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The Right to Die? Ethical and Legal Issues Surrounding Euthanasia and Physician-Assisted Suicide

Death with Dignity, Physician Assisted Suicide, Right to Die

The “Right to Die”
The term “Right to Die” evokes a strong response from people of either side of the ideological fence. Right to Life” proponents argue against any form of legalized termination of life, at any stage, including abortion, capital punishment, embryonic stem cell research, war, and any form of euthanasia, including physician-assisted suicide. Supporters of a patient’s “Right to Die,” or of the concept of “dying with dignity,” would argue in favor of the patient’s right to maintain the ability to opt for a humane and controlled end to his or her life, when that life is felt to be unbearable due to physical pain.

When most people hear the term “Right to Die,” they commonly associated it with the practice of physician-assisted suicide, such as the well publicized practices of Dr. Jack Kevorkian. However, a patient’s “Right to Die” actually refers to a broader concept than that of physician-assisted suicide, although it is certainly a part of it. Euthanasia and all forms of a patient’s right to terminate his or her life, or have his or her life terminated by another in the interest of ending suffering, are also considered in the argument about a patient’s “Right to Die.”

Physician-assisted suicide is thought by many to be a form of euthanasia, but strictly speaking, it is not. Euthanasia is the “intentional killing of another person at his/her request for compassionate motives,” according to Dr. Brian Pollard. Physician-assisted suicide is a practice in which the physician supplies the patient with the means to end his or her life, but does not carry out the actual killing.

The State of Oregon’s Death with Dignity Act
Euthanasia, in any form, is illegal in most countries, as is physician-assisted suicide. Some forms of euthanasia are legal in the Netherlands, and Belgium. In some Eastern Asian countries, suicide is considered to be an acceptable solution.

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The state of Oregon, however, has a law that permits the practice of physician-assisted suicide in some cases. Under the Death with Dignity Act, Oregon state law allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. (The Oregon State Web Site) The law requires that the patient make the request, in writing, and that the request must be verified by two witnesses who are not related to the patient, are not any type of medical personnel charged with the care of the patient, and are not entitled to any gain from the patient’s estate. (Wikipedia)

The law also requires that the patient’s expected

In order to participate in a physician-assisted suicide that is legally allowable by the Death with Dignity Act, a patient must be18 years of age or older, and a resident of Oregon. He or she capable of making and communicating health care decisions for him or herself, and must diagnosed with a terminal illness that will lead to death within six months. It is up to the attending physician to determine whether these criteria have been met. (The Oregon State Web Site)

The Death with Dignity Act was passed for the first time in November 1994, but was delayed by an injunction until October 1997. Placed again on the general election ballot in November 1997, the Act passed again, and has been implemented.

The only state in the United States with any form of legislation that recognizes a patient’s “Right to Die,” the Oregon Death with Dignity Act has been embroiled in controversy since its inception. That controversy spent quite a lot of time in dockets of the U.S. Supreme Court, after a November 6, 2001 directive issued by U.S. Attorney General John Ashcroft allowed the federal Drug Enforcement Agency to pursue action to revoke prescription-writing privileges and to pursue federal criminal prosecution of any Oregon physicians engaging in physician-assisted suicide. The next day, Oregon Attorney General Hardy Myers filed a suit in U.S. District Court for a temporary restraining order and preliminary injunction. The restraining order was granted, and the case made its way through the courts until the rights of the State of Oregon to govern its medical practices, and to enact the Death with Dignity Act, were ultimately upheld by the U.S. Supreme Court on January 17, 2006.

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Questions About a Patient’s “Right to Die”
The term “right to die” refers to issues regarding the death, or intended death, of a patient who would otherwise have been able to sustain life without the aid of life support or other “heroic” lifesaving measures. This issue at hand is not a question about the rights of patients to opt not to be recessitated or to have feeding tubes placed to sustain life, but to actually terminate that life before death is brought about by the medical condition of the patient.

Physician-assisted suicide and euthanasia are topics that tend to stir up a lot of emotion in the people advocating or opposing them. The fear of living in unendurable pain, or of watching a loved one suffer, is for many and incredibly gripping one. For those for whom this fear is actually a reality, the question of whether or not patients should have the “Right to Die” is one that may seem terminal in its unanswered state.

One common argument against physician-assisted suicide and euthanasia is the potential for discrepancies in the interpertation of when and how such action is called for. What sort of consent to “Right to Die” measures are appropriate? And in what state of health must the patient be in in order to consent? If the patient is mentally or physically incapable of giving consent, can his or her suffering still be ended through the use of physician-assisted suicide or euthanasia? And how often can proof of pain and perception of pain become confused in an unresponsive patient?

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Slippery slope is another concern for opponents of “Right to Die” measures. Long famous as a doctor who very publicly performed over one hundred acts of illegal physician-assisted suicide, in the infamous broadcast of Dr. Jack Kevorkian’s administering a lethal injection to ALS patient Thomas Youk on the CBS program “60 Minutes” was not a case of physician-assisted suicide. When Youk was unable to inject the lethal dose of medication that killed him, Dr. Kevorkian administered if for him, crossing the line from physician-assisted suicide to euthanasia.

Proponents of legal options for patients living with terminal illnesses and incredible pain and suffering have a response to these concerns.

How do you determine how much pain is too much pain?

Reference:

  • Dr. Pollard’s views on euthanasia