Physician assisted suicide essay conclusion

In the wake of Measure 16, Oregon hospice programs must develop practical policies to balance traditional commitments not to hasten death and not to abandon patients with dying patients' legal right to request lethal prescriptions The moral fallout of Measure 16 involved a collapse of the shared value framework that has guided hospice for the last two decades.

Center for Bioethics. Annals of Internal Medicine 6 : , 21 March Capron, Alexander Morgan. Even in Defeat, Proposition Sounds a Warning. Hastings Center Report 23 1 : , January-February Occasionally law that isn't made may be as significant as law that is. One such instance was the rejection on 3 November of Proposition by a majority of California voters. Had this initiative passed, the state would have been the first in the world since the Nazi era formally to permit physicians to perform active euthanasia.

Even though defeated, the strong showing for this ballot measure -- and the even stronger support it enjoyed outside the voting booth -- sounds a loud alarm for health care professionals not just in California but across the country. Cassel, Christine K. New England Journal of Medicine 11 : , 13 September In this Sounding Board essay, Cassel and Meier criticize the reaction of the medical profession to a recent, highly-publicized case involving the physician-assisted suicide of a patient said to be suffering from the early stages of Alzheimer's disease.

Research paper on suicide

While acknowledging the disturbing aspects of Janet Adkins' suicide with the help of Dr. Jack Kevorkian, Cassel and Meier maintain that the uniform response by doctors condemning physician-assisted suicide ignores the complexity of the issue. They argue that the medical profession's strict prohibition against aiding death fails to take into account the needs and values of patients or to acknowledge the limits of medicine and the inevitability of death.

They call for a broadening of the debate over assisted suicide and euthanasia and a more thorough and thoughtful analysis of the issues. The Nazi!


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Accusation and Current US Proposals. Bioethics 11 : , Jul-Oct In contemporary ethical discourse generally, and in discussions concerning the legalization of physician-assisted suicide PAS and voluntary active euthanasia VAE specifically, recourse is sometimes had to the Nazi! Some disputants charge that such practices are or will become equivalent to the Nazi 'euthanasia' program in which over 73, handicapped children and adults were killed without consent.

This paper reflects on the circumstances that lead to the use of this charge and offers reasons for putting the Nazi! A number of the philosophical presuppositions common to both the Nazi 'euthanasia' program and the currently proposed practices of PAS and VAE are examined. Noting that racist ideology and violent coercion characterized the Nazi program, the paper concludes with a cautionary consideration of the current circumstances that would specify PAS and VAE in the US.

American Journal of Law and Medicine 18 4 : , Recent news stories, medical journal articles, and two state voter referenda have publicized physicians' providing their patients with aid-in-dying. This Note distinguishes two components of aid-in-dying: physician-assisted suicide and physician-committed voluntary active euthanasia. The Note traces these components' distinct historical and legal treatments and critically examines arguments for and against both types of action.

This Note concludes that aid-in-dying measures should limit legalization initiatives to physician-assisted suicide and should not embrace physician-committed voluntary active euthanasia. Christian Reflections on Assisted Suicide. Journal of Medical Humanities 18 1 : , Spring In this paper the author argues that a narrative approach to understanding assisted suicide has been compromised by the notion that all narratives must be both coherent and unified.

He asks what we are to do with those narratives that cannot seem to cohere or be other than full of disunity? Is suicide the only way to make meaning out of suffering? He then proposes that the narrative found in the Gospel of Mark leads Christians to a life in hope and compassion in spite of apparent incoherence and disunity and threats of abandonment and suffering.

Coulehan, Jack. The Man with Stars Inside. Annals of Internal Medicine 10 : , 15 May Public opinion polls show that a large percentage of persons in the United States currently favor the legalization of professionally assisted death. This support reflects widespread fear and confusion over the tortuously prolonged and painful process of dying countenanced by contemporary medicine.

Physician-assisted suicide and euthanasia are complex moral issues. The current drive to translate them into debates about rights and public policy is curious: Does the energy directed toward palliation-by-death mean that our society is more compassionate now, or more just, than in the past? To the contrary, I believe that the movement toward assisted death reflects inadequate palliative care, poor patient-physician communication, great confusion about the right to refuse treatment, and profound inequity in U.

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Legalization of assisted death diverts us from addressing these problems. Palliation-by-death will drive us farther apart, not closer together. Degnin, Francis Dominic. Journal of Medicine and Philosophy 22 2 : , April At least from the standpoint of contemporary cultural and ethical resources, physicians have argued eloquently and exhaustively both for and against physician-assisted suicide.

Why Assisted Suicide Must Not Be Legalized

If one avoids the temptation to ruthlessly simplify either position to immorality or error, then a strange dilemma arises. How is it that well educated and intelligent physicians, committed strongly and compassionately to the care of their patients, argue adamantly for opposing positions? Thus rather than simply rehashing old arguments, this essay attempts to rethink the nature of human morality as both a source and a fracturing of human rationality- and with morality, the question of human nature in the context of violence, oppression, service, and obligation.

This interpretation of moral life is laid out roughly along the lines of the Jewish philosopher Emmanuel Levinas, and further clarified through a discussion of the Hippocratic Oath. These resources are then brought to bear on the specific arguments and recommendations concerning physician-assisted suicide. United States. Dellinger, Walter; Hunger, Frank W. Drickamer, Margaret A.

Practical Issues in Physician-Assisted Suicide. Annals of Internal Medicine 2 : , 15 January Support for the participation of physicians in the suicides of terminally ill patients is increasing, and the concrete effects on physician practice of a policy change with regard to physician-assisted suicide must be carefully considered. If physician-assisted suicide is legalized, physicians will need to gain expertise in understanding patients' motivations for requesting physician-assisted suicide, assessing mental status, diagnosing and treating depression, maximizing palliative interventions, and evaluating the external pressures on the patient.

