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Euthanasia and Physician Assisted Suicide

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Introduction

The Oregon law has raised many questions and controversies. In this law, a capable adult living in Oregon is permitted to ask for his or her own death. This can be requested, if the patient has been diagnosed by a physician with a terminal illness. The terminal illness should have the capacity to kill the patient in a period of six months. According to this law, the patient can request a physician in writing to prescribe lethal drugs that will end the patient’s life.  The act stipulates that this request is voluntary since the patient is the one to request for his or her death. The law also allows doctors or physician who do not have the capacity or who view this act as immoral to restrain from prescribing such lethal drugs to the patient (Nowak, 1997).

Many people find it hard to accept this law. The reason for this is that committing murder necessitates an act to end another human’s life. This makes such a person accountable for the death of the other person. Relying on this reasoning, many people are not able to find the moral difference between executing euthanasia and committing murder (Nowak, 1997).

Why Oregon Law May Be Justified

Each person has a right to live a life without suffering. Human beings have many choices that they can make in their life. Nonetheless, whichever they choose, it is not supposed to impede on somebody else’s right or freedom. Therefore, the Oregon law may be justified under certain circumstances.        

First is that the law permits euthanasia. This is the act of bringing an end to the life of a patient having an inherent suffering or pain (Bagaric, 2002). The patient is the only person who knows how much pain he or she is going through. Other people, such as doctors and family members, can only help the patient endure the pain, but it may reach a point at which it becomes unbearable. In such a case, the Oregon law which permits euthanasia may be justified. It is essential in cases, when the illness is incurable; thus, chances of the patient to survive are exceptionally small. If such a patient is given all facts of his or her condition and makes an informed decision to end his life, then the Oregon law will be a relief to such a patient (Bagaric, 2002).         

Another reason that may justify the Oregon law is that people should not be forced to live. People commit suicide every day. Some jump into rivers while others hang themselves. It is apparently that they do not want to live. Thus, the Oregon law may be justified because it does not permit such deaths but only permits deaths of terminally ill patient. Such patients may lack the reason to spend their last minutes receiving sympathy from friends and family members while constantly experiencing  extreme pain (Bagaric, 2002).      

Physician Assisted Death Role in a Dignified Death

A physician assisted suicide may be considered dignified, when it is humane. Such death, that is not being long and with negative side effects such as convulsions, may be termed as dignified. Doctors should only do this in case of receiving a written letter from the patient. They should not withhold treatment for patients whom they believe are terminally ill. They should give them palliative care as long as the patient lives.  A dignified death needs to be peaceful.

At times, physician may not be in a position to offer death with dignity. They can, however, contribute to a patient dying without indignity. This normally entails that these physicians respect patients autonomy and are guided by human reasoning. It may also involve setting aside various barriers that may prevent a dignified death. Thus, physicians are making an indirect input to death with dignity (Biggs, 2001). 

However, it can be concluded that physician are not in a position to offer patients a dignified death, although they can ensure that their patients die without indignity. They can achieve this in two ways. One is that physicians should not impose indignities on their patients. They should not take away choices from patients who look up to them. They should give the patient all possible choices available and let the patient choose which they feel is the best for them. Secondly, physician can help the patient to die without indignity by minimizing it. Physician should not deny patients certain services. Administration of pain reducing drugs, such as morphine, should not be withdrawn simply because the patient is almost dying. All care that is given to any other patient should be given to a terminally ill patient, as well. They should not be segregated (Biggs, 2001).

Components of a Dignified Death

A dignified death may have distinct meanings to different people. To some, death itself is undignified, consequently, there is no such thing like a dignified death. According to The Institute of Medicine, a dignified death is one that reduces patients suffering and frees from avoidable misery. A dignified death is also a death that has the accord of family members and caregivers. However, it should be the wishes of the patient and not any other person. A dignified death should be consistent with ethical standards, cultural and clinical values (Biggs, 2001).

A dignified death should show a consistency in living a dignified life. The lethal prescription given by the physician should not have adverse effects on the patient. It should not produce more pain to the patient. There should be a control of symptoms, preparation for death. Moreover, there should also be a close relationship between the suffering patient and the health professionals.   In a dignified death, the patient dies on his or her own terms and reasonably free with dignity (Biggs, 2001).        

From the above discussion, it is clear that there are the righteous parts of the Oregon law, Euthanasia and Physician Assisted Suicide. Therefore, it is necessary to take  each aspect of the problem into consideration.

Provisions of the Oregon Law Safeguard against Abuses

The passing of Death with dignity Act that permitted physician to assist suffering patients to commit suicide met legal challenges. The application of the Act was essentially delayed for years due to these legal injunctions (Yount, 2000). However, after several legal proceedings, court appeal finally lifted the injunction, thus, making Oregon the only state in the United States, where euthanasia is a permitted medical option. Since then, concerns have been raised on whether the provisions of the Oregon law safeguards against possible abuse when recommending physician assisted suicide (PAS) (Yount, 2000).

There are different ways through which the law safeguards against abuse of the dignity death act. The Oregon law requires the patient requesting physician assisted suicide to be aged 18 years and above. Furthermore, two independent physicians must be involved in affirming the diagnosis (Yount, 2000). The patient is also required by the Act to approve the physician assisted suicide request in the presence of two eyewitnesses. This ensures that the patient is competent enough and working willingly in making that critical decision. In a situation, where patient mental instability is detected, the physician is required by law to order patient counseling. The law also states that the patient can make a second request for physician assisted death, only after 15 days have elapsed since the first request (Yount, 2000).

