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Williams 1 Kasey Williams Dr. Aaron Phil 301 2nd December 2018 Physician Assisted Suicide and Euthanasia Physician assisted suicide and euthanasia and both highly controversial ethical issues. Physician assisted suicide is when a physician prescribes a medication to a patient for them to end their own life. In this case the doctor is not the one committing the act of killing but is helping the competent patient who is suffering from a terminal medical illness commit suicide. Euthanasia is when the doctor is the one killing the patient, this can be active or passive. Active euthanasia is when the doctor is directly killing the patient, normally with an overdose of medications. Passive euthanasia is when the doctor is killing the patient by just allowing them to die, this can be done by withholding treatment or turning off a machine that is helping them to stay alive. I believe that physician assisted suicide and euthanasia are both immoral, but physician assisted suicide should be legal due to the patient autonomy. This paper will be discussing the differences between physician assisted suicide and euthanasia and the positive and negative view points to both. Also, I will discuss my view points on both topics. Many think that euthanasia and physician assisted suicide are the same when they are not. The main difference between the two are the action of how they are done and the involvement of the doctor. In Physician assisted suicide involves the doctor but in an indirect manner (Dixon, par. 7). This is the patients’ choice to make but they are not alone when making it, but this decision is solely up to them. Although the doctor is normally not present other people such as family can be there for support. However, the patient cannot legally have help when taking the

Williams 2 medication prescribed to them. Euthanasia on the other hand has direct involvement of the doctor. Active euthanasia is normally the form of a lethal injection (Dixon, par. 11). Although these are two different actions of killing a patient they both require the patients’ voluntary request. Passive euthanasia still involves the doctor, but it is in a more indirect way. The doctor is withholding treatment from a patient on purpose to allow them to die. Physician assisted suicide and euthanasia can both be looked at as morally wrong in many ways. However, physician assisted suicide is currently legal in five states and the district of Columbia, whereas active euthanasia is illegal in all states. Some people argue that these are the easy way out of a difficult situation. People say this is because of the view of destiny, people are given what they could handle and nothing more. So, by choosing to die or commit suicide is violating the plan made for you (Engelhardt, pg. 119). People do not follow through with their own fate of natural death because they cannot accept their situation. I believe that people are only given what they can handle. Due to that I do not feel like people need to end their lives because they would not be given these issues if they could not handle it. This is not following through with the duty to live. We have the duty to live because I believe we were put on earth for a reason and by cutting our life short we are not following through with our duty or destiny. Another reason physician assisted suicide can be looked at as morally wrong is because it discriminates against people with disabilities. This is because the person must take the medication themselves. They are not legally allowed to have help from the doctor or family members when pursuing this path. So, a paraplegic would not be able to choose physician assisted suicide because they physically cannot take the medication alone. Since being able to take the medication by yourself is a requirement for physician assisted suicide, I believe this is discriminating against people with disabilities and therefore immoral. This is discrimination

Williams 3 because some people cannot take medications themselves. For example, with the paraplegic, they cannot take the medication without help from someone. This is a problem even if the medication could be mixed into a drink because the patient cannot mix nor drink the medication by themselves. This then is not a feasible option for those who are disabled and cannot do things without the help of family or friends because it is illegal for them to help the patient. People can choose physician assisted suicide prematurely. When choosing physician assisted suicide, there are times when not all forms of care are used beforehand (Gill, pg. 28). So, if a better form care was provided patients may not request this form of care. I think that this is true, patients find the worst in their situation rather than staying hopeful. If patients were more open to other options they may have a better chance at becoming more comfortable. To become comfortable the patient can take pain medications to alleviate their pain and discomfort. So, instead of finding other ways to be treated they decide on physician assisted suicide too early. If patients can decrease their pain level and achieve comfort they would be less likely to ask for physician assisted suicide because they are no longer suffering due to pain. This ties into the idea of the patient being hopeless (Gill, pg. 35). I think this has a lot to do with the mental state of the patient. Some patients received bad news and are not in the right state of mind to make big decisions regarding their care. Doctors try to explain the treatment options to the patients but at this point they are not comprehending what is going on or they only tried one thing and it was not successful. Patients have a bad mindset when something is not working properly so they tend to pick the last option of physician assisted suicide rather than considering another option. Active euthanasia can be looked at as morally wrong because of the action of killing. The doctor is pushing an injection into the patient to help kill them. I agree that active euthanasia is immoral because I think the doctor physically killing the patient in active euthanasia is worse

