Death typically engenders a feeling of distress and fear in most people. Death is sad, morbid, and difficult to cope with. For some people however, death will be the best thing to ever happen to them. Imagine this: laying in a hospital bed, too weak to get up, nothing but pain and sadness running through your mind and your body, and every day you pray that it will be your last. Studies by the American College of Physicians show that terminally ill patients are most fearful of the following issues: finance, abandonment, loss of control, self-image, long term care facilities, and vulnerability (American College of Physicians, 209). All of these things are reasonable fears that could bring anyone the desire to end their life; the biggest fear of all being the inability to choose when to stop the suffering. The authors of The Final Acts, an informative book on assisted suicide, talk about the process of dying and all that death encompasses, saying "although we may be lucky enough to reach ninety, we probably won't die at home in our own beds. And, unless we do some advance planning, our deaths may be pro-longed and/or painful. In addition, most of us will end up caring for elderly parents, relatives, friends, or partners before we die. And they won't die in their sleep either" (Bauer and Perry, Intro). The key issue surrounding assisted suicide is agency: having the power to choose. If death is imminent, why is it that we feel compelled to prolong the painful process for those we loved? Terminal illnesses can cause more than just physical damage to a person and their family. The emotional trauma from an event like this can leave permanent scars. And, if only one freedom is given to someone, it should be the ability to choose when to live and die. While it may seem unethical to let a person end their life, it is just as unethical to take away their right to decide. For this very reason, assisted suicide has become a very prominent issue of debate. 

Assisted suicide is an extremely prevalent topic, especially in the United States. Federal judge Neil Gorsuch states in his book on assisted suicide that "whether to permit assistance in suicide and euthanasia is among the most contentious legal and public policy questions in America today" (Gorsuch, 1). Assisted suicide, although not legal in many states, is a method of escaping the painful last moments of a person's life by allowing them to peacefully end their life prematurely. Assisted suicide is only thought of being used on terminally ill patients, or patients who are indefinitely going to die from their sickness. Depending on the type of disease, patients could potentially be left helpless in bed for weeks or even months before they actually pass away. The family is forced to watch them suffer until their last days, waiting on their life to end. Death from terminal illness is dominated by uncertainty and fear, and assisted suicide is a way to avoid this. Kay Gilderdale, mother of UK teenager Lynn, spent years watching her daughter suffer from M.E., or myalgic encephalomyelitis. This illness caused detrimental health issues for Lynn, and her and her mother both knew that there was no curing it. Kay used assisted suicide to help her daughter end her suffering by giving her an overdose of morphine. Kay was put on trial and plead guilty to assisting suicide, which was illegal in the UK at the time (BBC Panorama, 2011). The publicity surrounding her case, however, was very sympathetic. Although what Kay did was against the law, to her and her daughter it seemed to be the most ethical thing to do. Lynn had a choice, to live and suffer or to die in peace, and her mother only wanted what was best for her. Cases like this are prime examples of why assisted suicide should be considered for legalization.

One of the first things that need to be established when discussing assisted suicide is understanding the difference between assisted suicide and euthanasia. The two are often grouped together, and although they fall under the same issue, they are actually vastly different from one another. Assisted suicide, also known as physician-assisted suicide or P.A.S., involves a physician giving their patient the means to end their life (i.e. lethal injection or pill overdose). Doctors from the American College of Physicians would describe it by saying "medical help is provided to enable a patient to perform an act that is specifically intended to take his or her own life, for example, overdosing on pills as prescribed by the physician for that purpose" (American College of Physicians, 209). Euthanasia, on the other hand, is when the physician ends the patient's life by administering the drugs and killing the patient themselves. Euthanasia is defined as "the physician [performing] an act that is specifically intended to take the patient's life, through, for example, lethal injection" (American College of Physicians, 209). Knowing the difference between these two terms is vital when making a stance on the legality and ethicality of this issue. Knowing the difference between withdrawing treatment and helping someone to end their life is also imperative. If a patient requests to have their treatment terminated, and the physician obliges with this, they are not assisting in suicide. ER Dr. Vincent J. Lloyd states, "one is causing death, the other is withdrawing the things that are preventing the dying process from playing out naturally" (Lloyd). Although the result is the same, once again, morality and ethicality need to be considered.

