Top 10 Pro & Con Arguments - Euthanasia - artsocial.info
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A complete prohibition against PAD excessively limits personal liberty. Therefore PAD should be allowed in certain cases. Some acknowledge that assisted death already occurs, albeit in secret. The fact that PAD is illegal in most states prevents open discussion between patients and physicians and in public discourse. Legalization of PAD would promote open discussion and may promote better end-of-life care as patients and physicians could more directly address concerns and options.
What are the arguments against physician aid-in-dying PAD? Those who argue that PAD is ethically impermissible often offer arguments such as these: Religious and secular traditions upholding the sanctity of human life have historically prohibited suicide or assistance in dying. PAD is morally wrong because it is viewed as diminishing the sanctity of life. There is an important difference between passively "letting die" and actively "killing.
Vulnerable populations, lacking access to quality care and support, may be pushed into assisted death. Furthermore, assisted death may become a cost-containment strategy. Burdened family members and health care providers may encourage loved ones to opt for assisted death and the protections in legislation can never catch all instances of such coercion or exploitation. To protect against these abuses, PAD should remain illegal. Historical ethical traditions in medicine are strongly opposed to taking life.
For instance, the Hippocratic oath states, "I will not administer poison to anyone where asked," and I will "be of benefit, or at least do no harm. The overall concern is that linking PAD to the practice of medicine could harm both the integrity and the public's image of the profession.
Fallibility of the profession: The concern here is that physicians will make mistakes. For instance there may be uncertainty in diagnosis and prognosis. There may be errors in diagnosis and treatment of depression, or inadequate treatment of pain. Thus the State has an obligation to protect lives from these inevitable mistakes and to improve the quality of pain and symptom management at the end of life.
Is physician aid-in-dying PAD illegal? Physician aid-in-dying is legal in Oregon, Washington, and Vermont, where voter-approved initiatives or legislative action have legalized aid-in-dying under very specific circumstances. A Montana lower court has also determined that physician aid-in-dying is permitted under Montana's State Constitution; this decision was upheld by the Montana State Supreme Court in December In other states, without specific legislative authority or a court decision, physician aid-in-dying would most likely be considered illegal, and in many states is explicitly illegal.
Opponents immediately challenged the law and it was not enacted. In response, the Oregon Legislature referred Measure 51 a law to repeal Measure 16 for a public vote. Thus, physician-assisted dying has been legal in the state of Oregon since On May 20,PAD was legalized in Vermont when the governor signed a bill that was passed by the state legislature.
Similar legislation was been introduced in and in Connecticut, Hawaii, Kansas, Massachusetts, New Hampshire, New Jersey and Pennsylvania; none of these states has yet to approve these bills.
Euthanasia Debate - Pros & Cons of Physician-Assisted Death
The laws in all three states have strict patient eligibility criteria, limiting access to competent, legal residents of the state over age 18, with a terminal illness defined as an estimated life expectancy of 6 months or less that is confirmed by two independent physicians. There is a requirement for two oral requests with a day waiting period in between, as well as a written request that must be witnessed.
Prescriptions may be written no less than 48 hours after the receipt of the written request. Patients must be able to self-administer the medications i.
Providers may decline to prescribe medication under the Act. Several major court decisions have been made regarding this issue. In the case of Washington v. In another case, Vacco v. Quillthe Second Circuit Court found a New York law prohibiting assisted suicide was in conflict with the equal protections clause of the 14th amendment, which says that no state shall "deny to any person within its jurisdiction the equal protection of the laws. The Court also left the decision of whether to legalize PAS up to each individual state.
There have been high-profile cases related to specific incidents of aid-in-dying. Timothy Quill of Vacco v. Quill who was investigated but not indicted for his participation in the suicide of a patient after he published his account of the incident. Jack Kevorkian who claimed to have assisted over patients in death, and was acquitted on murder charges on multiple occasions.
Kevorkian administered a lethal injection. As a result of the show, Kevorkian was tried for first degree murder in Oakland County, Michigan. Prosecutors argued that, in administering a lethal injection to Youk, his actions constituted euthanasia rather than PAD.
Kevorkian was convicted of second degree murder insentenced to a year term of which he served 8 years, and was released in What does the medical profession think of physician aid-in-dying PAD? Surveys of individual physicians show that half believe that PAD is ethically justifiable in certain cases Cohen et al.
However, professional organizations such as the American Medical Association have generally argued against PAD on the grounds that it undermines the integrity of the profession.
Surveys of physicians in practice show that about 1 in 5 will receive a request for PAD sometime in their career Back et al. Qualitative research has shown that requests for PAD bring up sensitive issues and emotions.
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Physicians stated that the discussion around these issues was lengthy and included patient and physician concerns about depression, pain and symptom management, issues of control, and exploration of the fear of abandonment Back et al. What should I do if a patient asks me for physician aid-in-dying PAD? One of the most important aspects of responding to a request for PAD is to be respectful and caring.
Virtually every request represents a profound event for the patient, who may have agonized over his situation. The patient's request should be explored, to better understand its origin and to determine if there are other interventions that may help ameliorate the concerns that motivated the request.
If time permits, tell the patient that you would like to talk more about this at a subsequent appointment. That gives both you and the patient time to prepare for a fuller exploration of PAD as well as other palliative treatments, hospice, etc.
