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Physician-Assisted Suicide

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Leah Davis

on 12 November 2013

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Transcript of Physician-Assisted Suicide

Physician-Assisted Suicide
Three Stakeholders
Religious groups
Physicians
Patients with a social worker advocate
History
Compromise
Provide both psychological and spiritual consultations throughout end of life treatment, and before physician-assisted suicide
Require multiple medical consultations to diagnose patient as terminal
Clearly define "terminal" to mean only those who would die within six months even WITH treatment
Require assessment of whether patients are acting freely, influenced by financial pressures, or pressured by family and friends
Doctors have the choice to participate in PAS and counseling for these doctors would be recommended.
Ensure patients administer the drugs themselves and are not in any way coerced
Definition of the Problem
Religious Groups
Any form of suicide is viewed as murder, an offense against the self and the bonds of love and solidarity with family, friends, and God.
Only God controls when an individual should die.
People suffering from illness need the love and assistance of others most to assure them of their worth.
The right to life is the most basic human right. We should respect this and surround the patient with love, support, and companionship.

Physicians
Has been debated for many centuries since the creation of the Hippocratic Oath in fourth century B.C

This oath, which most doctors believe in, became the standard that outlawed PAS in all states

Debate came back into the public eye in the 1990s by Dr. Jack Kevorkian (Dr. Death).

During this time, the law stated that Americans do not have a Constitutional right to doctor-assisted suicide.

1994 Oregon became the first state to pass Death with Dignity Act
One of today’s most controversial medical issues
Physician-assisted suicide is death caused by an intentional lethal dose of medications that are prescribed by a physician and administered by a patient (Pickert, 2009).

Pain is not the most motivating factor for physician-assisted suicide: rather, hopelessness and other psychological factors (Emanueal, 2009).

Thus, the social problem PAS attempts to assist is the quality in end-of-life care.

It appears that PAS was created to help those suffering from hopelessness and other psychological factors at end-of-life

This means that the problems our society needs to address is better end-of-life care and psychological services for individuals suffering from terminal illnesses.


Patients
Patients can die with dignity

Tremendous pain and suffering of patients can be reduced, including psychological suffering.

The right to die should be a fundamental freedom of each person.

Pain and anguish of the patient's family and friends can be lessened, and they can say their final goodbyes.

Respect for a patient's autonomy, justice,
and compassion.
www.balancedpolitics.orgassisted_suicide.htm
History
2006, the U.S. Supreme Court concluded that the states could decide whether to pass the right to PAS (ProCon.org, 2013).

Today, four states have legalized physician-assisted suicide
Oregon (November 8, 1994)
Washington (November 4, 2008)
Montana (December 31, 2009)
Vermont (May 20, 2013)

(http://euthanasia.procon.org)
References
American College of Physicians (2013). Ethics manual. Retrieved from http://www.
acponline.org/running_practice/ethics/manual/manual6th.htm#euthan asia

American Medical Association (1996). Code of medical ethics. Retrieved from http://www.
ama-assn.org/ama/pub/physician-resources/medical-ethics/code- medical-ethics/opinion

Balanced Politics. (2013). Should an incurable-ill patient be able to commit physician-
assisted suicide? Retrieved from http://www.balancedpolitics.org/assisted_suicide.htm

Emanueal, E. J. (2009). Euthanasia and physician-assisted suicide. Arch Intern Medical, 162.

Euthanasia: State by state guide to physician-assisted suicide. (2013). ProCon.org. Retrieved
from: http://euthanasia.procon.org/view.

Kitching, M., Stevens, A., & Forman, L. (2008). Views regarding physician assisted suicide:
a study of medical professionals at various points in their training. Clinical Ethics. 27-33.

Pickert, K. (2009, March 3). A brief history of assisted suicide. Time U.S. Retrieved from
http://content.time.com/time/nation/article/

Snyder, L. & Sulmasy, D. P. (2001). Physician-assisted suicide. American College of
Physicians – American Society of Internal Medicine. 209-216.

United States Conference of Catholic Bishops (2011). To live each day with dignity: A
statement on physician-assisted suicide. Retrieved from http://origin.usccb.org/issues-and-action/ human-life-and-dignity/assisted-suicide/to-live-each-day/.

United States Conference of Catholic Bishops (2011). Assisted suicide and euthanasia:
From voluntary to involuntary. Retrieved from http://origin.usccb.org/issues-and-action/
human-life-and-dignity/assisted-suicide/to-live-each-day/









Criteria
Patients must convince two physicians that he/she is sincere, not acting on a whim, and that the decision is voluntary.

Patients must verbally state they want to participate in PAS and create a written request.

Patients are required to take a mental health evaluation and must not be influenced by depression.

Physicians must inform patients of alternative options such as hospice, counseling, pain control and comfort care.

Finally, the patient must wait 15 days before they are approved for PAS.

Once the patient meets all these requirements, they are given a barbiturate of their choice and can choose to die when they are ready

(http://euthanasia.procon.org)

(http://euthanasia.procon.org)
The AMA and the ACP do not support PAS as it is not compatible with physician's role as a healer (AMA, 1996) & (ACP, 2013).
interferes with patient trust
diminished end-of-life care
extortion of vulnerable clients
Potential considerations (Kitching, Stevens & Forman, 2008):
giving physicians choice
requiring counseling for medical professionals
requiring a multidisciplinary approach (Kitching, Stevens & Forman, 2008).
The ACP further notes that depression is common amongst terminal patients, which can lead to fluctuation over time in the desire to die. The desire to die may be connected to:
poor end of life care
poor pain management
perception of being a burden to ones family (Snyder & Sulmasy, 2001).
Additional considerations: age limitations for use of PAS & difficulty of clients to question the advice of medical professionals
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