Shirey Seigworth

Lori Bedell
CAS 138T
March 30, 2014
Euthanasia and Physician Assisted Suicide
What does pancreatic cancer, colon cancer, bone cancer, Lou Gehrigs disease, and most
other terminal illnesses have in common? That for most people suffering from these medical
problems, they experience a significant amount of pain at the end of their lives. One does not
have to have a notoriously painful disease to experience pain at the end of their lives. For
example, more than half of patients with terminal cancersuffer from poorly managed pain,
which shows that the majority of people experience substantial pain.
1
But how does this affect
the everyday person? Half of all men and 1/3 of women in the US develop cancer and today
there are over 14 million people in the US that currently have or have had cancer.
2
This means
that most people have someone in their lives, family or friends, which has or has had a struggle
with cancer or another life threatening illness. Sadly, some people are diagnosed as being
terminally ill with six months or less to live. Many times the end of their lives includes pain,
discomfort, embarrassment, and a strong reliance on others. The end typically includes taking
many medications and for some being reliant on machines. Some people do not wish to live a
life of such low quality when there is no chance of recovery. Patients who wish to end their
suffering should have the option of physician assisted suicide.


Differences between physician assisted suicide and euthanasia
Many people suffering from terminal illnesses wish to leave the world on their own terms
with as much dignity as possible. Euthanasia, also commonly referred to as physician assisted
suicide, is when a doctor helps a terminally ill patient to die.
3
It is a societal issue that has grown
in importance over the past two decades because states have begun to legalize physician assisted
suicide. Many people do not know the differences between euthanasia and physician assisted
suicide because the average person uses the two words interchangeably. Euthanasia is when the
physician performs the last causal step leading to the death of the patient, and thus can be said to
kill the patient.
4
Physician assisted suicide is when a doctor provide[s] the knowledge and/or
means by which a patient can take her own life.
5
There are two types of euthanasia: active and
passive. Active euthanasia is when a doctor kills a patient who has requested help in dying. An
example of this would be when a doctor injects a patient with lethal drugs. Passive euthanasia is
when the patient dies because the medical professionals either don't do something necessary to
keep the patient alive, or when they stop doing something that is keeping the patient alive.
6

Passive euthanasia includes but is not limited to switching off life support machines,
disconnecting feeding tubes, and not receiving life extending operations or drugs.
7
Many forms
of passive euthanasia are completely legal in the United States. In fact, disconnecting a
ventilator at a patients requestis accepted by society, yet this requires a more definitive act by
a physician than prescribing a medication that a patient has requested and is free to take or not,
as he or she sees fit.
8

Reasons for legalization
Physician assisted suicide is a valid option for terminally ill patients because it is just
that: an option. No one is forced to choose this path and the patient has to take the steps
themselves to end their life. In a poll of whether or not people support physician assisted suicide,
55 percent of respondents favored it, and 45 percent were opposed.
9
Terminally ill patients
with cancer and other fatal physical ailments that are forced to endure excruciating pain should
have the option of PAS. For instance, Jean Humphry was dying of bone cancer.
10
She was
suffering from Thrombosis, and the cancer itself was causing her bones to crack inside of her.
After a close brush with death she asked her husband of 22 years to help her end her life. Derek,
her husband, put himself in her shoes and after realizing he would ask the same of her, he helped
her end her life. Jean had lost control of her bowels and had to wear adult diapers. No adult
should have to live a life where they revert to being cared for like an infant.
11
Another example
is that of Dr. Anne Turner who was diagnosed with PSP, Progressive Supranuclear Palsy, a
neurological degenerative disease for which there is no treatment or cure.
12
Anne was a retired
medical doctor who had started to find easy tasks such walking, eating, speaking, and
swallowing increasingly difficult. After her diagnosis, she spoke with her family about her wish
to die before the disease progressed to a completely debilitating stage. With her familys support
she went to Zurich, Switzerland and died by physician assisted suicide. People should have the
right to decide when and how they die, especially if death is looming and inevitable.
13
This idea
is supported by polls in America that continue to show a majority of citizens support assisted
suicide in the belief that anyone should be able to choose how they die.
14
Patient autonomy is
important. People have control (generally) over their lives and make decisions that affect them
every day. How someone dies should be up to them as well.

