(iii) Assisted Dying: Control over the Human Body
“Dogs do not have many advantages over people, but one of them is extremely important: euthanasia is not forbidden by law in their case; animals have the right to a merciful death.” (Milan Kundera)
Critically analyse to what extent assisted dying laws for humans are capable of providing control over one’s own boundaries.
Assisted Dying: Control over the Human Body
Critically analyze to what extent assisted dying laws for humans are capable of providing control over one’s boundaries.
The average life expectancy has increased over the last two centuries, owing to a significant decrease in mortality, which was previously associated with poor nutrition and infectious diseases. However, population growth has been accompanied by a number of challenges, including an increase in chronic illnesses such as cancer and coronary artery disease. Unlike in the past, these diseases necessitate years of treatment, patients being constantly medicated, painful treatment procedures, and years of pain. Worse, certain diseases, such as cancer, are incurable at certain stages, and doctors’ only option is to help patients manage pain until they die. Despite technological advancements and medical advances aimed at preventing or controlling such conditions, debates about patients in the later and incurable stages of these terminal conditions continue to rage. There is also a growing recognition and emphasis that the patient must be at the center of any healthcare decision, and that the outcomes of these decisions must be tailored to their preferences and desires. For example, would a patient in the final stages of cancer prefer to continue living in pain despite the fact that they are in an incurable stage, or would they prefer to have an assisted death? Some jurisdictions, including Oregon, the Netherlands, and some states in the United States, have passed laws legalizing assisted suicide in some form. However, in many states, the issue of assisted suicide continues to spark legislative debates centered on the issue of ethics and morals in preserving and valuing human life, raising concerns about how these would increase people’s control over their bodies and lives.
Different states have enacted various laws to govern the activities of withholding or withdrawing treatment from patients in order to provide assisted suicide. These laws are intended to formally and legally guide competent adults’ desires and wishes regarding the type of treatment to receive or not receive once they lose competence. Despite the existence of these laws, no piece of legislation has accurately described assisted suicide or euthanasia practices. Many states have made it clear that their laws prohibit any form of assisted suicide, including euthanasia. However, the majority of these laws are centered on active or passive euthanasia. For example, the Western Australian Department of Health states that “an Advanced Health Directive cannot require or authorize a doctor or other health professional to take active steps to unnaturally end life.” These statements show that, while the department does not permit assisted suicide, the practice of euthanasia may fall under passive practices in this context. The 1997 Supreme Court ruling in the United States stated that assisted suicide is a concept that I do not understand. Concerning the question of whether assisted suicide is constitutional, the court ruled that it is not a crime across the country, but rather a matter of state rights. This decision highlighted the dilemma and confusion surrounding this issue.
Control of One’s Boundaries and Assisted Death Laws
Critics of assisted suicide laws argue that legalizing assisted suicide takes away people’s control over their bodies and places less emphasis on human life. This is contrary to the morals and ethics upon which society and human life are founded. They also argue that enacting such laws violates the code of ethics that has guided medical practice for over 2000 years. Supporters, on the other hand, argue that these laws are necessary to give competent adults more control over their lives and bodies. Previous research has found that the desire for assisted suicide is influenced by the desire to maintain control over one’s own life. Many people who choose assisted suicide want to have control over their death.
Every human being wishes to live a healthy and happy life until the day they die. However, life does not always go as planned or as desired. Accidents happen every day, and some result in victims suffering lifelong injuries, paralysis, and, in some cases, total incompetence. Some people must rely on others their entire lives to complete even the most basic tasks, such as eating. Their lives have been completely altered, forcing them to rely on the assistance of those around them to complete tasks that they previously completed easily. These changes in circumstances frequently cause some people to lose hope in life, and even with the best therapy and counseling, they are unable to recover, with their main desire being to end their lives. The rise of chronic illnesses with no cure, particularly in the later stages, renders most patients incompetent, making them feel helpless and undeserving of continuing with life. The desire to make decisions about their lives is taken away. As a result, the passage of assisted suicide legislation will be critical in providing these patients with increased control over their bodies and lives, which they previously lacked. With this control, they can choose how to end their lives rather than succumbing to the hopelessness and pain caused by their conditions.
Most terminal illnesses, such as cancer, render one helpless, particularly in their final stages. The patient is in constant pain and unable to perform any daily tasks. Many patients become bedridden as a result of pain and must rely on others for everything, including cleaning and relieving themselves. Many adults do not want to be in a situation where they are helpless and must rely on the assistance of others. Worse, in most cases, the medical practitioner will communicate that the patient has a limited time to live and should therefore prepare for the transition. As a result, in these circumstances, the patient will most likely choose to die in a specific manner, asserting that they still have control over their lives and bodies and not their condition. Their desire for control is influenced by a variety of factors, including their fears of future pain and loss of autonomy. Simply put, assisted suicide gives them more control over their lives and bodies at a time when their health conditions want to rob them of all control.
