Assisted Suicide Essay

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In the world today there are arguments for everything, ranging from matters of great importance to things that may seem ridiculously trivial. However, there are always different sides to every case and right and wrong is in the eyes of the person involved in the dispute. This argumentative essay is based upon a very serious situation that faces our medical community. The topic of assisted suicide and/or euthanasia is a highly debated subject with many issues and sides. In this essay, each topic will be discussed and analyzed and the arguments for and against this topic will be debated. I will discuss my reasons for advocating physician-assisted suicide and I will also provide objections to my argument, but even though these counter arguments have merit, I will provide enough evidence to support my thesis. The topic of my paper is physician-assisted suicide. Sometimes it is incorrectly referred to as euthanasia, but however subtle, there is a difference between the two. Euthanasia is when the doctor provides the means with which the patient may end his own life whereas physician-assisted suicide is when the doctor causes the patient's death, for example through a lethal dose. In his own words, the infamous Dr. Jack Kevorkian describes the difference between euthanasia and his own profession: "It's like giving someone a loaded gun. The patient pulls the trigger, not the doctor. If the doctor sets up the needle and syringe but lets the patient pull the plunger, that is assisted suicide. If the doctor pushed the plunger, it would be euthanasia." (McCuen 1994 p.54) Both euthanasia and physician-assisted suicide will be discussed in this paper as they pertain to the arguments for and against this subject. Ethics 3 There are many arguments for both sides of this case. In this part of the essay I will discuss the argument against assisted suicide. The Bible reads, "Thou shall not kill". The American Nursing Association (ANA) position statement reads, " A nurse must not act deliberately to end a person's life." These are two of the very basic arguments against euthanasia. However, the subject is much more complex than these two defining pieces of literature suggest - there are many reasons why it is morally wrong and unethical to take a patients life away, even though they may have requested it. The religious argument is one of the strongest and most powerful opponents to assisted suicide. It is based on two main points, the first defining the sanctity of life. "All life, but particularly human life, is recognized as a direct gift from God, one that never becomes personal property. It is ours not to give away, to damage, or to destroy at will, but to preserve intact until the moment when it is taken back" (McKhann, 1999, p. 63). The second point is entrenched in the Christian belief that suffering can be beneficial in its own right. Suffering should be looked at as a positive thing when it is unable to be avoided because it means the entry to something good. "An extension of this thinking is that suffering is a result of guilt that leads to repentance. The greater the suffering, the greater the guilt, hence the greater the need for repentance" (McKhann, 1999, p. 63). Besides the religious case against physician-assisted suicide, another argument would be that it violates medical ethics. The American Nurses Association (ANA) position statement reads, "A nurse must not act deliberately to end a person's life" (Sullivan, 1999, p. 31). The Hippocratic oath also states; "I will give no deadly medicine Ethics 4 to anyone if asked, nor suggest any such counsel" (Woodman, 1998, p. 162). Taken from two of the most prestigious and important documents in the medical field, these statements strictly forbid the taking of a patient's life or aiding a patient in his or her death. One of the most important things in health care is the relationship between the health care worker and a patient because it is the health care worker's job to provide not only medical care but also support, hope and a caring relationship. If a patient were distressed enough to bring up the subject and the physician were to agree that the choice is a rational one and that assisted suicide is a reasonable alternative, would this not reinforce the patient's feelings of despair and worthlessness? Even a suggestion of agreement might undermine any remaining hope. McKhann, 1999, p. 150 The last argument against assisted suicide that I am going to deal with is the patient's state of mind. When making any important decision in life, one must give it plenty of thought and be completely unbiased. When something tragic has happened to make one consider death, their state of mind must come into question. Are they considering death for the 'right' reasons? If a physician assisted death is to be considered, a patient must be considered mentally competent. There are many issues that interfere with a patient's mental capacity to make such a drastic decision. The patient may be temporarily depressed or may undergo a change of mind. Patients should be given Ethics 5 sufficient time and counselling in order to enable them to make sure their decision represents their true wishes. Guilt is another reason a patient's state of mind may come into question. Patients might feel guilty for staying alive and choose death to lift the financial burden or the strain on loved ones. Desperate and emotionally exhausted, families may give up too quickly and eagerly lend their support to the termination of a relative's misery, as well as their own. In the preceding paragraphs an extremely convincing argument has been made against assisted suicide. After all, it violates personal and medical ethics and it undermines the relationship of patients with their health care workers. Besides, what happens if a miracle cure is found after the patient has already made the decision for assisted suicide and gone through with it? Once suicide has been committed it is irreversible. What's done is done and there is no changing it. If the Hippocratic Oath and the ANA states that it is wrong, and the ever influential Bible argues against assisted suicide, then who are we to question it? Instead of trying to help end patients' lives, people and physicians would be better served by improving all patients' state of life and mind so that they can live out their last days free from pain and enable them to gain a sense of spiritual fulfillment. As mentioned in my thesis statement, I support assisted suicide. I want to make a cautious argument because I believe that under some carefully limited circumstances, it is permissible for a physician to assist a person in taking his or her own life in order to put an end to unwanted and unnecessary suffering. This includes Ethics 6 providing medicines or other means the patient can use to commit suicide or by directly administering these medicines themselves. As stated earlier in the religious argument against assisted suicide, life is a gift. However, in a time of suffering "the gift may no longer be wanted and the loan gladly repaid" (McKhann, 1999, p. 63). If it is God's place to give and take away life, then an implication of that objection is that we should not interfere at all with any life threatening condition because it is God's will. After all, what would happen if a person is bleeding to death from an accidental cut? To interfere and help would mean to interfere with God's prerogative to determine time and place of death. The religious argument is also flawed for two other reasons. What if a person has no faith or what if that person's faith suggests something different? With so many religions in the world, there are bound to be conflicting views on almost everything including suicide. The second reason is challenged "by those who do share the faith when the suffering seems out of proportion to any possible spiritual benefit. Even the most devout Christian will ask, "what have I done to deserve so much pain?" (McKhann,1999, p. 64). The religious argument against assisted suicide is quite strong but if one were to take a closer look, large holes in this argument can be blatantly seen. It is true that the physician-patient relationship is important. However, I feel that a patient's trust would not be undermined with the implement of assisted suicide. I would want to be able to trust my doctor to do what is best for me in every situation. If my life has become so unbearable that I feel I need to end my life, I would want my Ethics 7 doctor to help me die a painless, peaceful death and not one racked with pain and misery. I would want to trust that my physician will respect my every wish. Dr. Charles F. McKhann concludes, " most patients interviewed in my study felt that knowledge that their physicians had helped others to die would either have no effect or would enhance their respect for their physicians" (McKhann, 1999, p. 150). The role of the physician is to do what is best for the patient, and in some extreme situations this may include hastening death upon the voluntary request of the dying. If the role of the physician is defined solely in terms of healing, then, of course, this excludes assisting someone to die, but this is the wrong way to go about defining a doctor's role. I feel that a doctor's role is to do the best thing for the patient, whatever the circumstances may be. In nearly every case the answer will be to heal, to prolong life, to reduce suffering, to restore health and physical well-being. However, in some extreme circumstances, the best service a physician can render may be to help a person end their life in order to end intolerable pain as judged by the patient.

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