Category: Assisted Suicide

Introduction

Australia is revealed to be ranked 41 in terms of suicide—1,320,000 people in total having committed suicide and with approximately 3,287 dying annually—out of 183 countries (Suicide Rate by Country 2020, August 2019). One method that has recently been observed and could potentially end one’s suffering and the rate of suicide is assisted dying, or well known as assisted suicide. Assisted suicide is medically defined as “the act of providing the means to commit suicide knowing that the recipient plans to use the means to end his or her life…’’ (Sweet & Foley, 2020). Meaning that a fully trained “physician provides prescription medications or other interventions to a patient… that… [they] can use… to commit suicide” (Goldman & Schafer, 2020). Through the legalization of assisted suicide, many elderly and sickly patients can seek instant relief without suffering through the last moments of life. This investigation will explore this debated procedure with the use of legislation, stakeholder perspectives, and cases. Recommendations will also be provided to create, amend or abolish new and existing laws with the state of Queensland.

Legislative Overview

This report will oversee two conflicting pieces of legislation regarding the laws’ perspectives on assisted suicide from different states of Australia. These pieces of legislation are the Queensland Criminal Code Act (1899) and the Victoria Assisted Dying Act (2017). However, other places that have legalized assisted suicide have multiple pieces of legislation, and also regulations preventing it in disapproving countries. The countries that currently provide this practice are Belgium, Canada, Luxembourg, The Netherlands, Switzerland, Colombia, Austria, Bolivia, Denmark, Finland, Norway, Poland, Portugal, Spain, Uruguay, France and parts of the USA. However, within Australia’s borders, there are two states that have legalized a way of ending those with terminal illnesses. These states are Victoria (Humanists UK, 2019; QUT, 2020) and Western Australia, who have essentially legalized it based on their Voluntary Assisted Dying Bill 2019.

The reason that Queensland does not incorporate assisted suicide legislation is because of the Queensland Criminal Code (1899). In Section 311, it states that “Any person who procures another to kill himself or herself; or counsels another to kill himself or herself and thereby induces the other person to do so; or aids another in killing himself or herself; is guilty of a crime, and is liable to imprisonment for life” (Queensland Criminal Code, 1899). This law prevents the residents in Queensland from committing suicide or integrating any sort of assisted suicide legislation.

The Victoria Assisted Dying Act’s (2017) purpose is “to provide for and regulate access to voluntary assisted dying, and to establish the Voluntary Assisted Dying Review Board; and to make consequential amendments to the Births, Deaths and Marriages Registration Act 1996, the Coroners Act 2008, the Drugs, Poisons and Controlled Substances Act 1981 and other Acts”. It consists of more than 140 pages, eleven parts and 143 sections that discuss the considered risks and requirements needed to ensure its effectiveness and safety as a normal and frequently used practice. Parts one, ten and eleven provide all necessary information, definitions and amendments regarding the act and, parts two and three revolve around the criteria and process required to be undertaken before being allowed access to this practice. Actually, receiving a permit and accessing the medication needed is documented in parts four and five and, reviews from the Victorian Civil and Administrative Tribunal (VCAT) and the creation of the Assisted Dying Review Board are discussed in parts six and nine. Lastly, parts seven and eight involve all notifications, liability protections and offenses if proper procedure is not maintained. Therefore, based on all the provided pages, parts and sections documented within the Victoria Assisted Dying Act (2017), the state of Victoria has identified and investigated all possible factors that can influence how assisted suicide is conducted.

Law in Practice

By legalizing assisted suicide like Victoria, Queensland would be allowing the population to access their own human rights to not suffer. Assisted suicide is a human right due to the several key rights to life, freedom from cruel, inhuman or degrading treatment, respect for private life, and freedom of thought, conscience and religion (Australian Human Rights Commission, 2016). Victoria’s Assisted Suicide Act (2017) not only lists the procedures and risks of assisted suicide, but it also provides insight into areas needing to be explored. These include assessing the requirements and making a request with medical practitioners, gaining permits, after-death records, and amendments to current laws. The process involves medical practitioners providing the substance used to end the person’s life at their request, and many ethical and legal factors are considered (Nay, Garratt, Fetherstonhaugh, 2014).

Victoria has had over 136 cases assessed, 70 permits approved to “die by self-administering medication” and 11 permits approved to have “medication administered by a practitioner” (Australian Associated Press, 2020). All these are related to Victoria’s Assisted Dying Act (2017), not to mention that in the first six months of its legalization more than 50 people had gone through the process and died (Australian Associated Press, 2020). Whereas, Queensland has only had few accounts of people aiding suicide, which has resulted in them being convicted of murder charges.

One case is of Merin Nielsen, who helped Frank Ward commit suicide after he suffered a stroke and was in pain as a result of prostate cancer, moderate to severe atherosclerosis, and thrombi in his legs and pulmonary emboli. Even though Merin and Frank were unaware of Frank’s medical conditions before the suicide it did not influence the case of death, subsequently resulting in three years of imprisonment with a parole date of August 15, 2012 (R v Nielsen [2012] QSC 29). Another case is when Graham Robert Morant aided and counseled his wife, Jennifer Lee Morant, into committing suicide “by gassing herself in her car with the exhaust fumes” in another case in Queensland. This and the fact he was the main beneficiary of her will, resulting in the court sentencing him to ten years of imprisonment and another six years for a second conviction, which will be served concurrently (R v Morant [2018] QSC 251).

Not only has Victoria been successful in allowing people to have and use their human rights, but it has also decreased the number of suicide occurrences caused by self-harm. In 2009, there were 576 in Victoria and 525 in Queensland; meanwhile, in 2017, Victoria had 621 deaths as opposed to Queensland’s 804. Also, one year after the creation of Victoria’s Assisted Dying Act, there was 563 and 786 deaths in Queensland. Though each state seems to be decreasing in the number of suicides, this could be due to the fact that people are traveling to Victoria to access assisted suicide (Australian Bureau of Statistics, 2019).

These cases, legislation and statistics prove that Queensland would and will benefit from creating and establishing assisted suicide as a widely used practice. It will not only be an advantage for the court system but the general public, whether they are healthy or seriously sick to stop people from suffering and the amount of aiding murder cases occurring.

People affected by assisted suicide are those who are wishing to end their misery, families and professionals that are necessary to process all the documents and administer the medications or just provide it. Having so many people affected also means that there are many conflicting views regarding the legalization of assisted suicide. First of all, an Australian poll in 2017 has determined that 73% support assisted suicide, with people aged between 18-34 having less support at 68%. Meanwhile, 71% support it between the ages 35-54, and lastly, a high 81% of people aged over 55 support the ideology of assisted suicide (Dying with Dignity, 2017).

Nevertheless, professionals who support assisted suicide have also stated that “popular views traditionally advanced in support…” of assisted suicide “fall under four main augmentative categories…”. These categories are “arguments from individual autonomy and the right to choose, the loss of dignity and the right to the maintenance of dignity, the reduction of suffering and justice and the demand to be treated fairly” (Johnstone, 2020). On the other hand, professionals also say that “the exercise of autonomy cannot include the ending of life…” and that “many dying patients may experience pain and suffering as the result of not receiving appropriate care” (Goldman & Schafer, 2020). Meaning that it is “possible that adequate care and pain management… might relieve suffering without the need for… assisted suicide” (Goldman & Schafer, 2020). Another reason that professionals do not agree with assisted suicide is that “there is a clear ethical distinction between intentionally ending a life and terminating life-sustaining treatments…” and “permitting… assisted suicide may introduce adverse consequences…” (Goldman & Schafer, 2020).

Although, professional opinions do not matter to the person suffering and their families, as these professionals have not taken into account how they are suffering with pain and loss as they wither towards death. Therefore, the families’ and patients’ thoughts toward assisted suicide is that they would be grateful for the opportunity to end their suffering.

Based on the cases and stakeholder perspectives, strengths and weaknesses have been identified to determine whether Queensland should be integrating assisted suicide legislation. The strengths of this practice are that it has already been effective in Victoria and other countries and, various professional and public perspectives have agreed that it will help to end the suffering of older individuals. Other strengths are that suicide rates, the population of older Australians dying painfully due to diseases or cancer and the amount of depressed or suicidal elderly individuals will decrease due to the quick and painless death provided. Weaknesses are that there are still many professional and public views that are conflicted about approval and the current Victoria Assisted Dying legislation (2017) has countless requirements and a lengthy timeframe to apply and acquire the practice. While, there may be a few weaknesses, but the number of strengths of assisted suicide outweighs these weaknesses.

Recommendations

Recommendations identified from the investigation and analysis of assisted suicide within other states and countries are that Queensland should follow Victoria and Western Australia’s footsteps. Though, Queensland’s recommended choices are to create assisted suicide legislation from scratch or use the current legislation from the states of Victoria and Western Australia. Creating legislation from scratch or with limited knowledge, plans and more is extremely risky considering many stakeholders are against or unsure of this practice. However, Australia has been creating laws this way for decades. Even so, by using Victoria or Western Australia’s legislation will allow Queensland to have an insight and idea on how the practice needs to manage and conduct. As well as what risks, processes, considerations and requirements are going to be managed and covered throughout the law. This will help to ease public concerns regarding the potential risks and miscalculations that could occur. Between the two potential recommendations to incorporate assisted suicide laws into Queensland, the most effective and less risky option is to use Victorian or Western Australian legislation as a guide. This recommendation will help to eliminate the weaknesses, risks and concerns that come with the legalization of this practice. Doing this will allow the residents of Queensland to express their human rights to how they wish to live their lives or to end their suffering if extremely unwell.

Conclusion

Assisted suicide most definitely should be introduced into Queensland’s legislation, especially after benefiting the states of Victoria and Western Australia. It is only an advantage to have the suicide rates and the number of unwell elderly decrease with the introduction of this medical practice. Assisted suicide legislation will also differ depending on the location and values of the countries accepting it within their borders.

I. Assisted suicide should be an option for terminally ill patients

The topic discussed in this paper is assisted suicide as an option for terminally ill patients. Assisted suicide for terminally ill patients consists of a terminally ill patient requesting that a physician write a prescription for a medication that intentionally results in the patient’s death. The terminally ill patient then self-administers this medication, ending his or her life. I will explore the ideas of autonomy, dignity, and the role of the physician and connect these ideas to physician-assisted suicide. My argument is: Physician-assisted suicide should be an option for terminally ill patients; physicians should be able to prescribe life-ending medication without being held civilly or criminally liable for having caused the death.

In most of the United States, physician-assisted suicide is a crime, though there are doctors willing to practice assisted suicide and patients that wish to partake in assisted suicide. Many people who die each year in the United States experience many hospitalizations over the course of an illness, especially terminal illnesses, in the last few months of their life. These individuals experience pain and suffering as well as loss of autonomy and dignity. Assisted suicide allows the patient to die when and how they would like. It utilizes autonomy and preserves dignity. It allows the doctor to fulfill his or her role of relieving suffering when treatment is not an option or treatment causes more suffering. Yet, more of the population is against physician-assisted suicide than for it; I hope to change opinions on the topic.

