Should an incurably-ill patient be able to commit physician-assisted suicide?
Overview/BackgroundFor years, doctors have been prohibited from assisting patients in taking their own lives. Dr. Jack Kevorkian gained world attention by assisting in several suicides to dying patients; he was sentenced to over 60 years for his efforts, despite the gratitude of the patients and their families. Recent laws in Oregon and the U.K. have started a trend of legalization. But some, most notably the U.S. Attorney General's office, are determined to prevent the laws from going through.
- Tremendous pain and suffering of patients can be saved. Numerous ailments such as certain types of cancer result in a slow, agonizing death. Doctors have enough knowledge and experience to know when a patient's days are numbered. What purpose would it serve to suffer endlessly until the body finally gives out? Imagine what it would be like to spend six months vomiting, coughing, enduring pain spasms, losing control of excretory functions, etc. Then you must consider the psychological suffering; i.e. the knowledge that a patient knows he's definitely going to die and the pain is only going to get worse. Wouldn't it be more humane to give the patient the option to say when he's had enough?
- The right to die should be a fundamental freedom of each person. Nowhere in the constitution does it state or imply that the government has the right to keep a person from committing suicide. After all, if the patient and the family agree it's what they want to do, who's business is it anyway? Who else is it going to hurt? In a country that's supposedly free, this should be a fundamental right.
- Patients can die with dignity rather than have the illness reduce them to a shell of their former selves. Dying patients sometimes lose all ability to take care of themselves. Vomit, drool, urine, feces, and other indignities must be attended to by nursing assistants. Alzheimer's patients suffer from progressively worse dementia that causes memory loss and incoherent rambling. Virtually all people want others' last memory of them to be how they once were, not what they ended up being. For example, Ronald Reagan died of Alzheimer's. He and his family would like people to remember the brave man that stared down the Soviets, told Gorbachev to "Tear down this wall", and as the "The Great Communicator", provided historic leadership. Other patients and families have the same wishes for themselves. We should let people die with their dignity, pride, and self-worth intact.
- Health care costs can be reduced, which would save estates and lower insurance premiums. It's no secret that premiums on health care have took a major jump in costs over the last decade. Some workers around the country are going on strike simply to protest the increase in health care costs. We regularly debate how to provide cheaper prescription drugs, care for the uninsured, and fight the skyrocketing costs. Anything we can do to reduce that burden helps. Consider the huge cost of keeping a dying patient alive for several months. You must pay for x-rays, lab tests, drugs, hospital overhead, medical staff salaries, etc. It is not unheard of for medical costs to equal $50,000-100,000 to keep some patients alive. We have to ask ourselves, is this the best way to spend our money when the patient himself would like to die? Wouldn't the money be better spent on the patients that can be saved? You also have to consider the drag on a dying patient's estate. Most people want to be able to leave their children and grandchildren with something when they die. Medical costs eat into that estate. It's totally unreasonable to pour this kind of money into patients that just want to end their suffering. As Medicare, Medicare, and other government programs accelerate the United States towards bankruptcy, anything that causes a decrease in total costs must be a consideration.
- Nurse and doctor time can be freed up to work on savable patients. We face a critical shortage of medical staff in this country, especially nurses. Recent studies have confirmed the obvious--that understaffed hospitals make more mistakes and provide lesser quality care. And things are only going to get worse as the baby boom generation gets older and life spans increase. We have to ask ourselves if attending to dying patients (who want to die immediately) is the best use of medical staff time. Think of how many lives we can save if that nurse & doctor time is freed up. Think of how much the quality of care would increase.
- Prevention of suicide is a violation of religious freedom. A significant part of religious beliefs involves what happens in the afterlife. By preventing suicide, the government is imposing its religious belief that suicide is a sin. No one knows for sure what happens after we die; it should be up to the individual to determine what he or she believes. The government cannot legislate morality.
- Pain and anguish of the patient's family and friends can be lessened, and they can say their final goodbyes. Friends and family of the patient often suffer as much or more pain as the patient himself. It's difficult to see a loved one in such anguish for so long. It's emotional and physically draining to have the stress drawn out for so long. And when the patient does eventually die, it's often sudden or it follows a period when the patient has lost consciousness. Doctor-assisted suicide would give the patient a chance to say his final goodbyes and end his life with dignity.
- Reasonable laws can be constructed which prevent abuse and still protect the value of human life. Opponents of a doctor-assisted suicide law often cite the potential for doctor abuse. However, recent Oregon and UK laws show that you can craft reasonable laws that prevent abuse and still protect the value of human life. For example, you can require the approval of two doctors plus a psychologist (who verifies the patient has the capacity to make the right decision). You can proscribe waiting periods, get the additional sign-off of family members, and limit the procedures to certain illnesses. States should have the rights to pass laws that take into account the values and wishes of the people of that state.
