Personal Persuasive Statement on Physician Assisted Death

Sue Rodriguez once said “If I cannot give consent to my own death, whose body is this? Who owns my life?” this is the basis of the national divide that is the Death with Dignity Act. The Death with Dignity Act also known as physician-assisted death or aid in dying, gives terminally ill patients with a sound mind and a prognosis of six months or less to live the ability to request and receive a prescription medication to induce death. So the issue of physician assisted death is discussed in this persuasive essay. Due to the major controversy of the legislation, this can only be done in a handful of states including: California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont, and Washington. A universal fear within humanity is the fear of dying, most want to live as long as possible. This is the root of the problem that has divided lawmakers concerning Death with Dignity laws. Most people hold the sanctity of life and death as one of the most important things in life. But what has people divided is determining when a person is merely existing and a life is no longer worth living. Those against Death with Dignity laws believe physician-assisted death goes against basic ethics, moral code, and does not reflect the value of human life. But physician-assisted death is ethical and should be legal in the rest of the states because it improves the quality of life, patient autonomy, and preserves the common good in terminally ill patients.

The Death with Dignity Act first began with the Hemlock society founded in 1980 by Derek Humphry after he helped his wife take her own life in 1975 as she was terminally ill with breast cancer. What was first started in his Santa Monica garage would slowly grow to 80 chapters and was the first step in legalizing physician-assisted death. In 1991, those who supported the right-to-die movement secured their first win. A jury refused to indict Dr. Timothy Quill for giving a terminally ill leukemia patient a lethal dose of medication to end her life. This sparked nationwide outrage and brought Death with Dignity laws to the forefront. So much so in April of 1991, the Oregon Hemlock Society teamed up with the terminally ill Oregon senator to propose “Aid-in-Dying” in Oregon. 3 years later Oregon becomes the first state to legalize physician-assisted suicide. Although many other states have proposed physician-assisted suicide most (besides the eight mentioned in paragraph one) have ultimately gotten rejected.

One of the main arguments against physician-assisted death is it is unethical and immoral. Although the taking of a life is universally observed as unethical, Death with Dignity laws pose a new implication with this ideology. If one consents to the taking of their life to provide a better quality of life, is it still unethical?. It is a hard concept to grasp for someone not in their final moments but filmmaker Peter Richardson has given some insight by filming the final moments of terminally ill patients who opted for the Death with Dignity Act. Oregon has been the state at the forefront of the debate over physician assisted death considering it pioneered many right-to-die laws and groups. So, it was only right the filmmaker return to the issue’s roots and create the documentary “Dying in Oregon”. Although the documentary shows the lives of several terminally ill patients, most of the film focuses on Cody Curtis, a terminally ill woman with Cholangiocarcinoma.

In the beginning of the documentary, one wouldn’t even think Cody was battling cancer. But she explains in the film and in an open letter penned “How We Die” that she will know when “life’s not worth living anymore”. She goes on to say “ It’s really nice to have a way out, to die in comfort and with dignity. I don’t want to die bed-ridden and weighing seventy pounds. I want the children to remember me as I am now, in peace and not in pain”. What many of those against right-to-die laws don’t understand is although longevity concerning life is important, a life isn’t worth living if it’s filled with pain. Cody had Cholangiocarcinoma, the cancer of the bile duct, which is a rare and deadly disease with less than 20,000 cases a year. The 5-year survival rate for people with early-stage Cholangiocarcinoma is 30%. If the cancer spreads to the lymph nodes, the 5-year survival rate is 24%. Those like Cody with this type of cancer experience massive organ failure, major fluid build making patients look pregnant, extreme shortness of breath and weight loss just to name a few of the symptoms. This is all until their body gives out and they die. This is not a life worth living and isn’t a life at all. Death with Dignity Laws preserve and try to promote the quality of life so no one has to endure this in their final moments. Instead, their final moments are filled with peace, happiness, and love.

