Recognize the right to die with dignity, with a physician's assistance
While life must be protected, we must also permit people to have a humane death. Individuals have a right to determine the time and circumstances of their death. When people are near death and in unbearable pain or anguish, they should be free to seek medical assistance in ending their lives. It has long been recognized that patients have a right to refuse life-support technology, or to have it withdrawn when efforts to extend life are futile. By the same token, individuals should be permitted to seek a physician's assistance in dying when they choose to do so.
What Should be Done?
Legalize physician-assisted suicide and make it a socially accepted, stigma-free medical procedure for those patients who need it. Enact rules to determine that patients seeking such assistance are mentally competent, in great pain or mental anguish, and intent on ending their lives. Prosecute physicians who assist in ending life when these various rules have not been met. Require insurers to provide health and life insurance benefits to people who die with medical assistance.
Arguments For This Approach
Society has a pressing interest in preserving life, but not when further treatment is futile, pain is intolerable, or when the patient wishes to die. Society should recognize the needs and wishes of individuals who are near death. They deserve compassionate assistance, and should be able to get such assistance openly. This approach respects individual autonomy and the need for personal dignity. It does not force the terminally ill to linger helplessly and hopelessly, often at great cost. Physician-assisted suicide, which is generally accomplished by administering a lethal drug, is more humane than the current practice of withdrawing life-sustaining treatment. Many physicians secretly help incurable patients to end their lives. Making such assistance legal would permit the practice to be regulated, which would prevent abuse, and permit physicians to be do legally what many are currently doing illegally. There is no real difference between recognizing the legal right to medical assistance in dying, and the already accepted practice of responding to the patient's desire to end life- sustaining treatment. As long as regulations about the circumstances under which individuals may seek a physician's assistance in dying are clear and consistently enforced, the danger of abuse can be kept to a minimum.
Arguments Against This Approach
The severe pain that leads many patients to consider suicide is treatable. Seriously ill patients who consider suicide are not necessarily close to death. It is often hard to determine whether patients are terminally ill. But doctors are in a better position to make that determination than patients are. Many suicidal people are not terminally ill, they are depressed. They need treatment for depression, not assistance in dying. The right to die could easily become the duty to die. By recognizing the right to physician assistance in dying we condone situations in which people especially the old and the poor are deprived of medically necessary treatment. If physician-assisted suicide is legally sanctioned, the practice is likely to get out of hand. Severely incapacitated patients might feel emotional or financial pressure from relatives, or insurers, to end their lives. Recognizing the right to die compromises society's commitment to life. Under growing pressure to control the cost of health care, physicians who have the option of helping patients end their lives would face a severe conflict of interest.
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