Physician-assisted suicide has always been a very controversial subject in society—the ancient Greeks brought the subject to forum, as euthanasia in Greece and in Rome was an everyday issue. It is even written in the Hippocratic Oath (written in the 4th century B.C.E.), “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan” (“Hippocratic”). Today both euthanasia and physician-assisted suicide are still tough topics to tussle with, in our society and around the world.
Although the terms “physician-assisted suicide” and “euthanasia” have been used interchangeably, there is a distinct difference between the two. The name “physician-assisted suicide” may be self-explanatory: it is a patient dosing themselves on medicine prescribed by their attending physician while the doctor is not present in the patient’s room, and it is the patient’s decision whether to use the drugs or not, and when. (“Physician”) Euthanasia, on the other hand, is more aggressive; the doctor actually administers the drug to the patient which subsequently causes their death. In this paper I am going to address physician-assisted suicide specifically.
I am arguing for PAS on four bases: first, that refusal to allow it is a violation of the inherent right to self-determination of the terminally ill; second, that it can save patients and family, as well as health care providers, money; third, that physician-assisted suicide could save patients and families the trauma that comes with the uncertainty of natural and slow death; and fourth, that PAS is actually much more humane than allowing a suffering patient to die naturally.
Patients should have the choice of physician-assisted suicide, because it is a manifestation of their right to self-determination as it is interpreted from the Constitution. The Supreme Court ruled in Planned Parenthood v Casey (Leo) that “choices central to personal dignity and autonomy are central to the liberty protected by the 14th Amendment. At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe and of the mystery of human life.” This translates simply to the idea that one should have the final say about what happens to one’s body, outside of the realm of directly harming others.
Physician-assisted suicide can save patients, their families, and health care providers significant amounts of money. One Hospice Care professional cited a hospice care cost at roughly $6,000 per two months per patient (“Hospice”). Much or most of this is funded through Medicare or Medicaid, although both of these services are costly to these patients on top of their already high hospital care bills. Much of the money going toward hospice could be more advantageously propagated to medical research, children’s hospitals, and other medical programs that have unstable funding but serve functions crucial to the health of our society as well as other countries that rely on our medical breakthroughs. Outside of the realm of hospice care, “[a]ccording to recent Medicare data, for a beneficiary who dies of cancer after receiving conventional care, $30,397 (in 1995 dollars) is spent on medical care in the last year of life” (Emanuel and Battin). This includes medications that cost upwards of $4,000 a month, which may or may not be covered by Medicare (James).
The self-dosing of PAS could save patients and their families the pain and heartbreak that comes with prolonged dying and the uncertainty that accompanies it. It allows patients to decide when to end their own suffering, which gives family and friends ample time to say what they need to say to their suffering loved one.
Lastly, physician-assisted suicide is more humane due to the drugs prescribed and taken than letting terminally ill patients suffer until death. In the Netherlands they use high doses of barbiturates for PAS; this type of drug affects the central nervous system, and causes sleepiness. Barbiturates are a central nervous system depressant (CNS), used to calm patients before surgery and can be used to control seizures, sleep problems, and nervousness, although other drugs have begun to replace barbiturates in these last two areas (“Barbiturates: Purpose”). A barbiturate overdose can be likened to dying in one’s sleep; anxiety levels decrease and heart rate and respiration reduce (“Barbiturates Drug Information”), which is much more peaceful than the months leading up to death from the patient’s terminal illness.
One might argue that physician-assisted suicide is, at its basest, still simply suicide, and that if we as a country allow for the terminally ill to commit suicide, who is to say that we won’t extend this right to those who are depressed? Are we not denying this right of self-determination to them if we refuse physician-assisted suicide to them? I do agree that this could become an issue if PAS was legalized, but whereas such conditions as depression can be treated through medication, terminal illness can only be micromanaged, not cured, nor can the subsequent death be prevented once a patient is in such poor condition that a doctor will classify them as terminally ill. One might also argue that suicide in either form does directly affect the patient’s loved ones, but in the end, the one who suffers the most during the dying process is the patient who is dying.
