The concern over the legality or morality of physician-assisted suicide (PAS) is not a new phenomenon. This topic has attracted heated debates over the past and does not seem to end any time soon. The controversy surrounding this subject is majorly centered on the physician’s role in facilitating death. The American Medical Association notes that this practice occurs when a doctor offers the needed information or means to enhance patients’ choice to end their lives. Currently, PAS is legal in Washington DC, New Jersey, Hawaii, Montana, Vermont, Colorado, California, Washington, Maine, and Oregon (Morrow, 2021). Canada also legalized the practice in 2015. While its restrictions vary proportionately throughout the world, PAS is allowed in Japan, the United Kingdom, Belgium, Columbia, and Netherlands (Morrow, 2021). This paper holds divergent opinions on the morality of aiding dying. Hence, the essay looks into the subject by supporting the practice of PAS by addresses the concept, its legalization, supporting arguments, and opposing views.
Arguments for PAS
Most proponents of PAS argue that advocating for this practice shows respect for patient autonomy (Sjöstrand et al., 2013). In medical bioethics, autonomy relates to governance over an individual’s actions. This provision implies that a patient can determine the most appropriate medical intervention to be administered in the health care environment. Patient autonomy justifies informed consent. A patient may have the agency to participate in medical research or treatment only after receiving information on the benefits and the risk factors of an intervention. Therefore, physicians are obliged to respect the patient’s wish or preferred treatment method, which can be made orally or in writing. This logic naturally extends to PAS since patients are empowered to decide on their health care decisions and are also allowed to control the conditions of their deaths.
As much as this provision could be legally permissible, it contradicts the moral and spiritual beliefs regarding life. Kant’s reasoning in normative ethics, for instance, views suicide as a morally impermissible practice in the society. Even so, it is also imperative to understand that while Kant considered suicide amoral, his contention did not imply that voluntary euthanasia is wrong. In this connection, critics who would cling on normative ethics to discourage PAS should understand that this intervention the intervention of an expert, and not merely an individual’s decision to end their lives. Nonetheless, if committing suicide is immoral as Kant argued, then it would be logical for people to believe that killing other people or getting others to kill you is wrong in equal measure. After all, this move would look like an individual’s will to self-destruction which is problematic.
The other reason that most PAS supporters give to substantiate this action is that it relieves patients from suffering (Ahlzen, 2020). The main intention of administering medicine is to relieve patients from pain. Most PAS advocates would argue that guiding terminally-ill patients, for example, to inject lethal injection is a way of showing compassion and humanity to the dying people. When physicians know that their patients do not have any chances of living, such as the last stages of cancer, it is found appropriate to relieve them of the emotional and physical suffering through assisted suicide.
There is no doubt that this contention has also been challenged by many people who view this process as an amoral way of ending life. There is a conventional belief that death is another stage of life and that terminally-ill patients should be allowed to prepare for their death even during the last stages. Instead of assisting patients to die, PAS critics believe that they need to be given adequate care to bond with their families before they die (Lewis, 2017). Besides, those who think that PAS should not be justified with the love for patients and a way of alleviating their suffering understand that if this type of suicide implied a severe contradiction to the natural laws, notwithstanding that associating immorality with that would be fallacious, it would be difficult to substantiate its moral permissibility. In this connection, contemplating PAS would be monkishly scholastic.
Arguments against PAS
The quality of palliative care and access to hospice is one of the primary reasons why PAS should be discouraged. Considering that palliative care and hospice support quality end-of-life care, there is no substantial reason why one would still need to go for PAS. Given that these resources are already available, the actors should improve them to give better care instead of giving people another option to end their lives. According to Morrow (2021), United States has more than 4,000 hospice agencies throughout the country. However, due to the limitations on the Medicare Hospice Benefit as well as the funding restrictions that necessitate patients to have a life expectancy of at least six months, millions of Americans cannot access these services. While improving the quality and access to hospice and palliative care might seem more morally plausible than allowing people to end their lives, it is also worth noting that this move might not adequately address all the challenges encountered during end-of-life care. Even when there is improved access to palliative care, rare, untreatable, and persistent suffering will still be experienced. This statement implies that if PAS were illegal, patients with untreatable diseases in palliative care would have to endure the sufferings related to untreatable conditions. Pieces of evidence have shown that a significant fraction of patients still opt to have PAS when they are on hospice (Banović et al., 2017). Thus, it is rational to consider that whereas palliative care and hospice give chronic patients another opportunity to live, they are not sufficient to treat severe illnesses.
PAS opponents also cite that this practice could be a slippery slope to social depravity (Pence, 2017). Those who subscribe to this school of thought are worried that the widespread legalization of assisted suicide would pave the way for euthanasia. This contention holds that PAS is a roadmap to mercy killing of the incapacitated groups in the community. These include the physically handicapped, the mentally ill, demented, the elderly, and the homeless, without their consent. Conversely, this practice might propagate a society’s action to eliminate perceived “useless” in the community. Nonetheless, critics of the “slippery slope’s” perception believe that the current highly cultured society is less likely to allow mercy killing. The situation could be attributed to the pressure to act morally, and never be haunted by the feelings of ending someone’s life. Suppose Joseph Mengele, Adolf Hitler, and Joseph Goebbels were defeated in their quest to cleanse the gene pool in Germany, there is a high likelihood that contemporary society will resist a similar move (Pence, 2017).
It is justifiable to reaffirm that while physician-assisted suicide has attracted heated debates over the years, it should be promoted to safeguard patient’s autonomy and strengthen palliative care. The subject remains to be a controversial topic in modern health care. With the legalization of euthanasia in most nations in the west, many people have started to rethink the possibility of legalizing assisted suicide. While the practice has some strength, it is also essential to consider the challenges it might face. It is also imperative to understand the rights associated with assisted suicide, such as patient autonomy and conscientious objection.
Ahlzen, R. (2020). Suffering, authenticity, and physician assisted suicide. Medicine, Health Care and Philosophy, 23(3), 353-359.
Pence, G. E. (2017). Assisted reproduction, multiple births, and elderly parents-Time to regulate?, in. Medical Ethics: Accounts of Ground-Breaking Cases, 97-99.
Banović, B., Turanjanin, V., & Miloradović, A. (2017). An ethical review of euthanasia and physician-assisted suicide. Iranian journal of public health, 46(2), 173.
Dugdale, L. S., Lerner, B. H., & Callahan, D. (2019). Pros and Cons of Physician Aid in Dying. The Yale journal of biology and medicine, 92(4), 747–750.
Karsoho, H., Fishman, J. R., Wright, D. K., & Macdonald, M. E. (2016). Suffering and medicalization at the end of life: The case of physician-assisted dying. Social Science & Medicine, 170, 188-196.
Lewis, B. (2017). A deliberate departure: Making physician-assisted suicide comfortable for vulnerable patients. Ark. L. Rev., 70, 1.
Morrow, A. (2021). Overview of Physician Assisted Suicide Arguments. Very Well Health.
Sjöstrand, M., Helgesson, G., Eriksson, S., & Juth, N. (2013). Autonomy-based arguments against physician-assisted suicide and euthanasia: a critique. Medicine, Health Care and Philosophy, 16(2), 225-230.
Snyder Sulmasy, L., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper. Annals of internal medicine, 167(8), 576-578.