Williams 4 than the patient taking the medication prescribed to them in physician assisted suicide. This violates nonmaleficence because the doctor is to do no harm to the patient and by pushing lethal injection into the patient the physician is doing the ultimate harmful act, killing. I do not agree with the idea of active euthanasia because as a nursing student I believe that it is the medical teams job to do everything they can to comfort a patient, not do what we can to help kill them. Also, if active euthanasia is preformed there could be multiple factors that go wrong. These include miscalculation of dosages that will not properly work and the sudden change of heart halfway through the procedure. If a patient decides to stop halfway through the side effects may be irreversible but still potentially deadly due to the high dosages the patient is receiving. So, whether the patient would still die due to the amount injected into their body or would have damage due to the amount this is still immoral. This then brings back the idea of nonmaleficence, doing no harm to the patient, because the patient will either be killed or in severe life-threatening conditions. Therefore, I do not like the idea of euthanasia and think it is immoral and should not be a legal option for patients to choose from. There is no taking back what has been done to the patient if they change their mind. Finally, with active euthanasia I do not think the patient considers they are not the only person involved in the process. This form of death can cause emotional trauma to the family of the sick patient. Patients are worried about being a burden to their family because they need help but do not consider the effect it has on them when they die. Families may not receive closure from their family member being induced into the death rather than dying naturally. This can then leave the families in anger towards the doctors and medical staff who helped do this to their loved one. Also, I believe there could be more people who do not trust doctors. This is due to the social role doctors hold (Emanuel, pg. 636). People will start to think that doctors do not care

Williams 5 about helping patients, since with euthanasia they would easily be able to end their suffering rather than help them be comfortable. Many physicians did not report regret or emotional trauma after performing euthanasia (Emanuel, pg. 636). So, this will lead to a decline of doctor visits because patients would fear being lied to or not getting the proper help they wish for. Others say that this is an honorable way to end their life, dying with dignity. The largest benefit both physician assisted suicide and euthanasia have are the respect of patient autonomy (Emanuel, pg. 630). This is an essential value people have when it comes to being able to make their own decisions. Patients have the right to choose what they want out of their medical care. Therefore, by choosing physician assisted suicide or euthanasia these patients are doing something that many others would fear doing, taking their life before they are completely ready to go. This is debatable depending on how you look at the position the patient, the patient’s family, and the doctors are in. With this argument I think people need to look at the meaning of destiny. I believe that if someone chooses the route of medically assisted suicide they are not following their destiny as planned for them. As I mentioned before I believe people are only given what they can handle. Although I do not agree with Physician assisted suicide and euthanasia I do believe that people should have the option to choose physician assisted suicide during medical treatment out of respect for their autonomy. Physician assisted suicide and euthanasia have one large benefit: ending a loved ones suffering. Although the argument of whether dying this way is dignified or not is still up for debate by society, the decision is completely up to the patient. This is up to the patient so that they can remain autonomous, being self-governing and able to make their own decisions. Some people cannot find meaning in suffering and their physical deterioration due to an illness could potentially lead to a loss of personal meaning (Sullivan & Robert, pg. 54). So, for some people

Williams 6 this may be the most dignified way to die. This allows for them to pass on peacefully, also many people do not want their family to remember them in a way of suffering, so this may allow for them to give their family peace and to remember them for who they were not for how they were at the end of a terrible disease process. Many people think that pain is the most common reason for physician assisted suicide, but this is not true. People want to have more control over their final moments here on earth and want everyone else to respect their choices (Sullivan & Robert, pg. 54). This leads me back to the autonomy of the patients, for a patient to be completely autonomous they must be fully aware of the risks and benefits of their choices as well as being respected. Many physicians do not believe in physician assisted suicide, although they do not want to see their patients in pain it is their job to save lives not take them. But, they must respect their patients wishes. So, this leads to the idea of beneficence, the promotion of acting in what is good for the patient. Physician assisted suicide can help end a patient’s pain. By ending the patient’s pain, the doctor is doing good for the patient. I do not think that this is doing good because they are causing the ultimate harm of death on the patient. But, I do think that the patient having control over their medical care is very important and that they should have the right to choose what happens to them so the doctors and nurses act in a manner that benefits the patient. However, this voids the idea of nonmaleficence, the oath a doctor takes to do no harm. This is then immoral on the doctor’s end because their job is to save a patient’s life not end one. Although they are different, physician assisted suicide is preferred over euthanasia. This is because of the sudden change of heart right before the action is fully completed (Dixon, par. 11). In euthanasia once the physician would inject the lethal injection they cannot go back, and this leads to patients being abrupt and yelling stop in the middle of the procedure. But, with

