Introduction
Assisted suicide is a person’s life with the help of an outside party – usually a doctor. Such services are complex because they are a strict violation of a human right to life. At the same time, such service is the will of the person because of their right to die with dignity. Physician-assisted suicide occupies a separate place in the justice and ethics of medicine.
Legal Issues
Within the United States, the law’s attitude toward physician-assisted suicide varies from state to state. Only 20% of states allow such a service, including California, Maine, Washington, and eight other states. It is a legally authorized act performed as part of medical care for the terminally ill. The law authorizing this procedure differs for each state, but it is generally called the End of Life Act (States where medical aid…, n.d.). The rationale for the law is the concept of the dignity of death. Despite the resolution, there is the problem of where assisted suicide is justified: terminal illness has no solution, how much the patient is aware of his wish, and how painless it is. In addition, the concept of good faith is introduced, so there is the problem of the extent to which the doctor acts based on the patient’s wishes and the clinical picture rather than because of bribery or the wishes of relatives.
The law obliges patients to undergo a psychological evaluation if a single decision cannot be made. Patients must also meet several criteria, such as written statements, informed consent, verbal statements at intervals, periods between statements, and others (The Washington Death with Dignity Act, n.d.). On the physician’s side, the law provides rules on confirmation of terminal illness and the availability of a second opinion with similar findings and reasoning. The law also confirms that malice, intentional termination of life, and lack of resuscitation do not confer civil and criminal immunity.
Ethical Issues
The ethical challenges to assisted suicide are related to the concepts of the right to life and to die with dignity. The notion of the sanctity of life prevents a physician from taking action to provide medical care when necessary. Physicians themselves fear that this type of suicide leads to its frequency instead of seeking cures for the disease, which exacerbates the situation of medication and innovation (Hetzler et al., 2019). In addition, physicians are unsure if this is a sufficiently informed decision, as they may not have sufficient knowledge of the psychology of death. The inhumanity of the onset of death is also an ethical issue. It has been reported that side effects can be severe and unpleasant, including vomiting, muscle pain, asphyxia, and fear (Sinmyee et al., 2019). These are pronounced sufferings of the patient that do not provide relief until death.
Problems also arise on the patient’s side: the culture of dying and having access to death without knowledge. Even without terminal illnesses, patients have the right to end their lives in a justified way, although unbearable suffering is more often mental. Having access to procedures that hasten death leads to the domination of patients over physicians and the healthcare system (Trejo-Gabriel-Galán, 2021). In such circumstances, the ethicality of the decision being made is challenged due to the lack of proper qualifications and patient compliance with the law.
Conclusion
Physician-assisted suicide concerns the community and the medical community regarding law and ethics. According to the law, the main concerns are:
- The integrity of the physician and the absence of fraud.
- The existence of a reasoned decision.
- The absence of psychological abnormalities in the patient.
According to ethics, it is an attack on the sanctity of life, the lack of stimulation of innovation in medicine, and the inhumanity of death.
References
Hetzler, P. T., 3rd, Nie, J., Zhou, A., & Dugdale, L. S. (2019). A Report of Physicians’ Beliefs about Physician-Assisted Suicide: A National Study. The Yale journal of biology and medicine, 92(4), 575–585.
Sinmyee, S., Pandit, V. J., Pascual, J. M., Dahan, A., Heidegger, T., Kreienbühl, G., Lubarsky, D. A., & Pandit, J. J. (2019). Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying. Anaesthesia, 74(5), 630–637. Web.
States where medical aid in dying is authorized. (n.d.). Compassion & Choices. Web.
The Washington death with Dignity Act. Title 70, Chapter 70.245 RCW. Web.
Trejo-Gabriel-Galán, J. M. (2021). Euthanasia and assisted suicide in neurological diseases: a systematic review. Eutanasia y suicidio asistido en enfermedades neurológicas: una revisión sistemática. Neurologia, S0213-4853(21). Web.