THEME: TECHNOLOGY AND ETHICAL ISSUES Assisted Suicide: Multiple Perspective Should Doctors Be Allowed to Help Terminally III Patients Commit Suicide? YES NO It would be great comfort to people who If it is a question of someone’s wantingface terminal illness to know they could get the right to die, I say jump off a building. Buthelp to die if their suffering became as soon as you bring in somebody else to helpunbearable. All pain cannot be controlled, and you, it changes the equation. Suicide is legallyit is arrogant for anybody to say that it can. available to people in this country. Just don notQuality of life decisions are sole right of the ask a doctor to help you do it. That wouldindividual. violate the traditions of medicine and raise It is nonsense to say that death should doubts about the role of the physician.not be part of a doctor’s job - it already is. We One of my worries is that people will beall die. Death is a part of medicine. One of a manipulated by a doctor’s suggestion suicide.doctor’s jobs is to write death certificates. So A lot of seriously ill people already feel theythis idea of the doctor as superhealer is a load are a burden because they are costing theirof nonsense. The fact is that it is not easy to families money. It would be easy for a familycommit suicide in your own. It is very hard for to insinuate, “while we love you, Grandmother,decent citizens to get deadly drugs. Even if and we are willing to spend all our money andthey do, there is the fear that the drugs won’t not send the kids to college, would not it bework. There are hundreds of dying people who better if…?” There is no coercion there, butcould not lift their hand to their mouth with a you build on somebody’s guilt. We would havecup of coffee, let alone a cup of drugs, they a whole new class of people consideringneed assistance. suicide who had not thought about it before. Of course, people who are depressed or Then, too, I don not believe that youwho feel they are a weight on their families could successfully regulate this practice. Theshould be counseled and helped to live. But relationship between the doctor and the patientsyou have to separate those instances from begins in confidentiality. If they decidepeople who are dying, whose bodies are giving together that they don not want anybody toup on them. If you think there is a cure around know, there is no way the government can
the corner for your malady, then please wait for regulate it. The presumption is that physiciansit. That is your choice. But sometimes a person would only be helping people commit suiciderealizes that her life is coming to an end, as in after everything else had failed to end theirthe case of my wife, whose doctor said, “There suffering. But a lot of people won’t want to beis nothing else we can do.” that far along. None of the proposed regulations We are not talking about cases in which takes into account a person who is not sufferinga depressed person will come to a doctor and now, but who says, “I don’t want to suffer inask to be killed. Under the law the Hemlock the future. Let me commit suicide now.” I canSociety is trying to get passed, the doctor must imagine a doctor who would say, “Yes, we’resay no to depressed people. A candidate for going to make sure that you don’t have toassisted suicide has to be irreversibly, suffer at all.”terminally, hopelessly ill and judged to be soby two doctors.Derek Humphry is the founder of the Hemlock Daniel Callahan is a bioethicist and director ofSociety and author of Final Exit, a book the Hastings Center, a medical ethics thinkadvising terminally ill people on how to tank in Briarcliff Manor, New York.commit suicide.Source: - Authors: Derek Humphry & Daniel Callahan - From “Topics for Today – Third Edition – Lorraine C.Smith & Nancy Nici Mare. Assisted Suicide Should It Be Legal WebMD In March 1998, an Oregon woman dying of breast cancer asked her physician toprescribe a drug that would allow her to end her life. The doctor agreed. Later in the month shetook the medication. With that action, she became the first person in the United States to commitsuicide with the help of a doctor legally. This has come to be known as physicianassisted suicide. A physician honors a patientsvoluntary request for a lethal dose of medication, which the patient later administers to him orherself. Its legal only in the state of Oregon, and has been only since late 1997.
