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Physician-Assisted Suicide (PAS) Controversy

The issue of physician assisted suicide (PAS) has been sparking public controversy for over fifty years now, despite the fact that the essence of this issue can hardly be referred to as being highly controversial, simply because the discussion of assisted suicide’s practical implications lays well within the realm of logic. Apparently, many people who publicly express their opinions on the subject matter seem to be unaware that resorting to emotional arguments, while defending their point of view, actually undermines the conceptual sounding of their opinions.

In his article “Other People’s Lives: Reflections on Medicine, Ethics, and Euthanasia”, Richard Fenigsen comes up with a psychological theory, which refers to physicians’ unwillingness to even discuss the issue of PAS as such that directly corresponds to their subconscious anxieties, rather then to their devotion to the conventional code of medicinal ethics: “The doctors who resist euthanasia are in many instances people who entered medicine to conquer their own fear of disease and death” (Fenigsen, 2008, p.157). In other words, by refusing to assist terminally ill patients in their request to end their lives, physicians try to suppress their own fear of dying.

Such Fenigsen’s idea appears as not altogether being deprived of rationale, especially when we analyze the manner in which opponents of assisted suicide justify their stance on the subject. For example, in his article “Being a Burden: Reflections on Refusing Medical Care”, Martin Gunderson comes up with the following statement: “Love gives a reason to accept care. Altruistic suicide (based on patient’s willingness to stop being burden to society) rejects not only the offer of needed health care, but all other forms of care as well. It is the end of possibility of being cared for” (Gunderson, 2004, p.39). Apparently, it never occurred to the author that caring for terminally ill patients cannot be thought of something that has value in itself, especially given the fact that many of such patients actively resist medicinal care being forcibly imposed upon them, as it often causes incurable patients to continue suffering from an acute physical pain. In her article “Voluntary Euthanasia, Physician-Assisted Suicide, and the Goals of Medicine”, Jukka Varelius explains a legal rationale behind the idea that patients should be allowed to exercise a full control over their lives and deaths: “Since it is commonly accepted that medicine should be looking at things from the point of view of the patients’ interests, it is plausible that the view that a patient’s autonomy should be respected even if the courses of action she is considering taking were harmful” (Valerius, 2006, p.124). This thesis points out to the fact that the very essence of controversy, surrounding the issue of PAS, does not relate to ethical concerns, on the part of doctors and nurses, as much as it relates to the fact that the contemporary code of medical ethics is simply being outdated.

In their article “Who’s Not Afraid of Proposal B?”, Stephen J. Ziegler and Robert A. Jackson articulate the same idea, although in more subtle manner: “Although PAS has been practiced de facto for decades, elected officials have been reluctant to change the statutory status quo, while proving themselves being intellectually inflexible” (Ziegler & Jackson, 2004, p.42). The irony of a situation corresponds to the fact that, the more health care professionals grow to realize that PAS is not something inheritably wicked, the louder become the voices of neo-conservative bioethicists, who continue to refer to the practice of assisted suicide as utterly evil. For example, in his book “Life’s Worth: the Case against Assisted Suicide”, Arthur J. Dyck suggests that the legitimization of PAS will result in undermining the very notion of human life’s sanctity: “Euthanasia and physician-assisted suicide violate the moral responsibility to treat human beings as having incalculable worth” (Dyck, 2002, p.69). It is needless to mention, of course, that author does not bother to enlighten readers on where such moral responsibility originates from, in the first place.

Nevertheless, it would be wrong to think that opponents of PAS do not posses intellectually valid arguments, which actually substantiate their opinion on the subject of discussion. One of such arguments has been articulated by Theresa A. Harvath, Lois L. Miller, Kathryn A. Smith, Lisa D. Clark, Ann Jackson and Linda Ganzini in their 2006 study “Dilemmas Encountered by Hospice Workers When Patients Wish to Hasten Death”: “With PAS, the patient can choose a route that the family may or may not support. Hospice professionals report conflict between their advocacy for patients and for the family members who sometimes oppose physician-assisted suicide” (JHPN, 2006, p. 200).

Also, many opponents of PAS strive to bring people’s attention to the fact that legitimization of PAS might eventually result in the removal of this policy’s operational limitations. In her article “Assisted Suicide: Unraveling a Complex Issue”, Mary Ersek states: “The slippery slope concept is one of the strongest arguments for prohibiting the legalization of PAS. This is the idea that allowing PAS would inevitably lead to more morally questionable or unacceptable practices” (Ersek, 2005, p.50). Thus, we can conclude that that the issue of PAS is very likely to remain the subject of public debate into the near future. However, given the fact that it is namely cultural and scientific progress, which has been causing people’s sense of existential ethics to undergo a continuous transformation, throughout the history, we can assume with the high degree of probability that, as time goes by, more and more citizens are going to adopt more open-minded attitude towards the issue of PAS. In the next part of this paper we will summarize PAS pros and cons, as seeing by supporters and opponents of this practice:

Pros: 1) People’s ability to decide on whether to live or die corresponds to the notion of free will. PAS allows terminally ill patients to exercise a full control over their destinies, even while on the deathbed. In its turn, people’s ability to remain masters of their destinies constitutes an essential part of their humanity. Therefore, assisting patients’ in ending their lives represents a gesture of utter kindness. 2) PAS provides legal means for doctors to satisfy terminally ill patients’ last wishes, without endangering their own professional reputations and freedom. 3) Refusal to relieve patient’s suffering, even at the expense of terminating his of her life, constitutes a violation of Hippocratic Oath; therefore, PAS must be incorporated into medicinal practice as its integral component. 4) Caring for patients who represent a burden for society is socially counter-productive, because it deprives the representatives of younger generations of oftenly crucial medicinal resources.

Cons: 1) PAS violates the notion of life’s sanctity; therefore, it should never be institutionalized. 2) Doctors’ utilization of PAS, within a context of dealing with terminally ill patients, constitutes a violation of Hippocratic Oath, because physician’s willingness to assist patient in ending his or her life, symbolizes medicinal professional’s willingness to refuse providing medicinal treatment to an individual who requires it. 3) If we assume that physicians may be theoretically capable of killing patients, then the whole concept of Medicare, as such that is based on the establishment of trust between doctors and patients, would cease to make any sense. 4) Legalization of PAS will create potential preconditions for physicians to be willing to abuse their powers.

Bibliography

  1. Dyck, A. (2002). Life’s Worth: The Case against Assisted Suicide. Grand Rapids: Eerdmans
  2. Ersek, M. (2005). Assisted Suicide: Unraveling a Complex Issue. Nursing. 35(4), 48-52.
  3. Fenigsen, R. (2008). Other People’s Lives: Reflections on Medicine, Ethics, and Euthanasia. Issues in Law & Medicine, 24 (2),149-68.
  4. Gunderson, M. (2004). Being a Burden: Reflections on Refusing Medical Care. The Hastings Centre Report, 34 (5), 37-43.
  5. Harvath, T., Miller, L., Smith, K., Clark, L., Jackson, A., Ganzini, L. (2006). Dilemmas Encountered by Hospice Workers When Patients Wish to Hasten Death. Journal of Hospice and Palliative Nursing, 8 (4), 200-2009.
  6. Varelius, J. (2006).Voluntary Euthanasia, Physician-Assisted Suicide, and the Goals of Medicine. Journal of Medicine & Philosophy, 31 (2), 121-137.
  7. Ziegler, S. & Jackson, R. (2004). Who’s Not Afraid of Proposal B? Politics and the Life Sciences, 23 (1), 42-48.