Running head: PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

Physician Assisted Suicide Should be Legalized Fallyn Vandiver Jefferson Community and Technical College

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

With cancer and other terminal diseases becoming prevalent in society, an increasing number of people are being diagnosed with a life-ending sentence every day. Many are going to lose their life way before they actually die. They are falling victim to an illness which will cause them agonizing pain and destroy their quality of life months before their body surrenders to the disease. For those who choose to die before they lose control of their disease, there is an option called physician assisted suicide, also known as PAS. Though hardly legal in the U.S, PAS provides people with an easier way out; it allows a terminally ill person to obtain a lethal dose of medication from a doctor for the purpose of ending their life. Physician assisted suicide is a controversial topic with many supporters and antagonists, and only three states in the U.S. allow it. Oregons legislature is well devised and provides a good model of how states laws should be set; Physician assisted suicide should be available to terminally ill patients in all states. The majority of people who are on their deathbed have decided to fight until their end. Social norms have taught that people are supposed to fight their disease until it kills them, surrendering only when their body gives out, which is what has been done for years. A new philosophy is now being manifested. People, who have lived their lives on their own terms, want to die the same way. PAS is When a physician provides either equipment or medication, or informs the patient of the most efficacious use of already available means, for the purpose of assisting the patient to end his or her own life (Lachman, 2010, p.121). This should be an option for those who want it. Otherwise the determined will take matters in their own hands, causing a messy situation for their family. Individuals with serious chronic and terminal illness face an increased risk of suicide (The New York State Task force on Life and the Law, 1994, p. 13). As the pain and symptoms reduce the quality of life for the patient, the risk of suicide increases. The New York State Task

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

Force reports that some people see suicide as their only liberation from the pain and suffering (1994, p. 17). When the terminally ill take ending their life into their own hands, it can cause tremendous turmoil in many aspects. It leaves a burden on most of the loved ones left behind. If PAS has been used, it is known to the family members that the decision was carefully made and it was seemed competent by a doctor. This can be comfort to families. If the suicide is done outside of the care of a physician, it can be construed as impulsive, and often the wrong decision. Committing suicide, in a more traditional use of the phrase, is a result from not being able to utilize a physician to make ending life more gently. The life, of an actor named Wyatt Knight, ended in suicide. As he ended his battle with non-Hodgkins lymphoma, his life consequently ceased as well. The Los Angeles Times reveals that, An autopsy determined that Knight died of a self-inflicted gunshot wound (2011). This is not the type of obituary that families and friends like to see of their loved one passing. If physicians were allowed to help their patients end their battles in all states, it would not only be better for the ill victim, but their friends and families as well. Using PAS is undoubtedly less emotionally scaring for the relatives left behind. Terminal diseases cease the quality of life for their victims. Margot Roosevelt, an author of an article in Time Magazine, quotes the feelings of a retired veteran who had been diagnosed with terminal cancer. This isn't suicide; Suicide means a needless taking of life. When five doctors tell you nothing can be done, you are merely insuring that your life ends at the proper time. I don't want my daughters to see me wither away to 80 lbs. and have some night nurse shave my beard to get some tubing into my mouth. (2005).

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

The foremost reason for going through with PAS is so that quality of life is not ruined. Dignity is still present despite being terminal, and it continues to be a concern even in the late stages. In the same article, the wife of another Oregon resident, Dick Ferris, dying of pancreatic cancer, who chose to take a lethal prescription, tells her story. He could smell the decay inside of him. But after getting the prescription from his family doctor, she recalls, "He was able to relax, knowing he had control over his death." He chose to die on a Sunday morning, surrounded by his wife's three daughters and 9-yearold granddaughter. Says Gloria: "He told us, 'If I had any more love in this room, I'd have to keep it in Fort Knox.' Then he drank the Nembutal, and in five minutes, he was gone. (Rosevelt, 2005). Why should this not be possible for everyone? Dying on your own terms, painlessly, and surrounded by loved ones should be available to residents of all states. As of now it is only achievable in Montana, Washington, and Oregon. Ferris case shows an explicit image of the ideal death. The ability to die peacefully is much more humane than spending the last months of life in agonizing pain, miserably hooked up to machines reinforcing suffering. This brings the question: Why are people opposed to offering physician assisted suicide to those who want it? Some people fear that such laws would become abused. In 2007, J.M. Dieterle explains that people are concerned about vulnerable groups. The poor, minorities, elderly, and the uninsured could be pressured into using PAS, because they do not have any other option. In 2005, Jost reports that a whole stack of research investigations shows that there has been no abuse under the law. Dieterle gives statistics of people who have utilized PAS under Oregons

