Physician-assisted Suicide: Ethical Dilemmas and Free Will

Ethical Dilemmas

Physician-assisted suicide (PAS) remains a controversial issue, especially regarding its legality and morality. Several ethical issues shape the medical policies and laws guiding PAS in states such as Oregon. One apparent ethical dilemma relates to the ethical principle of autonomy, which gives a patient the right to choose the kind of care he or she needs (GMC, 2010). PAS violates this principle as it denies a critically ill patient the right to decide on his or her health.

Another ethical dilemma associated with PAS is patient dignity. This implies that a patient has a right to quality care that includes measures, which ease pain and suffering. International laws recognize and protect human dignity as an inviolable human status of all people (Killmister, 2010). Thus, even terminally ill patients have intrinsic dignity that should be protected through quality care. However, PAS proponents contend that, in situations of severe pain and suffering, intrinsic dignity is lost. The involvement of doctors in PAS also causes an ethical dilemma. The practice contradicts the physician’s duty of beneficence, which dictates that doctors should do no harm to patients under their care.

When a patient seeks for physician help to commit suicide, providing professional advice is important. The writer of this paper would tell such a patient not to use PAS as it violates medical ethics and undermines human dignity. The writer will further advise the patient to seek social and emotional support from family and inform him or her of the available symptom management interventions that can increase his or her quality of life.

The issue of allowing terminally ill patients to take part in trials of experimental drugs is very controversial. The writer of this paper would recommend experimental treatments over assisted suicide for terminally ill patients. It is the opinion of this writer that patients in the end-of-life stage should have the right to make free choices (autonomy) regarding the benefits/risks associated with phase II trial drugs. Moreover, experimental drugs, despite the safety concerns, do not undermine the patient’s intrinsic dignity.

Euthanasia and Free Will

It is the writer’s view that doctors be allowed to end the life of a terminally ill patient. However, they must first seek consent from the patient or his/her family. Based on the libertarian view, an action is considered morally acceptable if it serves the patient’s interests or free will and does not contravene the individual’s rights (McCarthy et al., 2010). Active euthanasia, sometimes, serves the interests of the patient and his/her family and does not violate the patient’s rights, especially when requested by the patient. Moreover, the doctor must improve the quality of life of the patient. However, for a terminally ill patient, the quality of life is diminished due to pain and suffering. Given this, the doctors should be allowed to help the patient, at his or her free will, terminate his/her life and end the pain and suffering.

A living will be used in place of informed consent when making end-of-life decisions. As a person’s future care needs are largely unknown, living will help provide instructions about the care that the person would desire during his or her end-of-life stage. A living will empower doctors to decide when active euthanasia (withdrawal of treatments) should be adopted (McCarthy et al., 2010). Moreover, living will specify the type of treatment or intervention that the patient may need at the end-of-life stage. Individuals can specify in their living wills whether they would want measures such as ventilators to be used to prolong their lives. Thus, living will assist in making end-of-life care decisions.

The use of life-support to prolong life raises many ethical issues. Treatments such as CPR, mechanical ventilation, and artificial nutrition and hydration (ANH) help prolong life for patients who have no chance of recovery (GMC, 2010). They hamper natural death by prolonging essential life functions such as breathing. Moreover, a withdrawal of life support often exposes the patient to a painful death.

References

General Medical Council [GMC]. (2010). Treatment and care towards the end of life: Good practice in decision making. London: GMC.

Killmister, S. (2010). Dignity: not such a useless concept. Journal of Medical Ethics36(2): 160-4.

McCarthy, J., Donnelly, M., Dooley, D., Campbell, L. & Smith, D. (2010). Ethical framework for end-of-life care. Dublin: Irish Hospice Foundation.