Chase White

Jolynne Berrett
May 2, 2016

Physician-Assisted Death:

A look into the ethics of Physician-Assisted Death

The ethicality of a person choosing to end their own life has always been hotly debated, but
never more so than when done with the aid of a medical professional. Physician-Assisted Death,
or PAD, is when someone who is deemed terminally ill and is mentally capable of making their
own decisions uses the aid of a doctor to help themselves commit suicide. Whether this action
constitutes murder on the part of the physician, or is within the rights of the patients to determine
for themselves remains an important question in American society. Arguments surrounding the
issue revolve around: fundamental questions of the physicians role in society, the Hippocratic
Oath in our current society, as well as socioeconomic issues of medical care and classism.
The topic of Physician-Assisted Death first came to prominence in American politics with
the rise of Jack Kevorkian. He famously assisted over 130 people end their lives, as well as
publicly advocating for the patients right to die. In 1999, Kevorkian was arrested and convicted
of second-degree murder, and was sentenced 10-25 years in prison. Kevorkian has remained a
very controversial public figure. Some of Kevorkians patients were indeed terminally ill, but
most were not; they were just looking to end their lives due to their own personal reasons. Which
is part of what make him such a monster in most peoples eyes. Despite Kevorkians advocacy
for Physician-Assisted Death, it remained illegal in the United States until 1994 when Oregon

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passed the Death with Dignity Act, which allows terminally ill patients to choose to end their
own life earlier than when the sickness would have taken them. It has since become legal in
Washington, Vermont, Montana, and California. Other states have begun to discuss the issue; but
throughout the United States, its a significant ethical, moral, and religious dilemma.
An immediate concern is that Physician-Assisted Death is in direct violation to the
Hippocratic Oath, which is still largely influential in the medical field. Written as an ancient
Greek medical text, the Oath bound physicians to a higher moral standard. Many feel that this
code of ethics is exactly what has traditionally given the medical profession a unique moral
standing in society (Phillips, n.pag). Allowing a professional to make life-altering decisions
requires a great deal of trust in the profession as a whole, and from this perspective, moral codes
such as the Hippocratic Oath are a necessary foundation for this trust to exist.
The administration of poison is explicitly prohibited per the oath; more abstractly, it
compels physicians to hold life sacred. Opponents of Physician-Assisted Death argue that the
practice does exactly the opposite. Indeed, some argue that true dignity in death comes from
resolute acceptance (Pies n.pag). Furthermore, if medical professionals are free to violate the
tenets of the oath in this specific context, the integrity of the oath as a whole is shaken. Unbound
to a particular moral code, the publics faith in Medicine may falter.
However, an increasing number find the Oath in its entirety to be a relic of antiquity. The
significance of the oath is frequently reduced to a single memetic phrase: first, do no harm - a
phrase which doesnt even belong to the original oath (Zamichow and Murray, n.pag). In a
society which accepts the subjectivity of most terms, harm itself is a point of debate. Those
who support Physician-Assisted Death may argue that extending the lifespan of a terminally ill

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and pained patient may be more significantly doing harm. The specifics of the Hippocratic
Oath have changed countless times over the centuries, and many aspects of the original would
have no place in a medical school today; therefore, it is argued that holding to any of its tenets
purely out of principle or tradition is a mistake. The arguments of the oath must be evaluated on
the basis of their relevance to a modern society.
Unfortunately, the intersections of class and their effect on medical care are enormous, and
can never be ignored in discussions of medical treatment. While there are romantic notions of
physicians as noble caretakers who shelter any in need, and most physicians accept the healer
role as a fundamental and enduring characteristic of the profession (Bordreau n.pag), the reality
is that without financial resources, people are unable to receive the same quality of care, and
morbidity rates for similar diseases and afflictions vary wildly through socioeconomic class. This
plays into Physician-Assisted Death in a unique manner. It is argued that Right-to-Die laws may
be disproportionately employed by lower-income citizens; those who cannot afford treatment
(which continues to cost more and more across the board) may be financially cornered into
selecting PAD (Hale, n.pag). A choice as significant as this, made under duress, cannot be
considered a valid choice. Conditions must be fair, and in Americas socioeconomic climate, they
simply arent.
However, this is not truly an argument against the ethicality of Physician-Assisted Death.
Rather, it is an important critique of the healthcare system, rising medical costs, and economic
inequality as fundamentally flawed. Cost of care has risen faster than inflation in the United
States (Patton, n.pag). The problems these systems apply to the poor are not specific to PAD, and