Patients no matter the disease should be able to make their own decisions concerning their health as it is their right. This idea is called Patient Autonomy, the formal definition of Patient Autonomy is the right of patients to make decisions about their medical care without their health care provider trying to influence the decision. The dying process is a fundamental part of life, just because someone seeks control over their death does not mean their autonomy should be taken. A person should not have to have a good reason to make a decision as that is what autonomy is all about. We do not judge and question competent individuals when they make a decision. As long as a person understands the effect their decision has on themselves, society should trust that a competent individual knows what’s in their best interest. So, just because a person is facing an inevitable death and makes an unorthodox choice concerning their death does not mean society should question their competency and decision making skills especially if there have been no signs of incompetence. Death is something that will have to be faced by every person one day or another, some may believe wholeheartedly the piety of life and would choose not to quicken the process of death. But others as previously stated, believe that a life of pain is not a life at all and may want physician-assisted death in the future. The choice of an individual should not matter as long as an individual is understanding of the effects of both choices.

One of the biggest concerns concerning autonomy is that by vetoing physician-assisted death because of personal views takes away a person’s autonomy. But another major concern is even if states pass physician-assisted death bills, a physician could potentially force and coerce patients into ending their life. Yet, acts like the End of Life Option Act come with several preventative measures to protect patients against abuse, including mandatory documentation, monitoring the law’s usage in a patient’s decision, and requiring that the patient is mentally competent. In addition, the act has made it a felony for a physician to coerce a patient into asking for the lethal medication and it guarantees that a patient may opt-out or reverse the request at any time. But not only is there protection for patients but also for physicians, the bill gives them civil and criminal immunity should a patient decide to go forth with physician-assisted death. In a nearly two decade study following Oregon’s progress with physician-assisted death the data has shown that the medical option “is sparingly used with fewer than 1 in 500 deaths (60 or 70 a year out of a total of over 30,000 deaths)”. So, while most patients do not utilize the bill, they would rather like the option incase their health declines and are left with no options for treatment. This aligns with data showing that while Oregon and Washington have legalized the act, most individuals who requested the lethal medication did not end up taking it. Judith Guest once said, “Autonomy is the whole thing; it’s what unhappy people are missing. They have been given the power to run the lives of other people”. You have a choice, do not choose to take away someone else’s power over their life.

At the end of the day, the main goals for physicians and society overall is to make the dying process as peaceful as possible, as painless as possible, and most importantly as dignified as possible. Physician-assisted death is offering all of these things if not more yet, society opposes the idea. It is morally wrong to inflict indignity onto others but it is equally as wrong if a person takes away another person’s dignity or to be a viewer to someone taking away another person’s dignity. Dignity is defined as the state or quality of being worthy of honor or respect. So, although what constitutes a death as dignified is subjective, most would agree that a death with honor and respect would be regarded as a dignified one. But even with this being true, for terminally ill patients there are more things that make a person’s death dignified especially when a person faces inevitable rapidly depleting health and painful complications. For someone that is terminally ill; privacy, pain management, personal care, communication, social inclusion, practical assistance, and most importantly control are some of the major things that constitute to a dignified death.

Things like hospice and nursing homes are no longer the most practical when compared to physician-assisted dying. Studies show that depression is highly prevalent in hospice and palliative care environments especially in cancer patients where depression is usually four times higher than the general population. Furthermore, suicide is commonly accompanied by depression especially among those with advanced terminal diseases where it is twice as prevalent as in the general population. Evidence has also suggested a strong correlation between loss of dignity and depression in patients with advanced terminal illnesses. Although there are psychotherapeutic interventions such as dignity therapy which is meant to address existential concerns. Other studies have shown that though the therapy reduces existential distress tremendously and provides mass social support it does not significantly improve anxiety, depression, suicidal thoughts, and more importantly quality of life. Why does a therapy matter if it is only a temporary solution to a definite and inevitable problem, having an undignified death. Will therapy fix the slow and painful process of losing bodily function in a teen with ALS? Will therapy fix the severe and persistent vomiting that a young woman experiences with gastric cancer? Will it fix the constant bone pain in your grandfather with lung cancer? Therapy does not take away the physical pain and agony that a terminal patient must endure and only permits temporary inconsistent results.

