In Physical & Mental Health, Suicide, violence

What Is a Physician Assisted Suicide Exactly?

For some, ending one’s life would seem a perfectly logical solution when faced with a painful and terminal illness. Today, mercy killing, is nothing new. Suffering and pain has always been a part of being human.  There has always existed the argument of mercifully ending the pain of those suffering from incurable illness or injury.

Difference Between Physician Assisted Suicide and Euthanasia 

Physician assisted suicide occurs when a doctor helps a patient end his or her life by providing information and/or the means to do so.  Through euthanasia the physician not only supplies the location for the suicide, but also ends the patient’s life.  For example, the physician would administer a lethal injection or end the patient’s life in another way.

A History of Physician Assisted Suicide

“My aim in helping the patient was not to cause death. My aim was to end suffering. It’s got to be decriminalized.” These are the words of perhaps the most famous, or infamous, proponent of physician assisted suicide, Jack Kervorkian.  Until his death in June 2011, Jack Kervorkian, nicknamed “Dr. Death,”  was an outspoken advocate of ending the suffering of terminally ill patients.  He participated in helping 130 people end their lives, through physician assisted suicide or euthanasia.  His actions created a whirlwind of controversy amongst the American public as to the morality of the topic.  Some heralded him a hero, others a villain.  He was tried four times during his career for his part in helping patients die.

Of the four trials which occurred between May 1994 to June 1997,  Kervorkian was acquitted three times,  the  fourth  ending in a mistrial.  However, in 1999, he was convicted of second-degree murder when he euthanized a patient in the late stages of Lou Gehrig’s disease.  He served eight years of a 10-25 year sentence, and  was released in 2008.

Famous Patients Whose Death Have Reawakened the Physician Assisted Suicide Debate

Most recently, the tragic story of Brittany Maynard reawakened the controversy surrounding this hotly debated topic.  Brittany was only 29-years old when she decided to take her own life with the help of physician assisted suicide.  At the time of death, Maynard was suffering from stage-four brain cancer.  The illness was making her life, as she described, unmanageable and unlivable.  She moved from California to Oregon, one of four states where physician assisted suicide is legal.

According to Sean Crowley, spokesperson for Compassion and Choices, Maynard suffered “increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms.”  Even though she publicly expressed her decision and reasons for ending her life, there were still those opponents  who argued that Maynard’s decision might encourage young people to accept mercy killing as an acceptable form of death.

In her public declarations, Brittany Maynard maintained that she is not killing herself; rather the cancer is killing her.  This is the opinion of many who choose mercy killing as a way of putting an end to their suffering.

Pros and Cons of Physician Assisted Suicide

However, those who oppose physician assisted suicide claim many not suffering from terminal illnesses may elect physician assisted suicide or euthanasia as a way of exiting a bleak life.  For instance, one of the criticisms of Dr. Karvorkian was that he ended the lives of those not suffering from a terminal illness, but rather those suffering from depression and other mental illnesses.

There are those in the medical community that passionately argue against physician assisted suicide, claiming it flies in the face of the Hippocratic Oath that each doctor takes to:  “First do no harm.”  Dr. Ira Byock is just such a physician.  According to him, physician assisted suicide and euthanasia can and do often go beyond requests to end life due to a terminal illness. For example,   “In April 2014, a 47-year-old Dutch mother of two was granted her wish to die because of long-standing tinnitus (ringing of the ears).”  A New York Times op-ed article by Doctor Byock documents another case in Holland in which over 40 people requested and received voluntary euthanasia for depression and other mental illnesses.

In recent years, physician assisted suicide statistics have soared.  As stated earlier, euthanasia and physician assisted suicides have been around since the existence of medicine.  In modernity, it is legal in countries across the globe.  In the  United States, Oregon became the first to make this controversial topic legal by enacting its 1994 Death with Dignity Act. This law enabled terminally ill patients to take their own lives by ingesting a lethal dose of prescribed medication.

Physician Assisted Suicide Statistics

Here are a couple of examples of physician assisted suicide articles.   In its article, “How many people choose assisted suicide where it is legal? “ The Guardian Newspaper reported that since 1998, the Dignity Act has helped hundreds of terminally ill patients end their lives.  However, according to the article not all patients enrolled in the program choose to end their lives through lethal doses of medication.

States that followed in Oregon’s example are Washington in 2008, Montana in 2009, and finally Vermont in 2013.  All four states, with the exception of Montana, require the patient to be  a resident of the state, at least 18 years-old, the patient must have spoken twice with a physician and have at least one written request, must have six months or less to live.

Seattle Cancer Care Alliance’s Supportive and Palliative Care Service

Dr. Elizabeth Trice Loggers, the medical director of the service tells how it assisted terminally ill patients seeking access to an assisted death.  According to doctor Loggers, of the terminally ill seeking death by assisted suicide, less than 3 percent actually used the legal dose of medication prescribed. However, whenever the program was used, patients and their families are very grateful for the prescription, whether or not it was used.  For Ethan Remmel, a 41 terminally ill man dying of colon cancer, having the lethal dose of medication at hand was a source of comfort and offered a sense of being in control. This feeling was important to just about everyone who participated in the hospitals Dying with Dignity program.

This makes sense since mostly everyone, about 97 percent of participants, in the program cited having control over their mental faculties as the number one reason for seeking a physician assisted suicide program.  In addition,  87 percent of the participants wanted to participate in the program because they are afraid of losing the ability to engage in activities like spending time with friends and family members. While three quarters of participants were concerned with losing their dignity during the final stages of their terminal illness.

An Alternative to Physician Assisted Suicide

Medicine has progressed and evolved at such a rate that there are possible alternatives to physician assisted suicide. There are ways of providing end of life care that will provide comfort and dignity for patients with painful conditions for which there is no hope of getting better.  Before physician assisted suicide is considered, terminally ill patients may want to consider Palliative Care.

This medical specialty, also known as Comfort Care, focuses on treating the whole person–mental, physical, and emotional.  This specialty is inclusive of a team of individuals such as pharmacists, nutritionists, massage therapists, doctors, etc., all working together to bring comfort to the patient. Additionally, comfort care can be quite convenient, as it does not have to take place in a hospital.   It is offered at long-term care facilities, hospices, outpatient clinics or even a patient’s home.  Just about any patient suffering from a serious disease can benefit from Palliative Care.  The list includes but is not limited to:

  • Cancer
  • Alzheimer’s Disease
  • Parkinson’s Disease
  • Amyotrophic Lateral Sclerosis (ALA)
  • Heart Disease
  • Kidney Failure
  • Multiple Sclerosis
  • Chronic Obstructive Pulmonary Disease (COPD)

Palliative Care benefits the patient by focusing on pain management, stress relief, nausea, shortness of breath, fatigue, loss of appetite and nausea, etc.  In short, Palliative Care is used to increase quality of life of the terminally ill and can be incorporated at any time during a life-threatening illness. Besides focusing on the emotional, spiritual and physical well being of the patient, comfort care emphasizes communication between family, patient, and primary care physician.  Electing comfort care does not exclude primary care physicians, so there should be no fear of giving up one’s doctor.

It is true that medicine has advanced greatly in recent decades. However, for some patients, end of life care may not provide the desired level of dignity and pain management.  For these people, choosing to end their lives through physician assisted suicide may seem the only solution.

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