While it is extremely important to the situation, the legalization of physician-assisted suicide is not the core of the issue. A broader view of assisted suicide reveals the major issue, which the patient's lack of freedom. Patients choose their care-takers and they have the right to deny treatment or choose certain medications. Although those things are all important, having the freedom to choose to either live or die is much more imperative. Studies show that "80 percent of the public want physician assisted suicide to be available to them as an option if they should find themselves in circumstances where their lives have become unbearable without hope of remedy" (Grayling). Obviously assisted suicide is not something that should be legalized for every individual. Some people suffer from depression when they are sick and will consider ending their life even if they can recover. If their sickness is curable, assisted suicide is NOT an option. In states that have legalized assisted suicide though, there are many parameters that a patient must meet before they can choose to end their life. So, for those who are terminally ill, and death is guaranteed in the near future, they should not be forced to suffer longer than necessary. In certain circumstances, requesting to stop palliative care is enough to end someone's life, but when it is not, and the patient continues to suffer, assisted suicide may just be the best way to go. The clearest way to put it is this: "When death is imminent and dying patients find their suffering unbearable, then the physician's role should shift from healing to relieving suffering in accord with the patient's wishes. This is not a matter of life versus death, but about the manner of dying, and it's not primarily about doctors, but about patients" (Angell). 

Along the same lines of assisted suicide comes the topic of DNR, or "Do Not Resuscitate." When someone makes the decision to be a "Do Not Resuscitate" patient, they are choosing to let their life end, even when it could be saved. DNR is medically defined as "a request not to have cardiopulmonary resuscitation (CPR) done if the heart stops or breathing ceases" (MedicineNet). Why is this so much different than choosing to end your life when you are terminally ill? Death is inevitable either way. Doctors will give gross amounts of morphine to patients to ease their pain and drag their life out a few weeks, or even only a few days longer. When in reality, morphine has many negative effects on the body that can even speed up the process of dying. It is found that, "The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. These effects seem to be more prominent in ambulatory patients and in those who are suffering severe pain" (RxList). Each of these side effects could easily speed up the rate of death, especially, as stated, in ambulatory patients and those with severe pain. Although morphine decreases the pain, the patient is still alive, and symptoms can only be eased to a certain extent. On the other hand, if a patient does not wish to die, morphine is a profound drug for pain relief, but if a doctor is administering morphine that will speed up the dying process regardless, the patient should be given the right to end their misery sooner. Even though a loved one may want to hang on to their friend, family member, or spouse a little longer, it is unfair to selfishly hang on to someone who is suffering.

A facet of assisted suicide that is often called into question by physicians is the Hippocratic Oath. While not all doctors have to take the oath, all are aware of its guidelines. "The oath is not a law, but an agreed upon ethical and moral ideal," says Dr. Vincent J. Lloyd. The oath states that the physician will do everything in their power to help their patients to the best of their ability, to benefit them, and to abstain from causing them harm. Further into the oath it also states that as a person in the medical profession, no lethal doses of drugs will be administered, even if requested by the patient (Miles, 8-9). While this may be an easy argument against the morality of assisted suicide, it is just as easily arguable that putting someone out of their suffering is doing everything in your power to benefit them. Giving a sick patient the power to control their manner of life or death is an easy way to put the patient's mind at peace and end their suffering. 

