Editor’s Note: This essay explores the ethical and practical aspects of assisted suicide. It examines the importance of quality of life over quantity, the need for clear criteria and regulations, and the moral dilemmas faced by individuals and society. The discussion includes the difference between active and passive assistance, the role of autonomy and dignity, and the implications of legalizing assisted suicide.
The Ethical and Practical Considerations of Assisted Suicide in End-of-Life Care
Most of us are born into this world without pain and suffering. The trauma of our birth is usually is left only on our mother, and we hear about it every year on our birthday. More often than not we grow up and live our lives free from physical pain and suffering. Many of us will have the occasional broken bone or repair surgery during our life. These are often short recoveries, which allow us to live relatively pain free lives. As we enter the last stage of our lives where dying is the outcome, most of us expect not to suffer. While we walk the line on the issue of assisted suicide, we must ask ourselves if being alive is the same as living.
If a person has stage four cancer and is in constant unbearable pain, doctors do what they can to ease their pain with medication. What if their pain can not be managed by medication and they want to end their suffering. How do we ignore their wishes and let them suffer ? We can not let people suffer Quality of life is more important than quantity of life. We end the lives of suffering animals whether they are pets or game that we eat. We obviously give more value to human life than we do animals, yet we won’t allow the animals to suffer. It does not seem logical to value human life the way we say we do, and not ensure that death is valued as much as life.
How can we let people suffer when they are dying? Do we allow people to suffer because we want to avoid person confliction within ourselves or do we avoid being judged by the masses? Can we reflect on our own lives and the lives of our loved ones and say that we want to suffer when we die. Anyone who can feel pain will say they do not want to be in constant pain and do not want to suffer when they are dying. Those that want their suffering to stop by ending their lives, should be allowed to be assisted in how they leave this earth.
The rules of who can be assisted in their death, must be clear and concise. There must be strict criteria for assistance to be given to someone who is terminally ill. There can not be room for doctors or family to hasten death for any other reason than that of the patient wishes. The application of the assistance would have to be regulated and safeguards placed to ensure the integrity of the assistance would not be compromised.
Many people are taught to treat others as we ourselves wish to be treated. As to this issue we do not treat others this way, we allow personal issues of beliefs cloud our thinking. On one hand we can look at assisted suicide as aiding in a murder. For most people murder is unacceptable and wrong so they are against assisted suicide based on that belief. If the intent is not to kill but to end suffering how can it be the same as murder?
Ending the suffering of someone who is in pain, is a natural biological response that most people have within them. A mother cleans and bandages a skinned knee of her child when they fall off their bike. She may also offer a icepack or medication to aide and ease the child’s pain. A husband rubbing his wife’s back to help relieve her pain while she is in labor during child birth. The doctor that gives pain management medications also aides the women to ease the suffering and pain of childbirth. Yet we won’t help someone with end stage pancreatic cancer end their suffering and excruciating pain.
It is absurd to consider making into law in which aiding in the death of our weak and suffering is accepted. As we open the door to assist people in ending their lives, we open the door for people to take advantage of those weak and suffering people. Doctors would be allowed to make judgment calls, providing lethal action when it is unwanted or unwarranted.” Considering legalization to be the first step on a slippery slope that ends with physicians exerting pressure on the elderly to be euthanized to free up a hospital bed, or even to doctors killing patients without their consent“(Young, 2010. p. B.7 ). This also opens up argument of what is acceptable and what is not. Doctors swear an oath to do no harm and to not give anyone medications that they do not need to treat an ailment, so doctors assisting suicide are actually going against this oath.
There are types of assisting in someone’s suicide. There is passive assistance and active assistance when a person helps in the suicide of another. While one is actively aiding someone in dying where drugs may be administered to hasten death, passive assistance is withholding treatment in order for death to occur naturally. Is there is a clear difference between removing a feeding or breathing tube, and actively injecting a medication that stopped someone’s heart. It is reasonable to say that giving someone something that ends their life, actually aides in killing them. Taking something away, means that there would be not benefit from having it in place. “If further care is unlikely to be of any therapeutic benefit, a physician is not obliged to continue therapy.”(Clarke & Egan, 2009). Many would view this as being the same thing, as the end result gives you death.
Along with passive and active assisted suicide, there are a few other areas of assistance that need to be looked at. The voluntary act of having someone aide you in killing yourself is knowing what is at hand.” A patient must understand the condition, prog nosis, and proposed therapy, and be able to reason consistently and to act on the basis of such reasoning. A patient must be able to communicate their choice and the reasons for that choice and understand the practical consequences of their choice”(Clarke & Egan, 2009).
