Sample Ethics Essay on Physician-assisted Suicide

Physician-assisted Suicide


            Physician-assisted suicide (PAS) entails a doctor deliberately and purposely offering a patient the understanding or support or both necessitated in committing suicide, encompassing counseling concerning lethal doses of medication, and prescribing the lethal doses or providing them. PAS and euthanasia are commonly merged under the umbrella expression “assisted dying”, an instance of the tendency of lawyers to substitute the term suicide with death and if possible dying. There are many terms used to denote PAS, which encompass “death with dignity”, and “compassionate death” just to mention a few. PAS is frequently taken for euthanasia (at times referred to as mercy murder). On the part of euthanasia, the doctor directs the way of death, normally a lethal medicine (Quill 57-65). On the contrary, physician-assisted suicide is at all times at the appeal and with the approval of the patient because the patient self-manages the way of death (Quill 57-65). There is thus a difference between euthanasia and PAS since for PAS, the patient requests for the drug and takes it on their own while for euthanasia, the physician gives the lethal drug to the patient. In accordance with research, more than 50% of the physicians surveyed have obtained appeals from patients desiring to terminate their lives. Doctors are just permitted to offer fatal drugs in nations where it is lawful, irrespective of the desires of patients or the diagnosis of their illness.



Request for Physician-assisted Suicide

            Studies affirm that by 2020, approximately three million American citizens aged 65 and above will die every year and about 42% of the deaths will happen in nursing homes. If a patient with a limited quality of life desires to accelerate death, physicians might feel torn between respecting the self-directed right of the patient to make a decision and respecting the inviolability of life. Patients suffering from cancer, in addition to Amyotrophic Lateral Sclerosis (ALS), Acquired Immune Deficiency Syndrome (AIDS), sophisticated or fatal diseases, inadequately controlled pain, and other diseases normally issue an appeal for hurried death. A research carried out concerning patients in Washington and Oregon suffering from ALS established that despondency was a major aspect in patients issuing an appeal under the Oregon Death with Dignity Act (ODDA) (Hendin and Foley 121-145). In accordance with the 2007 State Health Division report concerning ODDA, the most frequently documented issues were reducing capacity to partake in endeavors that make life pleasant (87%), losing self-sufficiency (99%), and losing self-worth (88%). Therefore, the rationales behind patients appealing for assisted suicide are intricate; they are not merely a concern of symptom management.

Frequency of the Requests

            Roughly, one out of a thousand dying Oregonians receive and take a lethal drug with about 20% personally considering it as an alternative (Hendin and Foley 121-145). Nearly 70 percent of polled hospital physicians and social workers in Oregon affirmed receiving appeals for assisted suicide from at least a single patient in the course of 2013. Nevertheless, these appeals are not restricted only to states where Patient-assisted Suicide is lawful as it should be. Some studies have confirmed physician’s willingness to undertake assisted suicide and euthanasia and that 80% of over 200 nurses in Australia conducted the requests of doctors for euthanasia. It was also established that less than 20% of over 1000 doctors carried out the procedure on appeals for assisted suicide or euthanasia from relatives or patients. While interviewing ten doctors that were willing to talk concerning being requested for assistance in dying, studies found their judgments concerning if it is right to assist patients in passing away were not rule-based, but circumstance-driven. The interviewees did not talk about the code of ethics or the career’s position declaration on physician-assisted suicide, but concentrated on the condition of the individual patient.