A few other states are making efforts to legalize assisted suicide. But soon Congress mayput a stop to it everywhere.The pros and consThe issue of physicianassisted suicide is emotional and controversial it ranks right up there withabortion. According to Dr. Clarence H. Braddock III, a faculty member of the University ofWashingtons departments of medicine and medical history and ethics, the arguments in favor oflegalizing assisted suicide generally run along these linesPeople should be able to control their own lives.Some terminally ill patients are allowed to end their lives by refusing medical treatments; in allfairness, those who dont have that option should be allowed to choose death.Death is a compassionate way to relieve unbearable suffering.Legal or not, assisted suicides occur, and it would be better if they were brought into the open.The arguments against legalization, Braddock says, usually go something like thisTaking a life under any circumstances is immoral.Assisted suicide has great potential for abuse. People without family support or adequatefinances, as well as the depressed, could be pressured to choose death.Physicians can be wrong about estimating how much time a patient has left, causing unnecessarydeaths.The public will lose its confidence in the medical profession if physicians get into the business ofhelping people kill themselves. An ageold debatePhysicians have been divided over the issue of assisted suicide since the birth of Westernmedicine some 2,000 years ago.Source:- Author: Michael Pretzer -Http://articles.cnn.com/2000-01-25/health/assisted.suicide.wmd_1_physicianassisted- suicide-terminally-ill-patients-deadly-drug?_s=PM:HEALTH
World Laws In Asssited SuicideVarious forms of medically assisted dying and/or assisted suicide for the terminally or hopelesslyill competent adult have been approved by 2010 in the following ten states and nations. Each hasits own rules and guidelines. All but Switzerland forbid foreigners coming for this type of help todie.• Switzerland (1940)• Oregon (1994)• Colombia (1997)• Albania (1999)• The Netherlands (2002)• Belgium (2003)• Washington (2008)• Montana (2009)• Luxembourg (2008)Also in 2010 England & Wales announced first prosecutorial policy statement about who will, orwill not, risk criminal charges when assisting a suicide. North AmericaUnited StatesVisit this page for information on assisted suicide laws in the United States including Oregon,Washington, and other U.S. states.CanadaThe law in Canada is almost the same as in England -- it is a crime to assist a suicide, punishableby up to 14 years imprisonment. The offence is rarely prosecuted and a 2002 significant casebrought against Evelyn Martens in BC resulted in acquittal.On April 21, 2010, the Canadian House of Commons rejected a Bloc Québécois MP’s legislationto permit assisted suicide in Canada under strict conditions. Bill C-384 was defeated on secondreading by a 228-59 margin.The bill would have allowed doctors to avoid murder and manslaughter charges for helpingterminally ill people or those in severe chronic pain to die. The bill stipulated that a physiciancould help someone to "die with dignity" provided nine conditions were met, including that the
person was 18 or older, suffered from a terminal illness or unrelenting physical or mental pain,had made two written requests to die at least 10 days apart, and had their diagnosis confirmed bya second doctor.MexicoIn Mexico, on April 22, 2008, the Senate voted 70-0 in favour of legalizing passive euthanasia.This concept allows doctors to withdraw life-sustaining medication from patients, but not to, forinstance, administer poisons. (Assisted suicide or active euthanasia occurs when an individualwho is not physically capable of ending his or her own life requests the help of a physician to doso.)The Mexican bill legalizes passive euthanasia -- the disconnection of life support equipment --when the patient is in palliative care and has been given less than six months to live. Doctorshave to act with consent from the patient or the patient’s family. The regulation stipulates that thepatient will have the option of "voluntarily requesting the suspension of healing treatment andselecting integral care to control pain." EuropeUnited KingdomIn England and Wales there is a possibility of up to 14 years imprisonment for anybody assistinga suicide. Oddly, suicide itself is not a crime. The first prosecutorial policy statement about whowill, or will not, risk criminal charges when assisting a suicide, was announced by England &Wales in 2010. Like France, there are laws banning a publication if it leads to a suicide orassisted suicide. But Final Exit can be seen in bookstores in both countries.Suicide has never been illegal under Scotland law. There is no Scots authority of whether it iscriminal to help another to commit suicide, and this has never been tested in court.The killing of another at his own request is murder, as the consent of the victim is irrelevant insuch a case. A person who assists another to take their own life, whether by giving advice or bythe provision of the means of committing suicide, might be criminally liable on a number of othergrounds such as: recklessly endangering human life, culpable homicide (recklessly giving adviceor providing the means, followed by the death of the victim), or wicked recklessness.Sweden
While it is correct that Sweden has no law specifically proscribing assisted suicide, theprosecutors might charge an assister with manslaughter - and do. In 1979 the Swedish right-to-dieleader Berit Hedeby went to prison for a year for helping a man with MS to die.NorwayNeighbouring Norway has criminal sanctions against assisted suicide by using the charge"accessory to murder". In cases where consent was given and the reasons compassionate, thecourts pass lighter sentences. A recent law commission voted down de-criminalizing assistedsuicide by a 5-2 vote.A retired Norwegian physician, Christian Sandsdalen, was found guilty of wilful murder in 2000.He admitted giving an overdose of morphine to a woman chronically ill after 20 years with MSwho begged for his help. It cost him his medical license but he was not sent to prison. Heappealed the case right up to the Supreme Court and lost every time. Dr. Sandsdalen died a yearago at 82 and, curiously, his funeral was packed with Norways dignitaries.DenmarkDenmark has no laws permitting assisted suicide, despite reports that it does.GermanyGermany has had no penalty for the action since 1751, although it rarely happens there due to thehangover taboo caused by Nazi mass murders, plus powerful, contemporary, church influences.Direct killing by euthanasia is a crime. In 2000 a German appeal court cleared a Swiss clergymanof assisted suicide because there was no such offence, but convicted him of bringing the drugsinto the country. There was no imprisonment.FranceFrance does not have a specific law banning assisted suicide, but such a case could be prosecutedunder 223-6 of the Penal Code for failure to assist a person in danger. Convictions are rare andpunishments minor. France bans all publications that advise on suicide - Final Exit has beenbanned since 1991 but few nowadays take any notice of the order.ItalyIn Italy the action is legally forbidden. Asia & PacificJapan
