Physician-assisted suicide is defined as a doctor “knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counselling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs.”
This practice is clearly controversial for a number of reasons, whether they be legal, social, ethical, moral, or religious. There are many who are opposed to it, for a great number of reasons.
Some doctors are opposed to it because it goes against the Hippocratic Oath, which states “I will give no deadly medicine to anyone if asked, nor suggest any such counsel.” Though not all medical schools require this oath, many doctors still follow it.
Other doctors, as well as many other opponents, are against the practice for moral and religious reasons. The act of killing someone or killing oneself is something against the morals of many, and something that most religions do not support. Many don’t view the practice of physician-assisted suicide as being any different than murder and suicide.
There also are many who oppose this practice because they believe the lines are too blurred. They question whether it’s ethical to offer this to people who are mentally competent while ignoring all the patients who are depressed and suicidal due to their suffering—which is precisely what this practice aims to prevent in the first place.
Ethical aspects of PAS:
Some terminally ill patients are in intractable pain and/or experience an intolerably poor quality of life. They would prefer to end their life rather than continue until their body finally gives up. Does the state have a right to deny them their wish?
Suicide is a legal act that is theoretically available to all. But a person who is terminally ill or who is in a hospital setting or is disabled may not be able to exercise this option — either because of mental or physical limitations. In effect, they are being discriminated against because of their disability. Should they be given the same access to the suicide option as able-bodied people have?
Many faith groups within Christian, Muslim, Jewish and other religions sincerely believe that God gives life and therefore only God should take it away. Suicide would then be “considered as a rejection of God’s sovereignty and loving plan”. They feel that individuals are all stewards of their own lives, but that suicide should never be an option. This is an important belief for members of these religious groups. They would probably be extremely reluctant to choose suicide (including physician assisted suicide) for themselves. But, for each deeply religious individual, there are many nominally religious or secular persons. Substantial numbers of adults who have liberal religious beliefs treat euthanasia as a morally desirable option in some cases. There are also many secularists, atheists, agnostics etc. who actively disagree with religiously based arguments. Many of these folks would like to retain suicide as an option in case they develop a terminal illness and life becomes unbearable.
Do devout believers have the right to take their own personal beliefs and force them on the entire population? Should religious liberals, humanists, atheists, agnostics, etc. be denied their religious freedom to choose PAS?
Many faith groups believe that human suffering can have a positive value for the terminally ill person and for caregivers. For them, suffering can be “a divinely appointed opportunity for learning or purification”. A Roman Catholic document mentions that “some Christians prefer to moderate their use of painkillers, in order to accept voluntarily at least a part of their sufferings and thus associate themselves in a conscious way with the sufferings of Christ crucified”. These may be meaningful suggestions to some Christian believers. However, can such arguments justify denying PAS to persons who do not share those beliefs?
Many people argue that pain experienced by terminally ill people can be controlled to tolerable levels through proper management. They conclude that there is no need for PAS. However, millions of individuals do not have access to adequate pain management. Tens of millions are without healthcare coverage. Many doctors withhold adequate levels of pain killers because they are concerned that their dying patient may become addicted to the drugs.
By making PAS available, some people will be pressured into accepting assistance in dying by their families. This pressure may sometimes occur in very subtle forms. This is an important argument in favor of strict controls that would confirm that a patient is not being influenced by others. Some feel that the potential for interference is so serious that all assisted suicide should be banned.
Some people wish to die because they are suffering from clinical depression. This is another argument in favor of strict controls to confirm that a patient requesting aid in dying is “of sound mind”.
In an age when total medical funding is restricted, is it ethical to engage in extremely expensive treatment of terminally ill people in order to extend their lives by a few weeks, if it is against their will? The money used in this way is not available for pre-natal care, infant care, etc. where it would save lives, and significantly improve the long-term quality of life for others.
Some people argue that patients would be frightened that their physicians might kill them without permission. This is not a valid concern, since a patient would first have to request assistance in dying. If they did not ask for suicide assistance, their doctor would continue to preserve and extend their patients’ lives.