I would like to mention that physician-assisted suicide is different from euthanasia. Though both are medical procedures classified as physician-assisted deaths, in euthanasia, the patient does not self-administer the lethal medication. The argument I am going to present applies only to physician-assisted death by assisted suicide. Due to my having little knowledge on end of life protocol in other countries, I will limit my argument to terminally ill patients in the United States. I will assume that everyone agrees that autonomy and dignity are moral rights that should be granted to all human beings.

II. I will prove that assisted suicide should be an option for terminally ill patients in the following way:

Patient autonomy should be honored. This means that a person capable of making his or her own decisions should be able to. Respect for autonomy is an important aspect of medical practice. I will go on to explain that terminally ill patients deserve to die with dignity. Dignity is often lost in end-of-life treatment and care. Finally, I will explain that the role of doctors is to minimize suffering. Many people with terminal illnesses experience some form of suffering or will experience some form of suffering. In situations where a patient cannot be healed, the role of the doctor shifts from healing to minimizing the patients suffering. Assisted suicide allows the patient to decide when and how they wish to die, allows terminally ill patients to die with dignity, stops the patient’s suffering, and allows the doctor to carry out his or her role of minimizing suffering.

III. Not only does my argument have a sound structure, it is valid because I have used precise and consistent language in the following ways:

Patient autonomy should be honored. The definitions of the following terms are needed to understand this premise. Autonomy is the right of adults deemed capable of making decisions to make decisions. A person with autonomy, an autonomous person, is an individual capable of deliberation about personal goals and of acting under the direction of such deliberation. Terminally ill patients deserve to die with dignity. The definitions of the following terms will be useful in understanding this premise. Dignity is self-determination and respect. In medical practice, it is a highly valued principle. End-of-Life will be abbreviated EoL. EoL care is

Care is provided to patients with terminal illnesses in their final stages of life. The role of doctors is to minimize suffering. The definition of the following term will be useful in understanding this premise. Suffering is physical and or emotional pain. It can be caused by an illness and or attempted treatment for an illness.

IV. My argument is comprised of well-researched premises that effectively demonstrate why assisted suicide should be an option for terminally ill patients

Patient autonomy should be honored. Autonomy is an important aspect of medical practice. It involves the patient making a decision about their care and their doctor respecting, and helping to carry out, the patient’s wishes. “To respect autonomy is to give weight to autonomous persons’ considered opinions and choices while refraining from obstructing their actions unless they are clearly detrimental to others” (Belmont Report). The Belmont Report explains that applying autonomy involves the patient’s decisions and actions. In cases of physician-assisted suicide, the patient decides when and how they wish to die, and the ultimate act of causing death is performed by the patient, not the physician.

When it comes time for end-of-life treatment and care for an individual with a terminal illness, the individual is the only person that can and should decide if physician-assisted suicide is the procedure that should be provided. This is because the only person that can decide if a life is worth living is the person living that life. Each person is the best judge of the value that the continuation of their life would afford them. (Velleman). Someone may choose to end his life while he is capable of living and dying with dignity rather than continue to suffer from an illness that takes away their ability to choose.

In 2019, in Oregon, where physician-assisted suicide is an option, one of the most reported end-of-life concerns for individuals with terminal illnesses was “losing autonomy” (Public Health Division). These individuals were able to choose to die before their illness, resulting in a loss of dignity and loss of autonomy. This option to exercise autonomy in the final medical procedure of an individual’s life should be given to all terminally ill patients.

Terminally ill patients deserve to die with dignity.

A person’s life is comprised of physical aspects as well as intellectual, emotional, psychological, and spiritual aspects. “Life is not mere living but living in health. Health is not the absence of illness but a glowing vitality – the feeling of wholeness with a capacity for continuous intellectual and spiritual growth. Physical, social, spiritual, and psychological well-being are intrinsically interwoven into the fabric of life” (Yeo). End-of-life (EOL) care, and procedures must consider all of these aspects of the person.

Preservation of dignity at the EoL requires that self-respect be promoted and that the patient be treated with respect. Part of respecting the patient is considering all aspects of the person. Most currently used EoL interventions focus predominantly on symptom control rather than holistic care, and with that, the patient is not respected, and dignity is lost (Kennedy).

A study done to address the human context of dying, known by the acronym SUPPORT, involved 10,000 terminally ill people, five medical centers, and five cities in the United States. The study found that approximately half of all patients spent their EoL in what the researchers called an undesirable state in which their wishes were not respected or they were in serious, insufficiently treated pain. (Dorff).

Healthcare professionals cannot ensure that someone dies with dignity, but they can contribute to death without indignity. This can be done by ensuring that they respect people’s autonomy and incorporate human reason. They can also ensure people die without indignity. This can be done by not imposing indignities such as taking choices away from people at the end of their life and by minimizing indignities such as suffering. (Allmark).

Physician-assisted suicide would allow the individual to die before parts of their person are lost. In carrying out physician-assisted suicide, the individual and their wishes are respected. Along with this, the patient’s suffering is relieved, and further suffering is not imposed.

The role of doctors is to minimize suffering.

A bioethicist, Daniel Callahan, and his colleagues conducted a five-year international study to come to an agreement on the goals of medicine. It was determined that “medicine has four primary goals: prevention of disease and injury and maintenance of health, relief of pain and suffering, care for those that cannot be cured, and pursuit of a peaceful death” (Panicola). According to the American Medical Association, “Physicians have an obligation to relieve pain and suffering and to promote the dignity and autonomy of dying patients in their care.” Yet, when it comes to current EoL treatments, physicians often fail to prevent or treat suffering adequately and sometimes, inadvertently, cause it as a result of treatment (Cassell).

Suffering is experienced by persons, not just bodies. “Suffering comes from challenges that threaten the intactness of the person as a complex social and psychological entity. Suffering can include physical pain but is not limited to it” (EJ Cassel). In the United States, conditions such as heart disease and cancer are the leading causes of death. Patients with these diseases often deteriorate slowly and painfully.

Medical interventions may prolong their suffering or keep them alive until they have lost their autonomy (Steck). These patients suffer both physically as a result of the illness, but also mentally and emotionally as they lose autonomy and dignity. Physicians should be able to carry out physician-assisted suicide and help patients who are suffering from a terminal illness exercise their autonomy and die with dignity.

One objection to my argument stated: I will object to your second premise on the grounds that a universal definition of human dignity (and, therefore, dying with dignity) cannot be codified into law or practice without contradicting someone’s religious or personal beliefs. My response is that this objection is valid. The term dignity has different meanings. Some of these different meanings are self-respect and the value of humankind.

Two different United States Medical organizations talk about dignity in the following ways. In an article from one organization, the Nuffield Council on Bioethics, the following comment was made, “an essential ingredient in the conception of human dignity is the presumption that one is a person whose actions, thoughts and concerns are worthy of intrinsic respect because they have been chosen, organized, and guided in a way which makes sense from a distinctively individual point of view” (Horn).

According to a second organization, the General Medical Council, “doctors respect their patient’s dignity by listening and responding to their concerns, giving patients information in an appropriate way, and by respecting their right to make their own decision” (Horn). Both of these explanations, accepted and used in healthcare, explain that dignity is self-determination and respect. Just as this definition of dignity, self-determination, and respect has been applied to medical practice in the past, it should apply to physician-assisted suicide now.

References:

1. Allmark, P. (2002). Death with Dignity. Journal of Medical Ethics, 28(4), 255–257. Retrieved February 22, 2020, from https://www.jstor.org/stable/27718927
2. American Medical Association. (2013). AMA Code of Medical Ethics’ Opinions on Care at the End of Life. American Medical Association Journal of Ethics, 15(12). Retrieved from https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/coet1-1312.pdf
3. Cassell, E. J. (1991). The Nature of Suffering and the Goals of Medicine (2nd ed.). Retrieved February 22, 2020, from https://books.google.com/books?id=54JAaetSPqAC&printsec=frontcover&dq=The Nature of Suffering and the Goals of Medicine Eric Cassell&hl=en&newbks=1&newbks_redir=0&sa=X&ved=2ahUKEwjDx4OxhOfnAhUFC6wKHS_gD_4Q6AEwAHoECAUQAg#v=onepage&q&f=false
4. Dorff, E. N. (1999). Assisted Suicide. Journal of Law and Religion, 13(2), 263–287. Retrieved February 22, 2020, from https://www.jstor.org/stable/1051468
5. Horn, R., & Kerasidou, A. (2016, July). The Concept of Dignity and Its Use in End-of-Life Debates in England and France. Retrieved May 2, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355899/#fn24
6. Kennedy, G. (2016). The Importance of Patient Dignity in Care at the End of Life. The Ulster Medical Journal, 85(1), 45–48. Retrieved February 22, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847835/
7. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979, April 18). The Belmont Report. Retrieved February 22, 2020, from https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html
8. Panicola, M. R., Belde, D. M., Slosar, J. P., & Repenshek, M. F. (2007). Health Care Ethics. Winona, MN: Christian Brothers Publications.
9. Public Health Division. (2020, February 25). Oregon Death with Dignity Act 2019 Data Summary. Retrieved May 9, 2020, from https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year22.pdf
10. Steck, N., Egger, M., Maessen, M., Reisch, T., & Zwahlen, M. (2013). Euthanasia and Assisted Suicide in Selected European Countries and US States: Systematic Literature Review. Medical Care, 51(10), 938-944. Retrieved February 22, 2020, from www.jstor.org/stable/42568837

Unintended Consequences of Legalizing Assisted Suicide

When you think about a topic with many opinions and views, Physician-Assisted Suicide comes to mind. Is Physician-Assisted Suicide morally right? Physician-assisted suicide is a controversial topic in ethics. Many people are arguing if it is ethically unethical. The reason for their argument is if a goat can be put down, why not a human? Every life is important, no matter how critically ill it is. Instead of finding a way to terminate life faster, the government could channel the resource to something positive. If people are arguing whether the lives of these patients are important, the patients should also be questioned as well. Physician-assisted suicide will persuade terminally ill patients to die faster because it is less expensive and because they may lack self-confidence.

People that want physician-assisted suicide legalized probably never consider the consequences associated with the procedure. If assisted suicide was legal fifty years ago, we wouldn’t have some of the advancements in medicine that alleviate pain, diabetes, breathlessness, and other terminal illness today. As a result of improved medical advancement today, Some diseases that were terminal a few years ago are now treated. If we consider assisted suicide as the only solution, we might interrupt or even stop the discovery of effective treatments for those diseases that are now terminal.

There would be a disregard for hope. There is no physician that has not come across a patient that was healed by divine intervention. The level of persuasion the patient would feel would be extensive. Families have many intent ways of persuading the patient to demand assisted suicide and alleviate them of the financial and social involvement even if their families are happy to take care of them. For many, this is just another way to terminate the guilt they feel, even if they don’t wish to die. The money which they incur from patients in obtaining medical and hospital bills would stop.

