Assisted suicide is “Suicide accomplished with the aid of another person,
especially a physician.” It is sometimes used interchangeably with euthanasia “The
act or practice of ending the life of an individual suffering from a terminal
illness or an incurable condition, as by lethal injection or the suspension of
extraordinary medical treatment.” The important part is that it is assisted
death rather than simply being allowed to die. Assisted suicide is an issue
which causes world-wide conflict with various countries differing strongly on
their legal stances towards assisted suicide. Currently there are only four
places which openly and legally authorise assisted suicide; Oregon since 1997,
Switzerland since 1941, Belgium since 2002 and the Netherlands since 2002.
Equally, there are countries such as Russia, Hungary, Republic of Ireland and
England and Wales that look upon assisted suicide as a criminal offence with
harsh penalties. Between these two extremes there are also countries such as
Germany, Denmark, Finland and Luxembourg where there is no specific law against
assisted suicide but equally there is no legislation proclaiming it to be
legal. Doctors themselves are divided upon whether it should be legalised. In
September 1996 issue of the BMA News Review, the results of a survey of over
750 GPs and hospital doctors showed that 46% of doctors supported a change in
the law to allow them to carry out the request of a terminally ill patient for
voluntary euthanasia, 44% were against euthanasia and supported the present law
and 37% said they would be willing to actively help end the life of a
terminally ill patient who had asked for euthanasia and so assisting suicide,
if the law allowed it. This debate will examine both the propositional and
oppositional arguments concerning whether assisted suicide should be legalised.
This debate has received a lot of press recently due to the death of Jack
Kevorkian, the man nicknamed 'Dr Death' since he claimed to have assisted more
than 100 suicides. Throughout his life he waged a defiant campaign to help
people end their lives, both sides of the debate would agree that he provoked a
national discussion, and doctor-assisted suicide is now legal in three American
states.
Pros
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Cons
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Every human being has a right to life. Perhaps the most basic and fundamental of all our
rights. However, with every right comes a choice. The right to speech does
not remove the option to remain silent; the right to vote brings with it the
right to abstain. In the same way, the right to choose to die is implicit in
the right to life. The degree to which physical pain and psychological
distress can be tolerated is different in all humans. Quality of life
judgements are private and personal, thus only the sufferer can make relevant
decisions. This was particularly evident in the case of Daniel James. After suffering a spinal dislocation as the
result of a rugby accident he decided that he would live a second-rate
existence if he continued with life and that it was not something he wanted
to prolong. People are given a large degree of autonomy within their lives
and since deciding to end your life does not physically harm anyone else, it
should be within your rights to decide when you wish to die.
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There is no comparison between the right to life and
other rights. When you choose to remain silent, you may change your mind at a
later date; when you choose to die, you have no such second chance. Arguments
from pro-life groups suggest that nearly ninety-five percent of those who
kill themselves have been shown to have a diagnosable psychiatric illness in
the months preceding suicide. The majority suffer from depression that can be
treated. If they had been treated for depression as well as pain they may not
have wanted to commit suicide. Participating in someone’s death is also to
participate in depriving them of all choices they might make in the future,
and is therefore immoral.
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Those who are in the late stages of a terminal disease
have a horrific future agead of them. The gradual decline
of their body, the failure of their organs and the need for artificial
support. In some cases, the illness will slowly destroy their minds, the
essence of themselves; even if this is not the case, the huge amounts of
medication required to ‘control’ their pain will often leave them in a
delirious and incapable state. At least five percent of terminal pain cannot
be controlled, even with the best care. Faced with this, it is surely more
humane that those people be allowed to choose the manner of their own end,
and have the assistance of a doctor to die with dignity. One particular
account was of Sue Rodriguez who died slowly of Lou Gehrig's disease. She
lived for several years with the knowledge that her muscles would, one by
one, waste away until the day came when, fully conscious, she would choke to
death. She begged the courts to reassure her that a doctor would be allowed
to assist her in choosing the moment of death. They refused.