Involuntary assistance is one of the most important aspects of this issue, as this assistance is when a patient can not speak for themselves but for most instances, a family member makes the choice on the outcome of life and death for the patient. This issues poses several concerns. How can the hospitals and doctors be sure that the person in charge of making this crucial decision has the patients wishes or best interests in mind. Is this person the best one to making the decision and are their motives clear and unblemished? “Jennifer Allwood thought it would be merciful to smother her 67-year-old father who had cancer. He was able to fight back and survived”.(Clarke & Egan, 2009).
Making a decision that can not be changed and the outcome hazardous should not be allowed to be made legal. The issue of assisted suicide will likely be debated for a long time to come. Looking at what benefits that come from it seem silly, for a few people to die faster. With all of the technology and advances in pain management, the actual need for someone to need to kill themselves smaller than one may think. “Having considered both sides of the issue, our conviction is that, after all, it is far better for the welfare of society to let a few suffer, and not run the risk of creating crime and criminals. It appears to us that there is ample reason to dread that the practice of euthanasia would, in the long run, cause more harm than good. That is why the law, laboring as it always does for the
good of majority, has logically prohibited it (Appel,2004).
People have the right to decide how they want to die and there is no need for anyone to suffer as their life is ending. People have in the past made the choice to help others end their suffering in times when the person could not consent, but clearly was suffering and in excruciating pain. A woman was “given a fatal dose of morphine” when she was close to death “in order to prevent further suffering.” The case was that of an army colonel’s wife in New York State who had attempted suicide by removing “all the woolen blankets and slow burning material off her bed,”
then “lying on a heavy straw mattress” and setting fire to it. The woman was “a horrible sight to behold” and was “literally roasted alive”; when she lifted her arm to shake hands with Kempster, “the flesh dropped from the bone, leaving the forearm absolutely bare.” A certain end “was only a few hours away,” “every moment was torture of the most horrible kind,” and the patient “was shrieking with agony” while “waiting for death to relieve her from her suffering.” The woman’s personal physician indicated that he intended to inject her with only ten drops of morphine; Kempster, called in to consult, advised him to “fill the syringe”-and when the personal physician refused to take responsibility for such a decisive step, Kempster took hold of the needle and administered the fatal dose himself.5 Not only did he believe he had done
right-a judgment allegedly confirmed by the priest who had been called in to administer the woman’s last rites-but he expressed his firm intention, if
necessary, to end actively the lives of other patients. Kempster said that “he never went on a journey-and he [had] been all over the world-without taking with him the means by which to end the life of an unfortunate human being who might be injured in an accident beyond the hope of recovery, and whose
sufferings were severe”(Appel,2004).
How can we turn our backs on the ones that are suffering when they can not come back from the road to death? We all deserve the right to die with dignity and free from pain. Three key points that support active assisted suicide are “ the relief of intractable pain, the respect for autonomy and the closely related fear of a loss of dignity that accompanies the loss of autonomy”(Clarke & Egan, 2009).
Seventy percent of the people polled in a survey favored to “allow doctors to comply with the wishes of a dying patient in severe distress who asks to have his or her life ended”(Jannetti, April, 2010). This percent is very high considering that in most states in the United States outlaw assisted suicide. The number of people who want it to be available must advocate that it is there for them if and when they need someone to aide them in dying, instead of suffering the pain that they may have to endure otherwise.
Living is not the same as being alive and if more of us understood that premise then much of this argument may not need to be expressed. In the end, we must do what is best for the people who are suffering and adhere to their wants and wishes. We must honor them by allowing them to leave this world as free of pain and suffering as they entered it.
Works Cited
1.Clarke, D.L. (2009). MMed Sci, MBA. Department of General Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg Metropolitan Complex.
2.Egan, A. SJ, PhD. (2009). The Jesuit Institute – South Africa, Victory Park, Johannesburg.
3.Lachman, L. (2010). Medsurg Nursing. Pitman: Mar/Apr 2010. Vol. 19, Iss. 2, p. 121-125.
4.Young, H. (2010). The Ottawa Citizen. Ottawa, Ont.: May 1, 2010. p. B.7.
5.Jannetti, A. (2010). “Survey on Assisted Suicide.” Retrieved from Medsurg Nursing