Ethical Dilemma and Stakeholders
Is it morally or ethically wrong to institute PAS? This is the first ethical dilemma. If the State will pass a law legalizing PAS, what will be the safeguards? Who is the ultimate judgment regarding the patient’s right to live or die? This is the second ethical dilemma.
Safeguards in the Oregon Statutes
There is no constitutionally protected right with regards to PAS. However, it is essential to add safeguards because PAS is prone to abuse. No matter how clinical it may sound, at the end of the day, PAS is a license to kill. The God-given power to kill had been transferred to the hands of physicians. A cursory overview of the Oregon Death with Dignity Act will reveal several safeguards. There must be a waiting period before the terminally ill patient can avail of PAS. At least two physicians must concur that the patient will probably die within six months. Request for PAS can only be approved after a written request has been made. Request for PAS is approved after the patient went through the process of informed consent.
There are three major stakeholders in this case. The first stakeholder is the terminally ill patient that requested PAS. The second significant stakeholders are the terminally ill patients that did not ask for PAS. And finally, the third considerable stakeholders are the physicians who will give sign the documents to facilitate PAS.
From the point of view of the primary stakeholder, the procedures with regards to PAS must be clear and easy to follow. The State must avoid unnecessary delay. From the point of view of the secondary stakeholder, there is fear that PAS can be utilized to hasten the early demise of the uninsured, members of the minority groups, poor people, and ancient patients (Lynn, 1999). With regards to the third major stakeholder, it is almost impossible to determine with exact certainty that the patient is going to die within six months (Feutz-Harter, 2012).
The safeguards have flaws, and due to the absence of a reliable system that could prevent the abuse of PAS, the State must do everything in its power to stop the creation of a law that is similar in nature to the Oregon Death with Dignity Act. The safeguard that requires two physicians to sign on relevant documents is not enough. Even if the State requires a third-party consultant, it is relatively easy to persuade a physician to sign the papers. For example, family members can convince a friend or someone they knew to sign the documents. Another major flaw of the safeguards is seen in the “six-month rule,” wherein the doctors must be sure that the patient is going to die within the said time frame. Medical science has not yet reached a level of sophistication that it can predict the time of death. The Oregon Statute noted that mentally ill patients and those who suffer from depression are not allowed to avail of PAS. However, it is difficult to properly diagnose depressed people. The most problematic aspect of PAS is its tendency to eliminate the incentives needed to improve palliative care. PAS is a quick-fix solution to a problem that requires sensitivity, love, and compassion from family members and from the medical community. In the long run, PAS can do more harm than good. It is also prone to abuse. Everything must be done to block the legislation of this statute.
Feutz-Harter, S. (2012). Legal and ethical standards for nurses. WI: PESI Healthcare.
Lynn, J. (1999). Guidance for mortals. New York: Oxford University Press.