Ross Whittaker

Kelly Turnbeaugh
ENGL-1010-073
April 28, 2016
Annotated Bibliography Assisted Suicide
While looking for databases for research I found a database titled Opposing Viewpoints
Resource Center. This sounded like a great site to look up topics that I would be interested in
discussing for the Issue Exploration Essay. Searching through the website I found a number of
issues that were relevant to me but the biggest interest is assisted suicide. I started to ask myself
what I would want if I were terminally ill and suffering in pain. Should I live through it hoping
that some new cure will be found or just end it? This is a big question and one that people today
are asking themselves. With this research I wanted to answer what were peoples thoughts on
assisted suicide and what is deemed appropriate for assisting the passing of a human.
Veatch, Robert M. "From forgoing life support to aid-in-dying." The Hastings Center Report
Nov.-Dec. 1993: S7+. Opposing Viewpoints in Context. Web. 20 Apr. 2016.
Summary. The author Robert Veatch goes through the history of bio-ethics and significant
events that have shaped the arena. These include the Harvard Ad Hoc Committee on Brain Death
which focused on whether pronouncing someone as dead was a matter of biological fact or
philosophical judgement, the founding of the Hastings Center Death and Dying Research Group
which distinguished euthanasia from allowing to die, and the court case Quinlan v. Morris

which decided that a physician who inherits a patient in the emergency room could not insist that
life-support continued.
Evaluation. Its interesting that there was a committee that was formed to decide when someone
was dead. I think that it is a big deal to decide where to draw the line because someone might
decide to end life support even if there is still a significant chance that they may be recovered.
Robert Veatch is a long-time fellow of the Hastings Center and Professor Emeritus of Medical
Ethics at Georgetown and Senior Research Scholar at the Kennedy Institute of Ethics.
Reflection. This made me think what about the religious side of the argument. What happens
with thou shalt not kill if it was the patients decision? The other aspect is that of the womens
rights movement and that of abortion, this is also a big issue that still hasnt been fully decided;
however if there is the option of terminating a pregnancy how much further is ending a sad life.

Gopal, Abilash A. "Physician-Assisted Suicide: Considering The Evidence, Existential Distress,

And An Emerging Role For Psychiatry." Journal Of The American Academy Of
Psychiatry And The Law 43.2 (2015): 183-190. PsycINFO. Web. 20 Apr. 2016.
Summary. The journal submission goes into detail how there is a possibility of a correlation
between mental illness and the request of physician assisted suicide. The article explains that
psychiatrists are needed to screen patients mental health not just physicians for physical health.
The Oregon Death with Dignity Act clearly defines that the patient needs to be dying with a
terminal disease.
Evaluation. The article was written in 2015 which is a lot more relevant time frame. The author
mentions that there are very few locations that permit Physician Assisted Suicide (PAS)

including Oregon, Washington, Montana, and Vermont. The article was written before California
passed the California End of Life Option Act which is effective this year.
Reflection. I find it interesting that the physician and physiatrist plays such a prominent role in
ending a persons life. It makes sense that people should be screened beforehand but I think that
if people are in such a state that they shouldnt be permitted to perform PAS then wouldnt they
end up committing suicide on their own?

Sullivan, Mark D., Linda Ganzini, and Stuart J. Youngner. "Should psychiatrists serve as
gatekeepers for physician-assisted suicide?" The Hastings Center Report July-Aug. 1998:
24+. Opposing Viewpoints in Context. Web. 20 Apr. 2016.
Summary. This article discusses how psychiatrists are subjected to a moral conflict every time
that they evaluate a patient. Instead of the patient being the decision maker the responsibility is
placed upon the psychiatrist to make the life ending decision. The article mentions how some
initiatives have included a time frame to be evaluated (to make sure that it is persistent request)
and psychiatric consultation to make sure that the decision is the patients desire and not an
influence of someone else.
Evaluation. This article is by a member of the Hastings Center and was published in the JulyAugust 1998 report. I found it interesting that patients who were considering PAS were leaving
the decision up to the doctors that were evaluating them. Another interesting point is that most
(90%) of completed suicides have evidence of some psychiatric disorder at the time of death.
Reflection. I think that we cant have it both ways. Someone has got to take the blame of the
decision maker. I am starting to think that the psychiatrist should evaluate the mental health but

also strongly suggest help before giving a green light. The article also brings the point of how
psychiatric disorders are common in the terminally ill.

Parks, Jennifer A. "Why Gender Matters to the Euthanasia Debate." The Hastings Center Report
Jan. 2000: 30. Opposing Viewpoints in Context. Web. 20 Apr. 2016.
Summary. Parks describes the conflict in physicians as trying to balance the moral dilemma of
their commitments to healing and saving lives versus serving the patients needs and respecting
their autonomy all while keeping their trust. Parks cites Susan Wolf who claims that women are
more likely to request PAS and are also more likely to be granted their request. Parks provides
the contrary opinion that women might be discounted for the same reasons, such as the concept
of weakness, but in the end are just as capable at making their own decisions as men.
Evaluation. Another Hastings Center Report this time in 2000. This article was a six page article
written in a peer reviewed journal and cites many opinions. Growing up in a time where gender
equality is pushed, I have no doubts that women are just as capable as men in providing for their
own wellbeing. I do think however that society still views women as lesser halves which might
influence the acceptance of the patients request.
Reflection. I think that Parks has a point that women are taken less seriously when they request
PAS.

