Ending a Life

Physician-Assisted Suicide

Questions to be answered (in the order listed):

1) Is suicide ever morally permissible? If so, under what conditions?

2) Is assisted suicide ever morally permissible? If so, under what conditions?

3) Is physician assisted suicide ever morally permissible? If so, under what conditions?

4) Should physician assisted suicide be made:

A) Legal

B) Illegal

or, C) Should the law remain neutral?

Physician-Assisted Suicide

If suicide is morally permissible, under what conditions?

Unrelievable pain and suffering?

Terminal illness?

Permission/support of others?

Loss of control or dignity?

All of the above?

Another distinction: refusing, withdrawing, or withholdings treatment is not necessarily suicide.

Physician-Assisted Suicide

Suicide

1) Suicide

NO: Violates the sanctity of life

Life is a gift from God, we can't give it back

Suicide goes against natural law

Suicide is a violation of the categorical imperative (Kant)

Life is a condition for happiness; it shouldn't be taken away (Utilitarian)

Suicide

1) Suicide

NO (cont.):

Rule in favor of suicide might lead to general happiness in the short run but in the long run it could be abused

Suicide is always the result of mental incompetence

Suicide is a violation of commitments to others

Suicide

1) Suicide

YES: Autonomy and freedom can be expressed in the way that we live and in the way that we die (Kant and Utilitarians, i.e. autonomy and general happiness permit suicide)

Individuals determine the quality of their lives and when they are no longer worth living

There is such a thing as rational suicide

An expression of the right to control what happens to one's body

Assisted Suicide

2) Assisted Suicide

NO: Suicide is Wrong

YES: Sometimes it is permissible when the person can't do it alone or without assistance

Physician-Assisted Suicide

3) Physician-Assisted Suicide

NO: Suicide is Wrong

Suicide goes against the moral tradition of medicine, e.g. Hippocrates

Physicians must not kill but always seek to cure

Physician-assisted suicide will destroy the trust of patients

Physician-Assisted Suicide

3) Physician-Assisted Suicide (cont.)

YES: Assisting is helping patients to the very end, duty of fidelity

Assisting assures patients of their own freedom and dignity

Physician assisting assures a quality death

Legalization

4) Legalization

NO: Suicide is Wrong

Will be abused

Slippery slope

Managed care will lead to abuses

Dutch experience

Legalization

4) Legalization (cont.)

YES: We can legally refuse treatment which is life-supporting, this is a logical extension

Protects doctors from charges of abuse

Enhances the doctor-patient relationship

Each state should be allowed to determine

Oregon is a model

The "Push" on the Debate

1) Beliefs about end of life conditions

2) Beliefs about the cost of 1)

3) Beliefs about the management of pain and suffering

A) Among physicians

B) Among laypersons

4) Beliefs about the meaning of suffering

The Debate