South African Journal of Bioethics and Law, Essay Example

Physician-assisted suicide (PAS) involves the termination of an individual’s life by directly or indirectly administering a lethal substance (Ahlzen, 2020). The physician provides a given patient with life-ending medications upon the patient’s request to end their life. Such a patient could be suffering from incurable medical conditions or painful, terminal illnesses that make them prefer death to life. PAS is also known as voluntary euthanasia because the physician participates in response to the patient’s informed consent. PAS ethics are associated with critical concerns that have intensified debate regarding the controlled environment at the end of a patient’s life for many years. These aspects have generated critical concerns regarding the legalization of PAS, even though public discussion about the issue focuses on the desire for control over the manner of death and timing (Ahlzen, 2020). Concerns have also been raised regarding the potential of harm or abuse of societal prohibitions against assisted suicide or directly causing an individual’s death. The ethical debate on physician-assisted suicide attracts different opinions and arguments from different individuals depending on their understanding of the issue and ethical values. For instance, PAS opponents claim that it’s morally inappropriate and should not be allowed regardless of the situation of each case, as noted by Jacobs & Hendricks (2018). Other opponents assert that PAS undermines the fundamental role of medicine because it contradicts the physicians’ role and healers. On the contrary, proponents assert that PAS is ethically legitimate in exceptional and rare circumstances, but the law and professional codes and standards should not be changed to legalize the practice. This paper will explore multiple factors like chronic and life-threatening diseases, the financial implications of incurable diseases, ineffective medical technologies, family suffering, unnecessary costs and suffering, the right to self-determination, and physician’s moral duty of relieving suffering since they are essential aspects that justify the legalization of PAS.

Chronic and life-threatening illnesses

Patients suffering from chronic and life-threatening illnesses should be allowed to exercise their right to PAS since the treatment provided lacks positive health outcomes (Jacobs & Hendricks, 2018). PAS should be allowed, especially for patients suffering from chronic illnesses like neurological conditions, cancer, and coronary heart diseases, since continued treatment have no medical benefits (Doyal & Doyal, 2001). Moreover, the conditions cannot be cured in all cases regardless of the advancements in modern medicine, which minimizes the patients’ chances of recovery. Terminal illnesses or advanced progress in illnesses like cancer also increase the possibility of death.  Such cases morally justify the clinical warranty of PAS because chronic and life-threatening health conditions are associated with symptom severity that increases the patient’s suffering due to pain and symptoms severity (Doyal & Doyal, 2001). PAS is also clinically warranted in response to life-threatening and chronic diseases because the high number of deaths associated with cancer, diabetes, and heart disease remains high, implying that they have no cure. Chronic illness also remains the main cause of death in America, as Rosenberg et al. (2020) explained. According to Tatalovich (2020), they also increase the country’s health costs since they account for $ 3.8 trillion of its annual budget. These concept s implies that the possibility of dying due to chronic and life-threatening illnesses is high; thus, PAS is clinically warranted. The lack of medical benefit in continued treatment is also an instrumental factor that justifies why PAS should be allowed because modern science cannot be applied in treating chronic conditions; hence it’s morally right to assist the patients in ending their life. The practice also exempts the patients from continued suffering due to pain and symptom severity since the available treatment interventions cannot assist them efficiently (Reed, 2021).

Moreover, the patient’s consent is a key aspect considered by physicians while engaging in PAS. It implies that the physician should respond to the patient’s request to end their life if they are suffering from incurable diseases since they are associated with pain, symptoms severity, and low quality of life (Rosenberg et al., 2020). In this regard, PAS should be allowed because the patients have a right to be exempted from pain and suffering upon their request.

Financial implications of incurable illnesses

Physician-assisted suicide should be allowed to protect the patient’s family from the burdensome financial implications of treating chronic health conditions like cancer. Individuals who hail from low-income families could be willing to protect their loved ones from huge hospital bills associated with chronic illness; hence PAS should be allowed to facilitate such objectives, as explained by Braswell (2018). They could also seek PAS to save their families from huge medical expenses, especially if they know that their health conditions have no cure. For instance, the financial implications of chronic conditions like cancer could force a patient or their family to part with $12 000 annually, which implies that cancer treatment costs remain high (Rosenberg et al., 2020). The hard economic times also imply that the households cannot afford the required cancer treatment costs because the median weekly income for salaried employees in the United States was $900 in 2018 (Tatalovich, 2020).