- Vital organs can be saved, allowing doctors to save the lives of others. We have long waiting lists for hearts, kidneys, livers, and other organs that are necessary to save the lives of people who can be saved. Doctor-assisted suicide allows physicians to preserve vital organs that can be donated to others (assuming the patients are organ donors). However, if certain diseases are allowed to run their full course, the organs may weaken or cease to function altogether. Once again, we have to put the needs of the living ahead of the needs of the dying.
- Without physician assistance, people may commit suicide in a messy, horrifying, and traumatic way. A common myth is that teenagers have the highest rate of suicide. However, in actuality, the elderly have by far the highest rate. Older Americans often see nothing ahead of them but loneliness and pain. So if these people are going to commit suicide, which is better--controlled, compassionate doctor-assisted suicide or clumsy attempts like taking sleeping pills, jumping off a building, or firing a bullet into one's head? If you were a family member, which would be more traumatic--saying goodbye to a loved one at the hospital or coming home to see his head and brains splattered against the wall from a bullet? Unfortunately, if people truly want to die, nothing is going to stop them. If that is the case, let's be humane and orderly about it.
- It would violate doctors' Hippocratic oath. Upon receiving a medical degree, each doctor is required to take a Hippocratic oath, which says among other thing, "First, do no harm". Assisting in suicides would be a violation of that oath, and it would lead to a weakening of doctor-patient trust. The oath was created in part so patients could be reassured that doctors only wanted to help them, not hurt them. A weakening of that oath may cause patients to wonder.
- It demeans the value of human life. In this country, human life means something. For each death, we have 1-2 days of ceremonies, elaborate burials, and months of mourning. When 3,000 people died in the 9/11 attacks, donations poured in from all over the country. We donated money, blood, time, prayers, and tears. And we will probably always mourn the annual anniversary of the attacks. In other countries around the world, life isn't so sacred. Wars are fought constantly for disputed territories and old grudges. People celebrate having their sons and daughters blow themselves up and kill scores of civilians. The Saddam regime, Communists, Nazis, and others have shown us that human life is to some, nothing more than a science experiment or political resource. The thing that elevates Western society above others, generally speaking, is the value we put on each and every life. To stomp out a life because it's not convenient or it's expensive demeans that value. Human life is much more that just a cluster of biological cells.
- It could open the floodgates to non-critical patient suicides and other abuses. Any loosening of the assisted-suicide laws could eventually lead to abuses of the privilege. For example, patients who want to die for psychological or emotional reasons could convince doctors to help them end their lives. Attitudes would loosen to the point that certain states may decide that any person can commit suicide at any time. We can't let our values shatter this way.
- Many religions prohibit suicide and the intentional killing of others. The most basic commandment is "Thou shall not kill". Virtually all religions have a law against killing. We need to protect the morality of not only the patients but the doctors that must extinguish their lives.
- Doctors and families may be prompted to give up on recovery much too early. If a patient is told that he has, for example, six months left to live with progressively worse pain, he may decide to end things before things start to get worse. This wipes out valuable time that can be spent with family and friends; it also denies the slim chance of a recovery or the possibility of discovering a doctor error.
- Government and insurance companies may put undue pressure on doctors to avoid heroic measures or recommend the assisted-suicide procedure. Health insurance providers are under tremendous pressure to keep premiums down. To do this, they must cut costs at every turn and make tough decisions. Many doctors are already prevented from give patients certain tests or performing certain operations despite what the doctor believes is truly necessary. Legalizing assisted suicide would likely invite another set of procedures as to when life-sustaining measures should be undertaken. We shouldn't give the insurance companies any more power over human life.
- Miracle cures or recoveries can occur. You can never underestimate the power of the human spirit. A cheerful, never-give-up attitude can often overcome the longest of odds and the worst of illnesses. You also have to consider the constant medical and pharmaceutical advances that just might lead to a miracle recovery. We should never get to a point where we spend more time looking for a way out of life than for a way to sustain life.
- Doctors are given too much power, and can be wrong or unethical. Patients put their faith and trust in the opinions of their doctor. If doctors tell a family there's absolutely no chance for a patient to survive, the family is likely to believe them. This is a problem for two reasons. First of all, doctors make mistakes just like any other people. A wrong diagnosis could lead to the suicide of a savable person. Second, doctors have the ability to play God and decide who they encourage or discourage on the prospects of recovery. For example, imagine a doctor who believes there is too much of a shortage in medical staff & resources to pour extra time & money into elderly people. He may always lean towards the side of "no hope" when the odds are sketchy. Decision-making ability on matters of life and death should stay where it belongs--with God, not doctors.
Related LinksDeath with Dignity Organization
Compassion in Dying Federation
Top 10 Pros and Cons of Doctor Assisted Suicide
Euthanasia Pros and Cons
From a Slippery Slope to an Avalance
Written by: Joe Messerli
Page Last Updated: 01/07/2012