Situational Suicide

In our highly progressive modern culture, medical advancements are occurring everyday. Discoveries in the fields of drugs and developments of life-sustaining mechanical systems are revolutionary, creating miracle medical recoveries where a few years previously survival was a slim hope. As miraculous as the medical advancements prove to be, they can also tread heavily on the lines of life. Life-support systems where the patient is sustained by oxygen and nutrition tubes, without hope of recovering independent functioning, is a situation that is new and strange to our society. Never have humans faced the many moral components that a position like this raises. For example, consider a person with normative mental functioning, yet reliant on machinery for breath and food because of permanent paralysis - never before have people existed in this way.

Philosophers, as well as scientists and psychologists, maintain an under-pinning debate of quality of life versus quantity of life. Although nothing is novel concerning the basic ethics in this debate, a situation like the one described can strike up a fierce dispute in modern philosophers. Should value be placed on the quantity of years spent living on this earth, or should quality of life be considered only? And how do you compare two immeasurable concepts? One person’s view of quality of life differs from another, and one person might view quantity to have a value higher than quality itself. Yet despite conflicting opinions, these are merely the roots underneath the looming issue of Physician-Assisted Suicide (PAS).

The definition of PAS is the administration of a lethal dose upon the patient’s request with the intention of ending their life with relative ease. General euthanasia is distinguished from PAS by the fact that the latter must be patient-initiated and administered. PAS, as well as general euthanasia, is in a unique moral situation. Not only is it philosophical, but the issue extends into a myriad of levels –encompassing ethical, political, and medical spheres. It is an issue that radiates into all aspects of social life, because once the legal and therefore accepted view on a decent end-of-life alternative is or is not changed, the entire society will be influenced. Now will the influence be for good or for ill? That is the crux of the matter.

Oregon has legalized Physician-Assisted Suicide since October 27, 1997 upon enacting the Death with Dignity Act. The Act gives patients a way to avoid a prolonged inevitable death through legal suicide. Many stipulations surround the application for and administration of the lethal dose; primarily the patient must be under the care of a physician that has declared the patient terminally ill without hope of recovery. Proponents of the Act support the freedom it grants to Oregon residents. The privilege to choose a relatively painless and rapid death gives terminally ill patients a peace about their end, supporters say. To debilitated patients, the Act functions as a trump card over a fatal illness.

This Act essentially involves the issue of quality versus quantity of life. The Oregon Death with Dignity Act upholds that quality of life is more precious to a person than quantity, and therefore grants the right to terminate the life of a person once their life is unlivable, being void of quality. In establishing the Act, the lawmakers in Oregon defined a person’s life as unlivable because of lacking livable health qualities or being sustained in unlivable circumstances. Pain is paramount in their definition. A patient suffering from unendurable pain or facing a lingering painful death from a disease, such as malignant cancer, have the right to an honorable and painless suicide in the views of Oregon lawmakers.

PAS laws are appearing on more and more state ballots as interest in the issue spreads throughout the nation. The advancements in medicine leave people anxious about end-of-life issues, and what personal control their medical options allow. Patients desire that their decisions are dominant, and that the quality of life versus quantity of life is their decision alone. Current statutes establish that patients have absolute right to know every medical process performed and full rights to deny medications or procedures at anytime. Documents such as living wills and Do Not Resucitate (DNRs) are growing in popularity because they guarantee the patient's wishes are known and followed. Refusing life-sustaining medical equipment or medication can be outlined in these documents, and the patient can also stop the administration of them at anytime.

The US law regarding end-of-life issues already encompasses respect for the patient's decisions and protects their rights to refusing treatment. Because of the provision currently available in the law, Physician-Assisted Suicide acts are unnecessary, and even harmful to society. PAS is morally wrong and should not be legalized because the issue negatively affects numerous ethical, political, socio-economic, and medical areas. Passing PAS acts across the nation could endanger the medical circumstances of the poor, the weak, the aged, and the debilitated as PAS becomes a standard end-of-life option that would target and pressure patients in these situations. Patients outside these situations, namely the wealthy, middle-aged, and those of full mental capacities should consider the impact such laws would have on other situational levels, and detest the possibility of coercion in them. For example, a lower-class elderly retiree with a debilitating disease might not want to become a financial burden to her family for her remaining life-span, and therefore opts for PAS because of convenience.

Undoutedly, issues regarding retarded or quadriplegic individuals will be raised - perhaps the law-makers will decide that they maintain a low quality of life, therefore they can be allowed to request a suicide. How would that demonstrate the value of life? If patients who meet a certain criteria can be aggressively euthanized by the medical profession, what is to stop that criterion from expanding? Where do you draw the lines regarding the appropriateness of suicide? Or do we simply believe that suicide through the administration of a physician becomes acceptable by affiliation?

In consideration of the Natural Law Theory, PAS stands in opposition to its values. Natural Law Theory (NLT) states that life should be preserved and fostered in every individual, regardless of their state of health. Performing suicide for reasons of declining health or impending death would never be supported, espcecially injecting a patient with a lethal dose. Although PAS is morally wrong, and inconsistent with NLT, refusal of medication should always be a patient’s right. Although firm on the subject of suicide, NLT does not ignore the importance of quality of life, and is only adverse to its artificial termination. Modern technology has expanded until life can be preserved beyond that of natural stamina, supported by medical machines and high-dosage prescriptions. The patient may choose to let the disease run its course uninhibited by medicine, knowing it would lead to certain fatality. This is within the full moral compulsions of the patient, and does not endanger the rights of other humans.

I find that the provisions already enacted within the United States regarding patient’s rights and medical procedures allows for decent and comfortable deaths without necessitating Physician-Assisted Suicide laws. End-of-life quality can be facilitated through non-invasive pain-killing medication and establishments such as Hospice care. Legalizing suicide is morally wrong, regardless of medical situation or of support from medical and governmental agencies.

Links: Access to Oregon’s Death with Dignity Act: http://www.oregon.gov/DHS/ph/pas/

Following official document retrieved from Oregon's Death with Dignity Act:

REQUEST FOR MEDICATION

TO END MY LIFE IN A HUMANE

AND DIGNIFIED MANNER

I, ________________, am an adult of sound mind.
I am suffering from _______, which my attending physician has determined is a terminal disease and which has been medically confirmed by a consulting physician. I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives, including comfort care, hospice care and pain control.

I request that my attending physician prescribe medication that will end my life in a humane and dignified manner.

INITIAL ONE:
_____ I have informed my family of my decision and taken their opinions into consideration.
_____ I have decided not to inform my family of my decision.
_____ I have no family to inform of my decision.

I understand that I have the right to rescind this request at any time. I understand the full import of this request and I expect to die when I take the medication to be prescribed. I further understand that although most deaths occur within three hours, my death may take longer and my physician has counseled me about this possibility.
I make this request voluntarily and without reservation, and I accept full moral responsibility for my actions.
Signed: ___________
Dated: ___________

-Kaitlin Rich