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Kelsie Bettridge Collin Hull English 2010 7 October 2013 Death with Dignity Imagine you have been diagnosed with a disease that limits your life down to a matter of months. Every day you live a life of hopelessness and misery. You receive medicine but it doesnt take away the pain and you feel yourself getting weaker day by day. You slowly lose you who used to be as you are being conquered by your illness. Lying in our hospitals today are people who are in this situation, who are afflicted with excruciatingly painful and terminal conditions and diseases that have left them permanently incapable of functioning in any dignified human fashion. They can only look forward to lives filled with yet more suffering, degradation, and deterioration. Many of these patients with terminal illness seek for a way to be put out of their misery. When such people beg for a merciful end to their pain and indignity, it is cruel and inhumane to refuse their pleas. Compassion demands that we comply and cooperate. But what options do we have?

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Rapid and dramatic developments in medicine and technology have given us the power to save more lives than was ever possible in the past. Medicine has put at our disposal the means to cure or to reduce the suffering of people afflicted with diseases that were once fatal or painful. At the same time, however, medical technology has given us the power to sustain the lives (or, some would say, prolong the deaths) of patients whose physical and mental capabilities cannot be restored, whose degenerating conditions cannot be reversed, and whose pain cannot be eliminated. As medicine struggles to pull more and more people away from the edge of death, the plea that tortured, deteriorated lives be mercifully ended grows louder and more frequent. Several states have legalized a solution to this problem; physician-assisted suicide. Physician-assisted suicide (PAS) is defined as self-administering a lethal substance, prescribed by a physician, to end ones own life (Med Terms). Presently, it is only legal in four states; including Oregon, Vermont, Washington, and Montana. Unfortunately, this option still remains illegal in the majority of the United States. Whether or not we as a society should pass laws sanctioning assisted suicide has generated intense moral controversy. Physician assisted suicide should be legalized across the nation because patients have a right to choose to end

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their suffering; it is an ethical option under specific safeguards, and the quality of life deteriorates with the terminally ill. All persons have a moral right to choose freely what they will do with their lives as long as they inflict no harm on others. As part of the United States Declaration of Independence, all people are endowed with inalienable rights and of those rights include the right of life. This right of free choice includes the right to end one's life when we choose. For most people, the right to end one's life is a right they can easily exercise. However, there are many who want to die, but whose disease, handicap, or condition renders them unable to end their lives in a dignified manner. When such people ask for assistance in exercising their right to die, their wishes should be respected. Derek Humphrey, president of the Euthanasia Research & Guidance Organization, an advisor to the Final Exit Network, and a past president of the World Federation of Right to Die Societies, states his position that PAS should be legalized and describes the choice of the patients in his book, Final Exit: The Practicalities of Self Deliverance

and Assisted Suicide for the Dying.

Perhaps the most basic and fundamental of all our rights. However, with every right comes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the

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right to choose to die is implicit in the right to life. The degree to which physical pain and psychological distress can be tolerated is different in all humans. Quality of life judgments are private and personal, thus only the sufferer can make relevant decisions. (Humphrey) Humphreys position portrays not only the importance of choice on how to exercise our rights but also introduces the fact that the pain of the patient is personal and it should be up to them to make their choice on life.

Figure 1 People deserve the right to be granted the option to end their life with dignity.

Some people argue that the option for PAS is unnecessary because the medicine and technology we have today is able to rid the pain of those suffering. However, this cannot be a fair argument because level of pain is felt by the individual. Those who are in the late stages of a terminal disease have a horrific future ahead of them. The patients experience a gradual

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decline of their body, failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to control their pain will often leave them in a delirious and incapable state. Dr. Stewart, a professor of medicine and a primary care physician argues that At least five percent of terminal pain cannot be controlled, even with the best care (Stewart). Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and have the assistance of a doctor to die with dignity.

Figure 2 These percentages represent the 460 patients that have chosen physician assisted suicide in Oregon since 1997. This chart emphasizes the fact that

Some opponents of PAS fear that vulnerable populations may be coerced into premature death and that dying and helpless patients may be either abandoned or subjected to unwanted

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and unnecessary medical treatments. However, in a workable system, the option of physicianassisted suicide would arise only after all treatment options are exhausted, the best of hospice and palliative care has failed to relieve unbearable suffering, and if a mentally competent patient continues to request assistance in dying. Then, with outside opinion concurring, a physician would be permitted to prescribe medication that the patient could use to hasten death at a time of the patient's choice. Timothy E. Quill, a former primary care physician and a palliative care consultant, states that Physicians should (and do) appropriately assist (some) patients to die. Quill goes on to explain that PAS is an ethical last option after proper palliative care (Quill). Also, there will be certain limitations in which PAS should be permitted that will protect patient from being coerced into an unwanted decision.

Figure 3 This list demonstrates how the rights of the patients are strictly protected and regulated.