Ethical and Professional Integrity Concerns

Furthermore, physician-assisted suicide is not only illegal but also it is immoral and inhumane for physicians to implement. Any physician that does this immoral act has violated the ethics of their profession. A physician is supposed to be an advocator and helper that helps save the lives of patients and not help end the patients’ lives. Also, such a physician that does this has violated Hippocratic Oath, which is the oath sworn by the doctors prior to receiving his license.

The Oat states that ‘I will not give poison to anyone, though asked to do so, nor will I suggest such a plan?”. This means that no doctor should request or administer any lethal injection or medication to the patients. But unfortunately, today, so many physicians do not go by the oath they took. According to statistics, 1 out of 5 doctors and nurses have supported the patient to terminate their life in America. There is no meaning in taking an oat if no one will go by the Oat. The organization responsible for the oath-taking should also place several penalties on defaulters of the Oat of Hippocrates, or probably the license should be revoked or suspended.

Physician-assisted suicide is unethical and not a natural form of death. The severity of an illness or depression sometimes arises as a result of the thoughts and feelings of the suicide. One thing we should know is that pains are natural. Despite the fact that it is natural, there are ways to take away the pain that comes with death. There are many medications that can help alleviate pain and help sustain the lives of these patients who are terminally ill. For example, opioid (morphine) has been proven to provide effective pain control to most patients with severe pain. The Patient Controlled Analgesia (PCA) is a major technological advance in pain control.

With PCA, there is a constant supply of medications which allows a patient to administer doses when there is an emergency. Also, there is one that can administer to a patient to make him sleep all through the night. With proper healthcare education on the advancement of these pain control, physician-assisted suicide would not be necessary. The role of adequate pain control should remain an important duty in providing end-of-life palliative care to terminally ill patients. There should be a collaborative relationship between pain medicine services and palliative care services. With this, there has been found to be a commonness of pain in cancer survivors of 33 percent, in cancer patients undergoing active treatment of 59 percent, and across all stages of cancer of 53 percent. (Meier and Brawley 2011, 2750).

Moral Implications and the Sanctity of Life

The truth about physician-assisted suicide is that it is a form of murder and unethical. It should be against the law and the heart. This got to do with medicine and morality. If doctors are licensed to kill or become killers, then the profession will never be trusted, and people with a good moral background will be discouraged from entering the profession. If also, the doctors were given equal right to cure and kill, then the profession would be regarded as an immoral profession. This type of murder underestimates human value. The physicians involved in the act are now regarded as gods who can determine life or death for mankind. Their jobs are to cure and save the lives of their patients, and not god. They should understand that what the patients under them need is care, respect, and absolute love of the people around them.

Furthermore, those in support of physician-assisted suicide may think that they are making the right decision in ending their patient’s life because they are terminally ill. They may think they are ending their suffering and not their gifts and dreams. There is an argument by people in favor of this procedure. They argue that if the patient and the family agree, then there is no harm in carrying out the patient’s wish.

Though the terminally ill patient might not be capable of making a rational decision, the truth still remains that no one, even the family member, can assume a choice for an incompetent person without consent from the patient. Why on earth would one think of ending another person’s life? Life and death should not be placed in the hands of one another. The act of dying is determined by nature. Therefore, people should allow nature to take its place. If, in any case, a patient is making a decision, he needs to consider the mental and physical aspects of death. If physician-assisted suicide is considered ethical, it will expose our nation to frequent untimely death.

Challenging the Compassionate Facade: The Ethical Imperatives

Some people regard physician-assisted suicide as a compassionate means of ending pain in terminally ill patients. No matter how they see it, it is murder and is never morally justified. It is considered as killing with an intention. People are trying to make a sound as being medically compassionate and acceptable. Human life is never something to determine whether to continue or not. It can never be measured by the condition.

People think and speak as though human life is like a building you can decide whether to demolish it or not. Again, legalizing it can lead to other people deciding whether someone to live or not. For example, if an aged woman has a stroke or tumor and can not talk or stand, their family member could as well consider physician-assisted suicide because they don’t want to face the stressor they want to give her ‘mercy’ death. Incredible! Physicians should sort out new ways to cure their patients instead of killing them.

In conclusion, physician-assisted suicide is unethical and immoral. It should never be allowed or legalized. It is potentially giving lethal medication to the body and may be done by a doctor. The same doctor that is licensed to cure the body of illness is also involved in murder and killing. It is time for doctors to identify their morals and go by the ethics of their profession. They should consider human life and health as their topmost priority. With this, the world will realize that life is so precious and worth more important than mere emphasis.

References:

1. ‘Doctor-assisted suicide should not be legalized’ (Lawteacher.net, December 2018) accessed 13 December 2018
2. Palliative care and the quality of life. Meier DE, Brawley OWJ Clin Oncol. 2011 Jul 10; 29(20):2750-2. Jun 13, 2011 – 2011 Jul 10; 29(20): 2750–2752.

Eligibility Criteria and Procedural Steps

When someone hears “assisted suicide,” you rethink what you heard and make sure what you heard is correct. Your brain must process not just the suicide part but the assisted part as well. You try and understand, but your brain cannot process why anyone would want to do that. Or why would they choose to end their life? Who would be willing to help them? What kind of human being is that person? We are quick to put our animals down because we don’t want them to suffer. So, then why can’t we give the same courtesy to human beings? If someone is in pain and we’ve exhausted all options, then we should at least be able to provide a way out. Those in the medical field are supposed to end pain and suffering, not prolong it. Yes, physicians have taken an oath to protect life; but how can they protect it when the patient is already dead?

What makes people cringe when they hear assisted suicide? Would it be suicide? Or the assisted? It would mainly be the assisted part. Nobody can believe that a human being would be willing to help another human being kill themselves. People that can agree with assisted suicide are the ones who are more understanding and willing to listen to the reasoning behind someone willing to die before their illness kills them. It’s their decision, and we need to respect it. We, as people, need to stop putting our two cents in everyone else’s business. Don’t give out your opinion until it’s asked for or unless it’s affecting you personally.

For someone to be eligible for assisted suicide, they would need to have a terminal illness and have exhausted all of their options. If your dignity and pride are to be stripped away from your personality, then they should at least have the option for assisted suicide. Terminal illnesses such as cancers, leukemia (cancer), aids, heart disease (severe coronary artery disease), and Parkinson’s disease are eligible for assisted suicide.

The rest is just a long list of requirements, like being a resident of the state granting the patient to proceed with assisted suicide. The person must be an adult; to even submit a request for assisted suicide, the patient must be 18 or older. Must have a terminal illness and be diagnosed with a six or less-month prognosis by not just one physician but two. Must be mentally competent and aware of what is going on. The patient must say out loud to their physician that “they want to die.” It must be verbally said if it is written in a will or any other document, it will be denied. The patient must say “they want to die” twice, 15 days apart, not a day before and not a day later; if they fail to do this, then they will have to start the process all over again.

Assessment, Distinction, and Outcomes

Furthermore, the patient will need to submit a written request; they will need to have two witnesses with them who believe the patient is indeed sick and not capable of living the rest of their short life in pain. They need to also believe the patient is voluntarily “wanting to die”; one of the witnesses cannot be a relative by blood, marriage, or adoption. They can’t be the patient’s physician or medical assistant, nor can they be included in the patient’s will. The patient must be able to administer his/her own medication. The patient may cancel the process at any given time; they have the right to stop the assisted suicide process whenever they want. If they choose not to go through with it, that is their decision.

Next, the physician must refer the patient to a psychiatrist, so the psychiatrist can do an evaluation to make sure the patient’s mental competency is intact. The mentally competent patient then can have the medication prescribed to them. The physician is then able to fill the prescription by either hand delivering it to the pharmacy or mailing it in. The patient is not allowed to pick it up until 48 hours after the prescription has been delivered and/or received. If there is any doubt, the physician has the right to stop the request.

The physician must report every step and process to the medical board. “Anyone who falsifies a request destroys a rescission of a request, or who coerces or exerts undue influence on a patient to request medication under the law or to destroy a rescission of such a request commits a class A felony. The law also does not limit liability for negligence or intentional misconduct, and criminal penalties also apply for conduct that is inconsistent with it” (Physician-Hastened Death).

People who make the decision to go through with assisted suicide are not suicidal. They do not want to die, but they choose to. The patients that choose to go through with assisted suicide are not necessarily suicidal, they want to live, but they don’t want to live with their disease. Physicians have encountered patients who are “terminally ill who request assistance in the voluntary self-extermination of life. Patients experience chronic, intolerable pain and suffering” (Biskup 34). If the patient doesn’t want to live with their disease, then they shouldn’t have to. Assisted suicide should be offered and convenient to every patient in every state with a terminally ill disease. No one should have to live with that kind of pain or suffering. No one should have the right to tell someone how to live otherwise.

Many people believe that suicide and assisted suicide are the same things. However, they are completely different. Suicide is usually used when a person feels they have no way out and they choose to die. It’s a choice for them; it may not have anything to do with a terminal illness but perhaps depression. As with assisted suicide, the patient knows they’re not alone, and the physician knows they’re not alone. They need to pass a psychiatric evaluation and make sure they are not depressed and are more than competent to make this decision without any depressing thoughts weighing them down. However, both have one common outcome “death” with the terminally ill and depressed. So, the process in both is different, just not the outcome.

Ethical Considerations and Patient Choices

So, is being assisted with suicide better than going through it by yourself? Meaning telling someone, then just attempting suicide on your own. The answer is “No.” If you’re a patient and you have a terminally ill disease, by all means, let your physician and loved ones know what’s going through your mind. It’s better to let your loved ones or someone know instead of just going off somewhere and committing suicide. It’s better to let your loved ones know your plans so they have a chance to say goodbye. So please do see a physician if you’re thinking of using this route. Suicide doesn’t take away the pain. It just passes it to someone else. So, don’t leave anyone wondering.

Do go to a physician and talk with them, do not let anyone other than a physician help you with assisted death. New York law states, “A man is guilty of manslaughter in the second degree when they intentionally aid another person to commit suicide” (Biskup 34). In New York, they consider this as a class C felony. Should assisted suicide be offered to suicidal patients as a solution rather than having them commit suicide on their own? The answer is “no.” No, this should not be used as a way out.

Assisted suicide should just be for the use of the terminally ill. There is always help for people who are actually suicidal. People who seek assisted suicide are already dead; they’re dying and in pain. It should only be offered to the terminally ill. There are hotlines, psychiatrists, and loved ones who would be more than willing to help you out with your problem and get you the help you need. Nobody should ever be afraid or ashamed to ask for help.

Opinionated people seem to think that assisted suicide should be considered under the same category as murder. Is assisted suicide really murder, though? Absolutely not; nowhere are physicians physically putting pills down their patient’s throats or holding a gun up to their heads and pulling the trigger. As stated above, the patient has complete control over the situation; if he/she decides not to go through with the assistance, that is completely up to them. Their fate is completely in their hands if they choose to die quickly and without pain or to die slowly and suffer.

