Assisted suicide is compatible with medical ethos

The American Journal of …, 2011

SSRN Electronic Journal, 2000

台灣醫學人文學刊, 2002

The American Journal of Bioethics, 2011

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this "argument of preferable alternative." Our goal is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS.

The Permanente Journal, 2012

The article opens with the hypothesis that the default position that should guide healthcare providers when treating patients at the end of life is that patients opt for life. In the absence of an explicit request to die, we may assume that patients wish to continue living. Thus the role of the medical profession is to provide patients with the best possible conditions for continued living. The article makes a case for physician-assisted suicide legislation. It examines the ‘quality of life’ argument, and the issue of the patient’s autonomy and competence. It is argued that (1) quality of life is a subjective concept. Only the patient can conclude for herself that her quality of life is so low to warrant ending it, and that (2) only competent patients may request ending their lives. Patients’ lives should not be actively terminated by the medical team without the explicit consent of patients. The article then probes the role of physicians at the end of life, arguing that medicine should strive to cater to the wishes of all patients, not only the majority of them. Physicians should not turn their backs to justified requests by their patients. Physicians are best equipped to come to the help of patients at all stages of their illness, including their end-of-life. At the same time, in ending life, the final control mechanism should be with the patient. Thus physician-assisted suicide is preferred to euthanasia in order to lower the possibility of abuse and of ending the lives of patients without their consent and against their wishes. As matters of life and death are grave, they should be taken with utmost seriousness, requiring the instalment of ample checks against abuse and facilitating mechanisms designed to serve the patient’s best interests. The article concludes with nineteen careful and detailed guidelines for physician-assisted suicide. These are necessary measures designed to ensure that the best interests of the patients are served as they wished.

2011

52 Physician Assisted Suicide: An Exploration of the Dying Process Kunwar Kaur Abstract Up until about two decades ago, the practice of physician-assisted suicide was prohibited in the United States. However, the issues surrounding the legalization of physicianassisted suicide have long been the topic of debate as proponents seek to change public policy. Just as keenly, though, the opposition seeks to alienate any ideas that may even remotely resemble physician aid in dying. With such a rigorous ongoing debate, it becomes necessary to step back and examine, once again, the underlying cause for the emanation of such a request in the first place. A shared belief by both sides is that the groups of people most susceptible to the outcome of this debate are terminally ill adults and terminally ill children. Consequently, it is crucial to ask the question, how exactly does having the option to request physician-assisted suicide influence the dying process of a terminally ill patient? The ...

2017

This dissertation argues that the permitting of Physician Assisted Suicide (PAS) is not a desirable extension of patient choice. Should PAS be made permissible by making it a live option, then certain patients may request it and be harmed by wrongful death. Furthermore, the harm to patients who suffer wrongful death as a result of requesting PAS trumps the harm to patients who must endure unbearable suffering should PAS not be permitted. The line of argument in defence of these claims is, first, that contrary to the common view, agents may sometimes be harmed when they are presented with an additional option. Second, the harm that may result from having an additional option occurs as a result of certain features of the agent or the context in which the agent is choosing. This second argument goes beyond previous ones because it explains two additional harms to an agent from a new option. These are harms resulting from three types of weak character and resulting from normative featur...

This paper examines whether physician-assisted suicide (henceforth PAS) is morally permissible, and whether it should be legalised in the sense that those seeking or performing such procedure will be immune from prosecution. The issues of moral and legal permissibility are closely connected. One way to argue for the permissibility of PAS is grounded in the argument that a patient has the right to refuse life-saving equipment, or (if already connected) to have it withdrawn, and then to further argue that there is no relevant distinction between refusal/withdrawal and PAS, if the patient consents. This is essentially the argument raised in “The Philosophers’ Brief ”, filed by six distinguished philosophers (Dworkin et al. 1997). However, this argument has been soundly criticised (Kamm 2013, 46 –9). Frances Kamm points out that the general claim on which Dworkin et al. rely—that there is no moral difference per se between killing and letting die—is false. This is because a patient has the right to refuse treatment even when this is against his interest because the alternative would be forced treatment (which is unacceptable), but it is not true to say that a patient has the right to PAS even when it is against his interest. Also at issue is the Doctrine of Double Effect (henceforth DDE), according to which there is a moral distinction between an action that is intended to cause death and one that is merely foreseen to cause death. In section I of this paper, I shall argue against DDE, which purports to disallow PAS but not refusal/withdrawal. I shall argue that since it is permissible for a physician to prescribe morphine to a patient suffering excruciating pain, it is also permissible for her to prescribe such a drug to a patient suffering pain, with the intention that he be killed and hence relieved of the suffering. The grounds on which I rely is the thesis that intention is irrelevant to permissibility , as proposed by Judith Thomson and T.M. Scanlon. In section II, I shall discuss David Velleman’s argument that termination of life is morally impermissible. I proceed to examine in section III the theoretical version of the Slippery Slope Argument. In section IV, I shall consider the practical version of the Slippery Slope Argument. In section V, I shall discuss other consequentialist objections to the legalisation of PAS. In the final section, I shall consider the view that even if PAS is morally permissible, it does not follow that it should be legalised (Arras 1997; Steinbock 2005). The argument I consider is the consequentialist one that legalising PAS may have a very different significance -- when we consider the total consequences — than if there is only a single act of PAS, considered in isolation. While I agree that consequences are generally very important, I shall argue that we should approach the issue from a contractualist rather than a utilitarian perspective.