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The state of Oregon was the first state to legalize PAS and they put in place certain safeguards to ensure the highest ethical standards. The safeguards require the patient to have 6 or fewer months to live, determined by at least two qualified physicians, give an informed, voluntary decision, give two oral requests 15 days apart, a written request, a few others to ensure the safety of the patient (Death with Dignity Act). It is clear that under these safeguards the patient is protected and not rushed into making a decision. The Act also requires that the physician inform the patient of all other options before prescribing the lethal drug to guarantee that the patient is making a voluntary, informed, and educated decision. These safeguards would preclude abuse of the handicapped, the incompetent, minorities, the elderly, or other vulnerable populations. Patient and family anxiety about future suffering and death would be reduced; care and comfort at the end of life would be improved. The individual would be able to make this most private and basic of decisions personally, without unwarranted and unnecessary intrusion by the state or religious opposition. Patients diagnosed with illnesses that are not curable, extremely painful, and life limiting should be able to make the decision of whether or not it is of value to keep living. Under specific conditions, the option of PAS is an ethical last option for suffering patients.

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Legalizing physician-assisted suicide would be a more rational law than the current ban on assisting a terminally ill patient who requests help in dying. Proposal: The option for physician-assisted suicide should be nationally accepted. To ensure the protection of the patients, the safeguards of Oregons Death with Dignity Act should be incorporated into the law. In order to make a change, people need to be educated on this topic. A lot of people are not aware of the truths about physician assisted suicide and have irrational fears about consequences of the legalization of PAS in which most are protected against in the safeguards. In order to convince people and diminish their doubts, there needs to be an awareness program. This program should address the most common misconceptions and fears about the issue and provide facts that are contrary to them. The program can address fears including: that legalizing PAS will result in a slippery slope towards euthanasia, an overbearing number of deaths per year, and patients being coerced and manipulated into the decision. These stresses about the law can be overturned by the displaying the aspects of the safeguards that protect against them and also provide evidence from Oregons annual reports that prove they will not become an issue. Awareness can be distributed throughout the country be broadcasting public service announcements on television.

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Since the legalization of PAS in Oregon, there have been 127 legislative proposals in 27 states and in almost every case where there was a vote it would be defeated by just a small percentage (Death with Dignity National Center). If all of the voters were fully educated on the issue and the safeguards that would be implemented, it would most likely result in a higher acceptance of PAS and therefore more people would vote in favor of the legalization of it. If more people gained acceptance of it this would influence the legalization on a state level. If more and more states legalize PAS, it would help the chances of it becoming a national law. As the country gains more and more acceptance of physician-assisted suicide, Public officials and organizations will be influenced to get involved by helping to raise awareness and sponsoring the bill. Citizens who agree with the legalization of physician-assisted suicide should come together in every state and start petitions. A private group can then contact their House representative and Senators, arrange a meeting, present the facts of matter, and ask them to sponsor the bill. By taking action and getting involved things can change.

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Works Cited "Death With Dignity Act." Oregon Health Authority. N.p., n.d. Web. 1 Oct 2013. "Death with Dignity National Center." Annual Reports. N.p., n.d. Web. 5 Nov 2013. "Definition of Physician-assisted Suicide." Medicine Net. N.p., 20 sept 2012. Web. 25 Oct 2013. "Med Terms." Medicine Net. N.p., 20 sept 2012. Web. 25 Oct 2013. Humphrey, Derek. Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the

Dying. 3rd ed. Delta Trade, 2002. 22. Print.

Stewart, John. "Choosing Their Time." Time 165.14 (2005): 31-33. Academic Search Premier. Web. 1 Oct. 2013. Quill, Timothy E. "Physicians Should 'Assist In Suicide' When It Is Appropriate." Journal Of Law,

Medicine & Ethics 40.1 (2012): 57-65. Academic Search Premier. Web. 25 Oct. 2013. Illustrations and Charts:
Lachman, Vicki. Physician-Assisted Suicide: Compassionate Liberation Or Murder?. MEDSURG Oct. 2013. Nursing 19.2 (2010): 121-125. Academic Search Premier. Web. 1

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Marker, Lita. Patient's Reasons for requesting assisted suicide. 2013. Photograph. Patients Rights CouncilWeb. 4 Dec 2013. Shapiro, Nina. Controversy Over Death With Dignity Dies a Natural Death . 2013. Photograph. Seattle Weekly News, Seattle. Web. 4 Dec 2013.

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A common belief of opponents of Physician-assisted suicide argue that it will force doctors into performing PAS against their personal beliefs. However, out of the four states that have legalized PAS, none have attempted to impose any affirmative requirement that healthcare providers participate in assisted suicde. Two of the staes have express conscience protections. (Rienzi 145) There is no implication that doctors have that obligation to conform with the law and the belief that legalization will result to that is a slippery slope logical fallacy.