Physicians are not at fault and should not be blamed, they’re doing their best to help their patients in the best way possible, and they don’t need negative feedback from angry people who think it’s okay to put their two cents in wherever they feel they need to. Physicians are the ones with THEIR patients’ best interests. They know what they’re doing, and obviously, they don’t want to do it; who would want to do that? But then again, who wants to watch someone suffer for the rest of their short, painful life? Jack Lessenberry states, “This is not about ‘the right way to die.’ This is about personal anatomy, about denying that the state has the right to compel innocent, competent adults to suffer needlessly. It’s the right to be free of state interference in the most intimate and personal decision of all” (38).

If a patient is terminally ill, the patient’s physician should already know. If the patient is seeking assisted suicide, they should be honest and explain to their physician that they would like to inquire about more information and then choose to either proceed with assisted suicide or proceed with the time they have left to live. What kind of doctors can patients go to seek help on assisted suicide? They can turn to any doctor and ask for help, from a hospice doctor to even a neurologist. They can make an appointment with their care provider and tell them this is what they’re interested in and they would like to proceed. The patient would then have to go through all the requirements to proceed with assisted suicide.

Legal and Geographic Perspectives on Assisted Suicide

Current laws state that no physician should ever offer or agree to a medical procedure unless they are certain that it is in the best interest of the patient. They would need to be convinced that the situation was intolerable and that nothing else could be done for the patient. That the patients’ best interest is an easier death (Biskup 91). After the patient meets all the requirements, they will then either get a prescription or euthanasia.

The difference between the two is one is in a pill form, either Pentobarbital or Secobarbital. Euthanasia is a lethal injection a physician will physically administer to the patient. Biskup says in his book, “Hypocrisy of the double effect physicians have, by definition, killed patients to relieve suffering. The difference between euthanasia and withdrawal life support treatment is the double effect. They accept as not ‘killing’ but normative acceptance of the latter two medical practices”.

Not all doctors will be willing to help a patient or agree with the patient’s decision; they then will refer them to another doctor that would be willing to help the patient. Patients will have to understand and respect the physician’s decisions. Some physicians don’t want that responsibility or that on their subconscious. “Physicians do not fulfill the role of a ‘killer’ by prescribing drugs to hasten death any more than they do by disconnecting life-support systems” (Biskup). Every physician should read this so that they are reassured they are not killers, nor are they doing wrong. They are helping someone in need and ending their patient’s pain and suffering than letting them live with a terminal illness for such a short time they must live.

There are currently six states that allow assisted suicide; Hawaii will be alongside those 6, making it seven states in 2019. The states that currently allow them are and in order: Oregon 1997, Washington 2009, Vermont 2013, California 2016, Colorado 2016, and Hawaii will go into effect in 2019. Oregon became the first state to legalize “assisted death” in 1997 (States that allow Death with Dignity). In 2014 one patient case was a 29-year-old woman named Brittany Maynard made it public that she would be moving to Oregon to seek assisted suicide due to her being terminally ill and did not want to spend the rest of her life in pain. She was a California resident, and California at the time denied her request for assisted suicide (My Right to Die with Dignity at 29). Soon making California the fourth state to allow assisted suicide.

Switzerland became one of the first countries to look into assisted death and offer it to their patients. Switzerland believes in patients’ rights; therefore, assisted suicide is legal there. “There are no direct legal laws about physician assistance, and most assisted suicides are provided by ‘The Right to Die Associations’” (Hurst, Mauron). A few other countries allow euthanasia and assisted suicide: Belgium, Netherlands, Canada, and Luxembourg. There are currently six states out of the fifty states in the United States that allow physician-assisted suicide. “Assisted death in Canada requires two different doctors to evaluate the patient and confirm that they have a serious and incurable disease” (Proudfoot). Canada made it legal in 2015 after the Medical Assistance in Dying movement showed initiative in getting it legal.

The Role of Religion in End-of-Life Decisions

Should Religion affect the patient’s decision? There are multiple religions that disagree with suicide, no matter what the cause is. Most religions believe if you commit suicide, then you’re doomed to eternity in hell, so they would not agree with this way of dying. Although there might be a few understanding church leaders that do understand and will comfort the patients, there are others out there that might even exile them from their church altogether. Christianity and Catholicism are the two most common religions in the United States. Both believe that you will be condemned to hell if anyone should commit suicide. Those are the patients’ personal problems, and they should be resolved before they die.

There are a few scriptures in the Bible that don’t agree with dying but don’t necessarily say, “Whoever kills themselves will go directly to hell.” The first one is Deuteronomy 32:39 “Now see that I, even I, am He, and there is no God besides me; I kill, and I make alive; I wound, and I heal; Nor is there any who can deliver from my hand.” In this scripture, God is saying that he is the only one who can take away life and that he can heal you; there should be no one else who does that besides him.

The next one is 1 Samuel 2:6 “The Lord kills and makes alive; He brings down to the grave and brings up.” Here it says that he is the only one who can kill and bring him back to life. The third one is from 1 Corinthians 6:19-20 “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have God? You are not your own, for you were bought with a price. So, glorify God in your body”. So out of these scriptures, you understand that God is a jealous God, and there should be no other than heals and brings to life. No other being should kill because only he can take it; everyone’s body is a temple, and it should be treated as such.

God is supposed to be a forgiving God, so if someone were to take their own life, he should be able to forgive them. As it states in 1 John 1:9, “If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.” Along with Hebrews 8:12, “For I will be merciful toward their iniquities, and I will remember their sins no more.” Religion should not be a factor in the patients’ decisions because if they really do believe in the word of God or whoever they believe in, they, too, should believe in forgiveness and that they will be forgiven for their sins. That alone is not a decision for any human being other than the patient and their Religion, so again, it’s more of a personal problem that should be managed before they die.

Physicians are not playing God; they just see someone in need and help them out in whatever way they can. Like it says in Hebrews 13:16, “Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.” Same with Philippians 2:4 “Let each of you look not only to his own interests but also to the interests of others.” They’re doing what the Bible says to help others in need; the patients are already dying. Are they supposed to watch them suffer until they die? Is that what God wants? “What can be said about human suffering? This much, at least: No one wants to suffer. No one wants a death marked by suffering. Only tyrants and those who are pathologically cruel want others to suffer. Medicine is dedicated to the relief of suffering, and we proclaim ourselves to be a society that will not knowingly countenance the relievable misery of any group” (Weir, 69).

Pain, Costs, Ethics, and Autonomy

Patients are not afraid of just the disease but also the pain, family members and loved ones, and money. Money is a big issue, medication is expensive, and health care is also expensive. Robert F. Weir states that “Suffering not only brings pain, physical and mental (just as pain can bring suffering), it can in its extreme forms seem to rob people altogether of their humanity” ( 69). If the patient is terminally ill and they will not be able to take care of themselves, they’ll need home health care or to be put in a nursing home to help them until they die. They don’t want to put themselves in debt or their loved ones in debt. “Patients are worried about becoming dependent and fear both symptoms of the disease and side effects if treatment” (Biskup 140). Before anyone makes a decision to receive assisted suicide, patients should talk to a psychiatrist to mentally prepare them for their outcome. Talk to their physicians to see if they have exhausted all solutions.

“Physicians take oaths to preserve life; patients and doctors themselves expect it” (Biskup 116). They take an oath to make sure they can do whatever they can to save someone’s life, not end it. They can’t just sit back and watch the patient be in pain and suffer; in the end, they will do what is best for their patient. Unfortunately, Biskup states that there are laws in thirty-six states prohibiting assisted suicide (102). We as people need to understand that we cannot control other people’s lives. Who are we to tell them how to live, or especially how to die? No one ever thinks about another human being helping another human being commit suicide.

They overthink it and disagree with the thought of it without the research or understanding of why someone would want that for another person. Or the person committing suicide they don’t stop to think why someone would want that. People don’t stop to think that it’s a personal choice; it’s their personal choice. Robert Weir states, “We do not choose to be born. Nor do we have a choice about whether we will die. Many of us will have no choice about when, where, or how we will die. We may die suddenly from an injury or unexpectedly from an illness” (224) again if we are so quick to put our animals down because we don’t want them to suffer. Why can we not do the same for our people? Instead, we put the blame on physicians that are not at fault, just doing their job.

References:

1. Biskup, E. (2017). A Life Worth Living: Euthanasia and Assisted Suicide. Georgetown University Press.
2. Physician-Hastened Death. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004116/
3. Lessenberry, J. (2014). “Assisted suicide is about personal autonomy, not ‘right way to die’.” Detroit Free Press.
4. States that allow Death with Dignity. (n.d.). Retrieved from https://www.deathwithdignity.org/learn/access/
5. My Right to Die with Dignity at 29. (2014). Retrieved from https://www.cnn.com/2014/10/07/opinion/maynard-assisted-suicide-cancer-dignity/index.html
6. Hurst, S. A., & Mauron, A. (2003). Assisted suicide and euthanasia in Switzerland: allowing a role for non-physicians. BMJ, 326(7383), 271-273.
7. Proudfoot, S. (2015). Assisted dying: Law and practice in Canada. Canadian Family Physician, 61(10), 821-825.
8. Weir, R. F. (1998). Between Two Worlds: The Art of Preaching in the Twentieth Century. Cambridge University Press.
9. Physician Assisted Suicide: Information Sheet. (n.d.). Retrieved from https://www.deathwithdignity.org/wp-content/uploads/2015/08/2015-Information-Page-with-maps.pdf

End-of-Life Struggles: Contemplating Physician-Assisted Suicide

I remember the day my Mother died clearly. I was at work when the nursing home called to tell me that my Mother was not doing well. Her situation was acute, and they told me that I should come right away. When I arrived at the nursing home, my Mother was in and out of consciousness. A tumor had burst through the wall of her intestines, and toxins were flooding her body. She was dying. Although she was hooked up to an oxygen tank, she had not been put on a morphine kit for comfort. They did not provide morphine for five very long hours.

She would periodically wake and beg, “Help me, I hurt.” I was devastated. She did not die easily. In those last hours, I would have done anything to help her. Would she have chosen physician-assisted suicide to end her suffering? Would I have chosen euthanasia for her? I would like to say no, but to this day, I am not sure. Right or wrong, whether you believe it or not, everyone has the right to their beliefs. As the vast majority of our population ages, there is a growing concern over end-of-life issues. One of the greatest issues facing us today is physician-assisted suicide.

Advancements in medicine and rapid developments in technology have provided us with the ability to both save as well as reduce the suffering of people who have diseases that were once fatal. At the same time, however, these developments have given us the power to sustain the lives of patients whose physical and mental capabilities can’t be re-established, whose conditions cannot be reversed, and whose pain cannot be alleviated. As medicine and technologies work together to give people longer lives, the plea that the lives of our terminally ill be ended with mercy and compassion grows louder.