They will be asked to prognosticate not only about life expectancy but also about the onset of functional and cognitive decline.

Prevention of cruelty and protection of human rights

They will need access to reliable information about effective medications and dosages. The physician's position on physician-assisted suicide must be open to discussion between practitioner and patient. Protection of the patient's right to confidentiality must be balanced against the need of health care professionals and institutions to know about the patient's choice.

Insurance coverage and managed care options may be affected. All of these issues need to be further explored through research, education, decision making by individual practitioners, and ongoing societal debate. New York: Cambridge University Press, Part Two by Sissela Bok looks at debates concerning individual control at the end of life, the three main categories of contemporary views in choosing death and taking life, freedom to choose death, the history and background for and against suicide and indicates that legalization of euthanasia and physician-assisted suicide entails grave risks, dealing inadequately with the needs of the dying, particularly if these patients have no health insurance.

Emanuel, Ezekiel J. Archives of Internal Medicine 8 : , 22 April The Oregon Death With Dignity Act constitutes a major change in social policy and the practices of medicine. Regardless of one's position on the ethics of legalizing euthanasia and assisted suicide, the law raises serious problems that must be addressed prior to implementation: 1 its safeguards fail to ensure that assistd suicide be offered appropriately as an option only after efforts to treat reversible conditions have been exhausted and 2 its monitoring system fails to ensure that the consequence of change in social policy will be adequately evaluated.

Ethics 3 : , April Noting that the current debate on legalizing physician assisted suicide has centered on the care of individuals, the author proposes that the discussion be refocused around the question of what constitutes a good death. Harrisburg, PA: Morehouse Publishing, Foley, Kathleen M. Ganzini, Linda ; Nelson, Heidi D. New England Journal of Medicine 8 : , 24 February Physician-assisted suicide was legalized in Oregon in October There are data on patients who have received prescriptions for lethal medications and died after taking the medications.

There is little information, however, on physicians' experiences with requests for assistance with suicide. Of the respondents, 5 percent had received a total of requests for prescriptions for lethal medications since October We received information on the outcome in patients complete information for patients and partial for on an additional The mean age of the patients was 68 years; 76 percent had an estimated life expectancy of less than six months.

Thirty-five percent requested a prescription from another physician.

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Twenty-nine patients 18 percent received prescriptions, and 17 10 percent died from administering the prescribed medication. Twenty percent of the patients had symptoms of depression; none of these patients received a prescription for a lethal medication. In the case of 68 patients, including 11 who received prescriptions and 8 who died by taking the prescribed medication, the physician implemented at least one substantive palliative intervention, such as control of pain or other symptoms, referral to a hospice program, a consultation, or a trial of antidepressant medication.

Forty-six percent of the patients for whom substantive interventions were made changed their minds about assisted suicide, as compared with 15 percent of those for whom no substantive interventions were made P less than 0. Substantive palliative interventions lead some -- but not all -- patients to change their minds about assisted suicide. American Journal of Psychiatry 11 : , November OBJECTIVE: After passage, in November , of Oregon's ballot measure legalizing physician-assisted suicide for terminally ill persons, the authors surveyed psychiatrists in Oregon to determine their attitudes toward assisted suicide, the factors influencing these attitudes, and how they might both respond to and follow up a request by a primary care physician to evaluate a terminally ill patient desiring assisted suicide.

Two-thirds endorsed the view that a physician should be permitted, under some circumstances, to write a prescription for a medication whose sole purpose would be to allow a patient to end his or her life. One-third endorsed the view that this practice should never be permitted. Over half favored Oregon's assisted suicide initiative becoming law. Psychiatrists' position on legalization of assisted suicide influenced the likelihood that they would agree to evaluate patients requesting assisted suicide and how they would follow up an evaluation of a competent patient desiring assisted suicide.

Psychiatrists' confidence in their ability to determine whether a psychiatric disorder such as depression was impairing the judgment of a patient requesting assisted suicide was low. Physician-Assisted Suicide and the Dutch Courts. Cambridge Quarterly of Healthcare Ethics 5 1 : , Winter Until recently, little attention was paid to PAS [physician-assisted suicide] as such. During the last years, however, several cases of PAS that do not resemble the usual euthanasia cases have been brought before the [Dutch] courts. Most of these new cases do not concern patients suffering from serious somatic disases, like terminal cancers, but psychiatric patients.

They have raised several questions. Could PAS be justified when psychiatric patients are concerned? Could it be allowed when the person in question wants to commit suicide, not primarily because of an unbearable illness or disability that leaves no hope for the future, but rather because of intolerable life circumstances? This article discusses the recent court decisions in which these questions, at least to some extent, have been addressed. Until recently, physician assisted suicide was dealt with on the same basis as active voluntary euthanasia in the Netherlands.

Over the last years, several cases relating to assistance in suicide of mental patients did raise specific issues, not addressed so far in the debate on euthanasia. One of these cases resulted in a Supreme Court decision. The paper summarizes this decision and comments on it from a legal point of view.

Brief for Respondents: Washington v. Gostin, Lawrence O. Journal of Law, Medicine and Ethics 21 1 : , Spring While much has been written about the professional ethics of physician assisted dying, little is known about where the law draws the line, whether the law is enforced in practice, and how the law should be reformed to reflect changing public opinion and ethical thought.


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This article addresses these questions and the need for clearer public policy [in the United States] on physician assisted dying.

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