Physician-Assisted Suicide – an Utilitarian Perspective
Physician-assisted suicide is “the voluntary termination of one’s own life by administration of a lethal substance with the direct or indirect assistance of a physician. Physician-assisted suicide is the practice of providing a competent patient with a prescription for medication for the patient to use with the primary intention of ending his or her own life” (MedicineNet. com, 2004). Many times this ethical issue arises when a terminally-ill patient with and incurable illness, whom is given little time to live, usually less than six-months, has requested a physician’s assistance in terminating one’s life.
This practice with the terminally ill is known as euthanasia. Physician-assisted suicide and euthanasia is a controversial topic that brings up many ethical issues and the rights of the patients the physicians serve. Many questions arise when this topic is discussed. For example, does an individual have the right to end their life, if prolonging it will only cause more pain and suffering? Should families, who do not want to lose a loved one, be allowed to prolong the pain in the life of a terminally ill family member so they do not experience loss?
Is this more or less ethical than letting the person die? This paper will examine why terminally-ill patients should be allowed to make decisions regarding their care and their life.
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This paper will examine a utilitarian perspective on physician-aided suicide, which provides a solid argument for allowing physician-assisted suicides in certain circumstances. “Utilitarianism is a moral principle that holds that the morally right course of action in any situation is the one that produces the greatest balance of benefits over harms for everyone affected (Andre & Velasquez, n. d. ).
How would utilitarian thinkers view physician-assisted suicide? Utilitarians would assess each individual situation and determine the right course of action which is relative to the unique circumstances. For the utilitarians, the question is simply this when addressed with a terminally ill person: “Does it increase or decrease human happiness to provide a quick, painless death for those who are dying in agony? ” (Cavalier, Mellon & Ess, n. d. ) Initially, utilitarians identify all foreseeable outcomes of a certain action. In this case, physician-assisted death is the action in question.
Once foreseeable, outcomes are determined, utilitarians review the benefits and the consequences of a physician-assisted death for all the parties involved. Then, a course of action is selected that provides the most benefits and reduces the negative consequences. This approach is direct and logical. New issues and ethical questions have arisen as a result in technological advances in the field of medicine. One of these issues is quality of life for the individual. Is it better to keep a person hooked up to a life machine, if the person has no quality of life?
That is there is no interaction with other humans and the person is only being kept alive because the machines are handling vital bodily functions. These advances add to moral dilemma of physician-assisted suicide and to the intense debate if the practice of physician-assisted death is ethical. Furthermore, there are direct and indirect physician-assisted suicide practices. Direct physician-assisted suicide practices include: administering a legal dose of drugs to end a life, withdrawing or withholding life sustaining treatments, and palliative sedation.
Indirect physician-assisted suicides are a little bit different in that the physician may give lethal medications to an individual, but the individual administers the dose, not the physician. This practice places an ethical dilemma for the pharmacist filling the lethal dose of medicines. According to Ethics in Medicine, University of Washington School of Medicine state that those who argue in favor of physician-assisted death (PAD) present the following reasons for their opinions 1.
Respect for autonomy: The individuals who argue in favor in physician-assisted death believe competent people should have right to choose the timing and manner of death. They believe death is a personal matter and should be respected. 2. Justice: Justice requires that we “treat like cases alike. ” Competent, terminally ill patients have the legal right to refuse treatment that will prolong their deaths. For patients who are suffering but who are not dependent on life support, such as respirators or dialysis, refusing treatment will not suffice to hasten death quickly.
Thus, to treat these patients equitably, we should allow assisted death as it is their only option to hasten death. 3. Compassion: Suffering means more than pain; there are other physical, existential, social and psychological burdens such as the loss of independence, loss of sense of self, and functional capacities that some patients feel jeopardize their dignity. It is not always possible to relieve suffering. Thus PAD may be a compassionate response to unremitting suffering. 4. Individual liberty vs. tate interest: Though society has strong interest in preserving life, that interest lessens when a person is terminally ill and has strong desire to end life. A complete prohibition against PAD excessively limits personal liberty. Therefore PAD should be allowed in certain cases. 5. Honesty & Transparency: Some acknowledge that assisted death already occurs, albeit in secret. The fact that PAD is illegal in most states prevents open discussion, in which patients and physicians could engage.
Legalization of PAD would promote open discussion and may promote better end-of-life care as patients and physicians could more directly address concerns and options. (University of Washington School of Medicine, 2009) As with any debate there are two sides. Again, the University of Washington, School of Medicine offers the following arguments for those opposed to PAD: 1. Sanctity of life: Religious and secular traditions upholding the sanctity of human life have historically prohibited suicide or assistance in dying.
PAD is morally wrong because it seems to diminish the sanctity of life. 2. Passive vs. Active distinction: There is an important difference between passively “letting die” and actively “killing. ” Treatment refusal or withholding treatment equates to letting die (passive) and is justifiable, whereas PAD equates to killing (active) and is not justifiable. 3. Potential for abuse: Vulnerable populations, lacking access to quality care and support, may be pushed into assisted death. Furthermore, assisted death may become a cost-containment strategy.
Burdened family members and health care providers may encourage loved ones to opt for assisted death and the protections in legislation can never catch all instances of such coercion or exploitation. To protect against these abuses, PAD should remain illegal. 4. Professional integrity: Historical ethical traditions in medicine are strongly opposed to taking life. For instance, the Hippocratic Oath states, “I will not administer poison to anyone where asked,” and I will “be of benefit, or at least do no harm. ” Furthermore, some major professional groups American Medical Association, American Geriatrics Society) oppose assisted death. The overall concern is that linking PAD to the practice of medicine could harm both the integrity and the public’s image of the profession. 5. Fallibility of the profession: The concern is that physicians will make mistakes. For instance there may be uncertainty in diagnosis and prognosis. There may be errors in diagnosis and treatment of depression, or inadequate treatment of pain. Thus the State has an obligation to protect lives from these inevitable mistakes and to improve the quality of pain and symptom management at the end of life. 2009). Terminally-ill patients that are still able to make sound decision should be given the respect and allowed to maintain their dignity concerning their own life. A decision to end’s one life may be difficult for loved ones to understand, but ultimately the terminally-ill person wishes should be honored and fulfilled. The debate surrounding physician-aided suicide is an emotional and passionate debate where both sides hold solid arguments depending on personal experiences and religious beliefs.