Japan has medical voluntary euthanasia approved by a high court in 1962 in the Yamagouchicase, but instances are extremely rare, seemingly because of complicated taboos on suicide, dyingand death in that country.New ZealandNew Zealand forbids assistance under 179 of the New Zealand Crimes Act, 1961, but cases arerare and the penalties lenient.AustraliaThe Northern Territory of Australia had voluntary euthanasia and assisted suicide for ninemonths until the Federal Parliament repealed the law in 1997. Only four people were able to useit. Other states have attempted to change the law, so far unsuccessfully.Source: - http://www.finalexit.org/assisted_suicide_world_laws_page2.html Critical Responses “For years, doctors have been prohibited from assisting patients in taking their own lives.Dr. Jack Kevorkian gained world attention by assisting in several suicides to dying patients; hewas sentenced to over 60 years for his efforts, despite the gratitude of the patients and theirfamilies. Recent laws in Oregon and the U.S have started a trend of legalization. But some, mostnotably the U.S Attorney General’s office, are determined to prevent the laws from goingthrough”( http://www.balancedpolitics.org/assisted_suicide.htm). In this paper I am going to talk about the pros and the cons of assisted suicide are presentedby proponents and opponents of this controversial medical issue, and assisted suicide laws aroundthe world. When people see the word “assisted suicide” or “euthanasia”, they see the meaning of theword in two different lights. “Assisted suicide” for some carriers a negative connotation; it is thesame as murder. For others, however, “assisted suicide" is the act of putting someone to deathpainlessly, or allowing a person suffering from an incurable and painful disease or condition todie by withholding extreme medical measures. After studying both sides of the issue; however,
they find that some are for it because of their compassion and respect for the dying; others areagainst because of religious and moral reasons. In the article “ Should Doctors Be Allowed to Help Terminally III Patients CommitSuicide?”, two authors, Derek Humphry and Daniel Callahan”, give contradictory opinions toexpain why people have diffirent attitudes to assited suicide. There can be numerous of pros to assistance suicide. Image a love one sustaining afractured pelvis in an automobile accident. A few days later her lungs seems to fill up, her urinestops, her heart develops dangerous rhythm disturbances. So there she was: in coma, on dialysis,on a breathing machine, her heartbeat maintained with an electrical device. ..We know it wouldsurely be fatal. Many terminally patients who are in the final stages of their lives have requesteddoctors to aid them in exercising active euthanasia. It is sad to realize that these people are greatagony and that to them the only hope of living that agony to a half is through assisted suicide. “Itwould great comfort to people who face terminal illness to know they could get help to die if theirsuffering became unbearable. All pain cannot be controlled” ( from a book advising terminally illpeople on how to commit suicide by Derek Humphry).Another reason for supporters of legislation legalizing assisted suicide is that we ourselves havean obligation to relieve the suffering of our fellow human beings and to respect their dignity.Excruciating painful and terminal conditions and diseases have made them only look forward tolives filled with more suffering, degradation and deterioration. “When such people beg for amerciful end to their pain and indignity, it is cruel and inhumane to refuse their pleas.Compassion demands that we comply and cooperate” ( Dr.Francis Moore, National Academy ofSciences).Next, it is argued that all persons have a moral right to choose freely what they will do with theirlives as long as they inflict no harm on others. This right of free choice includes the right to endone’s life when we choose. Since 1961, suicide has been legal in many states and nations.Helping someone who wants to die in a peaceful, painless way should also be legal. As a recentcase of disabled rugby player Daniel James showed, hundreds of British people have traveledabroad for an assisted suicide and the Crown Prosecution Service cannot prosecute the peoplewho help them.Furthermore, “ the majority of British people, about 86 percent, are in favor of legalisingeuthanasia”, according to a recent YouGov survey. Ronald Dworkin, author of Life’s Dominion,
says that ““many people . . . want to save their relatives the expense of keeping them pointlesslyalive . . .”(193). If terminal patients have the option of assisted suicide, they can ease thedamaging financial effects of hospital care on their families, and preserve the individual right ofpeople to determine their own fate. The hospital costs skyrocket, only a few affluent terminalpatients can afford to prolong their lives. “The cost of maintaining [a dying person]. . . has beenestimated as ranging from about two thousand to ten thousand dollars a month” (Dworkin 187). On the other side of the issue; however, people who opposed any measures permittingassisted suicide do not believe that the terminally ill have the right to end their suffering.According to an article in the Houston Chronicle, Judge Reinhardt ruled on this issue by sayingthat “ A competent, terminally – ill adult, having lived nearly the full measure of his life, has astrong liberty interest in choosing a dignified and humane death rather than being reduced at theend of his existence to a childlike state of helplessness, diapered, sedated, incompetent” ( qtd. inBeck 36). This ruling is the strongest defense for the right to assisted suicide. It is an inherentright. No man or woman should ever suffer because he or she is denied the right. The terminallyill also have rights like normal, healthy citizens do and they cannot be denied the right not tosuffer.In addition, opponents of assisted suicide claim that society has a moral duty to protect and topreserve all life. To allow people to assist others in destroying their lives violates a fundamentalduty we have to respect human life. A society committed to preserving and protecting life shouldnot commission people to destroy it.Nobody should be able to choose when and how they die. The writer feels that life is somethingthat is valuable, even when people can not move around themselves, or can not do all things forthemselves. Life is not just something that everyone inherits. People were given life for a reason,and whether that reason is to work through a terminal illness or to make it through life withoutany health problems, nobody should be able to choose their life to death. Someone who fightsthrough a terminal illness dies with more dignity than someone who takes the easy way out does.In the same way, director of the Hastings Center, a medical ethics think tank in Briarcliff Manor,New York, said that “That would violate the tradition of medicine and raise doubts about theroles of the physician.”