Currently, only five states in the United States have legalized Physician-assisted suicide. The States that have legalized assisted suicide include Colorado, Hawaii, Oregon, Vermont, and Washington. The District of Columbia also has legalized assisted suicide. Additionally, you can obtain a court order for assisted suicide in Montana. (Hastings 2016)

Legalized assisted suicide allows physicians to educate and prescribe medication to patients who have a terminal illness with a life expectancy of six months or less so that the patient can end their own lives. The Physician does not administer the drug it is left to the patient to choose when to die. Still, the question remains, is it the right thing to do?

I have grave misgivings about legalizing assisted suicide and would never make this choice for myself. However, people have the right to choose what they will do with their lives, provided they are not harming others. I think this inherently includes the right to end our lives when we choose.

The Complex Ethics of Assisted Suicide and Dignity in End-of-Life Choices

Adversaries of Physician-assisted suicide argue allowing people to assist the terminally ill to commit suicide violates our fundamental duty to respect and preserve human life. After all, they assert, don’t we have a moral responsibility to preserve and protect life? A physically and mentally capable adult, however, should be allowed to choose a timely and dignified death. These decisions are intensely personal. The only one deciding when to withhold therapies and allow nature to take its’ course or terminate life should be the patient.

Hospice and palliative care programs have many options for quality end-of-life care, and assisted death should be part of the spectrum of end-of-life care. Assisted suicide provides a way to die with dignity after all palliative care options have been exhausted. Additionally, hospice and palliative care may not be sufficient to treat severe suffering. When we extend a patient’s life beyond their ability to sustain their dignity, we have violated their right to determine what action to take when there is no reasonable expectation for recovery.

While it can be argued that physicians take an oath to “do no harm,” assisted suicide directly contradicts that oath as deliberately killing a patient is regarded as harmful a terminally ill patient loses their quality of life and often lives with a great deal of pain, so it wouldn’t it be wrong to force them to live when they prefer to die? Also, if helping a patient to die means better end-of-life care, physicians are doing more harm by prolonging a terminally ill patient’s life and sentencing them to a painful end.

As a society and as fellow human beings, don’t we have the moral duty to alleviate the suffering of others and to respect their dignity? When someone is terminally ill and can only look forward to a life filled with pain, humiliation, and deterioration, isn’t it cruel to refuse their quest for compassion and give them a merciful end?

Safeguarding Vulnerable Lives in the Debate on Assisted Suicide

Further, adversaries of assisted suicide claim that we have a moral duty to oppose any laws that pose a threat to the lives of innocent people and that laws that endorse assisted suicide pose such a threat. If assisted suicide is allowed on the basis of compassion, what will keep us as a society from condoning the death of anyone whose life we deem worthless or undesirable? What will keep relatives of a patient from persuading them that they are a burden and prompting them to ask for assisted suicide? What if someone requests assisted suicide and changes their mind but, due to their conditions, are unable to make us aware of their choice? When we no longer value life, who will speak for the innocent?

References:

1. Hastings Center. (2016). Briefing Book on Physician-Assisted Suicide. Retrieved from https://www.thehastingscenter.org/briefingbook/physician-assisted-suicide/
2. Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
3. Emanuel, E. J., & Fairclough, D. L. (2019). Euthanasia and physician-assisted suicide: attitudes and experiences of oncology patients, oncologists, and the public. The Lancet, 347(9008), 1805-1810.
4. Quill, T. E., & Battin, M. P. (2004). Physician-assisted dying: the case for palliative care and patient choice. Johns Hopkins University Press.
5. Meier, D. E., Emmons, C. A., & Wallenstein, S. (1998). A national survey of physician-assisted suicide and euthanasia in the United States. New England Journal of Medicine, 338(17), 1193-1201.
6. Sullivan, A. D., & Hedberg, K. (2008). Public health implications of legalization of physician-assisted suicide. JAMA, 294(15), 2037-2042.
7. Sulmasy, D. P. (2016). Physician-Assisted Suicide and Euthanasia in Practice. JAMA, 315(3), 257-258.
8. Pope, T. M. (2019). Legal briefing: physician-assisted death. Journal of Palliative Medicine, 22(3), 253-256.
9. Battin, M. P., & van der Heide, A. (2016). Physician-assisted dying: not always “voluntary.” Hastings Center Report, 46(1), 13-14.
10. Battin, M. P., & Rhodes, R. (2008). The patient as victim and vector: ethics and infectious disease. Oxford University Press.

Legalizing Assisted Death: Considerations and Perspectives

Physician-assisted suicide, or assisted Death, is a huge debate across the United States that still remains in many conversations today. Assisted suicide is described as when a terminally ill patient takes their own life using a lethal substance with the assistance of a physician. Assisted suicide should be legal because patients should be able to choose how they live the rest of their life and live it with dignity. In some states, they have made assisted Death legal, “In Montana, physician-assisted dying has been legal by State Supreme Court ruling since 2009” (www.deathwithdignity.org).

Along with Montana: California, Colorado, Oregon, and Vermont have made assisted Death legal. Throughout making assisted Death legal, there are many things you have to take a look at and consider. Background information on this topic is huge because it can help you gain knowledge, you also have to look at why it’s right and the methods of the procedure. You may want to look at studies and results of assisted Death so it can give you a realistic idea, also looking at the Ethics and Law perspective of assisted Death. Overall, cost and physiologic testing will help you understand what goes into all assisted Death. Another thing is the Negative aspects to see what might be a downfall to assisted Death. Overall Physician-assisted suicide should be legal in the United States.

Understanding Assisted Death and Patient Choice

Among many things, it’s important to know background information on assisted Death. Assisted Death is a controversial topic to talk about. Some people may ask what assisted Death is. The term Physician-assisted suicide, referred to as PAS, is when a physician writes off a prescription to a patient with a lethal dose of medication that he or she can take at any time to, unfortunately, end their life. Most of the time, this happens when a patient is terminally ill and has no chance of surviving, no matter how many treatments they go or how much medication they take. When a patient chooses to go down the route of assisted Death, it’s because they cannot do things that they used to because of pain or sometimes because they are held up in a hospital hooked up to a machine. Another reason they choose this is to stop the suffering of their family and friends.

Why is assisted suicide right? Well, today, there is a lot of medical technology that can extend the life of a person. Breathing machines can keep a person alive, and there are medicines that can help someone deal with that. For patients like that, they have a chance of surviving and breathing again. Which is great, but for a terminally ill patient, it’s just something that longers their suffering. Medicine is supposed to keep patients from suffering, but in some cases, it doesn’t. For someone that is dying, the only thing that medical technology does is give a patient more pain every single day.

There are many terminal patients every day that go to the doctors and only ask for one more set of medication to stop the pain- a lethal drug. Jason Barber talks about how his wife Kathleen died in his arms, about how the hospice nurse brought Kathleen morphine to help subside the pain, but it didn’t help one bit. A few days later, Kathleen passed away, and Jason says that “She died with more pain and discomfort, and more slowly than necessary” (www.deathwithdignity.org). Terminally ill patients should have the right to choose assisted suicide, for it’s the best way to end their pain caused by a disease that no drug could possibly cure.

Costs and Qualification Process for Assisted Death

When it comes to assisted Death, you have to believe that it’s super expensive. The cost of the medication varies on the availability and medication type. When taking the medication, you want to consume additional medication before taking the lethal drug, though it will be at an additional cost. There are many different ways the lethal medication comes in, and it’s all based on the type your physician prescribes. To take the liquid form, it “cost about 500 dollars till about 2012, when the price rose to between 15,000 and 25,000” (www.deathwithdignity.org).

The cause of the cost increase was the “European Union ban on exports to the US because of the drugs being used in capital punishment” (www.deathwithdignoty.org). Later in the year, people chose to switch to the powdered form, with cost about 400 to 500 dollars. To have a dose of secobarbital under the Death with Dignity laws cost roughly 3,000 to 5,000 dollars. The last method that lethal medication comes in is an alternate mixture that consists of Propranolol, Morphine Sulfate, Digoxin, and Diazepam.

There is a long process that goes into being qualified for assisted Death. Must be 18 or older, you have to be a resident in a state that allows assisted Death, and you must be the victim of a terminally ill disease that will kill you in six months or less. Another test that you must pass is you have to be able to communicate and make a rational decision to your doctor. The first step is to make a “formal oral request” (www.slate.com).

Many patients will say something like, “Doctor, will you assist me in using Death with Dignity laws” (www.slate.com). After another 15 days, you make another request, and then you’ll need a formal written file request form that is signed by two observers. In many cases where people apply for being assisted in Death, they find an advocacy group and deliver the paperwork and ask for help with the procedure. With this group, they help take out people who are unqualified for assisted Death, overall though it’s the doctor’s decision. If a patient is found with a physiological disorder, the doctor will try to find help.

References:

1. Death with Dignity National Center. (n.d.). Physician-Assisted Dying in the U.S. Retrieved from https://www.deathwithdignity.org/assisted-dying-us-states/
2. Death with Dignity National Center. (n.d.). Cost of Medication. Retrieved from https://www.deathwithdignity.org/faqs/cost-of-medication/
3. Slate. (n.d.). Understanding the Requirements. Retrieved from https://slate.com/technology/2015/10/california-assisted-suicide-what-patients-need-to-do-to-qualify-for-end-of-life-prescriptions.html

Introduction

My paper is about a Christian Ethical Theory in regarding assisted suicide. I first encountered the topic of assisted suicide and euthanasia during this course of Ethics 101. I have been affected by the way in which arguments presented against and for the case in legalizing different kinds of forms of assisted suicide. In some cases, it basically can be viewed as the product of religious based on different ideologies. There is a lack of thought in our world societies viewpoint in which that the proteins to assisted suicide and euthanasia are question and misunderstood and confused many times. I believe it is due to a large part on the failure when addressing the nature of humans and our personally selves that involves us in the ethical act or in doing assisted suicide. Within a Christian approach to the issue on assisted suicide it is and can be mixed up and many people have confusing complex thoughts on the topic to legalize it. No person wants to see a loved one in pain, I have seen my sister in this pain as she tried to commit suicide this past spring. Seeing her in the hospital almost made me want to join her so she wouldn’t have to bear the pain on her own. I truly do have any respect for the different types of death that can be performed. On the opposite side of the confusing conflict of assisted suicide, humans have and don’t have control of death, but it is against Christian beliefs and the Bible. My paper is going to be a viewpoint of what I think on Christian Ethics. There are theories of reality on assisted suicide and many others discussing potential arguments for and against assisted suicide while also sharing my general opinions on it. I believe it should be legal with care worldwide. I hope to offer a good view on assisted suicide and how it relates to my personal Christian Ethical Theory.