In “Reasons to Reject Physician Assisted Suicide/Physician Aid in Dying”, Mark A. O’Rourke discusses how although wanting control over your final moments is a viable thing to want it’s not sufficient enough to want to end your life with physician-assisted dying. He also states that “but the remedy is education, support, and engagement with the patient rather than PAS/PAD”. The idea of “nothing else can be done” is not true. One can understand his argument but he is not in a position to say this. Firstly, there is a limit to everything. There are rare forms of diseases like Cody’s where’s there’s only expensive experimental procedures that are strictly trial and error and have no success rate but only prolong life. Support and education of your options are important but it does stop physical pain, it does not prevent people from having their last days disabled, and relying on others for even just using the bathroom and losing their dignity. If all the unnecessary spending and pain can be avoided why should PAD not be legalized in every state. This has been done in others and seems to be working fine although this may be something that O’Rourke and others might not choose for themselves, it does not mean those who are terminally ill should not have the option.

In another article titled “Physician Assisted Suicide Is Always Wrong”, Ryan T. Anderson speaks about the Hippocratic Oath which is an oath made by new physicians swearing to the healing gods that they will uphold certain ethical standards. In Anderson’s article, he cites a portion of the oath where it says, “I will keep [the sick] from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect”. He goes on to say “This is an essential precept for a flourishing civil society. No one, especially a doctor, should be permitted to kill intentionally, or assist in killing intentionally, an innocent neighbor… Doctors may help their patients to die a dignified death from natural causes, but they should not kill their patients or help them to kill themselves. This is the reality that such euphemisms as 'death with dignity' and 'aid in dying' seek to conceal”. This oath is 2,400 years old oath, Is it still an appropriate way of evaluating bioethics? More importantly, does it still matter that if a doctor prescribes a medication to a terminally ill competent adult who first requested to end unendurable pain would be a violation of the oath? Most assume that the oath is still taken but that isn’t the case, and if it is it isn’t recited in its original form as it is outdated. In medicine today the oath does not apply, within the oath, it says things like physicians are not “to cut for stone” which is used for a common urological procedure and “use the knife” which would mean surgery should not be practiced at all. The oath also tells physicians to “help the sick” which in the case of physician-assisted death is what is being practiced. So the oath clearly can not be used to evaluate an uphold bioethics as things have changed drastically in 2,400 years, advancements have been made, and diseases have become more prevalent and complex. An update should be made to the oath to say: Preserve patient autonomy and help determine and do what a competent patient regards as their best interest. This includes but is not limited to administering lethal medication to terminally ill patients to relieve them from suffering and die with peace as this does not violate the oath.

When first learning about what was once known as physician-assisted suicide I was too strongly against the sentiment and thought it was inhumane and immoral. But after educating myself on the stories of those who have chosen this way to die, the origination of the laws, and most importantly the reasoning and impact of these laws I have changed my stance on the situation. Not everyone will be forced to make the tough decision of whether their life is worth living but for those that do, they must have the opportunity to choose when their life is no longer their own. When their life is controlled by a disease and they’re just there until their body can’t take the pain and agony anymore. There must be more education on physician-assisted death as it does not go against any morals and is very beneficial to society and terminally ill patients. Everyone deserves autonomy and the ability to make their own choices, everyone deserves to live a quality life, and everyone deserves to die with peace and dignity. Go and view your state’s current stance on death with dignity laws and take action at www.deathwithdignity.org. Do not take away someone’s opportunity for relief due to closed-mindedness, educate yourself, and support death with dignity laws in your state.

Works Cited

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• Richardson, Peter, director. How to Die In Oregon. Tubi, TubiTV, 1 Jan. 2011, tubitv.com/movies/310499/how_to_die_in_oregon.
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