Ethics in Physician Assisted Suicide
Physician assisted suicide refers to the voluntary termination of the life of a particular patient. It is conducted through administering a lethal substance with direct or indirect assistance from the physician. The case of physician-assisted suicide has caused many debates. Some doctors argue that it is unethical to participate in patient assisted suicide since it violates the fundamental principles of medical practice. It violates the Hippocratic Oath of doctors. This oath states that doctors should always act in the best interest of their patients. It implies that doctors should do everything possible to help their patients recover (Carr, 2010). It shows that participating in physician-assisted suicide is a wrongful act in this case. Some people also do not support physician-assisted suicide since they argue that it violates the principles that Christians adhere to. According to Catholic teachings, it is wrong to violate the commandment of Thou shall not kill (Carr, 2010). It shows that people should not participate in physician-assisted suicide since it is unethical. However, some people argue that it is ethical to practice physician-assisted suicide. It should be performed to patients who may be suffering from painful, fatal, and degenerative conditions. Such conditions make patients suffer. This paper focuses on ethics of patient assisted suicide.
Utilitarianism can be used to solve the ethical problems that physician-assisted suicide presents. According to this theory, it is our moral duty to maximize pleasure and minimize pain. It also states that what determine whether an action is right or wrong are the consequences that result from this action (Bentham, 2009). Right actions should always bring the best outcome from the choices available. John Stewart, one of the founders of this theory, argues that actions are right if they promote happiness (Pojman & Fieser, 2011). In contrast, they will be wrong if they produce a reverse of happiness.
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Several people criticize application of utilitarianism as an ethical theory due to several reasons. One of these reasons is that in the real world, people do not have enough time to calculate how happy we become because of the actions that we may have performed. However, supporters of the utilitarianism theory claim that utility should not be measured by mathematical calculation but felt by normal people. Other people also argue that this theory is too demanding since it suggests to people to always act in order for them to become happy. Critics also claim that it is impossible to know all consequences that actions of a particular person will bring. This is because it is impossible for people to predict the future. Another key objection of this theory is that even though a certain thing may make a person happy, it does not mean that this act is right and that other people should follow it. However, people still value this theory since its moral duty is to maximize pleasure and minimize pain.
It shows that people supporting this theory would pursue patient assisted suicide since it maximizes happiness by reducing the pain that a particular patient may be experiencing. A case of Terry Schiavo can be used to illustrate the application of this theory. Terry died after doctors disconnected her feeding tube. On February 25, 1990, she had a cardiac arrest that made her to be in a persistent vegetative state (Goodman, 2010). Extreme hypokelemia was responsible for the cardiac arrest that she suffered. According to doctors who conducted her autopsy, Terry Sciavo had suffered severe atrophy on her cerebral cortex. They gave a diagnosis that Terru was in a persistent vegetative state. The only reflexive responses that she had were towards light and noise. She did not have any emotions. Doctors tried all forms of speech and physical therapies but they did not succeed in helping her. Nerve stimulation experiments also failed. It was therefore morally right to perform physician-assisted suicide on Terry since it would help in reducing her pain and suffering (Carr, 2010). Due to this, Michael Shiavo who was the husband of Terry suggested that they remove her feeding tube. He stated that Terry was in pain and it was very necessary for doctors to disconnect her feeding tube in order to stop her suffering.
Utilitarianism theory concentrates on maximum happiness of most people in the society. In the case of Terry, her husband and family may have incurring huge medical costs in order to keep her alive (Birnbacher & Dahl, 2008). It is very expensive to cover medical costs of a patient supported by machines. This is because such patients require constant medicl care and attention in order to maintain their vitals. It may cause families to take huge loans in order to pay the high medical costs. In this case, it would be right to participate in physician-assisted suicide since it would cause happiness to families taking care of a patient with no hope of surviving (Bentham, 2009).
Physician assisted suicide is wrong since it is against the teachings of Catholics. It will, therefore, make most Catholics happy if this practice is not allowed. Saint Augustin of the Catholic religion argues that it is never illicit for a person to kill another person even if the other person supports his/her own death. According to Catholics, patients seek for physician assisted suicide since their lives hang between life and death. Due to this, such patients beg that their souls would be released from the bonds holding them. Therefore, it is not right for doctors to release the souls of such patients. In the case of Terry, her parents were strict Catholics. They stated that they always taught their child to abide by the teachings of the Catholic religion at all times. They felt that it was not right for doctors to participate in the physician assisted suicide since they would be going against Catholic teachings. This would not cause maximum happiness to the catholic religion making it necessary to be condemned.
Doctors are usually in a dilemma when giving patients their opinion regarding physician assisted suicide. Some patients tell their doctors that they should not allow them to suffer because of any particular illnesses. This is because some illnesses torture the ailing patients because of the pain that may be caused by terminal illness. Mill was among the founders of utilitarianism. According to this philosopher, if a person sees another person trying to cross a bridge that is deemed to be dangerous, it is the duty of the other person to stop this person in order to save his/her life. However, if the person crossing the bridge continues to cross it despite being aware of the risks that face him/her, the person crossing the bridge has the freedom to exercise his/her own freedom. This is because it makes him/her happy. Individual liberty is important for the happiness of all people. Due to this, it is critical for doctors to value the will of patients to end their lives since it makes them happy.
