It is important to note that physician-assisted suicide is a highly intricate and complex ethical issue, which requires a thorough analysis and understanding in order to draw any form of evidenced conclusions. Physician-assisted suicide PAS is an act where a physician assists a patient to conduct the life-ending action by providing him or her with the necessary means to commit suicide by being aware of the patient’s willingness to do so.
Firstly, the most important reasons include the impossibility of cure, terminal illness, severe pain, and the right to die in dignity. PAS can be considered as a more passive variation of euthanasia, which is illegal in most states. Therefore, the former process adheres to the principles of patient autonomy and assists him or her in ending his or her life in a less painful manner. The four fundamental ethical principles in medicine include autonomy, non-maleficence, beneficence, and justice (Pettersson et al., 2018). The cause of the problem and its persistence is manifested in the fact that PAS creates conflict between autonomy and non-maleficence. In other words, those who oppose PAS claim that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks” (“Physician-assisted suicide,” 2021, para. 5). The supporting side argues that conscience dictates when PAS is applicable by honoring “patients’ informed decisions to refuse life-sustaining treatment” (“Physician-assisted suicide,” 2021, para. 11). In other words, PAS can be viewed as both ethically sound and incompatible practice in the medical community.
Secondly, the most relevant ethical theories are utilitarianism and deontology. Virtue ethics is not applicable because it is the virtuousness of a person which determines whether or not the action is right, which is impractical to determine (Pettersson et al., 2018). In accordance with utilitarianism, some argue that “permitting physicians to engage in assisted suicide would ultimately cause more harm than good” (“Physician-assisted suicide,” 2021, para. 4). Therefore, the net harm outweighs the net benefit. In the case of deontology, the duties of a medical professional include “do no harm,” beneficence, justice, and respect for autonomy. PAS adheres to the autonomy principle but violates non-maleficence and does not fully comply with beneficence. Therefore, both utilitarianism and deontology are more inclined to support the stance against PAS.
Thirdly, the key stakeholders of the problem include patients, physicians, healthcare managers, government, nurses, and informal caregivers, such as family members. Healthcare professionals, such as physicians and nurses, are more likely to be against the practice due to the sheer degree of responsibility put on their shoulders (Bravo et al., 2019). However, healthcare consumers, such as informal caregivers and patients, are most likely to support PAS if conditions include terminal stage, suffering, and patient’s request (“Physician-assisted suicide,” 2021). The other stakeholders include the government and healthcare managers, whose stances are interdependent on the policies enforced around the issue and public support for the practice. The key regulatory policy is centered around the Code of Medical Ethics, which strongly prohibits both PAS and euthanasia (Lagay, 2003). In other words, it is up to individual states, the public, and the medical community collectively to decide whether or not PAS is legal or illegal. The conflict of interest at heart is about responsibility and side effects of legalization, where patients and informal caregivers are interested in their cases, and the medical community is interested in a non-disintegration of core medical principles.
Fourthly, the issue is a national problem in the sense that the Supreme Court ruled in favor of individual states determining the legality of PAS. In 1997, the Supreme Court ruled that state laws criminalizing physician-assisted suicide are not unconstitutional (Lagay, 2003). In other words, states are free to ban PAS if they want to do so. The issue affects the elderly, terminally ill, and patients in severe pain the most. For example, old adults with age-related ailments, which are untreatable and unmanageable, might want to have an option to no longer suffer from these problems and end their life with dignity. PAS is a national issue, where certain states allow it, and others do not.
Fifthly, utilitarianism is based on outcomes, and deontology is focused on duty, these theories are key resources. In order to make PAS ethically sound, the net benefit must outweigh the net harm. In addition, for terminally ill patients in pain, it is adherent to beneficence if PAS is removing pain. Thus, the best solution is to allow PAS nationwide, but under strict conditions. For example, terminally ill patients and patients in severe pain, such as terminal cancer patients, might want physician-assisted suicide instead of prolonged suffering and pain. A patient must be terminally ill, in extreme pain, and he or she must competently request PAS with agreement from family members, and physicians must have a choice to refuse on the basis of their conscience (“Physician-assisted suicide,” 2021). By ensuring the latter practice, the benefit will outweigh the harm, and physicians will be performing their duties, such as autonomy and beneficence.
In conclusion, PAS needs to be considered as a viable option only under specific circumstances, which leave no alternative option for the patient’s dignity and well-being.
References
Bravo, G., Trottier, L., Rodrigue, C., Arcand, M., Downie, J., Dubois, M., Kaasalainen, S., Hertogh, C. M., Pautex, S., & Van den Block, L. (2019). Comparing the attitudes of four groups of stakeholders from Quebec, Canada, toward extending medical aid in dying to incompetent patients with dementia. International Journal of Geriatric Psychiatry, 34(7), 1078-1086. Web.
Lagay, F. (2003). Physician-assisted suicide: The law and professional ethics. AMA Journal of Ethics. Web.
Pettersson, M., Hedström, M., & Höglund, A. T. (2018). Ethical competence in DNR decisions –a qualitative study of Swedish physicians and nurses working in hematology and oncology care. BMC Medical Ethics, 19(63), 1-12. Web.
Physician-assisted suicide. (2021). Web.