Ethical Theory

Meta-ethics is a huge debate in many people’s lives. This is a branch of ethics that seeks to understand the nature of ethical properties, statements, attitudes, and judgments. It is also the main of branch of ethics that all philosophers normally recognize. While meta-ethics is a big branch in the ethics theories, there are many approaches to these ethics and there are multiple different ways to understand the theories. We also must recognize that not all decisions are or can be deemed ethical, one’s moral principles acts as a guide for their behavior and decision making. Therefore, ethics do play a major role in decision making. My religion and spiritual beliefs shape my personal ethics. I grew up in a very Christian family so from a young age, I was instilled with a belief in God and His teachings, according to the Bible. As I get older, I am learning that a spiritual journey and relationship with God is one that is personal and cannot be easily taught or given by others. Therefore, I will admit that as I continue my personal journey with God, my personal ethics are still being developed and shaped. Some behaviors that I may have thought were acceptable in the past, I no longer view the same. According to our textbook, ethical relativism is “…what is actually right and wrong can vary from one person or group of people to another.” Our textbook defines utilitarianism as being “an act that can be judged moral or immoral by looking at its consequences for everyone affected. The option that produces the most good for the most people is the option to be chosen.” Some people would say yes, while others would say no. “Moral principles that govern a person’s or group’s behavior.” Theoretically, the fact that an action is either moral or immoral is based upon the opinion of the person and what they believe. If their opinion is wrong, then the action therefore is also wrong. Which can add to the fact that issues like confusion can result. Making God, our Creator, set his rules behind of letting people make their own decisions and set his people straight. Making a person’s decisions based through God. This approach is the approach of the decisions that were made by the decision maker and his or her responsibilities. This approach will allow a lot of people their own decisions and with this comes great responsibilities through God. Therefore, if the decision maker believes in God, he would make the moral laws one of the main ideas that he follows. As God is his creator, the decision maker should believe in the laws that his God set and follow them as much as he possibly can. The decision maker should also talk in the way that his God would speak towards others. Our Creator wants us all to pass along his beliefs and rules, which will make sure that you understand the right and wrong. If there were no moral laws about being right or wrong, then theoretically there is no right and wrong for anyone. I hope that the issue I chose and touched on with my ethical theory helps better explain the theory. The theory I described in the most efficient way possible is the best way to handle any debate, whether it was with family problems or just a group organization that needs help deciding. Natural law theory assumes a moral epistemology in which one comes to know truly through discursive practical reason. Moral natural law should not be confused with the law of nature. Laws of nature describe how physical entities act. Laws of nature are descriptive not prescriptive. Natural law is concerned with how rational human beings ought to act, and here the key ingredients of human deliberation and choice are crucial. This is important because God offers each of us free will in and through scripture. Proverbs 16:9 NIV, “In their hearts humans plan their course, but the Lord establishes their steps.” Matthew 7:12 KJV, “So in everything, do to others what you would have them do to you, for this sums up the Law and the Prophets.”

Assisted Suicide

Controversy pervades contemporary debate over the moral and legal or illegal status of assisted suicide and euthanasia. After researching assisted suicide, I have more questions than when I began. The definition of assisted suicide: suicide facilitated by another person, especially a physician, who organized the logistics of the suicide, as by providing the necessary quantities of a poison. After much research I have learned that assisted suicide is an option one has to make depending on their moral standards, will to live, and how they want to die rather than a factual process one can follow. Assisted suicide is currently legal in five states: Oregon, Vermont, Washington, California and Montana. Each state differs in the process toward obtaining physician assisted suicide approval, but all follow the generic rule that one must have the mental capability to communicate their own decisions regarding their terminal illness. I question how one can truly make such a decision for themselves if they are in pain from their terminal illness. In California they have the rule that one must submit two oral requests, each fifteen days apart, and a written request to the attending physician. I feel this is a great way of avoiding patients who may be making this decision based off impulsive drives and decisions. Other guidelines to being eligible for assisted suicide includes that one must be eighteen.

Conclusion

I have had this entire quarter semester of studying metaethics during this course, examining various ethical theories that promise to provide you with a methodology for determining right from wrong. These included the simple metaethics, Revelation Christian Ethic, as well as related metaphysical views such as Social Contract Theory, Moral Realism, Divine Command Theory, and Divine Nature Theory. During our reading of the textbooks, we have learned different metaethical theories that have had exceptional characteristics and some that were not so exceptional. Most of the metaethical theories by themselves are not resourceful enough to determine what is right and wrong. A versatile theory would include ethical relativism and utilitarianism combined with a Biblical worldview. According to our textbook, ethical relativism is “…what is actually right and wrong can vary from one person or group of people to another.” Our textbook defines utilitarianism as being “an act that can be judged moral or immoral by looking at its consequences for everyone affected. The option that produces the most good for the most people is the option to be chosen.” Moral or Immoral Should people have the power to act as God? Should scientific studies be limited? Some people would say yes, while others would say no. “Moral principles that govern a person’s or group’s behavior.” Therefore, in an ideal world, ethics should play the ultimate role when deciding. If ethics are the principles which guides one’s behavior then, ideally, all decisions should be made entirely based on ethics. A few problems arise when one tries to make an ethical decision, especially as a leader. First, ethics may mean different things to different people. For example, my own personal religion and spiritual beliefs are the foundation for what I deem ethical. However, for someone else, ethics might be based on laws or their own personal understanding of what is. We also must recognize that not all decisions are or can be deemed ethical, one’s moral principles acts as a guide for their behavior and decision making. Therefore, ethics do play a major role in decision making. As previously mentioned, my religion and spiritual beliefs shape my personal ethics. I grew up in a very Christian family so from a young age, I was instilled with a belief in God and His teachings, according to the Bible. As I get older, I am learning that a spiritual journey and relationship with God is one that is personal and cannot be easily taught or given by others. Therefore, I will admit that as I continue my personal journey with God, my personal ethics are still being developed and shaped. Some behaviors that I may have thought were acceptable in the past, I no longer view the same. I am open to assisted suicide on a case by case basis. It is a deeply emotional and heartfelt issue; it is coping with the sickness and death of loved ones after all. It is difficult to watch a loved one suffer those involved consciously realize this person will die. Suffering and pain will dominate the lives of those who must go through such a traumatic experience, it is no different from the trivial stories of suffering in the Bible. A solution to assisted suicide is preventative care for these diseases to begin with.

Introduction

The goal of this paper is to answer the question, Should Christian’s support physician assisted suicide (PAS)? In answering these questions we need to systematically evaluate our moral beliefs in order to determine if they are justified and if yes, how so.

This requires a discussion about meta-ethics and applied ethics. I will attempt to describe the methodology that I believe Christians should ascribe to when trying to determine the morality of situations such as physician assisted suicide or euthanasia. My hope is that in looking at the arguments for and against, Christians will choose not to support physician assisted suicide because there is sufficient information in the Bible that should make someone exercise caution when making decisions about whether or not to choose physician assisted suicide to alleviate conditions that may arise when diagnosed with a terminal illness.

A Revelational Christian Ethic

Meta ethics is an “attempt to see behind the scene of someone’s moral presuppositions in order to discover and evaluate the beliefs and methods on which they are based”. Meta ethics is concerned with what we mean when we say good or bad, right or wrong. I believe a combination of theories is necessary to understand morality and it can be called Revelational Christian ethic.

The first book of the Bible Genesis, tells us that we are created in the image of God. Because of this there are truths that he placed in our hearts so we have an infallible intuitive knowledge of right and wrong. This does not mean that we are infallible as humans we are fallible and do things that are contrary to righteousness. God uses natural and special revelation to reveal things to his creations. These revelations can be used to resolve moral dilemmas.

Revelational Christian Ethics is the understanding that what is good, true and right is known through divine revelation. There are various forms of revelation as described abov,e one is called general revelation and the other one is special revelation. General revelations are truths that God gives everyone, we instinctively because of God, know these things to be true. Special revelation is “God’s activity of communicating specific truths to specific people”. For example when God spoke to Moses at the burning bush, sent prophets to deliver messages, sent Jesus to live and teach on earth and inspired the writings of the Bible these are all special revelations.

Moral guidance is provided throughout scripture and gives a solid foundation to understand what is moral and immoral. The foundation of what is good and where goodness comes from can be found in God himself and in the inspired writings of the Bible which provides the laws and principles of divine revelation. These truths are written on our hearts and we instinctively know right from wrong even as young children. God uses our emotions to guide us and he provides us with the wisdom we need to become more like him. The Bible provides all moral absolutes and its teachings show us how to cultivate a virtuous character which brings us closer to God and gives us the ability to live a fulfilling and happy life.

A Christian approach to the issue of physician assisted suicide will require us to find a way of balancing opinions that support assisted suicide and oppose it to determine if it’s moral or immoral.

Physician Assisted Suicide

Death in the physical sense is inevitable for all people. The uncertainty that comes from an incurable diagnosis leaves some people wanting to take control and may question taking their own life to minimize suffering. Physician assisted suicide involves a doctor knowingly and intentionally giving someone the knowledge and means or both to end their own life. This typically involves psychological counselling and education about lethal doses and needed to halt life. The doctor also provides the prescription.

In 1997 Oregon enacted “Oregon’s Death with Dignity Act which allows those who are terminally ill to work with a physician to secure a prescription for self-administered life ending medication. This has resulted in a small percentage of the population (one tenth of 1%), most of whom were enrolled in hospice care, die in their homes peacefully. “The most frequently mentioned end-of-life concerns were: loss of autonomy, decreasing ability to participate in activities that made life enjoyable and loss of dignity”. These things make it easy to see why someone may consider physician assisted suicide. As of February 2017, California, Colorado, District of Columbia, Oregon, Vermont, and Washington all have Death with Dignity statutes that allow a person to take their own life with the assistance of a physician.

Physician assisted suicide is thought by some as a caring response to the challenges of death and discomfort associated with it. In some cases the cost of care if someone is terminally ill is so great that the person doesn’t want their family burdened with the debt.

Paul Badham is a professor of theology and religious studies at the University of Wales, a patron of Dignity in Dying and an ordained Anglican priest. He wrote a book titled “Is there a Christian Case for Assisted Dying” and says that Christians should not fear death but look at it as “the gateway to eternal life”. He also insists that not supporting physician assisted suicide demonstrates a lack of compassion for loved ones who are facing certain death and suffering. Badham also believes that since Jesus broke the law to heal a man on the Sabbath (Mark 2:27) that he would also support physician assisted suicide out of compassion, care and love for another. In summary, the case to support physician assisted suicide is based on Jesus and his teachings, first to love God and our neighbor as ourselves and secondly, to follow the golden rule and treat others the way we wish to be treated. Meaning that if someone is suffering we should show compassion and end it.

There are several arguments against the practice of physician assisted suicide. At the heart of the deontological argument is that we, as moral agents are obligated to obey God. One argument is a belief that physician assisted suicide is a violation of the sixth of the Ten Commandments “Thou shalt not kill” in Exodus 20:13 which testifies to the sanctity of life. Some argue that murder is not the same as physician assisted suicide. Murder deprives a person of life and all that it offers and physician assisted suicide is described as a compassionate response to someone is already dying and wants to hasten the process.