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

law. Between 1998 and 2004, only eight percent of the people who used PAS were over eightyfive years old, and people as young as twenty-five had taken part. Of 208 patients, 203 of them were white, and over half were college educated (2007). This shows that the vulnerable groups are not the ones seeking physician assisted suicide, but more of the middle class, who are not seen as a crowd susceptible to being desperate for resources. He goes on to give evidence that out of the 208 people, 129 carried private insurance, others had Medicare or Medicaid; only two percent of them did not have insurance (2007, p.132-133). These findings prove that the uninsured are not using PAS as a way out because they cannot afford care. There is virtually no linkage of uninsured with abusing physician assisted suicide. The reality is that physician assisted suicide is relatively rarely used. In 2004, only one Oregon citizen out of 800 who died had utilized PAS. The ratio of patients who chose to take lethal medications to those terminal patients who did not was 208 to 64,706 (Dieterle, 2007, p. 134). Very few people are choosing to go this route. Roosevelt reported that over half of the prescriptions written were not even used; patients kept them as peace of mind, knowing that it was there if they needed it (2005). In 2010, Lachman added to the fact that PAS is rarely used by stating a statistic from the Oregon Center of Health Statistics. It finds that about 40,000 Oregon residents died in 2008, only sixty died from physician assisted suicide (p. 121). These finding show that PAS is not used by a large number of people; people fear the ability to do this. It should, however be legal for the ones who want it. Why should someone have to live their last days in tormenting pain? People may consider their lives to be over while on their death bed; they are waiting to die. This period, full of anxiety and fear could be optional by the use of PAS. They could chose to skip the last days of the dying process and leave earth more peacefully. Not everyone will choose PAS, but the choice

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

should be available. Physician assisted suicide is not much different than discontinuing life support, which is done without much controversy. Disconnecting someone from their IVs and stopping their vital medications is seen as a more dignified way to die. Removing all of the necessary help that is needed for life is a way for someone to die faster. Choosing to remove life support is usually done in a situation where the person is going to eventually die. It is done to relieve pain and suffering and said to put the person out of their misery. Ultimately, that is what is achieved, but not before the body shuts down, which must be torture in itself. After the vitals are stopped, the body still shuts down one system at a time, with the person remaining in a state of consciousness. They are basically dying of starvation and the lack of medicines that aid the bodys natural operations. Physician assisted suicide is another way to help the suffering, but is painless. Instead of speeding up the dying process, PAS omits it and all of the strain that dying involves. Frank Ostaceski owns a home for the dying in San Francisco. He agrees with PAS and people having the freedom to die well (Cloud, 2000). Cloud reports that 7 out of ten people would like to die at their homes with their choice of people present. Instead seventy five percent of terminal patients spend about 10 agonizing days in intensive care units, hooked up to IVs with strangers taking care of them. In addition to the wasted time, they are reluctantly racking up unwanted enormous hospital bills for procedures and treatments they do not want (2000). These issues need to be addressed, in that it a wasteful use of resources, money and medical staffs time to keep these patients in hospitals against their wishes. If an end of life patient wants to die in their own home peacefully after taking a dose of prescribed medication, they should be able to do so, in every state.

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

Studies show that PAS is widely accepted. In 2005, a Harris poll was conducted and published in Harris Interactive. Seventy percent of adults agree with doctors being able to help terminal patients in pain with ending their lives. Only thirty percent disagreed (Lachman, 2010, p. 121). Even in 1991, when the issue was more controversial, there were more people for PAS, than opposes. The Gallup Organization polled, questioning if doctors should give a painless alternative to a terminal patients as a request by the family or the patient. Sixty five percent of the responders answered yes (Worshop, 1992). While PAS needs to a personal judgment, laws to govern it are crucial. Fay Girsh, an advocate of PAS, states who do not allow physician assisted suicide is causing an underground structure, resulting in more physicians breaking the law (Worsnop, 1997). Compassionate physicians who break the law to give their patients lethal medications are a bad look for the profession. It is seen as worse to practice PAS illegally, than to practice it in ordinance with laws in place. Many complications could occur. The attempt may not work, but cause the patients health to worsen which can bring lawsuits against the doctors. Girsh also believes that if states do not allow physician assisted suicide, terminal patients are more likely to end their lives themselves, which can have problematic results (Warsnop, 1997). The attempt could fail, or the situation could be devastating for family members. Many cases are heard about people asking loved ones to contribute in their own suicide because they are unable to perform the tasks needed. Involving someone also puts a great burden on them, and causes hardships with the family and friends left behind. If the patient was able to use PAS, it eliminates the need to involve another person.