There is a significant gap between what lawyers and voters want and the professional ethics that guide medical practices. Many researchers believe that it is up to a medical practitioner to determine what is and is not a legitimate practice. Some physicians act on their personal beliefs, while others act professionally. Many terminally ill patients understand what their future holds and wish to end their lives in nonviolent medical terms. Often, it is out of self-respect and a desire not to be a constant burden on those around them. In contrast to normal suicide cases, they are thus able to end their lives in a less chaotic, less violent, and more respectful manner. However, because the dosage and timing of drug administration are critical, this is not an easy procedure. Failed attempts at these procedures may result in severe trauma to the patient; trauma greater than death itself, even for caregivers. In such cases, the patient may beg the practitioners to finish the suicide process. In such cases, the physician may be persuaded that assisting a patient in ending his life prevents more harm than the cause. Some physicians believe that stopping a patient’s physical and mental anguish at the patient’s request does not violate the medical ethics code.
A Physician’s Ethical Decisions
If the law decides to legalize assisted suicide, physicians face a conundrum. They could refuse to help the patients end their lives, forcing them to seek help from others or suffer in agony until they died. However, by doing so, they fail to investigate and meet the needs and desires of their patients, as their practice requires. The other option is to assist patients with assisted suicide as their law requires, which would be a violation of the code of ethics that the practice was founded on more than 2000 years ago.
A physician can provide assisted suicide in a variety of ways without violating their code of ethics or jeopardizing their personal beliefs. First, they must perform an extremely accurate prognosis. Such a task will necessitate knowledge and bravery, as they must determine, without bias or emotion, why one patient requires assisted suicide and another does not. Patients may make poor decisions near the end of their lives due to a lack of a clear and accurate prognosis; decisions that cannot be reversed. Physicians must investigate all treatment options and palliative care options, as well as discuss potential consequences with their patients and loved ones. They should also explain the potential consequences of refusing any type of care or treatment. Physicians frequently refer patients to other physicians for second opinions, as well as spiritual advisors and psychiatrists for evaluation and counseling. The psychiatrist conducts a thorough examination of the patient’s mental health to determine whether they are in the proper frame of mind while making decisions. The results of this mental evaluation must be presented to the law, which must determine whether the information provided by the patient is sufficient to allow for assisted suicide. Spiritual and religious personnel, such as clergy, offer counseling and therapy to patients in an attempt to help them reconsider their end-of-life decisions.
While the patient is undergoing the procedures outlined above, physicians are frequently advised to maintain a close relationship with the patient regardless of their final decision, whether to commit suicide or not. This physician can withdraw or withhold treatment, such as CPR or ventilator treatment, at the request of the patient or patient’s surrogate; the physician will not be violating the professional code of ethics. In cases where the patient appears to be mentally ill, the guardian or close family members have the legal authority to refuse assisted suicide. In such cases, the individual is mentally incapable of making such an important decision. As a result, they are unfit to have control over their own lives. The physician consults with the psychiatrist to determine whether the patient is in the right frame of mind to make such an important decision.
For many years, euthanasia and other suicide-assisted practices have posed an ethical and professional quandary in medicine. Most laws enacted in various states provide accurate decisions on the practice. However, they have not stated whether the practice is completely prohibited. More articulate laws are needed to provide competent adults with full control over their lives and bodies, as they should have the right to decide what happens in their lives. They will have the option of obtaining assisted suicide if their bodies become incompetent and they face major health challenges such as those caused by chronic conditions.
Barbuzzi, M. (2014). Who Owns the Right to Die? An Argument about the Legal Status of Euthanasia and Assisted Suicide in Canada. Penn Bioethics Journal, 1(1).
Mishara, B. L., & Weisstub, D. N. (2016). The legal status of suicide: A global review. International journal of law and psychiatry, 44, 54-74.
Myers, R. S. (2016). The constitutionality of laws banning physician-assisted suicide. BYU Journal of Public Law, 31, 395.
Snyder, S., & L., M. P. (2017). Ethics, Professionalism and Human Rights Committee of the American College of Physicians*. (2017). Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper. Annals of Internal Medicine, 167(8), 567-578.
Stefan, S. (2016). Rational suicide, irrational laws: Examining current approaches to suicide in policy and law. . Oxford University Press.
Sulmasy, D., Finlay, I., Fitzgerald, F., Foley, K., Payne, R., & Siegler, M. (2018). Physician-assisted suicide: why neutrality by organized medicine is neither neutral nor appropriate. Journal of General Internal Medicine, 33(8), 1394-1399.
Yao, T. (2016). Can We Limit a Right to Physician-Assisted Suicide? The National Catholic Bioethics Quarterly, 16(3), 385-392.