Most of us agree that suicide devalues life but at the same time most of us also believe there are some universal human rights that should be available to everyone including the right to live with dignity and the freedom to make choices without any unjust interference. This may be why physician-assisted death has emerged as a controversial issue because it forces the society to determine whether life is more important or one’s right to personal dignity and freedom from pain. Physician-assisted death could be defined as assisting terminally ill patients or individuals with life changing disabilities to end their life, either through terminating life-sustaining treatment or through physician prescribed medicine.
The first high-profile case to generate controversy on the issue was Karen Ann Quilan’s case in 1976. Parents of Karen Ann Quinlan, a young woman in her mid-20s, sought and were granted a court to have the right to discontinue all of Karen’s life-sustaining medical interventions so that she could die a natural death. Karen became comatose as a result of ingesting a mixture of drugs and alcohol. The court’s decision has been used as a precedent in subsequent cases in recognizing a patient’s right to refuse medical treatment, terminating treatment in special instances, and determining when and under what conditions medical interventions to sustain life could be terminated (Clark, Lucas, & Stephens, 1994). Another high profile case was that of Terri Schiavo (Christianity Today) whose case was the focus of the whole nation and involved everyone including Christian Rights, the court, and the politicians.
The major stakeholders in this social issue may include the patients facing life-changing disabilities or illness, the guardians of the patients, medical profession, religious organizations, the politicians, and the judiciary. As far as the society is concerned, it seems that public opinion is changing in favor of the physician-assisted death. In a Pew Research Center’s survey, 70 percent of the respondents said that there are circumstances when patients should be allowed to die while only 22 percent argued doctors and nurses should do everything possible to save a patient. In addition, 74 percent said that a family member should be permitted to make the decision whether to continue medical treatment for a terminally ill loved one who is unable to communicate his wishes (Pew Research Center, 2006). As far as the patients are concerned, Dan Crews could be considered a representative of a significant proportion of patients who are in vegetative state. Crews, who has been in vegetative state for twenty years now, argues that he has no quality of life and is never expected to be able to work. He feels guilty on being a financial burden on his family which is quickly running out of financial resources. Even though Crews has a legal right to die, his doctors refuse to grant his permission because they do not deem him mentally competent (Ghose, 2010). The guardians of the patients are often divided on the issue. Karen Ann Quilan’s parents didn’t want Karen to continue living in a vegetative state but Terri Schiavo’s parents wanted to keep Terri alive though lost the battle to her husband.
The medical profession is still hesitant to grant patients’ or their guardians’ wishes unless legal guidance exists. This is because doctors may fear malpractice or criminal lawsuits (China Daily, 2003). In case of religious institutions, a BBC Religion and Ethics feature on euthanasia claimed that Christians are mostly against euthanasia because they believe life is given by God and human beings are made in God’s image. On May 5, 1980, the Sacred Congregation for the Doctrine of the Faith issued an official Declaration on Euthanasia in which performing euthanasia on another or allowing it for oneself was called a violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity (Religion Facts). Thus, it is no surprise that Christian Rights opposed terminating Terri Schiavo’s life-support system. In case of judiciary, Supreme Court set a precedent in the very first high profile case of Karen Ann Quilan that the use of technology to artificially keep a patient alive could be refused by the guardians of the patient if the patient’s quality of life is not expected to change. The politicians have been slowed to introduce and pass bills allowing physician-assisted death in extreme cases though some progress has been made. At least two states, Washington and Oregon, have laws now that allow physician-assisted death in some form. Oregon’s Death with Dignity Act of Oregon was passed in 1994 and went into effect in 1997 (Center for Bioethics, 2005) while Washington State’s Death with Dignity Act was passed in 2008 after 58 percent of the voters in the general election of 2008 voted in favor of it and went into effect on March 5, 2009 (Marczynski, 2011).
As far as recommendations are concerned, first of all any physician-assisted death laws should have multiple verification steps, just like Washington State’s Death with Dignity Act. This means that any proposed bill should at least require the patient to be mentally and emotionally capable of making a decision, the application should be made in multiple steps, more than one doctor should verify the request, and impartial witnesses should be required. Such a multi-stage process will help address the concerns of the critics who argue that patients are not mentally fit to make a decision and that the legal system may be abused if doctor-assisted suicides become legal (China Daily, 2003). Another recommendation is that all states should require a public referendum. The politicians may be hesitant to introduce a bill due to potential political repercussions but a referendum will give the public a chance to express their opinion. The polls already show that public opinion is changing in favor of physician-assisted death under certain extreme circumstances and public referendums may encourage the politicians to proceed with relevant bills in their respective states.
Center for Bioethics. (2005). End of Life Care: An Ethical Overview. University of Minnesota’s Center for Bioethics.
China Daily. (2003, October 27). Euthanasia faces ethical and legal dilemmas. Retrieved January 28, 2012, from http://www.chinadaily.com.cn/en/doc/2003-10/27/content_275728.htm
China Daily. (2003, October 27). Euthanasia faces ethical and legal dilemmas. Retrieved December 12, 2011, from http://www.chinadaily.com.cn/en/doc/2003-10/27/content_275728.htm
Christianity Today. (n.d.). Terri Schiavo. Retrieved January 28, 2012, from http://www.christianitytoday.com/ct/special/terrischiavo.html
Clark, G. D., Lucas, K., & Stephens, L. (1994, June). Ethical dilemmas and decisions concerning. Journal of the American Association of Nurse Anesthetists , pp. 253-256.
Ghose, T. (2010, November 28). Paralyzed accident victim fights for right to die. Retrieved January 28, 2012, from http://www.jsonline.com/features/health/110948384.html
Marczynski, E. (2011, July 7). Death with Dignity Act may face amendment. Retrieved January 28, 2012, from http://westernfrontonline.net/news/13629-death-with-dignity-act-may-face-amendment
Pew Research Center. (2006, January 5). Strong Public Support for Right to Die. Retrieved January 28, 2012, from http://www.people-press.org/2006/01/05/strong-public-support-for-right-to-die/
Religion Facts. (n.d.). Euthanasia and Christianity: Christian Views of Euthanasia and Suicide. Retrieved January 28, 2012, from http://www.religionfacts.com/euthanasia/christianity.htm