Although suicide is no longer a crime, giving assistance in it is, everywhere except for Switzerland, Germany, Norway, and Uraguay. In Australia, a law was passed that allows terminally ill patients to ask for assistance by injection or taking drugs themselves.7 There is a debate about it because Parliament wants to overturn the statute, which is the world’s only voluntary euthanasia statute.3 In the Netherlands, it is actually a crime, but it has been ruled that physicians may assist in death under certain conditions. Some of these are that the patient must be ruled competent, and two doctors must conclude that the patient has less than 6 months to live.8 The United States has used them as an example to see what would happen if it were to occur here. They are having problems with it, mainly with abuse. The physicians there have reported that the main reasons people request it are “low quality of life, the relatives, inability to cope, and no prospect for improvement.10 Some sources show that people are requesting it for physical symptoms that it is almost ridiculou that they would go to such an extreme measure for. I think that the potential for abuse here may be great, because it is getting out of hand over there. People are becoming afraid to go to hospitals because euthanasia is becoming so commonplace. It now accounts for 15% of deaths. 1000 unconsenting deaths occur each year.1.
In 1994, the state of Oregon passed a ballot that gives limited physician-assisted suicide legality. This makes it the first in the nation to do so. A doctor must determine the patient has less than six months to live. A second doctor must decide that they are mentally competent and not suffering from depression. The patient must request it in writing with two witnesses, and then 48 hours before the doctor delivers the prescription the request must be repeated orally.1 It must be a voluntary act. However, those jugements are left to the physician. So far, it has never been put into action. Other states are considering similar legislation, such as California which has proposed a law that is similar to the guidelines that the Dutch have adopted.2 Lawsuits in Washington State and New York were ruled by the 9th and 2nd U.S. Circuit Courts of Appeals that laws prohibiting physician-assisted suicide are unconstitutional. The legal fate will be determined by the Supreme Court. In 1990, the decision of Cruzan v.Missouri Department of Health resulted in people having the right to avoid unwanted medical treatment, including food and water.5 It recognized the right to terminate unwanted medical treatment even when death would be the result.14 People often use the Constitution as a basis for argument. The 14th amendment prohibits the state from depriving “any person of life, liberty, or property without due process of law.” So to deny a dying patient medical assistance when requested is to “threaten this patient’s request for help is judged denial of constitutionally protected due process.”4
As the courts were in session to hear a case about whether terminally ill people have a constitutional right to physician assisted suicide, demonstrators sang and picketed outside a Supreme Court building.12 The emotions of the rights issue has been compared to that of abortion. Both of these issues dig into whether we have the right to choose such personal issues. People can feel very strongly about the issues of mercy killing, whether they oppose or support it.
The lack of laws cause people to avoid prosecution for assisting in a suicide. Kevorkian has escaped prosecution because there is not a state law prohibiting it, according to a Michigan judge.9 People are afraid that activities such as his would become widespread if assisted suicide were legalized. His actions have been opposed not because of the assistance, but because he had no real relationship with his patients and had not given them any kind of clinical evaluation. Many were also not terminally ill.3 It seems to show what is lacking in the medical sysytem, or what could become of it. Every case of assisted suicide is not convicted or prosecuted, even in states that make it illegal. However, the fact that there are many landmark “right to die” cases, shows that the law is commited to the prohibition. However, the procedures are not described as killing. If this were the case, the act would have to be justified similar to killing someone out of self defense.4
It is hard to define the conditions that there must be in order to make it legal, because there is so much that we do not know. For euthanasia to be ethical, there must be certain guidelines. The person must be a mature adult, and has been shown to be mentally competent and willing to make the decision. Some medical help will have already been given, and it should seem that the fight is hopeless.9
Many organizations have beliefs on this and they try to educate the public on euthanasia and what their views are. I contacted Marianne Smith, the Program Development Director of the Death with Dignity National Center.15 She explained to me in e-mail how the organization feels about euthanasia and what they do to educate the public about it. The organization is working toward better health care for paients.
