Assisted suicide is way to maintain control of ones own life

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By: Neris Pleitez

There are many people that have terminal disease and some of them either decide to keep fighting and stay alive while others question the idea of it. With the option of assisted suicide in some areas, they begin to think that’s the answer and sometime opt with ending their life through a prescribed drug. some patients go through the process of getting the lethal from a doctor and take it, while some on the other hand just get it to have the option of being able to end their life their own way. Washington is one of the few states in the U.S. that allows physician assisted suicide, and according to HealthDay News, between March of 2009 to December of 2011, there was a study at the clinic, Seattle Cancer Care Alliance that has a Death by Dignity program for terminal cancer patients.[1] In this study 114 patients enquired about the program and only 40 passed the screening and receive a prescription. All the 40 patients died, 24 of them died soon after receiving the medication, while others lived on while still having it in their possession till they passed away. A patient by the name of Ethan Remmel was one of the 40 patients and in his blog he posted, “So I have the medication now. It is safely locked up. I have not decided if or when I will use it, but it gives me great relief to know that I have some control over my dying process.”[2] He was an associate professor at Western Washington center and was a patient diagnosed with terminal colon cancer and did not have long to live, he thought of this not as suicide but a way to make his decision on something that he did not have before. He would have issues teaching as he would sometimes not make sense during his lectures. The pain he was bearing and the fatigue that was cause because of the cancer and his treatment was taking its toll on him. The pain killers he would use gave him side effects such as making him constipated and mentally loopy.  On his last blog post he said “You’ll just have to trust that my quality of life has become unacceptable to me and that I am a reasonable person”[2]. He could have proceeded taking whatever medication he was given to stay alive longer but he no longer felt it was the life he wanted. Felling the pain and fatigue all the time he felt the time to take the medication was coming was near and thought it was best to end his life himself rather than letting the sickness do it for him. Which many people on his very similar situation feel they should have but can’t due to the laws for assisted suicide. He was one of the few thousands of patients that could die by his own hand rather than just waiting for his time to come, and in some cases, that should be a clear option to anyone who may have felt the same way he did. Not having control of one’s own life is something many people fear but this may let people handle their situations differently and help them feel as if that life was always theirs.

 

[1] (HelthDay News, 2013)

[2] (Remmel, 2011)

Is assisted suicide right for you?

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By: Marisela S.

First, you need to know what assisted suicide is and the process you would have to take if you are considering assisted suicide. Assisted suicide has been a controversial topic for centuries. There have been arguments about whether or no assisted suicide is ethical. What if assisted suicide is a step in the wrong direction? Let me start off by saying assisted suicide is not for everyone but I do believe that everyone has a right to make that decision or at least know about all their options.

Furthermore, assisted suicide can be the last resort for some patients who aren’t so lucky. With that being said, assisted suicide is only legal in a few states in the United States. Which makes it harder for patients seeking a physician who’s willing to participate. Here are a few necessary steps you need to take in order to seek help with assisted suicide.  “To find out if your doctor is willing to participate in the law, make an appointment with him or her to discuss your end-of-life goals and concerns, including the option available under the state’s Death with Dignity law. Ask any kind of doctor: your hospice doctor, or your oncologist, or pulmonologist, or neurologist, or even your dermatologist or psychiatrist. Any physician licensed to practice in a “Death with Dignity state” is allowed to participate if s/he agrees; the law also says every physician has the choice not to participate.” (DD)

“If the first physician says yes, ask them for a referral to another doctor who will participate or ask another of your (probably many) doctors if they will participate. Both physicians need to certify that you meet the criteria under the law. The first physician will be your attending physician for the law. He or she will guide you through all the requirements of the law and, if you qualify, will write the life-ending medication prescription for you. The second certifying doctor will be the consulting physician under the law who has to certify all the criteria under the law have been met.” (DD)

You may be asking yourself “What now?” If you have found a physician that I willing to help you. That have already gone through the necessary steps moving forward. It is up to the physician to determine which prescription they will prescribe to you. After that, you will decide where and when you want to take your prescription. Only you know when and if will be the right time. Assisted suicide seems to have a negative view on it and everyone has their personal views on it. Even if you decide that assisted suicide isn’t for you it is still your right to know. There might come a time where that may be your only option and with so many laws prohibiting assisted suicide you should know and be informed about your right if you choose it. The information provided is just to help you understand and give some insight on what lies for you ahead if you are considering assisted suicide.

 

 

Work Cited:

 

  • “FAQs.” Death With Dignity. N.p., n.d. Web. 20 Mar. 2017.

Do No Harm; A Physician’s Take

By: Randi D.

