What is Physician Assisted Suicide?
Physician-assisted suicide occurs when a physician facilitates a patient's death by providing the necessary means and/or information to enable the patient to kill themselves.
What is Euthanasia?
The word "euthanasia" comes from the Greek words meaning "good death." It is done to cause death such as a legal injection or by other means. Someone other than the person being killed performs it such as a Doctor or other.
What is the difference between Physician Assisted Suicide and Euthanasia?
The difference comes down to who performs the last act. In PAS the person wanting to die is helped to perform the act him or herself. In Euthanasia someone else provides the action that causes death.
Who can receive it?
The law varies in each state that it is legal. Majority of the laws apply to the terminally ill or people with less than 6 months to live or r/t quality of life. However often the laws are vague and allow for interpretation. For example, in Oregon the majority of people cited their issues as emotional or existential: feeling a burden to family, loss of autonomy or inability to do things they enjoy (not pain or limited life expectancy).
Where is physician-assisted suicide legal?
Physician Assisted suicide, where the patient has to take the final action themselves (unlike euthanasia), is legal in the Netherlands, Luxembourg and Switzerland. In the United States there are assisted dying laws restricted to terminally ill and mentally competent adults in Oregon, Montana, Washington, Vermont, and most recently in California.
What physicians perform it and do all physicians have to?
In states where it is legal, a person with a medical license can prescribe the drugs for assisted suicide within the guidelines of the law. Currently Doctors are not required to carry out these wishes. However there is no reason why this could not potentially become a requirement for physicians, if the government writes law to deems it is best practice for that patient regardless of medical advice.
Should Assisted Suicide be considered Medicine?
Physician assisted suicide corrupts the profession of medicine by permitting the tools of healing to be used as a technique for killing. In testimony before the U.S. House of Representatives, Dr. Leon Kass elaborated on this point:
The legalization of physician-assisted suicide will pervert the medical profession by transforming the healer of human beings into a technical dispenser of death. For over two millennia the medical ethic, mindful that power to cure is also power to kill, has held as an inviolable rule, “Doctors must not kill.”
The American Medical Association (AMA) code of ethics rejects physician-assisted suicide. The AMA states: “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” In Fact, dozens of professional associations and groups representing vulnerable persons oppose physician-assisted suicide, including the American Medical Association, the World Health Organization, the American Psychiatric Association, and the American Association of People with Disabilities.
Does the patient get a psychological evaluation?
There is no requirement for this type of evaluation, and often the desire to die stems from a call for help and a treatable case of depression. Healthcare workers should be focused on healing these patients and treating their symptoms.
Should people be forced to stay alive?
No. Many people think that euthanasia or assisted suicide is needed so patients won’t be forced to remain alive by being “hooked up” to machines. But the law already permits patients or their surrogates to withhold or withdraw unwanted medical treatment. Medicine often goes to extraordinary measures to keep someone alive and the care becomes futile and not curative. It is the patients right to stop this care and let natural life take its coarse even in the event that death follows. Thus, no one needs to be hooked up to machines against their will. There comes a time when continued attempts to cure are not compassionate or medically sound. In this case, hospice can be a great medical decision. There is a big difference between being allowed to die of your disease and having a doctor intentionally end your life (as in PAS).
What if the person is suffering?
It is important to understand the desire to be of sound mind at the end of life and not to have to suffer as death approaches. We also recognize the obligations of physicians to respect a patient's refusal of more treatment, to provide means to relieve pain and suffering, and to provide palliative care. This can be achieved as well as keeping the art of healing at the core of medical practice. Within the realm of palliative care, there exists a well-recognized paradox that one can die healed. Physicians should be comforting and caring for patients while providing safe palliative care not death. There are great options of palliative care and hospice that can be provided to the patient where suffering does not have to incur.
Is it the same as hospice?
Euthanasia and Assisted- Suicide end in immediate death and do not allow for natural death to come. Hospice efforts are directed to making the patient’s remaining time comfortable. All interventions should be directed to alleviating pain and other symptoms as well as providing emotional and spiritual support for both the patient and the patient’s loved ones. Hospice allows natural death to follow.
What if alleviating pain with medication quickens death… isn’t that the same thing?
Providing pain medication to terminally ill or dying patients that has the side effect of hastening death is NOT euthanasia or assisted suicide as long as it is necessary to relieve the patient’s pain and suffering, and patient comfort is the primary motive and goal. Health care professionals have an obligation to relieve pain and suffering and promote the dignity and autonomy of patients in their care. No patient should die in pain because no one is willing to provide him/her with adequate pain relief. However, patients may refuse pain medications based on their own values.
For palliative care to remain a healing intervention, it cannot include “therapeutic homicide.” Euthanizing and healing are intrinsically incompatible. Involvement of physicians in such interventions is unethical and should not be accepted.
Shouldn’t people have the right to commit suicide?
Suicide is legal, and, tragically, people can and do intentionally end their own lives. Every 40 seconds a person dies by suicide somewhere in the world. Euthanasia and assisted suicide, however, are not private acts. Rather, they involve at least one person facilitating the death of another. This is a matter of public concern since it can lead to tremendous abuse, exploitation and erosion of care for the most vulnerable people among us.
Euthanasia and assisted suicide are not about giving rights to the person who dies but, instead, they are about changing public policy, giving doctors the power to prescribe or administer lethal drugs. By legalizing PAS, we weaken efforts for suicide prevention and weaken efforts to help the vulnerable. For more information visit the suicide Q&A link. Wide spread practice could lead to deaths of people who have treatable depression or curable illness.
How does this involve the government?
We are seeing a stronger role of government intervention in healthcare. The government should always advocate protecting citizens and providing resources for real healthcare. Legalizing PAS changes the practice of medicine and opens the door for society to view this population as expendable, costly, and burdensome. Many people use government health insurance. If PAS were to be widely accepted this government program can cover cost of PAS instead of treatment making people feel obligated to accept Physician Assisted Suicide instead paying out of pocket for treatment and being an economical burden to society or family. We should never see human beings as a burden and the government should see every person as a valued citizen.
Why is life important?
Life is sacred and an inviolable gift from God. Life should progress in a natural order. We should be providing comfort and compassion to those in their last days, not intervening in their number of days left on earth. Everyday of life is an opportunity to get closure, grow, and be loved. So lets protect and love life, not destroy it.
Leon R. Kass, “Dehumanization Triumphant,” First Things, August 1996, http://www.firstthings.com/article/1996/08/002-dehumanization-triumphant (accessed April 16, 2015).
Hippocratic Oath http://www.aapsonline.org/ethics/oaths.htm#bears
J. Donald Boudreau, M.D., Margaret A. Somerville, A.u.A. (pharm.), D.C.L.
“Physician-Assisted Suicide Should Not Be Permitted” New England Journal of Medicine