She feels that assisted suicide should be legal, but that “physician-assisted dying should be the response of last resort,” and “when all other options fail to relieve unbearable suffering, when the patient is acting on his or her own initiative, is not clinically depressed, and is capable of administering the medication personally.” The people who could be elgible are “only terminally ill, competent adults with decisionmanking capacity.” I also asked whether euthanasia could be avoided with adequate pain medicine. Her response was that “Physicians, medical associations and hospices all have stated that not all pain can be controlled.” Their view, which is one I encountered a lot, is that the medical professionals have not been trained adequately in pain management. Regarding the issues of potential “slippery slope” abuse, she says that physician’s aid in dying is more common than people realize, and legalization would just make it happen openly, instead of secretly. However, the state regulation should provide strict guidelines and penalties for violations.
I think that it is hard to make sure that the decisions are correct, so it should be carefully thought out. We are dealing with a very serious issue, which is death. It should not be an easy decision to make or to carry out. Becaue death is the consequence, the decision to kill oneself, and carrying it out should be very difficult and carefully thought out. This would help ensure that people have thought about it enough and know that this is the best decision. I don’t know how a solution can be thought of to deal with the debate, but things such as more health care education and informing patients of their rights should be a consideration. I hope that if legalization ever were to take place, that they would carefully restrict who qualified for euthanasia.
After all my research, most of my questions have been answered. It is difficult to come to a conclusion because there is no right or wrong answer. I don’t know how anyone can determine what should be done. Who can put a price on life and say who has the right to die? The basic choice is whether to let doctors help people die, and if so, how? I have found many great arguments either opposing or protesting this issue, which has led me to my final conclusions.
When I began this paper, I dived into it thinking that I was going to condone the idea of assisted suicide. I knew I could convince someone that it should be the moral and legal thing to do. I could not imagine a life without the ultimate choice or having to endure great suffering. I was going to defend this side, but also show the opposing side. Once I got into the research, I found many facts that I had not known before about why it has not yet been legalized. Many questions and opinions showed me that there were many things I had not even bothered to think about before. What a surprise to me that I could begin a project as a supporter, and then turn around my views. I now see where the opposers are coming from. There are just too many problems and considerations to think about before this could ever happen, and there are alternate solutions. I cannot say that this has given me a complete turn in the opposite direction, but I am definitely leaning toward the opposing side except in extreme circumstances when nothing could ever help the patient.
Works Cited
1 Annas, George J. and Michael A. Grodin. “There’s no right to
assisted suicide.” New York Times, 8 Jan. 1997, sec. A: 15.
2 Basta, Lofty L, M.D. A Graceful Exit: Life and Death on Your own
Terms. NY: Plenum Press. 1996. P.89-113.
3 Beauchamp, Tom L. Intending Death: The Ethics of Assisted Suicide
and Euthanasia. NJ: Prentice Hall. 1996. pp.1-5,11, 18.
4 Bresham, James F. Killing Vs. Letting Die: A Moral Distinction before
the Courts. America. Feb.1,1997, vol. 76 no. 1, p.8.
5 Brown, Gary. “A Cure Worse than the Disease?” America. Dec.14,
1996, vol. 75 no. 6, p.7.
6 “Euthanasia: Answers to Frequently Asked Questions.” International
Anti- Euthanasia Task Force. URL: http.//www.iaetf.org/answers.htm
7 “Frequently Asked Questions about Right to Die.” ERGO. URL:
http.//www.rights.org/ deathnet/ergo-FAQ.html
8 Gula, Richard M. Euthanasia: Moral and Pastoral Perspectives. NJ:
Paulist Press, 1994. pp.1-7.
9 Humphrey, Derek. “Why I believe in Voluntary Euthanasia.” URL: http.//www.rights.org/ deathnet/Humphrey.essay.html
10 Lund, Nelson. Assisted Suicide is Death Knell to Doctor Ethics.
Insight on the News. 10 Feb., 1997. p.30.
11 Mydans, Seth. “Legal Euthanasia: Australia Faces a Grim Reality.”
New York Times. Feb. 2, 1997, sec. 1: 3
12 Reibson, Larry. “Whose Right Is It?” Newsweek. 20 Jan., 1997, p. 36.
13 Swanson, William. “Mortal Concern.” MPLs St. Paul Magazine. Oct.
1996, p.52.
14 O’ Keefe, Mark and Tom Bates. “Suicide Debate Reaches Supreme
Court.” National Catholic Reporter. Jan. 17, 1997,vol. 33 no.10, p.