Ethical Dilemma of Assisted Suicide
"In the care of patients with terminal illness, arguably the singular purpose should be safe, effective treatment and relief of pain and suffering," yet it is within this context that a heated debate about assisted suicide exists (Goslin 2006 p 2). Overall, the public seems to support the individual's right to choose. This has been deeply ingrained within American culture in the presence of staunch individualism. It is also present within debates exploring how to handle the end stages of life for terminally ill patients who are in great suffering. The current research shows an environment where the public supports such measures; yet, overwhelmingly, physicians tend not to show the same type of support for the practice. Ethical considerations are also a major part of the debate; with religious beliefs and morality tend to influence support as well. Essentially, assisted suicide is an issue that is very controversial, and one which will continue to spur debate for generations to come.
Assisted Suicide
Physician-assisted suicide (PAS) occurs when a terminally ill patient requests the actions of their physicians in helping them end their life prematurely, before whatever condition or illness can actually cause their death. Essentially, PAS is different from withdrawal of life support and terminal sedation because it allows the individual to have an active choice in the matter of when and where they actually die (Curlin et al. 2008).
PAS is a practice that is widely debated as a hot bed controversial issue, yet has found some support in legislation around the world. Some European countries allow for assisted suicide in extreme cases. One notable example of this is in the Netherlands, which allows for assisted suicide to end "intolerable suffering" (Hendin & Foley 2008 p 124). This statute is protected under The Dutch Euthanasia Act, which allows for the possibility of assisted suicide when individuals meet the extensive list of criteria (Buiting et al. 2009). Here, the research states that it is also "granting physicians full immunity and then surveying them with questionnaires and interviews," (Hendin & Foley 2008 p 143). This essentially part of how the practice is observed and regulated within the Dutch environment and assures that cases of assisted suicide and euthanasia were properly reported and accounted for. Such restrictions also focus on making sure physicians are responsible for taking all the necessary precautions. Similar legislative practices exist also Belgium (Buiting et al., 2009). In this country, there are stipulations which also make assisted suicide possible, under the most extreme of cases (Chambaere et al. 2011). Although technically still illegal in the UK, England has adopted legislation that has decriminalized the act of suicide with The Suicide Act in 1961 in the UK (Curtice & Field 2010). This piece of legislation states that "the act of suicide itself is not a criminal offense," (Curtice & Field 2010 p 187). It therefore allows individuals to go abroad and enter into care in another country that allows PAS practices, because of the fact that assisted suicide is still illegal in the UK itself.
The United States has also had a long history of dealing with this controversial issue. In 1997, the United States Supreme Court "ruled that there was no right to assisted suicide in the Constitution but implied that states have the right to decide for themselves whether to permit or prohibit physician-assisted suicide," (Hendin & Foley 2008 p 121)
Since the 1990s, over nineteen states have tried to legalized measures of assisted suicide (Gorsuch 2009). Many of these have proven unsuccessful, and instead, most states actually have standing bans on PAS practices for terminally ill patients. Most recently, Washington passed legislation adopting PAS practices in extreme cases in 2008 (Buiting et al. 2009). The most notable case, however, is Oregon's Death with Dignity Act (Hendin & Foley 2008). This act allows for assisted suicide under the care of physicians under very specific circumstances. Terminally ill patients who have a diagnosis of living less than six months have the right to request PAS if desired under this state statute. The act also provides the physician the capability to prescribe medication in lethal doses so that individual can make the decision on their own in terms of when and where they want to die. In fact, Oregon was the first state in the United States to pass legislation supporting patients' rights to assisted suicide. Still, there are many restrictions and specifications of the law. Two witnesses must be present to witness the request, who are not family or physicians, and there...
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