There is no law in the United States that allows mercy murder, deadly injection, or application of euthanasia. Contrary to regulations in different European nations, the line in the US is marked at permitting physician-assisted suicide. Euthanasia is permitted in Holland, Belgium, and Switzerland to mention a few. In Holland, approximately 70 percent of the appeals for assistance in passing away are not given; the existence of a psychiatric disease was at least among the major rationales in the government-ordered researches. Holland permitted advance euthanasia instructions for patients suffering from dementia in 2002 (Hendin and Foley 121-145). Cautions concerning potential misuse on susceptible populations have been issued by different organizations. In a comparative research in Holland and Oregon, studies established no proof that patients in the susceptible populations were more probable of receiving physician-assisted suicide (Hendin and Foley 121-145). Susceptible populations were described as the ones in the class of the elderly, women, the uninsured (in Oregon), illiterate and semi-illiterate individuals, the underprivileged, the physically handicapped, chronically ill, children, individuals with psychiatric diseases, and ethnic minorities. An intensified risk was established to be with people with AIDS. The outcome demonstrates that the argument concerning the disproportionally effect of the susceptible groups is bogus.



Arguments In Support Of PAS

            The majority of individuals in the US back physician-assisted suicide under a couple of situations: that it is requested by the patient and that the patient is suffering from a deadly or incurable disease. Research shows that the percentage of the Americans supporting physician-assisted suicide is ever increasing. Studies found that the fraction of people that supports physicians being permitted by law to terminate the life of an individual with a terminal illness if the patient and the relatives appeal is approximately 75%. Moreover, studies affirm that the Americans back active requested euthanasia more than they back PAS. Easing suffering and the upholding of autonomy and management at the end of life are some of the arguments commonly provided in support of physician-assisted suicide (Quill 57-65).

Easing Suffering

The majority of individuals is scared of having to suffer unbearable pain and extended anguish at the end of life and being compelled to carry on a life that has lost every sense. When fatality is unavoidable, physician-assisted suicide may offer the “suitable death” that otherwise seems unattainable. In studies of patients with incurable diseases, it was established that the ones with pain, extensive care giving requirements, and depressive symptoms were most probable of considering PAS or euthanasia. Nonetheless, mental suffering may be more striking than physical pain (Berghmans, Widdershoven, and Widdershoven-Heerding 436-443). Follow-up interviews carried out with patients suffering from terminal illness established that the patients with depressive indications and the ones having shortness of breath had begun contemplating PAS and euthanasia, while augmented pain and a decrease in physical functioning did not bring about the need for a quickened death. On the contrary, half of the patients that had initially contemplated PAS or euthanasia were not thinking that option anymore after 5 moths. This implies that the desires of patients for PAS and euthanasia may not be mainly constant, and that therapeutic interventions intended to lessen conditions of hopelessness and dyspnea may decrease the urge for Physician-assisted suicide.

Autonomy and Management

Another key argument in the support of physician-assisted suicide is that a patient ought to have the right to choose a fast and unproblematic death if he or she has a terminal disease and there is no expectation of recuperation. The majority of terminally ill patients dread that a progression of their illness will deprive them of their self-respect and psychological faculties, and they detest the situation of turning into being totally dependent on other people. In this regard, the patients choose dying at a time of their choice instead of observing their fatal decline and a failure of self. In line with the principle autonomy and management, physician-assisted suicide ought to be totally voluntary, both on the part of the patient and on the part of the doctor. No one ought to be coerced to participate in physician-assisted suicide, and the patients ought to be free from depression when issuing appeals for the services. Patients must continue to have the right to seek treatment even when that treatment is deemed medically fruitless. Moreover, no doctor or care giver ought to be obliged to become involved physician-assisted suicide (Berghmans, Widdershoven, and Widdershoven-Heerding 436-443).

Arguments against PAS

            Arguments against PAS resolve around moral, admirable, and spiritual deliberations (Dees 339-352). Additionally, some people that argue against physician-assisted suicide take the slippery slope position. This means that they are concerned that the support of PAS for patients with terminal illnesses may influence active euthanasia and PAS for patients with incurable diseases and the ones suffering from mental distress. Moreover, it is argued that the legalization of PAS may sway people of vulnerable groups into requesting early death.


