Wolfgramm 1

Autumn Wolfgramm
Dr. Pfeiffer
English 1010
25 May 2016
Should Physician assisted suicide be legalized?
A day in the life of a terminally ill patient is often described as being excruciatingly
painful. Days often drag on and are very exhausting; simple tasks such as, walking and eating
have now become difficult and pose as a challenge. It seems as though the illness has completely
taken over their lives preventing them from doing the things they love to do. Because of the
impairing circumstances in which terminally ill patients deal with on a day to day basis their
quality of life is comprised and is no longer the same. In some of these patients perspective, the
only way out of the pain is to end their own life, because life itself seems worse than the thought
of death. However, rather than committing suicide on their own, many have sought out help from
their health care professionals to end their life in a more civil manner, through the meansof
Physician assisted suicide .
Physician assisted suicide, can be better described in terms of euthanasia, since Physician
assisted suicide is a form of euthanasia. Euthanasia is defined as intentionally causing the death
of a person, the motive being to benefit that person or protect him/her from further suffering.
There are different types and forms of euthanasia. Euthanasia can be divided into two categories
that define the character of the patients consent, which are: voluntary and involuntary. Voluntary
is when the patient is competent and gives consent, involuntary is when a competent patient
refuses euthanasia but it occurs anyway. Within these two categories, euthanasia can be further
specified as passive or active. Passive is sometimes poetically referred to as "letting nature take
its course." Essentially it involves discontinuing or not providing treatments that would be

Wolfgramm 1

reasonably effective in preventing the patient's death. Whereas, active refers to when the act of
euthanasia is the direct cause of the suffering patients death. In respect to Physician assisted
suicide, it is categorized as active voluntary euthanasia. This is true because the patient gives
consent to their physician and desires a direct cause of death to end their life. An example of this
is when an ill patient requests lethal medication from their doctor, with the intention of ending
their life.
The topic of physician assisted suicide is an ethical issue because to some it can be seen
as murder, since the physicians are administering fatal drugs that will end their patients' lives, as
well as many other reasons. However, at the same time it is important to ask whether or not the
physician can deny a patient's request about their patients' treatment plan. Especially if there are
no options of a better treatment or a cure? Should the physician comply with the patients request
to end their suffering? Or deny it, and have the patient continue to suffer?
The topic of physician assisted suicide is a very highly debated topic amongst the medical
field. Recently a survey was conducted and found that 57% of physicians practicing today have
received a request for physician assisted suicide in some form or another (Back et al). In many
surveys there is a small margin between physicians who agree that Physician assisted suicide is
acceptable and physicians that disagree with Physician assisted suicide. With almost half of
physicians agreeing that Physician assisted suicide should be legalized and half that contradict
this.
Who exactly does this issue affect and what are the terminal illnesses that are affecting
individuals to desire physician assisted suicide? Some of these illness are cancer, multiple
sclerosis, ALS as well as manyothers which are listed and depicted in the figure.

Wolfgramm 1

This issue particularly affects the community, state and country in which I live in because
physician assisted suicide is currently illegal. It however is legal in five states: California,
Montana, Vermont, Oregon and Washington, and in four countries: Switzerland, Belgium,
Netherlands and Luxembourg. Leaving the majority of the world as having physician assisted as
illegal. Affecting many individuals whose suffer through impairing medical conditions that wish
to end their life civilly but are not able to because of their location of residence.
On one side, that argues for physician-assisted to be legalized, many pose the argument
that these patients will no longer be suffering in pain. In places where physician assisted suicide
is illegal there are terminally ill patients who are writing their stories of why they want this to be
legalized. One reason being that their suffering and pain will finally come to an end. In the
United Kingdom there is a campaign known as, 'Dignity in Dying' that has been initiated to bring
awareness of physician assisted suicide. This campaign shares stories of many people who are
struggling with their illnesses and want to have Physician assisted suicide be an option for them.
Brian Swallow from South West London explains his situation of dealing with a very aggressive
prostate cancer that is spreading all over his body and how little pain relieving drugs do for him.
"[he has] several drugs to help [him] in this situation but of course this is palliative as the
cancer is in the blood and the bone marrow and cannot be cured. Eventually these drugs too will
lose effect, [he] just hope[s] that it wont involve too much pain"
This is just one of the many stories shared in this campaign pushing to legalize physician assisted
suicide.
Another reason as to why a patient requests to end their life aside from the fact because
quality of life is minimized and there is no better treatment or cure to help; or there is not a better