Another problem is that rapid and dramatic developments in medicine and technology strugglesto pull more and more people away from the edge of death.Finally, it is argued that sanctioning assisted suicide would violate the rights of others. Doctorsand nurses might find themselves "pressured" to cooperate in a patients suicide. In order tosatisfy the desires of a patient wanting to die, its unjust to demand that others go against theirown deeply held convictions. All in all, the case for assisted suicide is a powerful one – appealing to our capacity forcompassion and an obligation to support individual choice and self determination. But, the caseagainst assisted suicide is also powerful for it speaks to us of a fundamental reverence for life andthe risk of hurling down a slippery slope toward a diminished respect for life. With legislation inthe offing, we are compelled to choose which values are most important and to cast our vote. Assisted suicide laws around the world are clear in some nations but unclear – if theyexist at all – in others. Just because a country has not defined its criminal code on this specificaction does not mean all assisters will go free. It is a complicated state of affairs. A great manypeople instinctively feel that suicide and assisted suicide are such individual acts of freedom andfree will that they assume there are no legal prohibitions. This fallacy has brought many peopleinto trouble with the law. Currently there are only four places which openly and legally authorise assisted suicide;Oregon since 1997, Switzerland since 1941, Belgium since 2002 and the Netherlands since 2002.Equally, there are countries such as Russia, Hungary, Republic of Ireland and England and Walesthat look upon assisted suicide as a criminal offence with harsh penalties.As an example, the American Medial Association, opposes the procedure, “We believe the U.S.Supreme Court will recognize and honor our ethical code and refuse to declare a constitutionalright to physician-assisted suicide," said Dr. Thomas Reardon, vice chair of the AMA. Theorganizations Council on Ethical and Judicial Affairs has consistently condemned the practice”. Between these two extremes there are also countries such as Germany, Denmark, Finland,and Luxembourg where there is no specific law against assisted suicide but equally there is nolegislation proclaiming it to be legal.
Doctors themselves are divided upon whether it should be legalised. In September 1996issue of the BMA News Review, the results of a survey of over 750 GPs and hospital doctorsshowed that 46% of doctors supported a change in the law to allow them to carry out the requestof a terminally ill patient for voluntary euthanasia, 44% were against euthanasia and supportedthe present law and 37% said they would be willing to actively help end the life of a terminally illpatient who had asked for euthanasia and so assisting suicide, if the law allowed it. It can be said that one of the most out - standing reasons for this difference is strongreligious beliefs, "Those who considered religion very important in their lives were much lesslikely both to support legalization and to consider personal involvement in assisted suicide,"researchers said. For those who believe in a higher power, they feel that only that power can takethem out of life, while those without religious beliefs say it is their right to decide. “ Pro – lifersgenerally believe that human beings have no right to determine when a life is over; they feel thatonly God can decide that”( Worsnop “Assisted suicide Controversy 412). In today’s society, one of the most controversial issues is physician-assisted suicide forthe terminally ill. Many people feel that it is wrong, regardless of their health condition, to asktheir health care provider to end their life; while others feel it is their right to be able to choosehow and when they die. When a physician is asked to help a patient into death, they have manyresponsibilities that come along with that single question. Among those responsibilities are:providing valid information as to the terminal illness the patient is suffering, educating the patientas to what their final options may be, making the decision of whether or not to help the patientinto death, and also if they do decide to help, providing the lethal dose of medication that will endthe patient’s life.