Running head: PHYSICIAN-ASSISTED SUICIDE

Physician-Assisted Suicide:

Should Physician-Assisted Suicide Be Allowed?

Leecheon, Kim

Madonna University

ESL 4230 - Argumentative Paper (D2)

April 3, 2017
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Physician-Assisted Suicide: Should physician-assisted suicide be allowed?

For decades, the medical field has significantly developed medical knowledge,

technology, and nutrition. As a result, people's life expectancy is extended, and many people

suffering from serious illness are saved. These people are between life and death. The huge

development of the medical field creates critical concerns and society is in the middle of this.

The Hippocratic Oath proclaims: I will apply dietetic measures for the benefit of the sick

according to my ability and judgment; I will keep them from harm and injustice. I will neither

give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect

(http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html). This tenet is essential to

build the foundation of human dignity in society. Nobody has a right to intentionally kill a

person or assist in killing even if he or she is a doctor. Physicians might have patients with

serious illness which is incurable and at terminal stage, who are just waiting for death with

medicine which would enable them to prolong their lives a little longer. In such

circumstances, should physicians be allowed to administer assisted suicide in ending patients'

lives with or without their request? Although some argue that physician-assisted suicide

should be allowed in certain circumstances in order to help patients have a death right,

legalizing physician-assisted suicide has significantly impaired human beings' dignity.

Physician-assisted suicide is different from euthanasia in how the procedure is

performed. In the words of Diaconescu (2012), physician-assisted suicide occurs when a

physician takes action that helps a patient to end his or her life, and euthanasia occurs when a

physician takes action that directly and immediately results in the patient's death (p. 474).

Koenig (1993) explained that physician-assisted suicide may involve several things such as

"providing information on ways of committing suicide, supplying a prescription for a lethal

dose of medication, . . . or providing a suicide device that the patient can operate" (p.171).

Physician-assisted suicide would only be discussed.

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Physician-assisted suicide should not be allowed because there is no constitutional

law that enables a person to intentionally assist in killing another human being or willfully

kill another human being. Several commentators argued that "there is no right to aid or

assistance in committing suicide because there is no constitutional right to suicide"

(CeloCruz, 1992, n.p.). Logically thinking, if there is no right to commit suicide, there is no

right to help commit suicide. Therefore, there is no right to administer physician-assisted

suicide. In the words of CeloCruz (1992), nowhere in the Constitution or its amendments is

expressly mentioned a right to aid suicide or suicide itself (n.p.). The Constitution is the

supreme law in U.S.A and it supersedes all of the laws when it contradicts against any other

law, such as state law or case law. If there is no express right to suicide in the Constitution, a

right to suicide can be sustained only if it is implied "in the traditions and conscience of our

people as to be ranked as fundamentals" (CeloCruz, 1992, n.p.). However, it cannot be

implied that there is an implied right to suicide or aid suicide especially when it is related to

human life. At common law, suicide assistance was a felony and the state considered a person

who advised a perpetrator to commit a crime and who was present when the crime occurred a

principal in the second degree. (CeloCruz, 1992, n.p.). If a person gives another suicide

assistance, that person would be qualified as principal in second degree murder and be guilty

of murder because the suicide was homicide. Therefore, physician-assisted suicide should not

be allowed because there is no basis on the Constitutional law or common law.

Laws related to physician-assisted suicide should be clear and not obscure when they

take effect because more countries have legalized physician-assisted suicide than in the past.

Huntoon (2016) noted that:

Physician-assisted suicide has been legal in Oregon since 1997, in Washington State

since 2008, in Vermont since 2013, in California since Jun 9, 2016, and in Montana

since 2009. In early November 2016, the District of Columbia City Council voted to
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allow physician-assisted suicide, and a final vote on the bill is pending. In 2015, 18

state were considering laws to allow physician-assisted suicide. (p. 98)

Note. The map on assisted suicide is adapted from "Assisted Suicide Legislation in the United

States," by Charlotte Lozier Institute, 2015, retrieved from

https://lozierinstitute.org/tag/assisted-suicide/

The law must be specific and definite to the extent when dealing with human life and must be

followed exactly by a person who is allowed to administer assisted suicide if physician-

assisted suicide has been legalized. If the law is not clear and obscure when administering

physician-assisted suicide, there would be many more risks to cross the line between life and

death depending upon a doctor who could do assisted suicide or help suicide by a patient

based on the law. The case in the Netherlands represented this example. In 1996, two Dutch

doctors administered the non-voluntary euthanasia of disabled infants and were prosecuted,

but they were acquitted according to medical necessity by Court's reasoning (Huntoon, 2016,
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p. 98). The word, 'medical necessity' is not clear. What is medical necessity? Who could

define medical necessity? According to a Heritage Backgrounder article, the Court reasoned:

"if necessity justified ending life of a suffering patient who requests it, it equally justifies

ending the life of a suffering patient who cannot request it" (as cited in Huntoon, 2016, p. 98).

