There has always been a debate regarding the morality and immorality encompassing physician assisted suicide and also euthanasia. The articles, journals as well as the human rights advocates have put forward their views both in favour of and against the principles of human rights and the right to live. In this paper, the discussions shall be encompassing both the morality and the immorality of physician assisted suicide and then both sides of the debate shall be weighed and evaluated to reach a conclusion regarding the strength and the weakness of this concept. There has been both ethical as well as legal constraints regarding the legalization of physician assisted suicide. The enormity of the topic can be broken to ethical concepts like morality, the standard of living and then a little emphasis can be put on the legality of the topic, that is right to life and the legality of taking lives by a physician. The question to be pondered upon while discussing the topic is the very term of suicide and why is it called so, even though it is done in the presence of a qualified physician. The issues shall be dealt with subsequently.
Physician assisted suicide: Arguments in favour
In the ancient past, assisted suicide was norm where the dying or ailing patient’s life was taken to preserve his honour and it was not seen as a crime. In the recent age of modern technology and advanced medicine, it has become imperative on the physician to keep fighting to keep the patient alive. The question that keeps on getting repeated is what is the purpose of keeping a patient alive knowing that the patient will be subject to tremendous pain and there is no way of prolonging the life span. The modern medicine has progressed to include different techniques to ensure that the patient lives on life support. This is an expensive process, the costs of which need to be borne by the patient party. These medicines intend to force the patient to live a longer life, knowing that the patient will not survive for a very long time. On one hand, there is a utility of these medicines, as these prolong the life of the patients. On the other hand, some human rights activists have also rebutted the point of prolonging life by stating that it is a process of prolonging death, making the process of dying very painful and excruciating. Euthanasia and assisted suicide are not the same thing but they are undertaken with the intention of taking away a patient’s life so as to relieve the pain. Euthanasia can be classified into two types on the basis of the ability of the patient to give consent. Voluntary euthanasia is defined as euthanasia conducted with the consent of the patient. Involuntary euthanasia on the other hand is defined as euthanasia conducted without the consent of the patient as the patient is not in the position to give any consent. The decision in case of passive euthanasia is taken by another person on behalf of the patient. Euthanasia is conducted with the help of a medical practitioner, and therefore based on the procedure in which euthanasia is conducted, it is classified into active and passive euthanasia. Passive euthanasia is said to be conducted when the medicines or equipment on which the patient is surviving are withheld. Whenever life sustaining treatment that are keeping the patient alive are taken away, the patient ultimately dies. Active euthanasia is the use of legal medicines or substances to end a patient’s life. The question of active euthanasia involves many moral and ethical considerations and starts debates as to whether it shall be a legal method that can be implemented by the physician. Taking the definitions of active and passive euthanasia, the question of assisted suicide can be inferred because the intention in both the two methods is to relieve a patient of his sufferings and ensure that he does not suffer. The physician helps the patient by recommending medicines so that the patient can administer it at his own volition. The moral dilemma that the physician is faced with is, how can a doctor take the life of his patient where his profession demands that he save lives. The ethical dilemma in case of physician assisted suicide is immense as it is always argued that a doctor participates in the death of his patients which is against his morals. There are many historical references to physician assisted suicide as in one of his deliberations Plato claimed that the sick people should be abandoned to death and that the Hindus always believed in entrusting the elderly to take the suffering patients to the Ganges river. In cases of people trying to commit themselves to death, it is also important to take the reference of Eskimos, who exposed themselves to severe cold weather so that they could die in the cold when they understood that they were not competent to live any longer.
Physician assisted suicide is considered legal in some of the states of the United States of America, like Oregon, Montana etc. in those states, the laws favours the physician in cases when the patient is ailing and severely ill. The patients have to request the lethal dosage and the doctor has to ensure that the patient is in a mentally stable condition to make sure that he is capable of making the decision that he does not want to live any longer. The question of merely living and surviving and a life full of happiness are two different things and that is what the debate tries to encompass. A life full of sufferings is not a life fully lived. Merely having brain activity could be a good way to gauge that the patient is living, but if the patient cannot enjoy the beauty of life and become a liability on others even for the basic functions of life, that is rarely a life.
Opinion:
In my opinion, assisted suicide is ethical as it respects the wishes of a patient and his choice to end his life. The patient has the choice to live his life according to his own wishes. It is essential to respect an individual’s autonomy over his life. The choice entirely vests on the individual as to whether he wants to prolong his suffering or put an end to it. Elements of privacy, freedom and lastly autonomy are essential factors that should be give due credit. The utilitarian argument is an important argument that needs to be considered in this perspective that will help in the solving the mystery and also settling the issue of physician assisted suicide. Jeremy Bentham in his theory had said that it is more important to promote individual happiness and there is also a need to decrease unhappiness and suffering. Therefore, taking cue from the concept of maximum happiness of maximum number, it is wise to state that if the patient wants to reduce his suffering along with the suffering of his family, the caretakers by taking his life, the choice should be respected. By denying the patient to make the choice is denying the basic freedom that every individual should have. The notion that the doctor being the healer is turning into a murderer by abetting suicide should not be encouraged as there is no moral culpability as the doctor is merely assisting in the process of reducing the pain of the patient. The role of the doctor is to keep the interest of the patient way ahead of his own interest and therefore I believe that the doctor should act as a healer in a way that will end the suffering of the patient and also take away the life peacefully.
