Taking Sides on Physician-assisted Suicide

Human life is regarded so highly that terminating such a life, whether within or outside the law, attracts a great and emotive diversity of ideas. A wide variety of conditions including disease, depression, injuries, hopelessness, fear lead thousands of people to commit suicide every year across the world. While some of these people terminate their lives on their own employing such tactics as wrist-slashing, drug overdose, hanging, shooting or throwing themselves at fast-coming vehicles, other seek the assistance of physicians to terminate their lives. While physicians are duty-bound to accord their patients as much help as possible, they are bound by oath not to kill the patients. Physician-assisted suicide is therefore a very controversial issue which attracts as much support as it attracts opposition. This paper compares and contrasts the views of supporters and opponents to physician-assisted suicide.

Common ideas
The authors Richard Doerflinger, and David Watts  Timothy Howell agree that legalizing physician-assisted suicide or loosening the stringent measures which prohibit or govern the practice would make it easier for people to abuse the provision. Cases of patients suffering from terminal illnesses, and whose practical chances of recovery are negligible, deserve serious consideration when they request for professional assistance to terminate their lives. However, many people seek assistance to die out of fear, pain, ambivalence, or depression (pg 325). In other words, patients can take advantage of lenient rules governing physician-assisted suicide even when they are suffering only from treatable conditions. For instance, old people whose age renders them dependent on others may find in physician-assisted suicide a way of eliminating their interference with their childrens or caregivers lives. Rich but old parents whose children are eager to inherit wealth, the unhealthy and impoverished would be more vulnerable to pressure from their families to seek assistance to terminate their lives, even though they suffer from no degenerative or irreversible health conditions.

The scholars further point to the likelihood of health institutions, physicians, patients and their families employing physician-assisted suicide as a technique of keeping health-care costs down. Palliative care for the terminally ill can be quite expensive. Family members, governments and insurance companies have the responsibility of meeting these heavy costs even in instances where there is little possibility of the patients recovering from the diseases. There is therefore the concern that family members and public officials can find the incentive to press patients to request for assistance to terminate their lives as a cost-cutting measure. This would thus result in the termination of more lives than necessary and might leading to underinvestment in health-care.

According to Doerflinger, the right to life is fundamental and suicide is not the ultimate exercise of freedom but its ultimate self-contradiction (pg 317). Suicide, whether assisted or otherwise, is an assault on the right to life. However, society has changed from the family-oriented family of the 19th century to the modern achievement-oriented society which views old and sickly family members as a bother. Doerflinger argues that members of this younger generation are more likely to suggest physician-assisted suicide to their sick parents. By making it clear that they are not interested in the continued living of their older dependents, the younger family can narrow the patients range of choices, leaving suicide as the best way out of their suffering. The patients are therefore under intense pressure to request for assistance to terminate their lives. But according to Watts  Howell, in physician-assisted suicide unlike euthanasia, the patient has the absolute power to make the choice of action. Restricting the physicians role in the suicide to offering the assistance requested by the patient provides that the patient or those responsible for making decisions on their behalf are free from pressure from physicians or other family members. Watts  Howell therefore argue that there is little likelihood of people abusing physician-assisted suicide to influence others to request assistance to die. Watts  Howell therefore do not see the likelihood of abuse of physician-assisted suicide to get rid of old and sickly patients under pressure from their younger family members.

The role of physicians and the impact on physicians of assisting patients to end their lives also marks a point of difference between the writers. Doerflinger argues that no member of society has the power to end anothers life, whether legally or illegally. Killing people is a taboo and rules around it should not be brought down. Physicians are bound by duty and oath to take good care of patients, not to end their lives. When a physician assists a patient to commit suicide, the taboo is assaulted and there is nothing to stop that physician from killing yet more patients. Physicians who have not done it before are likely to be more unwilling to assist in suicide but once they have participated in one such process, they are more likely to assist in more suicides. Watts  Howell, on the other hand, argue that the moral integrity of the medical profession should not be maintained at the expense of the patients welfare. Physicians struggle to palliate the symptoms of patients suffering from debilitating and degenerative even when the patients condition is irreversible and unstoppable. The long suffering and indignity which such patients go through as physicians fight to keep them alive renders the physicians effort to keep the patient alive inhumane and not acceptable (pg 326) Rather than promote the level of the patients trust in the physician, the prolonged, unnecessary suffering erodes trust in the physician, as the physicians most important goal should be the comfort of the patient (pg 326). When the patients condition is known to be incurable, the physician should be assisted to end the suffering. Offering this assistance neither erodes patients trust in physicians nor makes physicians more likely to assist more patients to commit suicide. Allowing physician to take part in suicides deemed necessary only strengthens the physicians respect for the principle of caring. Patients who are in pain must not be made to pay the price of maintaining the moral integrity of the medical profession.

Logical appraisal
Watts  Howell make the more logical argument of the authors. Watts  Howell begin by making a clear distinction between two often-confused and related issues assisted suicide and voluntary active euthanasia. While they are both done to terminate the lives of patients, the role of the physician and the physicians level of participation in the process vary. Physician-assisted suicide places the decision of whether to terminate their lives or not entirely on the patients or those making decisions of their behalf. While Watts  Howell maintain a clear line between euthanasia and physician-assisted suicide, Doerflingers arguments treat the two as the same.

Although the central idea of their argument is that physician-assisted suicide is not wrong, Watts  Howell balance their argument by giving ample attention to the widespread opposition to their stand. For instance, they accept that allowing more space for physician-assisted suicide is likely to create some room for abuse. There should therefore be some legal and moral controls to minimize chances of abuse. By reasoning with their opponents and then arguing their point, Watts  Howell address many of the fears which drive most people to oppose physician-assisted suicide, sometimes out of ignorance and fear of the unknown.


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