The Death With Dignity Act and Physician Assisted Suicide
Introduction
According to the American Medical Association (1996), physician-assisted suicide (PAS) occurs when a physician facilitates a patient’s death by providing either the means or the information necessary to aid in the patient performing the life-ending act. PAS has had a long and controversial history dating back to the ancient Greeks and Romans. They believed that there was no reason to prolong life if continued pain and suffering was the only prognosis. The term euthanasia, in fact, stems from the Greek meaning "a good death". It was not until Hippocrates and his Hippocratic Oath, cautioning against deadly medicine towards patients, that a different view was seen. Early Christians held the opinion that suicide or martyrdom was an honorable or noble end to one's life, a way to make the ultimate sacrifice for God. Countering that view, Augustine of Hippo condemned suicide as being a mortal sin, going against God's law of "Thou shall not kill". As medicine has evolved and progressed exponentially since those ancient times, lives may very well benefit from an increase in length but may not always equate to an increase in the quality of life. PAS is one possible solution to this dilemma, albeit one with many ethical and legal debates concerning it.
Literary review
Presently, PAS is legal in the United States in three states - Oregon, which was the first in 1997, and then Washington and Montana both following in 2009. The Death with Dignity Act (DWDA) was proposed in 1994 in Oregon as a way for physicians to legally assist terminally ill individuals who wished to end their suffering and choose their own time of death. It was initially
stalled in the Fed...
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...doption of such measures as the DWDA are a real possibility. When that time comes, nurses will surely find themselves dealing with this issue more frequently. Even though it may be legal at that point, the nurse will be the one who has to decide as an individual their personal interpretation of the basic nursing concept of "to do no harm".
Works Cited
Code of ethics for nurses. (2001). Retrieved from www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf
Lachman, V. (2010). Physician-assisted suicide: Compassionate liberation or murder?. MEDSURG Nursing, 19(2), 121-125.
Rose, T. (2007). Physician-assisted suicide: Development, status, and nursing perspectives. Journal Of Nursing Law, 11(3), 141-151.
Volker, D. (2007). The Oregon experience with assisted suicide. Journal Of Nursing Law, 11(3), 152-162.
The word Euthanasia comes from the Greek and means “good death” (http://www.medicinenet.com/script/main/hp.asp) and in the range of this paper, it will be called physician assisted suicide or “active” euthanasia. The definition of “active” euthanasia is ending one’s life yourself or with aid of a doctor. It can be done in various different ways; however, the most common form is with a combination of drugs, usually given by a physician. ( http://www.medicinenet.com/script/main/hp.asp) The reason Physician Assisted Suicide (or PAS) is an important issue in this country and around the world is that there are many people out there suffering from debilitating, incurable and intensely painful diseases that would like to end their lives with dignity and without suffering. (Leo & Lein, 2010, The Value of a Planned Death)
PAS is an emotional debate that has been addressed in the courts repeatedly. In 1997, the Supreme Courts ruled PAS illegal in Washington State during the Washington et al. v. Glucksberg et al. case. Several of the main reasons provided are, the state has the commitment to protect life, the medical profession, and vulnerable groups (Washington et al. v. Glucksberg et al., 1997). However, in 2008 the Supreme Courts reversed their previous decision and passed the Death with Dignity Act legalizing PAS for Washington State. This declares that terminally ill individuals in the state of Oregon, Washington, Montana, and Vermont now have the liberty to choose how they will end their lives with either hospice care, palliative care, comfort measures, or PAS. The question remains is will the rest of the United States follow their lead?
Ethical decisions are being made by terminally ill patients as they face death. Some are choosing to end life through PAS, physician-assisted suicide. Dr. Jack Kevorkian has been helping patients end life through his machines. The public opinion is the use of this machine is considered murder, but some have changed their thinking and created laws to make it legal for a physician to help a terminally ill patient die. Physician assisted suicide is a dignified way to end life.
The Death with Dignity Act was approved by voters in Oregon in 1994 and was confirmed in 1997 when the law went into effect. It is a law that allows mentally competent, terminally-ill adults to voluntarily request a prescription medication
Braddock and Tonelli. “Physician-Assisted Suicide.” Ethics in Medicine University of Washington Medical School. 2008. .
In the medical field, there has always been the question raised, “What is ethical?” There is a growing conflict between two important principles: autonomy and death being considered a medical treatment. Physician assisted suicide is defined as help from a medical professional,
There are only three states that allow physician-assisted suicide: Washington, Oregon, and Montana. Oregon became the first by enacting the Death with Dignity Act which allows terminally-ill patients to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose. (Oregon.gov) In November of 2008 Washington became the second and in December of the same year Montana agreed and became the third. A poll was given to Oregon physicians in 1999, nurses, and social workers in 2001. The majority of physicians 51% supported the death with dignity act, 48% of nurses were in favor, and 72% of social workers were in support. (Miller) These polls clearly show that the majority of voters are in support of Physician assisted suicide.
Physician assisted suicide (PAS) is a very important issue. It is also important tounderstand the terms and distinction between the varying degrees to which a person can be involved in hastening the death of a terminally ill individual. Euthanasia, a word that is often associated with physician assisted suicide, means the act or practice of killing for reasons of mercy. Assisted suicide takes place when a dying person who wishes to precipitate death, requests help in carrying out the act. In euthanasia, the dying patients may or may not be aware of what is happening to them and may or may not have requested to die. In an assisted suicide, the terminally ill person wants to die and has specifically asked for help. Physician-assisted suicide occurs when the individual assisting in the suicide is a doctor rather than a friend or family member. Because doctors are the people most familiar with their patients’ medical condition and have knowledge of and access to the necessary means to cause certain death, terminally ill patients who have made
Harned, Mary. “The Dangers of Assisted Suicide.” Defending Life. Americans United for Life, 3 April 2012. Web. 20 March 2014.
Cotton, Paul. "Medicine's Position Is Both Pivotal And Precarious In Assisted Suicide Debate." The Journal of the American Association 1 Feb. 1995: 363-64.
Markoff, Steven. “State by-State Guide to Physician Assisted Suicide” ProCon.org. 13 December 2013, 30 March 2014.
Although widely condoned around the world, only one nation, the Netherlands has made physician assisted suicide legal. Five states tried Washington in 1991, California in 1992, Michigan in 1998,and main in 2000, Oregon in 1994 approved the “Death with Dignity Act” it won 51 percent to 49 percent. 91 people committed suicide with the aid of a physician in the first four years the law was in effect.
However, “The United States Supreme Court found that liberty as defined in the 14th Amendment does not include the right to assistance in dying” (Vacco v. Quill). It was later decided that the responsibility for determining whether assisted death should be legalized should belong to individual states. According to a report by CNN, in 1994 Oregon became the first state to legalize assisted suicide for terminally ill, mentally able adults. Today there are five states in which physician assisted suicide is legal. In Oregon, Vermont, Washington and California the option is given by each states individual laws. In Montana the patient must have a court decision. Oregon was the first state to pass the death with dignity act.
This is an annotated bibliography for research on assisted suicide and how it effects the patient and the family and friends involved. I am researching whether or not assisted suicide is inhumane or dignified upon request of the patient.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.