The Court's reasoning is obscure and flawed. First, the Court assumed that it justified ending

life of a suffering patient who requests it. In 1996, there was no law in the Netherlands that

allows physicians to administer assisted-suicide. Not until March 2014, the Netherlands

legalized physician-administered euthanasia for consenting minors (Huntoon, 2016, p. 98).

Therefore, it could not be justified to end the life of a suffering patient if he or she requests it.

Second, necessity is not clear and defined. Necessity should be first defined, and whatever it

is, necessity could not justify ending the life of a patient who cannot request it according to

the law. Third, because its assumption is flawed, its conclusion could not be right. Even if its

conclusion is correct, the conclusion could not be right because it does not mean that a patient

who cannot request assisted suicide wants to end his or her life. While physician-assisted

suicide has been legalized in several states, the law is not enough to take effect and surely is

flawed.

A law about physician-assisted suicide should not expand its area to healthy people

without strict standards and guidelines. The law without stringent guidelines would

jeopardize the elderly and the sick. Anderson (2015) explained that "physician-assisted

suicide will most threaten the weak and marginalized because of cultural pressures and

economical incentives that will drive it" (p.4). People could be the weak and marginalized

especially if they are suffering from severe illness, which could lead them to feel powerless,

depressed, or lonely. If they are in such a position, they would be at risk and vulnerable and

could choose to end their lives. The law should not be allowed for them to do this and at least

legal recourse. According to Huntoon (2016), the Netherlands has considered the law that
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"will allow physician-administered euthanasia in healthy elderly people who believe they

have completed life" (p. 99). However, there is no clear definition of completed life and

elderly people. Completed life and elderly people would vary depending on how it is defined

or who defines it. These points explain that the law could lead both healthy elderly people

and the weak and the sick to choose to end their lives, and open the door which could allow a

person who request it to do assisted suicide.

Physician-assisted suicide has caused ethical problems of physician administering

suicide and euthanasia. Although there are stringent guidelines that physicians should follow

when administering assisted suicide, they do not often abide by the guidelines. According to

an article published by the Heritage Foundation, lethal injections have been intentionally

administered to patients without a request and doctors "failed to report cases to authorities" in

thousands of cases in the Netherlands (as cited in Huntoon, 2016, p. 99). If physicians have

administered suicide without patients' request, an inference could be made that physicians

have intent to kill which could be a murder. Nobody can kill another especially when the

person did not request or cannot request it. Physicians should remember the Hippocratic

Oath, under which they should save patients, not kill patients, and should abide by the

guidelines. Professor John Keown of Cambridge University stated that "the undisputed

empirical evidence from the Netherlands and Belgium shows widespread breach of the

safeguards, not least the sizeable incidence of non-voluntary euthanasia and of non-reporting"

(as cited in Huntoon, 2016, p.99). This kind of problem is also known in other countries, one

of which is Ireland. Huntoon (2016) commented: "A court in Ireland has also noted a very

high incidence of non-voluntary euthanasia in countries that have legalized euthanasia"

(p.99). The key role of doctors is centered on saving and healing patients but assisting suicide

does not play a role in healing patients. There exists risks that physicians abuse their powers

to kill and powerless patients are vulnerable. Physician-assisted suicide would corrupt the
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profession of medicine.

Physician-assisted suicide impairs human dignity and equality before the law.

Anderson (2015) stated that the law must respect intrinsic dignity of human beings "by taking

all reasonable steps to prevent the taking of innocent lives" and equality before the law is

violated if a nation classifies "a subgroup of people as legally eligible to be killed" (p. 17).

Human dignity is intrinsic and society must preserve the dignity, and nobody can define who

can die and nobody can destroy human dignity. Determining a subgroup of people who could

request assisted-suicide is not the area that nations or laws can handle, and would impair a

fundamental right, human dignity. In the words of Anderson (2015), physician-assisted

suicide would make it possible to "treat some human beings as lacking dignity or worth",

which could cause them to feel "unworthy of the law's protection" (p. 18). Even if a person

has a right to assisted-suicide, whether deciding who is eligible to assisted-suicide would not

be the person but the government. Anderson (2015) stated that government officials have

classified people as eligible (p. 20). This attempts to define which lives are eligible for

assisted-suicide would impair equality before the law, and it would mean that some lives are

more worthy than others. In the words of Anderson (2015), "as the Supreme Court held in a

unanimous decision upholding New Yorks prohibition on PAS, there is a significant

difference between allowing someone to die of natural causes and killing him" (p.18). Human

dignity and equality before the law is so fundamental that it should not be invaded by the law

like physician-assisted suicide. Giving other people like physicians a power to do assisted

suicide would destroy intrinsic standard of values.

