The Ethical Debate of Assisted Suicide

1 January 2017

The Ethical Debate of Assisted Suicide Hippocrates the father of modern medicine stated “I will give no deadly medicine to any one if asked, nor suggest any such counsel”: clearly he opposed the practice of euthanasia, known later in modern society as “assisted suicide. ” The debate regarding Euthanasia or assisted suicide has been a subject that has been examined, discussed and ethically dissected for thousands of years.

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Early Roman and Greek cultures regarded euthanasia as an acceptable practice, both societies sharing the opinion that “there is no need to preserve the life of someone who has no interest in living. ” Centuries later, as a result of shifting morals and values, assisted suicide has become an issue of the ethics of quality vs. the sanctity of life as well as one that conflicts with religion and politics (Keelan, 2006).

When religion and politics are removed from the debate of assisted suicide, what remains is the desire of a terminally ill individual to choose to end their pain and suffering, to die of their own choosing with dignity and peace, to obtain a “good death. ” The debate for or against assisted suicide finds its origins based in religious, political and social beliefs and viewpoints. Those who support the practice feel that the terminally ill have every right to choose to end their lives in order to avoid pain and suffering.

Additionally they feel that current medical treatments for the terminally ill leave them with no alternative but to endure undo pain and suffering, prolonging a life that will end, regardless of medical practice and jurisprudence. Assisted suicide provides quality of life because it affords one the opportunity to plan and prepare for their eventual death, taking into account their needs as well as the emotional needs of those they love. To plan one’s death is to take control of one’s life to the very end, something advocates of assisted suicide claim allows for dignity and closure.

Advocates for assisted suicide will argue the choice to terminate the life of an individual who is dying is an individual choice and should remain so, separate from any religious or political interference or influence: it should not be governed or mandated by laws. Furthermore, they argue that even in the best medical settings, keeping a terminally ill patient alive is only palliative, that is medicine can only reduce pain but not eliminate it all together, that suffering can and will continue.

For those who are opposed to assisted suicide, often a religious or spiritual approach is the primary factor in deciding that such a practice violates both Gods and Mans laws with regards to the valuing of human life. Additionally they argue that only God has the right to take a human life and by choosing assisted suicide the patient and loved ones will not be spared any pain or suffering (Lynn, Harrold, 2006).

There is the belief or hope that advances in medical science have produced drugs and medical therapies that allow for a good quality of life for the terminally ill, affording them comfort and more time with loved ones before the end comes. Perhaps society’s opposition is actually rooted more in the emotional: under the best circumstances when a family member, friend or loved one is dying, the inevitability of their loss and the grieving that goes on long after a life has ended is difficult to process and prepare.

It is human nature to begin the grieving process after someone has died, not typically while a dying person is still alive. Ironically we want to shield or spare a terminally ill loved one the anguish of seeing our own grief while denying them the opportunity to shield or spare themselves from any or all anguish that can be resolved with assisted suicide. It is important to note and clarify there are several definitions amongst medical, legal, political and religious communities regarding what is considered assisted suicide.

The difference and understanding of assisted suicide is paramount in understanding and ultimately taking a stance or view on the subject. Particularly in the case of physician assisted suicide. In our culture and societies, medicine and those who practice it are regarded as life savers, not life takers. It is the opinion of many that our medical communities have a responsibility to preserve life, not to participate in the voluntary ending of one.

Many incorrectly assume that assisted suicide is always administered by or includes the involvement of physicians but this is not the case. A basic definition of assisted suicide states: “it is the act of intentionally killing oneself with the assistance of another who deliberately provides the knowledge, means, or both. In physician-assisted suicide, a physician provides the assistance” (Gupta, 2006). It is noted this definition actually provides two distinct, separate descriptions of “assisted suicide”; the intentional act of killing one’s self and physician assisted suicide.