Emotivism can also be used to solve ethical problems associated with physician assisted suicide. According to this theory, not all moral functions act as fact statements but as expressions of the writer or feelings of the speaker. It implies that moral statements are meaningless (Pojman & Fieser, 2011). This is because moral statements only show feelings of a certain speaker concerning an issue. This is wrong since it may end up influencing thoughts of another person. Researchers argue that the purpose of emotivism is to use moral judgment in order to express positive feelings that a particular person may be having. Theorists give an example that if “X” is good, it means “Hurrah” for X! In contrast, if “X is bad” it means that “Boo for X!” Due to this, people argue that since moral judgments are exclamations from people, they cannot be true or false. This shows that there cannot be moral knowledge and moral truths. People cannot reason about moral principles that should be followed by everybody. However, they can only reason about moral issues if they assume a particular system or norms. People support emotivism theory since it is simpler to apply and explains more facts. However, critics do not support this theory since they state that it denies moral knowledge and moral truths while explaining morality.
In case of Terry, some people argue that it was moral to take the life of Terry since it would help her die with dignity. Terminally ill patients are not able to support themselves. Some patients constantly vomit on themselves. In some cases, they drool or urinate on themselves. In this case, some doctors argue that it would be right to perform physician-assisted suicide since it would help patients die with dignity (Goodman, 2010). Terminally ill patients sometimes have nearly death experience. During this time, they argue that they meet their deceased relatives. In addition, terminal ill patients may sometimes experience extreme pain. Extreme pain that they may be suffering from may make them have elevated levels of systolic blood pressure. Their rate of breathing may also increase because of the pain that they may be feeling. Some doctors argue that patients in extreme pain do not like being moved from their previous positions. When a particullar doctor attempts to move them, such patients guard their positions in order to protect their body parts from moving. This is because these movements will make them experience pain. Some of these patients also do not have enough strength to morn or scream in order to express the extreme pain that they might be feeling. Due to this, they just stare at other people blankly without moving. In other instances, terminally ill patients may have many opportunistic infections. Some of these infections may cause development of fungating tumors. Such tumors may release discharge with odors. All these symptoms make terminally ill patients suffer significantly. Doctors argue that it is right for such patients to be killed through patient assisted suicide since it would help them avoid suffering.
However, this is not a fact statement since it may only reflect views of the doctor. These views may not be universally true. In this case, doctors are given too much power to determine fate of their patients, which is wrong. Family members trust doctors since they are always confident that doctors always want good things to happen to their patients. Although a patient may be suffering, he/she may have hope of survival despite the fact that he/she may not be living with dignity (Pojman & Fieser, 2011). Doctors can use several drugs to manage the pain that their patients may be experiencing. One of the most common drugs that doctors use to manage pain among patients is opiate. Alternatively, doctors can offer palliative care to patients in order to reduce the amount of pain that patients may be suffering from. Through symptom management and pain management, the patient is able to have comfort. The goal of palliative care is to ensure that patients live the highest quality of life in their remaining days. Therefore, it is not right for doctors to participate in physician assisted suicide just because they think that it is right for the patient. It is not right for doctors to make a decision that the patient should be allowed to die with dignity.
Instead of participating in physician assisted suicide, doctors may consider the option of offering hospice care to terminally ill patients. Hospice care is mostly given to cancer patients and other terminally ill patients, who are expected to live for about six months or less. In this type of care, a particular patient is given compassionate care in order to relieve some of the symptoms that this patient may be experiencing. Family members of such patients are also given techniques that they can apply in order to cope with death. Sometimes, some of the patients prefer to have home hospice care. In this form of hospice care, a family member or close friend is given the responsibility of taking care of the terminally ill patient while the patient is admitted at home. A terminally ill patient feels cared for and loved when a close family member cares for all their medical needs. Medicare has made it possible for doctors to cover for terminal ill patients. Through Medicare, terminally ill patients are able to access outpatient drugs for the management of their symptoms and relief of the pain that they may be experiencing. Such patients are also given spiritual and dietary counseling. Nursing care provided to them is also of high quality. Instead of doctors stating that physician assisted suicide helps to make patients die with dignity, they should consider providing hospice care to all patients to ensure that they die peacefully.
Overall, the view of utilitarianism is closer to my own view. I believe that physician assisted suicide should be conducted on terminally ill patients with no hope of recovery. This is because it would bring maximum happiness to everybody in the society. Some cancer patients experience extreme pain that may not be managed effectively using drugs. The pain is caused by the fact that the growing tumor may sometimes block major organs and destroy body tissues. Terminally ill patients may also experience chronic pain because of diluted blood vessels located in the brain. It will make such patients have migraine headaches. Family members sometimes spend many funds covering medical costs of a particular patient. According to research, patients supported by machines spend about $50,000 to 100000 $. It would be ethical if this money was used to save a patient with high hopes of survival. I also believe that it is right to end the life of a patient who may be suffering from a particular illness. The number of AIDS and cancer patients seeking physician assisted suicide has been increasing. Such patients suffer significantly from these diseases. It is right to perform physician assisted suicide in this case.
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