Wolfgramm 1

solution of treatment and they have no one around that would be able to take of them. Imagine
being told that you have an illness with no cure or solution and that furthering living life would
be a very painstaking pathway but on top of this you would have no one to take care of you. Not
only would you be suffering through a painful illness but you would have to do it alone with no
one to help care for you. For some this is unfortunately the case and because of this they desire
Physician assisted suicide.
In addition, the point that these suffering individuals will be able to physician assisted
suicide will have the ability to say goodbye to their families in their own time. With many
families who have a family member struggling with a terminal illness every day and every next
moment is not guaranteed that there loved one will be with them. Not knowing when your loved
one will pass that is suffering through a severe illness can put a lot of stress on an individual. But
through Physician assisted suicide they would be better able to know at which moment their
loved one will pass from them, allowing them to peacefully pass away.
There is also a very pro-choice side to this ethical dilemma in concerns with the patients
suffering. Many of these individuals suffering with terminal illness feel that they have the right
to be able to end their life. This is their health care and therefore they should have the choice to
end their life with the assistance of their physician. Physician assisted suicide is a theoretical and
possible option although illegal but it should be provided to them.
At the same time however there are those who disagree with physician assisted suicide.
They argue that physician assisted suicide is morally wrong because it is seen as murder to them.
The physician is literally giving lethal medications to kill their patient. Which is contrary to the
Hippocratic Oath that states that they will protect and safeguard human life. If physicians were to
perform Physician assisted suicide they would be violating this oath.

Wolfgramm 1

Not only this many faith groups within Christian, Muslim, Jewish and other religions but
many religions see suicide as a sin, physician assisted suicide included. The act of killing ones
self despite the measure of themselves or their physician is seen as a sin because it is going
against their Gods will. Through Physician assisted suicide, doctors would be playing God by
having the ability to end ones life at a given time. This is seen illy in the sight of these religious
worshippers because they sincerely believe that God gives life and therefore only God should
take it away. Suicide would then be "considered as a rejection of God's sovereignty and loving
plan.
The family of the person would also be losing their loved one very early. While enduring
a terminal illness can be very difficult and unpredictable in determining whether they are going
to be there the next moment. Because there is no guarantee of tomorrow or the next moment,
they might as well enjoy the moments they do get to have instead of ending their life at their
digression. There is a lot of uncertainty, while you may be struggling with a disease with no cure,
you could be the one to be able to combat it but going through with Physician assisted suicide
youd never be able to find that out. So, while it may be nice to be able to gather all your loved
ones together and physician assisted suicide s away at a desired time, it may be too early for your
family.
Many also question whether or not patients who request physician assisted suicide are
even mentally sane to make a decision like this. Having to endure such a physically exhausting
disease can often take its tolls on the mind too. Thus, many have asked whether or not these
patients suffering through their illness, would be in the proper mind state to make such a decision
to end their life through the means of physician assisted suicide.

Wolfgramm 1

Physician assisted suicide not only affects the patient themselves and their families and
loved ones but it also effects the physician. In countries and states where physician assisted
suicide is legal it is interesting to note that some of these physicians have reported feeling
emotional and psychological distress after assisting their patients with their death. Many
physicians who had practiced euthanasia mentioned that they would be most reluctant to do so
again." (Stevens 2006)
If physician assisted suicide were to be legalized throughout the nation I feel to satisfy all
the points brought there should be certain requirements and standards these patients must meet in
order to go through with this. That is that first and foremost they must find a physician is who is
willing to do this. If their own physician refuses to do so, then the patients must go and find a
physician who is willing. Once having done so, they must go through an extensive psychological
and mental exam to ensure they are mentally sane and realize what this decision fully entails.
Once this is completed their family, loved ones and any other beneficiaries of the patient should
also have input in this decision as well. After reviewing their medical condition and outlook of
their future as well as the mentioned requirements a committee should review all these material
and future make a decision if physician assisted suicide should be performed or not. I feel that
this method could be a possible solution to legalization of physician assisted suicide.
In conclusion, after analyzing the ethical dimension of physician assisted suicide, I feel
that physician assisted suicide should be legalized to provide an option for terminally ill patients.
Legalizing this to give this as an option would be similar to having a patient sign a DNR form. I
still feel that physicians would have to take the extra precautions mentioned above. Having this
be legal would just mean that these patients would be able to have lethal medications prescribed
to them and be able to administer it to them at their own digression. This way the physicians will

Wolfgramm 1

not be too involved and the patients family will be able to make the decision of timing if they
want to follow through it. Meaning that the lethal medications would be available to them but
they will not have to follow through if they do not want to, to try and satisfy everyones needs.