Gupta goes on to claim 60% of physicians agreed that physician-assisted suicide should be legal in some cases. It appears in medical circles, the issue of assisted suicide is considered both humane and appropriate for those with no hope of recovery. In the case of a person who is terminally ill, the denial of choosing assisted suicide often results in their committing suicide by their own hand in order to end their pain, once and for all. To deny one the right to end their own life is to force one to live against their own free will.

In his journal “End of Life Decisions and the Maximization of Length of Life” Edward Stringham states “Along with the actual physical pain and suffering comes mental suffering: the constant worry and concern about the well-being of their family members who are often spending time taking care of the dying loved one and in some cases, paying the bill for the artificial extension of life. The last month of life of a terminally ill patient can consume 40% of the total spent on healthcare during the lifetime of an individual.

If the patient has already told family members that he wishes to die and discontinue burdening himself and his family members, assisted suicide should be permissible—especially if the whole family and friend network is in agreement. ” Too often the mental death and the physical death all people experience sooner or later are not reconciled with one another and in the case of a loved one; the physical needs are often taken into account before the mental needs.

We can see the physical pain and suffering but cannot see or know what is taking place inside the psyche of a dying person. From a social standpoint the issue of assisted suicide crosses ethical and religious boundaries making it difficult for many people to understand or consider. Because ethics are often based upon personal morals people tend to have a “bandwagon appeal” attitude about assisted suicide; it is either right or it is wrong. Many cannot reconcile assisted suicide to being anything more than what their personal beliefs tell them it is: murder.

They hold true to their Christian beliefs that all life is sacred and the taking of a life, even to release or relieve someone of their pain and suffering is unthinkable, a sin in the eyes of God. For them, the right to life will always override the right to die by one’s own choosing. It is believed that seeing someone die a natural death is a part of the process of life, that is they consider it holy, justifiable and is in keeping with the natural order of things, i. e. God’s plan.

Changes in morality and ethics within our culture however have begun to consider assisted suicide as not only a personal choice but an option when medicine can no longer stop the pain or prolong life in a comfortable, dignified manner. Media attention has brought “right to die” discussions into the living rooms of millions of Americans, making it a subject that is being discussed more than ever. Assisted suicide is a subject that makes most humans uncomfortable for it makes us examine the subject of our own mortality.

When considering assisted suicide, with or without the presence of a physician, it is a question at some point most will ask themselves: “If I am dying and there is no hope for recovery, would I choose to end my life in order to end my pain and suffering? ” We are forced to examine our own morals, ethics and spiritual beliefs, a tall order for a healthy human being. For the terminally ill, the time for such personal examination can be well behind them, the focus being on release. In the case of a family member having to decide for a dying loved one, the biggest dilemma or question they face is “Am I doing the right thing?

As morals change, so do the terms and conditions of assisted suicide. While many still think of assisted suicide as murder, others have changed their viewpoints by claiming it should be allowed if a person has less than six months to live or they are in a permanent vegetative state. Perhaps a change in thinking such as this is an attempt to appeal to the moral majority as well as those who support the practice of assisted suicide. Or perhaps many individuals are beginning to apply the possibility of opting for it, as we are all going to die one day.

Fear of pain, medical expenses, prolonging the pain and suffering of self and family has created a new way of looking at assisted suicide: we all hope for a good death and by eliminating fear, pain and suffering, maybe that too can be considered God’s plan for us. Recent high-profile cases of assisted suicide, such as the case of Terri Schiavo, a victim of an abnormal cardiac condition which rendered her brain dead at the age of 26, raised the question (and awareness) as to whether or not assisted suicide is morally and ethically wrong. Schiavo’s husband Michael wanted to end his wife’s life by choosing passive assisted suicide.

Her parents were opposed to his decision as they felt that if their daughter could make the choice, she would choose to stay alive. Her husband argued Terri would not want to be kept alive, but neither side could produce substantiated proof or documents that supported these wishes, only conversations she had with family members and friends (Shepard, 2009). Shiavo’s parents attempted to dispute medical tests and diagnosis by claiming that while Terri could not speak she could move her eyes and make facial gestures that suggested recognition and emotional connection (Snead, 2006).