Physician assisted suicide- Arguments Against
The biggest rebuttal to the argument of physician assisted suicide is that the doctor will act immorally if he allows a patient to die and also plays an active role in taking away a life. The opponents to physician assisted suicide claim that the role of the doctor is to act in the best interest of the patient and has to also fight to keep a patient healthy and happy. The argument that the opponents put forward is that life has been created by God and that mere humans should not be given the right to take away a life that has not been created by them. The relation that exists between a doctor and patient is based entirely on trust and the relationship is that of “fiduciary”. By allowing a patient to die naturally in natural cause is the best to escape moral culpability and that if the doctor takes the role of an “executioner”, the role that he plays that of a moral healer will get negated. The relation of the doctor and the patient shall be corrupted and that the doctor will not live up to his reputation of healing a patient.
Another argument against physician assisted suicide is that the doctors take the Hippocratic oath, where if the doctor sees that a patient needs attention and care, it is the moral duty of the doctor to assists the patient and secure a safe recovery. The Hippocratic Oath states that the patient shall not give any deadly drug to a patient that will claim his life and that the doctor shall not give any suggestion to any patient knowing that might claim his life. The question that doctors who have been the power to save lives and play God every day, should not misuse the power they have been given by virtue of their degree. Can it be claimed that the doctor is also playing God when he is taking lives or assisting in the death of his patients. Is the doctor defying his morals and duties when he is taking lives. The vow that a doctor at the inception of his professional career is that the doctor will do no harm to the patient. Therefore, the use of the terms suicide means that the doctor is helping ending a life and when death happens at the hands of another person, does it still remain moral is the biggest question that the debate tries to solve.
There is an adage that states that power has the potential to corrupt completely and that when the person is given absolute power and authority, he shall misuse that power and that might affect the patients. Not only the doctor can abuse, the power also shifts to the relatives or anyone who has some relation to the patient to abuse that power and then exploit the authority that has been entrusted to him. If the physician assisted suicide is allowed, it might so happen that the dying and sick patients might fall prey to the abuse of the relatives. Though pain regulation is a method of regulating the excruciating suffering that the patient has to undergo, it is essential to state that there are various palliative care that are available to the patients. Many training techniques are adopted by physicians that help in the curing of pain and suffering of patients. Many times it happens that pain comes from wrong treatment, wrong medicines and wrong diagnosis and doctors are humans and they can makes mistakes as they are not infallible. Therefore, sometimes, it so happens that care and love can work wonders for the patients and that patients will recover if they are kept in a happy surrounding.
Patients who are undergoing treatment may sometimes feel very disappointed and they might have despair. Therefore, when a patient claims that he does not want to live anymore and that he wishes to die, it is because he might be feeling trapped in a situation and has no way of getting out. It is the duty of the doctor to distinguish between depression and suffering and sometimes the patient might just be suffering from depression, even though they are thinking that they might not live anymore. In such cases, taking away the life can be wrong and immoral. Do humans have the power to alter nature’s course is another way of looking at this debate. By just ending the treatment that is ongoing or by withdrawing life support, is the doctor simply ending the life or ending the suffering of the patient, thereby ensuring that he does not suffer any longer. From the point of legislature, it is imperative that there be a strong mechanism to stop the absolute misuse of power that might befall a doctor. The physician assisted suicide should have strong safeguards that state that doctors cannot be allowed to misuse that power. The ambiance should be created where the patients feel at home and not distressed. By allowing physician assisted suicide, it might so happen that the floodgates open for unethical practices to crop up and the patients fall in the hands of unscrupulous doctors who are driven by power and money and they do not have the moral high ground to care for the interests of the patients.
Opinion
The argument that can be advocated against physician assisted suicide is that without taking the extreme step of ending life, the technology needs to develop so that new methods can be achieved where the difficult to manage pain can be treated. Though there are many untreatable situations, it so happens that the palliative care might alleviate the situations and might help the patient live a better life without lesser suffering. The physician assisted suicide should be the last resort and the patients with disabilities shall not be treated like they are dying and that there is no hope left for them. The disabled people should not physician assisted suicide be threatened whereby they feel that they are dying of humiliation. Physician assisted suicide is a last method to deal with a suffering that is so acute that only death can resolve. But in no way should physician assisted suicide be treated as a method to promote suicide where any humiliation should not be an incentive to end a life. Physician assisted suicide should not in any way promote that suicide is a moral situation that can be ended. Physician assisted suicide is against morality and human dignity as it is the moral duty of every doctor to ensure that the patients live happily. By allowing physician assisted suicide, doctors will question and undermine that key principles that hover around medical ethics. The aim of the government should be to allow palliative care at affordable prices so that patients might have the opportunity and the option to opt for these techniques and that they do not end their lives. It shall be very difficult to ensure checkpoints for ensuring that there is no misuse of physician assisted suicide. Taking the example of Netherlands, it has been notices and reported that there have been instances when doctors have used lethal injections and those have gone unreported. Therefore, it is vital to keep in mind that doctors should not be given absolute power in taking a patient’s life.
References:
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