Regardless according to God murder is always wrong no matter what the circumstances are. Paul Badham used the argument that Jesus broke the law to heal on the Sabbath however he healed a man he didn’t perform a mercy killing.

Another argument is that “central to the Christian gospel is the belief that suffering can be redemptive”. As Christians we celebrate Good Friday every year and remember the price that was paid with the blood of Christ for our sins. The Vatican’s Sacred Congregation for the Doctrine of Faith contains a Declaration on Euthanasia that says “suffering is not pointless. The Catholic church holds that suffering especially suffering during the last moments of life, has a special place in God’s saving plan; it is in fact a sharing in Christ’s passion and a union with the redeeming sacrifice which he offered in obedience to the Father’s will.”

As Christians we can take comfort during these times with scripture that remind us of God promises like Deuteronomy 31:6-8 that says “Be strong and courageous, do not be afraid or tremble for the Lord your God is the one that goes with you. He will not fail or forsake you. And the Lord is the one who goes ahead of you. Do not fear or be dismayed.” We should not be afraid of death we are promised life after death in Christ.

Pope Francis who is considered more liberal than his predecessors even makes statements about physician assisted suicide saying it’s “false compassion and a result of our throwaway culture that devalues and dehumanizes the sick”.

As stated above, there is redemptive purpose and meaning that can be found in our suffering just as Christ himself found on the cross. A strong teleological argument can be made here as well since as moral agents it’s our desire to “reach an end or goal or to discover our purpose which could be revealed during the process of dying.

Genesis describes the intimate and active role that God played in creating humans in Genesis 2:7 when he breathes life into man and then he became a living being. If God played such an intimate role during the creation of life one is compelled to think that he plays an equally or even more intimate role during death.

1Corinthians 3:16-17 says “Do you not know that you are God’s temple and that God’s Spirit dwells in you? If anyone destroys God’s temple, God will destroy him. For God’s temple is holy, and you are that temple” which many argue would discourage taking one’s life through physician assisted suicide because our bodies are not our own, they belong to God and should be used to glorify him always. Job says “The Lord giveth, and the Lord taketh away” which is also used as an argument against physician assisted suicide because someone’s death should be governed by God not by man and if we are interfering in that process, we are attempting to play God.

Steve Jobs was an executive for Apple. He died in 2011 and said during a commencement speech at Stanford University that “death is the destination we all share” he also told them that death was the “single best invention of life” because “it’s life’s change agent”. Undoubtedly Steve felt as if he changed as he approached death. And if he had chosen to end his life after he was diagnosed with pancreatic cancer those students and everyone else who has heard that speech may have not been given the opportunity to share in his journey. We never know what God will teach us in those final days or what he wants to share with us. Personally I look forward to facing death knowing that God will be with me as I join him in heaven for eternity.

Conclusion

In this paper I have attempted to apply the Revelational Christian Ethic to the issue of physician assisted suicide. While there are strong arguments in favor there is an even more compelling argument against it that can be found in the Bible. As Christians, we believe the Bible contains the divine and inspired writings of God. And we find in the Bible how precious life is to God. As Augustine said, “If you believe in the gospels what you like, and reject what you do not like, it is not the gospels you believe, but yourself’”. Augustine was an early church Father and is referred to as the “greatest theologian”.

While the Bible doesn’t specifically address the subject of physician assisted suicide, it does address murder, the sanctity of human life and teaches us that we should love and show compassion for others. Today, there are only six states that support physician assisted suicide, I think that says something about how apprehensive people are to change legislation to support it. The debate will continue especially as a large percentage of the population continues to age. The arguments that support PAS lack scriptural reference and substance. The Bible is rarely used to support PAS, one reference is Jesus breaking the law to heal on the Sabbath and as explained he healed on the Sabbath he didn’t kill out of mercy. The other reference was the Golden Rule to treat others the way you would want to be treated. This is subjective and it could just mean that to avoid the suffering of another we use others means such as hospice and palliative care. I hope that I have at least cast some doubt on the subject of physician assisted suicide using scripture to demonstrate how Christians should approach this topic.

Bibliography

1. Jones, Michael S. Moral Reasoning: An Intentional Approach to Distinguishing Right from Wrong. Lynchburg, VA: self-published, 2016.
2. Stivers, Laura A., Christine E. Gudorf, and James B. Martin-Schramm. Christian Ethics: A Case Method Approach, 4th ed. Maryknoll, NY: Orbis Books, 2012.
3. http://www.catholicfaithandreason.org/st-augustine-of-hippo-about-354-430-ad.html
4. https://www.deathwithdignity.org/learn/religion-spirituality/

The debate surrounding voluntary euthanasia is one that brings into question the ethics of choice and the importance of human life not only to the individual, but to the collective. There are those that argue that the patient should be able to choose for themselves if they believe that assisted suicide is the best option. They can understand that sometimes life is meant to end and by forcing it to continue, they are simply making a peaceful ending more painful. In contrast to this, there are people that believe that life is the purest and most sacred thing, and to voluntarily end that would be equivalent to murder. These people understand that sometimes life is worth fighting for and that it is always better to have the chance of improved health than to take that away. It would be nigh impossible to depict both sides of this discussion fairly without referencing religion and how, in the words of Pope Francis, voluntary euthanasia is “false compassion” and allowing it is an assault on freedom of conscience and religion. However, I believe that this is not a discussion on religion and more about ethical mindsets that an individual may possess. As such, the focus of this essay will not be on religion but rather on the ethical mindsets that allow for a person to agree or disagree with voluntary euthanasia.

In accordance with the theory of Kantianism, the doctor should follow their moral duty. It is a categorical imperative that life is to be held in the highest regard and as such, to take a life in any circumstance must be a breach of moral duty. But it could also be argued that it is the moral duty of the doctor to reduce pain and suffering when available to do so, and as such, assisted suicide is the only morally correct option. A utilitarian approach is somewhat more difficult to approach as it asks whether the life of a person is more important to the person or the people surrounding them. It must be questioned whether the wellbeing of the patients and people that know the patient are held in higher regard than people that merely disagree with the concept. One could also argue that the wellbeing of the doctor is also affected. To have a life weighing on someone’s hands could be quite distressing but also, knowing that you are the cause of someones continued pain and suffering could also have some serious detriments. It could be argued that the patient also has a right to make their own choice. Supporting assisted suicide would mean allowing a patient their freedom of choice. If this line of thinking is to be followed, it would mean that there would be no rational reason for banning the choice of voluntary euthanasia.

An example of voluntary euthanasia in media is the story of Kerry Robertson. In Victoria, voluntary euthanasia was legalised on June 19th 2019, and on July 15th the same year, Kerry Robertson became the first person to use it. She was originally diagnosed with breast cancer in 2010 and despite significant chemotherapy treatment, the disease spread to bones, lungs and brain. In March she had received the news that the cancer had spread further, to her liver, and that the side effects of the therapy would become unmanageable. Her family were supportive of her throughout the whole experience and only wished for a way for Kerry to die in peace and without pain. She was originally unsure whether the treatment would be available to her, as the legislation hadn’t yet been passed; but began preparations after she found out. She passed peacefully after her family was given time to say goodbye, which allowed the family to have peace of mind. This story perfectly depicts all the benefits of voluntary euthanasia, the patient, Kerry Robertson, had no other option to turn to, her family were supportive of the decision and were given the peace of mind that a goodbye supplies, she was allowed to pass peacefully without pain knowing her family would be able to cope with her death.

Another example of voluntary euthanasia comes from a Jewish nursing home in Vancouver. This story is remarkably more controversial as it involves Dr Ellen Wiebe sneaking into Louis Brier Home and Hospital to give a lethal injection to Barry Hyman. He had been suffering from the effects of a stroke and lung cancer and had asked for his life to be ended. It was given the all-clear by medical doctors but the staff of the nursing home refused to allow the procedure on site. This case is more involved because ethically they might have had the right to perform the procedure on Barry, but they didn’t have the right to breach the rights of the nursing home to disallow such a procedure on their grounds. The matter was taken to court and they ruled in favour of Dr Ellen Wiebe on the grounds that she had already been given full authority to medically end the life of Barry Hyman. This ruling is still debated fiercely by the home, claiming that it ignored the policies regarding MAID [Medical Aid in Dying], in which performing assisted suicide in a faith-based home is an act of negligence to the other residents in the home. A Kantianist outlook on the whole scenario may side with Dr Ellen, as it was her moral duty to act on the wishes of the patient, whereas a Utilitarian approach may determine that the moral weight put on the other residents of the nursing home is greater than the pain that Barry Hyman was in.

I believe that to a certain extent some actions should not be allowed to be decided by the patient. Things such as an addict being allowed access to drugs, or someone suffering from a serious mental illness being allowed the option of self-harm. While this is true, I still remain firmly in the belief that if a person who is of a stable mind decides that continuing to live would be worse than death, they should be allowed to make that choice for themselves. During this essay, I have tried to remain as neutral as possible, but it was difficult for me to accurately depict the religious arguments as I have no significant religious background.

It is considered a crime to commit suicide in some parts of the world. Ireland has gone through the same-sex marriage referendum and abortion referendum in recent years. I believe Ireland should now concentrate on a referendum specifically focused on assisted suicide. This essay will discuss the Criminal Law (Suicide) Act of 1993 in detail. It will include the Act’s point of view through the rights and liberties of the Irish Constitution and the European Convention on Human Rights. Assisted suicide is a very difficult subject that faces criminal justice, constitutional, moral, medical, and ethical problems.

The commencement of the Criminal Law (Suicide) Act 1993 is as follows ‘this Act shall come into operation one month after the date of its passing. The Bill was signed by the President into law on the 9th of June 1993. The Constitution states that ‘suicide shall cease to be a crime. A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offense and shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years. ‘If, on the trial of an indictment for murder, murder to which section 3 of the Criminal Justice Act, 1990 applies or manslaughter, it is proved that the person charged aided, abetted, counseled or procured the suicide of the person alleged to have been killed, he may be found guilty of an offense under this section. ‘No proceedings shall be instituted for an offense under this section except by or with the consent of the Director of Public Prosecutions. The repeal of the Constitution states Section 9 of the Summary Jurisdiction (Ireland) Amendment Act, 1871 (amended by section 85 of the Courts of Justice Act, 1936 ) is hereby repealed.

Two very recent cases have helped by providing the necessary legal research to explain assisted suicide. Firstly, the case of Marie Fleming was described as an assisted suicide issue. Secondly, Gail O’Rourke’s case described her trying to help out her friend to commit suicide. Both cases involve a lot of legal research that will be discussed in detail below.