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Modern palliative care is immensely flexible and
effective, and helps to preserve quality of life as far as is possible. There
is no need for terminally ill patients ever to be in pain, even at the very
end of the course of their illness. It is always wrong to give up on life.
The future which lies ahead for the terminally ill is of course terrifying,
but society’s role is to help them live their lives as well as they can. This
can take place through counselling, helping patients to come to terms with
their condition.
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Suicide is a lonely, desperate act, carried out in
secrecy and often as a cry for help. The impact on the
family who remain can be catastrophic. Often because they were unaware of how
their loved one was feeling. Suicide cases such as Megan Meier, an American
teenager who committed suicide by hanging herself in 2006, as the parents
have to launch police investigations into why their child might have felt so
desperate. By legalising assisted suicide, the process can be brought out
into the open. In some cases, families might have been unaware of the true
feelings of their loved one; being forced to confront the issue of their
illness may do great good, perhaps even allowing them to persuade the patient
not to end their life. In other cases, it makes them part of the process:
they can understand the reasons behind their decision without feelings of
guilt and recrimination, and the terminally ill patient can speak openly to
them about their feelings before their death.
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Demanding that family take part in such a decision can
be an unbearable burden: many may resent a loved one’s decision to die, and
would be either emotionally scared or estranged by the prospect of being in
any way involved with their death. Assisted suicide also introduces a new
danger, that the terminally ill may be pressured into ending their lives by
others who are not prepared to support them through their illness. Even the
most well regulated system would have no real way to ensure that this did not
happen.
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At the moment, doctors are often put into an impossible
position. A good doctor will form close bonds with their patients, and will
want to give them the best quality of life they can; however, when a patient
has lost or is losing their ability to live with dignity and expresses a
strong desire to die, they are legally unable to help. To say that modern medicine
can totally eradicate pain is a tragic over-simplification of suffering.
While physical pain may be alleviated, the emotional pain of a slow and
lingering death, of the loss of the ability to live a meaningful life, can be
horrific. A doctor’s duty is to address his or her patient’s suffering, be it
physical or emotional. As a result, doctors will in fact already help their
patients to die – although it is not legal, assisted suicide does take place.
Opinion polls suggest that fifteen percent of physicians already practise it
on justifiable occasions. Numerous opinion polls indicate that half the the
medical profession would like to see it made law. It would be far better to
recognise this, and bring the process into the open, where it can be
regulated. True abuses of the doctor-patient relationship, and incidents of
involuntary euthanasia, would then be far easier to limit. The current
medical system allows doctors the right to with-hold treatment for patients.
Though, this can be considered to be a more damaging practise than allowing
assisted suicide.
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It is vital that a doctor's role not be confused. The guiding principle of medical ethics is to do no
harm: a physician must not be involved in deliberately harming their patient.
Without this principle, the medical profession would lose a great deal of
trust; and admitting that killing is an acceptable part of a doctor’s role
would likely increase the danger of involuntary euthanasia, not reduce it.
Legalising assisted suicide also places an unreasonable burden on doctors.
The daily decisions made in order to preserve life can be difficult enough;
to require them to also carry the immense moral responsibility of deciding
who can and cannot die, and the further responsibility of actually killing
patients, is unacceptable. This is why the vast majority of medical
professionals oppose the legalisation of assisted suicide: ending the life of
a patient goes against all they stand for. The Hippocratic Oath that doctors
use as a guide states 'I will neither give a deadly drug to anybody if asked
for it, nor will I make a suggestion to this effect.'
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Society recognises that suicide is unfortunate but
acceptable in some circumstances – those who end their own lives are not seen
as evil, nor is it a crime to attempt suicide. It seems odd that it is a
crime to assist a non-crime. The illegality of assisted suicide is therefore
particularly cruel for those who are disabled by their disease, and are
unable to die without assistance. For example, in March 1993 Anthony Bland
had lain in persistent vegetative state for three years before a Court Order
allowed his degradation and indignity to come to a merciful close. It might
cause unnecessary pain for people if they make an attempt at suicide
themselves and subsequently fail. Rather than the pain-free methods that
could be available through doctors and modern medicine.