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its fallacious to suggest that only one should be a point of focus. Arguing for the right to die can
happen alongside pushing for more equitable medical and healthcare options.
In an interview with Dr Jennifer Bentley I asked the question, What are you personal
thoughts on Physician Assisted Suicide? She stated, I think from a MD standpoint it's not our
call. Therefore I feel like we don't have a say. Personally I think if the pain is so bad and there is
no cure that it might be easier, i.e. cancer. I mean chemotherapy and radiation are a terrible thing
to go through (n.pag). She went on to explain that under the Hippocratic Oath it says first do no
harm, but that sometimes going through the treatment can make a person worse than they already
were, and if they are terminally ill to begin with, then why would they want to go through that.
In Oregon they have the Death With Dignity Act in place, in which people given 6 months
or less to live can go to their doctor and ask for the prescription, it must be signed off by a
second doctor. The first doctor is not legally required to give them the prescription. Most
patients who use the Death With Dignity Act have cancer (Cook n.pag). A lot of the patients are
concerned with losing control of their bodily functions, and living a happy life until the end.
Obviously this is a complex issue that provokes personal responses. But, considering
compassionate care, if I were to be diagnosed with a terminal illness, I would absolutely want to
have the autonomy and freedom to make that decision. Especially if the alternative is to put me
or my family into major debt, or to put my body through hell for only the promise of a small
amount of time. I don't know how I would feel if my husband or family were in that position; if I
would be okay with it. However, I do honestly believe that if its their body, its their choice. If a
doctor believes it goes against the Hippocratic Oath and will not perform this service, I truly
believe they should help the patient find someone who will help them. I also believe it should be

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very closely regulated, perhaps with one or two doctors agreeing that this course of treatment is
in the best interest of the patient.
As a society we need to take a careful look at what is really wrong with the Health Care
system. Not just the current healthcare, but also from the past: this issue has been around for a
long time. When lower-income citizens can afford to go to the doctor to get help before diseases
such as cancer get too far advanced, or when someone is showing signs for early onset
alzheimer's and they can possibly get put on a medical or pharmaceutical trial to help combat the
symptoms and attempt to find a cure, this might not be such as issue. But we must also look
toward our rights as individuals, and while we push for better healthcare, we can also push for
the right to die with dignity.

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Bentley, Jennifer MD. In Person Interview. April 28 2016.

Boudreau, Donald and Somerville, Margaret. Euthanasia is not medical treatment. Oxford
Journals. March 2013. Web.
Cook, Lindsey. Heres who uses Oregons Death with Dignity Act. U.S. News. October
2015. Web.
Hale, Christopher. Theres Nothing Progressive About Physician-Assisted Suicide. TIME.
October 2015. Web.
Patton, Mike. U.S. Health Care Costs Rise Faster Than Inflation. Forbes. June 2015. Web.
Phillips, Steve. Physicians, the morality of euthanasia, and the Hippocratic Oath. Trinity.
International University. July 2015. Web.
Pies, Ronald. Physician-Assisted Suicide: Why Medical Ethics Must Sometimes Trump the
Patients Choice. PsychCentral. 2012. Web.
Zamichow, Nora and Murray, Ken. The Hippocratic Oath and the terminally ill. LA Times.
December 2014. Web.

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