Opposing Viewpoints
Some believe that legalizing euthanasia/PAS will be a slippery slope that will lead to
doctors killing patients and insurance companies pushing this option to save money. The current
euthanasia laws in the Netherlands are allowing for involuntary euthanasia to take place. 11 to
12 percent of those euthanized in the Netherlands have been put to death without their
consent.
15
The laws in the Netherlands are quite lax and only 60 percent of euthanasia cases
were reported, whereas in the U.S. it is required and strictly regulated.
16
In the Netherlands,
legally, children as young as 12 may be euthanized with their parents consent.
17
However, the
laws involving euthanasia (in the United States at least) are very specific and the process has
strict guidelines. Suicide is considered a sin in many religions and therefore some people feel
strongly about preventing assisted suicide from being legalized or decriminalized. Yet, if
someone believed suicide was a sin they most likely would not be interested in physician assisted
suicide and it is merely an option. Many doctors believe it goes against the oath they take to do
no harm. The Hippocratic Oath states I will not give a lethal drug to anyone if I am asked, nor
will I advise such a plan, and euthanasia goes against this principle.
18
However, a doctor cannot
be forced to prescribe anything they do not want to and could refer a patient to another doctor if
they believe it goes against their principles.
Model for legalization
Currently there are 4 states that have legalized physician assisted suicide. These include
Oregon, Washington, Montana, and Vermont. Oregon was the first state to pass a bill legalizing
PAS in 1999. In Oregon, a patient must be 18, a resident, of sound mind, terminally ill with 6
months to live.
19
The patient must orally request euthanasia two times at least 15 days apart, and
they must submit a written request with signatures from two witnesses.
20
They also have to have
their terminal illness and ability to make knowledgeable decisions confirmed by two doctors and
they must be informed of all other options. Oregons Death with Dignity Act has been the model
for the other three states, which have adopted almost identical requirements. This bills allows
for patients who are 100% capable of deciding on whether or not they want to live to have an
option to end their lives in a respectable manner. Since PAS was legalized in 1998 only 1,050
patients in Oregon have requested lethal medication under the law and 673 have died using it.
21


In 2012 in Washington State, 121 prescriptions were given to terminally ill patients and 83
ended up taking the lethal medication.
22
In Washington, there have only been 255 terminally ill
people to exercise that option so far under the states 2009 Death with Dignity Act however,
only 241 have died after ingesting them.
23
Dr. Richard Wesley from Washington voted for
legalizing physician assisted suicide in 2008, little did he know he would be diagnosed with ALS
or Lou Gehrigs disease just one month afterwards.
24
Dr. Wesley got his prescription for
barbiturates in 2010 after being diagnosed as terminally ill. He was wheelchair bound but could
not operate it because he lost all function in his limbs, relied on a respirator to breath, and ate
through a feeding tube.
25
The fact that doctors choose this path shows that it is not unethical or
immoral even to those in the medical community.

Potential Outcomes
If physician assisted suicide is legalized in all 50 states, current and future terminally ill
patients will have more security knowing that if their pain becomes unbearable they have an
option to end their lives without taking drastic means or without incriminating others who help
them. If physician assisted suicide is not legalized, terminally ill patients will continue to be
forced to live in terrible pain. If they decide to end their lives without help, they could
experience more pain or even be unsuccessful and worsen their current situation. If they are able
to receive help, the aiding parties are likely to be arrested and convicted of murder like Jack
Kevorkian and others. Oregon, Washington, Montana, and Vermont have had success with their
PAS laws and over a dozen other states have considered legalizing PAS. There have not been
any publicized controversial cases in these states where foul play or bad intentions have been a
factor. Few people even choose physician assisted suicide and the numbers show that even
fewer people actually choose to take the drugs and end their suffering. People are not flocking to
their doctors for lethal prescriptions and physician assisted suicide is not advertised as something
people should choose. If PAS does not become legal in all or most 50 states, people who wish to
end their suffering will be forced to suffer or take desperate measures that have negative
consequences for themselves and others.
How to help the legalization of PAS at the state and federal level
All state governments should adopt PAS legislation allowing for physician assisted
suicide. The legislation should be similar if not identical to the previous bills that have been
passed within the United States. Governors, state congressmen, and other officials should draft
and introduce legislation in congress. As for what individual citizens can do, the most effective
step one can take is to vote to legalize it on a states ballot initiative. Some states have asked
citizens to vote on the legalization but with little success.
26
Many people are not fully informed
of many politic issues, especially ones that do not pertain to them. Other states have attempted
to pass legislation through state congresses. Writing to your state congressmen/women is an
effective way of supporting the passing of legislation because government representatives are
supposed to act upon what their constituents want them to do. Joining organizations that support
physician assisted suicide can be effective because the more people that lobby for something, the
more likely it is to gain support from government officials. Publicity for the topic can help gain
more public approval. One could join groups such as Compassion and Choices or the Death with
Dignity Nation Center.
27
Special interest groups can work with governing bodies to draft and
introduce legislation. One would have a better chance at legalizing PAS on the state level,
however, efforts can still be made at the national level. Spreading the word and conversing
about physician assisted suicide even amongst friends and family could help gain more support.
There are many steps, big and small that can have a significant effect on passing legislation for
physician assisted suicide.
















