Assisted Death

Assisted death happens when a critically ill, sane patient, making the choice of their own volition and having met strict legal safeguards, takes prescribed medication which ends their life (Berg, 2012). The practice has been known to be legally and ethically accepted and has therefore been in existence for quite some time. The victims, in an effort to hasten their deaths refuse treatment or at times request for terminal sedation. The right to suicide is as well ethically and legally accepted. According to (Cauthen, 2015) assisted suicide might allow someone to altogether reasonably, because of their condition, refuse life-sustaining treatment. This article seeks to put a spotlight into the ethicality of assisted death.

The issue of assisted death has been a heated debate for decades; whereas some organizations believe that physician assisted death is ethical as it is a solution for patients that are going through unbearable pain, others such as religious organizations have continuously opposed this idea. There has been a question whether assisted death should fall within the moral and legal compass. There are circumstances that might result in such a situation, for instance, in a case where the victim might be suffering from extreme pain that might prevent them from expressing their views. According to Sumner, (2011), assisted death is currently illegal in the UK and most countries worldwide. It is used interchangeably with the two intertwined phrases. To start with is physician-assisted death (PAS) which entails a doctor’s predetermined action to deliberately avail to a person the know-how and the procedure of committing suicide through either provision of counsel and or lethal prescriptions. Secondly is euthanasia where a doctor provides the means of death usually via lethal medication. However, physicians are only allowed to recommend these lethal medications in countries where such an exercise is legal patient’s preferences or the prognosis for the disease notwithstanding. The two medical procedures; PAS and Euthanasia are more often than not confused. In physician-assisted death, the patient self-administers the means of death. In assisted death, there could be several forms under which it is categorized. This includes active and passive assisted death, voluntary and involuntary assisted death, indirectly assisted death and assisted suicide.

Cauthen, (2015) says that active and passive assisted death is where the practitioner directly and willingly causes the patient’s demise. In this form, the healthcare practitioners do not deliberately take the patient’s life; they just let them die. This is an immoral distinction, since even though a person doesn’t actively kill the patient, they are aware that the result of their malpractice will occasion the death of the patient. Active assisted death is when death is caused by an act, say when a patient’s life is terminated by being availed with an overdose of a prescription. Passive assisted death is done by withdrawal of some health procedures or and letting the person die (Cauthen, 2015). This could be done by denying the proper patient treatment. Putting off a life supporting machine that is keeping a person heartbeat kicking, so that they die of their disease: Withholding treatment: for instance, not carrying out surgery that will extend life for a short time (Berg, 2012). Traditionally, passive assisted death is thought of as less evil than active assisted death. But some people think active assisted death is ethically better.

According to Kasher, (2009), voluntary assisted death occurs at the bidding of the individual who dies. On-voluntary assisted death happens when the person is unconscious or otherwise vulnerable for example, an infant or a person of extremely low judgment, to make an informed choice between living and dying, and an appropriate person implements the decision on their behalf. Non-voluntary assisted death also includes cases where the person is a minor who is mentally and emotionally sober to take the decision but is not considered in the constitution as old enough to make such a decision, so someone else must take it on their behalf. Involuntary assisted death occurs when the dying person chooses life, and their life is terminated anyway (Kasher, 2009). This is mostly considered murder, but it is possible to imagine cases where the killing would directly or indirectly benefit the person who dies.

Indirect assisted death, on the other hand, means providing a treatment routine that has the side effect of expediting the patient’s demise. Since the cardinal intention is not to take life, this is seen by some people as morally palatable, bearing witness along these lines is formally called the teaching of double effect Indirect Assisted Death. This involves administering painkillers that have the effect of expediting one’s death. Owing to the fact that the intention is not to kill this is considered morally palatable albeit not by everyone. Consequently, assisted suicide usually refers to instances where the dying person needs help to kill themselves and makes a suggestion to that effect. It may be as basic as getting potentially lethal drugs for the sick person and putting them at arm’s length. (Ziegler, 2014).

Healthcare practitioners have given diverse reasons as to why they opt to practice, and patients go for assisted death. According to Meyers & Bosshard, (2008), physicians opt to it since some patients might be suffering from a tremendously painful terminal illness which prompts them to prefer dying to living. Next on the list is when patients apprehend being a burden to their families thus dying becomes the best option to rule out such a possibility. Thirdly, some patients may have neurological infections prompting them to consider assisted death. Geographical immobility may also provoke assisted death intentions. Lastly but to a less extent, patients may prefer dying due to consistent lack of sleep; Insomnia

Patients on the other hand apparently take on assisted death mostly because their illness limits their avenues of enjoying life, secondly some disease may reduce efficiency on the part of patients due to eroded concentration. Lastly, a substantial number of patients may have lost hope and or interest in life.