Another fairly common debate among the topic of assisted suicide is the "slippery-slope" theory. This theory argues the possibilities of what could happen if assisted suicide were to be legalized everywhere. The first matter is patients who suffer from depression. Where would the line be drawn as to who can and cannot partake in assisted suicide? The answer is simple. Only terminally ill patients would be given this choice. One of only four states who have legalized assisted suicide is Oregon, and it has been notably documented that "the law has been used sparingly (most requests are refused) and exactly as intended. Assisted dying there has accounted for 596 deaths over 14 years, only 0.2 percent of all deaths in the most recent year. Most patients were suffering from metastatic cancer, and the prognosis was clear" (Smith). Most patients who were given the lethal injections did not even administer them, but simply kept them as reassurance that if things got too tough, there was a way out. If other states are well adjusted to the legalization of assisted suicide, there is no reason that the entire country should not legalize it as well. 

Many people have different notions about the term assisted suicide. While the term itself sounds intimidating, in reality, the effects are mostly beneficial. Yes, a life will be lost, but it is much more comforting, in my opinion, to know that a loved is no longer suffering. The presence of someone in misery can be more disheartening than the lack of their presence at all. 

The overarching concern that the assisted suicide debate brings about, as mentioned previously, is the lack of choice. Though it may sound cliche, the foundation of the United States was built on freedom; the freedom of choice, speech, religion and so on. All of those things are essential to most peoples' lives. For individuals without terminal illnesses, death is not something that is too far out of their control, nor should it be. A person's life and body are the most important piece of property that they own. However, for people with terminal illnesses, death is much less in their power. Life expectancy is shorter, and the day that their life will end is usually unknown. In addition to their final days being unpredictable, the pain and suffering experienced by these patients is only administrable by large quantities of pain medication, and even with that, symptoms are never guaranteed to be completely alleviated. When a patient is known to be sick without cure, and are constantly suffering, the best gift that can be granted to them is the ability to end the pain that they are enduring.

Carol Oyster and the story of her father's death were featured in The Final Acts book, where Carol states her stance on assisted suicide and her reasoning behind this stance. Carol tells of how her father was diagnosed with prostate cancer at the age of 68 and passed away at 76. Carol's father was not given the means to commit suicide by a physician, so he took matters into his own hands. After the 8 years of suffering that Carol's father went through, and knowing that his death was inevitable, he chose the timing and the means by which to end his life. Although Carol was heart broken by the loss, she knew her father's high level of morality and decided to look farther into the topic of assisted suicide to provide herself with some relief over what he did. Carol says about her father: 

He was, however, a profoundly moral man. To his mind, a promise was a promise, and honesty was obligatory -- even when unkind or unwelcome. I (and I believe he) would argue that his act does not rise to the arguments that would classify suicide as immoral. Because he was dying, grief and deprivation on the part of the survivors (our family) was inevitable, regardless of when his death occurred. I believe he perceived his suicide as moral in that hastening his death would lessen the length of time that the family would suffer. (Bauer and Perry, 95) 

By perceiving his suicide as an act of morality and bravery, it is easy to see how Carol came to the conclusion that assisted suicide can be very beneficial for patients with long-term illnesses. If everyone were to view assisted suicide from the same perspective, the perspective of someone with a loved one who is suffering, then it would be much more widely accepted. Unfortunately, many people see assisted suicide as a means of getting rid of the burden of someone who is constantly sick and in need. This is not the case whatsoever. By granting a sick patient the right to end their suffering, the family and physician are giving the patients control over what little life they have left. Assisted suicide is a personal choice, and it should remain exactly that: a choice.

Assisted suicide is becoming a much more discussed topic, and the movement to have it legalized across America is growing at a slow, but promising pace. Only 4 states have deemed the method to be legal, but these states have had great success with it. Hopefully in the near future, every terminally ill patient will have the right to choose how and when they die. Until then, the goal is to spread awareness of the benefits of assisted suicide as well as trying to spread understanding of the reasons behind it. Although death is imminent, those whose life is cut short by pain and suffering should be left the choice to end their suffering early. Sometimes referred to as "death with dignity," assisted suicide is a safe and painless way to end a loved one's misery. While the Hippocratic Oath calls into question the meaning of truly benefiting a patient, it is undoubtedly true that a physician should be an advocate for those who are ill. If death is the last wish, then prolonging any suffering is simply unethical.