Wolfgramm 1

Annotated Bibliography
Andre, Claire, and Manuel Velasquez. "Assisted Suicide: A Right or a Wrong?" - Resources.
N.p., Oct.-Nov. 1987. Web. 24 Apr. 2016. <https://www.scu.edu/ethics/focusareas/
bioethics/resources/assisted-suicide-a-right-or-a-wrong/>.
If assisted suicide is allowed on the basis of mercy or compassion, what will keep
us from "assisting in" and perhaps actively urging, the death of anyone whose life we deem
worthless or undesirable? Will keeping the inconvenienced relatives of a patient from persuading
him or her to "voluntarily" ask for death? What will become of people who, once having signed a
request to die, later change their minds, but, because of their conditions, are unable to make their
wishes known? And, once we accept that only life of a certain quality is worth living, where will
we stop? When we devalue one life, we devalue all lives. This source was also used as a point of
argument and perspective for those who oppose legalizing PAS.
Physician-Assisted Suicide: The Legal Slippery Slope." Medscape Log In. N.p., 1 Aug. 2001.
Web. 26 Apr. 2016. <http://www.medscape.com/viewarticle/409026_2>.
However, in voluntary euthanasia, the physician alone is the cause of the patient's
death, whereas in PAS, the patient and the physician work together to bring about death, with the
patient taking the final action to end life. For example, a physician performs euthanasia when he
or she deliberately injects a lethal amount of potassium chloride into a patient for the express
purpose of terminating the patient's life. Euthanasia is an act whereby a physician intentionally
causes the death of a terminally ill patient. Patients who request euthanasia are asking that their
life be taken by a physician before the disease causes their death. When euthanasia is performed
absent patient choice, such as may be the case with incapacitated patients, it is called nonvoluntary euthanasia. The most common example is that of a physician giving a patient a
prescription for a lethal amount of medication that the patient later ingests to bring about death.
This source was used to explain and describe PAS in relation to euthanasia to better understand
the concept of PAS.
Cauthen, Kenneth Physician-Assisted Suicide and Euthanasia Web. 15 Jan. 2016.
<http://www.frontiernet.net/~kenc/asuici.htm>.
Cauthen explores legalizing physician assisted suicide and what it could do for
many individuals lives. He presents arguments against legalizing PAS, such as conflicting
religious views on the issue, how it violates the Hippocratic oath that physicians swear in by, as
well as other contradicting arguments against the issue. This source provides strong arguments
against physician assisted suicide which I could use as counter arguments, other perspectives on
the issue in my paper. Cauthen also describes possible scenarios of what could theoretically
occur if PAS were to be legalized, while also providing possible solutions to the hypothetical
problems of legalization of PAS. I could use his solutions and create other possible solutions to
legalizing PAS.

Wolfgramm 1

Braddock, Clarance H., MD, and Mark R. Tonelli, MD. "Physician Aid-in-Dying." : Ethical
Topic in Medicine. Helene Starks, PhD, MPH, Denise Dudzinski, PhD, MTS and
Nicole
White, MD, MA, 18 Feb. 2016. Web. 30 Apr. 2016. <http://depts.washington.edu/
bioethx/topics/pad.html>.
What are the attending physicians duties and responsibilities under the
Washington Death with Dignity Act? Confirm the following eligibility criteria: Washington State
resident Age 18 and older Competent (able to make and communicate an informed decision to
health care providers) Terminally ill (incurable, irreversible disease expected to cause death
within six months, as determined by the attending physician and a consulting physician) Able to
voluntarily express his or her wish to die Assure that it is an informed decision, which means the
patient has an appreciation of the relevant facts, after being fully informed about the following:
Medical diagnosis Prognosis Potential risks associated with taking the prescribed medication
Probable result of taking the prescribed medication Feasible alternatives including, but not
limited to, comfort care, hospice care, and pain control Evaluate the patient's request: Assess
reasons, Explore and recommend alternatives (palliative care, hospice, pain/symptom
management, psychosocial and/or spiritual counseling, palliative sedation). This source was used
as reference for a possible comprise and solution if PAS were legalized.

