Assisted-Suicide
Right or Wrong
Deciding when to die and when to live is an issue that has only recently begun to confront patients all over the world. There is an elderly man lying in a hospital bed, he just had his fourth heart attack and is in a persistent vegetative state. He is hooked up to a respirator and has more tubes and IV’s going in and out of his body everywhere. These kinds of situations exist in every hospital everyday. Should physicians or doctors be allowed to assist patients, like this one, in death? Even though, physician-assisted suicide is illegal in the U.S., many doctors are helping suffering patients die. Physicians should not provide treatments that have a low chance of succeeding, such as respirators for patients in a permanent vegetative state.
Rita L. Maker, an attorney and executive director of the International Anti-Euthanasia Task Force, believes “the debate isn’t about the tragic, personal act of suicide, nor is it about attempted suicide…the current debate is about whether public policy should be changed in a way that will transform prescriptions from poison into medical treatment”(45).
Oregon is the only state that allows assisted suicide. A doctor will prescribe medication and the pharmacist will say “be sure to take all of these pills at one time-with a light snack or alcohol-to induce death”(45). The states insurance companies pay for the medication, which are paid for by Medicaid called “comfort care”(46).
“Whether other states embrace Oregon-style care will depend upon a willingness to carefully examine what truly is at stake in this debate…about public policy”(46). It
does not matter about your point of view on physician-assisted suicide; it’s the layout and plan that matters. For example “Walter Dellinger, acting solicitor general, said ‘the least costly treatment for any illness is lethal medication’ he was right. A prescription for a deadly overdose runs about thirty five dollars… the patient won’t consume any more health care dollars”(Marker 46). Whenever the economy was involved there was always a major hill to climb. Not to long ago patients were told to come in to get check ups that were not necessary. All the hospitals and clinics got paid back for everything they did to the patient. Finally, people became smarter and started to say no the unnecessary treatments. Now their income relates to the information they provide, the less the better.
Marker reports that in recent years “a significant number of health-maintenance organizations or HMO’s are ‘for-profit’ enterprises where stockholder benefit, not patient well-being, is the bottom line”(47). There are programs that allow physicians from telling the whole truth. The doctor will say one thing when it really means something different and usually it is for the worse. Not many people research into their medical coverage until they are sick. Once that happens you are not going to have a clue what your plan covers. Marker stresses that “having a physician friend who would talk over a planned assisted-suicide before prescribing a lethal dose is nothing more than a fantasy for the vast majority of American”(48).
Today, if its a patients first visit it will be no longer than twenty minutes and if the patient returns its visit will be ten minutes. Another example is that some medical programs want doctors to not treat patients right a way and will usually cause a conflict. Marker points out “a survey published in 1998 in the Archives of Internal Medicine…
found that doctors who are the most thrifty when it comes to medical expenses would be six times more likely than their counterparts to provide a lethal prescription”(48).
If a physician is truthfully against assisted-suicide he or she will offer every possible alternative to the patient. To sum it all up, Wesley Smith, an attorney and consumer advocate, expresses “the last people to receive medical care will be the first to receive assisted-suicide”(qtd. in Marker 49). If we embrace assisted suicide as medical treatment, it will return our embrace with a death grip that is cold, cruel and anything but compassionate”(49).
On the other hand, Marcia Angell, executive editor of the New England Journal of Medicine, it should not be a crime for doctors to respect the wishes of terminally ill patients who want assistance in committing suicide. She start of her argument by referring to a Supreme Court decision in which,” they found dying patient [sic] have no right to decide for themselves to cut short their suffering by asking their doctors to prescribe an overdose of sleeping pills or painkillers.” The court said it is the state legislatures fault for having laws on physician-assisted suicide. So the patient will not have a choice if he or she wants to die unless the state changes the laws. Angell claims that,” the Supreme Court missed the point: Dying can be slow and agonizing, and some people simply want to get it over with.” The only legal option patients have is if they
want their life support shut down. Too bad most patients are not on life support so they can not request it (33-34).
