Physician Assisted Suicide

Two major questions here: 1) In the US, given that you can refuse medical treatment (or a feeding tube), therefore ending your own life, should physician assisted suicide be legal?

2) Is there a moral issue with this?

Or maybe it's just one question, with the second being a component of the first. In any case, I'm interested in hearing your thoughts.

There's a huge difference both ethically and legally between voluntarily not starting a process that will prolong your life and actively starting a process that will end it. The two aren't comparable.

Under the understanding that PAS is when the person in question takes their own life using materials provided, while direct euthanasia is when someone else does it for them, I support the legalization of PAS, and do not see any moral quandary that is applicably legislative (i.e. that involves others).

I oppose direct euthanasia, morally, on a general basis, but PAS is acceptable under the theory that suicide should be a legal human right, IMO.

legal or not don't think think that health care workers should be allow to assist. There is a massive potential of abuse of power and it undermines the basic principle of "Do Not Harm'.

edited 19th Oct '11 2:21:33 PM by joeyjojo

The potential for abuse I can't argue against, but a case could be made that keeping someone who is in a condition where they want to die but are unable to commit suicide unassisted is doing harm itself and that having a medically-trained person help them is less likely to go horribly wrong than having a well-meaning but unskilled friend or family member do so.

@USAF no PAS is when the healthcare worker is the party that commits the act (usually injecting a lethal dose of morphine). The difference between it and euthanasia is that in euthanasia the person involved either didn't make the decision - their family or the physician or somebody else commits a "mercy kill" that was not requested by the patient. However, some arguments against PAS include that it'll lead down a slippery slope to euthanasia.

I should also point out that I'm defining PAS as when a doctor helps a mentally competent terminal adult patient to commit suicide by giving them medicine that will kill them.

I am against anyone directly killing another per their own wishes, but I do not object to providing someone the materials necessary to take their own life. Such is where I draw the line.

Doesn't the Hippocratic Oath stop this?

"Do no harm" is no longer a part of the Oath, it seems.

edited 19th Oct '11 2:57:56 PM by USAF713

Eh, it's better than physicist-assisted suicide.

*badum-tish*

@Madrugada: I concede that there are times when the living does more harm than good, but I don't think there any realistic danger of 'back alley euthanasia'.

I think the point is how you define harm. If I stand there while you're suffering and very slowly dying and have the means to end it peacefully for you - and you ask me to - and I do nothing. Not everyone will agree but I think you can see the basis for people thinking that COULD BE harm.

"Do no harm": without proper context that phrase was really holding back surgeons and certain treatments.

This is something the physician and patient may work out between themselves. The state may lay no claim on my life and how I choose to end it and as such has no business interfering. (This does not mean to bar them from regulating, as ever.)

edited 19th Oct '11 3:18:54 PM by GreatLich

Surgeons were a different profession to physicians in Hippocrates's time.

Students were forbidden 'to use the knife', that was seen as the role of barbers.

edited 19th Oct '11 3:29:43 PM by joeyjojo

I would interpret "do no harm" as "do nothing that will make a person's life worse than it is." I consider killing a person to be making their lives worse.

However, I think giving a person the means to kill themselves, assuming they are of right mind and properly informed, thereby giving their consent meaning, is ethical, in that it enables a right I think people should have—the right to end their own lives. Thus, so long as the patient themselves, and only they, administer the suicide in whatever form it takes, I think it's alright, in the context of the euthanasia debate.

USAF: That discriminates against people who are physically unable to take their own life.

If you're capable of giving meaningful consent, you're capable of taking your own life.

If that is sufficient, then note that the phrase "the patient themselves, and only they, administer the suicide" does not reflect that position.

Frankly, that be a non-issue if more people would leave clear instructions on how to proceed in the event they become comatose or completely senile, etc.

edited 19th Oct '11 6:37:53 PM by GreatLich

What I meant was, if you're capable of giving meaningful consent, you're capable of working some sort of delivery mechanism, whether it be through your mouth, or by blinking to set off a machine, or whatever.

If you aren't capable of giving informed consent, it's a totally different ballgame.

Are you sure about that?

edited 20th Oct '11 8:33:53 AM by Leonshade

FWIW, I live in the Netherlands, where assisted suicide/euthanasia has been regulated for many years already. Not so much as in making it 100% legal, but as in allowing for the doctor who performs it not to be prosecuted for murder if certain conditions are properly fulfilled. So far I haven't heard of "back alley euthanasias" here.

In the Netherlands, the law allows the medical review board to suspend prosecution of doctors who performed euthanasia when all of the following conditions are fulfilled:

-The patient's suffering is unbearable with no prospect of improvement.

-The patient's request for euthanasia must be voluntary and persist over time (the request cannot be granted when under the influence of others, psychological illness or drugs).

-The patient must be fully aware of his/her condition, prospects and options.

-There must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above.

-The death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present.

-The patient is at least 12 years old (patients between 12 and 16 years of age require the consent of their parents).

So far the overwhelming majority of people having undergone euthanasia in the Netherlands were cancer sufferers.

edited 20th Oct '11 12:04:46 PM by JoseB

Those terms are completely acceptable to me.

The "Voluntary and persist over time" and the "Second doctor must agree" check each other and serve as a check of sorts on 'back alley euthanasia'; The "suffering is unbearable with no prospect for improvement", and "patient must be fully aware of their condition and options" check each other and unscrupulous relatives or guardians.

If amended as such, I have no objections.

I agree with the Netherlands list too that seems like a moral/ethical way of handling it without the slippery slope risk.

Oh doctors mercy kill people all the time. the point I as trying to make was that there is no real way to screw euthanasia up unlike say back alley abortion which it often gets compared to. If they don't die the first time you can always just give them stronger and stronger drugs till they do.

edited 20th Oct '11 3:39:31 PM by joeyjojo