While health and medicine usually look at improving and extending life, increasingly medical professionals and society are being forced to ask how far those efforts should go. Perhaps the most pressing ethical medical dilemma concerns whether an individual has the right to die. Euthanasia
, or mercy killing, means the deliberate killing of a patient who is terminally ill and/or in severe and chronic pain. More recently, “physician‐assisted suicide” has superseded the term euthanasia as terminally ill patients take more assertive roles in expressing their wishes and requesting physician support.
Although technology and advanced drugs provide physicians with “heroic” means of prolonging life, more people are questioning whether doing so is the right action, and, more importantly, many are asking why they must suffer at all with painful terminal diseases like Huntington's Disease, Alzheimer's, or the end‐stages of AIDS. Those in favor of physician‐assisted suicide argue that patients remain in control, administer the lethal drugs themselves, and die by choice with limited pain and suffering. Dr. Jack Kevorkian has stood at the center of the debate for providing lethal drugs to terminally ill or profoundly suffering patients who want to die. Despite arrests and jail sentences, Kevorkian continues to assist patients in their deaths.
Opponents to physician‐assisted suicide point to several concerns:
- Making an accurate terminal diagnosis can be difficult because doctors do make mistakes and many patients beat the odds.
- Patients who claim they want physician‐assisted suicide may be reasoning through the clouds of depression, which often triggers suicidal thoughts. Treat the depression, and the patient regains the will to live.
- Inadequate pain management often causes patients to long for death. Many people harshly criticize a medical establishment that they claim is insensitive to or outright fails to provide adequate pain management. In these cases, critics say, relieve the pain (even with addictive drugs) and many patients enjoy life again.
- Of greatest concern to opponents of physician‐assisted suicide is the risk that the “right to die” could become the “responsibility to die.” People may see poor or vulnerable individuals, especially the elderly, as a burden and pressure them into “doing their duty” of dying.
Overall, opponents feel that allowing physician‐assisted suicide devalues human life and fails to address deeper issues in the society.
After protracted debate and two years of court challenges, the state of Oregon legalized physician‐assisted suicide. A terminally ill patient must obtain a terminal diagnosis from at least two physicians who declare that the patient has six months or less to live. The patient must be evaluated for depression and meet other qualifications. If the request is approved, the patient must wait a minimum of two weeks before becoming eligible to receive the lethal prescription.
Although the physician‐assisted suicide law has seen limited use since its implementation, it has had an unexpected consequence. The debate over the law has forced medical professionals to reevaluate pain treatment in Oregon. Physicians are more willing to prescribe pain medications, and the number and quality of hospice care facilities has rapidly increased. Harshest opponents of physician‐assisted suicide admit there have been some positive outcomes from the Oregon experiment, although they still oppose the law, and the debate continues.