Angell has no clue why the legislature would make a patient suffer when he or she does not want to suffer anymore. She goes on pleading that this is the same choice the Supreme Courts allows when people abort their babies and when people get married. “Dying patients suffering intractably should have the option of taking and overdose, just as they have the option of turning off life supports” argues Angell. Even if the doctor prescribed pills to the patient in most cases would not take them. But, due to the fact, that the patient had the option of taking the pills would make them happy. When the patient thinks the time is right can take the pills in peace (34).
Doctors then would have the option, too. No one would be “pressured to ask for assisted suicide…[or] pressured to refuse life supports”(34). The Supreme Courts verdict was a whitewash against doctor-assisted suicide, 9-0. The justices’ opinions pretty much all said “the notion that permitting doctor-assisted suicide would be too great a departure from tradition, and besides, god palliative care should relieve all suffering”(34).
Angell concludes “compassionate doctors always have helped dying patients to end their lives”(34). Even though this is all done under the table, by the doctor supplying the patient with mass quantities of a certain prescription. Only if the doctor is strong inside and knows what the patients needs instead of wants then the doctor should prescribe a drug. She states that “polls consistently show about two-thirds of the public favor permitting doctor-assisted suicide”(35). Finally she sums it all up by saying
“sooner or later…the practice will become legal, because dying patients need that choice and their doctors need to be able to help them”(35).
Timothy E. Quill, M.D., practicing physician, wrote this article in the New England Journal of Medicine, which pertains to aiding someone to death. Diane, Quills’ patient for eight years, was feeling weak and had a breakout on her skin. Quill did some blood work. Many years of Diane’s life was lost as an alcoholic and a depressed person, but she fought her way out of it (111).
Although the odds were against her, Quill let her be aware of the consequences she would face when they get the bone marrow test back and what they would do if the results were not so good (111).
The test came back and the oncologist diagnosed Diane with ‘acute myelomonocytic leukemia.’ The oncologist wanted to put a Hickman catheter and start chemo as soon as possible. Quill recalled that “[Diane] was enraged at [the oncologists] presumption that she would want treatment, and devastated by the finality of the diagnosis. All she wanted to do was go home and be with her family. She no further questions about the treatment and in fact had decided that she wanted none…”(111). Quill stated “I have been a longtime advocate of active informed patient choice of treatment or nontreatment, and of a patient’s right to die with as much control and dignity as possible”(111). Quill was confused that Diane wanted to give up her twenty five percent chance of living after she fought to overcome alcoholism and depression. He knew that she would have to change her mind, soon (111).
Quill pointed out “it was extraordinarily important to Diane to maintain control of herself and her own dignity during the time remaining to her”(111). Diane clearly told Quill that she wanted to die. Quill used to be head of a hospice program, he knows how
to keep people from suffering using different medications, but Diane did not care. She wanted to die in the easiest and least painful way. Quill expressed that “I felt the effects of a violent death…an ineffective suicide…the possibility that a family member would be forced to assist her [then] the legal and repercussions that would follow”(112). Diane continually informed her family with her choices and her family supported her on all her decisions. The Hemlock Society discussed any an all the problems she faced. Diane called Quill seven days later asking for sleeping pills. Quill knew this is what the Hemlock Society encouraged and wanted to discuss this over with Diane again. “She was having trouble sleeping…I made sure that she knew how to use the barbiturates for sleep, and also that she knew the amount needed to commit suicide” Quill cautioned (112). They promised each other they would see each other on a basis and before she took the pills (112-113).
The months ahead were very strenuous. Her son and husband did everything at home to spend as much time with her as they could. Also, Diane’s best friends stopped by when they could (113). Quill confirmed “bone pain, weakness, fatigue, and fevers began to dominate her life…it was clear that the end was approaching”(114). Diane phoned all her friends to ask them to visit her and say their ‘good byes.’ She came to my office one last time “it was clear the she knew what she was doing, that she was sad and frightened to be leaving, but that she would be even more terrified to stay and suffer”(114) Quill enforced.