PHYSICIAN ASSISTED SUICIDE SHOULD BE LEGALIZED

As Oregons legislature is outlined, a persons decision to utilize the PAS right is not one that is thoughtlessly made. An initial request is orally submitted to a physician. After which, there is a mandatory waiting period of at least 15 days, a secondary requisition is made to the same physician (Lachman, 2010 p. 122). Once the patient has made a proclamation of this idea, it is inevitable that they will contemplate it back and forth to make sure ending their life is the best choice; they are literally faced with a life or death decision. Once the mandatory waiting period is over, and the person still agrees that PAS is the best choice for them, they submit a written request. As an added precaution to omit any mistakes, the person must then wait 24 hours before a medication is prescribed (Lachman, 2010 p. 122). This allows more time for thought, discouraging a wrong decision. The law seems to be set up so that the person will likely change their mind about going through with PAS. For the determined, however, the ability to choose favorably is possible. The mandatory waiting times are key points in Oregons law. They are required so that someone has plenty of time to think after they have spoken their feelings to someone about ending their life. Under the law, the person is counseled that they should inform their next of kin about their decision. Doing so would get families involved in the decision, providing the patient with more support, either with their choice to end their life, or continuing it. The law has more guidelines to ensure that PAS is right for the patient. Before any request is made, two doctors need to agree that those only six more months of life is possible (Lachman, 2010, p. 122); the right to PAS is only in place for terminally ill patients. A psychiatric exam is ordered if the doctor feels that one is needed (Lachman, 2010, p. 122). Any discrepancies in the patients ability to make rational decisions denies the ability to utilize PAS. Before the request is granted, "patients must give a fully informed voluntary

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decision (Lachman, 2010, p. 122). The choice to end life is never set in stone until the medicine is taken, so the patient has the right to change their mind at any time. This process is not legally binding. The patient is in control of the whole process, while the doctor is there to guide, provide information, and make the process as painless as possible. As other guidelines of the law state, Oregon does not allow residents of other states to take part, only licensed doctors are to write the prescriptions, the health department must be notified about cases, and they do not authorize active euthanasia (Lachman, 2010, p. 122). Death is inevitable and inescapable, but the suffering that goes with it can be eased by PAS. Some people want to die on their own terms and should be able to do that. The ability for physicians to assist someone with a terminal illness in ending their life should be legal everywhere. Having the help of a health professional is a better choice than committing suicide or removing the vital support that is protecting life. Research has shown that physician assisted suicide is not being abused in any way. The thoughts that it may put pressure on vulnerable groups have proven to be incorrect by statistical data. Some want to fully extend their life and live even through the tough process of dying, but some want to do away with that time all together; PAS is a humane way to do that. All states need to follow the example of Oregon and legalize the ability to get the help of a medical professional to assist in suicide.

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References Cloud, J., Cole, W., Sieger, M., Cray, D., Fulton, G., Moffett, A., Thompson, D. (2000, September 8). A Kinder, Gentler Death. Time Magazine U.S., 156 (12). Retrieved from http://www.time.com/time/magazine/article/0,9171,997968-1,00.html.Roosevelt Dieterle, J. (2007). Physician Assisted Suicide: A New Look at the Arguments. Bioethics, 21(3), 127-139. Retrieved from http://internal.jefferson.kctcs.edu:2070/ehost/pdfviewer/pdfviewer?vid=12&hid=13&sid= f52c4899-768f-40fe-865b-c846398d01a8%40sessionmgr13. Jost, K. (2005, May 13). Right to Die. Is it too easy to remove life support? CQ Researcher, 15(18). Retrieved from http://internal.jefferson.kctcs.edu:2063/cqresearcher/document.php?id=cqresrre20050513 00&type=hitlist&num=3. Lachman, V.D. (2010, March/April). Physician-Assisted Suicide: Compassionate Liberation or Murder? Medsurg Nursing, 19(10), 121-124. Retrieved from http://internal.jefferson.kctcs.edu:2070/ehost/pdfviewer/pdfviewer?vid=13&hid=12&sid= cdcbba7c-2f98-4aba-af75-a4b884d2a16c%40sessionmgr11. Los Angeles Times Staff and wire reports. (2011, November 5). PASSINGS: Wyatt Knight. Los Angeles Times. Retrieved from http://articles.latimes.com/2011/nov/05/local/la-mepassings-20111105. Roosevelt, M. (2005, March 28). Choosing Their Time. Time Magazine U.S., 165 (13). Retrieved from http://www.time.com/time/magazine/article/0,9171,1042442,00.html.

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The New York State Task Force on Life and Law. (1994). When Death is Sought: Assisted Suicide and Euthanasia in the medical context. 9-22. Retrieved from http://www.health.ny.gov/regulations/task_force/reports_publications/when_death_is_so ught/chap1.htm. Worshop, R. 1992, February 21). Assisted Suicide: Should doctors help hopelessly ill patients take their lives? CQ Researcher, 2(7). Retrieved from http://internal.jefferson.kctcs.edu:2063/cqresearcher/document.php?id=cqresrre19920221 00&type=hitlist&num=2. Worsnop, R. (1997, September 5). Caring for the Dying: Would better palliative care reduce support for assisted suicide? CQ Researcher, 7(33). Retrieved from http://internal.jefferson.kctcs.edu:2063/cqresearcher/document.php?id=cqresrre19970905 00&type=hitlist&num=1. . .