Physician assisted suicide should be legalized

What would you do if you only had a month to live? This hypothetical question for most healthy individuals is the unfortunate reality for many terminally ill patients. Death is as inevitable for those who are healthy as a horse as it is for those battling incurable diseases; the only uncertainty in this matter is time. We do not know when we are going to die, but in the back of our minds, we know that at some point the blood will stop pumping through our veins and the world will continue without us. Most of us view death as an unfortunate occurrence, a painful loss. This is certainly true in many and perhaps most instances. However, we sometimes forget that death can also mean the end of suffering, or the ultimate source of closure. As complicated as death is, it is dichotomously simple. Because of its complicated consequences, physician-assisted suicide is a popular topic of debate in America’s changing health care policies. The American Medical Association (AMA) formally rejects the validity of physician-assisted suicide. However, it has already been legalized in 4 states. In appropriate times, physician-assisted suicide can serve as a solution, and should be a legal and viable option for Americans.

The AMA states their stance on physician-assisted suicide on their website, claiming that it would cause too many complications. It writes, “Physician-assisted suicide is fundamentally incompatible with the physician’s role as a healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life.” The AMA’s hesitant approach to physician-assisted suicide is understandable. Unfortunately, it is also egotistical and oversimplified.

Why is it that the law categorizes death as so black and white? In truth it is much more of a gray area. Clearly murder should always remain illegal, as it carries the connotation that it was against the will of the victim; physician-assisted suicide would then be classified as something that the patient explicitly wanted and had lucidly expressed beforehand as a preferred option. Admittedly, it would be difficult, as the AMA worries. But any meaningful change starts with finding the courage to confront adversity and be willing to find a solution.

Our healthcare system is based off of an infinite progress model, in which cures are perpetually sought after. We invest money and resources in expensive research, technology and end-of-life care. End-of-life care is extremely costly, to such an extent that a cap to end-of-life expenses has sometimes been proposed. This raises the conflicting suggestion that there can be pricetag assigned to the value of a life. This too, while morally and ethically challenging, directly confronts the reality of the high costs of care. Approximately 25% of Medicare costs are to treat 5% of Medicare users to cover end-of-life care. I am not suggesting that we shouldn’t spend money on end-of-life care, but in many instances, these costs are unnecessary. In some cases it is spent on surgeries that do not improve the quality of life of the patient, but only prolongs their life for a couple of months. From a humanistic perspective, how valuable are these few months of being hooked up to ventilators and IVs, if you are still going to die in the near future?

The answer will of course be different for everyone as it depends on the patient’s priorities at the end of life. This individualized factor challenges the AMA’s understanding of the obligations of a physician. As “healers,” physicians are obligated to more than just attending to their patient’s physical needs; if a patient does not want to fight for their life anymore, they certainly have the option to stop treatment. But under existing law, they then have to wait until their body gives out. Hospice care is designed to make this as comfortable as possible, but it is still painful for the patient and their families and friends. To watch someone decline bit by bit every day is heart breaking. Physician-assisted suicide could help expedite the inevitable and salvage the dignity of the patient. Physicians should not feel a responsibility to prolong a life if it is not compatible with the patient’s desires. Culturally, physician-assisted suicide suggests a doctor has given up on a patient, but in reality is a humbling acceptance of natural defeat.

The fact that the AMA uses the word “impossible” to describe a policy condoning physician-assisted suicide is naive and, frankly, disappointing. Physician-assisted suicide would be challenging to outline and put in a consistent practice, but by no means impossible. Doctors as healers should return to practice of helping patients reach a healthy state. Health is not just physical, but it is a condition of well-being in conjunction with mind and body. The Oregon Death with Dignity Act, passed in 1994, includes specific requirements and safeguards to physician-assisted suicide. Some of the regulations are that the patient must be of sound mind when they ask for a prescription for a lethal dose of medicine, two doctors must sign off on the diagnosis stating that the patient has less than six months to live, there must be two witnesses to confirm the patient’s request (one must be a non doctor and unrelated to the patient), and finally, the patient must make a second request at least 15 days after making the first. These requirements help to ensure that it is what the patient really wants. Who should deny this dying patient their last wish?

Not everyone wants to die rather than face the natural course of their illnesses, but not everyone wants to live through them either. Patients should be given the option to take a lethal dose of medication to quickly escape their pain and face their future with dignity and closure, and the government should support this as a viable option. No physician has to sign off on the papers if they are not comfortable, and no patient should ever be coerced into it. But it should be available to any individual.
Carissa Zukowski is a freshman majoring in Public Health Studies and Art History. She is from Baltimore, MD, and is an Opinion Staff Writer for the News-Letter.

3 Responses to "Physician assisted suicide should be legalized"

  1. Derek Humphry   April 23, 2014 at 1:28 pm

    Considering that the Oregon law is now 20 years old, and has been a much watched ‘laboratory’ for the physician-assisted suicide subject, it is taking an awful long time for other states to catch up. This is due to opposition by churches.

  2. Piobair   April 23, 2014 at 4:37 pm

    I was reading a blog describing the degeneration and death of the author’s loved one from the same disorder as mine. After a slow inexorable decline to being bedridden in a nursing home; blind and aphasic with severe contractures and multiple UTI’s from his Foley catheter (it’d adhere to his urethra requiring it to be torn away to be replaced, like repeatedly passing kidney stones the size of golf balls), his bowel finally became paralyzed and peristalsis ceased. He began regurgitating and aspirating feces. Yeah; at the end, he drowned in his own shit.
    For some of us, dying’s no metaphor, and the American medical industry’s myopic focus on prolonging our suffering for as long as possible at minimal cost and maximized profit scares the hell out of me. It’s that widows are four times more likely to live in poverty than married women. 49% of foreclosures and 62% of bankruptcies are directly caused by medical bills.
    Ours is not only a Capitalistic society, but a sadistic one that revels in the suffering of others; not only do we refuse to pay for services to the homeless, we criminalize wearing blankets. Euthanasia and assisted suicide is criminalized not only because it deprives corporate interests of profit, it deprives a Calvinistic society of what Santayana described as a fierce pleasure in the existence of misery. If someone wants to choose to die on their own terms, they’re limited to secretly cobbling together something off the ‘Net while they still have the mobility, dexterity, and strength to do so, perhaps quite a bit sooner than they might choose otherwise, and then forced to die alone so as not to expose their loved ones to the draconian prosecution of a vindictive police state which imprisons a greater percentage of it’s citizens than any other nation on earth. Dying is hard enough. The logistics of dying in America makes it so much worse.

  3. Thaddeus Mason Pope   April 23, 2014 at 6:06 pm

    As we recently argued in JAMA, the lessons from the Oregon laboratory are being learned elsewhere.

    Already in Washington, Vermont, Montana, and New Mexico. Plus, very active recent and ongoing efforts in Canada, Massachusetts, elsewhere.


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