Ethical, Moral, and Spiritual Deliberations

Many doctors feel that it is unethical, morally incorrect, and in opposition to the Hippocratic Oath to terminate the life of a person deliberately, even when the patient appeals for it. In accordance with the Code of Medical Ethics (CME) of the American Medical Association (AMA), PAS contradicts the healing responsibility of a doctor (Dees 339-352). Moreover, people may not be in a position to believe their physicians wholly if they learn that they have the authority of terminating the life of their patients. Furthermore, the approval of PAS by relatives may place an unjustifiable moral and ethical yoke on the family members and allies of the deceased. For instance, if a doctor is not in attendance at the moment of the suicide endeavor of a patient, the patient could request a member of family or a pal to assist with the preparation and issuance of the lethal drug. When death then does not take place fast, the member of family or pal may as well feel persuaded to take the actions necessary to hasten the death process, for instance, putting a plastic paper over the head of the patient. The person that takes part in actions of PAS may suffer thoughts of guiltiness and an extended and intricate grief-stricken progression.

The majority of religious denominations also criticize PAS and euthanasia (Tamayo-Velázquez, Simón-Lorda, and Cruz-Piqueras 677-692). They consider existence a gift from deity, and thus sacred. According to such religions, it is not for people to choose when existence is not worth living any more if death fails to come quickly and as expected. It is only allowable for a patient to forego or end a treatment process that is not likely to heal or assist the patient but results to excessive trouble for both the patient and the family. This situation is evidently in utter contrast to the aforementioned position of autonomy and management at the termination of life. For Islam and Christianity among other religions, the inviolability of life and the control of deity are unconditional and supersede the desire of a patient to terminate his/her life ahead of time (Tamayo-Velázquez, Simón-Lorda, and Cruz-Piqueras 677-692). In accordance with most religious beliefs, human autonomy does not spread out to a right to cause their death at a period or in a way they desire irrespective of the situation.

Moreover, offering care to the terminally ill is a considerable progression in the practices of religious individuals. They believe that they ought to give care that is not just limited to the physical requirements of the dying individual but as well tackles existential and religious requirements, for instance, significance of pain and death. Sequentially, this strengthens the affiliation and the emotional connection between a patient and the care provider (Tamayo-Velázquez, Simón-Lorda, and Cruz-Piqueras 677-692). In a religious point of view, care for the terminally ill is not mainly a burden; instead, it is a chance for the care provider to extend kindhearted love and to develop spiritually by assisting an individual in ache and anguish and by offering self-sacrificing service to an individual in need. The terminally ill person, alternatively, may learn to uncover significance in anguish, susceptibility, and dependency, and to recognize and offer self-sacrificing love to God and human beings. On this note, physician-assisted suicide is viewed as robbing terminally ill patients and their care providers of an opportunity for spiritual development and a profound comprehension of life.

The Slippery Slope Position

The majority of people against physician-assisted suicide are worried that the justification of PAS for the terminally ill may bring about the speedy request and approval of PAS for most chronically ill, the handicapped, and the emotionally depressed patients. In addition, it could lead to the recognition of active euthanasia for individuals whose quality of life seems exceedingly low but that are not in a position of choosing by their own. If PAS is to be limited to the terminally ill, doctors should have the capability of predicting with a considerable degree of precision the duration a patient with a fatal illness is anticipated to live. However, in a study of Oregon doctors, researchers found that 30% of doctors that were ready to prescribe fatal drugs had no confidence in predicting if a patient would live for a couple of months or weeks (Hendin and Foley 121-145).

The people that support the slippery slope position also affirm that if intolerable suffering is the key explanation for the justification of PAS, it is not evident why such justifications should be limited to the people suffering physical symptoms. The recurrently ill and the handicapped individuals may suffer equally or in excess of terminally ill patients and they characteristically have to bear their pain longer (Stevens 187-200). For instance, diseases like ALS, AIDS, and multiple sclerosis to mention a few develop gradually and could take many years to cause death. Thus the legalization of PAS fails to clearly explain its justification only for patients with unbearable pain and no chance to live for long but not for patients with similar pain but the “incorrect” type of illness. Moreover, some of the patients that doctors help to pass away do not experience terminal illnesses.