The average monthly cost for a chemotherapy session is $12,000, which implies that cancer patients have to part with $48,000 if they require four chemotherapy sessions per year (Rosenberg et al., 2020). Cancer patients also part with $ 10,000 for a cancer drug per month in the United States. The costs represent 70% of the households’ average monthly income. According to Tatalovich (2020), terminally ill individuals retain their right to PAS if they cannot afford treatment costs. Moreover, most chronic conditions are incurable; hence the patient and their families pay high costs with no medical benefits because the patient eventually dies. In this regard, PAS should be allowed because it’s morally right for patients to avoid leaving huge economic burdens on their families when they die. Tatalovich (2020) explained that cancer-related deaths are also 20% higher among patients from poor counties in the United States, while most individuals in such places cannot afford the treatment costs. This aspect implies that chronic health conditions attract high treatment costs that could be challenging to most patients; thus, PAS should be allowed (Braswell, 2018).

Ineffective medical technologies

Physician-assisted suicide should also be recognized as morally and legally acceptable in situations where the patient is suffering from chronic health conditions that cannot be addressed through the available medical technologies. Modern medical technologies play a significant role in prolonging the patient’s life because respirators support an individual’s failing lungs while medications sustain their physiological processes (Reed, 2021). However, such technologies only prolong the patients’ suffering due to terminal illnesses; hence they are ineffective in guaranteeing their full recovery. Even though medications are meant to minimize the patient’s suffering, they subject terminally ill individuals to more agony and pain. According to Braswell (2018), PAS would be appropriate for such patients because it would prevent them from prolonged pain and suffering.

Medical technologies do not guarantee that they will recover from their illnesses which justifies why it’s morally right to assist them in ending their lives rather than subjecting them to prolonged suffering without the hope of recovery or treatment. According to Reed (2021), PAS should be allowed because terminally ill patients have a right to end their lives. After all, it’s morally right to end suffering and pain associated with incurable health conditions. Physicians also act in the best interests of terminally ill patients when they participate in PAS; hence it’s a moral practice that should be allowed when the available medical technologies are ineffective in addressing the problem (Jacobs, 2018).

Family suffering

Physician-assisted suicide should also be allowed to prevent a patient’s family from the emotional and psychological impacts of their loved ones’ physical suffering. Even though the available medical technologies could be ineffective in addressing a patient’s suffering, it also attracts a high price because drugs are costly (Doyal & Doyal, 2001). In this case, the patient’s family suffers from economic hardships that subject them to psychological torture because they have to address their loved one’s healthcare needs. The patient’s physical suffering could also be unbearable to their family members, causing emotional distress. Furthermore, a competent dying patient is sometimes aware of their emotional and psychological impacts on their family members, especially if their health conditions attract huge treatment costs. Human life is also expensive, implying that only a handful of families can afford to prolong terminally ill members’ lives, as noted by Braswell (2018). Such families struggle with huge hospital bills when their loved ones die, even though they may fail to recognize the cots when their loved ones are still alive. In this regard, PAS should be allowed to prevent the patient’s family from high hospital bills and the emotional and psychological impacts of an individual’s suffering explained by Rosenberg et al. (2020). Patients also have the right to assisted suicide if they feel that treatment costs would have devastating impacts on their families financial well-being when they die. Additionally, it’s morally acceptable to grant a peaceful death to terminally ill patients because it prevents huge hospital bills incurred without the hope of a positive health outcome (Reed, 2021).

Unnecessary costs and suffering

PAS also enable the patients to endure the end of their life without unnecessary costs and suffering. Terminally ill patients are usually at the final stages of symptoms severity that may lower their dignity while dying since they may require more assistance from family members and care providers to conduct basic life activities like bathing, eating, or walking (Tatalovich, 2020). The situation may lower their dignity among various family members if they feel that the patient is too demanding or becoming a liability. The family members’ attitude towards the patient could also change due to unnecessary costs and suffering facilitated by an individual’s illness. PAS ensures that the patient passes away with dignity; hence the authorities should legalize it since it’s a human right that should be protected, as explained by Braswell (2018).  Moreover, ensuring that patients die with dignity is an ethical value that should be promoted by respecting the patient’s right to PAS, as noted by Braswell (2018).