Endnotes:

1
Woolston, C. (2013). Pain control at the end of life. Retrieved April 6, 2014,
from Health Day website: http://consumer.healthday.com/encyclopedia/aging-1/
misc-aging-news-10/pain-control-at-the-end-of-life-643650.html
2
Cancer prevalence: How many people have cancer? (n.d.). Retrieved April 4, 2014,
from American Cancer Society website: http://www.cancer.org/cancer/
cancerbasics/cancer-prevalence
3
Physician-assisted suicide: Is it murder or compassion for a doctor to help kill
a patient? (n.d.). Retrieved July 2, 2013, from
http://www.abcactionnews.com/dpp/marketplace/law_tv/
physician-assisted-suicide-is-it-murder-or-compassion-for-a-doctor-to-help-kill-a
-patient
4
Dworkin, G., & Frey, R. G. (1998). For and Against: Euthanasia and physician
assisted suicide. Cambridge, England: Cambridge University Press.
5
Ibid 3
6
Active and passive euthanasia. (n.d.). Retrieved July 23, 2013, from Ethics
Guide website: http://www.bbc.co.uk/ethics/euthanasia/overview/
activepassive_1.shtml
7
Ibid
8
Rogatz, P. (2005). Physician assisted suicide should be legalized. In N. Harris
(Ed.), At Issue: The ethics of euthanasia (pp. 24-30). San Diego, CA:
Greenhaven Press. (Original work published 2001) 26
9
Hafner, K. (2012, August 11). In ill doctor, a surprise reflection of who picks
assisted suicide. Retrieved July 19, 2013, from New York Times: Money and
Policy website: http://www.nytimes.com/2012/08/12/health/policy/
in-ill-doctor-a-surprise-reflection-of-who-picks-assisted-suicide.html?pagewanted
=all&_r=0
10
Humphry, D. (n.d.). Legalizing euthanasia: Medical perspectives on death and
dying. Retrieved July 2, 2013, from Markkula Center for Applied Ethics
website: http://www.scu.edu/ethics/publications/iie/v4n2/euthanasia.html
11
Ibid
12
Turner, A. (n.d.). Dr. Anne Turner. Retrieved July 2, 2013, from Dignity in
Dying website: http://www.dignityindying.org.uk/personal-stories/uk/
south-west/bath/dr-anne-turner-story-9.html
13
"Basic Arguments about Euthanasia." A New Zealand Resource for Life Related
Issues. Life Resources Charitable Trust, n.d. Web. 15 May 2013.
<http://www.life.org.nz/euthanasia/euthanasia3/>.
14
LaHaye, B. (1999). The sanctity of life must always be respected. In D. A. Leone
(Ed.), At Issue: The ethics of euthanasia (pp. 27-29). San Diego, CA:
Greenhaven Press. (Original work published 1997)
15
Nolan, J. (2005). Legalized euthanasia in the Netherlands raises Serious ethical
concerns. In N. Harris (Ed.), At Issue: The ethics of euthanasia (pp.
56-60). San Diego, CA: Greenhaven Press. (Original work published 2001)
16
Ibid
17
Ibid
18
"Do euthanasia and assisted suicide violate the Hippocratic Oath?"
ProCon.org. ProCon, n.d. Web. 15 May 2013.
<http://euthanasia.procon.org/view.answers.php?questionID=000198>.
19
Physician-assisted suicide: Is it murder or compassion for a doctor to help kill
a patient?

20
Ibid
21
Hafner, In Ill Doctor
22
Washington state department of health 2012 death with dignity act report
executive summary. (n.d.). Retrieved July 19, 2013, from Washington State
Department of Health website: http://www.doh.wa.gov/portals/1/Documents/
Pubs/422-109-DeathWithDignityAct2012.pdf
23
Hafner, In Ill Doctor
24
Ibid
25
Ibid
26
Kingsbury, K. (2008, May 16). A new fight to legalize euthanasia. Retrieved
April 6, 2014, from TIME website: http://content.time.com/time/health/
article/0,8599,1807401,00.html
27
Euthanasia and assisted suicide: Issues and groups. (n.d.). Retrieved April 6,
2014, from Government Information website:
http://diglib.library.vanderbilt.edu/
ginfo-pubpol.pl?searchtext=Euthanasia&Type=LTR&Resource=DB&Website=GOVTINFO