Some people may argue that physician-assisted suicide enhances a patient's

autonomy because a patient could relieve intolerable and useless suffering, and reduce fear by

giving the person self-control during dying process. However, even if patients have autonomy

to voluntarily end their lives, it does not mean that they have a right to assisted suicide. Finns
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explained that when people are ill or suffering from serious illness, their right to autonomy to

assisted suicide cannot be found "unless you are ill enough or suffering enough, or depressed

severely and incurably enough - in each case 'enough' in the view of somebody else, other

people" (as cited in Anderson, 2015, p. 20). Patients could not have entire autonomy to die

because government officials or other people should judge patients on the basis of which

patients are eligible for suicide when they request it. If patients suffering from serious illness

voluntarily request physician-assisted suicide, they must be under certain circumstances that

fit its condition to die. If a patient cannot request due to his or her physical or mental

condition, it would not be possible to exercise his or her autonomy to suicide. In any cases, it

would not be easy to define or specify autonomy. Dr. Kass stated that "governments exist to

secure inalienable rights, first of all, the right to self-preservation; now we are being

encouraged to use government to secure a putative right of self-destruction" (as cited in

Anderson, 2015, p. 19). While people have autonomy to do whatever they want on their body,

a right to die, in fact, depends upon other people's hands and it seems to be difficult to find

out clear line of what autonomy is. It is necessary to think whether a person could commit

assisted suicide if a person has autonomy to die. A right to autonomy is not a simple matter

and nobody can guarantee that he or she has autonomy to die or a right to assisted suicide.

Development of medical technology made it possible for patients with serious illness

to live a little longer and led to legalize physician-assisted suicide. Unfortunately, the law has

created critical problems as to human dignity. There is no basis to support a death right in the

Constitution and its amendments which describe human's basic and fundamental rights. At

common law, killing another human being or assisting in killing another was a crime of

murder. The law would jeopardize patients when physicians administer assisted suicide

because the law is unclear and obscure, and its interpretation would vary depending upon

courts or physicians. The law has expanded its area from patients suffering from serious
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illness to healthy people without stringent safe guidelines so it endangers the elderly who are

healthy but may not have the will to preserve their lives. The law has corrupted physicians'

profession of medicine. The law would impair human dignity and equality before the law.

Some people may argue that the law gives patients autonomy or a death right to end their

lives by assisted suicide, but the word 'autonomy' in terms of a death right is not clear. Having

autonomy to assisted suicide does not mean that people themselves can have a right to

assisted suicide.
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References

Anderson, R. T. (2015). Always care, never kill: How physician-assisted suicide endangers

the weak, corrupts medicine, compromises the family, and violates human dignity

and equality. The Heritage Foundation. 3004, 1-22. Retrieved from

http://www.heritage.org/health-care- reform/report/always-care-never-kill-how-

physician-assisted-suicide-endangers-the- weak

CeloCruz, M. T. (1992). Aid-in-dying: Should we decriminalize physician-assisted suicide

and physician-committed euthanasia?. American Journal of Law & Medicine, 18(4),

369-394. Retrieved from http://www.aslme.org; http://www.allenpress.com

Diaconescu, A. M. (2012). Euthanasia. Contemporary Readings in Law and Social Justice,

4 (2), 474-483. Retrieved from

http://www.addletonacademicpublishers.com/contemporary-readings-in-law-and-

social-justice/journals/crlsj/about-the-journal.html

Hendin, H., & Foley, K. (2008). Physician-assisted suicide in Oregon: A medical

perspective. Michigan Law Review, 106(8), 1613. Retrieved from

http://go.galegroup.com/ps/retrieve.do?tabID=T002&resultListType=RESULT_LIST

&searchResultsType=SingleTab&searchType=BasicSearchForm&currentPosition=8

&docId=GALE%7CA191392259&docType=Article&sort=Relevance&contentSegm

ent=&prodId=GPS&contentSet=GALE%7CA191392259&searchId=R3&userGroup

Name=lom_madonnaul&inPS=true

Huntoon, L. R. (2016). (Ed). Physician-assisted suicide and euthanasia; The destruction of

morals, ethics, and medicine. Journal of American Physicians and Surgeons, 21(4),

98-101. Retrieved from http://www.jpands.org

Koenig, H. G. (1993). Legalizing physician-assisted suicide: Some thoughts and concerns.

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Journal of Family Practice, 37(2), 171. Retrieved from

http://www.quadranthealth.com/

Trachtenberg, A. J., & Manns, B. (2017). Cost analysis of medical assistance in dying in

Canada. CMAJ, 189. 101-5. doi: 10.1503/cmaj.160650