The right to self-determination

Physician-assisted suicide should also be allowed because the patient has a right to self-determination since they can accept or refuse treatment. The right to self-determination also applies even when refusing treatment would lead to a patient’s death (McCormick, 2011). An individual’s right to self-determination implies that they have a right to PAS because it provides them with the opportunity of ending their suffering due to chronic health conditions (Jacobs & Hendricks, 2018). They also have the right to request their desired treatment even if it would lead to their deaths which shows that PAS should be allowed because it preserves the patient’s right to self-determination. An individual’s right to assisted suicide is also inherent and cannot be granted by other people, as noted by McCormick (2011).  Physician-assisted suicide should also be allowed because it allows patients to be masters of their destinies. The right to PAS is also liberty that should be upheld because it enables them to pursue their happiness and interests (Jacobs & Hendricks, 2018).

According to McCormick (2011), the right to PAS protects individuals from prolonged suffering and pain associated with terminal illnesses. Physician-assisted suicide should therefore be legalized since individuals have an inherent right to PAS, as noted by Doyal & Doyal (2001). PAS also enables a patient to only end their life which is morally right because it belongs to them. It should be allowed because an individual’s right to assisted suicide serves as their final chance of exercising autonomy since they are regarded as human beings making the last choice in their lives rather than individuals waiting to die (Ahlzen, 2020). PAS should be allowed because it protects an individual’s right to decide for themselves. The practice is instrumental in promoting the patients’ psychological well-being because they control and make choices regarding when and how they should end their lives (Tatalovich, 2020).

Physician’s moral duty of relieving suffering

PAS should also be allowed because physicians have a moral duty of relieving their patients’ pain and suffering. The moral duty implies that they should preserve the patient’s right to assisted suicide if it’s the only way to eliminate the suffering. The practice is morally justified because physicians act in the best interests of their patients, which legally justifies the practice (Reed, 2021). Moreover, assisting competent terminally ill patients in ending their lives is morally acceptable because it enables a physician to provide the required medical expertise on how they can end their lives without pain, as noted by Jacobs (2018). PAS is also a moral practice among terminally ill patients if they suffer from incurable diseases because it protects the family from financial burdens that may affect their financial capabilities when their loved ones pass away (Ahlzen, 2020). For instance, it’s morally right to protect a patient’s family from huge hospital bills and the psychological impacts of witnessing the physical suffering of their loved one. Jacobs & Hendricks (2018) explained that PAS is morally right if death preserves the interests of various patients on life-prolonging treatment. It shows that PAS should be allowed because it protects the physician’s moral duty of relieving the patient’s suffering if they are suffering from an incurable illness (Lapierre et al., 2018).

Physicians also play an instrumental role in PAS because they assist the patients with the required expertise on the right timing and dosage, which is morally acceptable. Physician-assisted suicide involves critical drug administration of the right dosage at the right time, which implies that failed attempts can cause greater trauma than death on the patient (Lapierre et al., 2018). In this case, the physician’s expertise is essential in preventing the trauma; hence their direct professional involvement is morally acceptable since it guarantees successful assisted suicides. Their involvement also prevents the patient from more suffering associated with failed suicide attempts which prevent more harm. Additionally, ending a patient’s life at their request does not violate medical ethics and goals (Jacobs & Hendricks, 2018).

