Bioethics Discussion Blog: Physician-Assisted Suicide: Which State is Next?

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Monday, January 19, 2009

Physician-Assisted Suicide: Which State is Next?

With the vote approval of the residents of Washington state last November and to take effect March 4, 2009, physician-assisted suicide (“physician-assisted death”,”physician aid in dying”,”death with dignity”,take your pick) is now permitted (and supported by the Supreme Court) in two states. Oregon was the first in 1997 and has been well documented. Read the documentation in the full free article “Physician-Assisted Death — From Oregon to Washington State” by Robert Steinbrook, M.D. in the December 11, 2008 issue of the New England Journal of Medicine.

“The act permits terminally ill state residents, defined as adults with an illness expected to lead to death within 6 months, to request and receive a prescription for a lethal dose of a medication that they may self-administer in order to end their life.”

There is controversy regarding these acts both on the part of the general public but also amongst physicians. The professional question is whether it is the duty of physicians to facilitate the death of those patients who desire to die. An interesting social question would be whether it is simply a matter of state’s best interest to permit and allow the facilitation of such autonomous death decisions by terminally ill patients and in this way perhaps to conserve scarce resources that could be used on other patients or citizens in general. On the other hand, one might ask if the primary motivation for the state would be to look to the best interest of the terminal patient irrespective of the shepherding of these resources. And would everyone agree that it is in the patients’ best interest to have the option to allow death to come sooner? There are arguments that adequate diagnosis and treatment for depression may be ignored or that none or inadequate attempts at palliative care is being rendered for these patients.

If physician-assisted suicide with the limitations and controls already set by the states of Oregon and Washington were considered in your state or country, would you vote or agree to approve it?

For more on this topic, here are the links to the previous threads on this blog:

Summary of Oregon’s Death with Dignity Act - 2007


Should Physicians Provide Information so Patients can Hasten Dying?


Should The Mentally Ill Deserve Assisted Suicide?


“A Wasted Illness” And The Request To Jump From The Train with the poem by Thomas Hardy

Thomas Hardy - A Wasted Illness

Through vaults of pain,
Enribbed and wrought with groins of ghastliness,
I passed, and garish spectres moved my brain
To dire distress.

And hammerings,
And quakes, and shoots, and stifling hotness, blent
With webby waxing things and waning things
As on I went.

"Where lies the end
To this foul way?" I asked with weakening breath.
Thereon ahead I saw a door extend -
The door to death.

It loomed more clear:
"At last!" I cried. "The all-delivering door!"
And then, I knew not how, it grew less near
Than theretofore.

And back slid I
Along the galleries by which I came,
And tediously the day returned, and sky,
And life--the same.

And all was well:
Old circumstance resumed its former show,
And on my head the dews of comfort fell
As ere my woe.

I roam anew,
Scarce conscious of my late distress . . . And yet
Those backward steps through pain I cannot view
Without regret.

For that dire train
Of waxing shapes and waning, passed before,
And those grim aisles, must be traversed again
To reach that door.

..Maurice.

2 Comments:

At Tuesday, January 20, 2009 10:28:00 PM, Blogger Jessica Knapp said...

Thank you for writing about this topic! I think it is so important, and I'm always happy to see people discussing it.

I think your post laid out a lot of the arguments against physician assisted suicide, but maybe not all of the arguments in favor of it.

I'll tell you right now, I'm about as for this movement as you can get. Death with dignity gives patients autonomy over the manner in which they die. It offers compassion to those who are dying anyway, many of whom are dying with pain and suffering. I think society has a strong interest in preserving life, but sometimes individual liberty must win out over that maxim. Also, some in the medical profession would tell you that PAS already occurs but under the radar. Legalizing it will lend an openness to the discussion.

Also, to address one question you pose: Why would everyone need to agree that it's in the patient's best interest to hasten death? The point of death with dignity initiatives are that the decision can be made by the individual facing an imminently terminal illness, not by society at large.

Also, the laws do not allow for those who have depression to receive physician assisted suicide.

 
At Wednesday, January 21, 2009 6:58:00 AM, Blogger FridaWrites said...

Given the recent case in England in which a man with quadraplegia went to Switzerland to die, I'd like to ask that people be screened and treated for depression first and that any such causes of depression be addressed and remedied. I'm afraid this would be overlooked. Pain control should also not be forgotten.

I'm not sure if the law also allows those with severe disabilities to commit suicide, but the lack of support systems, jobs, accessibility, even in-home rather than nursing home care, leads many to desperation, as it did for this man in England.

A "terminal" illness can be of quite lengthy duration.

 

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