Evaluate for depression or other psychiatric conditions and treat appropriately. Make sure to assess patient understanding. Discuss all alternative options, such as palliative care and hospice. Where appropriate, ask for help from a palliative care specialist to assure that all options have been explored.
What if the request for physician aid-in-dying persists? If a patient's request for aid-in-dying persists, each individual clinician must decide his or her own position and choose a course of action that is ethically justifiable and legally permissible.
It is useful to carefully reflect on and think through where you stand on the issue and be prepared to openly discuss your position with the patient, acknowledging and respecting difference of opinion when it occurs.
Patients who ask for PAD-in states where it is legal or illegal-understand that physicians will have different opinions about what they can and should do. The most important thing is to be clear and transparent about your position. Even in states where it is illegal, some physicians will decide to help their patients, particularly when patients are enduring unbearable suffering. While we cannot condone this practice, we must recognize its occurrence and the reasoning behind it. No physician, however, should feel forced to provide assistance if he or she is morally opposed to PAD.
Confirm the following eligibility criteria: Washington State resident Age 18 and older Competent able to make and communicate an informed decision to health care providers Terminally ill incurable, irreversible disease expected to cause death within six months, as determined by the attending physician and a consulting physician Able to voluntarily express his or her wish to die Assure that it is an informed decision, which means the patient has an appreciation of the relevant facts, after being fully informed about the following: Living Wills Also known as an advance directive, a living will is a legal instrument concerning healthcare should a person become incompetent.
The remaining states subsequently passed similar acts, the specific requirements of each varying from state to state. InCongress passed the Patient Self-Determination Act requiring healthcare facilities — such as hospitals, nursing homes, and home health agencies — to inform patients of their right to create an advance directive at the time of admission.
Surrogate Healthcare Decision-Making Whenever a patient is incapable of making decisions about care, physicians must turn to a patient surrogate for directions on future care, especially those made near the end of life. Creating a medical power of attorney ensures that the surrogate is trusted by the patient.
For example, the patient might specifically direct that no feeding tube or mechanical breathing is used, but other decisions can be made by the surrogate. Each state has laws regarding the proper wording of the agreement, as well as conditions that can affect the choice of proxies and the conditions under which a power of attorney might apply.
The Supreme Court recognized the principle that a competent person has the right to forego treatment, including nutrition and hydration, in the case of Cruzan v. Director, Missouri Department of Health. By extension, surrogates have the same authority acting on behalf of the patient.
Nevertheless, controversy remains, as evidenced in the cases of Terry Schiavo in Florida and Brittany Maynard in California. Lacking a living will, her husband, Michael Schiavo, was appointed her legal guardian in June One year later, her physician determined she was in a persistent vegetative state requiring feeding and hydration tubes.
Inher husband initiated a do-not-resuscitate order for Mrs. Schiavo based upon his belief there was no hope for her recovery. Her doctors agreed that Terri was in a persistent vegetable state with little hope for recovery.
Euthanasia Debate – Pros & Cons of Physician-Assisted Death
For years, the case of Terri Schiavo moved through the Florida courts, the state legislature, and the U. Terri Schiavo died on March 31, — 15 years after her initial collapse.
A Gallup Poll indicated that more than half of Americans agreed with the decision to remove the feeding tube. Despite brain surgery, the tumors returned, leading to a diagnosis of grade IV astrocytoma — commonly called glioblastoma — in April According to the American Brain Tumor Associationglioblastoma leads to headaches, seizures, memory loss, loss of movement, language dysfunction, and cognitive impairments.
Her physicians gave her six months to live. Brittany agreed that no treatment could save her life, while the recommended treatments — surgery and radiation — would destroy the time she had left. If you ever find yourself walking a mile in my shoes, I hope that you would be given the same choice and that no one tries to take it from you.
Conflicts Regarding the Right to Die Physician Responsibility The American Medical Association has opposed physician participation in euthanasia or assisted suicide for decades. Nevertheless, many physicians have begun to reconsider their role in end-of-life decisions: Shavelson thinks the decision to help a patient end his life should be no different from any other medical decision: Religious Teachings Most of the formal religious organizations in the United States are opposed to any effort that might legalize or promote euthanasia in any form, excluding the withholding of assisted breathing, food, or water.
According to a Pew Research articlea sampling of the faiths and the reasons include: The three branches of Judaism — Orthodox, Conservative, and Reform — prohibit assisted suicide in any circumstance.
Presidential Medal of Freedom, explained his position in a Guardian article: For me that means having had the conversations with those I have crossed in life and being at peace. It means being able to say goodbye to loved ones — if possible, at home. I revere the sanctity of life — but not at any cost. I can see I would probably incline towards the quality of life argument, whereas others will be more comfortable with palliative care. Yes, I think a lot of people would be upset if I said I wanted assisted dying.
Their concerns are especially relevant in a society with an aging population. The Population Reference Bureau projects that the population of people 65 years and older will double byaccounting for one in four Americans.
The Financial Dilemma In an interview with The Washington TimesMildred Solomon, president and CEO of The Hastings Center a nonpartisan bioethics research institutenoted that millions of people die each year after years of debilitation and chronic illness.