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          When it comes to physician-assisted suicide (or PAS, for short), there are plenty of opinions on both sides of the spectrum. The family members, patients themselves, and government officials responsible for making PAS laws cannot seem to find common ground. Today, I will be exploring a point of view that is not often considered: the physician’s.


Currently, there are six states in the United States that have passed legislation permitting assisted suicide. While each state’s verbiage varies, generally speaking, the requirements are similar. In order for PAS to be an option to a patient, the patient must be diagnosed as being terminally ill with less than six months to live. The patient must be deemed mentally competent, not suffering from any mental illness that would impair judgment. In some states, the request must be made in writing twice, 15 days apart, as well as requested verbally to multiple physicians. The idea is to prevent the patient making a decision based on pressure from outside opinions. The catch is, no physician may directly cause the patient’s death (ex: administering the life-ending drugs intravenously, which is considered euthanasia, not PAS). The physician may only prescribe the drugs. It is entirely up to the patient to decide if or when to fill the prescription and take them.

It is also important to take into account the terminology used. PAS can be broken down into two categories, active and passive. Active meaning something (such as drugs) are actively given to induce death. An example of passive PAS would be removing a tube for tube feeding when it is required for the patient to receive nutrients, which passively and directly causes death. Terminal sedation (TS, also referred to as ‘Palliative Sedation’) is often mistakenly associated with PAS[1]. Terminal sedation is administered when pain cannot be controlled by medications alone. The patient can be conscious, but sometimes that is not enough. In this situation, they may need to be completely unconscious. Sometimes, the patient remains in this state until death. This is not considered PAS, as death cannot be proven to be a direct result of sedation. TS must be initiated either by the patient themselves, or by other means such as a medical power of attorney or as requested by the patient’s advanced directives.  Another term incorrectly interchanged with PAS is euthanasia. Voluntary euthanasia is done at the request of the patient, to be done directly by a physician. It is important to note, while voluntary euthanasia is legal in a few countries, involuntary euthanasia is not legal anywhere in the world.


          Now that we have defined exactly what PAS is and is not, we will look at the physician’s point of view.


In a study done by the American Journal of Hospice and Palliative Medicine[2], as many as one in three physicians support PAS. But, we also find that even though one in three agree with the option of PAS, far fewer are willing to participate in PAS themselves.  Digging deeper into this study, it is revealed that 31% had “no objection” to PAS but when it comes to withdrawal of life support, the number of “no objections” jumps to 95%. Why is it that physicians tend to be okay with withdrawal of life support but not PAS, if the outcome is the same? Dr. Gerrit Kimsma, a general practitioner and lecturer in medical ethics at the Free University of Amsterdam gives his opinion; he says it is a conflict between two of his goals as a doctor: the goal of saving a life, and the goal of helping people who are suffering. It is suggested that some physicians may not agree with PAS for religious reasons, some believing life is sacred and should be saved at all costs. According to a study done by the AIM[3], another suspected reason is some physicians believe having PAS as an option decreases the quality of palliative care in general. The study revealed a correlation between the physician’s education on end of life care and support of PAS. The physicians that felt they had adequate education and training on the various methods of palliative care were less inclined to support PAS, suggesting adequate knowledge of other options makes PAS a less appropriate solution. In addition, another study[4] showed differences in PAS approval rates when the method used to assist death changed.  When the method was a lethal prescription, 36% of physicians would prescribe the medication “if it was legal”. When it came to a physician administering a lethal injection “if it was legal”, the number fell to 7%.

Responses vary by physician demographic, physician specialty, and many other factors. This makes research on the topic very difficult to accurately portray how physicians feel about it. An oncology specialist would presumably receive far more requests for PAS than a pediatric specialist, potentially skewing results.

One of the most important things to remember, is that even where it is legal, physicians are never required to participate in PAS. It is always their decision. If is against a physician’s personal beliefs, or the physician believes there is a better alternative for the patient, they are within every right to refuse the patient’s request and furthermore, they are not required to refer the patient to another physician who would be willing to grant the patient’s wishes.

With all of this in mind, whether physician assisted suicide is truly considered “doing no harm” or the opposite, it appears that physicians, much like the patients and family members, will just have to agree to disagree. Before making any permanent decisions, physicians should consider all options and view each patient for the individual that they are. PAS is not a one-size-fits-all solution.

 

-RD


 

[1] (Angela Morrow, 2017)

[2] (To Die, to Sleep: US Physicians’ Religious and Other Objections to Physician-Assisted Suicide, Terminal Sedation, and Withdrawal of Life Support, 2008)

[3] (Attitudes and Practices of U.S. Oncologists regarding Euthanasia and Physician-Assisted Suicide, 2000)

[4] (A National Survey of Physician-Assisted Suicide and Euthanasia in the United States, 1998)