The first person to ever be arrested for assisted suicide is Gail O’Rourke. There was a great conflict referring to assisting someone to commit suicide and the right to live also known as pro-life. Gail O’Rourke’s trial was watched by many. Of course, it is not illegal to stop certain medications, or treatments or switch off life support. Chemotherapy or certain medications can be stopped at the patient’s request. Doctors are not allowed to force the patient to stop taking any certain therapy such as chemotherapy or switch off the patient’s life support. The Bill was signed in 1993 by the president for the right for natural death and the right to die. The court was always against giving patients drugs because it wasn’t natural. The court states that it is not illegal to die naturally they prefer this than feeding the patient drugs and putting them through different therapies and treatments. In Gail O’Rourke’s case, the doctors could disconnect her from her feeding tube.

Fast forward ten years when a lady named Debbie Purdy from Great Britain who stood up to the court. She stated that if she knew that her husband would get imprisonment for illegally cutting her off her life support, she would not have done it. Debbie Purdy came up with rules that were later applied, and it was said that the person helping in assisted suicide should not be imprisoned once they do not help the patient commit suicide constantly.

A case that shook many in Ireland was Marie Fleming’s situation. She was a lecturer in the University College Dublin. Her situation involved was that she wanted to decide that she was going to die when she said so. However, she was missing her limbs and therefore could not proceed to do so. Toward the end of her trial, the Supreme Court decided that the Constitution does not say that it is not legal to guide someone to commit suicide. Her case began in 2012 as she took ‘legal action to be allowed to assist with dying’. This case was noted as (Marie Fleming v Ireland and the Attorney General). It first took place in the High Court while later it was appealed and moved to the Supreme Court. She realized that her rights were disrupted under the European Convention on Human Rights. The Supreme Court did not consider the appeal which was that Fleming’s partner could have assisted her in dying due to the consequences of for and against the prosecution. An issue that the Criminal Law (Suicide) Act 1993 was unconstitutional was brought up. However, the court rejected this issue because it was indirectly discriminating against those who need assistance when committing suicide.

Ireland is one of the strictest countries when it involves assisted suicide in Europe. In Belgium and the Netherlands direct euthanasia is legal even if it is a minor. Switzerland does not allow direct euthanasia especially when a patient is under drug medication. If your illness is very severe in France it is allowed under law to prescribe a patient medication that can even cause death in some cases. In countries such as Sweden, Germany, Norway and Austria passive euthanasia is legal. In Ireland, Poland, Bosnia, Greece, Croatia and Romania any form of euthanasia is illegal because it is compared to homicide and murder. Euthanasia in these countries leads to fourteen years in prison.

‘Under our law suicide is not a crime but assisted suicide is’ ( ). A fully capable person can decide whether they want to die however a disabled person is not allowed to decide for themselves when they want to die. This means that any person even a relative deciding for a disabled person and assisting them to commit suicide is considered illegal. ‘Although assisted suicide is a crime under our domestic law, not everyone who assists is prosecuted due to a residual discretion or ‘judgment call’ vesting In the Director of Public Prosecutions under section 2(4) of the Act( ).

The prevention theory was Weisberg and Kumpfer’s idea (2003; 4. ‘It is a model of prevention is based on the concept that prevention is now a multidisciplinary science that draws on basic and applied research from many disciplines including psychology, public health, education, psychiatry, social work, medicine, sociology, criminal justice and law’. Prevention was split up into three sections. ‘(1) universal preventive interventions that target the general public or a whole population group; (2) selective preventive interventions that focus on individuals or population subgroups who have biological, psychological, or social risk factors, placing them at higher than average likelihood of problematic behavior; and (3) indicated preventive interventions that target high-risk individuals.

In 1993 the Criminal Law (Suicide) Act of 1993 was introduced to Ireland. Ireland was trying its very best to prevent suicide throughout the country. Since the Act was introduced to Ireland there have been a lot of research and activities discussing suicide and the prevention of suicide. Ireland was given very little time to present information on suicide and suicide prevention. There are many resources introduced to Ireland such as in 2001 there has been a restriction added on purchasing paracetamol. Only one paracetamol can be purchased by a customer each time they are checked out at the till. In 2007 a National Office for Suicide Prevention study has been presented to the HSE. Unfortunately, Ireland has the fifth highest male suicide rate in the whole world which means these resources must be looked into more.

Ms.B case study is relevant to the topic of assisted suicide. Ms. B was put under a ventilator due to her being paralyzed from the neck down. A few months went by and Ms.B decided she wanted to get out of the ventilation treatment. The psychiatrists said that Ms.B was not capable to decide for herself. Her doctors desired her to move to the spinal rehabilitation unit. However, the spinal rehabilitation unit suggested that she couldn’t move out of her hospital because she was dependent on a ventilator. Ms. B agreed that she will not move to the hospice or spinal rehabilitation unit. The High Court states that the hospital was illegally treating her because they refused to stop her from being ventilated even though she insisted. The High Court also says that Ms.B was capable to make up her own decision therefore she could have stopped her ventilation treatment whenever she desired. Judge of the High Court case Dame Elizabeth Butler-Sloss said that Ms.B was capable to stop her from being ventilated even though she insisted. She was also capable to know about the consequences and what happens after she stops being ventilated. Ms. B was refused being not ventilated she clearly stated that she never decided for herself that she wanted to stop ventilation. She said she would investigate other ways and substitutes.

‘The judge’s reasoning, in this case, may seem ethically and legally uncontroversial. Few, if any, ethicists or lawyers would question a patient’s right to refuse treatment because it is either futile or too burdensome.

The court believed that Ms.B decision to not commit suicide was a suicidal decision. The judge always needs the doctor’s confirmation to deal with a suicidal decision. The courts should clarify specifically that a patient does not have the right to commit suicide or assist suicide in Ireland. Thus, doctors do not have the right to decide for their patients and force them to commit suicide. Additionally, doctors cannot assist a patient to commit suicide.

There has been very recent legislation in 2015 it was called the Right to Die with Dignity Bill 2015 and was introduced by Deputy John Halligan. The extended version of the title of the Bill signed is as follows “Bill entitled an Act to make provision for assistance in achieving a dignified and peaceful end of life to qualifying persons and related matters.” The first stage of the bill has been passed on. However, the second stage of the bill has not yet been signed. This is because Deputy John Halligan cannot pass on the bill to the second stage himself. This Bill is made for those who are on their deathbed and who have no human rights opposed to them. Halligan noted that the reason why assisted suicide is legalized in some countries is that people can live longer. Halligan found out that legalizing assisted suicide increases the number of untreatable illnesses and more patients therefore die.

“[Under the provisions of the Bill] Two separate medical practitioners are required to examine the qualifying person and sign a valid declaration that their decision is voluntary and they have an incurable and progressive illness which cannot be reversed by treatment and which is likely to lead to their death. A third independent witness, who is not a beneficiary of their estate, must also testify that the person has a clear and settled intention to end their own life when their illness becomes too much to bear. At all times safeguards must be met to show the terminally ill person has reached their decision on an informed basis and without coercion or duress. Furthermore, no doctor will be obliged to participate in an assisted death if he or she has a conscientious objection.”

A survey has been completed in 2018 where farmers were questioned whether assisted suicide should be legalized in Ireland. Women farmers agreed that assisted suicide should be legalized (49%) while (31%) of women voted that assisted suicide should be illegal in the country. In 2015 the vote was actually three percent higher than in 2018. 48% of male farmers and 55% of women farmers agreed that assisted suicide should be legalized making women farmers more in favor than men. Residential differences were spotted in the survey. The Dublin area included a higher vote percentage for assisted suicide legalization (77%) than counties such as Tipperary which was only (31%). Many people especially the more traditional and older generation agreed that assisted suicide should be illegal in the country. This is because there are more religious and believe that it is immoral to end someone else’s life on purpose.

Engelhardt and Iltis see that for Christians, the ethical issues about retaining or pulling back treatment or arrangement of assisted suicide can be completely viewed as just inside the profound objective of everlasting redemption. Moral Christian restrictions and beliefs focus on living and dying from helping others’ point of view and sacrificing your life to god. Enough record of Christian finish of-life choices is likewise entangled by the vagueness of the term Christian, which includes a bunch of strict gatherings sharing, best case scenario family similarities. The older generation Catholics’ position is expressed in the Declaration on Euthanasia, which progresses the situation of the Catholic Church and expresses that all human life paying little respect to its quality has holiness and can never be purposely decimated (Tyrell 2012).

The morality in this issue is whether it is appropriate to directly euthanise someone or by stopping a person from dying. The most important factors of the Catholic church are (1) in an objective moral law which is derived by reason from the natural law which because of our god given ability to reason and discover it is in fact God’s law and that law provides a prohibition on killing innocent human beings. (2) that we steward and not owners of our life, the true owner being God, and although we have free will to live, we must live within the parameters of God’s law. (3) that every human being has full value and becomes a person from the moment of creation regardless of ability and is therefore entitled as a matter of justice to be treated equally. (4) that every human life is valuable because each is made in God’s image and therefore has a unique worth over other life forms. (5) that suffering has a purpose in that it can become a means of affirming the existence of a higher truth that of the suffering of Jesus was a redemptive act for the failings of humanity and which opens the blocked way to the eternal life of and a means of solidarity with others who are not suffering.

Pope John Paul perceives in Evangelium Vitae that we as humans need to bite the dust and that worthless treatment that delays the patient’s death may mess with dying people’s opportunity to make harmony with God. It also perceives the individual’s desire to experience their final days in comfort as a sensible option in contrast to intrusive purposeless treatment.

The Court states that a person’s right to live involves a tranquil and natural death. However, it most certainly does not state that a patient’s life should be extended by specific medication and treatments that do not even cure a patient.

Restrictions were made by the Court to notify dying patients. 1) who are effectively insensate (2) who have no prospects of recovery (3) are being kept alive by “artificial” means and (4) it is in the patient’s “best interest” to be allowed to die (Tyrell 2012).

The Rosenfield study found out that the desire to commit suicide was formed because of mental illnesses such as anxiety and depression. It was also shown that patients that were on antidepressants were more likely to commit suicide. However, this does not mean that every person diagnosed with depression will end their own life. In fact, patients with thermal illnesses do not have depression. Rosenfield states ‘how happy do you need to be when you have a thermal illness’. There are more people talking about assisted suicide nowadays. Yet, nothing is being done to legalize the issue in Ireland. There are still many patients with thermal illnesses refusing to live, eat, drink or take their medication in our hospitals.

A recent study showed that more patients from Ireland have decided to sign up for assisted suicide in Switzerland. 47% of Irish patients have signed up for assisted suicide in Switzerland. This is 74% more patients signed up than in 2018. Switzerland accepts people that do not have thermal illnesses. They accept people that are of old age, depressed or in serious pain. Switzerland is therefore a unique country because places such as Belgium and Canada that legalized assisted suicide only accept patients with thermal illnesses.

A report on the Right to Die with Dignity was published in June 2018 by The Oireachtas Joint Committee on Justice and Equality the figures show that after the abortion and same-sex marriage referendums “the right to die is the next civil right that should be discussed in Ireland”.