Summary
Voluntary termination of human life is one of the most controversial topics related to human health. People experiencing significant psychological or physiological suffering often resort to suicide methods. The ethics of this issue are incredibly confusing, and these contradictions only intensify when considering the problem from a medical perspective. Due to its radical nature, physician-assisted suicide is the subject of controversy. Additionally, this issue is complicated by the frequent mixing of wording and terms, which increases misunderstanding. According to the terminology of the American Medical Association, physician-assisted suicide (PAS) is the act of providing the patient with information and means from a healthcare professional to end one’s own life (“Physician-assisted suicide,” n.d.). This paper aims to explore and evaluate PAS based on this formulation by analyzing various aspects of this issue and reasoning for and against this technique.
Technical Aspects
For a more detailed analysis of physician-assisted suicide, it is necessary to investigate the technical aspects and features of PAS. This question is confusing because PAS is occasionally used as an umbrella term. It combines such concepts as doctor-prescribed death, the right to die, and death with dignity (Dugdale et al., 2019). However, these formulations distort the meaning of PAS by adding emotional overtones. From a technical perspective, physician-assisted suicide consists only in creating conditions for the patient to end his life by the medical specialist. In this context, the word “suicide” is critical since the decision and actions at the end of life are made by the patient, albeit with the preliminary help of a healthcare provider (“Physician-assisted suicide,” n.d.). In addition, an important technical detail is the availability of PAS only for terminally ill patients who can live no more than six months without medication (Pies & Hanson, 2018). Thus, physician-assisted suicide is the most accurate term to describe the process and should not be confused with other descriptions.
Public Policies
Additionally, the legal status of this process can help distinguish it. Physician-assisted suicide is not only a medical but also an official term enshrined in laws. Legislation is one of the characteristics of PAS that differentiate it from, for example, euthanasia, although the purpose of these two processes and their final result are very similar (“Physician-assisted suicide fast facts,” 2022). Physician-assisted suicide is legal and available in the District of Columbia and ten different states of America based on a 1997 Supreme Court decision (“Physician-assisted suicide fast facts,” 2022). From a legal perspective, regions of the United States are free to decide the status of PAS. However, it should be understood that what is described only applies to the United States, and laws and procedures for using PAS may differ in other countries (Mukhopadhyay & Banerjee, 2021). Such ambiguity in the legal and medical position of PAS only adds to the general confusion in the analysis of this process.
Arguments Supporting
Nevertheless, subject to the official wording, existing legislation, and guidelines for the work of medical professionals, a more detailed analysis of physician-assisted suicide becomes possible. In particular, it is possible to examine in detail the arguments in favor of PAS. One of the fundamental arguments in defense of PAS in this context is the need to respect patient autonomy. This rule is one of the basic principles of biomedical ethical healthcare, according to which a person has the right to control their actions (Dugdale et al., 2019). Therefore, defenders of this position argue that the principle of autonomy should also extend to the right to end one’s life (Sulmasy et al., 2018). Such a decision, in this context, is seen as equal to a decision to accept or refuse medical care.
Another notable argument is the need to alleviate a person’s suffering. As stated earlier, PAS can only be used by terminally ill patients forced to live off medications that support their condition (Pies & Hanson, 2018). As a result, they are forced to depend on drugs, special procedures, or equipment. PAS, in this case, can serve as a relief, an end to the suffering that is unethical to continue (Dugdale et al., 2019). This method is considered especially relevant in challenging conditions, when a person loses the ability to live their former life due, for example, to paralysis.
Finally, another argument is the safety of physician-assisted suicide as a practice. Suicide as a method is often associated with pain caused by crude methods of inflicting fatal injuries. In comparison, PAS is performed in a medical setting, contributing to a high level of patient awareness and an easier, painless death (Dugdale et al., 2019). In this context, it is assumed that a suffering person who is ready to commit suicide can attempt to end their life with or without assistance. However, in the conditions of medical institutions, this attempt will be more conscious, balanced, and controlled.
Arguments Against
Despite a significant number of arguments allegedly supporting the interests of patients, there are many opponents of this initiative. Much of the opposition to physician-assisted suicide is built on a critique of opposing arguments, the destruction of the patient-physician relationship, and the undermining of the very foundation of healthcare (Pies & Hanson, 2018). First, the “right to commit suicide” put forward by the defenders of the PAS is being criticized. Although a person has the right to autonomy, there is no legal provision that would provide them with the right to end their life (Pies & Hanson, 2018). Moreover, the very definition of suicide does not imply another person’s participation, even indirectly. Simultaneously, technically, without the help of a physician, PAS cannot exist, which brings this initiative closer to deliberate harm to human life.
Secondly, according to some opinions, the existence of PAS as a concept negatively impacts society. According to Sulmasy et al. (2018), physician-assisted suicide can affect morality, as it provides a legal initiative to end life as an alternative to suffering. The normalization of suicide can lead to an increased frequency of this phenomenon. Finally, as an initiative, PAS goes against the very essence of medicine as a field of healing and providing care to those in need (Sulmasy et al., 2018). Doctors, by their vocation, must do everything to contribute to the recovery of the patient and the improvement of their condition. Killing patients out of pity or at their request is contrary to this concept and, as a result, should not be a normalized medical practice.
Personal Opinion and Conclusion
Thus, the problem of physician-assisted suicide is multi-component, challenging to analyze, and includes moral, ethical, and legal issues. In addition, in many cases, the study and discussion of this topic are hampered by errors and inaccuracies in terminology. However, the analysis of the essence of the process allows asserting that the legalization and widespread distribution of PAS is unacceptable. Both in its fundamental structure and current form, this initiative does more harm to society than good. As a result, I agree with the opponents of physician-assisted suicide. From my point of view, the development of methods of providing assistance is much more promising and correct than legitimizing the possibility of dying. Thus, PAS is currently an inferior program with many shortcomings from medical and legal perspectives, making it unacceptable for use in healthcare institutions.
References
Dugdale, L. S., Lerner, B. H., Callahan, D. (2019). Focus: Death: Pros and cons of physician aid in dying. The Yale Journal of Biology and Medicine, 92(4), 747.
Mukhopadhyay, S., & Banerjee, D. (2021). Physician-assisted suicide in dementia: A critical review of global evidence and considerations from India. Asian Journal of Psychiatry, 64, 102802. Web.
Physician-assisted suicide. (n.d.). American Medical Association. Web.
Physician-assisted suicide fast facts. (2022). CNN. Web.
Pies, R. W., & Hanson, A. (2018). Twelve myths about physician-assisted suicide and medical aid in dying. HCP Live. Web.
Sulmasy, D. P., Finlay, I., Fitzgerald, F., Foley, K., Payne, R., & Siegler, M. (2018). Physician-assisted suicide: why neutrality by organized medicine is neither neutral nor appropriate. Journal of General Internal Medicine, 33(8), 1394-1399. Web.