Williams 7 physician assisted suicide it is all in the control of the patient to take the medication or drink the liquid. So, the sudden change of heart is making physician assisted suicide more favorable. Although I feel that both forms of medical assisted death are morally wrong because they both have to do with killing or to help kill a patient, in my opinion I agree with the statement to prefer physician assisted suicide. This way the patient can change their mind and not take the medication. Whereas if I was the doctor who was pushing them with lethal injection and halfway through they decided that they did not want to go through with it, I would know that they had a slim chance of survival due to what is in lethal injection and what those substances can do to the human body. This is something that many people are not aware of that can cause a large issue in more ways than one. The main reason is that if someone does not know what the medications in lethal injection do, they may not understand the risks of stopping it. Also, since the body weight must be considered for the injection to work properly it is very common to mess up which is the leading cause in why lethal injection does not always work right. So, if someone choses euthanasia, there is a chance of it not working and causing serious side effects or having too much and the patient deciding that they no longer wanted it and it could potentially kill them anyways. So, I think that it would be better for the patient to go with physician assisted suicide in case they did have a change of heart, so that they could turn back around. Pain and suffering is the second reason people argue that physician assisted suicide and euthanasia are good implementations in the medical field. This is because many terminal illnesses cause a large stress on the human body. An illness such as cancer could last days, weeks, months, or years because they have no set date to end a life. So, the drawn-out process of these diseases can cause real damage on the body and its immune system and other body systems. These diseases start to affect all organs and cause pain that medications can’t control

Williams 8 and cause the patient to suffer. So, if a patient can end their suffering to be at peace they might consider these options. I do think patients should have the option of physician assisted suicide or euthanasia when they are suffering with uncontrollable pain. This brings back autonomy, the patient is competent and able to choose what they want for themselves. Another reason people seem to like the idea of physician assisted suicide or euthanasia is for psychological reassurance. There is no real data available that this is proven true yet but many people who are ill have talked to their doctors about this (Emanuel, pg. 635). This would relieve pain in numerous people as well as improves death. It also gives patients reassurance to know that it is an option (Emanuel, pg. 635). I also think this refers to what I said earlier about family reassurance as well. People do not want their family to remember them in pain and suffering. They want to be remembered as who they always were as a fun and loving family member. So, I think this is something that patients worry about when they know they are sick they are afraid people will lose sense of who they were. Also, these patients’ do not want to be a burden on their family to have to worry about and care for them. I personally believe that the psychological reassurance is a big factor in the choice of euthanasia or physician assisted suicide. But I also think that the patient does not realize that their family will still suffer after their death. Although the patient does not want to be a burden on their family they are still causing them pain by inducing their death because the family will not have closure to the situation. These are all good reasons to allow physician assisted suicide to be legal so that the patient can remain autonomous. This is then extending the choice of how a patients’ life ends, giving the control over their treatment. The positives of physician assisted suicide discussed above seem to be good enough reasons to make these options legal throughout the country. Euthanasia should not be legalized

Williams 9 due to the problem I have previously stated; how things could go wrong and cause more harm if the injection does not properly work or the patient decided halfway through they no longer wanted this. I personally believe that these are both immoral, but that does not mean that they should be illegal. Physician assisted suicide should be legal for people to choose as a form of their medical treatment since they have the right to make this decision due to their autonomy. Due to my own beliefs I would not choose to take part in this because I personally do not find it moral. Although, I believe that others should still have the option to choose if they wanted physician assisted suicide because this may be the right option for them with what they are going through.

Williams 10 Works cited Dixon, Nicholas. “On the Difference between Physician-Assisted Suicide and Active Euthanasia.” Hastings Center Report, vol. 28, no. 5, Sept. 1998, pp. 25–29. EBSCOhost, proxy-clarion.klnpa.org/login?url=http://search.ebscohost.com/login.aspx? direct=true&db=phl&AN=PHL1662606&site=ehost-live&scope=site. Emanuel, Ezekiel J. “What Is the Great Benefit of Legalizing Euthanasia or Physician-Assisted Suicide?” Ethics: An International Journal of Social, Political, and Legal Philosophy, vol. 109, no. 3, Apr. 1999, pp. 629–642. EBSCOhost, proxy-clarion.klnpa.org/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=phl&AN=PHL1667495&site=ehost-live&scope=site. Engelhardt Jr, H.Tristram. “Physician-Assisted Death: Doctrinal Development vs. Christian Tradition.” Christian Bioethics: Non-Eucumenical Studies in Medical Ethics, vol. 4, no. 2, Aug. 1998, pp. 115–121. EBSCOhost, proxy- clarion.klnpa.org/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=phl&AN=PHL1661848&site=ehost-live&scope=site. Gill, Michael B. “Is the Legalization of Physician-Assisted Suicide Compatible with Good Endof-Life Care?” Journal of Applied Philosophy, vol. 26, no. 1, Feb. 2009, pp. 27– 45. EBSCOhost, proxy-clarion.klnpa.org/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=phl&AN=PHL2131797&site=ehost-live&scope=site. Sullivan, Dennis M., and Robert M. Taylor. “The Ethical Landscape of Assisted Suicide: A Balanced Analysis.” Ethics and Medicine: An International Journal of Bioethics, vol. 34, no. 1, Mar. 2018, pp. 49–57. EBSCOhost, proxy-clarion.klnpa.org/login?

Williams 11 url=http://search.ebscohost.com/login.aspx? direct=true&db=phl&AN=PHL2366229&site=ehost-live&scope=site....