Terminal Sedation and Physician-Assisted Suicide Term Paper
Terminal Sedation and Physician-Assisted Suicide Term Paper
The complexity of ethical issues in medical practice compels discussants and professionals to focus on evidence-based ideas whenever making specific decisions. This concern arises from the fact that many stakeholders are involved in every ethical decision-making making process in healthcare. The ultimate goal of every process is to safeguard the rights of the greatest majority. This introductory part gives a personal statement of reflection regarding terminal sedation and physician-assisted suicide (or euthanasia).Terminal Sedation and Physician-Assisted Suicide Term Paper.
Soh, Krishna, Sim, and Yee (2016) define “terminal sedation” as any form of treatment administered to dying patients to relieve symptoms such as agitation and pain. This practice, therefore, is not the moral equivalent of euthanasia. This is the case because euthanasia is usually known to result in death. There is also an ethical difference between the right to die with dignity and other rights related to freedom from state-inflicted pain, medical treatment, and personal dignity. Terminal Sedation and Physician-Assisted Suicide Term Paper.
Dying with dignity entails a natural process while every right related to personal dignity, state-inflicted pain, and medical treatment is a product of decision-making. Such rights are, therefore, left in the hands of patients, clinicians, or state officers. Ethical considerations should, therefore, foreclose the possibility of using pain medication to hasten or cause death. Stakeholders must make ethical and acceptable decisions.
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Terminal sedation has become a longstanding and acceptable clinical practice in palliative care. This is something informed by the nature of terminal illnesses such as cancer. Patients living their last days can be supported using this method. Mentally competent terminally ill adults should be allowed to make personal decisions regarding euthanasia. The decision is guided by the principles of beneficence and self-determination (Hammaker & Knadig, 2016). However, the fact that the average time from sedation to death is 2-4 days affects this right. This is the case because patients might not achieve the targeted outcome immediately. The procedure might result in suffering.
The right to die and the traditional right to refuse life-saving medical treatment encompass the broader right to euthanasia. This is true because the final decision should be made by the patient. Unfortunately, there is a danger that the right to euthanasia and terminal sedation in terminally ill patients could be extended to the wider population during bioterrorist attacks and global pandemics. The occurrence of such attacks can result in a situation whereby many patients are wiped out using euthanasia.Terminal Sedation and Physician-Assisted Suicide Term Paper. In the event of war or an emergency, decision-makers should strive to protect life instead of choosing euthanasia and terminal sedation (Hammaker & Knadig, 2016).
Finally, this right should not be extended to situations whereby victims of a bioterrorist attack or a global pandemic are neither terminal nor in a persistent vegetative state. The approach will ensure that more lives are saved using evidence-based techniques.
Decision-making procedures should be taken seriously whenever dealing with ethical concerns in healthcare such as euthanasia and terminal sedation. Using my decision-making model, I can successfully come up with the best ideas to advise my patients and colleagues. Societies should, therefore, make appropriate ethical decisions whenever addressing these questions affecting humankind.
Statement of Reflection
Practitioners must make desirable decisions whenever addressing their patients’ ethical concerns. The use of powerful decision-making models empowers professionals in medical practice to meet the needs of critically ill patients (Soh et al., 2016). This understanding has empowered me to come up with this personal statement of reflection: Throughout this course, I have acquired adequate concepts and ideas that have empowered me to make appropriate ethical judgments and decisions by principles such as autonomy, self-determination, beneficence, non-maleficence, and justice.
References
Hammaker, D. K., & Knadig, T. M. (2016). Health care ethics and the law. Burlington, MA: Jones & Bartlett Learning.
Soh, T. L., Krishna, L. K., Sim, S. W., & Yee, A. C. (2016). Distancing sedation in end-of-life care from physician-assisted suicide and euthanasia. Singapore Medical Journal, 57(5), 220-227. Web.
The recent advance of the life -saving interventions and mechanical devices, that result from the medical technology has prolong dying process, which raise need to end of life care [1]. Dying process is too often needlessly protracted by these medical technology is consequently marked by incapacitations, intolerable pain, and indignity [2]. Terminally ill patient commonly experience unremitted and intolerable pain despite optimal pain management [3]. In these situations, physician assisted suicide is sometime applied, which is controversial legally and ethically issue [4]. Physician assisted suicide used interchangeably with physician assisted death and assisted suicide, is suicide undertaken with the aid of another person, sometime a physician (American Heritage Dictionary Entry). Terminal Sedation and Physician-Assisted Suicide Term Paper.Which means knowingly and intentionally providing a terminally ill patient with the knowledge or means or both required to commit suicide, which also usually include counseling about lethal doses of certain drugs either by prescribing, supplying such lethal drugs or both [5]. Among countries that permit physician assisted suicide, person who has been diagnosed as terminally ill and who physically suffer from unresolved symptoms with life expectancy of 6 months or less can request from the physician to prescribe and/ or supply a lethal dose to self-administered to end his/her life [6].