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If someone is threatening to kill themselves it is your
moral duty to try to stop them. Those who commit
suicide are not evil, and those who attempt to take their own lives are not
prosecuted. However, it is your moral duty to try and prevent people from
committing suicide. You would not, for example, simply ignore a man standing
on a ledge and threatening to jump simply because it is his choice; and you
would definitely not assist in his suicide by pushing him. In the same way,
you should try to help a person with a terminal illness, not help them to
die. With the exception of the libertarian position that each person has a
right against others that they not interfere with her suicidal intentions.
Little justification is necessary for actions that aim to prevent another's
suicide but are non-coercive. Pleading with a suicidal individual, trying to
convince her of the value of continued life, recommending counseling, etc.
are morally unproblematic, since they do not interfere with the individual's
conduct or plans except by engaging her rational capacities. The impulse
toward suicide is often short-lived, ambivalent, and influenced by mental
illnesses such as depression. While these facts together do not appear to
justify intervening in others' suicidal intentions, they are indicators that
the suicide may be undertaken with less than full rationality. Yet given the
added fact that death is irreversible, when these factors are present, they
justify intervention in others' suicidal plans on the grounds that suicide is
not in the individual's interests as they would rationally conceive those
interests. We might call this the ‘no regrets' or ‘err on the side of life’ approach
to suicide intervention.
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'Were the disposal of human life so much reserved as
the peculiar province of the almighty, that it were an encroachment on his
right for men to dispose of their own life, it would be equally criminal to
act for the preservation of life as for its destruction'. If we accept the
proposition that only God can give and take away life then medicine should
not be used at all. If only God has the power to give life then medicines and
surgeries to prolong people's life should also be considered wrong. It seems
hypocritical to suggest that medicine can be used to prolong life but it
cannot be used to end someone's life.
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Only God can give and take away life. Life is Sacred so no one has the right to take a life,
this includes ones own. As a result both suicide and assisted suicide are
wrong. There are many passages within the bible that speak of the idea that
God has appointed a time for all to die, 'Hebrews 9:27, “And as it is
appointed unto men once to die, but after this the judgement:” Ecclesiastes
3:1-2, “To every thing there is a season, and a time to every purpose under
the heaven: A time to be born, and a time to die; a time to plant, and a time
to pluck up that which is planted;” Ecclesiastes 7:17, “Be not over much wicked,
neither be thou foolish: why shouldest thou die before thy time?” In addition
to this, physicians are nowhere in Scripture given authority to take
someone's life. Apart from the government in the case of capital punishment,
all other human beings are given the commandment “Thou shalt not kill,”
Exodus 20:13 and “Thou shalt do no murder,” Matthew 19:18.
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However, the idea that we should not kill is not
absolute, even for those with religious beliefs — killing in war or
self-defence is justified by most. We already let people die because they are
allowed to refuse treatment which could save their life, and this has not
damaged anyone's respect for the worth of human life. Concerning the notion
that legalised voluntary euthanasia might lead to involuntary euthanasia
being carried out, there is no evidence to suggest this. As Ronald Dworkin
states, 'Of course doctors know the moral difference between helping people
who beg to die and killing those who want to live.'
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It would have a damaging effect on society. Some people who do not agree with voluntary euthanasia
argue that if it was legalised, it would damage the moral and social
foundation of society by removing the traditional principle that man should
not kill, and reduce the respect for human life. It might also be the case
that once voluntary euthanasia has been legalised, this might lead to cases
of involuntary euthanasia being carried out. With people deciding that
someone else's life such as the elderly or the terminally ill is not worth
living and therefore performing euthanasia without their consent. A recent
study discovered that some sufferers of locked-in syndrome – as many as three
out of four of the main sample – were happy and did not want to die.
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