The Act only authorizes a certified physician to recommend toxic doses of controlled substances to those patients who are terminally ill or suffering from a disease that is incurable and which is likely to result in death within six months. The law requires the physician to conduct a thorough medical investigation. This is meant to validate that the patient’s current condition is beyond recovery. Inappropriate prescription of lethal doses when aiding a patient to commit suicide is also controlled by the federal act. It is considered unlawful, if medical personnel prescribe lethal substances without prior federal registration.

The law requires a prescription of the physician assisted suicide to be conducted as the last option in medical care setting, which implies that all possible palliative and therapeutic options have proved to be futile. Consequently, it makes the physician to be more committed to the research and development of better treatment care. Therefore, the possibility of recommending assisted suicide becomes significantly reduced.

The provisions of the Act make it explicitly clear that physician assisted suicide should only be made by a person capable of making an informed decision and right choices. The decision must essentially be made freely on the basis of adequate information and without external coercion. In a situation, where a person is considered to have severe intellectual impairment, the law requires that the person should be deemed incapable of making such critical decision. Therefore, the person deciding over the fate of the sick patient must be a person with the authority to make such decision on behalf of the patient, for instance, family relative or an heir.

Pros and Cons of Legalizing Physician Assisted Suicide in United States of America

Legalizing a physician assisted death will be beneficial especially to those patients whose lives entirely depend on the medical technology that keeps them alive. Even though advanced medical technology can keep a terminally ill patient alive, the patient functioning is usually at extremely minimal levels. Therefore, legalizing a physician assisted suicide will permit terminally ill patient to die a peaceful death with some degree of dignity (Tong, 2007)

Authorizing a physician assisted death in the United States of America will be essential. Thus, helping in ending the life of suffering person, particularly when they have made the decision, is more humane and morally justified than to let the person suffer. Furthermore, every person should be allowed to decide whether to end life, especially when they are suffering from an incurable disease (Tong, 2007). Many people believe that assisting suicide to ill patient is more humane than just letting the person continue to live in pain and agony.

Authorizing a physician assisted suicide in the US will enable the health care sector to save the cost of dealing with terminally ill patient with no hope of recovering. For instance, a research study conducted in 1998 indicates that through physician assisted suicide, the country can save more than $627million. This represents approximately 0.7 percent of annual health care costs. In addition, a physician assisted death needs to be legalized because it is normally viewed by many as an ultimate victory of the personal autonomy and control over the naturally unpredictable process of dying.

Legalizing a physician assisted suicide in the United States of America will pose a considerable concern to reliability and integrity in the health care institutions. This is because of a possible mix between the profit driven managed health care and the physician assisted suicides supported by bureaucracies that exist in these sectors (Yount, 2000). These activities may essentially quicken the death of the patient. For instance, the cost of prescribing lethal doses for assisted suicides ranges from $30 to $50. This is cheaper as compared to the cost of providing a  patient with long term and incurable disease with care. Therefore, legalizing a physician assisted suicide will essentially act as an incentive for the health care provider to save the cost by denying crucial care to the patient (Yount, 2000).

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Legalizing a physician assisted suicide will quicken the decline in the provision of quality health care. There is a strong link that exists between cost cutting incentive pressure among the physician and their enthusiasm to recommend lethal doses to sick patient. Therefore, making it legal, it will essentially provide medical professional with a quick option to maximize their profits at the expense of the life of patient with terminal illness (Tong, 2007).

The effects of legalizing physician assisted death will affect the people who are economically and socially disadvantaged in the United States of America. The reason for this lies within a limited access they have to medical resources. Furthermore, they are normally discriminated against by the health care systems (Morrison, 2009). Legalizing a physician assisted suicide will essentially increase the health risk of people of color, elderly, poor people who has chronic and progressive conditions.

According to a recent study conducted in the United States of America, most suicide requests are normally made by people who are terminally ill on the basis of depression and fear. Therefore, a request for assisted suicide on the basis of fear and depression is usually common to all terminally ill patients. Hence, when the medical professional fails to recognize the inconsistency, anxiety and depression that motivates the patient to request physician assisted suicide, patient ends up being trapped by the request and dies in a state of unrecognized fear (Morrison, 2009).. In addition, depression cases that are common among terminally ill patient can be treated. However, physician providing primary care are usually not experts in diagnosing anxiety and depression. Thus, legalizing a physician assisted suicide will make depression remain undiagnosed, and the only treatment to depression will remain to be the prescription of lethal doses (Morrison, 2009).

Conclusion

With regard to the issue at stake, the legalization of a physician assisted death in the United States of American will essentially remain to be controversial due to diverse attitudes and values attached to the human life (Morrison, 2009). However, most people view legalization of a physician assisted suicide as being morally justified, especially when a patient is suffering from untreatable disease with unbearable pain. However, due to the increased possibility of exploiting the Act to the advantages of health care giver with vested interests, it is essential to amend the law in order to ensure that all loopholes have been eliminated before the law is applied in the entire United States of America (Tong, 2007).

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