The practice has both advantages and disadvantages altogether. Some groups and organizations have been so much against assisted death, some being governmental and others non-governmental as well as religious groups. They have spearheaded campaigns against aided death across the globe. They do this following various misgivings of the exercise (Robinson & Wise, 2013). To begin with, assisted death infringes on the sanctity of life; life has divine respect and reverence attached to it. Additionally, people may condone irresponsible suicides by non-critical patients. It may violate the Hippocratic Oath by doctors. This is an oath that states the obligations and proper conduct of physicians. Fourth, religions have it that only God could take life; they, therefore, castigate assisted death. Finally, insurance companies may pressure doctors to terminate the lives of their clients to meet their selfish motives should assisted death be legitimized.

It is practiced in part or whole in various countries within the confines of laid out regulations that include Canada, Germany, Netherlands, and Uruguay. These are some of the countries that are well-known for practicing assisted death for quite some time.

In Canada assisted death was treated a criminal offense in Canada until 1972, after which it was scrapped off the Criminal Code. Physician-assisted suicide has been legitimate in the Province of Quebec since the termination of life care law (“medical aid in dying”) was enacted by the provincial government on June 5, 2014. It was declared legally palatable across the nation because of the Canada’s Supreme Court decision Carter v Canada (AG), of February 6, 2015.

In Germany, termination of somebody’s life with respect to his demands is more often than not illegal under the German criminal code (Stone, 2008). Assisting death by, for example, administering poison or weaponry is legally acceptable. Since suicide Percy is legal, assistance or motivation is not punishable by the common legal procedures entailing complicity and incitement. There can, however, be legal consequences on some conditions.

In The Netherlands, assisted suicide is legal under the same terms as assisted death. Physician-assisted suicide was endorsed under the Act of 2001 which highlights the specific procedures and requirements needed for provision of such aided demise in Netherlands is in line with a medical model which requires that only doctors of fatally ill patients are allowed to consent to a demand for aided death. The Netherlands take patients well above age 12 legible subscribe to assisted suicide procedure if need be.

In Uruguay, the judges are mandated to overlook punishment of a person who previously lived honorably where he undertakes a homicide on compassion grounds, necessitated by incessant requests of the dying patient.

Other countries that support the practice are Switzerland, Japan, and some states in the U.S.A.

According to Ziegler and Bosshard, (2007), regard for autonomy may be neglected as an ethical principle simply because it is so imbued in our day by day occupations and therefore we underestimate it. In any case, those whose freedom and self-determination are slighted in nations everywhere throughout the world can confirm its significance. It is thus not astounding that autonomy and decision to end-of-life treatment are just debatable in democratic and open societies (Ziegler & Bosshard, 2007).

Another ethical principle supporting physician-assisted death is empathy for our kindred nationals (Meyers & Bosshard, 2008). Albeit contemporary palliative drug is equipped for mitigating the most enduring towards the end of life, it can’t prevent all of it. A few patients will keep on experiencing intolerable physical indications or mental distress in spite of the best that palliative care can offer. This distress is pointless since it can be anticipated by permitting patients the choice of medical aid in dying. Compelling patients to experience superfluous suffering is not sympathetic but rather pitiless (Meyers & Bosshard, 2008).

The individuals who advocate for the legal and ethical choice of medical aid in dying have been very reliable in calling upon these two principles, autonomy, and empathy, in backing up their arguments.

If a patient has made an intentional solicitation for medical aid in dying, having been thoroughly educated of his anticipation and of the greater part of the choices accessible for end-of-life consideration, then a doctor’s ability to conform to that solicitation can’t compromise the patient’s autonomy. Murder substitutes the will of the culprit for that of the casualty. Medical aid in death regards the freedom of the patient.

There is hence no relationship between medical aid in dying and instances of unjustified manslaughter. In light of it, there is no moral case of evidence against a law which would furnish dying patients with this choice. Furthermore, there is an extremely solid ethical case for it. It is my opinion that permission to subscribe to advance demands for medical assistance in dying to be allowed any time after a patient is diagnosed with the condition that is sensibly likely to occasion incompetence, or after a diagnosis of irremediable disease but before the suffering becomes unbearable. Patients with psychiatric problems should not be allowed to make advance requests for assisted death.

References

Berg, L. H. (2012). Assisted Death and Physician-assisted Suicide Among Patients with Amyotrophic Lateral Sclerosis in the Netherlands. New England Journal of Medicine, 346(21), 1638-1644.

Cauthen, K. (2015). The Ethics of Assisted Death. Lima, Ohio: CSS Pub.

Kasher, A. (2009). Dying, Assisted Death and Mourning. Amsterdam: Rodopi.

Meyers J. & Bosshard G, (2008). Assisted Death and Law in Europe. Hare publishing, Switzerland.

Robinson, M., & Wise, E. (2013). Analgesic Ladder for Pain Management. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Stone, B. (2008). Death as a salesman: what’s wrong with assisted suicide. New Regency Pub.

Sumner, L. W. (2011). Assisted death: A study in ethics and law. Oxford: Oxford University Press.

Ziegler, S. J., & Bosshard, G. (2007). Role of non-governmental organizations in physician assisted suicide. BMJ: British Medical Journal, 295-298.