For the sake of equality, justice, sympathy, and mercy, the validation of PAS for the terminally ill could be simply offered to all the chronically ill, the handicapped, and the psychologically troubled (Malpas 353-359). This could also be easily extended to the justification of active voluntary euthanasia for the persons incapable of causing their death and the validation of involuntary euthanasia for the patients that are not in a position of deciding on their own anymore. A different concern of the supporters of the slippery slope position is that people in susceptible groups, for instance, the elderly, the poor, and the handicapped, may feel coerced to request for PAS instead of continuing with lives of dependence, suffering, and destitution. In brief, there is an alarm that the right to die may become the obligation to pass away. Even though people are not publicly subjected to demands to terminate their lives, once the alternative of PAS is achievable, individuals whose quality of life has worsened significantly may not have the enthusiasm to continue with care and treatment when death seems the more coherent and less troublesome option.

In case the terminally ill and their relatives fail to discuss end-of-life choices and inclinations explicitly, the elderly and terminally ill patients may feel pressured to request PAS if it were lawful and some relatives articulated approval for it with the purpose of relieving the family of psychological and economic trouble. Amusingly, studies of terminally ill patients established that elderly patients and the ones that felt appreciated by other people wee less probable of requesting PAS as compared to patients receiving inadequate care and appreciation. Moreover, PAS and euthanasia are not as expensive as the outlays of continued care, for relatives, insurance firms, and the community (Malpas 353-359). In a health care system typified by rising costs, PAS would be the crucial cost-saving instrument. Even with the voluntary option of PAS, some patients, especially the elderly that have become unwell, handicapped, and dependent, may be forced by feelings of guilt and selfishness in spending valuable resources and requiring care to take up the available legal alternative to terminate their lives with the purpose of relieving the family, doctors, and the community from monetary, physical, and psychological burden.


            According to this study, though physician-assisted suicide and active euthanasia may at times be beneficial, they can cause lasting guilt for doctors and relatives that take part. Moreover, the issue of PAS has been strongly criticized by religious groups amid others. Any person that assists in the death of a patient has to take responsibility irrespective of the situation. There is a great burden on conscience, dragged emotions, and an immense mental burden on the involved doctors (Stevens 187-200). In some cases, patients are forced by circumstances, instead of their illness, to request physician-assisted suicide and euthanasia. In this regard, the legalization of physician-assisted suicide could act as just a legal death option for many. The legalization of PAS and discourse of its pros and cons have to consider the aspects discussed in this study to ensure that no one takes advantage of the alternati

Works Cited

Berghmans, Ron, Guy Widdershoven, and Ineke Widdershoven-Heerding. “Physician-assisted suicide in psychiatry and loss of hope.” International journal of law and psychiatry 36.5 (2013): 436-443.

Dees, Marianne, et al. “Unbearable suffering of patients with a request for euthanasia or physician‐assisted suicide: an integrative review.” PsychoOncology 19.4 (2010): 339-352.

Hendin, Herbert, and Kathleen Foley. “Physician-assisted suicide in Oregon: a medical perspective.” Michigan Law Review 24.2 (2008): 121-145.

Malpas, Phillipa J., et al. “Why do older people oppose physician-assisted dying? A qualitative study.” Palliative medicine 28.4 (2014): 353-359.

Quill, Timothy E. “Physicians should “assist in suicide” when it is appropriate.” The Journal of Law, Medicine & Ethics 40.1 (2012): 57-65.

Stevens, Kenneth R. “Emotional and psychological effects of physician-assisted suicide and euthanasia on participating physicians.” Issues L. & Med. 21.3 (2005): 187-200.

Tamayo-Velázquez, María-Isabel, Pablo Simón-Lorda, and Maite Cruz-Piqueras. “Euthanasia and physician-assisted suicide Knowledge, attitudes and experiences of nurses in Andalusia (Spain).” Nursing ethics 19.5 (2012): 677-691.