Texas Right to Life. "Why Assisted Suicide Should Not Be Legalized." Texas Right to Life.
N.p.,22 July 2010. Web. 06 May 2016. <https://www.texasrighttolife.com/why-assistedsuicide-should-not-be-legalized/>.
If suicide and physician-assisted suicide become legal rights, the presumption that
people attempting suicide are deranged and in need of psychological help, borne out by many
studies and years of experience, would be reversed. If society creates a "Right to suicide" and
legalizes "Physician-assisted suicide," the message perceived by a suicide attempter is not likely
to be, "We respect your wishes," but rather, "We don't care if you live or die; your life does not
matter. Often, suicide attempters are apparently seeking to establish some means of
communication with significant people in their lives or to test the affection of their loved ones.
Psychologists have concluded that other motives for attempting suicide include retaliatory
abandonment, aggression turned inward, a search for control, manipulative guilt, punishment,
escapism, frustration, or an attempt to influence someone else. Communication of these feelingsrather than death-is the true aim of the suicide attempter, which explains why, paradoxically but
truthfully, many admit after an obvious attempt that they really did not want to kill themselves.
This resources was used as a counterargument for legalization of PAS.

"Should Euthanasia or Physician-assisted Suicide Be Legal?" Should Euthanasia or Physicianassisted Suicide Be Legal? N.p., n.d. Web. Oct.-Nov. 2015.

Wolfgramm 1

<http://www.debate.org/
be-legal>.

opinions/should-euthanasia-or-physician-assisted-suicide-

This resource was an online debate where various peoples of differing

backgrounds and cultures could submit their opinion on the legalization of PAS for a survey. The
vast majority of the individuals surveyed felt that PAS should be legalized. While a very small
percentage of them disagreed with PAS being legalized. Some of the reasoning of the individuals
who agreed with legalizing PAS were that it would end unbearable suffering and that this choice
should be left up to those suffering through a terminal illness. While those who did not agree feel
that it murder and is morally wrong.
"The New England Journal of Medicine." New England Journal of Medicine N Engl J Med
198.1 (1928): 50. Web. 9 May 2016.
In this Medical Journal there was an article about Physician-Assisted Suicide.
This article had specific case studies and personal stories of people suffering through a terminal
illness and there desire to have PAS as an option because in New England PAS is illegal. This
source was used to describe what patients who do not have PAS as a legal option feel like.

"Frequently Asked Questions." Patients Rights Council. N.p., n.d. Web. Feb. 2016.
<http://www.patientsrightscouncil.org/site/frequently-asked-questions/>.
This resource was used heavily as the information was very pertinent and useful.
This source answered the most frequently asked questions about PAS and what it entails. It
answered questions such as, where it is legal, if it is legal what does that mean/the process in
which one goes through, difference between euthanasia and assisted suicide and things of that
matter.
"Personal Stories (Assisted Suicide)." Wisconsin Right to Life. N.p., n.d. Web. Nov.-Dec.
2015. <http://wrtl.org/assisted-suicide/personal-stories-assisted-suicide/>.
This was a blog and compilation of stories of individuals who had access to PAS
in places of the United States where it was legal. Their stories were written before they passed
away and gave insight as to why many terminally ill patients desire legalization of PAS. A
common thread between all these stories is that, they all desperately wanted an outlet to end the
pain, and PAS seemed like the only legitimate way to end it.
DuBose, Edwin R. Physician Assisted Suicide: Religious and Public Policy Perspectives.
Chicago, IL: Park Ridge Center for the Study of Health, Faith, and Ethics, 1999. Print.
This source was used heavily throughout the whole paper, gave a lot of insight as
to why religious people see PAS as a negative thing and feel that it should remain illegal. Also
explained the legal perspective side and what this would do to the public if it were legalized.

Wolfgramm 1

Presented both pros and cons to legalizing PAS but in the end concluded that PAS should remain
illegal.