The main causes to request physician assisted suicide among terminally ill patients according to cohort study conducted in Switzerland, were 56.7% cancer, nervous system causes 20.6%, and mood disorder (mental or behavioral disorder) 2.8%, among terminally ill patient who aged (25-64 years), compared with terminally ill patients who aged (65-94 years) cancer 40.8%, circulatory 15.2%, and nervous system causes 11.3% [7]. The Hippocratic Oath includes the unambiguous statement “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan” [8]. An argumentative assay is a writing method, challenging communication task that calls upon sophisticated cognitive and linguistic abilities, where the writer takes a position and tries to convince the reader to perform an action or to adopt a point of view regarding a controversial issue [9]. Therefore, the aim of this paper is to create an argumentative essay to argue the use of physician assisted suicide for terminally ill patients as a last resort to end their suffer and end their life, while taking the legal and ethical points of view of opponents and proponents into consideration. Terminal Sedation and Physician-Assisted Suicide Term Paper.
Physician assisted suicide defines as “knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs” [10]. Physician assisted suicide is considered the most controversial end of life practice according to its ethical acceptability and the desirability of legalization [11]. Netherlands’s physicians have applied physician assisted suicide since 1977, then it has done legally since 1992 [12]. Also, Oregon legalized physician assisted suicide in 1997 [13]. According to Oregon’s Death with Dignity Act, the patient who request physician assisted suicide should be; an adult with 18 years old or more, capable to make and communicate the health decision, diagnosed with terminal illness that will lead to death within six months, and an Oregon resident [14]. The purpose of this literature review is to discuss the opponent’s and proponent’s points of view related to physician assisted suicide, from the legal and ethical sides.
Legal Arguments
Opponents
Physician assisted suicide is illegal in china under Article 232 “whoever intentionally commits homicide shall be sentenced to death, life imprisonment or fixed term imprisonment of not less than 10 years; if the circumstances are relatively minor, he shall be sentenced to fixed-term imprisonment of not less than 3 years but not more than 10 years”, and Article 233 “whoever negligently causes death to another person shall be sentenced to fixed-term imprisonment of not less than 3 years but not more than 7 years; if the circumstances are relatively minor, he shall be sentenced to fixed-term imprisonment of not more than 3 years, except as otherwise specifically provided in this Law” of the Criminal Law of People’s Republic of China [15].
In Turkey, physician assisted suicide is illegal under Article 84 any person who commits, helps, supports, or encourages a person for suicide is punched with imprisonment from 2-5 years [16]. In United Kingdom, assisted suicide is also illegal under Suicide Act 1961 [17]. In Jordan, physician assisted suicide is not of the physician duties according to article number 3 “it is not permissible to terminate the life of a patient who is suffering from incurable and insurmountable disease and whether accompanied by pain, either directly or indirectly, except brain death, according to the scientific conditions approved by the Medical Association” [18].
Proponents
Physician assisted suicide has been legalized in Switzerland since 1942 and is accessible for noncitizens, and according to swizz law assisting suicide is punishable just if done for “whoever, from selfish motives, induces another to commit suicide or assists him therein shall be punished, if the suicide was successful or attempted, by confinement in a penitentiary for not more than five years or by imprisonment” article 115 of the penal code of Switzerland [19]. Terminal Sedation and Physician-Assisted Suicide Term Paper. In 1994 voters in Oregon approved the Death with Dignity Act, which allowing a physician to prescribe a lethal dose that self-administers voluntarily by the terminally ill patient, the patient and the physician who follow the requirements of the act are protected from criminal prosecution [20].
In 2008, Washington Death with Dignity Act passed with the same to Oregon law [21]. Also in 2013, Vermont Patient Choice and Control at the End of Life Act has been in effect [22,23]. In 2016, California’s physician assisted dying law took effect according to the End of Life Option Act [24]. Also, in Finland, is not a crime and connected to end of life care [24].
Ethical Arguments
Opponents
The ethical principles of beneficence (working to achieve the patient’s best interest), nonmaleficence (avoidance of harm), patient autonomy respect, as well as promotion of justice and fairness (American College of Physicians Ethics, Professionalism, and Human Rights Committee, 2013). Both of the profession and ethical traditions emphasize care and comfort, and physician shouldn’t intentionally participate in ending a person’s life [25].
Proponents
Some patients may get benefit from physician assisted suicide, and for dying patients, the motivation for requesting physician assisted suicide may not be physical pointless suffering but loss of autonomy (97.2%), in ability to engage in enjoyable activities (88.9%), loss of dignity (75%) [26]. Dying process could be beneficial in order to spiritual and existential healing through relational and personal wholeness growth, also individual learning process for the patients, their families, and those who caring for them [27]. Terminal Sedation and Physician-Assisted Suicide Term Paper.
Argumentative Statement
Physician assisted suicide is inconsistent with some of ethical principles such as nonmaleficence. Similarly, in laws of many countries physician assisted suicide is illegal. Therefore, the author refutes the use of physician assisted suicide for terminally ill patients in order to end their suffering and end their life, and use palliative care instead it.
Legal Defense
According to the position of the American Medical Association physician assisted suicide is fundamentally inconsistent with the physician’s professional role, their position consistent to the medical constitution and duties of the physician and profession in Jordan. Physician assisted suicide for terminally ill patients is illegal in many countries (Figure 1). In Oregon, the incidence of physician assisted suicide has been increased from 0.6 in 1000 deaths to 3 in 1000 deaths in 1998 and 2014 respectively [28]. Terminal Sedation and Physician-Assisted Suicide Term Paper.