A couple days later Diane’s husband phoned me and said Diane passed away. She told her son and husband goodbye and leave her alone, an hour later she was dead lying in her favorite blanket. Quill called the medical examiner and told him Diane died of ‘acute leukemia’ (114). Quill indicates that “I said ‘acute leukemia’ to protect all of us, to protect Diane from invasion into her past and her body, and to continue to shield society for the knowledge of the degree of suffering that people often undergo in the process of dying”(115).
Quill concludes by praising that:
Diane taught me about the range of help I can provide if I know people well and if I allow them to say what they really want…about life, death, and honesty and about taking charge and facing tragedy squarely when it strikes…that I can take small risks for people that I really know and care about. Although I did not assist her in suicide directly, I helped indirectly to make it possible, successful, and relatively painless. Although I know we have measures to help control pain and lessen suffering, to think that people do not suffer in the process of dying is an illusion (115).
Betty Rollin, an employee at NBC News, wrote Last Wish, a book about her mother’s death, which this article goes back and tells the story of how she help assist-suicide upon her mother. “Next to the happiness of my children, I want to die more than anything else in the world” my mother’s words [spoke] to me one late fall afternoon to convince me that she really meant it: She wanted to die, and would I please help”(241).
Rollin reveals that “[they] did research [and] found out what it would take for her to die ‘safely’ (241). Rollins mothers doctor wrote her out a prescription that would end her life quickly and peacefully. Rollin misses her very much and even if she runs through her mind a tear will develop in her eye every time. Rollin does not display any pictures of her mother because she breaks down every time she sees her mothers profile. The life her mother was living was terrible. It was like she was in a room with no windows or doors, when she died it was like she got out of the room, and she was happy to get out. Rollin and her husband were happy, also (241-42).
Rollin wrote a book about her mother the Last Wish, which was made into a television movie. She has received many letters that agreed with her and some that did not. The letters that did not agree with her, people wrote “death by any person’s hand is killing a life god created” (242). Rollin pleads “but I still remember my mother’s own view. ‘God gave me a brain…and I’m glad its still working so that I can die the want I want to”(242).
A young geriatric nurse wrote “I believe its doctors who cannot deal with death. They put the feeding tube in and walk away feeling like heroes. They don’t want to know that the patient can’t talk, can’t move, can’t do anything for herself. I’ve had patients beg me to help them die. I support euthanasia. Talk to nurses in geriatrics. They know the truth”(242-43). The nurse conclude by saying ‘they know the truth,’ what she means by this is people who are suffering and dying, want to die. But they cannot die unless they have a little help (243).
Rollin reveals that “I do not think family members should be the ones to help a desperate person die. It happened to work out in my family…instead we urgently need is a law that would allow physicians to carry out the wishes of a dying person” (243). Assisted-suicide laws must have regulations. The regulations were passed a year ago in Washington State. More regulations will be submitted in California this November and it will say: “The patient must be mentally competent, must be declared terminally ill by two physicians, and must be able to revoke the decision at any time”(243).
Michael White, a lawyer and president of American Against Human Suffering, asked me to join him to speak in front of the American Bar Association (ABA). We tried to the vote of the ABA of physician-assisted suicide. They revoked our proposal (244).
Rollin claims that “there are people dying in hospital beds…near the end of life, with nothing ahead but pain and terror. They have a right to die, if that’s what they truly want”(244). The people against me talk about god and interfering with God’s creation. Don’t we interfere when we hook some one up to a respirator to keep then alive, exclaims Rollin (244).
Another reason assisted-suicide is good is to take away pain, if dying patients have a choice to end their life they wouldn’t, but knowing they have a choice would put them at ease and when they think it is the right time to end their life they can do so, just like Rollins mother did. Rollins mother took the prescription when she felt most comfortable. Rollins concludes it by saying “times have changed…but ultimately, I can’t help these people the way I helped my mother. What I can do is join the fight to change the law. It’s going to be a state-by-state battle, and California is next up.
I am totally for physician assisted-suicide. Physicians should respect the wishes of their patients, even when the patient wants to die. Decisions about how to die are personal, private matters that the government should stay out of. Dying patients should have the right to choose a quick, painless death and doctors should be allowed to help them achieve it.
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