was terminally ill with no hope of recovery, a physician would have to stop treating the patient. We know this does not happen; physicians will continue to treat pain and the symptoms of a disease without being able to cure it. Sometimes medications prescribed in order to cure disease cause harm, so would this not also be a violation of the Hippocratic Oath? Similarly, Chemotherapy is not a pleasant experience. I have often heard people say, “The cure is worse than the disease” when it comes to cancer and the treatments for it. When a physician can help, he or she should, either by healing or comforting.
The Hippocratic Oath would also surely be opposed to medicine being the commodity it is today. Currently, in our system, physicians deny care based on financial means. Is this not neglect? Refusing a patient based on financial means would be indirectly causing harm, would it not? Denying someone treatment based on financial means causes more harm than physician-assisted suicide. In one case, you have someone who wants to and could get well but can’t get well because medicine has become a commodity, and treating it as such is “morally unpalatable” (Pellegrino 258). It is said that, “Health is a fundamental requirement for the fulfillment of the human potential and freedom to act and directs one’s life” (Pellegrino 248). In physician-assisted suicide you are helping someone to ease his or her pain and suffering because failing health has blocked his or her potential. Attempting to use the Hippocratic oath as a means to prohibit physician-assisted suicide is hypocritical. It is a greater violation that occurs everyday in denying health than that of assisting in death.
Some physicians have argued that “physicians do not want this option” and “suicide is never acceptable” (Girsh 189). When people rely on a doctor to defend or protest physician-assisted suicide it utilizes a false ethos. Doctors are not philosophers, or spiritualists by trade. They know no more about what is right or wrong in the world than anyone else does. “Medicine has no competence to manage the meaning of life and death, only the physical and psychological manifestations of those problems. Medicines role must be limited to what it can appropriately do, and it has neither the expertise nor the wisdom to respond to the deepest and oldest human questions” (qtd in Gill 60). In other words, doctor’s role in society is to administer medicine, not dictate human morality. Patients will determine whether they want to die or not. The physician merely requires the knowledge and compassion to assist. Any physician who has a moral objection to assisting should be allowed to refuse but should realize it is a moral objection and not a violation of the Hippocratic Oath.
Currently, doctors are allowed to “engage in the more death-related act of withdrawing a respirator from the respirator-dependent patient” (Robinson 16). Again would this not also violate the Hippocratic Oath? Physically disengaging a life saving machine is no less harmful than prescribing medication that would end someone’s life. In one scenario, which is legal, the “act of death” lies in the physician’s hands, where as in prescribing medication, the patient must have the determination and desire to physically take the pills, and the “act of death” is in their own hands (Robinson 16).
Some physicians will resort to “covert and undocumented practices when they feel compelled, for ethical and humane reasons, to provide assistance” (Linville 204). Some physicians do this because of close long term relationships with their patients (Linville 204). And by doing this, they risk their careers and lives. But it is not fair for people who do not have these relationships with their doctor to be unable to obtain the same treatment. It is also unfair to criminalize a physician who is following the direction of his patient within the scope of his knowledge and abilities.
Finally, physician-assisted suicide is said to be about autonomy. Those who argue against physician-assisted suicide claim “[the patient] will not be able to exercise her autonomy in the future” (Gill 56). However, terminally ill patients with less than six months to live have a short future, and how much of that they would maintain their autonomy in would also be questionable. Those who support physician-assisted suicide argue “that the suicide of a person who is about to die does not violate the value of autonomy because the person’s decision-making ability is going to disappear whether she commits suicide or not” (Gill 55). They also argue, “It is the ability to make big decisions that is of profound moral importance” (Gill 58). Physician-assisted suicide should be legalized in the United States so that everyone will be given the opportunity to evaluate their own life and morals and make a decision that is best for them. Banning physician-assisted suicide does not prevent deaths. Nor would legalizing it increase deaths. It would simply allow the terminally ill to choose when to die.
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