PAS is also an essential practice that provides physicians with an opportunity of exercising compassion towards their terminally ill patients (Jacobs & Hendricks, 2018). Compassion is also a moral obligation that physicians should uphold while addressing the diverse needs of the patients. Compassion enables physicians to address their moral duty of relieving suffering through support, kindness and caring since it provides them with the ability to understand their patients’ suffering and take appropriate actions. The numerous benefits of compassion like reduced stress, increased social connectedness, happiness, and reduced psychopathology play an instrumental role in improving the patient’s psychological well-being (Jacobs, 2018). Moreover, the benefits justify why PAS should be allowed because it’s a compassionate act that alleviates the patient’s prolonged pain and suffering. It also enables the physician to develop the will to do what is morally right to alleviate the patient’s suffering and connect socially with the patient’s family. Jacobs (2018) explained that PAS should be allowed because it enables physicians to respect and protect the specialty of human life, which ensures that they continue finding better solutions to terminal illnesses. For instance, the prolonged suffering caused by cancer has resulted in extensive research on minimizing the severity of the symptoms.

Conclusion

PAS should be recognized as a moral and legal practice since its effective in situations where the patient suffers from life-threatening health conditions like neurological conditions, cancer, and coronary heart diseases since continued treatment has no medical benefits because continued treatment lacks medical benefits. PAS also protects the patient’s family from the burdensome financial implications of treating incurable health conditions like cancer. It should also be recognized as morally and legally acceptable in situations where the patient is suffering from chronic health conditions that cannot be addressed through the available medical technologies. Such technologies only prolong the patients’ suffering rather than facilitating recovery from terminal illnesses; hence they are ineffective in guaranteeing their full recovery. PAS prevents a patient’s family from emotional and psychological impacts associated with their loved one’s physical suffering. The right to PAS also preserves the patients’ self-determination because it enables them to refuse or accept the available treatment interventions. PAS should also be allowed because the physician’s primary objective involves relieving suffering and pain on their patients. However, effective measures should be adopted to prevent the detrimental impacts of physician-assisted suicide misuse.

References

Ahlzen, R. (2020). Suffering, authenticity, and physician-assisted suicide. Medicine, Health Care, and Philosophy, 23(3), 353-359. https://doi.org/10.1007/s11019-019-09929-z

Braswell, H. (2018). Putting the “Right to Die” in Its Place: Disability Rights and Physician-Assisted Suicide in the Context of US End-of-Life Care. In Studies in Law, Politics, and Society. Emerald Publishing Limited. https://doi.org/10.1108/S1059-433720180000076005

Doyal, L., & Doyal, L. (2001). Why active euthanasia and physician-assisted suicide should be legalized. BMJ (Clinical research ed.), 323(7321), 1079–1080. https://doi.org/10.1136/bmj.323.7321.1079

Jacobs, R. K. (2018). Legalizing physician-assisted suicide in South Africa: Should it even be considered?. South African Journal of Bioethics and Law, 11(2), 66-69. DOI: 10.7196/SAJBL.2018.v11i2.635

Jacobs, R. K., & Hendricks, M. (2018). Medical students’ perspectives on euthanasia and physician-assisted suicide and their views on legalizing these practices in South Africa. South African Medical Journal, 108(6), 484-489. DOI: 10.7196/SAMJ.2019.v109i3.13816

Lapierre, S., Castelli Dransart, D. A., St-Amant, K., Dubuc, G., Houle, M., Lacerte, M. M., & Maggiori, C. (2018). Religiosity and the wish of older adults for physician-assisted suicide. Religions, 9(3), 66. https://doi.org/10.3390/rel9030066

McCormick A. J. (2011). Self-determination, the right to die, and culture: a literature review. Social work, 56(2), 119–128. https://doi.org/10.1093/sw/56.2.119

Reed, P. A. (2021). Physicians assisted suicide and Christian virtues. Christian bioethics: Non-Ecumenical Studies in Medical Morality, 27(1), 50-68. https://doi.org/10.1093/cb/cbaa021

Rosenberg, L. J., Butler, J. M., Caprio, A. J., Rhodes, R. L., Braun, U. K., Vitale, C. A., … & Farrell, T. W. (2020). Results From a Survey of American Geriatrics Society Members’ Views on Physician?Assisted Suicide. Journal of the American Geriatrics Society, 68(1), 23-30. https://doi.org/10.1111/jgs.16245

Tatalovich, R. (2020). Morality politics of physician-assisted suicide: Comparing Canada and the United States. International Journal of Canadian Studies, 57, 71-91. https://doi.org/10.3138/ijcs.57.x.71