Lachman, Vicki D. "Voluntary Stopping Of Eating And Drinking: An Ethical Alternative To

Physician-Assisted Suicide." MEDSURG Nursing 24.1 (2015): 56-59. Academic Search
Premier. Web. 20 Apr. 2016.

Summary. Voluntary Stopping of Eating and Drinking (VSED) is when a person refuses to eat
or drink in order to die quicker. It is an ethical alternative to PAS because it does not involve
drugs or external assistance. In this study patients were monitored as they abstained from eating
and drinking. Caregivers have the responsibility to give palliative care similar to hospice care.
Again the argument for is a persons autonomy, compassion, personal liberty, but a point is made
for justice. Patients who are on life support can have an existing living will which dictates what
to do when health is beyond a certain point so why can patients who have debilitation pulmonary
disease or heart failure also have the same choice when their condition is below their standard of
living.
Evaluation. MEDSURG Nursing is the official journal of the Academy of Medical-Surgical
Nurses. Vicki Lachman is the board chairperson for the American Nurses Association. I think
that people would choose an ethical alternative even if it is a longer duration and more
uncomfortable than PAS. The interesting thing is that VSED is available everywhere because it is
voluntary and can be done without assistance whereas PAS is available in very few areas legally.
Reflection. What are the expense differences between the drugs taken for PAS and the care
needed for VSED? I cannot imagine what it would take to force yourself not to eat. Starving is
usually not an option. I assume it is terribly unpleasant.

Biller-Andorno, Nikola. "Physician-Assisted Suicide Should Be Permitted." The New England

Journal Of Medicine 368.15 (2013): 1451-1452. PsycINFO. Web. 20 Apr. 2016.
Summary. The article focuses on the role of physicians and to how they are to simply not
preserve life but also apply their expertise to help improve patients health or alleviate suffering.
The author suggests that even with the new laws allowing PAS it should still be up to the

physician to accept whether they want to participate in the process. However if they do wish to
use their expertise for that cause then they shouldnt be stopped. In any case, careful regulation,
comprehensive monitoring, and an ongoing critical debate are required to ensure that physicianassisted suicide remains a choice that is based on caring relationships among the patient, the
family, and health care professionals
Evaluation. The important argument is that if the physicians can get past the moral implications
of ending someones life then they should be allowed to use their training to ease the suffering of
their patients. The author is a member of Research Ethics Committee of the Federal Institute of
Technology Zurich and Visiting Professor of Biomedical Ethics at Harvard University.
Reflection. I believe that it is important to keep in mind that although its the patients decision to
ask for PAS it is also the physicians decision to help. I dont believe that physicians should be
forced to help but I do think that they should be able to help if desired.

Boudreau, J. Donald, and Margaret A. Somerville. "Euthanasia Is Not Medical Treatment.

British Medical Bulletin 106.1 (2013): 45. Publisher Provided Full Text Searching File.
Web. 29 Apr. 2016.
Summary. The authors acknowledge that physicians have been blamed for lingering death
where patients await treatment that may or may not help them. They call for the medical
profession to be vigilant and avoid over-compensating by endorsing society-sanctioned
euthanasia. They propose that the degrees of freedom available to physicians confronted with a
dying patient must be strictly limited. The Hippocratic Oath is quoted saying I will neither give
a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.

Evaluation. One of the arguments is that physicians never have wanted to partake in the aid of
dying. Even the use of lethal injection has been reluctantly performed and not advocated. The
idea that society plays a big role on what methods are used is an interesting concept. If
advocators are able to sway public opinion by using nonthreatening words such as death with
dignity rather than euthanasia
Reflection. Again I think its a great point that physicians would be against the practice of
assisted suicide. Would it be such a stretch to say that those performing the procedures are not
physicians? On top of that can just anyone be trained in how to administer the drugs?

Pestinger, Martina, et al. "The Desire To Hasten Death: Using Grounded Theory For A Better
Understanding 'When Perception Of Time Tends To Be A Slippery Slope'." Palliative
Medicine 29.8 (2015): 711-719. PsycINFO. Web. 20 Apr. 2016.
Summary. The study used Grounded Theory to analyze 12 patients in Germany where they
requested for their death to be hastened even though it is illegal for a physician to do so. Patients
may have the desire to hasten death because they are trying to balance life time and anticipated
agony but the perception of time can be confusing. Most patients expressed their fear of agony
and not of death itself.
Evaluation. The study is extensive and performed by the Palliative Medicine journal. Palliative
meaning relieving the pain and suffering of terminally ill patients. Its interesting that patients are
focused on how long they will be suffering rather than how much they will suffer. When patients
are with someone they feel safe around such as close family and in the study the specialist
inpatient unit their desire to leave the world immediately is diminished.

Reflection. I find it interesting that patients are concerned with the duration of their suffering. I
wonder if the idea of going without food or water ever occurred to them because they seem to
want the quick way out or nothing. I also find it interesting that the patients mainly wanted to
express their options and to know that they still had control. Its not too hard to sympathize with
the feeling of hopelessness that sets in when you feel that you are out of options. Sometimes
having another option even if its not as pleasant can be a comfort as a last ditch effort.