Approaches to Care in Physician Assisted Suicide
Voluntary euthanasia and physician-assisted suicide are two different types of euthanasia that lead to the termination of a living person's life with the help of medical intervention. The earliest recorded case in history is recorded in Gerland, Switzerland, during the 6th century. This particular incident involved a woman by name of Soror Marcella who is said to have consumed poison after having been seriously ill for many years and wanting no more pain or suffering. Voluntary euthanasia still exists today but has been often criticized for lack of evidence as most people die from pneumonia rather than cancer or congestive heart failure.
In the Netherlands, euthanasia is a legal practice that is regulated by law. It has been practiced since the 18th century. This practice was then introduced into law in the Termination of Life on Request and Assisted Suicide (Review Procedures) Act which was passed on April 5, 2002 to ensure that assisted suicides are performed in accordance with high standards of medical conduct and care.
In United States, physician-assisted suicide is illegal but it is legal for patients to refuse treatment. In 1997, Dr. Timothy Quill published a book entitled "Dying in the State of California: Medical Implications of the Natural Right to Die". This publication discussed the assistance provided by Drs. Quill and Goodin to Ms. Helen Prejean which helped her to end her life.
The American Medical Association (AMA) has been the main proponent of euthanasia in the United States. In 2002, the AMA introduced a proposed model for assisted suicide and continues to advocate for legalization. The AMA has spoken out against existing law and publicizes its support for "compassionate" and "quality" palliative care, which includes physician-assisted suicide, as an alternative to aggressive treatment for patients with chronic debilitating conditions.
Researchers have analyzed 1,298 cases of Voluntary Euthanasia in Belgium throughout the 20th century. From the data collected, they found that a very low percentage of people who had been euthanized have done so after suffering a long time illness or having suffered many years of chronic disability. This means that physician-administered euthanasia is not primarily practiced on those who are terminally ill.
According to a study conducted by the Oxford University Department of Law and Ethics, the results in the Netherlands show that since legalization of voluntary euthanasia, there has been no evidence as to whether lives are being saved as intended by proponents. The report also states that "there is little evidence in its favor".
A study was conducted to determine the effect of legalizing assisted suicide in the State of Oregon. The study compared aggregate state-level data from the years 1992 to 1997 with the data from 1998 and 2002 after legalization. Its findings suggest that legalization resulted in a small net increase in total suicides, primarily among people aged 50 to 64 years and those aged 65 years or more. These findings are also supported by a longitudinal study of physician-assisted suicides which found that cancer patients were less likely to commit suicide on legalizing assisted suicide than expected, while non-cancer patients were more likely than expected to commit suicide.
In another study, 30 physicians who had assisted in 1316 deaths were interviewed by telephone and online surveys. The results show that patients who request euthanasia are highly likely to have cancer or amyotrophic lateral sclerosis. They also found that pain, depression, poor social support, lack of clarity about the causes of death, and medical treatments perceived as burdensome had a significant effect on the physician's decision for euthanasia.
Another study was conducted to determine whether there was a correlation between physician-assisted suicides and changes in overall suicide trends in Oregon. The University of California, San Diego examined suicide rates in Oregon before and after legalization. It analyzed death records from the state's department of health registry from 1990 to 2007. This study has been criticized by Dr. Arthur Lien, an emergency medicine physician from Oregon who stated that "the statistical analysis and the way the data was collected is flawed" because it only measured changes in reported suicide rates up to 2007.
In a study by the University of California, San Diego School of Medicine, it examined whether there was a correlation between physician-assisted suicides and changes in overall suicide trends in Oregon. The study analyzed death records from the state's department of health registry from 1990 to 2007. This study has been criticized by Dr. Arthur Lien, an emergency medicine physician from Oregon who stated that "the statistical analysis and the way the data was collected is flawed". Dr. Lien was referring to the fact that it only measured changes in reported suicide rates up to 2007.
Although there are arguments on both sides, the debate over voluntary euthanasia is very controversial. Some of the most common arguments include:
There are some common themes among those who oppose physician-assisted suicide. These include a concern that it will lead to non-voluntary euthanasia, a slippery slope argument and an interest in maintaining human dignity. Many opponents are also very concerned with professionalism and whether medical associations shall be in a position of assisting their patients' actions by providing necessary drugs or knowledge of lethal dosages when the ultimate goal is that the patients will commit suicide without them being involved personally.
The concept of human dignity is important since it deals with the question of whether a person's life should be sacrificed for the benefit of others. In opposition to this idea, legalization of physician-assisted suicide would recognize that some people think a person's life is worth less than others and some people believe that people have a right to end their own lives. Those who oppose physician-assisted suicide often see this as violating the Hippocratic Oath which begins: "I will give no deadly medicine to anyone if asked, nor suggest any such counsel," and the first line of which is "I swear. I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. Thus, practicing medicine without limit of time or number."
Those in favor of physician-assisted suicide often see it as an individual's right to their own life and consider euthanasia as a form of mercy killing. It is also seen as a way for people who are terminally ill to experience a state of euphoria and leave this world in peace.
Supporters of physician-assisted suicide also have other concerns that make them oppose the practice, including:
Some physicians who support voluntary euthanasia have published articles on the topic. Some are former opponents or only became supporters due to personal experiences with the practice.
"See " !"Voluntary euthanasia" below.
Conclusion"
In his article "The Physician-Assisted Suicide Debate", Dr. Peter Goodwin wrote that while "a few small-scale studies have demonstrated significant benefits" with physician-assisted suicide legislation, there were also reports in the academic literature which claimed that euthanasia advocacy "could encourage physicians and nurse practitioners to wield their power of life-ending judgments in inappropriate ways". He also said that when physicians or others who opposed the practice described it as a slippery slope argument, this was evidence of the debate's intensity and complexity. Dr.
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