Despite a medical diagnosis of permanent vegetative state, Robert and Mary Schindler, Schiavo’s parents, held out hope that their daughter would one day recover. The Schiavo case sparked national debate: many felt that since Terri was alive she was a living human being; to euthanize Terri Schiavo would be committing murder. Others felt that because she would remain in a vegetative state, she was no longer “alive” and therefore her husband had every right, morally, ethically and legally, to choose to end his wife’s life. As a result, for the first time in U. S. history, a sitting president, George W.

Bush, acting from a conservative religious position, signed legislation to keep Terri Schiavo alive. Ironically, as the governor of Texas, Bush signed into effect the Texas Advance Directives Act, also known as the Texas Futile Care Law which grants hospitals the right to cut off life sustaining treatment within 10 days of a doctor giving written notice that such treatment is no longer appropriate or successful.

Bush opposed allowing Terri Schiavo to die naturally by having her feeding tube removed, an act that is in fact allowable under the Texas Futile Care Law. Futile-care” laws effectively disregard a patient’s directive or family member’s decision, and instead, place control of end-of-life matters in the hands of physicians and hospital ethics committees (Marietta, 2007). Eventually all appeals to keep Schiavo alive failed and on March 31, 2005, thirteen days after her feeding tube was removed, she passed away. Her feeding tube had been removed and replaced two times previous to her death, amid the ensuring political and religious debates and arguments surrounding assisted suicide (Quill 2005).

But was it murder? The conservative religious contingent steadfastly considers assisted suicide to be murder. However, when considering the toll a protracted, non-curable illness takes on the patient and their family, assisted suicide should be looked at as a viable option for those who are terminally ill or in a permanent vegetative state. It begs the question as to why citizens can legally sign a “Do Not Resuscitate” or “DNR” order which can lead to an early death but cannot legally choose to die via assisted living.

Those supporters of the “Right to Life” will claim that a DNR order allows for a natural death while assisted suicide ends a life prematurely. It is important to note the clarification between euthanasia and assisted suicide: euthanasia generally refers to mercy killing, i. e. the voluntary ending of the life of someone who is perceived as being terminally or “hopelessly” ill. Assisted suicide on the other hand “occurs when persons deemed as having terminal illness or a disability are aided in a deliberate act of ending their lives by physicians, loved ones or other care givers or acquaintances.

The difference between euthanasia and assisted suicide occurs because the latter constitutes a joint action between the person wishing to die and another complying with those wishes” (MLPD, 2011). Any terminally ill patient should be afforded the right to choose assisted suicide as a means to end their pain and suffering, be it through passive or active euthanasia. Ultimately the decision to terminate life must be based upon the quality of life of an individual.

In doing so, they obtain their “good death”; they die when they want to, on their own terms, in their own time, all things that many human beings, if given the chance, would aspire to do. Politics and religion aside, just as all human beings should be afforded the right to make decisions that govern and affect their lives, they should be able to make decisions that govern how their lives will end. For those who want to spare their families the burden of having to make the choice of terminating life in the event they experience a cardiac arrest or stop breathing, signing a DNR order is appropriate.

In the case of an individual who is terminally ill, they should have the right to end their suffering, to spare themselves (and their families) the emotional and financial burden that will surely occur when trying to prolong a life that modern medical science cannot save. Looking at the issue of assisted suicide from this perspective, one wonders if Hippocrates, the father of modern medicine and early opposition to euthanasia, would change his opinion about ending ones’ life early to end undue pain and suffering.

Assisted suicide is not murder; it is a release from the tragic agony of an individual whose soul is trapped in a physical body that can no longer sustain and support their life. To deny a dying person their right to choose assisted suicide is to be morally and ethically questionable; to insist on prolonging human suffering and pain it morally and ethically unthinkable. Religion and politics must give way to allow a person the right to choose assisted suicide.

In doing so, individuals can obtain a good death, spending their final days, hours and minutes in peace, knowing that they soon will end their suffering in this life and begin a new journey into the next one.

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